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O pinion
September 9, 2009
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No Sales Tax
for Health Care
May be the worst idea ever
L ois D anks
D e s p e r a te ly
search in g for a
way to fund a $1
t r i l l i o n
h e a lth c a r e r e
fo rm p a c k a g e ,
th e O b am a a d
m inistration floated a trial bal
loon in a W ashington P ost a r
ticle on M ay 27 — a VAT or
V alue-A dded Tax.
S enate B udget C om m ittee
Chairm an Kent C onrad agreed
the tax should be considered.
So did O bam a's econom ic ad
viser Paul Volcker. R ecently
e v e n U .S . R e p . C h a r le s
Rangel, D em ocratic C hairm an
o f th e H o u s e W a y s a n d
M ean s C o m m ittee gave the
tax a plug.
A VAT is essen tially a n a
tio n a l sa les tax th a t is c o l
lected at each step in the pro
d u c tio n p r o c e s s a n d u l t i
m ately passed on to the c o n
sum er in h ig h e r p rice s. F o r
exam ple, a flour m ill ow ner
buys grain and pays a VAT;
he sells flour to a baker and
she also pays a VAT; and so
by
A m ericans for Fair Taxa
tion. In 2001 th is group
ca lle d for rep lacin g the
federal incom e tax w ith
a national retail sales tax,
and dubbed it the "F air
Tax."
T h is m ay so u n d a p
pealing: no m ore ho rrib le tax
returns to fill out! B ut som e
basic m ath show s otherw ise.
To replace current taxes w ould
require a sales tax rate o f 30
percent.
M e a n w h ile ,
D e m o c ra ts
would also like to slip some form
o f sales tax through to pay for
th e b a llo o n in g d e f ic it a n d
health care initiativ es. G iven
that openly pushing such a tax
could m ean political suicide,
Democrats are sugarcoating the
idea by coupling it with propos
als such as instituting a higher
income tax on the w ealthy or
o ffering to subsid ize people
below the federal poverty level.
This is a slick effort to make a
regressive tax seem p ro g res
sive. D on't buy it. N o m atter
how they spin a sales tax, it still
hits the people who can least
No matter how they spin a
sales tax, it still hits the
people who can least afford it
the hardest.
on until the consum er pays $4
for a lo a f o f bread instead o f
$2! The VAT is w idely used in
E u ro p e and o th e r c o u n trie s
such as A ustralia, Japan, and
B razil — and tax rates range
as high as 25 percent.
E z e k ie l E m a n u e l, th e
b r o th e r o f th e p r e s id e n t's
chief-of-staff Rahm E m anuel,
w a s h ir e d by th e W h ite
H ouse B udget O ffice to help
overhaul the U .S. healthcare
system . A y ear ago last May,
h e p u b lis h e d
a book,
H ealthcare, G u aran teed that
proposed using a 10 percent
VAT to fu n d h e a lth c a re r e
form.
T h r o u g h th e y e a r s , th e
rig h tw in g has m ade sim ila r
p roposals in an effort to free
the rich from paying taxes on
th e ir p ro fits, d iv id en d s, and
inheritances. But with the U.S.
deficit soaring, D em ocrats are
d esp erate to raise revenues.
A nd w hat b etter way to do it
than by prop o sin g a re g re s
sive tax to fund a program that
w o rk in g p e o p le re a lly ca re
ab o u t, lik e p u b lic ly fu n d ed
healthcare.
F ro m th e r ig h t, a m a jo r
p u s h e r o f th e s a le s ta x is
Kennedy’s Most Passionate Purpose:
National
health care
proposals
by M arc H. M orial
afford it the hardest. Folks with
sm aller incom es see a m uch
larger proportion o f their pay-
checks hit by sales tax because
all o f it is spent every month
ju st to cover basics. M illion
aires m ay pay more sales taxes
on their expensive yachts, but
have money left over to invest,
all free o f sales tax.
Any v ersion o f a n ational
sales tax will worsen an already
regressive U.S. tax structure.
Over several decades. Republi
cans and D em ocrats have al
ready shifted most o f the cost
o f g o v ern m en t and serv ices
onto the w allets o f workers.
Rightwing groups utilize talk
show s and bogus stu d ies by
conservative think tanks to hide
th is re a lity an d p ro te c t the
wealthy from paying more taxes,
M eanwhile, Democrats are pig
gybacking their VAT proposal
onto healthcare reform.
But no m atter w hich party
is pushing the idea or how the
po litician d resses it up, this
one is a no-b rain er fo r w o rk
ing folks. A sales tax by any
nam e stinks.
Lois Danks is the organizer
o f Radical Women in Port An
geles, Wash.
M y in tro d u c tio n to
Sen. Edw ard Kennedy
cam e in 1979, when as a
21 year old Senate intern
I w itn essed his sp e ll
b in d in g p re s e n ta tio n
b efo re the S en ate F in an ce
C om m ittee in support o f one
o f his earliest proposals for
national health coverage.
I did not know it then, but
o v er the years, as I w atched
S en ato r K en n ed y 's tireless
a d v o c a c y f o r th o s e w h o
s c rip tu re c a lls , "th e le a st
am ong us," 1 cam e to under
sta n d w h y h e w as c a lle d
"the L io n o f the Senate."
D u rin g his 47 years in the
S enate, no one ro am ed far
ther, fought h ard er or w as a
m ore fearless ch am p io n for
th e r i g h t s o f e v e r y d a y
peo p le than Ted K ennedy.
From the bleak hills of A p
p a l a c h ia to th e s h a n ty
tow ns o f South A frica to the
b a c k s t r e e ts o f B o s to n ,
S e n a to r K en n e d y w ent
talk and m oral equivocation,
Senator Kennedy w as a straight
shooter w ho w as clear about
th e v alu es he and his p arty
should stand for. In his 1980
presidential concession speech
he said, "It is the glory and the
g reatn ess o f o u r trad itio n to
speak for those w ho have no
voice, to rem em ber those who
are forgotten, to respond to the
frustrations and fulfill the aspi
rations o f all Am ericans seek
ing a better life in a better land.
We dare not forsake that tradi
tion."
S enator K ennedy n ever for
so o k th a t tr a d itio n an d he
gave life to it in ev ery th in g
he did - from his fights to im
prove public ed u catio n to his
battles for a living w age to his
e n d o r s e m e n t o f B a ra c k
O b am a for P resident. H is life
is a v iv id ex am p le o f a m an
an d in the b est in terest o f the w ho stood tall and firm even
in the face o f the m ost v eh e
n atio n .
As a sk illed p o litician who m ent op p o sitio n .
I am h o peful that his m ost
au th o red m ore than 300 laws
an d su p p o rte d th o u sa n d s o f p assio n ate purpose - the p as
o th e r p ieces o f critical le g is sage o f n ational h ealth care -
lation, he show ed us the value b e c o m e s a liv in g , en d u rin g
o f rea so n o v e r rh e to ric and legacy to his rem ark ab le life.
Marc H. Morial is president
p rag m a tic co m p ro m ise o v er
and chief executive officer o f
p artisan p o stu rin g .
In an era o f political double- the National Urban League.
r ig h ts th e N a tio n a l U rb a n
L e a g u e f ig h ts f o r d a ily -
eq u ality , ed u c atio n , em p lo y
m ent, and h ea lth c are fo r all.
He tau g h t us that standing
on prin cip le, and not y ielding
to ev en the h arsh e st c ritic s,
is the true b aro m eter o f states
m a n sh ip an d le ad e rsh ip . He
d id n ot m in d criticism w hen
he k n e w th a t w h a t he w as
fig h tin g fo r w as rig h t, ju s t,
Senator Kennedy went
wherever there was a need to
support democracy's highest
ideals o f freedom and
opportunity fo r all.
im prove the lives o f those who
are too often lo ck ed o ut and
left behind, including workers,
w om en, people o f color, the
p o o r and d isp o ssessed , im m i
g ran ts, ch ild ren , and peo p le
w ith d isab ilities.
A s o n e o f th e la s t U .S .
S en ato rs w ho fo u g h t for the
C ivil R ights A ct o f 1964, he
sto o d for m any o f the sam e
Helping Primary Care Doctors
Reform must
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W
w h erev er there w as a need to
sup p o rt d em o cracy 's h ighest
id eals o f freed om an d o p p o r
tu n ity for all.
L ike his o ld e r
b r o th e r s J o h n
an d B o b b y , he
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in te rest and p e r
sonal gain, but as
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F a m ily
d o c to rs
work to keep adult and
children healthy and
aw ay from the em er
gency room, control
ling medical costs for
fam ilies and the gov
ernm ent alike. Yet, lost in cur
rently heated healthcare policy
discussion is the fact that there
Congress should contemplate
legislation that provides incen
tives for those who choose to
become primary care physicians.
Forgiving a portion of student
loans for those who do is a good
start. The average medical school
grad ow es hundreds o f thou
sands o f dollars in loans.
P ro v id in g
g o v e rn m e n t
funded salary increases is an
other option. Fam ily care phy
sicians typically eam less than
half that o f a highly specialized
doctor. Along the same lines,
tax breaks for family care doc
tors, increasing the money they
take home, could also be used
as an incentive.
If som ething isn’t done, the
family physicians academy pre
this field has dropped over 51 dicts a shortage of 40,(XX) pri
percent in the last tw o decades. mary care doctors by 2010. We
There are many reasons for this: will see longer lines in d octor's
the low er pay, longer days and offices and more people using
less prestige key am ong them. the em ergency room for basic
T h e c o u n try is sp e n d in g care, increasing medical costs
quite a bit o f tim e discussing for everyone and defeating the
health care and reform ing the purpose o f the healthcare plan
current system. If we are to truly the O bam a ad m in istratio n is
revam p the way health care is w orking to pass.
Judge Greg Mathis is vice
adm inistered in this country, we
must consider all o f the needs president o f Rainbow PUSH
o f the p a tie n ts...a n d that in and a board member o f the
c lu d e s p ro d u c in g q u a lifie d Southern Christian Leadership
Conference.
doctors w ho can serve them.
10 years, we will need
close to 140,(XX) fam
ily d o c to rs b u t are
currently only attract
ing h alf o f that num
ber.
A c c o rd in g to th e
A m erican A cadem y o f Family
Physicians, the number of medi
cal school graduates entering
We must consider all o f the
needs o f the patients...and that
includes producing qualified
doctors who can serve them.
is real a shortage o f family care,
or prim ary physicians, in this
country.
If this issue isn 't addressed,
the more than 40 million people
the O bam a adm inistration in
te n d s to ex ten d co v erag e to
through its healthcare plan are
unlikely to have a doctor avail
able to treat them.
There are about 1 (X).(X X ) fam
ily physicians, w hich include
primary care doctors and gen
eral pediatricians, in the U.S.
healthcare system. In the next