While Senator Sanders’ vision of a “Single-Payer” universal healthcare system has its obvious long-term cost-saving merits and uniform pricing and accessbility, there are nevertheless rival political ideologies (right and centrist), large special interest forces, private “for-profit” marketplace interests and the “corporate-owned” Mainstream Media which deliberately seek to paint Sanders’ proposals/platforms as “too radical” and the true burgeoning of a “nanny socialist state” -- all of it being as hollow, facetious and overly cynical, given how Unviersal Healthcare is now PRACTICED in various forms in over 58 countries globally (per Wikipedia.org and the World Health Organization).
When Sen. Sanders first unveiled his overall domestic tax plan and Medicare for All vision last January, even the Mainstream Media’s widely perceived, “liberal-leaning” New York Times’ Margot Sanger-Katz wrote in her “Upshot” column that she and others might have “thought you were reading about tax policy, not health care.” So it also went with much of the Mainstream Media narrative: Bernie Sanders’ “progressive individual- and employer-derived healthcare “taxation proposals” and new “safety net” progam expenditures would just lead to greater federal budget deficits, but also that his initial proposition of “Single-Payer Univeersal Healthcare” lacked any kind of a detailed blueprint and framework for its structural/operational implementation and deployment.
Because of this prevailing media-portrayed cynicism and tacit dismissal (including the logical proposition that Mr. Sanders’ “Single-Payer” plan would lead to massive “cost-savings” for both U.S. consumers and businesses not falling prey to a current, long-standing federal “antitrust-exempt,” monopolist-based For-Profit/Big Health Insurance marketplace), we’d like to focus on the narrative that the “public is reticent and wary” of proposed “progressive income tax increases,” which Americans might feel they are being yet again burdened to carry.
More households would pay income tax under the Sanders Medicare for All proposal because of the 2.2 percent surtax on taxable income (as a billed “income-based premium” on individual taxpayers) and the repeal of health care–related tax exclusions and deductions. According to Sanders’ budget plan, the new tax would raise $210 BILLION in annual tax revenue, but it also emphasizes a “family of four” taking just the “standard deduction” (as opposed to “itemized deductions”) “can have an income of up to $28,800 annually” and NOT pay this “premium” surtax. The Sanders campaign further estimates that a family reporting income of up to $50,000, which is now paying just under $6,300 annually for health insurance, would pay just $466 per year – a savings of about $5,800 per year.
A variety of additional tax revenue would be raised from a new 2.2 percent tax rate on Capital Gains and Dividends Income also reported on an individual basis, which is expected by Sanders’ budget economists and advisers to raise another $92 BILLION or so annually. Furthermore, the Tax Policy Center makes a point of noting that the Sanders plan would “extend” the Social Security “payroll tax” (combined at an employee and employer tax rate of 12.4-percent) to earnings over $250,000 annually. The TPC analysis noted that the Sanders plan would exact a new 0.2-percent payroll tax on both the employee and employer on the same tax basis as the current Social Security payroll tax.
Keeping in mind that Sen. Sanders’ tax plan is based on a broad, overall domestic budget proposal for a whole menu of government-backed programs, including his ambitious goals of offering “tuition-free” college education to all Americans, an enlarged push for a Clean Energy transition (away from fossil fuels), and wide array of and jobs-based infrastructure improvement programs. In order to fund the expansion of these programs, Sanders’ plan is also based on “Progressive Income Tax Rates,” particularly targeting the $250,000-plus income brackets of upper- to top-income invidual and married/joint taxpayers.
In a country, where “Reaganomics” and decidely “right-leaning limited government movement” meant pretty much 30 years-plus of “regressive tax-rate cuts” being made almost across the board but focusing on larger percentage tax rate decreases for the upper-income $250,000-and-up income tax brackets, the Sanders “Progressive Income Tax Rates” will likely draw the greatest scrutiny and maybe resistance.
Even as Table 1 from TPC’s research illustrates how the percentage rates on “Ordinary Income” remains unchanged for the under-$155,850 tax brackets (joint filers) and actually decreases marginally for higher income brackets. But when the 2.2 percent “Surtax on Taxable Income” is levied on all brackets, the “additonal tax” on “Adjusted Gross Income” really focuses on “progressive” 9-percent to 24-percent tax hikes on the $200,000-plus AGI brackets for “single filers” and $250,000-plus AGI brackets inclusive of joint filers. Similarly, the 9- to 24-percent progressive rate increases will also apply to “Capital Gains and Dividends” income.
By any stretch, ANUH does NOT profess to be an expert in the field of tax policy, research and analysis. However, the Sanders tax plan might face the most serious questioning about whether low- to middle-income taxpayers could absorb BOTH 2.2-percent tax rate increases in “Ordinary Income” and “Capital Gains and Dividends” (though the latter may be less problematical because some lower-income taxpayers typically find they have less disposable income left for investing in stocks, bonds and other investment instruments) in the $10,000-plus to $100,000 AGI tax brackets.
For those reasons, it has been our belief at ANUH that some portion of “taxation and social responsibility” should be laid upon “the biggest financial and physical burdens on American health care providers” --- the manufacturers and suppliers of “Unhealthy and Addictive Consumable Products.” In our previous organizational incarnation as Americans for Nonprofit Healh Plan Insurance Exchanges (ANHPIE) back in 2009, we had proposed a special “Federal Excise Tax” on “Unhealthy Consumable Products” as a way to help fund “nonprofit-based insurance exchanges,” which would also be populated by well-established “Nonprofit Community Health Plans” that currently operate in almost all 50 states of the Union.
Unfortunately, when the “closed-door/closed-forum” for “Healthcare Reform” in Congress opted to vote for passage of the greatly watered-down and diluted “Patient Protection and Affordable Care Act of 2010” (what is also coined as “Obamacare”), ANHPIE soon later had reason to cease to exist (because ACA’s “state-run” health insurance exchanges are still dominated by “antitrust-exempt” For-Profit/Big Health Insurance carriers) and our tax plan also disappeared with it.
Today, as ANUH has looked over and studied the Sanders campaign tax plan and Medicare for All platform, we still can’t help but wonder if both of the 2.2-percent “Premium Surtax on Taxable Income” and “Capital Gains & Dividends” income may place a perceived, slighter tougher financial burden on low- to middle-income brackets up to and slightly over $100,000 a year (particularly for “joint filers” with “child dependents”). Perhaps, maybe the best way to get that 84.5-percent of Ameircan taxpayers falling within the $75,000-or-less tax brackets to support and buy into Sen. Sanders’ Medicare for All plan, an “Excise Tax on Unhealthy Consmmable Products” suppliers would conceivably shift some of tax burden off of the shoulders of lower- to middle-income taxpayers.
Without laying claim to any kind of expertise on “taxation models” and revenue-generation, ANUH is simply contemplating what the 10-percent Federal Excise Tax Scenario will raise in $105 BILLION in taxation – could it be enough to perhaps “halve” either of the Sanders plan’s proposed 2.2-percent levies with the “Premium Surtax on Taxable Income” or the “Capital Gains & Dividends” income tax charges for the $100,000 and less income brackets? Or maybe the 10-percent scenario on “unhealthy consumables” would be enough to entirely fund the “Premium Surtax” for low- to middle-income taxpayers?
In any of those events/scenarios, ANUH’s proposed “Federal Excise Tax on Unhealthy Consumable Products” would at least parcel out a new level of “societal responsibility” on the manufacturers, suppliers and distributors of these consumables.
To get a fuller picture on what kind of “healthcare” and “societal” cost burdens are on the U.S. healthcare industry, here’s a sampling of some of the “leading suspects” of “Unhealthy Consumables” account for on an annual basis:
- Tobacco/E-Vapor Products are estimated to cost America over $326 BILLION in smoking-related illnesses during 2014, resulting from $170 BILLION in direct medical care costs for adults and $156 BILLION in costs to businesses associated with lost productivity (including $5.6 BILLION attributable to second-hand smoking), according to the Center for Disease Control and Prevention (CDC). Lung cancer and heart diseases are the two most prevalent smoking-related illnesses and causes of early mortality, in addition to high blood pressure and oral cancers (related both smoking and smokeless chewing tobacco and snuff products). Given the relative infancy of e-vapor products, such as electronic cigarettes and e-vapor pipes, scientists and governmental agencies are still trying to identify certain chemical-related illnesses from “scented” vapor liquids.
- Alcohol Consumption is estimated to cost American society over $249 BILLION total annually, according to the CDC. Broken down, that total cost manifests itself through early mortality at $75 BILLION; lost productivity and workplace absenteeism at $82 BILLION; direct healthcare costs at $28 BILLION; crime at $25 BILLION; and driving-under-the-influence car crashes at $13 BILLION. Liver and heart disease are the most prevalent illnesses burdening health care systems, but also causes cancers and diabetes in other instances as well.
- Sugared Candies/Baked Goods and Non-Alcoholic Sweetened Beverages are among the leading causes of “morbid obesity” in the United States, with coronary heart disease, type-2 diabetes, pre-diabetes, metabolic disease, high-blood pressure, osteoarthritis, high cholesterol, gout, and nonalcoholic fatty liver disease and a variety of cancers ¾ possibly making it the most costly burden on American healthcare at around $1 TRILLION annually, according to a Forbes magazine calculation based on worldwide data estimates by Credit Suisse AG’s “Sugar at a Crossroads” report published in August 2013.
Those same aforementioned diseases/illnesses being confronted by American healthcare can also be found at “Limited-Service Eating Places,” namely fast food establishments, where menus are typically dominated by a variety of vegetable- and meat-based fried foods as well as sweetened beverages and desserts, which most often are linked to the pandemic of obesity in America. Similarly, “Full-Service Restaurants” commonly use vegetable oil-based frying agents for the cooking of meat and vegetables, in addition to starchier breads and potato variations. #
– Michael A. Freeman