Never Allow Zombies to Be Transplant Surgeons (totally stolen from Sierra Madre News)
As I was spending my free time flipping through the latest in zombie literature on PubMed, as I’m often wont to do, I came across this troubling article headline from a 2008 issue of the journal Health Affairs:
The Politics of Paying for Health Reform: ZOMBIES, Payroll Taxes, and the Holy Grail
My first thought, naturally, was holy crap! An argument for taking my tax dollars and financing health care coverage for zombies may be intellectually stimulating discussion, but not something I can in good conscience throw my weight behind. I was shocked to think that, given all the outrage about the remote possibility of illegal immigrants gaining access to our cherished health care coverage, there was nary a peep about these flesh-eating ghouls roaming our hospitals and taking up all our precious H1N1 vaccines and doping up on all our anesthetics (they like the ether, or so I’m told).
But because I try to read a little bit more beyond the headline of an article, I guess I came out with a slightly better understanding of what it was about health care reform that zombies factored into.
Mainly there was a lot of non-zombie-related tripe, starting with the political context of the challenges that health care reform chases, such as a blindly accepted ideal that raising taxes is akin to feasting on the flesh of your relatives, and that somehow we find safety barricading ourselves in the financial shelters of employer- and employee-provided health insurance premiums, payroll taxes, federal/state revenues, and those delectable “sin” taxes, not to mention the out of pocket payment that so many U.S. citizens (and non-citizens) fork over. Within that context, and considering the public’s general desire to eschew change like a zombie cowers from fire, the incomprehensibly large 1.2 trillion dollar price tag is a tough pill to swallow for most. The main arguments this paper reviews are about the economic feasibility, not the moral undergirding, of health care reform and the authors offer up several non-mutually-exclusive options.
On the side of the conservatives, they have mainly advocated for the so-called “golden grail”: the elimination of the tax exclusion for employer-sponsored insurance, instead favoring a far more modest tax “rebate” that would allow the federal government more funds (to the tune of $200 billion per year) to spend on covering the uninsured (or, more likely, financing arms stockpiling against the impending ravenous hordes). Problem is, they’d be taxing the health insurance benefits and only offering modest compensation, so that doesn’t end up being particularly popular. Furthermore, this policy in and of itself does not guarantee that health insurance is any more accessible or affordable, thereby having only questionable relevance to health care coverage beyond generating oodles of money for the federal government to spend however they please.
The so-called “foreigner” plan, or value-added tax, is on the more progressive side of the health care debate, most closely approximating a true socialist plan. In these cases, the VATs would draw their funding from a broadly applied taxation system that would divorce the health care provisions from the bill by linking it to taxation unassociated with health care. While this makes it a little more palatable in some ways, it is hard to get people to agree to willingly tax themselves for a public good. Furthermore, this taxation would have to supply funding for an expense industry that makes upwards of 16% of our GDP. Again, hard but for the most liberal of the hippies to swallow.
There is also the “All-American” way of financing health care reform from general revenues by, say, halting multi-billion dollar war machines in Iraq and Afghanistan and diverting funding to, say, health care policy. Another way would be to roll back the tax cuts for the wealthy implemented early in Bush’s tenure, which could help generated much needed funds from a source traditionally associated with stupid amounts of cash. Making Medicare and Medicaid more efficient would also generate funds, but is this financially tenable or politically palatble?
Which finally brings us to the true crux of my exposition on this topic: the Zombie plan. I save this for last even though it’s probably the worst of the plans. Which makes sense, because anything associated with zombies is generally not good for anybody’s health.
Right away, the paper lambasts the employer mandate as being inequitable, leaving many uninsured, promoting “job lock,” unaccommodating to part-time, self-employed, and “new economy” labor forces, and putting companies front-and-center into making some of the most personal decisions any of us will ever have to face. Furthermore, businesses routinely respond less than favorably to any government interference into their financial practices, making it unlikely that they will adopt mandatory minimums of coverage without a fight. Furthermore, demanding that they shoulder the burden during tough economic times virtually guarantees that some businesses will go under while others will never start to begin with. The reason this is called the “Zombie” plan is because it’s a viciously evil beast that should just die but keeps being resurrected.
However, efforts are being made to blow the head off and ride the corpse down the snowy mountain into the valley of promise, the most recent iteration being the so-called “public option.” While its critics say that it smacks of backdoor, government-sponsored commie-care, advocates instead herald the pay-or-play option by instituting a payroll tax on participating businesses that want to buy their way into a government-assisted health plan or opt to pay for it on their own. Kind of like having a zombie that does chores for you (a la Fido). Proponents say that if it works for Medicare and Medicaid, why couldn’t it work for everybody?
So, from the looks of it, we’re stuck with a zombie health care financing system and it looks like the most politically tenable option, even in spite of the hemming and hawing of the conservative naysayers. And even the health care reform proposed today is just a variation of the zombie theme, just gussied up to look like it might not eventually chew a hole into our faces.
But, in all honesty, don’t the zombies always win? Why shouldn’t they take control of our health care coverage, too?
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