Matthew Holt

Heritage & Roberts decree, all the world be taxed

The Supreme Court’s decision upholding the ACA is deliciously ironic. The “individual mandate”–an idea promoted for everyone in the 90s and for Massachusettians (?) in the 2000s by the arm of the Republican party known as the Heritage Foundation–was found to be legal. But not as a mandate, instead as a tax.

Put aside for a minute the dreadful political contortions required to get this quasi-universal health insurance bill past Congress in the first place. Put aside the fact that the supposedly non-political Supreme Court hands down decisions time after time that are a pure reflection of the exceedingly public extreme political views of its justices. Put aside for a minute the fact that the ACA has undeniably kickstarted a round of changes in the health care delivery and insurance system that at least has the potential to lower costs and improve care, and that the luncay of politics meant we nearly lost that momentum.

Instead focus on what the Supremes have done. They’ve cut through decades of rhetoric about how we pay for health insurance and clarified it thus: we pay for health care via taxes–whether they are private taxes on employers and employees (and now¬†individuals) or public ones on citizens.

The–often not observed–principle behind modern taxation is that people (and hopefully corporations) pay according to their ability, and public goods (schools, aircraft carriers, fire engines) are funded with the proceeds of that taxation and¬†distributed according to need. The ACA which has a whole host of redistribution within it does not goes as far towards this principle as I might like, and it still makes certain groups (the elderly, those with middle incomes) pay more than what I’d consider their fair share. But the ruling at least gives us a starting point.

In any rational society health care ought to be a public good financed through taxation and distributed in some manner that makes rational sense. America has never officially believed that. Now it at least has affirmed the concept.

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6 replies »

  1. Well Thomas Jefferson warned us about this day. We no longer have a constitution. I wonder if JohN Roberts considered the fact that ending the Constitution would end the Supreme Court? well No matter. The only thing conservtives can do now is pull all our money out of the baNks and sell off all stocks bonds mutuals ira’s etc. exit the market now is the solution. If we have 60million people do this we can pull trillions back away and I promise somone will be paying attention. You wanted an immediate solution? You now have one

    Thank you for ASKING

  2. The mandate by itself is a tax, all right, but a very regressive one.

    A worker making $40,000 a year with a family is mandated to buy an insurance policy that will cost at least $10,000 a year for very skimpy coverage, and up to $20,000 a year for decent coverage.

    By itself that is cruel, so there are two safety valves — the worker can go uninsured and pay a penalty, (which leaves him uninsured); or he can get a subsidy from tax dollars to hold the premium down to 8 or 9 per cent of his income.

    The money for the subsidies will come ultimately from the income tax, which is our most progressive source of revenue.

    The problem is that all of this is a lurching, intricate, social machine. Someone has to enforce the mandate, collect the penalties from people who in many cases are broke, monitor incomes to get the subsidies right, and then defend the subsidies from deficit hawks in Congress.

    This is what happens when Democrats want to do something progressive, but they want to do it in 2008 with Obama and a recession, vs doing it in 1965 with LBJ and a booming economy.

    I am just reinforcing what Matthew said above. An honest willingness to raise taxes produces a much more solid program. We will see if the ACA jalopy can hold up through the winter.

  3. LOL, between the post and the comments I’ve had my entertainment for today; thanks!
    No matter whether one thinks health care is a public good, there are enough delicious ironies in this decision and the reactions to it, to keep us going for quite awhile!
    I did read that someone offered to pay for Justice Scalia’s broccoli…..

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