By Jane M. Orient, M.D.,
It may be unpopular to say so, but it is true: the U.S. is very close to, if not past, the tipping point at which the majority of the people are net beneficiaries of big government—or so they think. People who receive a check from the government may see voting for a smaller government as contrary to their best interest. If they don’t pay taxes, why should they care about a tax increase?
Perceptions are, however, deceiving.“Healthcare reform,” as the (Un)Affordable Care Act (ObamaCare) is billed, probably shows more clearly than anything else how most Americans, including Romney’s notorious 47%, are harmed by government “benefits.”
Lower wage earners, who produce real goods or provide a service their fellow Americans value, pay for those benefits even if they’re not liable for federal income tax. Fifteen percent is taken right off the top of their earnings for the Social Security/Medicare tax. This is 100% a tax, and 0% an investment. It is 100% spent, immediately, on other people’s entitlements, with a politician’s promise that the workers may get an entitlement someday, paid for by future workers—if they and the program survive long enough.
All Americans, including the working poor, will, as early as 2013, be hit with the medical device tax and the rest of some 18 ObamaCare-related tax hikes amounting to perhaps $500 billion. Starting in 2014 is the ObamaTax proper, the individual and employer mandate. Most Americans will have a choice of one tax (a “penalty”) or else a much higher tax equivalent (a “premium”) for an ObamaCare compliant health plan. Even if the employer continues to offer insurance, the employee has to earn all the money that the employer uses to pay for it. The premium has to cover all the ObamaCare mandates that the worker may not need or want, or to which he objects.
All Americans also have to pay the hidden regulatory taxes. ObamaCare will have tens of thousands of pages of rules. Compliance will be so costly that most independent physicians may close their doors.
Beyond tax increases, expensive employer mandates, or simple uncertainty about what the rules will be, will cost untold numbers of jobs. As more people are forced onto Medicaid, access to care will worsen. Obama’s “accountable care organizations” will incentivize “providers” to cut services to Medicare beneficiaries. So even the current beneficiaries of entitlement programs, a big chunk of the 47%, will be harmed by ObamaCare.
So who are the true beneficiaries of big government, who should most dread the budget hawks and vote to maintain the current regime? They are members of the affluent, privileged class, many of whom live inside the Beltway. They make more than $100,000 per year, and of course they pay income taxes. Or so it seems.
Actually, the money that goes back to the Treasury from their paychecks came from the Treasury in the first place—that is, from the earnings of those who toil in the private sector. If taxes go up, those whose money comes from government, whether directly or indirectly, might or might not have fewer dollars to take home, but while they may gain less from taxpayers, they still lose nothing of their own creation.
Republicans need to explain why they will repeal ObamaCare. Besides lower taxes for almost everyone, even those who don’t pay federal income taxes, more people would be able to keep their current insurance, their doctor—and their job.
Some people are government dependents because of misfortunes beyond their control. But to have 47% of the population in such a situation is a disaster for everyone except for the 0.0001% super-elite who aim for absolute control.
We need politicians who can help people gain the ability and desire to work, rather than cling to an overburdened government wagon pulled by declining numbers of the “rich.” Healthcare reform is an ideal opportunity to educate people about the dangers of that wagon.
Once they understand the situation, most Americans, not just 53%, should be on the side of limited government.
Jane M. Orient, M.D., Executive Director of Association of American Physicians and Surgeons, has been in solo practice of general internal medicine since 1981 and is a clinical lecturer in medicine at the University Of Arizona College Of Medicine. She received her undergraduate degrees in chemistry and mathematics from the University of Arizona, and her M.D. from Columbia University College of Physicians and Surgeons. She is the author of Sapira’s Art and Science of Bedside Diagnosis; the fourth edition has just been published by Lippincott, Williams & Wilkins. She also authored YOUR Doctor Is Not In: Healthy Skepticism about National Health Care, published by Crown. She is the executive director of the Association of American Physicians and Surgeons, a voice for patients’ and physicians’ independence since 1943.
