This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as press secretary in Washington, D.C. for a Democrat Congressman from Oregon (Les AuCoin), as an Oregon state government manager in Salem and Portland, as press secretary for Oregon’s last Republican governor (Vic Atiyeh), and as a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write. I could have called this blog “Middle Ground,” for that is what I long for in both politics and golf. The middle ground is often where the best public policy decisions lie. And it is where you want to be on a golf course.
As a health care lobbyist for more than 25 years, I worried a lot about moves to create a so-called “single payer health care system.”
Who is the “single payer?” Well, it’s the government. And who funds the government? You and me as taxpayers.
Over the years, my clients favored a well-balanced health care system, one that involved at least three parties – (a) the government, (b) the private health care system (including providers and insurers), and (c) individuals.
Better to fund a system with all those as payers rather than a single one.
But, despite all the machinations over the years, the single payer system is alive and well these days. It’s just moving behind the scenes, out of view of the public.
Just consider excerpts of a recent editorial that appeared in the Bend Bulletin under this headline:
Editorial: New taxes planned for Oregon with single payer insurance
Here is the major quotation from the Bulletin’s editorial writers:
“Out of the spotlight, a task force is crafting a plan to make Oregon the first state with a single-payer health care system.
“Oregon Democrats control the state Legislature and the governor’s office. So, at least for now, yes this is coming.”
And the new taxes? Of course, they’ll be needed for pay for the plan because Oregon, in contrast to the federal government, cannot fund government by going into debt.
If the proposal takes shape, there will be at least three new taxes – (a) a payroll tax; (b) an expanded personal income tax, and (c) even a new sales tax.
Under a “single payer” plan – some call it “Medicare for all,” a single government agency takes responsibility for running health care for all. Everybody would be on the same insurance plan and have access to the same services.
Advocates are fond of saying such a system could help fix problems by making health care accessible to more people and, thus, more equitable.
But, there will be tradeoffs. In other countries with such systems, there can be long wait times. Some procedures that people may feel are necessary may not be covered. And, of course, wealthier people will still find ways to get access to care others cannot find.
The biggest challenge is paying for a single payer system.
The behind the scenes report says this, according to the Bend Bulletin:
“Payroll tax will be a flat rate on wages up to the Federal Insurance Contributions Act (FICA) limit (currently about $138,000, subject to annual increase), and higher rates on income over the FICA limit.” The exact rate is not specified. That tax would be assessed on employers, though it may have an impact on employees, of course.
“The report doesn’t give a hint of how much payroll taxes may go up. It does suggest the increase would apply to households to a threshold income of 300 per cent of the federal poverty level. That’s about $79,000 a year for a family of four. There may be a new, higher tax bracket set for higher income earners.
“And the report says, if there is a determination that more revenue is needed, there would be a sales tax on all goods and services except ‘essential’ things such as groceries and utilities. The state would also establish a refundable sales tax credit to ease the burden on low-income families.”
Once the single payer proposal emerges from the shadows, it will be interesting to see how it fares politically.
Will a governor and legislators be willing to take on the heavy lift of advocating for more taxes? I wonder.
If was back as a lobbyist, I’d advocate against the huge tax expansion and contend that there were better ways to improve health care by relying on the perspectives of “three players, not one” – government, private health care, and individuals.
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Speaking of government out of control, how about this perspective on U.S. Senator Bernie Sanders continuing advocacy for “billionaires to pay their fair share of taxes.?”
The Wall Street Journal points out today: “The trouble with this story is that Bernie has already run out of billionaires. There are 724 of them in the U.S., according to the 2021 Forbes billionaires list, released in April. At that point their collective net worth was $4.4 trillion, although that figure has presumably since risen along with the stock market.
“But note the problem. Biden’s infrastructure plan includes about $550 billion in new spending, but the overall bill is near $1 trillion. Sanders’s budget is purportedly $3.5 trillion. Yet that number is far too low, according to analysts at the Committee for a Responsible Federal Budget. ‘We estimate the policies under consideration,’ they said last month, “could cost between $5 trillion and $5.5 trillion over a decade, assuming they are made permanent.’ Add it all up.
“If Sanders were to confiscate every asset of every American billionaire— Jeff Bezos’s rockets; Elon Musk’s bitcoin; Larry Ellison’s boats; Oprah Winfrey’s houses; Ted Turner’s ranches; Jay-Z’s car collection; even the starched shirt off the back of poor Larry Fink, who tied for last place on the Forbes list, at $1 billion—it still wouldn’t cover the cost of Democrats’ next two legislative plans.”
What Sanders advocates, at least this time around, is not single payer health care. It is other ideas for big government. But, just as in health care, there are not enough taxpayers to foot the bill.
That hasn’t bothered Sanders and his ilk in the past. It may not bother them now. But I’m not sure hard-pressed Americans will stand for it.
Perspective from the 19th Hole 