Here's why: If you're relatively healthy and relatively young and you have a health insurance plan with a $5,000 or $6,000 deductible, then in all reality you really don't have health insurance. Without a major accident or sudden health problem, most people don't rack up $6,000 in medical bills in a year all on their own. Worse than that, having to pay the first six grand of your annual medical bills 100 percent out of pocket is understandably going to make people "covered" by those plans very hesitant to go to the doctor until they get really worried or a lot sicker. In other words, they'll be showing up in the emergency rooms instead, where that $6,000 deductible will be eaten up pretty quickly.
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This scenario is exactly how this tax season will produce the first profound effect to the health care system. Health-insurance companies will enjoy a bonanza of people signing up for high deductible plans that, at least at first, will bring them thousands — maybe millions — of customers who will pay their premiums and still avoid doctors and real health care like the plague.
In the short run, this will boost health-insurance earnings but in the longer run, the system will be more heavily taxed by all those ER visits.
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But let's talk politics now, because unfair and painful taxes have had a way of causing very strong political reactions in this country ever since the Boston Tea Party. You'd have to be a lot denser than Nancy Pelosi and Joe Biden put together not to see the huge political opportunity that's just been handed to the Republicans now that millions of American consumers and small business owners have just been forced to deal with a very new and very painful tax all at the same time.
It's one thing to attack all taxes all the time. It's another thing to rail on about a tax like the AMT that only affects richer people in Middle America and upper middle class folks on the coasts. But it's a much, much, much more effective thing to attack a new tax that hits mostly younger voters who in the past have sided more with the opposing party. It's a much, much, much more effective thing to stake your campaign or your party's message on a promise to repeal or neutralize that tax. And it's a much, much, much more effective thing to point out that your opponents and your opponents' party takes 100 percent full responsibility for making that tax exist in the first place.