In grappling with the healthcare problem, what USA Today editors called the “single biggest threat to America’s economic future”, I sometimes feel like the proverbial blind man trying to describe an elephant.
As I mentioned in my last post, I hadn’t realized that the debt-ceiling legislation merely delayed the “draconian cuts” penalty until after the 2012 election. Now in today’s Joplin Globe comes a column by Robert Reich providing clarity to yet another aspect of the problem.
Reich agrees with two appellate federal judges that the ACA was based on an unconstitutional premise, viz., that the government can tell people what to buy. Example:
OK people, everybody, and this means you, head of household, buy at least one pound of broccoli every month. It’s good for you. And you had better have your receipts ready for inspection by the IRS after December 31 too.
Reich properly points out that this indeed is like what the ACA tries to do because, and this is the heart of it, the mandate is to buy private insurance, not government insurance. I guess I’ve been feeling the wrong part of the elephant, but I didn’t really get that before now.
See, that’s the problem, the motive’s don’t mix. Government wants to make people’s lives better (no, really, it does), and the private sector wants to get as many dollars out of you as possible. That’s capitalism, the engine of the economy. Now taxes are a different animal. The Constitution says Congress has the power to tax us. It’s a parent kind of thing: eat your broccoli, it’s good for you and all of society will be better for it. The words “promote the general welfare” apply here, and that’s why we have the EMTALA law (even if it is extortion on a grand scale). As a society we want to be kind, not mean, and I hear nobody calling to repeal EMTALA. But basic economics says we can’t have stuff, indefinitely at least, without paying for it. I found a CBO report that says this,
CBO projects that without significant changes in policy, total spending for health care will be 31 percent of GDP by 2035 and will increase to 46 percent by 2080. Total spending for Medicare is projected to increase to 8 percent of GDP by 2035 and to 15 percent by 2080. Total spending for Medicaid is projected to increase to 5 percent of GDP by 2035 and to 7 percent by 2080.
Thus, Reich’s conclusion,
So what do Obama and the Democrats do if the individual mandate in the new health care law gets struck down by the Supreme Court?
Immediately propose what they should have proposed right from the start — universal health care based on Medicare for all, financed by payroll taxes. The public will be behind them, as will the courts.
Sigh. That, unfortunately, is the same conclusion to which I myself had reluctantly come a few weeks ago. Since then I have sought alternate schemes unsuccessfully. Even the USA Today editors, as I mentioned in my last post, recognized healthcare as central to the debt dilemma and yet had no solution to it but to dump the accelerating costs on the backs of seniors and retired military. That’s no solution. At best it is just kicking the can further down the road. The problem, like the black hole it is, will just keep growing until it consumes every dime the economy makes. The damn elephant is even bigger than I thought.