You can't start any economic argument by saying that paying any cost is a must. You will get fleeced.
It is not true that universal healthcare pays for everything. The most expensive and experimental treatments will not be covered ever by the system, and it shouldnt.
I fail to see your point. All healthcare systems ration care. Not all of them lead to financial ruin at the rate the American healthcare system does. My statement stands. A person ought not face financial ruin. It may be the case that there aren’t enough resources to treat the disease it this does not negate the belief that they shouldn’t face financial ruin.
The logical consequence of this is that any cost must be paid. And if the person cant pay it someone else does. So if someone gets a rare cancer whose treatment has 1% effectiveness and costs millions, it should be paid by someone else.
The principle is wishful thinking, not economics. We as people every day make trades of our life for money. We pick a means of transportation riskier than other to save some money, we choose to use a bike to be physically healthier in the long run but expose to short term risks. We eat those cheese french friends with a beer, or smoke. Etc etc.
We are no strangers to paying our pleasures with our life.
- It is the tendency of all men to magnify their own services and to disparage services rendered them, and private matters would be poorly regulated if there was not some standard of value. This guarantee we have not (or we hardly have it), in public affairs.
Americans often believe that universal healthcare is this pristine ideal that will solve everything, but thats because you haven't analyzed the consequences of it and its real life consequences.
The problem of healthcare in the us is not public-vs-private, its the extreme regulatory environment.
The idea that once you have insurance the problems just magically go away is wishful thinking. These companies are predatory and stupid, and if I hadn't taken the time to read every single line for the 4-page, 10-pt font bill they sent me I wouldn't have even known they were charging me as though I was uninsured.
In the age of high deductible plans I'm not sure this is accurate. For many Americans the $5,000+ for a deductible each year is unsustainable, especially if someone on the plan has an ongoing issue or they have to meet the deductible multiple times (changing jobs or an issue than spans calendar years).
Without the ACA, this wasn't possible for millions of people. With the ACA it was still too expensive for millions of people. With the ACA minus the individual mandate it will be too expensive for even more.
Also before the ACA, health care plans came with yearly and lifetime coverage limits. Coverage limits that were far below what care would cost in many cases. So even with insurance you could still face financial ruin.
... in an open market.
They're claims that are so simply phrased, people can repeat them without thinking critically about them, but if you do, and start unpacking them, the claims are either wholly unsupported, or unknowable.
"Taxes == get fleeced" ... no. Or, at least, not as a matter of course. Maybe some taxes are bad, or unfair, but we can judge each tax on its merits.
"Government program provides worse services" ... no. Or, at least, not as a matter of course. Maybe some things the private sector does better? But a huge swath of civic life relies on government services because, well, that's by definition what government provides, the building blocks of civic life.
Sure. I pay private healthcare and i also pay a medicare tax. Im already getting fleeced for a service I don't use.
> "Government program provides worse services" ... no. Or, at least, not as a matter of course. Maybe some things the private sector does better? But a huge swath of civic life relies on government services because, well, that's by definition what government provides, the building blocks of civic life.
Government is just unable to provide something more efficiently than the private market, it has to be a very particular case for that to be true. What i can do is provide services no market can provide. (like security, legal, etc). A private legal system would run afowl, private armies would be civil war, etc. But thats not because the government is efficient,its because it cant be provided otherwise. I would never call 3.6 trillion defense spending efficient.
The argument in favor of public run healthcare is that private healthcare is unable to do it not that the government is better at doing it.
Do you have a peer reviewed citation for that?
I can tell you feel passionately about this, but your feeling that you're being ripped off by your taxes isn't going to translate well to any sort of workable policy.
>Paying taxes isn't getting fleeced.
I think it's fair to accurately address the arguments being put forth, rather than reinterpreting them. Taxes are necessary, and I don’t think any serious person would argue otherwise. The problems come when we get into the details:
Conflating local, state, and federal governments with their respective tax regiments only serves to muddy the waters. Additionally, conflating property, income, and capital gains taxes compounds the problem.
Scaling anything from 60M people to 300M is non-trivial (just ask Twitter, which is pretty simple).
Arguing for a collectivist approach in the US (which was partially founded on individualism), seems to betray the entire reason for our independence from Europe (the old country) in the first place.
Let Europe do Europe, and America do America.
Edit: Just to be clear, individual European countries are 20% of the population of the US at best, so it makes more sense to compare them with US states (e.g. The state of CA is the 6th largest economy in the world). Top-down policies do more harm than good in such a large heterogeneous place as the lower 48.
Bodies are mostly the same, they break down in mostly the same ways. There isn't a lot of mystery in providing care, either. Nor a lot of mystery in how you'd fund it.
We just aren't doing any of that, cause our politicians are bought so very, very cheaply, and enough people are enriching themselves in small ways through small grifts that changing the system would impact a lot of people who are just well-off enough to be listened to.
Scaling advanced systems to large numbers of users is very difficult and is the reason Facebook is worth ~1/2 Trillion dollars.
"James Madison argued, especially in The Federalist No. 10, that what distinguished a direct democracy from a republic was that the former became weaker as it got larger and suffered more violently from the effects of faction, whereas a republic could get stronger as it got larger and combats faction by its very structure."
<our politicians are bought so very, very cheaply, and enough people are enriching themselves
If this were true, we should arbitrage this value-mismatch and create a market for buyers and sellers of this powerful, political influence. "cheaply"? As the saying goes, "Extraordinary claims, require extraordinary evidence."
It is possible that the lawmakers share the same views as the for-profit/non-profit corporate execs, just like I agree with Green Peace(i.e. lobbyists) that we should end the practice of whaling significantly. The sovereign nation of Japan disagrees.
Sometimes government is the efficient solution. Sometimes private enterprise is.
Private actors, by definition, must extract something from any service to pay themselves.
The government has no overhead. It can run with absolutely no profit and that is its intended model.
A private health care company that returns zero profit to its shareholders? Shut 'er down.
A private transit company that returns zero profit to its shareholders? Shut 'er down.
And yet, government services can run indefinitely at break-even because they're not beholden to the market.
Only government can be so efficient--the private sector always loses efficiency through someone scraping something off the top.
Realz.
Some things governments simply do better; health care is one of them. Denying that fact in the face of the mountain of supporting evidence is nothing but dogma.
I can't see a reasonable argument for that.
> And if medicare were expanded to the entire population of the us, its expenditures could be 40-45% of gdp.
Even with a naive covered-population-number based extrapolation that ignores that Medicare currently covers the elderly, who tend to have greater medical needs than average, that's not right; national health expenditures are about 18% of GDP, Medicare is about 20% of NHE, and Medicare currently covers around 15% of the population, so a naive population-based extrapolation would put Medicare-for-all at about 24% of GDP.
On the extrapolation, of course they are all simplistic and wrong, both mine and yours. You are capping the NHE of GDP to cap medicare, as if the expansion of medicare were going to eliminate out of pocket or private health. Because it doesnt, if it replaced only half of expenditures, the 24% becomes 33%.
Its true Medicare takes care of older patients, but also private insurance subsidizes medicare all along the path to that because it pays more than medicare to every provider, which means on the pool of patients, the medicare patients tend to represent losses and the rest profit. Furthermore there is the argument that if medicare expanded 7 fold, it would also be less efficient the bigger it gets, which is true of private and public organizations alike.
We cant know, its messy and even expert economists cannot get this right: but it has to be in the order of magnitude of 25 to 40% of gdp. That is state-crushing expenditures.
No, I'm not, I'm using the current expenditures as the projection baseline. I'm clearly not using the current NHE share of GDP to cap Medicare because the projection (24% of GDP) is greater than the current NHE share of GDP.
> as if the expansion of medicare were going to eliminate out of pocket or private health.
No, you made a claim about Medicare expenditures being 40-50% of GDP if it covered the whole population, not other expenditures. Now you're moving the goalposts (and still not supporting your mutating guess with any actual concrete basis.)
> We cant know, its messy and even expert economists cannot get this right: but it has to be in the order of magnitude of 25 to 40% of gdp.
Well, that's a sudden drop in your estimate of what now seems to be total NHE from your earlier claim that Medicare expenditures alone would be 40-50% of GDP. Another round of this and you'll be conceding costs below the current 18% of GDP.