Health Care Reform and the Unpopular T-Word
WASHINGTON
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Program of health of push of the Democrats while publishing the assurances on sanitary Attendance be them
(29 July 2009)
Subjects of periods: Reform of health
The Hydra many-headed, with enough toxic breath to kill, is one of the orribili beasts in Greek mythology. In Hercules& amp; #8217; great discord of s with it, would cut one of relative the witness, solo in order to make to appear two more. Any thing makes, he couldn& amp; #8217; the t it continues. You can think next to Congress& amp; #8217; the efforts of s in order paying health reform like being a po' as a battle in order to empty a Hydra many-headed. The members of the conference have supplied un' idea after an other to pay the not assured cover of. But still haven& amp; #8217; the t it has a legislation that could pass. And that& amp; #8217; s in the great part because the majority of those ideas has a base defect. They do not raise the yield quickly as the health costs increase. The program in order to impose a surtax to the advanced guadagnatori, as an example, wage a beautiful rispettabile piece of the invoice in the course of next years. But the yield from the tax increases only fastly (approximately) like l' economy of the United States develops itself. The same one is true for the majority of the taxes. The health costs, on one side, is developing much more quickly dell' economy. During l' last decade, l' economy has expanded itself gives approximately 20 for one hundred and expenses of health ballooned 50 for hundreds. The isn& amp of I crack; #8217; t approximately beginning to close itself, l' or l' other. Thus any thing the conference makes in order to pay the relative programs, it can& amp; #8217; the t it continues. The numbers show that there is only un' sure escape from the problem and, after the months of the argument of the round one, that solution has reappeared: It& amp; #8217; tax the S.A on the health. If the conference tax the health, the yield has a probability to increase with health expenses. A health tax moreover will generate a reason so that the laborers and the commerce you delay the development of the & amp of health expenses; #151; thus to reduce the amount of taxes has had to pay the nation& amp; #8217; invoice of health of s. The health debate is now in one of those moments of the calmone–storm. After it upsets of it of activity snow the slid week, everyone is waiting for the committee of finances of the senate in order to free the relative invoice. That invoice immediately will be transformed in the point of reference for all the other great players. The republican heads will take to the blows it, hoping to maintain the republicans moderate of the senate dall' support it. The blue dog conservative Democrats will support that the invoice demonstrates their fondatezza of a less expensive program that the version current of the Room, with the less generous subsidies for not assured. The liberal ones will take to theirs own blows to the invoice. The majority of the intrigue, the Obama president will have to decide if to render to the invoice its own. The rest of we will want to put to fire on two questions. How much serious one is Washington approximately the slowing down dell' elevation the development in the health costs? And Washington will calculate outside a sense to cover the not assured majority of? Since it happens, is l' politics that can help with both editions. It& amp; #8217; s the same politics that will allow that the conference resolves the relative erculeo problem of the estimate: Taxation of the healthcare.& amp; #149; In recent days, the finances committee is considering just a such tax, on the ndemnity-disease that the Americans receive from their employers. The fact that these benefits are not taxed, like l' economist Jonathan Gruber of the Institute Massachusetts of famous Technology, comes from the & amp; #8220; nient' other that arbitrary an administrative decision has made 60 years of ago.& amp; #8221; Unfortunately, that decision has generated all the kinds of economic damage. Since & amp of health; #151; various of food, garments and dellamaggior part dell' other & amp of things; #151; isn& amp; #8217; t taxed, it& amp; #8217; s effective on the sale. And when something is on the sale, people often buy to it more that they have need than In the event of the health, buy the & amp; #151; or theirs buys of the employer for they & amp; #151; insurance regimes that don& amp; #8217; t ago a lot of a effort in order to control the costs. Rather than exercising the pressure on the hospitals to uproot outside the administrative waste, the programs regard the cost of that waste. Moreover they regard the costs of drugs of name of marks that they are not more effective of the generic alternatives and other kinds of expensive cure that make little one in order to improve the health. Consequently, l' tax exclusion at last raises your tax to pay, via expensive expenses of sanitary Attendance be them. Effectively, if there is a single idea of health on which liberal and the conservatives accosentono the & amp; #151; comprised Douglas Elmendorf, director of the & amp congressuale influential dell' office of the estimate; #151; it& amp; #8217; s that it discards l' exclusion. However many politicians are restii to exit against l' exclusion, for l' obvious reason for which they render it healthy for-tax. The blue dogs can be the best example. They have pushed with justice the heads of the Room for being harder approximately development than cost to maintain. But the majority of the blue dogs has not been decided to obtain the specific, sull' exclusion of tax or on the majority of the all other. In order to take care itself of this political truth, the committee of finances of the senate has been intriguer from a version of a health tax, being pushing from the Democrat Massachusetts John Kerry, that it comes dressed in on with an entire lottery of lipstick. The doesn& amp of tax; #8217; fall of t directly on the laborers. It doesn& amp; #8217; fall of t even on the employers. It falls on everyone& amp; #8217; favorite scoundrel of s: companies of assurance against the diseases. Insurers who have offered the policies that they have cost more of a sure sum of the & amp; #151; perhaps $25,000 a & amp; #151; it would face a tax. The turning out yield of tax would contribute to pay the not assured cover of. Presumablly, the insurers would pass the cost of the tax on the companies, than then they would have become less disposed to offer the expensive programs. Preferibilmente would move some of the money that now they are spending sull' assurance against the diseases in the compensation of the cash, than, naturally, to be taxed, raising more yield. But to impaccare the program as tax on the insurers still cannot be enough in order to render it gradevole to the palate. Thus the conference moreover would make probably it to only apply itself to the more expensive tape of the programs. David Axelrod, the councilman of Obama, recently has pointed out the $40,000 programs to Goldman Sachs (a company that now is apparently approximately popular how much the health insurers). With this tightened method, the tax would raise only a small part of the yield be necessary in order to cover the not insured one and the conference still would have to count on a concoction of other increases and reductions of tax expenses. But to begin to raise l' exclusion still would help the & amp; #151; particularly if the conference regulated the threshold so that the tax you increase more slowly than the health costs they are increasing. That sense, more and more of most expensive, less efficient programs finally was hitting in on against the tax. For all l' elegance budgetary of the tax, although, the relative real importance is the much largest one. It would begin to chip via to the reasons perversi in our medical system. That& amp; #8217; s that arguments. The isn& amp of idea; #8217; t in order to punish the organized traders of Goldman or, for that matter, laborers trade-union that they have own generous programs. L' idea is of giving to the companies and the incentive laborers in order to choose the medical programs that try to reduce the useless costs. Without that reason, he is us of the wonder that our sanitary system so as to is disturbed? This us filler the & amp; #151; and you have known that this was coming, didn& amp; #8217; t you? & amp; #151; to the Hydra many-headed. Finally, Ercole has realized its wasn& amp of strategy; #8217; operation of t. Thus it has carried in its grandson, Iolaus, than torched the open wounds that Ercole has inflicted on the Hydra, impedicente all the new witness to grow. And that one has worked. Ercole and Iolaus have emptied the beast. They have made how it? Obtaining to the root of the problem. Email: leonhardt@nytimes.com
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