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Comment by fzeroracer | Hacker News Reader

I am all for Basic Income but the way the author wants to implement it would be a disaster.

My mother is fully disabled and unable to work as a result of her stroke and she relies on Medicaid, Food Stamps and SSI to live. $13000 per person would be lower than what she gets right now and that's without considering the insurance issues. These changes would quite literally kill or leave homeless a large amount of America's disabled, poor or elderly population.

If Basic Income is to work then it needs to be actually liveable and adjusted based upon the CoL in each area.

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The article's author also wrote a book advocating a universal basic income, “In Our Hands: A Plan to Replace the Welfare State,” which was first published in 2006. In that book he allows that services for the disabled would need to be retained and could not be replaced with a UBI.

Of course. The problems of the disabled, the mentally ill and so forth are obvious, and the solution is obvious: don't remove all the social security besides UBI.

But that's also the downfall of UBI, because it means that most of the other transfers will remain a necessity, and the bureaucracy to distribute it will remain a necessity, and the whole issue of welfare dependency is back with us, and so is the constant discussion of what support and subsidy should be expanded.

(I'm looking at this from European angle where the welfare is often, though not always, stronger than in the US).

> and the solution is obvious: don't remove all the social security besides UBI.

I think that's where there are two camps within UBI supporters: those who want social security + UBI, and those who want to replace all or most social services with UBI. You can probably see how that maps to the political spectrum.

> The problems of the disabled, the mentally ill and so forth are obvious, and the solution is obvious: don't remove all the social security besides UBI.

The solution isn't to either remove all other benefit programs or to retain them all. in a static, unchanging way.

Its to build UBI in a way that it naturally grows with productivity, and keep existing means-tested benefit programs (whether general or targetted to specific narrow needs like disability) and count UBI income the same as earned income in the means tests for those programs, phasing the programs out as the UBI rises to a level where it is no longer possible to qualify for them. This does leave you with the administrative costs of those programs for some time, but with dropping caseload which reduces the total costs (both benefit and administrative) over time, eventually to zero when the programs are retired because UBI makes them obsolete.

This also lets you start UBI at a very level level, and reduces risks and provides opportunities to address unforseen consequences of the UBI implementation, because you aren't doing a big-bang implementation where immediately the entire social support structure depends on UBI alone.

(Essentially, instead of being obsolete and removed when UBI is first implemented, other programs are deprecated and to be removed in the future with defined criteria.)

>If Basic Income is to work then it needs to be actually liveable and adjusted based upon the CoL in each area.

There's a good argument to be made for a larger sum for the disabled who cannot work. But I'd be extremely opposed to any regional adjustments. If individual cities and states want to supplement the UBI, then that's up to them, but people moving out of high-cost areas and into low-cost ones is part of the natural ebb and flow that keeps the cost of living reasonable. And can you imagine what a CoL adjusted UBI for San Francisco would look like? A massive ripoff of the rest of the country.

> There's a good argument to be made for a larger sum for the disabled who cannot work. But I'd be extremely opposed to any regional adjustments. If individual cities and states want to supplement the UBI, then that's up to them, but people moving out of high-cost areas and into low-cost ones is part of the natural ebb and flow that keeps the cost of living reasonable. And can you imagine what a CoL adjusted UBI for San Francisco would look like? A massive ripoff of the rest of the country.

I don't know what the solution is here but if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am sure I'd be broke even with any supplement in San Diego but at least I'll be broke in San Diego.

Edit: I cannot support any discrimination in basic income based on "ability to work". I'd rather the whole thing fail. I'd rather we never have basic income implemented at all than this bastardization go through. Personally, I'm all for death panels. We should not try to keep everyone alive at all costs. If I get in a freak accident and it'd cost me $10M+ to keep me alive with little to no chance of a full recovery, please let me die.

Something we need to discuss separately from universal basic income is the need to reduce cost in healthcare. I'd gladly support expanding Medicare to everyone without having to qualify. We would need significantly greater penalties for Medicare fraud and add incentives for whistleblowers and make it easier to report fraud. I'm OK with "lite" Medicare that drops expensive procedures and lets patients suffering from rare cases fending for themselves in order to cut costs especially if there is little chance that the patient will ever recover fully.

My preferred approach for health insurance is to eliminate all of the regulations about what insurance plans must cover, and any other rules that prevent high-deductible catastrophic insurance from being available on the market. You could then buy a very cheap plan that covers everything once expenses exceed, say, 20k, and be responsible for everything before that out of your pocket. Then, unlike now, people would actually factor in cost into their decisions about which doctors and hospitals to visit, which would hopefully drive down wasteful spending.

The other thing I'd support is removing medical licensure from the law. People would still be free to visit only AMA-approved physicians, but there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US.

>I don't know what the solution is here but if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am sure I'd be broke even with any supplement in San Diego but at least I'll be broke in San Diego.

Sure, and when the people of California realize that they're attracting all of the deadbeats from around the country, they'd be forced to adjust.

I can support letting the bottom fall out like this provided we had full single payer coverage for everyone. Any additional coverage can then be whatever you want with the only protection from law being protection from false advertising.

I can also support removing the ama-fia's control on licenses but I'm afraid we'll just replace it with something similar when it comes to which providers are eligible to reimbursements from the new single payer healthcare system.

My idea is that these catastrophic insurance plans would be affordable by anyone with their basic income. Debt financing could cover anything below the deductible, for the indigent. Getting such loans would also be easier because of the UBI. Again, people would be financially responsible for their own healthcare, which restores sane incentives, but it wouldn't be possible for it to financially destroy them. No need for a single payer system if this works as I envision it.

"Debt financing" and plans that may be absent or sometimes cover nothing much, is the dystopian nightmare we're trying to escape. Healthcare is not a normal consumer good subject to normal pricing pressures and amenable to substitutes. Single payer works extremely well.

As I stated in a response to the parent commenter, the AMA does not control the number of medical school seats/new physicians in the country. Indeed, medical licensing is done by the states and is not a federal process.

> there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US.

First, the AMA does not control the number of medical school seats in the country. Accreditation of US medical schools is done by the LCME, part of the AAMC. With some research, you'd find that the number of medical school seats is growing each year.

Second, the limiting factor for physician training is NOT medical school but residency. In point of fact, the US imports residency trainees from overseas - we're not constraining ourselves artificially but instead of surplus training positions.

Through a historical fluke, residency training depends on funds allocated by Congress through Medicare funding.

I understand your frustration at healthcare costs, but please research these issues.

Apparently this has changed in the last decade (http://usatoday30.usatoday.com/news/health/2005-03-02-doctor...). But until the number of doctors rises dramatically, I think it's safe to assume that the same interests are at work as before.

Further, the LCME is run in equal parts between the AMA and the AAMC. http://www.ohsu.edu/xd/education/schools/school-of-medicine/... See "Who serves on the LCME?"

> if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat.

I am guessing so would a lot of other people, which would create an opportunity of a lifetime for California landlords, adjusting the rents to the point where UBI would only offer marginal incremental benefit.

San Diego is nice, but Hawaii is about as expensive and pretty much nicer.

The problem of course with that argument is that people also need to move into higher-cost areas in order to find jobs for certain industries. If there was no regional adjustment that encourages individuals to stay put. Poor people congregate in low-cost areas with low job opportunities.

A CoL adjustment for San Francisco isn't the problem, but rather the fact that San Francisco costs so much to begin with.

The blame for the high cost-of-living in SF lies with the people of California, and especially the people of SF. It'd create a massive moral hazard to have the federal government subsidize that. Run your city like a gravy-train and everyone else will bail you out. People will, I hope, never stand for that. I'm very wary of insulating people from the consequences of their decisions, especially entire political units.

> The problem of course with that argument is that people also need to move into higher-cost areas in order to find jobs for certain industries. If there was no regional adjustment that encourages individuals to stay put. Poor people congregate in low-cost areas with low job opportunities.

That isn't a problem. You get a concentration of people collecting a basic income who move into a low cost area, then they have money to buy housing and food and so on so there are jobs needed to construct housing and sell food, so then some of them get those jobs. Then they have even more money which leads to even more jobs etc. and soon enough the low cost area isn't so low cost, but that isn't a problem anymore because now they have jobs.

This is far too simplistic, especially when you consider the issue of gentrification and the rise of housing costs associated with it. You ignore that this leads back to the same issue: Poor people are now living in a higher-cost area where their previously held job no longer suffices to live.

So now you force these poor people out of homes that they used to be able to afford into even poorer areas with worse job security. This is assuming that they're even able to acquire new jobs. And it would only get worse with automation.

A basic income that doesn't scale based off of CoL is one that's bound to fail in the face of automation.

How is a basic income that scales based off of CoL even supposed to work?

A UBI causes the cost of living to rise in the short run. If you readjust the UBI the cost of living will rise again and again.

Cities like San Francisco will become more attractive because they not only have more jobs they also pay you more UBI. The more people move in, the higher the cost of living if housing supply is constrained. Readjusting the UBI then makes the city even more attractive. At the same time small cities become less attractive because not only are people moving into the city but their UBI is shrinking too.

> This is far too simplistic, especially when you consider the issue of gentrification and the rise of housing costs associated with it. You ignore that this leads back to the same issue: Poor people are now living in a higher-cost area where their previously held job no longer suffices to live.

A basic income would allow you to move to some town in Oregon or Colorado without having to worry about starving to death until you can find a job as a bouncer or the like. Once you do the presence of people like you creates some other jobs for plumbers and carpenters etc. The idea that this is going to turn every Podunk town in America into San Francisco or New York City and leave the poor with nowhere to live is clearly untrue.

Many retirees choose to live in Florida because they no longer have a job and would rather live somewhere sunny with low expenses.

UBI would have a similar effect - maybe you still want to have a job, but you can choose to accept a somewhat lower paying job to live somewhere nice. It would also put less pressure on places like San Francisco.

Being less dependent on jobs is a good thing. We should allow this migration to happen naturally, rather than subsidizing people to stay where they are.

San Francisco costs so much because so many people want to live there. Not every person who wants to live there should be able to live there - there's only so much housing in the city.

Yeah. The solution is to property tax those businesses out of the high cost of living areas. If basic income were paid for entirely by a new progressive property tax (or even better, a land value tax) it could ratchet down the wealth inequality, not just the income inequality.

Would people in high cost of living area paying higher income taxes which subsidize the lower cost areas be a massive ripoff to those in the high cost areas?

Under the Murray UBI plan recipients would be required to spend $3000 per year on health insurance. That would be your mother's replacement for Medicaid. However, that doesn't factor in co-pays, deductibles, balance-billing, and the myriad other costs of private insurance. A health care premium of $3000 is going to have a high deductible. My premium is close to $3000 a year, and my deductible is $5250. Under this plan a disabled person requiring frequent medical care would have $4750 to live off of, after health care costs. That's a whopping $395 per month.

UBI is not feasible absent a universal single-payer system. Health care is just too damn expensive to be paid for by the individual.

> Under the Murray UBI plan recipients would be required to spend $3000 per year on health insurance. That would be your mother's replacement for Medicaid.

"Annual premiums edged beyond $17,500 for an average family." http://www.ncsl.org/research/health/health-insurance-premium...

And this is in the marketplace that purposefully excludes Medicare recipients, who are older and are disproportionately more likely to have health problems and pre-death expenses.

Here's data on per capita spending on Medicaid, there are very few states where non-disabled adult spending is less than $3k http://kff.org/medicaid/state-indicator/medicaid-spending-pe...

It seems to me the simple calculation is to see that, currently, the US spends ~$9,500 per capita annually for healthcare (that number seems so crazy to me, but therein lies the problem). The WSJ article didn't go into more detail, but I don't understand how $3k per year goes to cover that $9500 amount without huge deductibles and copays, which disabled people won't be able to pay because they will have no other assistance beyond their UBI.

I don't see how UBI works without some other form of guaranteed health insurance for the poor.

FYI http://www.uta.edu/faculty/story/2311/Misc/2013,2,26,Medical...

Her SSI should not go way. She paid into that system and deserves what she was promised. SSI is a retirement plan (albeit a coerced one) not a welfare system. I am all for SSI reform in the light of UBI, but that doesn't nullify the need for retirement, and it should effect only future retirees.

>If Basic Income is to work then it needs to be actually liveable and adjusted based upon the CoL in each area.

What's the point of that? Moving isn't difficult.

Moving fast enough to significantly affect CoL can be extremely difficult if you're poor, less so if your not.

Surely basic income should make moving much easier then?

Depends on how its implemented: one that is implemented as suggested in the source article here (below poverty level and replaces existing poverty supports with aid that is in many cases less valuable in total -- including replacing programs that are federal/state cooperative programs whose value currently is sensitive to local, or at least state-by-state, costs) may well not do so, and indeed may make it harder (as well as making it harder for the poor to even survive.)

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