Cut Gouging and Inequities
Congress is still talking about a “Grand Bargain” that “balances” far more spending cuts than tax increases. That is another way of saying that you – the consumer of Medicare and Medicaid services, the recipient of Social Security, and the average taxpayer will take the brunt of the spending cuts, while the wealthy get their income taxes restored, not raised, to their pre-Bush modest levels. Don’t buy it!
There are two ways to cut Medicare and Medicaid. The right wingers want to cut benefits. Consumers want to cut vendor fraud, the overcharging and the immense over-diagnosis, over-treatment and erroneous or unnecessary procedures and prescriptions documented so often by, among others, the Dartmouth Institute for Health Policy and Clinical Practice, Johns Hopkins University School of Medicine and the Harvard School of Public Health.
Don’t think this is small stuff. The waste and fraud amount to hundreds of billions of dollars a year! Americans pay the highest prices for drugs in the world even though most of them were developed in the U.S. significantly based on government research, development and with tax credit subsidies for Big Pharma. Even Mr. Obama’s 2013 budget recognizes savings from excessive drug industry pricing.
The nation’s leading expert, Harvard’s Malcolm Sparrow, has estimated that computerized billing fraud and abuse is anywhere from 10 to 25 percent of the nation’s health bill. This adds up to $270 billion to $650 billion a year. A big slice of that fraud is taken out of Medicare and Medicaid.
A single-payer, full Medicare for all system – formerly supported by President Obama, Hillary Clinton and many members of Congress, before Mr. Obama took it off the table in 2009 – would cut present administrative costs in half. Canada’s system, which allows patients to freely choose their doctor and hospital, covers everyone for half of the $9000 per capita that Americans will pay this year. Our system leaves 50 million people uncovered of whom 45,000 will die this year alone due to lack of coverage, according to a peer-reviewed study by Harvard Medical School researchers.
Longer range savings come from reducing medical malpractice, hospital-induced infections and plain errors that annually cost 200,000 lives, and more injuries and sicknesses. Some hospitals are proving these savings can come quickly with common sense solutions: better sanitation, checklists and stronger internal peer reviews.
The trilogy of health care fraud, waste and abuse requires public discussion, along with the vastly greater returns from better funded policing of the healthcare system. Yet pundits and columnists ignore reaping savings from the bloated healthcare industry and assume the cuts must overwhelmingly come out of people’s hides – namely benefits.
As economist Dean Baker has written, we don’t need to cut Social Security benefits (already solid for the next 25 years) whether in money or later age eligibility.
Congress could also simply raise the social security tax on incomes above $115,000, increase the minimum wage, inflation adjusted, to that of 1968! And adopt other long-overdue improvements such as disability enforcement efficiencies. The initiatives will move the trust fund to sustainability for the next 75 years.
The deep bias of public dialogue here, whether in such reborn deficit-reduction commissions as Simpson-Bowles or in the general media is revealed in the use of the word “entitlements.” It is only used to apply to Medicare, Medicaid and Social Security, which involve recycling peoples’ tax dollars. It is not used to describe the massive corporate entitlements shoveled out daily to business welfarists in the form of subsidies, bailouts, giveaways, tax loopholes, debt revocations, loan guarantees, discounted insurance and other aid to dependent corporations. Why? Power produces privileges.
When 30 large companies, such as Verizon and General Electric, make a total of $160 billion in U.S. profits from 2008-2010 according to the Citizens for Tax Justice and pay NO federal income taxes there is a substantial loss of revenue to the U.S. Treasury. Two thirds of corporations pay no income tax on their profits under the Swiss cheese tax code.
Moreover, the corporate welfare they receive in various modes, including free research, development, and inflated government contracts (a disguised subsidy) is hardly a recycling of their taxes.
Just taxing corporations at the rate paid in the prosperous nineteen sixties would bring in hundreds of billions of dollars yearly. Another great revenue producer is a tiny Wall St. speculation sales tax, a far tinier rate than what you pay in sales taxes.
What about taxing capital gains and dividends the same as ordinary income? That was the case under Ronald Reagan. Then there is the bloated military budget, so full of redundancies, waste, boondoggle weapons programs such as the F-22, endless weapons cost over-runs, contracting fraud and boomeranging Empire expenditures as to boggle the minds. Even retired high military officers condemn giving the Pentagon such blank checks.
Anyone who has been in the armed services has seen the runaway expenditures, especially those that hugely outsourced contracts inflict on American taxpayers.
It is hard to remember when the last thorough Congressional investigation of the Pentagon budget occurred. Why, Congress can’t even get the Department of Defense to provide accountings so as to be auditable by the Congressional Government Accountability Office (GAO). The Defense budget is half of the entire U.S. government’s operating expenditures and it is not even auditable!
So enough already of the twisted, evasive talk of the Grand Bargain on your backs. The Grand Bargain should be both Parties paying close attention to corporate welfare, corporate tax escapes, and corporate crime, fraud and abuse before unraveling the most meager social safety net in the western world.
Ralph Nader is a consumer advocate, lawyer and author of Only the Super-Rich Can Save Us! He is a contributor to Hopeless: Barack Obama and the Politics of Illusion, published by AK Press. Hopeless is also available in a Kindle edition.