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Bush's new health care proposals
President Bush will propose that Americans be allowed to take tax deductions on more of their out-of pocket medical expenses, as part of an initiative the White House believes will rein in soaring health costs by shifting responsibility toward individuals, according to congressional and other sources familiar with the administration's thinking.
The new tax breaks for personal health spending, to be included in the 2007 budget Bush will release in less than two weeks, are designed to help the uninsured and to allow people with insurance to write off a greater portion of the money they spend on co-payments, deductibles and care that is not covered. Under current tax rules, people can deduct medical expenses only if they exceed 7.5 percent of their adjusted gross income.
This idea is slightly funny. The premise is that people don't pay enough of their medical bills when they have private insurance. The way to get them out of insurance is to...um...pick up part of their medical bill. Admittedly the percentage of third-party payment would fall, at least if this works as planned. But note we are making the government the new insurer. I also predict the tax deduction will evolve into a credit which will evolve into...Yikes!
That is not all. Health savings accounts will be expanded and:
Bush intends to propose changes to allow people to keep their insurance, without extra cost, if they change jobs or decide to start a business, building on a decade-old law that was designed to make health coverage more "portable."
I have no idea what is the underlying premise as to whether people overinvest or underinvest in private sector health insurance. I will blog more details of this as they become available. In the meantime, Arnold Kling shares my doubts.
Posted by Tyler Cowen on January 25, 2006 at 09:32 AM in Medicine | Permalink
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Comments
I'm young and healthy. If I can get the cash value of what my company spends for my health insurance, I would do it and buy catastrophic care with the tax deduction.
When going to the doctor, I would insist that the cost and expected benefit be weighed in medical decisions.
Millions of people like me would do plenty to change today's health care system.
"But note we are making the government the new insurer."
How is this true? Is it that the government needs to decide what is deductible, similar to what an insurer decides is covered?
Posted by: Ivan Kirigin at Jan 25, 2006 10:42:05 AM
Your first paragraph echoes my thoughts exactly. What is the logic behind this? Presumably, the President has SOME smart people working for him. Is this purely a political move or is their some logic to it that I am missing?
Posted by: joshg at Jan 25, 2006 4:02:18 PM
Thanks for the link to Arnold Kling's post where he notes that themWhite House logic seems to be based on negative income effects dominating substitution effects (upward sloping demand curves) v. David Altig's post suggesting normally slope and elastic demand
curves and income elasticities greater than one.
Posted by: pgl at Jan 25, 2006 8:11:25 PM
It seems to me that part of the issue here is equity. As things now stand employer-paid health insurance is tax-free income to recipients. This is equivalent to its being counted as income, but then being totally deductible, even for non-itemizers.
Why shouldn't those who pay for their own insurance, or their own medical expenses, be entitled to the same tax treatment? This is simple fairness. Is it "inefficient," and hence a crime in Libertarian World? Well, so be it. Efficiency is not God.
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