Health & Taxes

It was long known that eating a well-balanced diet reduced the rate of scurvy, a disease that can ultimately lead to death, especially for sailors who might be away from the mainland for months at a time.  In fact, more British sailors died of scurvy in the 18th and 19th centuries than from wounds received in warfare.  Eventually, a connection was made between citrus fruits and the disease and once naval provisions included a lot of fruits, scurvy was essentially eradicated.  Interestingly, scientists of that time didn’t know why these foods prevented scurvy and it wasn’t until the 1930s that vitamin C was isolated and that a lack of the vitamin was the cause of the disease.

Two other diseases, cholera and dysentery had a similar history of discovery and treatment.  Cholera is caused by bacteria and dysentery by virus, bacteria, or a parasite (amoebic dysentery) and both diseases follow a similar progression: infection of the gastrointestinal system leading to diarrhea, severe dehydration, electrolyte imbalance, and if untreated, eventually death.  Millions of people have died from the diseases over the centuries and hundreds of thousands of people continue to die each year, particularly in undeveloped countries.

As with scurvy, before they could identify the cause of the disease, medical researchers saw an association between prevalence of the disease and communities that had access to clean drinking water compared to communities that didn’t.  They also observed an association between the disease with communities having closed sewer systems (rather than open gutters to transport raw sewerage) and those without.  Between the late 1800s and early 1900s many American communities invested in water and sewerage treatment plants.  Today, less than 20 cases of cholera and dysentery are reported in the U.S. each year.  

This is more than just a story of how modern medicine has conquered diseases, saving the lives of millions.  It is also a story of the positive way our taxes are put to good use as virtually every water and sewerage treatment plant in the U.S. is a municipal operation funded through local taxes.  If you ask people what their taxes are used for, most will probably respond “to pay for national defense.”  In reality, when you look at how federal, state, and local taxes are spent, much of it is for public health and medical treatment.  In addition to sanitation, taxes are used for immunization, such as flu vaccines, medical research, and for direct treatment, such as operation of VA hospitals and state psychiatric hospitals and community mental health clinics.  Taxes pay directly for care through Medicare, Medicaid, and the State Children’s Health Insurance Program.  The health insurance of federal, state, and local public employees and their families, including active duty military personnel is paid for by taxes.  And taxes pay for other operations that support public health, such as food inspections and drug certification.

So why do so many Americans dislike taxes?  In large part, I believe, most Americans don’t associate their taxes with the positive, productive services they provide, including public safety (police and fire departments), public parks and recreational facilities, public education, and infrastructure such as highways, bridges, and dams.  Worse, the Republican Party has steadfastly denounced taxes in an effort to convince Americans the path to “making America great again” can only be accomplished by the private sector.  That’s why every Republican sponsored federal budget, including the one Donald Trump recently submitted to Congress, cut spending for health services.

Conversely, the story of how we conquered cholera and dysentery are powerful examples of our tax dollars put to good use.  Interest in ensuring health services to all its citizens derives from the knowledge that, as noted in this blog’s motto, “the health of a nation is dependent on the health of its people.”  In the late 1800s and early 1900s, the leaders of many countries, particularly in Europe, recognized they could not win wars if military age men were not fit for service; they could not compete in the world market if their factory workers lost time due to illness and early death; and their population could not grow if their women died in childbirth.  Thus, from a governmental perspective it made sense to invest tax dollars to ensure the country’s population was healthy.

If educating the American public about the benefits of universal health care is a battle, then right now we are losing.  Consider this, when Fox News states: “more people get their news from Fox, than from any other network,” that’s an accurate statement.  A recent survey found that more people watch Fox News than CBS, NBC, and ABC combined.  And more people watch Fox’s editorial “news” shows than CNN and MSNBC combined.[1]  That provides a large platform for conservative pundits to convey conservative themes.  And it works.  For example, a growing number of Americans believe Social Security is a Ponzi scheme and private charter schools produce better results than public schools; positions that have been refuted by data-based evidence.  Most importantly, Republican Politicians and Fox pundits have been very successful in convincing Americans they are overtaxed, and that the government wastes their tax dollars.

Unfortunately, Democrats tend to shy away from these arguments, afraid they will be pilloried for supporting government programs and the taxes needed to pay for them.  In this regard, the battle for universal health care involves educating the public about the benefits of paying taxes.  In particular, this isn’t about a few, freeloading members of society taking advantage of the taxes we pay.  Like clean drinking water, it’s about all Americans benefitting from healthcare because we all pay the health care transaction tax and thus all have access to treatment.


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