The OLD Philosopher – John M. Miller
If the USA had universal health coverage for all its citizens, the costs of that care would eventually drop dramatically. It would not happen immediately, or even quickly, but it would happen. The primary reason for that is because the profit motive would be entirely removed from medical care.
Making profit from a reasonable human right such as health care is like the government allowing a profit to be made by a toll-taker every time we drive on a street or highway, or a private agency taking a cut out of all military expenditures, or privately-run corporations making a profit on the activities of the State, Commerce, or Agricultural Departments. Governments are public entities, and private corporations are private. However, with the exception of Medicare and Medicaid, in effect American health coverage has been essentially a private enterprise. No other developed countries operate their health care on that basis.
Since the beginning of Social Security, there was an upper income limit on the amount any employee had to pay. Currently that figure is $137,600. Furthermore, Social Security was based solely on earned income, which means wages, salaries, bonuses, and commissions. Social Security dues were never charged for investment income, income from trusts, and other such income-producers which did not involve earning money from one’s own labor.
As time has passed, the upper limit has risen beyond which employees did not have to pay more money into the Social Security Administration coffers. But here is a suggestion for bringing Medicare to everyone, from the proverbial cradle to the inevitable grave.
The idea is straightforward, but it also represents a major shift from what we now have. Charge everyone the same percentage that has long been charged to everyone. That percentage now stands at 6.2%. But Social Security taxes would be levied for all of their earned income. There would be no limit beyond which they were not required to pay.
Were that to be done, in effect their income tax rates would be considerably lowered, as happens now under current conditions. All those Social Security taxes would be deducted from the total taxable income upon which their income taxes are calculated. That is the way the tax system has always operated.
Two major undeniable benefits would result from such a change. Social Security itself would last indefinitely, and its failure has been a growing concern for years. Secondly, high-income earners would have the satisfaction of knowing that they, more than any other taxpayers, were the ones who provided the necessary medical safety net for millions of Americans who otherwise could end up devastated by a catastrophic illness. Whether those taxpayers would be pleased to see it that way, or even try to perceive it in that light, is another question - - - but not for this essay.
If most of the expenses of medical care were covered by a federally-funded Medicare-for-All health care service as they are now for Medicare patients, everyone, especially lower-income people, would not be so hard-pressed to pay for all their other ordinary expenses. Medical costs, particularly catastrophic medical expenses, are one of the chief causes of poverty and bankruptcy in the US.
Throughout the family of nations, many different options have evolved for how various states operate their national health systems. Because many federal fiscal issues in the USA are unique compared to the rest of the world, no doubt our Medicare-for-All would be unique. Congress would need to decide how national health care should operate at optimum levels in America. But it is obvious that our present medical system is in bad need of repair. There is unanimous agreement on that.
One important alteration from the current Social Security system would need to be instituted in order fully to fund Medicare for All. As there has been an upper limit beyond which Social Security dues are not collected, in this system there would be an upper limit beyond which Social Security monthly payments would not rise for the affluent. The highest annual Social Security payments are now something under $50,000 per year. That number would not rise for them. Thus the retirement incomes from Social Security would remain constant for the wealthy, while their Social Security taxes would rise dramatically.
Furthermore, employers would also have to match the unlimited individual employee payments to Social Security as they do now. Self-employed workers would still have to pay 12.4% on their entire annual taxable income. However, those payments would be deducted in calculating their corporate or individual income tax, as also happens now, thus reducing their income taxes.
Some form of Medicare-for-All is imperative for repairing the failed American health care system. This proposal is a suggestion for a possible complete funding for such a system.
April 28, 2021
John Miller is Pastor of The Chapel Without Walls on Hilton Head Island, SC. More of his writings may be viewed at www.chapelwithoutwalls.org.