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Healthcare reform: Mandate or incentive? [Most commented]

October 7, 2011 | 12:01 pm


In his Op-Ed on the Patient Protection and Affordable Care Act, former professor of public policy William D. Leach dismisses the hype surrounding the measure:

There is nothing novel or coercive about linking taxes to the purchase of specific types of goods or services. As any taxpayer probably knows, there are many tax provisions that raise or lower your tax bill depending on what you have bought and what you have elected not to buy.

The act states that as of 2014, people without insurance will pay higher taxes. Beginning at the same time, insurance companies will no longer be able to deny coverage based on preexisting conditions.  Once it kicks fully into gear, in 2016, a single individual with no dependents will pay an extra $695 or 2.5% of his applicable income, whichever amount is higher.  As Leach sees it:

Every tax creates winners and losers. To evaluate whether a specific tax is good public policy, all we can do is judge whether it distributes the tax burden fairly and whether it creates positive economic incentives.

It makes sense for governments to use tax laws and other types of economic incentives to encourage behaviors that are good for society or that increase overall economic welfare, and to discourage behaviors that cause general economic harm.

Congress' goal was simply to discourage people from using subsidized healthcare without paying into the system, as it places an unfair burden on others in society, according to Leach.  But reader response was overwhelmingly negative, for a variety of reasons.  Here’s a sampling from our discussion board:

"Desirable behavior"

"...legislator's goal is indeed to engineer society by providing tangible monetary incentives that reward desirable behavior..."

OK, who decides desirable behavior? Republicans? Democrats?, Left wing or right wing? Or how about the individual, the person that will reap the rewards, or suffer the consequences.

BTW, how's this for a "desirable behavior"; it's good for people to own homes, so why doesn't the federal government encourage no down payment loans to people that normally couldn’t afford them? The banks will go along with it. A tangible monetary incentive, as the current state of the economy would indicate. Not!

-- edwardskizer

Real healthcare solutions exist -- in other countries

The Health Care Reform Bill was something north of 2,000 pages. To date, HHS has written 3,000 pages of regulations and thousands and thousands of pages are still to come. For example, HHS still has to write the regulations on what has to be in the health insurance policy that by law I am required to buy. Since today I have no idea what will be in the health insurance that I am by law being required to buy, I cannot say whether or not HHS has done a good or bad job in writing regulations. To me the unknown is the truly frightening reality of the of the Health Care Reform Bill and the actions of HHS. 

I spent my entire working career in Germany. In the 1880s Germany created a national health care system and a national pension system that has basically worked for more than a century. In addition, this health care system consumes far less of Germany's GNP than the health care system in the United States and basically gets the same results. If we wanted real health care reform, we would have adopted policies that work in countries such as Germany and did not. If we wanted health care reform, we would have addressed the realities of why costs in this country are so much higher than in the rest of the industrial world and we did not. Personally, I think we should scrap this law and try again, but I guess on this point I am a voice in the wilderness. 

-- jeff1947

Name another country where sick people end up bankrupt

How can people claim to live in the greatest country on Earth when being ill can lead to bankruptcy? Most developed countries have a form of public health care, and we need the same.

Would people prefer it if there was an extension of Medicare (and corresponding increases in tax burden) that would cover medical expenses? I'm honestly curious about that.

-- DTurkin

A government-mandated purchase?  Where does it end?

"Incentive?"  LOL....oh come on.  This is the first time in our nation’s history that the government forces a free and private individual to purchase the product, or face the confiscation of the fruits of your labor, for the simple fact that you are in the USA.  It's more corporatism via the establishment statists.

It, like the assassination of a US citizen without due process at the hands of the government, is a horrible precedent.  Freedom and liberty loving individuals everywhere should be very concerned.

What next? 

-- More.Liberty

Monetary coercion is not the solution

The bottom line is that tax policy shouldn't be used to force certain behaviors.  Calling out dozens of plainly wasteful government mandates in order to defend the latest one is hardly convincing.

Taxed.  Enough.  Already.

-- jhklat

*Spelling errors in the above comments have been corrected.


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Supreme Court may end fight over healthcare reform law. Or not.

--Julia Gabrick

Photo: Flanked by congressional members, Chairman of Restore America's Voice Foundation Kenneth Hoagland speaks during a news conference this week on Capitol Hill. Approximately 1.6 million signatures collected on petitions urging a repeal of the healthcare reform law were delivered to the Hill at the news conference. Credit: Alex Wong / Getty Images

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