PNHP and Heritage agree?
Modern Physician Apr 1, 2003 Editorial An irresistible force By Joseph Conn
…on March 10, an officer (Stuart Butler, vice president of domestic and economic policy studies) of the conservative and politically influential Heritage Foundation testified before a Senate committee that a “social contract” exists in the United States to “ensure all residents have affordable access to at least basic health care . . . “
So now, even the Heritage Foundation accepts the idea of universal coverage.
Butler concedes it would take a public/private partnership to cover everyone, but his plan, presented to the Senate subcommittee on aging, calls for phasing out what he calls the “regressive” tax breaks given on employer contributions to healthcare benefit plans. The excluded federal and state income and payroll taxes—estimated at $125 billion in 1988—would be better spent, he argues, providing “more progressive” tax credits or subsidies to individuals for obtaining health insurance themselves.
Butler did not urge employers to stop paying for their employees’ healthcare coverage, but that is inevitably what would happen without the tax breaks.
http://www.modernphysician.com/article.cms?articleId=1817
Comment: As we approach the inevitability of major reform of our highly flawed system of funding care, it is instructive to note policy issues on which groups as diverse as Physicians for a National Health Program and the conservative Heritage Foundation can agree.
Heritage believes in a “social contract” and PNHP believes in a “human right” to affordable, universal access to health care, though Heritage would limit that to “basic” care and PNHP would include all “beneficial” care.
Heritage recognizes a fundamental flaw in the regressive tax benefits of employer-funded health plans. The regressive nature is due to the fact that health plans provided by the employer are actually part of the employee compensation package. Since they are deductible to the employer, but not taxable to the employee, higher-income individuals receive a much greater tax benefit than do lower-income individuals. This is tax policy that benefits the wealthy but not the poor.
Remarkably, both Heritage and PNHP believe that our health care system should be funded through tax policies that are more progressive. This is a dramatic meeting of diverse minds. Both PNHP and Heritage believe that we should use the tax system in health care funding, and that the taxes should be more equitable.
Unfortunately, we are still in different worlds on the next step. Heritage would turn the hapless recipient of a tax credit loose in the overpriced and inadequate private individual insurance market where the masters of “market medicine” will relieve the patient of their funds without the necessity of providing adequate, affordable access to beneficial services. PNHP stands firm on the principle that only a publicly administered, single payer system of social insurance can ensure that everyone would have truly affordable access to all important beneficial services.
There is one important caveat. Although we agree that employment-linked insurance should be eliminated, we cannot do that until we have established a program of social insurance. In spite of the injustices of our current system, it is crucial that we maintain the employer’s role in providing coverage. Without it, tens of millions more would join the ranks of the uninsured.
We need to proceed, as expeditiously as possible, with our efforts to establish a single payer system. But, until we are there, let’s not dismantle the employer base of coverage.