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The health care bill unveiled this week by the House of Representatives (with
the full support of the Obama administration) is one of the worst pieces of
legislation ever drafted. If passed, it will reduce the quality and increase
the cost of health care in America. But more importantly, it will severely
undermine our already weak economy. To burden a country currently in the throes
of a violent recession with such a bureaucratic albatross clearly illustrates
the scarcity of economic intelligence in Washington.
In the first place, specifically taxing the rich to pay for health care for
the uninsured is the wrong way to think about tax policy and is an unconstitutional
redistribution of wealth. While the government has the constitutional power
to tax to "promote the general welfare," it does not have the right to tax
one group for the sole and specific benefit of another. If the government wishes
to finance national health insurance, the burden of paying for it should fall
on every American. If that were the case, perhaps Congress would think twice
before passing such a monstrosity.
In the second place, the bill is just plain bad economics. For an administration
that claims to want to create jobs, this bill is one of the biggest job-killers
yet devised. By increasing the marginal income tax rate on high earners (an
extra 5.4% on incomes above 1 million), it reduces the incentives for small
business owners to expand their companies. When you combine this tax hike with
the higher taxes that will kick in once the Bush tax-cuts expire, and add in
the higher income taxes being imposed by several states, many business owners
might simply choose not to put in the extra effort necessary to expand their
businesses. Or, given the diminishing returns on their labor, they may choose
to enjoy more leisure. More leisure for employers means fewer jobs for employees.
More directly, mandating insurance coverage for employees increases the cost
of hiring workers. Under the terms of the bill, small businesses that do not
provide insurance will be required to pay a tax as high as 8% of their payroll.
Since most small businesses currently could not afford to grant 8% across-the-board
pay hikes, they will have to offset these costs by reducing wages. However,
for employees working at the minimum wage, the only way for employers to offset
the costs would be through layoffs.
The uninsured self-employed, or those working as independent contractors,
will be forced to buy insurance or pay a tax equal to 2.5% of annual income.
Either choice will divert resources from more productive uses into an already
out-of-control health care bureaucracy.
Sadly, the bill does nothing to restrain or alter the dynamics that have caused
health care costs to spiral ever higher. In fact, the bill will intensify these
pressures.
The simplest (but by no means fullest) explanation of why health care costs
so much is that demand exceeds supply. Demand is a function of how much people
are prepared to pay. Insuring more people will drive demand for health care
services even higher. (To truly get a handle on out-of-control health care
costs, we need more people paying for routine medical care out of pocket, and
tort reform for medical malpractice. See
my previous commentary.)
As costs continue to soar, expect additional tax hikes to fund the added expense.
As these additional taxes further encumber a weak economy, the diminished tax
base will yield lower total tax revenues - despite higher rates. As the politicians
attempt to pass ever higher increases to make up for revenue shortfalls, a
vicious cycle toward insolvency will ensue.
The worst part of the whole fiasco is trying to imagine the bureaucracy necessary
to administer this plan. My guess is that the government provider will mis-price
its policies on the low side, pushing employers to dump private sector insurance
for the taxpayer-subsidized alternative. Such a system will further distort
health care pricing and, ultimately, make a bad situation intolerable.
The enormity, complexity, and expense of this bill could well pull the rug
out from what many of my cheerleading colleagues believe to be the beginning
of an economic recovery. The way I see it, the economy is walking dead anyway,
and this measure is the equivalent of a stake through the heart. But even if
we manage to escape the grave this time, Congress is working on a few other
ideas that will surely keep us buried.
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