The Senate Finance Committee Peers Behind the Couch
The Senate Finance Committee just released its package (pdf) of financing options for comprehensive health care reform. None of them are painless. They all require raising taxes or cutting profits on one group to pay for health services for another group. But this is it. This is where health reform lives or dies. For all the talk of a public plan, all the talk of the individual mandate, the bottom line question in health care reform is simple enough: Can you pay for it?
There's little in the options packet that will surprise observers. What's more interesting is what's not in the packet. A tobacco tax, for instance. One staffer recently suggested that there's a good reason for this: We now tax tobacco so heavily, and have cut the ranks of smokers so dramatically, that there just isn't much new revenue you can find in a pack of cigarettes. Plus, we just raised taxes on them to fund the expansion in the Children's Health Insurance Plan. Putting more energy into tobacco taxes would be both excessive and, in all likelihood, ineffective.
The more important omission is any kind of tax that's not related to health care. There is no talk of a value-added tax, or a rise in the marginal tax rates. Some of PresidentBarack Obama's revenue proposals are included in what's essentially an appendix, but that's about it. At the end of the day, the health care system will pay for health care reform. The final price tag may prove significant, but it represents a shift in spending rather than a rise in spending.
(Photo credit: Senate Finance Committee web site.)
May 19, 2009; 11:07 AM ET
Categories: Health Economics , Health Reform
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