Health Care, Here We Come

Unless you've been living in a cave, or some other sort of news-free environment, you should be well aware that the health care bill has the sixty votes needed to begin the process of plowing it's way through the Senate. As the Times notes today, there are still a number of significant hurdles in merging the Senate version with the House version. For the uninitiated or uninformed that means this: Though a health reform bill has passed in the House and is on it's way to passing in the Senate, those bills are different and do not become law until the same version can be approved by both the House and the Senate, at which time it can be submitted to the President.

Megan McArdle has a nice piece covering the many issues of process involved in passing health care reform and the concerning language in the bill which would attempt to make certain provisions unrepealable by future Congresses. Many of the complaints about the passage of this bill, from both right and left, has been the downright icky and open way in which key votes were obtained. It was announced late Sunday that conservative Democratic Senator Ben Nelson of Nebraska would support the bill in exchange for Medicare concessions for his home state of Nebraska, meaning that federal tax dollars would help Nebraska pay for a share of Medicare expenses that other states have to shoulder themselves. Some folks have complained that this amounts to outright bribery at the public expense, and they're right, to an extent, but Megan quite correctly points out that this is how politics worked and how it's worked for hundreds of years.

But putting aside the existence of bribes/pork as part of the making of political sausage, there's an interesting side issue here that's all about how we structure government and utilize tax revenues. Nebraska's Medicare concessions are symptomatic of a complaint I've had for a long time, where tax money is siphoned from jurisdiction to jurisdiction. Left or right, it's an inefficient use of tax money, plain and simple. We pay taxes to the federal government, but the federal government winds up sending some percentage of that money to individual states- states which we also pay taxes too. At the state level, a certain percentage of revenues from taxes and federal funds are then redistributed to cities, municipalities, and counties. If there's a logic behind this sort of trickle down taxation I'd love to hear it, but the end result is a redistribution of wealth to jurisdictions where the complex web of money distances individuals from the political process. And I'd raise the same questions about this sort of redistribution as I would about redistribution on the non-governmental level. Why for instance, in Connecticut to the citizens of wealthy towns pay high federal and state income taxes, only to have money siphoned back to their towns in the form of property tax relief?

I know this is a bit of a tangent, but it's yet another patently inefficient and structurally deficient problem with our current system that's been laid bear by the current debate. And to relate this post to my last, there's a question I'd pose to everyone, but primarily to liberals and supporters of "big government." Why don't we simplify things? Why does health care legislation need to be thousands of pages long and why do we siphon money through multiple layers of government? Giving money directly to the people that need it would be a far more effective way of dealing with a problem like the uninsured than the incomprehensible legislation before us. So why not? Why not the simple solution?