A Tale Of Two Healthcare PlansSeptember 11th, 2012 4:00 pm David Cay Johnston
No issue affecting taxes so clearly divides the two parties in the U.S. election as healthcare. The two parties, in their platforms, describe very different approaches to healthcare economics. Both use political plastic surgery to cover up ugly truths.
The stakes are huge. Americans spend $2.64 per person for healthcare for each purchasing power equivalent dollar spent by the 33 other countries that make up the Organization for Economic Cooperation and Development. The OECD data shows the U.S. spends $8,233 per capita compared with an average of $3,118 in the other 33 countries.
A growing share of federal tax dollars, in direct spending and in tax breaks, is going to U.S. healthcare as the population ages, even though about one in six Americans lacks health insurance.
America‘s healthcare system, more accurately described as a non-system sick care system, totaled 17.6 percent of the economy in 2010, compared to an average of 9.2 percent in the other 33 countries, as the OECD data shows.
In the United States, total public and private cost of healthcare is significantly greater than the total of corporate and individual income taxes, as well as payroll taxes. For each dollar paid in all three of those taxes in 2010, healthcare came to $1.29.
If we just lowered our costs to those of France, which has universal care in what is widely regarded as one of the best systems if not the best, it would save almost as much money as Americans paid in individual income taxes in 2010. The French spend 6 percentage points less of their economy on healthcare. In the United States, the individual income tax in 2010 came to 6.3 percent of the U. S. economy, the lowest since Truman was president.
Take a look at your pay stub to get an idea of the kind of money being spent on a system that fosters bankruptcy, bedevils small business and ranks 31st among the 34 OECD countries in preventing premature death.
The Republicans say the federal government is “structurally and financially broken” and that “three programs – Medicare, Medicaid, and Social Security – account for over 40 percent of total spending,” which is “harming job creation and growth, (while) projections of future spending growth are nothing short of catastrophic, both economically and socially.”
The Republicans promise to “empower millions of seniors to control their personal healthcare decisions,” a vow immediately followed by a promise to cut federal spending.
The clearest explanation of what that would mean comes from Representative Paul Ryan, the Republican vice presidential nominee. Before he started obfuscating, Ryan laid out his plans in detail. He boasted that by changing Medicare from a plan that provides treatment for every older American into one that gives seniors a fixed sum to buy their own health insurance, taxpayers would save through 2084 the present equivalent of $4.9 trillion.
What Ryan did not mention is that his plan would also mean $8 of increased private spending by seniors and the disabled for each tax dollar saved.