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Comment by toomuchtodo | Hacker News Reader

Kudos. I like your style. I paid $42K in federal taxes last year, I'd pay more to get universal healthcare and real social safety nets here.

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If you'd pay more taxes, would you also simply donate more toward such efforts? If not, would you donate under some Kickstarter-like scheme in which pledges of donation were only enforced in the event that some threshold were met?

Congratulations on your income!

> If you'd pay more taxes, would you also simply donate more toward such efforts?

I currently am, but to Watsi.org. It gives me a bigger bang per dollar compared to the amount of middlemen in the US healthcare model.

I've thought about several ways to drive down the healthcare in the US, and it seems the only sure fire method is for politicians to get into office who believe in single payer. To that end, I use my wealth to max out my contributions to campaigns and PACs (if applicable) of candidates who support that goal.

> Congratulations on your income!

No need for that at all. I only mention it because, so often, I hear people say, "I'm tired of taxes! Less taxes! You already tax me enough!". To which I say, "Its complicated". I mention it because there are people out there (like myself) who do not mind paying taxes.

With my tax dollars, I buy civilization. I would like to buy more civilization for my fellow humans, but I need their help as well, otherwise my efforts are wasted into the ether by themselves.

We are all in this together.

Charities and donations will not truly solve the problem.

United States needs major reforms:

1. implement what I term socio-capitalism (private property and enterpreneurship is protected, but there is a social safety net in the form of universal health care and unemployment benefits) -- U.S. already made the first step with "Obamacare", but there is a lot more to do;

2. reform the government to reflect the Swiss model 1:1, and institute direct democracy, as well as make lobbying highly illegal.

Admittedly reforming the government will be a very difficult task, for those in power will fight by every means available to preserve it. The good news is, it could be done through the current political process.

She/he could do that, but it wouldn't make a large impact. I think the OP meant that they'd rather pay more taxes with the assumption that everyone else is paying more taxes too. That would make a large impact.

It's the same reason why it's not hypocritical for the super rich to desire higher taxes on the rich, yet still pay the minimum legal requirement.

I find it shocking that anyone wants to trust the American Government with their health..

That seems to be extremely idiotic given the record the American Government has when dealing with Health Care, pick either Medicaid, Medicare or the VA system.... You want that on a National "Universal" Scale... are you a sadist or something?

Most of the current problems with Health care costs in this nation are directly attributable to government policies dating back to the 40's

That's because your information on Medicare is wrong. I and many others would be happy with Medicare for everyone. It's well run and more efficient than private insurance. Expanding Medicare to everyone would give it even more bargaining power and price controls.

http://www.reuters.com/article/us-column-miller-medicare-idU...

Yep, Medicare is very efficient. Medicaid, on the other hand, is state by state, and is oftentimes run very poorly. I would love to have Medicare for all.

Medicare also has a payout problem so bad that doctors refuse to accept. Many providers have stop taking Medicare, I know my grandmother has all kinds of problems find places outside of the Hospital to take medicare

Price Controls have never worked in the history of man kind, we have a over all provider shortage now, if you remove the incentives and make being a Doctor a low paying job no one will spend the money to become a doctor. Price control always result in any less supply or lower quality or both...

That is what Medicare will get you, EXTREME wait times, it will take you weeks or months to be able to see a doctor, but hey it will be free, who cares if you die while on a wait list.....

You get what you pay for

Your theory falls apart to the evidence of health systems in basically every other OECD country.

A theory that fails to match the data in any case doesn't seem to be much of a theory, is there something I don't know about that's happening in other counties?

My guess is that doctors in other countries have less choice. In the US a doctor can opt out of Medicare and offer concierge services instead. Which many of them have done because Medicare reimbursements are much lower than in the private market.

US doctors also can make money through self-referrals such as ordering a test be done through a clinic in which they are an owner.

This article from 2009 talks about the latter case in detail: http://www.newyorker.com/magazine/2009/06/01/the-cost-conund...

I supposed we could try to outlaw that practice, but a whole lot of doctors would lobby like hell to prevent that bill from making it through Congress.

So in France you have a similar system:

There are base prices for operations, doctor visits and the like. But doctors can choose to charge above this price (and mostly do so in places like Paris, where rent is too high to charge just base price).

Doctors have to declare whether or not they do this. So if you're a price-sensitive person you can lookup doctors "inside" or outside the system.

In my experience, there are longer waits for things like optomotrists, but that's more due to government-mandated limits on how many can graduate in a year than the price controls (that you can opt out of anyways).

General practitioners are fine though. Like "call for an appointment, show up the next day" sort of fine. And even in big cities I would always end up at a doctor charging "base" price. The visits would end up only costing something like 7 euros.

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