Article & Journal Resources

Washington Post columnist Robert J. Samuelson writes that, while "covering the 47 million uninsured already looms as the centerpiece" of the health care debate, out-of-control spending is the real problem, but it is not being adequately addressed by politicians, who only "pay lip service" to the issue.

According to Samuelson, politicians would rather cater to the public's belief that everyone should have adequate health care than address the hard questions, such as "How much will health spending increase taxes, depress take-home pay and crowd out other government spending—on schools, roads, parks, defense?" He argues that "the politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care." Because people believe that either employers or the government pay for health care, they have no incentive to control costs.

Samuelson suggests making people "see and feel health costs" by making "Medicare beneficiaries pay more"; creating a "dedicated federal health tax to cover all government health spending" that would rise and fall according to spending levels; and getting rid of "the income tax exclusion for employer-paid insurance and replac[ing] it with a tax credit of lesser value" so "workers would have more pretax income, but they'd have to spend more after-tax dollars for insurance." However, Samuelson says that such proposals are not likely to be adopted because they "would inflict 'pain,' and candidates who embraced them would invite political ruin." (Samuelson, Washington Post, 12/6/07)