But I emphasize, the health care delivery system is incredibly complicated, and making it both more effective and efficient will require the commitment of the professionals who work within it.
A grand bargain will include myriad other deals. We should scour the tax code, allowable deductions and subsidies for both potential savings and higher revenues. I’d eliminate most subsidies to the lumber, mining, agricultural, cattle and fossil fuel industries. I’d offer more subsidies to foster the development of green industry and energy. I’d end a range of deductions — especially by utilizing means-testing.
I’d raise taxes on gasoline, soda, tobacco products and carbon emissions, and I’d make major investments in early childhood education, job training, prison anti-recidivism programs (cheaper than jail time), infrastructure (of all types) improvements and mass transit. I’d institute a privately funded infrastructure bank and a financial-transactions fee (coordinated with Europe’s). Short-term, I’d spend money to make jobs — public and private. Getting people working, making money, paying taxes, off assistance and participating productively in the economy is the single most effective thing that we can do.
There are infinite combinations of taxing, spending and cutting to create a grand bargain. The important thing is to construct one with compromise and fairness.
Brian T. Watson is a Salem News columnist. Contact him at firstname.lastname@example.org.