Tag Archives: Insurance

Health Care, Values, & Obligations: What Are Taxes Meant For?

dsc_0588“I like to pay taxes. With them, I buy civilization.” –Oliver Wendell Holmes Jr.

Hello friend,

Have you ever been in the middle of one of your most mundane daily activities—exercising, depositing money at the bank, adding two numbers, driving to the grocery store, tying your shoes, stuff like that—doing your thing the way you have always done it, when someone comes along and points out a totally different way to do it? Or maybe they even ask you why you are doing it in the first place? Suddenly you are forced to defend something you have never even thought about before. You have always just done it. It’s how you learned, and you never considered another way. Never even realized there was an option. But then there it is, right in front of you. It seems so obvious that you cannot believe that you didn’t notice it all this time. And here you are, your mind freshly blown, with a workout that suddenly has you losing weight, doing “new math,” banking online, having your groceries delivered, or using the “Circle Technique” on your laces. It seems crazy! Has that ever happened to you?

I think that is happening to me with health care. I suppose it has been happening for many years, but it feels sudden. My mind is spinning with a new possibility that was there all along.

Let me just say up front what I want and why. I want “free” health care for all people, and I want it because ensuring people’s health and well-being is at the core of the kind of common human decency that I believe we owe to the people we share space with.  

I could go on and on for pages about the Why part, but let’s get right to the meat of things. I look at health care like any other thing that our parents and grandparents believed was the job of the government–using our tax dollars–to provide for our care and convenience. Without any of us even thinking about it, of course our tax dollars pay for a police force, the fire department, streets and highways, a sewer system, drinking water, a strong military, elementary and high school education, and environmental protection.

Seriously, have you questioned lately why we all pay taxes on those things? Have you ever questioned it? I haven’t. And when I do question them now, my answer is, “Of course I am willing to pay taxes to fund those services. They exist to provide my most basic needs and things that I value: protection from hostile forces, safe travel, order in my neighborhood, health, safe food and drink, education.” I can’t imagine ever opposing chipping in for those basics for all people. They are what I would deem essential, and no more for me than anyone else. I won’t say it is technically everyone’s “right” to have these basics, but it reflects our basic human decency that we see them as essential for all. Therefore, it is our obligation to provide them.

If you are with me so far, I think now is a good time to sneak in my basic question: How is health care NOT on that list of essentials? Honestly, I am trying to see how it differs and am struggling for answers. The only thing I can come up with is that, “It’s just how it’s always been in America.” (And, I must add, only in America.)

I suppose we all have the same blind spot I had until recently! I don’t think I am the only one who, if pressed for an answer, sees caring for the health of all as at least as important as providing fire protection for all or education for all. I don’t want to get into splitting hairs here since I have already deemed them all essential, but if forced, I don’t think it would be farfetched to suggest that, of those three just mentioned—health, fire protection, and education—health care just might be most important. In any case, I have yet to hear an argument that kicks it off the list.

But perhaps you want to quibble. Maybe you think the health and well-being of your neighbors should not be your concern, and anyway, you aren’t interested in paying more in taxes to help them out. They aren’t that valuable. So let’s look at some of the other stuff you regularly pay taxes for. As we do, try to build a sort of ranking system for how important—indeed, how essential–you believe these are relative to your own health and that of others you know. Here are just a few:

  • City parks
  • Space exploration
  • Street sweeping
  • Recreational programming
  • Subsidies for agriculture and big oil companies
  • The Arts
  • Lifetime salaries for Senators and Congressmen
  • National Parks
  • Science research
  • Zoos
  • Corporate Bailouts (e.g. the auto industry or Wall Street)
  • Libraries
  • Snow removal

We could go on and on, of course, as our taxes go to so many different and important things. How is your ranking system going so far? I won’t bore you with how I rank them. I will only say that I don’t value any of them—value them for me or for others (and believe me, I really love libraries!)—more than I do health care.

I really want to make clear here that, before all of the defenses go up and we have to start battling each other about how we could pay for it, I am just trying to establish an agreement on what we VALUE. It is a separate issue. My point is that if we all agreed with me (this happens in my dreams, and it’s fabulous!) in thinking health care was at least as important (even essential) as things like education, clean water, and the police, then, logically speaking, we would be forced to agree that we ought to be willing to ensure equal access to health care for everyone by taking care of it with our tax dollars. By extension—and this is the painful realization part—if we have agreed on what we value and yet still fail to act to make it right, we are failing a moral obligation.   The blood of the uncared for is—literally and figuratively—on our hands. I am not okay with that.

I know, I know, you probably wanted to skim through that last paragraph really fast and get to the part where you defend your side by saying it is too expensive and our system is broken and it’s not your fault and such. I feel you. I really do. That’s why I think it is important to first separate the argument so that we are not conflating what we value (morally speaking) and what we are eager to pay for (financially speaking).

And believe me, I make no claim that I am any kind of an expert on how much everything costs and how much more or less we would pay if we blew up our system entirely and went to a single-payer system (a.k.a. socialized medicine, universal health care, or government-run health care). As a total amateur on these topics, my sense is that we already pay a ton for insurance premiums, co-pays, and deductibles, and it also seems like pharmaceutical companies charge through the roof and own so many of our representatives in Washington, DC. My guess is that if the insurance industry was dismantled and the pharmaceutical prices were government-controlled, so much of that money that we now spend could go to getting everyone equal access to quality care. I am sure there is a down side of it, too, because at this point, who really trusts the government to run anything, right?

But we are Americans. We take pride in the idea that we are exceptional. It is supposed to be our thing to figure out the best way to do stuff, and then to keep leading the way with our exceptionalism. If we look at the examples of all the hundreds of other countries in the world who provide health care to their people, and if we see problems in their systems, I feel confident that we could figure out the solutions and move forward with a system that affirms in action what we claim to value (Because Love does, right? It doesn’t just say.). I feel like the “changing our system will be too hard” excuse is weak and lazy, especially if the result is immoral. I think we are better than that. I hope we are. I feel like it is time to put our money where our values are.

How about you? Is health care something you value enough to put your tax money down to guarantee it for everyone? Open up your journal and try to keep an open mind as you parse through this sticky issue. I think this is an especially tough one to tackle with an open heart and mind because, for many of us, it is just something we haven’t ever considered. Our system has been this way our whole lives, and a suggestion to change something long-held usually meets with defense as a first reaction (because of course we are right). So, take a breath, and start with logic. First, is your health valuable to you? How valuable? As important as your safety? Your education? Your water? Your public parks? The arts? Which of the things that you pay taxes for do you think are moral obligations of a society to provide for its people? Which are things that are great and you value, but they aren’t obligations or essential? Which things that you are taxed on do you feel are a rip-off? For the sake of argument, let’s say we had always been taxed for universal health coverage: where would it fit with your last three answers: Moral Obligation, Important-But-Not-Essential, or a Waste/Rip-off? Based on your answer, should single-payer/universal health coverage be a part of the American system going forward? Okay, if you were able to answer most of those logically, relax! Now, feel those natural defenses that probably came up when this issue arose. What makes you most squeamish about agreeing to include universal health care to your list of givens? Is it the money itself (that you think it is going to be much more expensive for you)? Is it that you don’t want to put anything else into the government’s hands? Is it that you don’t think some people deserve it or that too many people who aren’t taxed much because they are poor will take advantage of your hard-earned dollars by using the health care system as much as you do? Do you agree with my assertion that if we agree that health is of such importance to us that we deem medical care to be essential—like we agree on education and safety and the like—then we are morally obligated to provide it? If not, where is the flaw in my thinking? If my thinking is sound, then we are either failing morally on this topic or you disagree that health is of such importance. Which is it? Leave me a reply and let me know: Which things are worthy of your tax dollars, and how does health care fit into your priorities?  

See yourself in your neighbor,


P.S. If this made you really look at health care and taxes for the first time, or if it made you think of them in a new light that helped you clarify your position, I hope that you will share it with others. We owe it to ourselves to examine our values. May you be Peace.

How Much Is ENOUGH? Money & Our Fear of Losing It

DSC_0043“He who is not satisfied with a little, is satisfied with nothing.” –Epicurus

Hello friend,

I recently had the most eye-opening conversation with a loved one. Have you ever known someone for a long time, are sure you understand them thoroughly, and then one day they tell you something that makes you go, “Really??? You really think that?” Maybe you always kind of knew something like that was in them and just steered away from it in conversation, or maybe it totally just came out of left field. In either case, the new information forces you to look at them through an entirely new lens. The color and texture of their portrait in your mind has changed. It is amazing what a simple revelation can do!

So, here’s how it happened. We were talking about taxes and what types of things they should cover. A recurring theme from her side was that she shouldn’t have to pay for anyone else’s problems; it is her hard-earned money and no one else is entitled to it (“entitlements” was a word frequently repeated). I raised the issue of health care and the different ways it is paid for around the world. I proposed the possibility of blowing up our current system, removing the insurance part of the deal, letting the government take over (scary thought, I know), and guaranteeing “free” health care for everyone in the country. This, of course, would mean using our taxes—most likely a large increase in them—to pay for it. [WRITER’S NOTE: This topic of taxes and health care is rich journaling territory, as it speaks directly to our values. And now that it is in my head, don’t be surprised if the whole letter next week is about it. See how easy it is to come up with a topic—ha!]

The less interesting part of her reply to my proposal was the typical response of a conservative person to a liberal idea, essentially, “It’s an admirable idea. You figure out a way to make it work and, more importantly, a way to pay for it without taking any more of my money, and I am in.” As I pressed her more on why, if the spiritual leaders that most of the world’s people claim to worship urged us to do so, we are not ALL morally obligated to find a way to get everyone taken care of, I could feel her defenses rising higher and higher. The tension was palpable.

Finally, she said in a panic, “If China calls back the debts we owe, we would ALL be in huge trouble and NONE OF US would have the health coverage that you are talking about!” This was a totally new angle to me, and I have to admit to being a bit stunned by it. “None of us?” I asked. “NONE!” She said it as a fact. There was genuine alarm in her tone. I explained how the wealthy people have, since our country’s inception, always had enough. They have never been without plenty of food and the best health care. “No matter what happens,” I said,“the wealthy will be alright.” I could actually hear comfort and reassurance in my tone. Her fearful, doubt-filled voice responded meekly, “Do you think so?”

Now might be a good place to give you a little background on the socioeconomic history of my companion. She is a White woman who was raised in a comfortable, middle class home in a comfortable, middle class town. Her parents were never out of work, and they paid for her college education. She married an upwardly mobile White man, and they slowly and steadily increased their wealth—paying for their own children’s educations as well–to the point that now, in retirement, they own multiple homes across the country and have clearly moved beyond the middle class. To any neutral onlooker, it is clear that she will never want for anything financially for the rest of her life. And, much to her credit, she continues to share generously with her family.

So, why the pronounced fear of losing her money to the whims of Chinese financiers and her fierce protection of her tax dollars from the folks she believes are stealing from her by using “entitlements”? Hmmm…..

Talking with her left my mind spinning with theories and questions about this strange relationship between a woman and her money. While it may seem strange to me, I also realize it is probably not at all unique. This mentality of scarcity, of lack—as though, “If I share my money with others, I will never see it again and it won’t be replaced by other money,”—could be a familial thing. It could certainly be a generational thing. After all, this woman’s parents grew up during the Great Depression, and the lessons learned of necessity by that generation would undoubtedly have been passed down to her.

There is likely also something political about it. After all, isn’t that wariness and protection of one’s resources rooted in the very word “conservative”? I also think there is this “You pull yourself up by your own bootstraps” mentality that exists especially in people who already have money, and you can argue over whether that mentality is how they were able to get the money in the first place, or if the mentality is simply a way to justify a stinginess when it comes to sharing their money with others, whether through taxes or charitable donations.

I still can’t figure out the thing about limits, though. That is, Is there a dollar value high enough in her bank account such that she would finally feel like she would be great even if the country had a recession, or high enough that she wouldn’t mind if her tax dollars went to help others who haven’t been as lucky as she has? Or is it simply hard-wired that no matter how much she has, she will always have that scarcity mentality? And, paradoxically, could her swelling bank account make her even more protective of her dollars? After all, you always hear of those studies that say it is poor people who are most likely to share what they have with others, not the wealthy. Is it because poor people know how hard it is to have so little that makes them more likely to give to someone else who needs a hand? This is complicated!

Even as I try to come up with a clear explanation of my own relationship with money and how much is enough for me, I find inconsistencies that muddle the theory. One of my grandfathers was known as a real penny-pincher, and I can definitely tell that I inherited that, either genetically or socially passed. I do not like to spend money, especially on myself (even though I secretly delight in gifts of new stuff). While I have definitely given to causes, I also feel that dread of “Can I afford to give? Will there be enough left?” scarcity mentality when the doorbell rings or the donation basket comes around. I give, but not tons, and I usually do so with both a little twinge of worry and a heavy dose of guilt, knowing I could give more. In so many ways, I feel like a cheapskate. And yet, I am the first in line to vote for a levee or referendum that increases my taxes to put money into schools. And when my friend challenges me to come up with the answers to make quality health care accessible to everyone, I tell her that I don’t mind one bit if my taxes go way up to do it. I suppose I am like, “Take it all off the top—from my wages for taxes—and then let me figure out how to make it work with the rest.” Of course, I would like to have more than I do now—much more, even—but I am surviving in the middle right now. There is not much money for things like vacations or other extravagances, but there is plenty of food in the fridge.

I guess what I have always wanted is to have just enough so that I don’t have to think about it. You know, just up to the point where my penny-pinching tendencies wouldn’t have to kick in. I would like to be able to donate more than I do now and still have the food in the fridge. And while vacations and extravagances would be nice, I would be okay if I was always had as much as I do now.

So, maybe enough for me would actually be if I made more than I do now so that my taxes and donations could go up and I would be left with just as much for the bills as I have now.   That is being greedy, I know, because of course I could survive on less (billions of people around the world prove that). But, within the conditions of my spoiled American life and what I have become accustomed to, I will claim that as my baseline. I know my ambitious mind would drive for more if more were readily available, but I am okay with what I have. It allows for my dueling natural tendencies to co-exist: the penny-pincher and the guy who is eager to give in order to help others rise. That is enough for me.

How about you? How much money do you need to feel psychologically comfortable? The outward signs of comfort may be what you are imagining, but remember that we are really talking about a level of comfort in your mind with what you have, living without fear and without all your defenses up around the issue of your money. Where is that level for you? How would you categorize your current financial situation? Do you have as much as you need? I hope the answer to that is yes. Now, do you have as much as you want? Of course, we all probably want to be billionaires, but within reason, how much more do you want in order to feel the kind of comfort you usually imagine? Is your general mentality one of lack or abundance? How generous are you with your money? Do you feel that twinge of worry, like me, every time you open up your pocketbook? Is it a justified worry based on your situation, or are you actually like my friend who has plenty but worries anyway? How do you give? Are you someone who donates to causes that matter to you? Do you focus your generosity on family members? Do you begrudge the government for taking your money for taxes? Would you be fine with your taxes being higher? Do you live within your means, or do you outspend your resources? How does that play into your view on how much is enough? If you are a big spender, do you think there is any amount that you would agree is enough for you? How much fear do you have of losing your money and the status that comes with it? How extreme of a situation would it take for you to truly no longer have enough? How likely is that to occur? Does your fear of that loss match up to its probability? If you gave more—in whatever way—would you fear more? Why do we protect so fiercely? Are the wealthy generally the most protective of their money? If so, why? Is there some amount that you could name that, for almost anyone, ought to be enough? How about for you? Leave me a reply and let me know: How much is enough for you? 

May you be wealthy in Love and Peace,


P.S. If today’s letter helped you to look differently at your relationship with money and how protective you are of it, please pass it on. Share the gift of self-knowledge!