Paying for Health Reform: Tax the Fella Behind the Tree
The American public is deeply divided over whether to raise taxes to pay for health reform. A fascinating Kaiser Family Foundation review of recent survey data finds that in five polls taken over the past four months, about half of those questioned said they’d be willing to pay higher taxes as the price of reform.
However, the amount of tax they are willing to pay appears to be low, they’d much prefer someone else pay, and they don’t like the idea of taxing employer-sponsored insurance one bit. Most striking, a dispiriting 60 percent think the system can be fixed without spending any more money at all—an outcome that no health economist I know thinks is remotely possible.
As the Kaiser paper notes, much depends on how the question is presented. For instance, 57 percent said they’d pay higher taxes when CBS and the New York Times asked about a plan where “all Americans have health insurance they can’t lose, no matter what” Unfortunately no plan being seriously considered in Washington would cover all of the uninsured. When Kaiser asked if people would be willing to pay more “in order to increase the number of Americans who have health insurance”—a much more realistic description—only 41 percent said they would.
When it comes to the kind of tax increase people prefer, taxing employer-sponsored plans gets a collective thumbs-down, whether the question focuses on the most generous plans or all coverage. No matter how the question is asked, no more than 40 percent of respondents favor such a tax hike, and in most formulations, two-thirds oppose the idea.
So what kind of tax increase does the public like? As President Obama has concluded, two-thirds are happy to raise income taxes on those making $250,000 or more. This proves once again that Russell Long’s old doggerel: “Don’t tax me, don’t tax thee, tax that fella behind the tree” remains as true as ever. Respondents also support raising taxes on cigarettes and booze and, by much smaller majorities, on snack foods and soft drinks.
Obama’s non-starter of a plan to cap the value of deductions for top-bracket taxpayers was favored 55 percent to 40 percent in a June Quinnipiac College poll, although it has been a while since anyone has thought much about that plan.
And an across-the-board tax increase? Just 29 percent of those surveyed support that, according to a June Kaiser poll. With 60 percent in that survey believing that more uninsured can be covered at no cost at all, these results send a powerful and depressing message to Capitol Hill: Without a much better sales job, anything short of free lunch reform will generate a significant public backlash. Good for the critics. Bad for significant changes in the way we deliver and pay for medical care.