OP-ED

Why is this the one thing?

By JOE FLOWER

When the terrorist attacks of 9/11 hit the United States, and then suddenly we were plunged into war, first in Afghanistan and then in Iraq, I don’t remember anyone demanding that the wars be “deficit neutral.” No one talked about whether we could afford them. They were things we just had to do.

When George W. Bush proposed giving vast sums to rich people in the form of tax cuts, no one argued that it would be “deficit neutral.” Rather, it was argued that cutting taxes wouldn’t bring in less tax revenue at all, it would bring us more tax revenue, because the economy would grow so much faster. And besides, it was somehow terribly urgent, something we just had to do.

When the banks tottered and needed to be shored up with taxpayer money to the tune of nearly $1 trillion, there was no way to argue this would be “deficit neutral.” We might get the money back, we might not. Whether we could afford it was not the question, we just had to do it to save the banking system. Similarly, the “Stimulus Bill” was terribly urgent, and something we just had to do, whether we could afford it or not.

Then we come to health care reform, and suddenly, it seems, this is where we draw the line. The president says that health care reform must be “deficit neutral.” It can’t actually cost us anything in tax funds. And everyone nods sagely and argues over how to do this. Why?

Why is this the one thing that we can only do if we can prove ahead of time that it will not actually cost anything? Our current system costs us an estimated 44,000 lives and impoverishes millions of Americans every year, and causes untold suffering – why is this the one huge national problem that everyone agrees we can’t afford to solve?

With nearly 30 years’ experience, Joe Flower has emerged as a premier observer on the deep forces changing healthcare in the United States and around the world. As a healthcare speaker, writer, and consultant, he has explored the future of healthcare with clients ranging from the World Health Organization, the Global Business Network, and the U.K. National Health Service, to the majority of state hospital associations in the U.S. He has written for a number of healthcare publications including, the Healthcare Forum Journal, Physician Executive, and Wired Magazine. You can find more of Joe’swork at his website, www.imaginewhatif.com, where this post first appeared.

Livongo’s Post Ad Banner 728*90

Categories: OP-ED

Tagged as: ,

11
Leave a Reply

11 Comment threads
0 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
10 Comment authors
Gary LampmanMatthew HoltOnline PharmacyMD as HELLAlexander Saip Recent comment authors
newest oldest most voted
Gary Lampman
Guest
Gary Lampman

The Congressional Health Care Bills are nothing less than a Bait and Switch. The Con in the Conservative vernacular is just that “a Con Job.”There angle is I’m against everything that does not Cater to Corporate Welfare and profitability. Wars are acceptable without justifiable cause in exchange for unjustifiable blood shed and lost of life of our Armed Forces for personal Gain. Health Care or more accurately Health Insurance Reform is no different. Catering to Corporate interests of manipulation and exploitation of the sick for personal Gain. Can you see the similarities? Since the Two wars ,we have already exceeded… Read more »

Matthew Holt
Guest

Yes I want my money back from the bastards at Halliburton who pushed us into war & occupation without end in Iraq and Afghanistan. Yes I want a punitive tax on the super rich who forced through a 50% cut in taxes on dividends (dividends!) which went only to the very very rich and was paid for by forcing other taxpayers to borrow and pay more (it was like buying your mistress an apartment and forcing your wife and kids to pay the mortgage). But there’s $2.5 trillion in the health care system now and at least 25% or more… Read more »

Sean
Guest
Sean

Peter said — “Where were the fiscally responsible Republicans then, saying they were looking out for our childrens’ future?” Peter, Republicans can’t claim superiority on fiscal responsibility. That is exactly my point. But there was then and is now a large and growing constituency comprised of both Democrats and Republicans who fear that we have incurred a debt that will destroy our country. I cited Pete Peterson and the Concord Coalition who have been talking about this for years. Why is it that no one can advocate fiscal responsibility without being labeled a Republican and then lambasted for Bush administration’s… Read more »

Online Pharmacy
Guest

Joe, I agree with you that it seems ridiculous this is the focus. However, I’m looking at it from a different angle. We all knew Republicans would be mad about some aspect of this bill – they would find something to pick apart. So why not give them something (like being deficit neutral) as a “bait” of sorts? Boy, have they taken it! I’d like to think this is the strategy of those implementing this bill, as I don’t think the concerns over its effect on the deficit will ultimately prevent anyone from supporting it.

MD as HELL
Guest
MD as HELL

Healthcare costs zero until an individual decides he wants some. With 300 million individuals wildly accessing the healthcare system, because they can, there will be such a hole in the budget as to make the subprime crisis look miniscule. War was chosen by 536 people. It can be curtailed, won or lost, or abandoned. Once the healthcare system as it exists today is hobbled, it will cost a political fortune to get it back. Just like the economy which is spiraling down undr the weight of socialist BS, healthcare will become smaller and inefficient and a shadow of its former… Read more »

Alexander Saip
Guest

Andrew, I believe Joe is talking about the costs of healthcare reform, not healthcare costs.

tcoyote
Guest
tcoyote

How about: “9 trillion in debt over ten years is not sustainable and we’d better not make commitments we cannot afford to keep”? No-one is going to want to own dollar denominated assets or buy our bonds. This is how empires, or worthy republics, come to an end.
Is that California you said you live in? Is there something in the water out there that causes people to spend more than they take in?

Peter
Guest
Peter

“Of course in this era of partisanship, people assume that anyone who advocates fiscal responsibility today must be a die-hard Republican and Bush supporter.” As an accused “liberal” who advocates “free” healthcare I was for using a tax on gasoline (it was a war about oil after all) to pay-as-you-go for the Iraq War. Where were the fiscally responsible Republicans then, saying they were looking out for our childrens’ future? They were too busy engratiating their war machine private contractor$ with deficit dollars and too busy lying to Americans. Republicans now claim they hold the higher ground in looking out… Read more »

Andrew Weinstein, MD
Guest
Andrew Weinstein, MD

Unlike the other examples you gave, health care is not a “one time” expense. Accountants treat known, recurring expenses (healthcare) differently than non-recurring expenses (war). They must be budgeted for, year after year. It has to be budget neutral because Obama promised he wouldn’t raise taxes on the middle class. If you don’t get this, then your real question is, why bother with a budget?

Sean
Guest
Sean

You make a good point. It’s a question that should have been asked in each of those instances. Deficits and soaring debts are the biggest threat to our nation today, and have been for years yet the problem has either been underestimated or ignored by almost everyone. It’s hard for people to grasp that this threat is just as real and dangerous as the threat of bombs or healthcare shortages, and should transcend party lines. Of course in this era of partisanship, people assume that anyone who advocates fiscal responsibility today must be a die-hard Republican and Bush supporter. There… Read more »

nk
Guest

Joe – Good points, but Congress is missing the bigger point. The Baucus bill does nothing material to change the forces that cost us $2.4T in healthcare costs every year. Doctors still get reimbursed the same, patients still don’t care about the actual costs because they are insulated by insurance (public AND private) and we are still obese, ridden with diabetes and other preventable ailments. We want and need change, but the $900B Baucus bill is a sham at best.