Goodbye to Health Care Reform
Friday, April 18, 2008 at 11:43AM Yesterday I received a message at my office and was called to the bedside of health care reform. The patient's pupillary and gag reflexes were absent; there was no palpable pulse. Chest exam revealed no respiratory effort and absence of heart sounds. The patient was pronounced dead at the time of examination.
The cause of death? Reckless campaign promises, made by the two remaining Democratic candidates in the debate Wednesday night. This is how Walter Shapiro reported it in Salon:
Wednesday night's debate may have more lasting significance if either Obama or Clinton is elected president than it did in helping sort out the primary field. Pressed by [moderator George] Stephanopoulos to make a "read my lips" no-new-taxes-on-the-middle-class promise, both candidates took the bait. Clinton expressed this Republican-esque promise in unequivocal terms: "I am absolutely committed to not raising a single tax on middle-class Americans, people making less than $250,000 a year." Obama eagerly joined in this bidding war, saying, "I not only have pledged not to raise their taxes, I've been the first candidate in this race to specifically say I would cut their taxes."
Both of these candidates have been traveling coast to coast, promising sweeping health care reform. Now, I do not pretend to be a financial whiz, but I know enough about health care to say with confidence that it will be impossible to provide universal health care without raising taxes. Obama/Clinton may respond by saying that we will find the money to insure 47 million Americans by (1) ending the Iraq War, (2) making health care more efficient, and (3) allowing the Bush tax cuts on the rich to expire.
Hoooey. The Republicans have been foisting this something-for-nothing nonsense for decades now. It never works. Real, comprehensive health care reform will require tax increases on everyone. A mandate requiring every American to carry health insurance is, in itself, a tax. Clinton proposes mandates. Obama does not, but as soon as he looks at the budget numbers if he is elected president, he will change his mind. I don't think universal health coverage can be achieved without mandates, at a bare minimum.
At any rate, whichever health care reform is proposed, it is completely irresponsible for any candidate to promise that he or she can make it happen without broad-based tax increases. No other industrialized nation manages it without some kind of tax, be it direct (via income) or indirect (with mandates). It can't be done.
From my perpsectivie, health care reform is DOA on the Democratic side without taxation at least on the negotiating table. Let's assume Clinton is right and reform can be financed purely through savings from requiring everyone who can afford it to buy coverage. This is a big if. To put such reforms on the table without at least a backup plan for financing is ridiculous.
People who are serious about health care reform will admit it will be expensive and may require new taxes. People who won't are candy salesmen.
All this talk about who has the courage to answer the phone at 3 AM,and neither candidate has the guts to tell Americans universal health care is going to cost them money. Well, maybe we'll find someone serious about reform in 2012. 2008 is already history, as far as I am concerned.
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