Thursday, January 24, 2013

How to Raise Taxes to Pay for Healthcare

Watching President Obama's inauguration made me think about what a great opportunity was lost when Congress passed the health care bill.

The Affordable Health Care Act does nothing to affect the most important contributor to rising health care costs -- people's behavior. You don't have to be a statistician to know that Americans are getting fatter. Obesity is an epidemic in America. Obesity leads to heart disease, diabetes and other health problems. And obesity is almost 100 percent preventable through diet and exercise.

If we really want to reduce the cost of health care, why not reduce the number of sick people? The data is irrefutable that if people lost weight they would feel better and be healthier. Almost everyone knows someone who has lost a substantial amount of weight who will tell you that they feel much better as a result.

So what if we were to impose a fast food tax of ten cents per gram of animal fat? A Big Mac has about 24 grams of animal fat and a Whopper has 41 grams of animal fat. This would increase the cost of these sandwiches by about two and a half to four dollars. A bucket of Kentucky Fried chicken would increase in cost by about seven dollars.

We could impose this tax while at the same time issuing everyone who files a tax return a credit voucher that could be used to buy supplies to plant a garden (seeds, plants, pots, soil and garden tools for example). This would encourage people to grow their own food which would make them more active. Plus, it would prompt them to become more interested in their food and eat healthier. In major metropolitan areas, people could grow vegetables on window sills, balconies, fire escapes and roof tops like they did back in World War II (see my post from February 22, 2012). People might pool their coupons to create co-operatives and grow even more vegetables. We might even call them "health care victory gardens."

The plan could be revenue neutral; spending the anticipated revenues from the junk food tax would be offset by the garden credits so all the Grover Norquist republicans could vote for it.

The nice thing about this idea is that the tax would be completely avoidable. People could avoid it just by eating healthier. Those who chose not to eat healthier (who ultimately will impose huge new costs on the health care system in years to come) will be made to pay a little more for their unhealthy habits.

The idea is not without precedent. State governments sued big tobacco and made them pay for the increased health care costs. The unfortunate thing about this was that this did nothing at the individual level to discourage smoking. By hitting the consumer right in the pocket book, we can help those who consistently make bad food choices (and ultimately impose huge costs on the tax payer) make better choices.

Incidentally, this approach would be great for the environment. The Environmental Protection Agency estimates that 14 percent of the greenhouse gases linked to global warming come from livestock production. So if people ate healthier, preferring a vegetarian meal to a cheeseburger, we would not only save on health care costs, but we could protect the environment as well.
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posted by Bob Fischer at 1 Comments

Tuesday, January 22, 2013

The 28th Amendment to the Constitution: Guaranteed Health Care for All

I saw this provocative bumper sticker on the road recently, and I thought it was a useful idea for illustrating some thinking tools. Provocation is one such beneficial tool for generating new thinking. Go ahead. . . say something outlandish and see where it leads you!

As alluded to in the picture, health care is of course, not a right guaranteed by the constitution. But what if it were? Let's use this bumper sticker as a PO (PO is short for provocative operation, saying something that doesn't make sense in order to see where it takes you). 

Let's say that Congress has passed the 28th Amendment to the constitution that says, "All Americans are entitled to receive necessary health care regardless of their ability to pay."

So what happens next? Without funding the amendment, people all across the county would go to doctors and demand treatments without paying for them. Fearful of lawsuits, health care providers would meet these requests, but quickly realize they have no way to pay for all the increased costs and quickly start to go out of business to avoid bankruptcy.

Congress could not allow this, so they would have to provide funding and decide what constitutes basic health care. Legislators would have to decide who got what treatments and how much the government would pay for these treatments.

And this is why health care as a "right" is different than all other rights. Because all the other rights restrict the power of the government and protect individual liberties. That's why you have the right to remain silent, you have the right to a speedy trial, and the right to a jury of your peers. Without these constitutional guarantees, the government could throw you in the slammer without charging you with a crime and leave you there until you confessed.

If free health care becomes a right ("free" meaning that it's free for some people and our government confiscates money from others to pay for it) then it's the only right that empowers government at the expense of individual liberties.

While you have the right bear arms, if you cannot afford a gun, the government doesn't issue you one. And while you may have freedom of speech, the government will not pay to print hand bills or produce radio or television advertisements for you to express your ideas.

I would be in favor of an amendment that guaranteed people equal access to health care regardless of their race, sex, religion, sexual orientation or anything else. But it's not necessary in this country because everyone already has equal access. But a right to free health care is just another way to extend the power of government at the expense of individual liberties.

What do you think of provocation as a thinking tool? How would you use it in your daily life to think better?
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posted by Bob Fischer at 0 Comments

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