Thursday, January 25, 2007

Tax Breaks are Broken

Ooooh, a political post. I have to do it though, after listening to the States of our Union and our State.

We need massive reform of our nation's health care system. Forty percent of Americans don't have any insurance. Costs have spiraled to the point where we pay nearly twice what other developed nations pay for health care. Prescription drug costs rise in direct proportion to the profits of big drug companies, which, I'm willing to bet, are in direct proportion to the number of lobbyists they employ.

This is a mess. And the solution, according to conservatives, is tax breaks.

Not cost controls. Not negotiation with drug companies. Not universal coverage through a comprehensive plan.

No. Tax breaks. The president and the governor of Missouri believe that if you give someone without insurance an extra $2400 off of his or her taxes, he or she will spend the money on health insurance. At least they say they believe that.

Call me a cynic, call me a Democrat, call me crazy--but I don't think people will spend their tax break on health insurance. And here's why: we live in a consumer society. We consume. Consume, consume, consume. That's what we do with our money. Buy stuff. Sometimes it's stuff we need. Increasingly, it's stuff we don't need, which helps explain why we are now a nation with "negative savings" (we owe more than we have), while the economy continues to improve.

Here's the thing about health care: you don't have to pay for it to consume it. Which is a good thing. I'm certainly not advocating a system in which those who don't have insurance don't receive treatment. I just think we need a system in which everyone has insurance. Or, better still, a system in which everyone has health care, and no one has to have insurance.

Because what we have now is a system in which those who have insurance pay more, because the only way for those who don't have insurance to get health care is to use the system on an emergency basis. No preventive care, just visits to the emergency room. Study after study shows that preventative care is much cheaper than treatment. Especially treatment in the emergency room. But we continue to err on the side of treating people on an emergency basis and sending them into bankruptcy when a catastrophic event occurs.

That doesn't work, and doesn't even begin to address the cost side. We have got to do the hard work that will lead to coverage for everyone, and a system in which all split the costs--which will be significantly lower without the presence of whole industries devoted to keeping them higher.

Sometimes the best choice is no choice at all.

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