Whom do we think we’re kidding?
America can afford health care for all citizens
The next time someone tells you that America can’t provide affordable quality health care for all citizens because it is too expensive — “The nation can’t afford it,” or “Taxes are already too high” — point out the following:
First, American health care is exceedingly more expensive than in other nations, primarily because the industry provides a service required by all that has no significant restraining market forces to prohibit unreasonable pricing. In particular, pharmaceutical and equipment companies can and do charge what the market will bear. Also, consumers do not have access to prices prior to service and are not sufficiently knowledgeable to judge quality and price. Generally, the consumer will learn of and must accept the price after service is rendered. One doesn’t have access to competitive prices for the product before receiving it as in internet shopping for a new car.
Second, since America embarked on its conservative political shift in the 1980s, a majority of the public has been brainwashed to believe in the tax fairy syndrome: i.e., all taxes can be reduced forever and things will somehow work out, which in part they have — for the top 1 percent of earners. During America’s great prosperity of the last three decades, the average income of the nation’s lower half of workers has been stuck at a constant of $16,000. But during this period, the top 1 percent increased their average income from $428,200 to just over $1.3 million (data corrected for inflation). (footnote 1) This economic outcome is the result of the mythical trickle-down economic concept, whereby the rich “job creators” will share their resulting wealth with the workers, which was first fraudulently sold to the working class in the 1890s and repeated just before the Great Depression and Great Recession, with disastrous consequences for the underclass.
But the main question is how the lower half of the American workforce can afford any health insurance policy that would provide adequate coverage for a family on a static income of $16,000 a year. Perhaps the government should support at least half of the American population, as America ranks first among the 35 developed nations with 418 deaths per 100,000 persons from non-communicable diseases, ranks first in the “percentage who say they have skipped seeing a doctor because of cost,” and ranks last in life expectancy. (2) But a majority of the members of Congress tell us, and the president said again on June 21 in Iowa, that the U.S. “is the highest-taxed nation in the world,” and the public believes it. It is a good line for being against raising taxes for government to support health care or fix the nation’s multitude of unsafe bridges.
Thirdly, despite this false political propaganda, America’s “tax burden” is far from the greatest in the world. The Organization for Economic Cooperation and Development, which is associated with the United Nations and represents 35 nations having the world’s advanced economics, reports the following 2015 data: The U.S. ranked 28th in total taxes paid as a percent of gross domestic product; that is, the monetary measure of the market value of all goods and services produced in the nation in a given year (national wealth production). And we rank 22nd for corporate tax revenue as percent of GDP and 13th in tax revenue paid per capita.
Fourth, corporate tax revenues as a percentage of GDP have steadily declined from just under 6 percent in the early 1950s to about 1 percent in 2009. The nation’s current net taxes paid, as a percentage of GDP, has in recent years been less than the post-World War II average. Thus, by an internationally adopted standard, the current net American tax burden is a light load for both individuals and corporations, and less than in the 1950s.
Fifth, in 2012, an OEDC study found that among the 20 richest nations, America had the lowest public spending on health and social problems, relative to the percentage of GDP, and based on international rankings, 19 nations were better providers of food, shelter, education and health care for their total populations than the United States.
Sixth, this study noted the United States didn’t provide government-guaranteed health care for all citizens, as provided by the other nations, which have political systems ranging from conservative to social democracies and economic systems ranging from capitalist to socialist, utilizing various combinations of private and public sector providers. Thus, in the real world, neither the particular economic or political ideology has kept other nations from providing their citizens with a better median well-being than the United States.
Human behavior and values make a social order great, not a given, uncompromising political or economic ideology. People who selflessly practice human and spiritual values and possess a sense of ethics and compassion while respecting the dignity, human rights and freedoms of others make a social order stable, productive and satisfying — the culture we try to instill in young people at home, in school and in church. This model is clearly not functioning in the America of 2017, nor did it in 1990.
The worst of the more recent worst cruel examples of what America has become is the embarrassment of United States Congress, lacking such values we expect of young people. With a handful of exceptions, about all members of one political party have voted for or agreed to vote for dropping the current health insurance coverage of about 20 million Americans in order to provide another tax deduction for the most wealthy Americans. Meanwhile, the nation ranks first internationally in wealth inequality, and the political class tells us quality government health care for all citizens is unaffordable when the other 20 richest nations can afford it. The country now waits as congressional holdouts of the current legislation negotiate for their enticement from the Senate majority leader to vote yes on subjecting a portion of “the 20 million” to future suffering and an earlier death.
Thomas P. Wallace lives in Loon Lake and is the author of “America is Self-Destructing: Wealth, Greed and Ideology Trump Social Justice and the Common Good.”
1. Cohen, Patricia (Dec. 7, 2016) “Research Shows Slim Gains for the Bottom 50 Percent,” The New York Times, Florida edition
2. Porter, Eduardo (June 28, 2017) “The Price of Cutting Access to Health Care,” The New York Times, Florida edition