"But how will she pay for that?"

A quick note on budgets as moral documents

During her appearance on The View this week, Kamala Harris announced that she wanted to find a way for Medicare to include Home Health Care. Recognizing the twin challenges of young families supporting children also having to support aging parents, she argued that the stresses of depending on family to pick up the slack is simply too great. Besides, this would be a great way to keep us aging boomers in our homes rather than in group facilities.

Predictably, the question in my title shows up. Today, the editorial board of the Washington Post used the phrase in their headline. They point out that there have been attempts to meet this need in the past but they have been hampered by the cost of implementation.

In 1988, Congress passed the Medicare Catastrophic Coverage Act but dropped an amendment that would have added long-term care coverage. And even the slimmed-down bill proved too much for voters: Seniors wanted protection against extreme medical expenses but were so angry about paying higher premiums that a pack of booing, screaming seniors chased then-House Ways and Means Committee Chair Dan Rostenkowski out of a town hall. Congress repealed most of the program after 17 months. Finally, in 2010, the Affordable Care Act included a long-term care program called the Class Act, but this program, too, lasted barely a year and a half. The Obama administration gave up on it in October 2011, after determining it could not be simultaneously self-sustaining, financially sound for 75 years and affordable to consumers.

You don’t have to be a demographer to recognize the challenge. What was costly in 1988 and 2010 becomes even more so given the percentage of the population in retirement. And the life expectancy for Boomers is greater than it’s ever been. The op-ed closes with this:

In a policy area where many other politicians have tried and failed to make progress, Ms. Harris deserves credit for restarting a necessary discussion. She would deserve even more credit if her plan were not itself a work in progress.

To recap, they recognize that this is a serious need in our society. Caring for the elderly, alongside the needs for childcare supports are issues as serious for today’s families as the price of eggs. Probably more so. Because the absence of these social supports means a commitment to part-time work if it’s feasible to work at all.

Harris’s answer to the “how to pay” question usually involves higher taxes for the upper classes and corporation and increased economic growth. Trump, who is rarely asked the “how to pay” question continues to argue for eliminating taxes on tips (regardless of income) and increase deductibility on annual taxes (given that most people don’t itemize, this seems like a dodge).

Consider this editorial cartoon that appeared in the Washington Post this morning. It is done my Michael Ramirez, a conservative cartoonist for the conservative Las Vegas Review-Journal (the paper formerly owned by the late Trump supporter Sheldon Adelson).

See how Ramirez easily dismisses these proposals? How crazy that anyone would consider such things! Even little kids recognize that.

But every single one of those proposals is aimed at meeting a real need in the society. Not only would it greatly lessen inequality but it would expand the workforce while addressing the “kitchen table” issues everybody says is what citizens care about. Over the long run, proposals like those Ramirez scoffs at would reduce social services, improve health care (and thereby lessen costs), and even lower the crime rate.

Nearly two years ago I wrote a piece on here about Stephanie Kelton’s book, The Deficit Myth. She is a persuasive advocate for Modern Monetary Theory. I don’t want to rehash that whole MMT argument here, but I do want to pick up part of that piece.

What, then, is the point of taxes if not to fund programs? Kelton argues that paying taxes back to the government is a principal brake that keeps the economy from overheating. She agrees that inflation is a real problem that impacts real people and circumstances (as the last year has shown us).

If tax revenue isn’t the funding source, what should guide our Fiscal Policy decisions? It's often said that budgets are moral documents. You can tell where priorities are by where we spend our money. Kelton affirms this point enthusiastically. If we have under-resourced care for the elderly, inner city poverty, a shift toward a cleaner climate, or the creation of jobs that will support a living wage, it's not because we didn't have the money but because we chose not to.

If it’s in the nation’s best interest to care for the elderly, to support families, to address the challenges of housing costs, and to expand economic opportunity, why don’t we see that as a priority?

We pretend like the budget is set in stone and that any changes can only come through miraculous economic expansion. But we have built these inequalities into our budgets and then pretended that we have no options.

Clearly we do. What we lack is national leaders willing to tackle the big challenges that create immense struggles for way too many families. We need moral leaders who won’t just avoid the problem because it’s hard.