Koch's Comments: Medical care and tax evasion

How can it be that in the Western world only the United States is without legislation that provides universal medical care?

ed koch 88 (photo credit: )
ed koch 88
(photo credit: )
This year, Democratic presidential candidates will urge the adoption of legislation to provide universal health care, meaning care for the 47 million uninsured Americans as well as everyone else. The biggest debate will be whether to create a single payer system like Canada and Great Britain where the single payer is the government, or a system resembling the prescription drug insurance we now have, with consumers having a choice of private sector insurance companies vying for their business. This would provide an element of competition absent in the single payer system. The prescription drug approach has apparently worked better than many thought. It still has the glaring omission of failing to use the leverage of the government's purchasing power to get the lowest price for drugs. If the Secretary of Health and Human Services were given the power to negotiate the purchase of all of the drugs for the various drug plans, instead of leaving the individual insurance companies to negotiate with the drug companies on their own, it would save money. The Democrats now in the majority in Congress say that they will pass a law to give the power to negotiate prices to the Secretary of Health and Human Services, Michael O. Leavitt, who continues to say he doesn't need it. Another approach would be to exempt, for this purpose only, insurance companies from the anti-trust laws so that they could bundle their purchases, using the bulk purchasing power of the entire industry. At the moment, former US Senator John Edwards is in the lead among the candidates, proposing a vast expenditure by the government to cover the 47 million Americans now not covered. We are spending a fortune on providing medical care for those not covered by insurance. But the latter are not getting the kind of medical attention we would want for ourselves. We want a doctor with the same name and face in charge of our case and not have to rely on a hospital emergency room when we get sick. Emergency room care costs lots more than regular care at a doctor's office. In 2006, the US spent over $1.7 trillion on health, which is 16 percent of our Gross Domestic Product. After years of discussion, how can it be that in the Western world only the United States is without legislation that provides universal medical care, prepaid by insurance that must be purchased by employers, the self-employed and by those individuals not covered by Medicare and Medicaid. Knitting the disparate groups together to cover everyone is surely possible. A few of the 50 states have decided that they can no longer wait for the federal government to preempt the field, including Vermont, Massachusetts, and California. My candidate for president in 2008 is Hillary Rodham Clinton and her position on any single issue will not cause me to change my mind, but I am surprised that she is not in the lead on this issue, having been so out front when she was the first lady. Yes, she was burned politically at the time, but the issue has, I believe, become paramount for the next election. I do not believe that the war in Iraq, no matter what tack it takes between now and 2008, will be the only major issue that the voters will take into consideration in determining their vote. There are enough experts out there that Hillary could ask a panel to examine all of the international health plans proposed and in existence and come up with the best plan. Unless and until I am convinced otherwise, I support the concept of a single payer system -- the US government. * * * According to The New York Times, "the unpaid taxes, mostly on unreported earnings…the IRS estimated was about $300 billion a year." The Times states that the IRS estimates that of this amount the loss is "$169 billion on unreported business income, almost all of that from sole proprietors, like painters, plumbers, dry cleaners, florists, limousine drivers and restaurant owners." These businesses tend to be cash businesses. One doesn't have to be a rocket scientist to figure out that cash businesses are rife with criminal acts involving income tax evasion. I have no doubt that hiring the right minds to figure out how to find the crooks would produce an enormous recovery of revenue, providing efforts were made to send those detected as violators to prison. When I was Mayor of New York City, we had a plan to collect unpaid taxes and it worked to some extent. We used an amnesty program which allowed taxpayers to avoid prison time if they voluntarily came in and filed amended income tax returns paying interest, but no penalties. The Times reported, "Based on an analysis of audited tax returns from 2001, the IRS recently estimated that the government lost $290 billion that year as a result of underreporting and underpayment of taxes." New York has a history of intelligent people not filing annual income tax returns. If those owing money don't file, we are deprived of revenues that could otherwise be provided and used for vital services. * * * Question for all of those who want to pull our troops out of Iraq immediately. Do you think the terrorists will seek to follow us across the sea? If they do and God forbid we sustain civilian casualties comparable to those caused in Iraq by car bombs, will you publicly accept responsibility? * * * Previous entries: Celebrity protestors Voters need choice Prejudice in politics We must have allies in Iraq NY needs change George Bush is my hero