Should I get a tax exemption for my new bicycle pedals?
The Patient Protection and Affordable Care Act (ACA), or ObamaCare, allegedly expands the number of people who have health insurance. While the law has many troubling qualities–including its command to “buy insurance or get taxed!”– the goal of getting more people to have health insurance insurance is not new.
Ever since World War II, the federal tax code has encouraged people to get health insurance (though only if it is done through an employer-based plan). So the ACA’s goal of using the levers of power to nudge people toward insurance is not new.
Having coverage, though, is not the same as getting care. For example, people who are enrolled in Medicaid are “covered,” yet increasingly they are having trouble finding a physician. Worse, actually getting health care can isn’t the same as getting healthy. In some cases, it can actually be fatal, as in the case of hospital-acquired infections.
So while health insurance can be helpful, the ultimate goal for public policy ought to be a health population. Insurance is a means, not — unless you work for an insurance company or a public agency that administers Medicaid or Medicare — the final goal.
If insurance is one way to promote health, what are some other ways? Diet and exercise, which brings me to my bicycle pedals. I recently spent $200 on some “clipless” pedals and the specialized shoes they require. True to the promise, they’ve made cycling easier and more enjoyable. It’s likely I will now get more exercise.
Should I continue to ride more frequently, I should then have a lower risk for diabetes, heart disease, and other maladies. That’s good for me and my family, and the insurance pool to boot. It’s also good for the public treasury, since I’ll be able to work (and pay taxes) longer.
Since my pedals should contribute to my health, with those positive effects for society, shouldn’t their purchase be treated like health insurance, lowing my taxable income?
That’s never going to happen, of course. How could government make sure that I’m not taking the tax break and then, instead of using the shoes, selling them on eBay?
Private insurance companies do take some steps to encourage people to exercise, with discounts for gym memberships and such. But again, there are compliance costs. Riding my bike outside (yay!) isn’t subsidized, but riding a stationary bike (ugh) indoors is. As for diet, I could get a small kickback from my insurance company for buying certain fruits and vegetables, but I’d rather not submit to that amount of snoopervision.
Attempting to nudge people through the tax code has already caused all sorts of problems such as healthcare inflation and being locked into a plan chosen by someone else. ObamaCare offers the hope of giving people greater choice, yet policies offered in exchanges are tightly regulated in what they can offer.
ObamaCare represents yet another effort to get the levers of power configured in a “just right” way to get a “just right” environment. Admittedly, giving me a tax break for a new bicycle would be committing the same mistake. Oh well. I sounded good while I was out pedaling.
What to do next? That’s a topic for another day.