We have low taxes because we don’t pay enough to have good services. (And we do have low taxes.) We have weak services because Republican lawmakers, who have great private services for themselves, subsidized by the rest of us, promote the idea that government services are inherently bad.
Republicans seem incapable of understanding that there are actually some things at which government is decidedly better and cheaper than so-called free market capitalism. “Best government is least government” is catchy, but false. Call it capital blindness.
The national government has a proven track record of competent, efficient management in a number of fields. It is also true that there are things that private enterprise is better at, but these don’t include provision for old age, public education, and especially health care.
We have low taxes because
we have lousy services.
It’s very easy to understand why these three are so expensive if the “free market” runs them: Anything that relies on capitalism must generate profit for the owners, as well as endless growth. Any enterprise in which a large chunk of the money generated must be skimmed off the top and given to rich owners cannot be as economical as a similar enterprise that does not have that expense.
In addition to profit, our health care system also must pay for a highly complex system of bookkeeping that too often is devoted not to providing health care, but to preventing it. These two things are why healthcare costs every American citizen upward of $8,000 per year, while Europeans and others pay half that for superior service covering everyone.
It’s important to realize too that when someone is ill under national healthcare, nobody tries to prevent this person from getting treatment. Treatment denial is one of the tragic consequences of private healthcare in the US. It costs countless lives and generates untold misery.
Under national healthcare,
nobody tries to prevent treatment.
Consider two people who fall prey to the same serious medical condition. The insured European learns of his ailment early, following a regular checkup. The system swings into action, with tests and imaging, and consultations with specialists. A surgery is soon performed, and after a recovery period the patient returns to work.
The uninsured American has not seen a doctor in years. His job pays about $30,000, and family health insurance would cost half of that. He feels increasingly ill, but no one will see him because he’s not insured. Eventually he is brought in to ER in great pain. It’s too late, but he does get emergency surgery. He receives a regular disability check from the government and spends his last weeks in a wheelchair.
Cases like these are probably common, with comparable contrasts in outcomes. Obviously, lack of healthcare insurance has public costs well beyond what the insurance premium itself would cost.
The saddest thing is that many Americans don’t want a national health care plan that covers everyone because they believe the uninsured don’t deserve health care. They should suffer and die, because they are lazy and irresponsible. They say this about people working full time for minimum wage. Could cruelty be more stark?
Our marginal tax rate is 27%,
one of the lowest in the developed world.
Even now, after the highly successful establishment of the Affordable Care Act, which added millions to the insured population, there are still some 35,000,000 people who get no healthcare at all. This is equal to the entire population of Canada. If the entire population of Canada had no healthcare insurance, it would be a catastrophe of national importance. Is there some reason that an equal number of uninsured in the US is not a catastrophe? There is not. It’s as if California, the most populous state in the union, had no healthcare.
Americans in general, especially Republicans, are fond of complaining about high taxes. But taxes in the US are actually quite low. Our marginal income tax rate is 27%. That’s the rate paid on taxable income in the highest bracket. The highest rate in Europe is Belgium, at 54%, and a number of other countries are within 10% of that. At 27%, we are one of the very lowest of the developed would. How could that be?
Our taxes are low
because we fail to provide
efficient national healthcare.
It is because we fail to provide all of our citizens with efficient national services for health care. Nor is provision for old age adequate, and public education funding is also unsatisfactory. But health care is the worst.
The fact is, not only do we fail to provide health care insurance to a number of citizens equal to the entire population of Canada, but we spend literally double for health care what the more advanced nations pay, because the necessity for profit plus insurance bookkeeping makes private healthcare insurance inherently expensive.
The number of uninsured
is equal to
the entire population of Canada.
The losses from this failure are huge. Every uninsured family is one step away from the disaster of medical bankruptcy (the most common cause of bankruptcy) that will destroy family finances for at least two generations. When a serious medical condition strikes an uninsured person—which can happen to literally anyone—not only are family finances destroyed, but there are major losses for the public at large. National productivity drops when anyone is lost to disease, or can no longer work. Tax rolls are reduced. Public assistance costs are increased. Now, this is not so expensive for just one person, but remember, we have uninsured equalling Canada’s entire population.
We know exactly who is responsible for perpetuating this overpriced boondoggle: the political party in the service of very rich capitalists.