Taxes and Tyranny

One of the very first bits of political writing I ever read on the World Wide Web was this 1996 column from a British libertarian named Jan Clifford Lester. Professor Lester argues that only taxpayers should be allowed to vote. After discussing the slogan “Taxation Without Representation is Tyranny,” he goes on:

This then prompted me to consider the converse proposition: Representation Without Taxation Is Tyranny. It would, of course, be a fallacy to think that this is entailed by the first proposition. But surely it is just as reasonable. It was accepted by most people as a fair limit on the franchise in the mid-nineteenth century. Why should people who are not taxpayers be allowed to vote money away from those who are? If we must have state services, it should at least be for those who pay for them to vote for which services they want and how much they wish to pay. To allow those providing, or living off, the services to vote is like allowing a shopkeeper to vote on what you must buy from him, or a beggar to vote on what you must give him. Naturally, I hear you say, but doesn’t everyone pay tax, at least on goods and services? And so is it not trivially true, insofar as morals can be ‘true’? No, they do not and it is not. Not by a very long chalk.

Professor Lester then differentiates state employees, who are paid out of taxes, from others who are not:

To take a clear case, when a direct state employee, such as a civil servant, receives his salary cheque there will be an apparent deduction for the amount of tax that he pays. As a matter of fact this is a mere book-keeping exercise designed to keep up the pretence that he is a taxpayer along with everyone else. Abandoning this pretence of taxpaying and simply paying him less in the first place would save taxpayers’ money in administration and make the political reality clearer to all.

If a “direct state employee” is merely “a clear case,” what other cases are there?:

So who does not pay taxes and so ought not to have an electoral vote? Judges, state-school teachers, all in local government, state policemen, all in the armed forces, all in prison, all in the NHS, all in the civil service, all employees of the BBC, all the unemployed, all in academia (except, perhaps, in the University of Buckingham), some farmers, some solicitors, maybe some barristers, any employed in businesses that receive tax-subsidies in excess of their tax-payments, and MPs with insufficient taxed market-incomes to cover their salaries. I cannot list them all, but you see the size of the problem. You can also see that there is no class conflict in any quasi-Marxian sense here.

Who, then, does pay taxes? Well — anyone who is left. If you are in any doubt as to which category that you are in then the simple test is to ask yourself whether, in your current position, you would have more purchasing power or less purchasing power if taxation were completely abolished.

That is rather a sweeping list- denying the franchise to “any employed in businesses that receive tax-subsidies in excess of their tax-payments,” for example, would mean that a great many people would have to wait for the results of quite a thoroughgoing audit of their employers before they would know whether they would have a place at the ballot box. And if we take Professor Lester’s “simple test” at face value, no one would be qualified to vote. If “taxation were completely abolished,” taking with it all enforcement of laws, one might expect new obstacles to be put in the path of wealth creation.

Professor Lester reaches his conclusion:

There are some who are on the periphery of net tax-receiving and whom it will not be possible to distinguish with certainty. These people receive most of their income from purchases by state institutions or state employees. The latter is especially hard to be sure of. For instance, those working for The Guardian and New Statesman &Society might just fit this category. But if it is too hard to prove then they might have to be given the benefit of the doubt. Though if the state sector shrinks, due to a new Taxpayer Democracy, then enterprises will decline to the extent that they necessarily depend on indirect state patronage. In the case of the latter two publications I would expect such journals as The Times and The Spectator to expand to replace them.

In view of the percentage of economic activity in modern societies that “purchases by state institutions and state employees” represent, one rather doubts that even The Spectator would pass this test.

And why stop there? If the employees of The New Statesman are disfranchised because most of their subscribers are net tax recipients, why should employees of the bar across the street from the offices of The New Statesman retain the right to vote? And if those workers are classified as net tax recipients because most of their income is derived from purchases made by net tax recipients, shouldn’t any purchases they make, and any purchase the bar makes, also be classified as a transfer of tax monies? Follow those knock-ons far enough, and again we come to a scenario in which voting is abolished altogether.

Moreover, while there are various schools of thought which propose that in a well-ordered society the laws defining those relationships among people which we call “property” could be written in a way that would reflect some moral reality given in nature, the radicalism of Professor Lester’s proposal would suggest that he does not believe that the UK has attained a particularly high level of justice. So, how can he consider any corporation chartered and regulated by the British state, even if the voting shares of that corporation’s stock are held by private individuals, to be less than suspect?

And what of tax recipients in other countries?  To return to his examples of The New Statesman and The Guardian, while it may in 1996 have been the case that both of these publications derived most of their revenue from net recipients of UK taxes, two thirds of  The Guardian’s revenue now comes from readers outside the UK, half of them in the United States. Few of these readers are in the pay of the British state, but it is possible that most of them are net tax recipients in their own countries. If so, would employees of The Guardian still be disqualified from voting in Britain because they are indirect recipients of US tax dollars?

Nor is that the only implication. Professor Lester is surely right that our conception of taxpaying is too narrow if it is simply limited to figures that appear on ledgers. I would not defend the idea that the line on a state employee’s pay stub indicating that some number of pounds or dollars has been deducted from his or her gross pay represents actual taxpaying. On the other hand, his conception of tax-receiving is just as narrow as this. So in the USA, profitable corporations pay their shareholders far less in dividends, and their executives far more in compensation, than do their counterparts in other advanced countries. This is largely the result of the US corporate income tax, under which companies pay taxes on money they distribute as dividends but not on money they pay to executives. Therefore, a rational analysis of taxes in the USA should classify as tax payments all compensation executives receive in excess of what their counterparts receive in countries with different tax regimes. That analysis would reveal that many of the individuals who are in the habit of regarding themselves as the USA’s greatest taxpayers are in fact net recipients of tax dollars. Professor Lester would have to deny them the franchise as well.

In fact, Professor Lester’s proposal might have some rather amusing consequences if applied to the USA. Not only executive compensation, but interest payments are also deductible from the corporate income tax. That encourages US firms to take on far more debt than do their counterparts in other countries. Those debt levels in turn give rise to the private equity sector, the “corporate raiders” who sometimes make such a big splash in the business pages. If we classify them as net tax recipients and on that account deprive them of the vote, we would suddenly have a bunch of disfranchised billionaires and centi-millionaires running about. I confess that I would find it difficult to refrain from laughing out loud if corporate raider-turned-politico Willard “Mitt” Romney were to lose the right to vote.

What brought this old column to my mind was an essay that popped up in my Twitter feed this morning, a 2017 piece by philosopher Philip Goff. Professor Goff begins with the observation that right-wing libertarians who denounce all taxation as theft are only the most extreme advocates of a widespread notion, the notion that what is listed on pay stubs and other accounting instruments as a payee’s pre-tax income is property to which that payee is morally entitled.  Again, this is the fallacy that Professor Lester identified, equating taxpaying with ledger items rather than with the actual allocation of resources.

Professor Goff writes:

Your gross, or pre-tax income, is the money the market delivers to you. In what sense might it be thought that you have a moral claim on this money? One answer might be that you deserve it: you have worked hard and have done a good job, and consequently you deserve all your gross income as recompense for your labour. According to this line of reasoning, when the government taxes, it takes the money that you deserve for the work you do.

This is not a plausible view. For it implies that the market distributes to people exactly what they deserve for the work that they do. But nobody thinks a hedge-fund manager deserves many times more wealth than a scientist working on a cure for cancer, and few would think that current pay ratios in companies reflect what philosophers call desert claims. Probably you work very hard in your job, and you make an important contribution. But then so do most people, and the market distribution of wealth patently does not reward in proportion to how hard-working people are, or how much of a contribution they make to society. If we were just focusing on desert, then there is a good case for taxation to correct the amoral distribution of the market.

If we have a moral claim on our gross income, it is not because we deserve it, but because we are entitled to it. What’s the difference? What you deserve is what you ought to have as a result of hard work or social contribution; what you are entitled to is the result of your property rights. Libertarians believe that each individual has natural property rights, which it would be immoral for the government to infringe. According to Right-wing libertarians such as Robert Nozick and Murray Rothbard, taxation is morally wrong not because the taxman takes what people deserve, but because he takes what people have a right to.

Therefore, if taxation is theft, it’s because it essentially involves the violation of people’s natural rights to property. But do we really have natural rights to property? And even if we do, does taxation really infringe them? To begin to address these questions, we need to think more carefully about the nature of property.

Professor Goff distinguishes between three schools of thought. Right libertarians hold that all things that have value to humans gained that value because someone discovered those things and by his or her labor created that value. For them, it is a truth inherent in the structure of the world that each individual has inalienable right to possess the fruits of his or her labor. Property law represents an attempt to tease out the moral facts that make up this truth. Property law must therefore recognize ownership as a relationship between a particular person and a particular object, and it must prohibit all other persons from interfering with this relationship.

Left libertarians agree that property law is just if and only if it teases out moral facts about the relationship between people and things. However, they do not accept that these facts are as Right libertarians say they are. Rather, they believe that it is unjust for any one person to lay exclusive claim to nature. At its most extreme, Left libertarianism proscribes ownership of anything other than one’s own body. At its most modest, it lays down rules enjoining requirements for sharing what one does own, and insisting on joint responsibility among members of a community for the use of the resources under their control.

Opposed to both varieties of libertarians are the social constructivists. Professor Goff summarizes their views thus:

Libertarians believe that property rights are natural, reflecting basic moral facts about the world. Others hold that property rights are merely legal, social constructions, which are created by us and can be shaped to suit our purposes. We can call the latter view ‘social constructivism’ about property. (Please note, our focus here is specifically on social constructivism about property; we are not considering a more general position according to which morality as a whole is a social construction.)

To bring out the difference, ask yourself: ‘Which comes first: facts about property or facts about property law?’ For the social constructivist, the right to property is not some natural, sacred thing that exists independently of human conventions and legal practices. Rather, we create property rights, by setting up legal institutions to ensure that people have certain legal rights over the material world. For the libertarian, in contrast, facts about property exist independently of human laws and conventions, and indeed human laws and conventions ought to be moulded to respect the natural right to property.

This distinction is crucial for our question. Suppose we accept the social-constructivist view that property rights are merely legal. Now we ask the question: ‘Do I have a moral claim on the entirety of my pre-tax income?’ We cannot argue that I am entitled to my pre-tax income on the basis of my natural property rights, as there are no such things as ‘natural’ property rights (according to the social-constructivist position we are now considering). So, if I have a moral claim on my entire pre-tax income, this must be because it is exactly the amount of money I deserve for my hard work and social contribution, presumably because in general the market delivers to each person exactly what they deserve. But we have already concluded that this is not a plausible claim. Without the belief in natural property rights, existing independent of human laws and conventions, there is no way to make sense of the idea that the deliverances of the market are inherently just, and hence no way to make sense of the idea that each person’s gross income (which is just the income the market delivers to them) is hers by right.

Here’s where we’re up to: to make sense of the idea that taxation is (moral) theft, we have to make sense of the idea that each person has a moral claim on the entirety of her gross income, and this can be made sense of only if property rights are natural rather than mere human constructions.

Further:

As already discussed, social constructivists do not deny the existence of property rights, rather they take them to be social or legal constructions, which humans are free to shape to reflect what they deem valuable. Jesus declared that ‘The Sabbath was made for man, and not man for the Sabbath.’ Analogously, for the social constructivist, property rights are made to serve human interests and not vice versa.

It is plausible that human flourishing requires certain legally protected rights to property, and hence most social constructivists will advocate a system of property rights. At the same time, there are other things of value – perhaps equality, perhaps reward for hard work and/or social contribution (which as we have seen is not well-protected by the market) – and in order to promote these other values, most social constructivists propose making property rights conditional on the payment of taxes. In the absence of pre-existing natural property rights, there is no moral reason to respect the market distribution of wealth (there will of course be pragmatic, economic reason, but that is another matter).

Professor Goff argues that Right libertarianism fails at two points. First, it cannot answer the basic claims of Left libertarianism, and so fails at the outset. Second, even if we choose to overlook this failing, it can defend the idea that gross income is a measure of special moral importance if and only if it can demonstrate that the market is operating in its best possible state, in no way distorted by political intervention. As this claim would leave Right libertarians without much of anything else to say, they would seem unlikely to adopt it.

I would like to add one point to Professor Goff’s description of social constructivism. Many years ago, I studied the legal codes of ancient Rome. I can’t say that much stuck with me from that study, but one thing I remember very clearly is that every time the ancients said they had “rights” they specified against whom they had those rights.  That is to say, rights were definitions of what was and what was not allowed in particular relationships among people. The concept of rights is simply not relevant to relationships between people and inanimate objects.

A property right describes, not what may happen between a person and a thing s/he owns, but among various people who might encounter that thing. That’s why I can’t kick your door down, but a police officer with the proper warrant can. Your ownership of your door gives you rights against me that it doesn’t give you against the agents of law enforcement. Likewise with the various actions allowed a tenant and a landlord with regard to the same location. Or for that matter, with regard to the right of free speech a citizen may have against the state, as opposed to the rights that same citizens might have against the owners of a social media platform with terms and conditions specifying that they can “terminate your account at any time, for any reason or no reason.” You may be able to challenge their particular exercise of that right in court, but if so it isn’t because you have the same right against them that you have against the state. Rather, it is because there are rights built into the law of contract that sometimes override particular provisions parties may write into a particular agreement.

It seems to me that the social constructivist view of property law is obviously right, and that the both varieties of libertarian are simply being childish. If you disagree, well, there is a comment section.

Ancient Regime

Shortly before the stock markets closed yesterday afternoon, the US Supreme Court announced a ruling on the so-called “Affordable Care Act” (also known as ACA.)  Health care stocks generally rose on the news of the ruling, in some cases sharply, while shares in health insurers showed a mixed reaction.  Today, the trend has been slightly downward across the board.

A majority of the US Supreme Court held that the US government does have the power to compel citizens and other residents of the USA to buy health insurance.  While the court rejected the Obama administration’s argument that this power, the core of the law, was within the scope of the authority the Constitution grants the federal government to regulate interstate commerce, it concluded that, because the law is to be enforced by the Internal Revenue Service in the process of collecting taxes, it is supported by the government’s authority to levy taxes.

In effect, the law establishes a tax that will be paid directly to health insurance companies.  US residents who refuse to pay this tax will be assessed an alternative tax, one paid to the treasury.  As written, the statute did not include the word “tax,” speaking instead of “premiums” and “penalties.”  These words are euphemisms.  This is clear not only from the Supreme Court’s legal reasoning, but also from the most basic economic logic.  A law which directs people to dispose of their wealth in a particular way to advance a particular set of policy objectives is a tax, whatever label marketing-minded politicians may choose to give it.

Many opponents of the ACA have spoken out against the idea of a tax directly payable to private citizens.  For example, today on the Counterpunch website Dr Clark Newhall complains that the bipartisan Supreme majority represents “Corporatists United.”  Dr Newhall denounces the statute and the ruling in strong terms.  I would like to make three quotes from Dr Newhall’s piece abd add my own comments to them:

In an eagerly anticipated opinion on the Patient Protection and Affordable Care Act, colloquially known as “Obamacare’, an unusual alignment of justices upheld the Act nearly entirely.  The crucial part of the decision found the ‘odd bedfellows’ combination of Chief Justice Roberts joining the four ‘liberal’ justices to uphold the ‘individual mandate’, the section of the law requiring all Americans to buy health insurance from private health insurance companies…

Many supporters of the ACA object to the term “Obamacare.”  The law was crafted on the model of a regime of health insurance regulations and subsidies enacted in Massachusetts in 2006.  That regime is widely known as “Romneycare,” in honor of Willard M. Romney (alias “Mitt,”) who, as Massachusetts’ governor at the time, had been its chief advocate.  So calling the federal version “Obamacare” is simply a matter of continuing to follow the Massachusetts model.  Now, of course, Mr Romney is the Republican Party’s choice to oppose Mr Obama in this year’s presidential election.  Therefore Mr Romney and his surrogates are creating much merriment for political observers by trying to attack the president’s most widely-known legislative achievement, which as it so happens is identical to Mr Romney’s most widely-known legislative achievement.

Dr Newhall goes on:

Those who make, interpret and enforce the laws no longer lie on the ‘left-right’ political continuum. Instead, they are in effect at ‘right angles’ to that continuum.  The ideology that drives the Supreme Court, the political administration and the Congress is not Conservative or Liberal but can best be described as “Corporatist.”  This is the ideology that affirms that “corporations are citizens, my friends.”  it is the ideology that drove the Roberts Court to the odious Citizens United decision.  it is the ideology behind a bailout for banks that are ‘too big to fail.’  And it is the ideology that allows Congress to pass a law like the ACA that is essentially written by a favored industry…

It seems to me very clear what Dr Newhall means to evoke in these sentences is the spectre of fascism.  During the 1930’s, fascists in Italy, Britain, Belgium, and several other countries used the words “fascism” and “corporatism” interchangeably, and economic historians still cite Mussolini’s Italy, and to a lesser extent Hitler’s Germany, as examples of corporatist economics in practice.  The American diplomat-turned-economist-turned-journalist-turned-pariah Lawrence Dennis argued in a series of books in the 1930’s that laissez-faire capitalism was doomed, that state ownership of industry was a dead end, and that the economic future of the developed world belonged to a system in which the state coordinated and subsidized the operations of privately-owned corporations.  The most famous of the books in which Dennis endorsed this system was titled The Coming American Fascism.

Not only the word “corporatism,” but also the image of a ruling elite “at right angles” to the old left/right politics might well remind readers of fascism.  The fascists continually claimed to represent a new politics that was neither left nor right; while such anticapitalist fascist tendencies as il fascismo della sinistra or Germany’s Strasserites were not markedly successful in the intra-party politics of fascist movements,* all fascist parties used anticapitalist rhetoric from time to time (think of the “National Socialist German Workers’ Party,” and of Joseph Goebbels’ definition of revolution as a process by which the right adopts the language and tactics of the left.)  Moreover, the image of “left” and “right” suggests that political opinions form a continuum that stretches from one extreme to another, with any number of points in between.  That in turn suggests that people who disagree may have enough in common with each other that their conflicts may be productive.  Fascism, on the other hand, demands a one-party state in which a single ideology is imposed on everyone.  Fascism finds nothing of value in political conflict, and strives to annihilate disagreement.  I think that’s what the late Seymour Martin Lipset was driving at in his book Political Man when he placed most fascist movements, including the Italian fascists and German Nazis, not on the far right, but in the “Radical Center.”

Counterpunch is edited by Alexander Cockburn, who recently declared that the United States of America has completed its transition to fascism.  So it would not be surprising if by these remarks Dr Newhall were insinuating that the ACA is fascist in its substance.  I would demur from such an assessment.  Before I can explain why, permit me to quote one more paragraph from Dr Newhall’s piece:

Why does Corporatism favor Obamacare?  Because Obamacare is nothing more than a huge bailout for another failing industry — the health insurance industry.  No health insurer could continue to raise premiums at the rate of two to three times inflation, as they have done for at least a decade.  No health insurer could continue to pay 200 million dollar plus bonuses to top executives, as they have done repeatedly.  No health insurer could continue to restrict Americans’ access to decent health care, in effect creating slow and silent ‘death panels.’  No health insurer could do those things and survive.  But with the Obamacare act now firmly in place, health insurers will see a HUGE multibillion dollar windfall in the form of 40 million or more new health insurance customers whose premiums are paid largely by government subsidies.  That is the explanation for the numerous expansions and mergers you have seen in the health care industry in the past couple of years.  You will see more of the same, and if you are a stock bettor, you would do well to buy stock in smaller health insurers, because they will be snapped up in a wave of consolidation that dwarfs anything yet seen in this country.

Certainly the health insurance industry was in trouble in 2009, and the ACA is an attempt to enable that industry to continue business more or less as usual.  In that sense, it is a bailout.  Indeed, the health insurance companies are extremely influential in both the Democratic and Republican parties, and there can be little doubt that whichever of those parties won the 2008 elections would have enacted similar legislation.  Had Mr Romney been successful in his 2008 presidential campaign, doubtless he would have signed the same bill that Mr Obama in fact signed.  The loyal  Democrats who today defend the ACA as a great boon to working-class Americans would then be denouncing it in terms like those Dr Newhall employs, while the loyal Republicans who today denounce the ACA as a threat to the “free-enterprise system” that they fondly imagine to characterize American economic life would then defend it on some equally fanciful basis.

In a deeper sense, however, I disagree with Dr Newhall’s assessment quite thoroughly.  A moment ago, I defined taxation as any law that requires people to dispose of their wealth in particular ways to advance particular policy objectives.  If we think about that definition for a moment, we can see that the United States’ entire health insurance industry exists to receive taxes.  In the USA, wages paid to employees are subject to a rather heavy tax called FICA.  Premiums that are paid for employees’ health insurance policies are not subject to FICA, and so employers have an incentive to put a significant fraction of their employees’ compensation packages into health insurance premiums.  Since the health insurers have been collecting taxes all along, it is quite misleading to call the ACA a bailout.  It is, rather, a tax increase.

Now, as to the question of fascism, certainly fascist regimes did blur the line between the public and private sectors.  The most extreme case of this was of course the assignment of concentration camp inmates as slave labor for I. G. Farben and other cartels organized under the supervision of the Nazi state.  So it would not have been much of a stretch for fascists to grant corporations the power to collect taxes.  Even if they had done so, however, fascists could hardly claim to have made an innovation.  Tax farming, the collection of taxes by private-sector groups in pursuit of profit, was the norm in Persia by the sixth century BC, and spread rapidly throughout the ancient world.  In ancient Rome under the later Republic, tax farming proved itself to be a highly efficient means of organizing tax collection. So the fact that tax farming is one of the principal aspects of the US economy is not evidence that the USA is a fascist or a proto-fascist regime.  Indeed, the fact that the Supreme Court seriously considered a case that would have challenged the legitimacy of tax farming is an encouraging sign, however unedifying the opinions that the court issued as a result of that consideration might be.

Of course, in the ancient world tax farmers bid competitively for the right to collect taxes, and the winners put their bids into the public treasury.  In the USA, there is no such bidding, and no such payment.  Instead, wealthy individuals and interest groups buy politicians by financing their campaigns and their retirements.  Perhaps we would be better off to adopt the ancient system.

At any rate, “fascism” seems a misnomer for our economic system, almost as misleading as “free enterprise” or as anachronistic as “capitalism.”  A more accurate term, at least as regards the components that are dominated by tax farming, would be neo-feudalist.  The US political class is increasingly an hereditary class; Mr Obama defeated the wife of a former president to win his party’s nomination to succeed the son of a former president, and now faces the son of a former presidential candidate in his campaign for a second term.  This hereditary nobility will now sit atop a system in which the non-rich are legally obligated to pay tribute or provide service to those in power in the land, who will in turn honor certain obligations to them.

*Fascism being what it was, “not markedly successful in intra-party politics” often meant “shot several times in the head and dismembered,” as happened to Gregor Strasser.

Car Insurance vs Health Insurance

Earlier this evening, I posted a long comment on a post at Secular Right.  In the post, blogger Heather MacDonald said that she was, in principle, a supporter of the idea that the law should require people to buy health insurance.  In support of this view, she pointed out that motorists are required to buy car insurance.  My reply:

“I see little difference between mandated car insurance and mandated health insurance—in most places, having a car is virtually a necessity of life” Car insurance and health insurance have a couple of things in common. The chief of these is that both categories of products are called “insurance.” The rest of the similarities, such as the fact that the some of the same companies sell them and some of the same agencies regulate them, stem from this point of vocabulary.

The similarities between car insurance and health insurance, however, are dwarfed by the differences between them. You choose an auto dealer, choose a car, negotiate a price for that car, arrange financing for it, pay that price, buy the fuel of your choice for it, decide which routine maintenance tasks you will perform on it yourself and which you will entrust to a mechanic, choose the mechanic who will perform those tasks, and pay that mechanic for those routine tasks, all without input from your insurer. If car insurance were the same thing as health insurance, you would be dependent on the insurer to make all of these payments and all of these decisions for you. To use mandates for car insurance as an analogy to justify mandates for health insurance, then, is like saying that because lightning rods protect your house from lightning, they should also protect your garden from lightning bugs.

If the USA’s political leaders were serious about controlling the cost of health care, in fact, they would move to make health insurance more like car insurance- not by making it mandatory, but by removing the tax incentives that reward employers for redirecting money from employee’s paychecks to health insurance premiums. Under our current system, a substantial percentage of the compensation US employers pay to keep their employees on staff goes, not to them in the form of money they can spend as they see fit, but to insurers to form funds from which employees can draw only in the form of medical expenses. Therefore, when those employees become consumers of health care they have no incentive to keep the cost of their health care down. Health care providers obviously have no such incentive. Even employers and insurance companies have only a very weak incentive to keep costs down, since employers are paying premiums with money that would otherwise go to the corporate income tax or to some other tax shelter. That’s why the cost of health care has for many consecutive years grown at a rate well in excess of the general rate of inflation, something which is not true of cars, car insurance, or any of the services car insurance usually covers.

If the corporate income tax were abolished, it would be possible for health insurance to become like car insurance. Consumers could choose and pay for their own routine health care, and pay also for insurance to cover catastrophic health expenses, as consumers now buy car insurance to cover catastrophic auto expenses. Doubtless, the modern world being what it is, there would be a political demand for substantial public sector subsidies for low-income people who have need of health care. So long as these subsidies were in the form of direct transfers of money to these potential consumers, they might leave the recipients with as much incentive to negotiate for lower prices as they have when considering the purchase of other goods and services that money could gain them. Not being as far to the right (or as secular) as most people who hang around here at Secular Right, I would be eager to support a generous program of subsidies along these lines.

The Nation, 7 November 2011

In this issue, Mark Oppenheimer (of Bloggenheimer fame)  recommends two books and a magazine article about the Church of Scientology.    The books are Janet Reitman‘s Inside Scientology and Hugh Urban‘s The Church of Scientology.  The magazine article is Lawrence Wright‘s profile of ex-Scientologist Paul Haggis.  Mr Oppenheimer writes that even “liberals for whom ‘tolerance’ is a sacrament” look for ways to ban religious practices that diverge substantially from social norms.  The interest of the review is Mr Oppenheimer’s own queasiness as he considers a relatively new and aggressively evangelical religion.  Time and again he squirms about, first praising religious diversity in general, then expressing his disapproval of Scientology in particular.  For example: “[E]mbracing the free market of religion requires that we be discerning buyers. We can be grateful that America is the country where Scientology may flourish, but we need not be grateful for Scientology.”  And:

Scientology may be one of those native religions that at first seems bizarre but adapts, grows and eventually thrives in our country’s fecund, undepleted spiritual soil.

Would that be a good thing? In many ways, no. It would mean more people reading L. Ron Hubbard’s tedious books when they could be reading real literature. It would mean more people suspending critical judgment, ignoring the factual record and insisting that Hubbard was a great warrior, adventurer, intellectual and teacher. It would mean more dollars misspent on auditing, instead of on good psychotherapy, badly needed prescription drugs or some really helpful classes at a community college.

On the other hand, if Scientology is still around in fifty years, some lucky Americans will discover in its practices the right cure for what ails them. For whatever reasons, either auditing or Hubbard’s “study tech” or Scientology communication classes will give them what public school—or a Freudian analyst or Judaism or Christianity or the Quaker meeting or the local Masonic lodge—could not. Scientology will give them a community. It will give them a way of life. Yet I remain worried about Scientology, worried enough that I can say this: I hope, fifty years from now, it’s not my children or grandchildren who turn to the church. But I also believe that freedom of religion is necessary. Without it, freedom of speech is a hollow guarantee.

Scientology may not last, but there will always be something like it. Reitman’s and Urban’s books are gifts to all religious people, especially Scientologists. They pay Scientology’s hierarchy the simple courtesy of holding them to adult standards of truthfulness and ethical behavior, and they confront Scientology lay people with some hard truths about their church. They also make the case—Urban’s book, explicitly so—that government and religion do not mix, and that perhaps it would be better, less entangling, to tax religious organizations. Reitman and Urban offer religions the respect they deserve in the form of the scrutiny they require. The Constitution, guarantor of free press as well as free religion, offers nothing less.

Mr Oppenheimer’s piece includes some interesting remarks about US tax policy.   To quote:

Most fascinating is Urban’s argument that Scientology has been instrumental in shaping how the US government defines religion. Beginning in 1967, when its tax-exempt status was revoked, the church fought a lengthy battle to have its exemption restored, infiltrating the Internal Revenue Service and harassing agents; in 1993 the IRS caved, offering Scientology a full tax exemption, sweetheart terms on back taxes and an unusual promise of secrecy (the deal was eventually leaked to the Wall Street Journal). Urban seems disheartened that Scientology bullied its way to victory—in Reitman’s book, IRS commissioner Fred Goldberg Jr. emerges as either a coward or a fall guy—but Urban powerfully makes the point that the IRS should not be in the position of deciding what is and is not a religion.

“The United States does not register religious groups and has no official hierarchy of religious organizations,” Urban writes. “And yet, federal income tax law does provide exemption for religious organizations, and, therefore, there must be some means to determine whether a group claiming to be religious is ‘genuine’ for purposes of tax-exempt status.” Supporters of religious tax exemption argue that it promotes religious charitable giving and prevents entanglement of government and religion. But if the government is going to grant religions special treatment, somebody has to approve that treatment, and it has turned out to be the tax man.

In 1977 the IRS promulgated a thirteen-point list of criteria for religious exemption (a recognized creed and form of worship, a formal code of doctrine and discipline, a literature of its own, etc.). It is probably no coincidence, Urban argues, that these guidelines were written “during the height of Scientology’s efforts to reemphasize its religious profile,” to complete its transformation from a philosophy, or self-help group, or whatever, into a religion. The IRS surely would have clarified its rules about religion over time, but it seems clear that the conflict with Scientology forced its hand. Urban writes, “As such, the complex legal and extralegal battles between the church and the IRS have been central to the shifting definition of religion itself.”

It would not be startling if, years from now, Scientology’s main legacy was its substantial contribution—if it can be called that—to tax law.

Professor Urban comment on a paradox which may be inescapable in a society that values religious freedom.  If “the power to tax is the power to destroy,” as Chief Justice of the United States John Marshall wrote in the Supreme Court’s ruling in McCulloch vs Maryland (1819,) then one would think that religious freedom requires special limitations on the government’s ability to tax religious groups.  Yet such limitations imply an official definition of “religious group,” which in turn implies an official ecclesiology. The “thirteen-point list of criteria” Mr Oppenheimer mentions is not the only test the Internal Revenue Service uses to determine tax-exempt status for religious groups, and that’s just as well.  Criteria such as “a distinct creed and form of worship,” a “definite ecclesiastical government,” “a formal code of doctrine and/or discipline,” and “schools or courses for preparation of its ministers” would all tend to rule out, for example, many of the Quaker groups that played such an important role in the USA in the eighteenth and nineteenth centuries.  Quaker ecclesiology in those days (and still, at least officially, for many Quakers today) regarded creeds, hierarchies, catechisms, seminaries, and ordained clergy as just so many idols and abominations, affronts to the Almighty.  If they had allowed themselves to be carried away by testosterone, such Quakers might have looked at the thirteen points of the IRS list and declared them to be a definition of a godless group.  Of course, if it were left up to people of that leading to replace the IRS list with their own definition of “religion,” I’m sure the result would be very nearly useless for purposes of deciding who should and who should not pay what tax.  “[I]f the government is going to grant religions special treatment, somebody has to approve that treatment, and it has turned out to be the tax man.”  Who else could it be, if not the IRS?  Congress would never dare pass a law defining what constitutes a religious organization, and without official definitions any person or group could claim the religious exemption.

In the same issue, Katha Pollitt’s column documents clueless remarks about Occupy Wall Street that media eminences made in the early days of the movement and contrasts them with relatively well-informed expressions of sympathy that similar people have made in recent days.  My favorite bit was this: “The more people join the movement, the clearer the message becomes. Former [New York] Times executive editor Bill Keller still doesn’t get it—“Bored by the soggy sleep-ins and warmed-over anarchism of Occupy Wall Street?” is how he began his October 16 column. (But then it took him till this summer to acknowledge that he’d been wrong to support the Iraq War, so maybe eight years from now he’ll apologize for snarking at OWS too.)”

Will visits to the doctor go the way of visits from the doctor?

In the last few days, television audiences in the USA have been hearing a great deal about IBM’s “Watson” computer system.  The occasion of this publicity is Watson’s appearance as a contestant on the popular quiz show Jeopardy.  IBM has emphasized Watson’s potential in the medical field:

Throughout this material, IBM’s spokespeople keep inviting us to imagine a near future in which Watson or systems like it will be found “in every doctor’s office.”  What this phrasing suggests to me is a situation in which there are about as many doctors as there are now, those doctors are distributed in offices as they are now, and in those offices they examine patients who come to them as they do now.  The state of affairs that this phrasing suggests is that these future offices will differ from their present-day counterparts in that Watson-like natural language processors will be installed to provide the patient with an “instant second opinion.”

A moment’s reflection will reveal that there is essentially no likelihood of such a scenario being realized, at least not in the USA.  As soon as a machine is invented that is capable of giving a medical opinion that is of any value whatsoever, flesh-and-blood doctors will vanish from the lives of low-income patients forever.  Once the machine is so improved that it can be trusted to give a sound diagnosis most of the time, with none but the trickiest cases requiring review by human doctors and none but a small percentage of those requiring active intervention to overrule the machine, the only patients who will ever meet their doctors will be the very wealthy and the scientifically interesting.

The parallel I would draw is with the institution of the “house call.”  As recently as 40 years ago, it was so common for doctors to call on their patients at home that when people occasionally had to go to the doctor’s office to receive care, it was considered grounds for a radical overhaul of the healthcare system.  Now, when a doctor does make house calls, it’s national news.  I predict that 40 years from now, it will be as rare for a patient to visit a doctor for examination as it is today for a doctor to visit a patient at home.

What will the consequences of this change be for public policy?  The central dilemma in technology policy is always the same, that there is little or no interval between the time when it is too soon to say what the effects of a development will be and the time when it is too late to do anything about that development.  One thing we can say is that demand for medical doctors will drop dramatically, probably to 1% or less of the current per capita demand by 2050.  Whether that means we will have only 1% as many doctors then as we do now, or that some larger number will share 1% of the income that doctors now collect, of course depends on a wide range of factors.  Whichever way it goes, certainly no prudent investor would be interested in funding a new medical school at this time.

The cost of health care is a focus of much discussion in the USA, where it represents at least 1/7 of GDP.  Eliminating doctors would change the way this spending breaks down, but would neither reduce demand for health care nor increase its supply.  Moreover, many have argued that the reason health care costs so much more in the USA than in similar countries is that Americans do not really have a market for health care.  Rather, employers pay for health insurance in order to avoid paying the corporate income tax.  Since employers pay insurance companies money that would otherwise go to the taxman, they have little incentive to negotiate lower premiums; since insurers raise premiums when providers charge them more, they have no incentive at all to negotiate for lower prices.  As long as the corporate income tax and its health-insurance deduction remain in place, US health care costs will continue to rise no matter how little money goes to doctors.  Perhaps if the USA were to abolish the corporate income tax and replace it with a consumer-driven revenue source like the Value Added Tax, a consumer-driven health care system might emerge, but until then, technology cannot solve our problems.

Of course, unemployment is also a public policy problem.  What happens to all the M.D.s whose degrees will become worthless in the years ahead?  And what happens to public opinion when the appearance of a horde of jobless doctors makes it clear that education is no guarantee of employment?  Marxism may be dead, but will it stay buried in a world where the owners of capital are the only economic group who lead lives secure enough to plan for their futures?