Let's try to imagine, shall we, that John McCain is not a dishonest con man deliberately heaping scorn on every American who earns a paycheck. Let's try to imagine, instead, that he is telling the truth about what he knows and understands when he suggests, as he has all week, that income taxes are the largest and only tax facing working Americans.
I can't really say that this would mean giving McCain the benefit of the doubt, because it would require a staggering, incomprehensible stupidity on his behalf to have spent more than two decades in the Senate without learning that the payroll tax exists, or that it, and not the income tax, is the largest share of the tax burden for 7 out of 10 American workers. To accuse the senator of such staggering ignorance seems to me even more insulting than to assume the simpler, more logical explanation -- that he's just a bastard who doesn't give a rip about the actual day-to-day expenses of working families and that he is willing to say the most ridiculous and absurd lies if he thinks it might improve his standing in the polls.
But as I said, let's pretend. Let's pretend that this simpler and likelier explanation isn't the case, and that John McCain really, truly believes what he is saying -- that taxes refers only to income taxes.
What would that mean for those whose job it is to brief the senator on the issues? What sorts of conversations must be occurring backstage at his rallies this week?
JM: Boy the crowd loved that bit about the evils of tax cuts for the middle class.
AIDE: Yes, sir.
JM: They especially liked the bit where I rolled my eyes and got all sarcastic about That One's tax cuts for people who don't even pay taxes.
AIDE: Well, yes sir, but you know, actually, they do pay taxes. Everybody who gets a paycheck pays the payroll tax, and ...
JM: The what now?
AIDE: The payroll tax, sir.
JM: Play dough fax?
AIDE: Uh, no sir. The payroll tax.
JM: Made of wax?
AIDE: Payroll tax.
JM: Potato sacks?
AIDE: Payroll tax, sir. It's the biggest burden on most work --
JM: Day-old snacks?
AIDE: Now you're just messing with me, aren't you sir?
JM: Let's roll craps!
AIDE: Sir.
JM: I just don't understand where you're getting this from, son. Taxes means income taxes. Everybody knows that. They're whaddya call it? Cinnamons.
AIDE: Synonyms, sir. And actually, no, you see the Social Security Trust Fund is --
JM: Slush fund?
AIDE: OK, I'll give you that one. That's actually kind of true. But the trust fund is paid for with --
JM: With Reagan's tax-cut in 1982. You may be too young to remember that, son, but Reagan cut taxes in 1982, thus increasing revenue enough to create the Social Security slush fund.
AIDE: Reagan cut income taxes, sir. But he paid for that income tax cut with a corresponding increase -- the biggest tax-increase in American history, sir -- a corresponding increase in the payroll tax.
JM: Day-glo racks?
AIDE: I ... I don't even know what that means, sir.
JM: Balderdash!
AIDE: (sighs) Yes, sir.









Remember, Sen. McCain has NEVER worked for a regular wage or salary. He was in the Navy, as was his father and his grandfather. As a military brat myself, I can tell you that you are not in the real world in that situation (for example, my first post-dependent trip to an emergency room, I went to find the hospital pharmacy for my prescription; I knew nothing about going to a drugstore). He went directly to Congress with a short side trip to marry a wealthy heiress. So in fact, he really doesn't have any idea about payroll taxes because he's never dealt with them. It continues to amaze me that people think that someone like McCain, who has been paid by taxpayers his ENTIRE LIFE, understands anything about "regular Americans."
Posted by: Alabama Blue Dot | Oct 21, 2008 at 02:46 PM
Cable hacks?
Faithful flacks?
Day-old sacks?
Table cracks?
Maypole packs?
Grable was stacked? (You betcha!)
Posted by: damnedyankee | Oct 21, 2008 at 03:09 PM
ABD - I think you're onto something there. I've heard very cogent arguments for looking at the military as the Usonian equivalent of a welfare system - a safety valve for otherwise unemployable folks, a means to provide poor but deserving people with access to school and health insurance, and a simple way to distribute wealth to projects the government wants supported.
Posted by: mike.timonin | Oct 21, 2008 at 03:17 PM
Yet half the people I know are ocnvinced he's a regular joe. And that Palin is a fun, feisty lady. They scare the hell out of me.
Posted by: Rosemary Molloy | Oct 21, 2008 at 03:25 PM
a means to provide poor but deserving people with access to school and health insurance
I dunno about "otherwise unemployable", but not only was McCain in the Navy and then Congress virtually his entire adult life, but his father, both grandfathers, and siblings were all lifelong military as well, along with at least two of his sons.
I have great admiration for members of the U.S. military -- I have several family members and friends who serve -- but by no stretch of the imagination does it give any sort of understanding of what its like to live outside that protective cocoon.
Posted by: hapax | Oct 21, 2008 at 04:00 PM
They keep talking about Working Americans as if they thought everybody was a Working American. As an Unemployed American, I find that taxes are the least of my problems. And I haven't heard of too many people being driven to financial ruin by taxes. I could be wrong though.
Posted by: SueW | Oct 21, 2008 at 04:02 PM
this reminds me of the old Johnny Carson bit about Reagan and Yassir
Posted by: Boze | Oct 21, 2008 at 04:03 PM
incidentally, it's right here:
http://www.youtube.com/watch?v=AdmULsIEyEI
Posted by: Boze | Oct 21, 2008 at 04:06 PM
I think my absolutely favorite interview question asked of John McCain was one intrepid reporter who raised the health insurance question. The conversation went something like this:
reporter: "You're against universal health care supported by tax dollars collected from the American people, correct?"
McCain: "Yes [blah blah taxes blah blah]"
reporter: "But you yourself, as a former military person, and now member of the government, have ALWAYS had health care provided by tax dollars collected from the American people. How do you reconcile this?"
McCain: *deer in headlights look, followed by misdirecting blather*
Posted by: embees | Oct 21, 2008 at 04:17 PM
So let me get this straight (I really am ignorant here, but unlike McCain I have the excuse of not have been alive for 70 years). "Payroll tax," when used as a distinction from "income tax," refers to Social Security and Medicare withholdings, right?
Posted by: Stephen | Oct 21, 2008 at 04:18 PM
And I haven't heard of too many people being driven to financial ruin by taxes. I could be wrong though.
At least I haven't heard recently that people were paying 50% of their income when the top tax rate was only 35%.
Some people are math and logic challenged.
Posted by: ohiolibrarian | Oct 21, 2008 at 04:55 PM
That's correct, Stephen.
It's one of those taxes that actually hits harder on people who earn less - there's no exemptions, and the amount of taxable income caps out around $100,000. The Earned Income Credit was designed, as I recall, as a way for the working poor to recover some of their payroll taxes.
Posted by: Cathy W | Oct 21, 2008 at 04:56 PM
The exchange actually reminded me of the exchange between The Tick and Thrakkorzog. See here (7:52 to 8:18).
Posted by: tgirsch | Oct 21, 2008 at 05:11 PM
Remember: Country First . . . then reggaeton, a bit of rockabilly, then a waltz, a bit MORE country, some alternative rock, a samba, some adult contemporary and finally an Irish jig.
Posted by: J | Oct 21, 2008 at 05:11 PM
Or, alternatively, "Country First" . . . THEN stir-fry, pan-fry, deep-fry, blanch, roast, poach, charbroil, grill, bake and eat raw.
Posted by: J | Oct 21, 2008 at 05:13 PM
It's one of those taxes that actually hits harder on people who earn less - there's no exemptions, and the amount of taxable income caps out around $100,000. The Earned Income Credit was designed, as I recall, as a way for the working poor to recover some of their payroll taxes.
So wait, why don't people earning more than $100,000 pay the payroll tax? I mean somebody does pay them right? Or is it all that it is hidden in investments and such?
And even if that is the case why isn't the money taken out as soon as they get paid and put into social security? It's not simply the rich sticking it to the poor is it?
Posted by: practicallyevil | Oct 21, 2008 at 05:19 PM
So wait, why don't people earning more than $100,000 pay the payroll tax
Social security and Medicare taxes, also known as FICA taxes must be withheld from your employees' wages. As an employer, you must also pay a matching amount of FICA taxes for your employees. Currently the social security tax rate is 6.2%. You are required to withhold 6.2% of an employee's wages for social security taxes and to pay a matching amount in social security taxes until the employee reaches the wage base for the year. The wage base for social security tax is $97,500 for the year 2007. Once that amount is earned, neither the employee or the employer owes any social security tax. cite
I believe the reason behind this is that Social Security caps out at a certain payout, and thus paying social security taxes on money over that limit would be deemed unfair.
Posted by: cyllan | Oct 21, 2008 at 05:23 PM
Ah, thanks.
Posted by: practicallyevil | Oct 21, 2008 at 05:25 PM
I have great admiration for members of the U.S. military -- I have several family members and friends who serve -- but by no stretch of the imagination does it give any sort of understanding of what its like to live outside that protective cocoon.
At my old job both of my peers were ex-Army. One was 24, joined at age 19 after a year of community college. Served as a scout in stationed in Germany for most of his time. This was his first civilian job.
The other was mid-30's. Joined right out of HS and successfully completed Ranger School. Served in the first Gulf War and also in Somalia. He was among the team that was sent in to find the guys whose Black Hawk went down. Earned a Purple Heart there as well. After he got out he was a police officer in Kansas and in Minnesota. This was also his first civilian job.
Me, I never was in the military or police, etc. Worked my whole life in the private sector, corporate world. Just about every week the three of us had a conversation about how different the "real" world is from the military. They struggled with all kinds of things, including payroll taxes, health care, savings/401k decisions. It also took them awhile to learn how to interact with their peers, supervisors, and subordinates. We did new hire employee training, and they consciously had to remember not to treat the trainees as new recruits. I sometimes had to step in and remind them. I also had to remind them that sometimes it is OK to question what your boss asks you to do. In a constructive way, of course, but you don't have to just click heels and leave the office anymore.
I hated that job, but I do miss the guys.
Posted by: chris | Oct 21, 2008 at 05:30 PM
So wait, why don't people earning more than $100,000 pay the payroll tax?
We do. We just pay it up to a certain point, then stop; the last few paychecks of the year have fewer deduction. (100K is not unusual in Silicon Valley - but then, we pay well over 30% of our income for housing, which in most parts of the country is considered very bad).
I think the idea (at least back when this was seriously considered to be a form of retirement fund) was that if you made more than that you'd put it in a real retirement fund.
Posted by: jamoche | Oct 21, 2008 at 05:31 PM
wow! I didn't know much about payroll taxes either. Informative Tuesday!
Posted by: Jessica | Oct 21, 2008 at 05:34 PM
J, you remind me of a newspaper vending machine I saw once. Across the top the vendor had blazoned USA TODAY. Beneath that someone had scribbled, "Tomorrow the World!"
Posted by: hapax | Oct 21, 2008 at 05:36 PM
And McCain is definitely out of touch with the average working American.
I love that McCain was totally caught off guard when it was pointed out to him that he receives health care paid for by taxes.
I heard from a co-worker that Cheney has had enough heart problems that he would be un-insurable by private company standards.
It's a shame that no one in government has any idea what it's like for your health problems to be excluded from your insurance coverage, or better yet, for you to be denied coverage based on the problems that you have.
Posted by: Jessica | Oct 21, 2008 at 05:37 PM
Private companies don't have the resources and facilities to maintain an evil robot.
"Heart problems," yes...
Posted by: Dahne | Oct 21, 2008 at 05:57 PM
It's been my misconception for a number of years now that the Social Security and Medicare taxes were income taxes. They appeared on my W2s which state my income, so it made sense to me to lump them in that manner. In my view the only difference between them and the city, state and federal taxes was that they were unrecoverable.
The distinction doesn't have much practical value for your average worker as either way it means they have less money. It isn't until you struggle with your tax forms or with the statements of a campaigning politicians that there's a need to think about it in a more precise fashion.
Maybe the McCain campaign is counting on this, it's highly doubtful the average American has that kind of precise knowledge because it isn't practical. I didn't, though maybe I'm just an uninformed ignoramus.
Posted by: MeanderingMind | Oct 21, 2008 at 06:33 PM
I think Dahne wins a nice new shiny inter net!
MeanderingMind has summed up my position exactly. I never thought about social security and medicare taxes aside from "Oh well, there goes that money".
Posted by: Jessica | Oct 21, 2008 at 07:26 PM
6.2 per cent? Holy smurf on a bicycle.
Does this inlcude unemployment insurance or is there no such thing in the US?
6.2 per cent... [walks off, muttering.]
Posted by: inge | Oct 21, 2008 at 08:05 PM
And McCain is definitely out of touch with the average working American.
That's true, but it's because he's seven-houses-owning, millionaire John McCain, married to filthy-rich Cindy McCain, not because he's a federal employee.
I love that McCain was totally caught off guard when it was pointed out to him that he receives health care paid for by taxes.
He probably doesn't look at it as "health care paid for by taxes" but as "health care paid for by employment."
Just so that we all know what we're talking about: yes, federal employees, including members of congress, get health insurance from their jobs. And yes, it's generally a somewhat better deal than is available to many people in private employment, and a much better deal than the poor souls looking for individual coverage. But it's not "free." There's an employee contribution, around 25-28% of the premium for most plans. The government pays the rest, just like any other employer, as part of the employee's compensation.
And I think it's really stupid to tie health care to employment, but that's another issue, and one not limited to government employees.
Neither are government health insurers all that much happier about actually paying out money for health care. I quote from the FEHB site:
"Managed care is an important part of health care today. You will find managed care features in all the plans described on this site. Common features of managed care are pre-approval of hospital stays, the use of primary care providers as "gatekeepers" to coordinate* your medical care, the use of a prescription drug formulary**, and networks of physicians and other providers."
*means: find cheapest option
**means: find cheapest option
As with any other health insurance, there are co-payments, deductibles, patient contributions, "customary and reasonable" fee caps, and all the rest of it. It ain't free, and it ain't always delivered without conflicts with the insurer. McCain is just rich enough not to need to care.
It is true that federal health insurers can't turn down an eligible member based on pre-existing condition. That' a big advantage, and one that should be available to everyone.
Posted by: Amaryllis | Oct 21, 2008 at 08:08 PM
And a double post and a quotation. Huh.
Again I went up to Craigbilly Fair,
And who should I meet but another beggar,
And this beggar’s name they callèd him -- Payroll Tax!
And the name of his wife it was Ould Madam Ball-o’-Wax;
There was Rallax and Rallax and Ould Madam Ball-o’-Wax,
There was Rover and Rover and Kitty-lie-over,
There was Rooney and Mooney,
And Nancy and Francey,
And Lily and Billy,
And Jamie and Joe;
And away went the beggar-men all in a row.
-apologies to Richard Hayward. I blame Fred. Also damnedyankee.
Posted by: Amaryllis | Oct 21, 2008 at 09:01 PM
Let's try to imagine, shall we, that John McCain is not a dishonest con man
GRRRRRR....ARRRRRGGGHH......WRRRRRFFFFFF......MMMMMMPPPPRRRRRR.......
Nope, no go -- just too much of a stretch on the old imagination.
Posted by: patter | Oct 21, 2008 at 09:08 PM
Just so that we all know what we're talking about: yes, federal employees, including members of congress, get health insurance from their jobs.
And their salary comes from ...?
Federal employees' health care is completely paid from taxes. It just comes out of different pockets.
Posted by: lightning | Oct 21, 2008 at 09:16 PM
Does this inlcude unemployment insurance or is there no such thing in the US?
Unemployment insurance is completely separate from social security. It's administered separately by each state, but also has some federal aspects to the program, and is funded entirely by a tax on employers. There are also restrictions on who can claim it - basically you have to be fired or laid off "not for cause", after having worked full-time for a certain number of hours over a certain period of time; if you quit voluntarily or are fired for just cause, you can't claim the benefit. (It may be that temporary employees can claim benefits at the end of a contract, but I'm not positive that's the case.)
If you qualify for the benefit, you get a certain percentage of your former earnings, with a fairly low cap (I want to say something like $300/week), for up to six months as long as you certify weekly that you have actively looked for work in the past week. (Upgrading your education doesn't count, much to the disappointment of people who find they need different credentials than they have in order to earn a living wage.) Sometimes, if the economy is particularly bad, Congress will extend the eligibility period to nine months.
Posted by: Cathy W | Oct 21, 2008 at 09:44 PM
As a 20 year navy vet, I can assure that I paid payroll taxes the entire time: Social Security, FICA, all of it. As a military man, me and my family recieved 'free' health care for the duration of my service. They did not dock my pay for it. As a retiree, me and my MRS. get free health care, as per my military contract, for a mere $350 dollars a year.*
Posted by: Hawker Hurricane | Oct 21, 2008 at 09:50 PM
Federal employees' health care is completely paid from taxes.
And Ford employees' health insurance is paid for by car buyers. And Microsoft employees' health insurance is paid for by Windows buyers. So? That's how our system works, stupid as it is.
I'm under the impression that there are few anarchists or libertarians among the regulars here. We admit the necessity of a government, and of taxes to pay for it. We're all customers of the government, and government employee salaries and benefits are part of the overhead of government business.
The federal health benefits program is an employer-based health plan like any other, better than many due to Uncle Sam's size and clout, but not different in essence. And it's just not true that health care for feds is in any way free, or that federal employees never need to worry about premium increases or argue with the Claims Adjustment Department for coverage. (HH:$350 a year? wow.)
"Universal health care supported by tax dollars," as the original question asked, is not the same thing as an employee-benefit health plan, even if the employer itself is funded by taxes.
Posted by: Amaryllis | Oct 21, 2008 at 10:29 PM
I think the point of the interviewer's question is, that if McCain thinks it's okay for taxpayer money to fund his health insurance (and his salary), why isn't it okay for taxpayer money to fund my health insurance?
Posted by: Lila | Oct 21, 2008 at 10:59 PM
If taxpayer money funds his salary, is it okay for taxpayer money to fund everyone's salary?
Look, I'd like to see a national, tax-funded, decoupled-from-employment health plan. And if the argument is that the government is already managing health plans because it runs FEHB and Medicare so it could also manage a true national, general-public plan, again, fine with me. But as long as health benefits are considered a part of an employee's salary, then no, the fact that taxes pay for health care for federal employees doesn't imply that taxes should pay for health care for everyone.
Posted by: Amaryllis | Oct 21, 2008 at 11:32 PM
I think the point of the interviewer's question is, that if McCain thinks it's okay for taxpayer money to fund his health insurance (and his salary), why isn't it okay for taxpayer money to fund my health insurance?
I had just about this very thought a few weeks ago. We have a surprising (to me, anyway) number of conservatives where I work, and I was thinking about how crappy it is for them to sit there with their really remarkable job security and their zero-premium taxpayer-funded health insurance (we pay a premium for dependents, but not for employee-only, and they're good plans) and it just pissed me off.
Sure, the logic breaks down a little if you look at it too hard - we get the free insurance, but we also get lower wages than we would in the private sector, it's all part of the overall compensation package, blah blah blah. But the point to me is that they're so disconnected, and most of them have been working in government for years, I'm not sure they really understand what the stakes are for everyone else.
It's funny, my tax burden (such as it is) has never really bothered me. But now I'm working somewhere that takes an automatic 8% out for the retirement plan, and that is killing me. When I went from temp to permanent, I got benefits and paid time off, but I also got that 8% cut. I want to tell them "Look, I'm only 29, I have student loans, just let me keep my money for a little bit longer and I swear I'll invest more when the raises start kicking in. Please!"
Posted by: burgundy | Oct 21, 2008 at 11:43 PM
zero-premium taxpayer-funded health insurance
really? where??
Posted by: Amaryllis | Oct 21, 2008 at 11:46 PM
Amaryllis, my sarcasto-meter is broken, on account of The Tired, and I'm about to go to bed, on account of The Tired, and it's probable the conversation will have developed into 20 other things by the time I'm next able to check. So.
If the multiple question marks were sarcasm, then I think I pretty much addressed the objections you raised in previous comments, and yes I know the city is paying the premiums for us, that wasn't my actual point.
If the multiple question marks weren't sarcasm, then all I have to say is yes, we have a pretty awesome benefits package, plus the city tries to pay everyone a living wage (no full-time employee makes less than $11/hr, and you can debate if that's "living" or not but at least they're trying), and at least some of the time they require contractors to provide a living wage and affordable insurance plans to any employee working on the contract.
I should probably not even be posting at all, on account of The Tired, but it's all typed up so I'm going to go ahead and hit Post anyway.
Posted by: burgundy | Oct 22, 2008 at 12:15 AM
Pear pimples for hairy fishnuts?
Posted by: Dan M. | Oct 22, 2008 at 12:22 AM
burgundy: Sorry, no, I didn't mean to convey sarcasm (tired, too). Just jealousy and curiosity: I didn't know there was such a thing as a government-job zero-premium health plan. I gather it's a city-level thing, so good for the city. (not sarcasm, sincere!)
The area where I live -- greater Baltimore-Washington -- is largely populated with government workers at various levels. They don't seem to me to be disconnected from everyone else; around here, they are everyone else, trying to get by like everyone else.
My original point, and I did have one :) was just that, if McCain and his fellow gazillionaires are out of touch, don't know what the stakes are for most of us, it's not because of a gold-plated taxpayer-funded federal health plan.
Posted by: Amaryllis | Oct 22, 2008 at 12:45 AM
Pear pimples for hairy fishnuts?
I was just thinking that :)
Posted by: jamoche | Oct 22, 2008 at 12:52 AM
You guys just reminded me of an editorial cartoon that came out back in 1991 or 1992 when Reagan was being questioned about Iran-Contra or something. This was back in the days before the internet and google, so try as I might, I can't find it online, much to my dismay.
I don't remember everything about it, but it was a 4-panel thing with an interviewer asking Reagan questions and Reagan mis-hearing everything. The last question was "Did you trade arms for hostages?" and Reagan cupping his ear, saying, "What? Did I raid barns for sausages?"
The cartoon was labeled "Reagan's best defense".
Posted by: Michele my bell-flower | Oct 22, 2008 at 01:46 AM
It's past my bedtime too, but I just wanted to chime in before konking out . . .
I too work for a municipality. In the early 90s our benefits package became "cafeteria-style": every employee got a set amount of (taxpayer-provided) benefit dollars to spend however she saw fit - various health plans including those for spouses/domestic partners/dependent children, child care, etc. Leftover dollars could be paid out in cash or put into a reimbursement account for uncovered expenses (dental, vision, co-pays).
Then the medical options started shrinking. And the premiums went up. I could no longer purchase a PPO health plan (I'm HIV+, I want my own goddamn personal physician and not some HMO, thank you very much!) and have money in the reimbursement account for my dental and eyecare. A few years later, it got so bad that I was paying roughly $200 bi-weekly just for the PPO health insurance. And the healthcare options kept dwindling. Things aren't quite so bad now, but I still have to pay out of pocket for dental and eyecare.
And you know what? I'm *fortunate*. A huge portion of my coverage is taxpayer-funded but certainly not guaranteed. And I'm looking to retire next year, and my health coverage then will be even shakier - subject to overall, citywide budget & labor negotiations.
And I'm *still* more fortunate than most working people. I've got a good income so this doesn't make a huge dent in my life, like choosing between eating and health insurance.
Which is why I get really pissed off at people (*ahem*Sarah Palin*ahem*) who try to pass off universal healthcare as socialism. Dammit, I want the single parent who's flipping burgers to have the same access to healthcare that I do! Including preventive medicine.
We can work out the details to prevent people from taking advantage of the system. But to claim that good universal healthcare - which just might be part of that "life, liberty, and the pursuit of happiness" part of the D of I - is evil and wrong is just . . . well, evil and wrong.
Posted by: Jared Bascomb | Oct 22, 2008 at 01:48 AM
As a person with some serious pre-existing conditons, I'm pretty sure I understand the logic between excluding them, and even excluding people entirely based on them.
The whole idea of health insurance, surely, is that you have a probability of getting sick and a probability of staying healthy. Some people pay in money and never take much of anything out, and some people take a lot more out than they'll ever pay in; but in theory it averages out so that the plan makes enough money to pay the employees (and the stockholders, if it's a private insurance company). It helps work out this average if you can vary how much people have to pay on how likely they are to need the coverage.
But someone with a pre-existing condition has a 100% chance of needing care. So to make the costs work right, they'd have to pay in the entire amount anyway, which would mean there'd be no real benefit to the plan for them. And if they pay less than that, then everyone else has to pay more to make it balance out. In effect, such a person is getting something for nothing (or no benefit at all).
Now, of course, a government health care plan wouldn't need to make a profit. But it still, in some sense, needs not to lose money--any losses need to be made up by tax increases, or else they increase the already-huge deficit.
That said: a) if I'm missing a link somewhere, I'm happy to be corrected and b) none of this means I don't want health insurance (which I currently haven't got). It's just a question of how such a thing can be feasible.
Posted by: Mabus | Oct 22, 2008 at 03:14 AM
As a military brat myself, I can tell you that you are not in the real world in that situation
I can't remember who described the US military as "a little bit of Sweden inside a country that is rapidly turning into Brazil" - but I do remember Colin Powell admitting surprise and dismay when he discovered, after leaving the army, that not everyone in the US gets a free annual checkup from their doctor.
Posted by: ajay | Oct 22, 2008 at 05:58 AM
Now, of course, a government health care plan wouldn't need to make a profit. But it still, in some sense, needs not to lose money--any losses need to be made up by tax increases, or else they increase the already-huge deficit.
Well, in the UK, where everyone is covered and pays the same National Insurance (adjusted for earnings, like income tax), the system manages to stay pretty much in the black while treating people who require more in care than they could ever put into the system. As it stands, most NHS hospitals break-even even without the mass application denials of American insurance companies (the few that don't only overspend because of poor management and waste, rather than the cost of caring for those with chronic conditions). Part of the idea behind the NHS (and most other public-funded healthcare schemes) is that everyone starts with a clean-slate, and the NHS agrees to take care of them no matter what conditions arise. Taxes are slightly higher in the UK than the US (National Insurance, which covers healthcare, pensions and benefits, is 11% for the employee and 12% for the employer, while the US equivalents, Social Security and Medicare, come to around 8% for both employee and employer) but once private insurance costs are factored in, I doubt there'd be a significant difference in actual expenditure - I don't have the relevant statistics to hand, unfortunately.
Posted by: SchrodingersDuck | Oct 22, 2008 at 06:24 AM
One of the advantages of the National Insurance system is that there is no need for a medical assessment before you can claim benefits - or to have made contributions - all you need is a valid National Insurance number (automatically issued at 16 if your parent have registered you for child benefits, otherwise applied for when you start work). The only purpose of the National Insurance number is to allow the civil servants to keep track of your account (and give them something to mislay through carelessness, but that's another story). As there's only one huge National Insurance Fund there's far less bureaucracy involved so the system is a lot more efficient, even allowing for the money spent hunting down fraudsters (and losing data discs).
In general, Mabus, the more people who are part of this sort of scheme, the less each person with relatively inexpensive health etc has to pay to support those who need it. The risk is spread across the greatest possible base of contributors and the whole thing not only works, but carries everyone and produces (in the UK, over the past few years) a sizable surplus.
Posted by: alfgifu | Oct 22, 2008 at 08:25 AM
"I can't remember who described the US military as "a little bit of Sweden inside a country that is rapidly turning into Brazil"
Wow; huge slam on Brazil there. Unitedstatesia should be so lucky as to "turn into Brazil." A solvent, progressive government; free, first-rate care for HIV/AIDS sufferers; a massive new commitment to public education; wide and deep tolerance for gays and lesbians; NOT occupying or basing in 75 foreign countries; unbeatable music; and very, very few fat people.
Brazil could teach us a few things.
Posted by: J | Oct 22, 2008 at 09:04 AM
Mabus, I urge you to look at the many universal healthcare systems that exist. The problems you describe either do not exist in practice, or are vastly smaller than you seem to believe. I honestly wonder how you can think that *every other developed nation* has this wrong. Especially when the USA has such embarassing statistics for life expectancy and infant mortality (slightly lower taxes are worth the lives of small infants? *REALLY*?).
Posted by: malpollyon | Oct 22, 2008 at 09:08 AM