arthur-alpert-pic21So I’m reading “Somewhere Toward the End,” thrilling reflections on old age by a 91-year-old Englishwoman, Diana Athill, when she tells a story about cataract surgery.

Rather than pay thousands at a private eye institute, she visits the “splendid if rather Dickensian-seeming Moorfields Eye Hospital where the operations were done for free with exquisite precision.”

It was free under the British National Health Service.

Knee-jerk conservatives will object right here: “Free? No, it’s not free. It means taxes!”

Oh, the horror.

As the Obama administration and the Congress approach consensus on a health care reform, they must agree on how to pay for it.

Of course, the political right, protective of the status quo (worsening outcomes, burgeoning costs, CPA-directed doctors’ decisions) rages against taxes. And many liberals, afraid to rile the electorate, won’t defend them.
For Americans won’t pay for what they get.

Our tax-aversion stems, in part, from years of anti-tax propaganda aimed at emasculating government so that the affluent and powerful institutions may rule un-hassled.

It’s a long way from Oliver Wendell Holmes Jr., who famously said, “I like to pay taxes. With them I buy civilization.”

Taxes are good. Unless, of course, you believe that profit-making enterprises should (could?) operate the military and spy agencies; protect our air and water; serve children, the elderly and sick; maintain public order and safety; build and maintain roads and highways, the power grid and so on.

If you so believe, you belong to a religious sect that mistakes faith for science and exalts materialism, much like the Marxists.

Dante’s Hell must have a special circle, of course, for those who hate taxes but love spending. Like Dick Cheney, who infamously retorted when Treasury Secretary Paul O’Neill warned of a looming fiscal crisis:
“You know, Paul, Reagan proved deficits don’t matter.”

As President Clinton left office, the Congressional Budget Office estimated the U.S. would run an average annual surplus of $800 billion a year from 2009 to 2012. Now Washington likely will run a $1.2 trillion annual deficit through 2012.

How come? The business cycle caused 37 percent of the swing to deficit but 33 percent results from the Bush tax cuts and Medicare prescription drug benefit enacted several years ago, plus higher interest payments on the debt, says a recent New York Times report.

Locally, two enchanted Republicans, then-Representative Heather Wilson and then-Senator Pete Domenici, advocated the Bush tax cuts and Medicare privatization.

In fairness, corporate Democrats also decry taxes. Gov. Bill Richardson reduced rates on upper-income earners and boasted of it.

What a comedown from FDR, who said, “Taxes, after all, are dues that we pay for the privileges of membership in an organized society.”

As the existing health care system wastes away, the Obama administration and health industry say it’s time to cover everybody and maximize efficiency to limit spending long-term.

For the insurers, having Washington strong-arm citizens to buy their wares is manna from heaven. But face it — the only way to save real money is take it from the insurers and pill producers. And that’s not in the cards, not when they bankroll both parties.

This explains, too, why single-payer (tax-supported government insurance for all, as in other industrial nations), isn’t even on the table today. Big Medicine — the insurance, pharmaceutical and hospital industries –vetoed it.

Having killed single-payer, Big Medicine isn’t far from victory, needing only to asphyxiate the “public plan” that would compete with private insurers. And it’s already gasping for air; congressional bigwigs are considering cooperatives, instead.

So if there’s “reform,” industry certainly will benefit. The public? Not so much.

Which may be just, given that we’re so irresponsible.

Or is there another way to characterize people who won’t pay for services?