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Wednesday, August 5, 2009, 11:55 AM
Wesley J. Smith

The president hasn’t supported this plan, but many Democrats (and John McCain during the campaign) want to tax employee health insurance as income if the benefits or employee’s income are above a certain point. I understand the notion as a way of raising revenue–the wisdom of which is beyond our scope here. But some argue that taxing health insurance will improve health care as it reduces costs.  From a column by Ruth Marcus in today’s San Francisco Chronicle:

On health care, the best way to help pay for expanded coverage would be to at least limit the amount of health care employers can provide tax-free. This would not only produce needed revenue but also help slow rising health costs. Done correctly, most middle-class taxpayers would be better off. According to my reporting, Obama’s economic advisers have urged that the president support a cap; his chief political adviser, David Axelrod, is opposed. So instead of taking the political risk – and angering unions to boot – Obama has held back, hoping that lawmakers would come up with a tax cap themselves. But without presidential leadership, this hasn’t happened.

Huh? So, by creating an incentive to provide lesser coverage for employees, health care will be improved and costs contained?  The only way taxing health benefits contains costs would be because it would induce companies to offer less comprehensive coverage and hence, less access to treatments for employees.  Is this what Obamacare is to become?  Punishing people with “too good” coverage (as we pay for illegal aliens and abortion)?

Here is another way that taxing good policies might control health costs: If employers changed their health insurance coverage after Obamacare went into effect because of the taxes, any replacement policy would have to be one approved by the government, even if a private plan, which would force employees into a system of care rationed by a utilitarian bioethics rationing board like NICE in the UK. No wonder politicians are having a hard time at the town hall meetings.

So, the point seems to be to reduce coverage to the lowest common denominator, on our way to an eventual single payor plan (since private health insurance would be highly regulated and unable to compete with a public plan). But that wouldn’t improve health care, it would be deleterious to most, while the funding increases might help the few who today don’t have coverage.  But we can deal with that problem with vouchers, increasing competition, and the like, without punishing those with good care today.  Moreover, please note: Under the current proposals, members of Congress could keep their own Cadillac policies for years. Let them eat cake!

4 Comments

    John Howard
    August 5th, 2009 | 2:04 pm

    It’s income, so it should be taxed like the rest of income. Yes, the basic plan should be less comprehensive insurance, and if someone wants to add coverage for organ transplants and prescription drugs and reproductive treatments and birth control and abortion, then they can go purchase private supplemental plans for those things. I don’t want to be paying for those things, and I don’t want to pay extra because I buy out-of-pocket insurance using post-tax income, compared to people who get employer provided plans.

    Brian
    August 5th, 2009 | 2:26 pm

    My understanding of the proposal of taxing health-care benefits as pushed by conservatives (John McCain didn’t seem to know or care about health-care policy much) is that it would be accompanied by a move away from employer-based insurance to a more individual-based system, NOT to a government-based system. If your company is paying $5K for your insurance premiums, then that would be switched to a $5K boost in your salary (which as income would be subject to tax) but (and here I get a bit fuzzy) you would then get a tax credit commensurate with that amount, and you would be able to choose your own insurance with more freedom than only having the few (or one) plans that your employer has chosen and negotiated. It’s all a part of giving the consumer more power, which is supposed to control costs because right now too many health-care consumers have no concept at all of what they’re paying for the services they’re receiving. Of course, taxing benefits just to pay for a government-run health care system makes zero sense as a way to improve anything.

    padraig
    August 5th, 2009 | 2:30 pm

    Hey Wes, finally a health coverage topic we can agree on. Wholeheartedly.

    If anything you were too easy on the idiotic idea of taxing health care. Such a tax would fall most heavily on middle class families and working poor. I know far too many folks who work marginal jobs just to keep their health coverage. This sort of tax would absolutely break them.

    Proposing this sort of tax was IMHO the final nail in McCain’s presidential run. Good to see Obama’s not calling for it.

    College Goyl
    August 19th, 2009 | 12:36 pm

    “It’s income, so it should be taxed like the rest of income.”

    There is part of the problem — yes, it is income, but it doesn’t have the same liquidity as your paycheck.

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