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Bruce Bartlett: A Conservative Case for the Welfare State
http://economix.blogs.nytimes.com/2012/12/25/a-conservative-case-for-the-welfare-state/#more-158917
Republicans are now using the fiscal impasse to try to raise the age for Medicare and reduce Social Security benefits by changing the index used to adjust them for inflation. They know that such programs will be easier to abolish in the future if the number of people who qualify can be reduced and benefits are cut so that privatization becomes more attractive.
This is foolish and reactionary. Moreover, there are sound reasons why a conservative would support a welfare state.
<snip>
In a new paper for the New America Foundation, Professor Lindert summarizes his findings. He points out that there are huge efficiencies in providing pensions and health care publicly rather than privately. A main reason is that in a properly run welfare state, benefits are nearly universal, which eliminates vast amounts of administrative overhead necessary to decide who is entitled to benefits and who isn't, as is the case in America, and eliminates the disincentives to work resulting from benefit phase-outs.
<snip>
Thus, for no more than the United States already spends through government, we could have a national health-insurance system equal to that in Britain. The 7.6 percent of G.D.P. difference between American and British total health spending is about equal to the revenue raised by the Social Security tax. So, in effect, having a single-payer health system like Britain's could theoretically give Americans 7.6 percent of G.D.P. to spend on something else--equivalent to abolishing the payroll tax.
This is a powerful conservative argument for national health insurance.
Republicans are now using the fiscal impasse to try to raise the age for Medicare and reduce Social Security benefits by changing the index used to adjust them for inflation. They know that such programs will be easier to abolish in the future if the number of people who qualify can be reduced and benefits are cut so that privatization becomes more attractive.
This is foolish and reactionary. Moreover, there are sound reasons why a conservative would support a welfare state.
<snip>
In a new paper for the New America Foundation, Professor Lindert summarizes his findings. He points out that there are huge efficiencies in providing pensions and health care publicly rather than privately. A main reason is that in a properly run welfare state, benefits are nearly universal, which eliminates vast amounts of administrative overhead necessary to decide who is entitled to benefits and who isn't, as is the case in America, and eliminates the disincentives to work resulting from benefit phase-outs.
<snip>
Thus, for no more than the United States already spends through government, we could have a national health-insurance system equal to that in Britain. The 7.6 percent of G.D.P. difference between American and British total health spending is about equal to the revenue raised by the Social Security tax. So, in effect, having a single-payer health system like Britain's could theoretically give Americans 7.6 percent of G.D.P. to spend on something else--equivalent to abolishing the payroll tax.
This is a powerful conservative argument for national health insurance.
Comment by Don McCanne of PNHP: Thank you, Bruce Bartlett, for perhaps the greatest Christmas gift of all - a rationale for why we all have to join together to provide health care for everyone.
(The 2003 NEJM article cited is that of PNHP co-founders Steffie Woolhandler and David Himmelstein, plus Terry Campbell of the Canadian Institute for Health Information.)
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