I do not understand the visceral response to taxing wealthy people that can afford to make their country better. It is not merely about providing government handouts to undeserving people.

This presumption that anyone that needs help is undeserving is the parochial mindset that makes any improvement impossible. It is about improving the overall quality of life with improved infrastructure, funding for government services that everyone uses including but not limited to the dastardly regulation of food and drugs, better education, and more efficient communities.

What happened to the old maxim "you can't get blood out of a turnip"? The turnip being the 99.9%. I thought everyone generally understood this concept. It's easy to just ride out the tumultuous times when you're gainfully employed talking out of the side of your neck about policy in a privileged enclave.

This article is the same old propaganda to change the discussion from income inequality to morality. It is such a cliche to pull out the old bourgeois argument now and this guy at the Times presents this like it some ground breaking discovery.

You'd think that Douthat out of boredom would learn some economics if he's going to go public with his words. Here's a clue Ross: the owners think workers are overpaid.

Dean,

I agree with you that the US needs to import primary care doctors. As a worker in the Information Technology field I have been competing in the job market here in the US for well over a decade with massive numbers of workers who were brought into the US simply to lower the payroll costs for corporations doing Information Technology work in the US.

As a result my income is far lower than I estimated it would be at this point in my life. Had I known ten years ago that my government would have worked so aggressively to limit my income by importing millions of Information Technology workers into my country I would have saved more, spent less, given less to charity, purchased a smaller home and probably would have had fewer children.

If I had been told early in my career that my government planned to do this to my chosen field I would have left the field entirely. A prospect I am still entertaining. Work now comes only in the form of six month contracts; opportunities for full-time employment continue to shrink. I assume corporations are simply waiting for additional visas to be approved after the Presidential election.

In addition, each year the various firms I have worked for have decreased the percentage of healthcare costs they cover and have increased the portion I need to pay. At the same time those who provide healthcare services to my family continue to increase their prices and do nothing to reform the cottage industry like economic characteristics of their field.

I see no reason why this needs to continue. In fact it clearly cannot. Why should I be asked to continue to pay artificially high monopoly salaries for physicians, dentists and orthodontists with my now globally competitive (and lower) Information Technology salary? Why do I need to park my 30 year-old car next to the new (and different) Mercedes every time I take my children to see their dentist?

I am now being told by the leading Republican Presidential candidate that the Social Security payroll taxes I have been paying my entire career – 15.3% of my gross income – (you find out quickly that the employee pays both the employee and employer portions when you are on your own and you have the option of being paid on a W2 basis or via a 1099) have been going into a Ponzi scheme and that the money is gone.

I don’t believe that the money is gone. Madoff said all the money was gone, yet Irving Picard, the court-appointed trustee for the Madoff victims, was able to recover about 50% of the missing funds. If the US needs to reform the health care industry in order for my Social Security to be paid, so be it. If they need to raise income and capital gains taxes back to the levels of the Regan administration, or Eisenhower, then do that. The wealth needed to pay back the loans made by the Social Security trust fund to the US government (in the form of US Treasury bond purchases by the trust fund) exists here in the US. It simply needs to be tapped.

to open up doctors to foreign competition? I say no. As it stands, consumers have little ability to properly evaluate the competence of their doctors, so they must simply trust that the barriers to becoming a doctor in this country are high enough that few idiots get past. But if we start reducing the barriers to entry and accepting doctors from Uzbeki-beki-beki-stan (where medical students may not push themselves to the brink, like here) there will surely be more bad doctors in this country -- and because consumers are poor evaluators of the quality of their medical care, the free market would not properly sort this out and quite likely more people would die unnecessarily etc.

My real point is this: you repeatedly make the claim that high-earners are wrongly subsidized by the government, but aside from the financial sector I just don't think there is strong evidence that you are right.

How about treating all income as earned income?

that poorer countries pay the high cost of training doctors so that those doctors can move here, leaving the countries that shouldered the cost of their training without their services?

There's a word for that. Exploitation.

Andrew,

there is no reason to lower our standards for doctors. Just set up a testing facility in Uzbekistan (staffed by U.S. testers) where students could demonstrate their competence after having gone to a U.S. certified med school. They could then practice wherever they want in the U.S. It's all very simple.

John Q. my suggestion is that we tax a fraction of the wages earned by foreign trained doctors practicing in the U.S. and repatriate it to the home country to pay for the training of more physicians. There is a word for that: smart.

Andrew:
The system already exists and has existed since at least the late 1960's when I worked in it. Briefly: The Educational Commission for Foreign Medical Graduates gives exams around the world for graduates of foreign medical schools to see if they are the equivalent of American medical school graduates before they are allowed to come to the US as hospital residents -- that is the usual first step to being allowed to take any state medical boards. (Canada is an exception since its own medical school accrediting body uses standards comparable to US standards.) Once a foreign medical graduate has completed his residency he is allowed to take the state medical exam boards and (if he passes) be licensed as a physician to practice medicine in that state -- just like the American medical graduate who passes the same test.
Wikipedia has a fuller explanation of how ECFMG functions.

Douthat is utterly clueless or dishonest -- and I think it's the latter. That is as dishonest a description of liberalism as it's possible to make. I imagine he pats himself on the back for it the more absurd it is.