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Time Capsule: Let the Government Giveth to Healthcare by Takething it Away from Healthcare Profiteers

November 15, 2013 Time Capsule 1 Comment

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in December 2009.

Let the Government Giveth to Healthcare by Takething it Away from Healthcare Profiteers
By Mr. HIStalk


It’s increasingly clear that nobody wants to pay for healthcare, especially those who receive lots of healthcare services. The lobbyists of every patient or provider group have the same recommendation: let someone else foot the bill because we can’t afford it.

Everybody is convinced that everyone else is profiting obscenely from healthcare. When healthcare reform is being debated (which sounds more civil than the “debate” really is), it looks like that old Clint Eastwood spaghetti western, where Clint and Lee van Cleef and some other guy are listening to a musical pocket watch playing down, grimacing and jaw-flexing and finger-twitching, ready to blast each other into oblivion once the last note plays.

(I never really believed that scene, even if there really were musical stopwatches that played that loud in the 1870s. Given that at least one gunplay participant is always a black hat-wearing oaf of a bad guy, you know in real life that guy’s not waiting until the other gunslinger draws his hogleg – he’s going to start shooting up the place before Clint even lights up his stogie).

Anyway, I have invented a healthcare financing model that is fair to all, requires minimal administrative cost, and is transparent. Here it is:

Heavily tax the personal incomes of individuals who make big bucks from delivering healthcare products and services.

Corporate finance is too complex for me. Money-losing companies seem to thrive, even when showing a paper loss. And don’t even get me started trying to cogitate the difference between “making a profit” and “having a positive cash flow” because I just can’t grasp it.
I do know this, however: at some point, organizations have to pay out profits to living, breathing individuals who file that income on an IRS tax form. That’s where my plan kicks in: when that person makes excessive healthcare income, I want them taxed heavily.

(How do I define “excessive healthcare income”? Easy: it’s anyone who makes more than me.)

Uncle Sam then takes the proceeds and plows them back into covering healthcare costs. That neatly closes the loop so that those profiting heavily from healthcare have to help pay for it. I’m fuzzy on my MBA economics, but I think there’s some kind of economic multiplier effect in there, too, and God knows we could use that right about now.

Scumbag drug company shareholders, shady device manufacturer executives, glad-handing EMR vendor sales directors, wildly overpriced nurse staffing agency owners, million-dollar hospital VPs, and gazillion-dollar plastic surgeons from El Lay: it doesn’t matter. Uncle Sam knows how much of your income comes from healthcare-related salary, dividends, capital gains, and business income. Sorry pal, you’re getting socked with a 50% tax rate on that money.

You know that Joe Sixpack will love the idea of sticking it to million-dollar non-profit hospital executives or Ferrari-driving doctors. There aren’t enough of those caviar-eaters to outvote the masses no matter how much whining comes from AHA or AMA.

This confiscatory tax plan sends a message: it’s OK to make a nice living off the backs of sick people, but you don’t get to make more than a year than the average patient makes in a lifetime. Sorry, John Hammergren and Neal Patterson, we aren’t paying you to become multi-centimillionaires just because you sell supplies and equipment that sick people need.

Other countries use the Value Added Tax. It’s easy to collect, it’s consistent, and it’s hard for cheaters to avoid. Therefore, I advocate the Healthcare Unjustifiably Rich Tax. Don’t just tax the healthcare rich, HURT ‘em.

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