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April 14, 2010


Brendan is close to right: Leonhardt's piece didn't debunk much, but it was itself bunk.

I'll restrict myself to one example. Leonhardt wrote, "Focusing on the statistical middle class — the middle 20 percent of households, as ranked by income — underlines this point." But no reasonable definition of the middle class would restrict it to the middle quintile of households, and Leonhardt surely knows that.

Leonhardt's contortions are entertaining but also depressing. His misleading and fundamentally dishonest diatribe is what passes in the New York Times for thoughtful analysis.

Okay, I won't restrict myself to one example.

Leonhardt wrote, "Income taxes aren’t the only kind of federal taxes that people pay. There are also payroll taxes and capital gains taxes, among others." Hello!? Capital gains taxes are income taxes. Is Leonhardt really this dumb, or is he simply trying to slip one past us?

He also wrote, "I realize that it’s possible to argue that payroll taxes should be excluded from the discussion because they pay for benefits — Social Security and Medicare — that people receive on the back end. But that argument doesn’t seem very persuasive. Why? People do not receive benefits equal to the payroll taxes they paid. Those who die at age 70 will receive much less in Social Security and Medicare than they paid in taxes. Those who die at 95 will probably get much more." That's the dopiest argument about the insurance nature of the Social Security program I've read in a long time. And Leonhardt ignores the fact that the lowest four income quintiles receive more in Social Security benefits than they paid into the system; it is the top quintile that is subsidizing the other four.

And Brendan buys into Leonhardt's crap?

Regarding Americans who don't pay taxes, the comments I've heard or read correctly state that about half of all Americans pay no Federal Income Tax. I suppose some speakers have misstated the proposition as if it included taxes other than FIT, but I haven't heard them. I think Leonhardt pretty much created a straw man by focusing on the misstated version.

It's politically important that so many Americans don't pay FIT. When you add this group to the Federal employees and those receiving big federal benefits, it adds up to a majority of Amerians. This majority has an economic reason to support higher and higher federal spending paid for by higher and higher Federal income tax -- at least in the short term.

At some point the Laffer Curve will kick in. High enough tax rates will shrink the economy, reduce taxes collected, and put the country into the kind of economic disaster Greece is now facing.

The Mark Blumenthal and Charles Franklin link is broken. :(

I liked the gorilla. :)

Fixed -- thanks!

Re Noah's article, there are two basic facts:

1. Every American has access to some health care. At the very least, nobody can be turned away at Emergency Rooms.

2. On average, those with health insurance get more medical care than those without.

I don't like Noah's approach to what constitutes facts. It's difficult to assign truth values to a value judgment.

Are the uninsured getting "sufficient" care? That depends on one's standard of sufficiency. IMHO if "sufficiency" means "ideal, then most of the uninsured and most of the insured are getting less than ideal care. I have no doubt that ordinary Americans get worse care than people like President Obama, Alex Rodriguez, and Warren Buffet.

Noah deals with the definitional problem by implicitly assuming that a level of care below the average gotten by insured Americans is "sufficient". Then he labels as "incorrect" all those who don't share his unstated definition.

Incidentally, don't forget that half of all insured Americans receive medical care below the median level of care for insured Americans. If the median level of care received by insured Americans is the definition of "sufficient", then the half of all insured Americans whose level of care is below the median may also be getting "insufficient" care. Of course, Noah doesn't deal with this point either, since he never explicitly says what he thinks constitutes "sufficient" care.

Slate's Tim Noah is right about one thing:
"it's best not to think too hard about whether your work is changing minds."

Noah's heart (and Brendan's?) is wrapped around the moral urgency of universal coverage. No way is Noah going to let 58% of a poll's respondants convince him his heart is misleading him.

However out in the real world of uninsured people (where I live), the core problem with our health care system is its high costs. Most of its other problems, including accessibility, are consequences of its cost problem.

Obama's solution increases costs (just about everyone knows this -- even those who deny it), so Obama's solution will exacerbate most of the consequential problems.

However, many think achieving the goal of universal coverage is worth it.

"At some point the Laffer Curve will kick in."

Ah, supply-sider fantasies... the `80s are over, dude.

David, there are 2 broad categories of costs, and you're conflating them.

First, there's the overall cost of providing universal health care. This cost is paid for in the legislation with taxes.

Second, there are the individual costs of treating patients. These costs are out of control and a big reason why health care is so expensive in the U.S.

So when you say, "Obama's solution increases costs," which type of costs are you referring to? Obviously, the total cost of health care will go up, but complaining about that is like complaining that your expenses have gone up because you've moved into a bigger house -- without noting that you've also gotten a raise.

If you're talking about the individual costs of treating patients, then, well, the reform bill has various mechanisms to bring down these costs, ranging from market competition to bundling reimbursement. You may not believe these will work -- and maybe they won't -- but neither can you assert, without evidence, that "Obama's solution will exacerbate most of the consequential problems."

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