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About a third as much, and this is assuming that people actually donate that much, which as a rule they don't, not even where people don't pay taxes.
Now sure, the absolute amount spent would probably be lower if we just assumed that people that couldn't produce paperwork to prove they could fund their ER visit didn't deserve to live. If you prefer zero taxes and zero life expectancy for anyone unfortunate enough to need lifesaving treatment they can't afford, that's a perfectly valid preference. It's just intellectually dishonest to frame an argument that it's inefficient to let poor people live as an argument everyone would get more care if it wasn't for the pesky government paying for it.
Your premise was we have some kind of private system; my thesis is the uncovered poor would be better off with that than whatever it is we have now where they can maybe go to the ER "free" but otherwise pay a gazillion dollars in regulatory and other imposed costs if they actually try to get some prophylaxis.
If you want to say universal healthcare could be better than whatever we have now -- sure I won't disagree with that. Right now we have about the worst imaginable public-private bastardized system replete with deep regulatory capture.
>If you prefer zero taxes and zero life expectancy for anyone unfortunate enough to need lifesaving treatment they can't afford, that's a perfectly valid preference
... this is not my thesis at all, as you're relying on "can't afford" being at the level it is now where the poor are being billed for all manner of things they wouldn't be in an actually private free market and you're also relying an an absurd premise there will be no charity or any other options for them. For instance, in the Philippines I could just walk into a private pharmacy and buy penicillin essentially no questions asked to treat strep throat on the private market for ~half a day's local wages. (Yes Philippines have public healthcare and hospitals but you're not gonna get that meaningfully in some rural barangay). In USA it takes me 1-2 days wages to treat strep throat because I must go to a doctor to write me magic piece of paper that say I will not go in a cage for having a prescription drug, pay all his regulatory overhead, pay regulatory overhead for a lab, then go to a highly regulated pharmacist and then buy my antibiotics from probably the highest-barrier industry in the US through an anointed company and supply chain blessed by the government. I am much better off having cheap, but non-free antibiotics to treat strep than having to wait until it becomes Scarlet Fever and going to the ER for "free" or being taxed into oblivion to get "free" antibiotics that are then administered in the most bloated and uncompetitive way by government to the point I give up other necessities to pay the tax.
You have the fully private provision you insist is more efficient. It costs more for worse outcomes than every other developed country, who also have regulations. If your original claim that the private sector is so efficient it could deliver everything for a third of the tax cost of the current system, it's remarkable that you're actually paying a large multiple the cost of the fully socialised systems for many people to have no care or crippling copays.
Sure, you can move the goalposts by claiming that true private provision requires there to be no medical regulations. But in order for that claim to be remotely credible you'd have to be able to point to all the countries that have great outcomes from having no medical regulations or public healthcare at all (the Philippines where the government is the main provider of healthcare but it doesn't have the time or inclination to enforce regulations on OTC antibiotics doesn't count, even if its health outcomes were excellent, which they're unsurprisingly not). Not gonna lie, if I'm suffering from the symptoms of a heart attack, I don't think antibiotics for half a day's pay are going to help, and literally the only efficiency argument for restrictions on ER rooms being allowed to employ extra admin staff to check insurance paperwork before deciding to administer treatment being an efficiency loss is that it's more efficient to let me die if I can't pay. As I've said, common argument but the complete opposite of your original setup where everyone gets the same outcomes for a third of the cost.
And you can argue that it would be better if those patients could get free urgent care instead of free ER to do the same thing at way higher cost, and I would agree that would be better than what we have now. But either way we're at an entirely different starting point.
What you can't argue is we actually have a private system in the US (and somehow miss the elephant in the room that over 1/3 of healthcare spending in the US is public Medicare/Medicaid, then add VA on top that) and then allude it's no true Scotsman or a moved goalpost if I point this out. In fact every time I do point it out, you just go back to morally proselytizing about dead poor people because it's a great way to distract from the fact you've lied and knowingly lied.
Correct me if I'm wrong, but aren't private hospitals entirely free not to accept EMTALA patients if they also choose not to accept Medicare funding? And that some do, and remarkably still manage to be significantly more expensive than the rest of the world. Weird all these profit making companies opting in to accepting the regulation though, if it's that big a burden.
Like I said, if it was easy to do so much better than socialized healthcare simply by abolishing regulations on the private sector (which itself is a different discussion entirely from whether private companies are intrinsically more efficient), it's surprising nobody seems to have achieved this, anywhere. The true purely private healthcare system that delivers the same or better health outcomes at lower cost doesn't exist.
If you truly thought our health care was privatized it's all a moot point, because it wouldn't have been included in our original argument. In either case your point is moot because I never compared to hypothetical socialized healthcare but rather our current entire government system.
It blows my mind you would even use the "1/3" statement if you thought it was private because if it was private it wouldn't have even been in the subset of stuff I was comparing relative cost to. I never claimed private things would cost 1/3 the price of things already "private."
Mathematically impossible to achieve the functions of the US government for a third of the cost without cutting healthcare spend. Which has been demonstrated to be entirely possible by other countries, but only by choosing to let more people die or, ironically, removing some of the dependence on inefficient private companies for provision...
Obviously people are a lot more willing to give away value when it costs them virtually nothing (like roads in a rural area with definitionally extremely low traffic)
You can see the government having a monopoly and captive buyer causes them to be horribly inefficient, as they have no competition (and no private competitor will emerge when the price at point of use by their competitor is zero).
Here's a lovely 160 acre plot for $100,000: https://www.zillow.com/homedetails/E1-4-Sec-15-T-24-R-89-Bk-...
Or do you mean people can't try this out in areas that have already been developed by generations' worth of other people's private and public investments?
Imagine for a moment I had a private school that was equal in all ways to a nearby public school including cost. People would say "why I already paid taxes for the public school, why would I go there and then have to pay yet again." No one would go to the private school. Whereas if they were not made to pay the taxes, they'd be about as equally likely to go to the private school as the public one, and the overall costs would be same.
It is very difficult to establish a robust private road system in a place with public roads. The public views the public road as an established asset rather than the reality (they are an ongoing subscription of maintenance costs). The costs are invisible to the public, even if they might be worse, they just see the road as "free" when they drive on it. This means the public can end up spending even more money with worse results than use of private roads, but be stuck in a local minima they will never escape from.
You can go buy land anywhere you want (i.e. where there are no public roads) and your private roads can compete just fine.
Anyone has always been free to do this since this nation was created.
What's the problem?
I build a private interstate next to a public interstate.
Lets say it costs me $0.20 / mi per honda civic that travels on it, and the public road costs $0.30 / mi per honda civic that travels on it in amortized costs.
At the point of use, the user sees my toll of say, $.25 / mi with some profit, and at point of use the user sees $0.00 for the public highway.
Who on earth would bother to take my toll road, even though it is more efficient and cheaper? They've already paid the tax, and not only that, it is largely invisible to them. The government will literally imprison them or take their shit if they don't pay it, it is a sunk cost, the government has violently usurped my competition via payment under threat of violence.
You can't compete with 'free' at the point of use enforced by a violent actor against a sunk cost. Yes if you buy a plot of land that appears to not even be accessible by vehicle without some kind of unknown corner-crossing easement (one linked), then you will win out vs the non-existent competition there, but of course if the government shows up and taxes you to build a road even then you would lose.
It's not the public's job to provide customers for your toll road.
You can build your toll road and have unencumbered competition elsewhere.
No I'm talking about using infrastructure a private entity has paid for as competition.
Would you call it "unencumbered" competition if I started stealing a few bucks from everybody that goes to the gas station, then paid people to take my road with the ill-gotten gains instead of the public interstate, then declared that the government is free to compete unencumbered? Of course you wouldn't, I can't just take money from everyone at the gas pump, but the government can so that their public "toll" is already paid and I can't compete even if my road is cheaper.
The end result is public roads have a mobster-type clamp on the encumbered market. You can't compete with them because they have a monopoly on violence and use it to prepay the toll to game the price at the point of use.
What hypothetical car has the option to use your road or use the public road, but wasn't provided to you as a potential customer by the public road?
Agreed, when a public road provides your customer, it's hard to win that competition.
But again: you can just build your roads away from public roads, find your own customers, and then you don't need to compete with them.
Mine, where I live the roads for miles and miles are all private with public easements and are privately funded. Of course by your definition that would make the public road illegitimate, because it has unfairly poached a private road user (not sure I agree with that).
Separately, how do you handle it when a neighbor decides to neglect their portion of a road?
Not sure what the illegitimacy point is about.
Sometimes other private roads, sometimes private property/houses, sometimes public roads. Sometimes people travel exclusively on private roads, sometimes not. I don't understand your point here, a private road isn't allowed to connect to a public road but a public road is allowed to connect to a private road? It doesn't pass any sort of symmetrical test.
>Separately, how do you handle it when a neighbor decides to neglect their portion of a road?
If they neglect their road they can't go buy groceries or use their property. So it is extremely rare, as they're basically forced to do it out of practicality, they would be hurting themselves more than anyone else. Down to the point it's well within the tolerable amount of charity. Usually some retired person comes along with a backhoe because they have nothing else to do, and until then the roads are large gridded so the roads never become impassable. In practice your concern hasn't become a problem in my years of living on private roads.
Re maintenance: Again, obviously doesn't work outside of an area that definitionally does not have very few people/businesses.
If everyone lived in density like yours, first of all we wouldn't have nearly anything good about modern life, but secondly yes we could obviously have the system you describe. I'll take public roads and modern life any day.
Sometimes yes sometimes no.
>If everyone lived in density like yours, first of all we wouldn't have nearly anything good about modern life, but secondly yes we could obviously have the system you describe. I'll take public roads and modern life any day.
I'd say high density public roads are causing a big problems for cities. Cars are subsidized in a way that distorts the market to overrepresent car travel over private mass transit or other more efficient alternatives. I believe our cities would be much safer and more enjoyable, without losing access to needed goods, if the roads were all privatized.
I'm not opposed to say, privatizing many functions of government so that they are no longer commons. I feel this would solve that problem better than making the commons larger.
Let's start off with the first point "They are just easements on private property" That's what most public roads are. They are still owned by the public (the government) and maintained by the public (the government). Where I'm from, we have plenty of dirt and gravel roads just like this. Once every 10 years or so the county comes in and re-gravels them. They are mostly only ever used by private individuals and they cross through private land, but they are ultimately public. There are actual dirt roads which are also publicly owned but unmaintained.
Where there are private roads, they've been an absolutely nightmare. What's happened with private roads is rich individuals tend to like to throw up gates and no trespassing signs on the roads. Particularly if it blocks off public land, which they don't own, and turns it into their playground. That happens all over the country. In particular you'll see it happen to lakes an on beaches all the time.
But finally, you benefit from the public road whether you want to admit it or not. And particularly when population density goes up, public roads become much MUCH more important. The model you propose is one that only works if we are in very rural locations. It completely breaks down as soon as you need to get goods into a grocery store or supermarket. We subsidize with our taxes the damage done to roads by shipping products and goods. Because I like eating fresh fruit and vegetables, I don't mind that I'm paying a little more taxes so I can have access to those goods. Along with amazon shipments and my mail.
There's a reason no ideal libertarian society exists, because they go to shit when they are tried (see Argentina who is currently looking for a bailout from the US because of their dumb economic policies that you likely support). There are plenty of failed "free town" experiments. The book "A Libertarian Walks Into a Bear" is an amusing story about exactly how this system ultimately turns into a trash heap city.
I pay like $50/month in property taxes and that's basically exclusively for public school and college, which while I'm not thrilled to be paying anything above $0 at least basic education has a massively positive ROI.
We don't have any sort of effective police/fire presence, public roads, any public utilities, or really any government services besides grade school education and it's been that way for 50+ years without any sort of apocalypse or us all being eaten by bears. Which is amazing because I don't have to worry about some asshole coming along to choke me out on the pavement were it I would have the bad judgement to sell a loose untaxed cigarette.
So far the place hasn't turned into a trash heap, and I've gotten the services I used to get by public services in other areas for 1/3-1/2 of what I was paying before.
I'm happy to have it as my little secret, but I hate to see y'all suffering.
None of those factors are possible and/or desirable, in cities. And cities are necessary things.
If I don't fix my road, I just can't go anywhere, which obviously forces me to voluntarily fix it. If I don't voluntarily fix it, I'm stuck until someone comes along with a backhoe, and given only the tiniest % of people will purposefully sabotage their ability to go buy groceries, the burden of having to fix a neighbors road is so miniscule that it fits well within tolerable natural rates of charity.
The end result is the county roads are enforced by violence (tax man will toss grandma out of her house if she doesn't pay up, and assault her if she resists), while the private roads are enforced by a mixture of voluntary action on your own property and some relatively rare charity for those who just don't give a shit if they ever leave their house.
The difference here is the government can initiate violence against me, while the people involved in the private roads cannot.
How would you maintain the road if I, who also uses the road, doesn't pay for maintenance?
-public access private easements (my road)
-public access non easement (grocery store parking lot, cost amortized by customers)
-toll road (some highways, etc)
-completely private road (only owner uses it, i.e. private farm road)
Only the first of those has the potential for the kind of abuse you mention, I think, because it mimics the government kind of road in some ways where the maintenance costs aren't captured at the point of use. If it gets bad enough charging $0 you might need switch to some other kind of private road.
In any case this isn't nearly as bad as the tragedy of the commons situation if it is a government road, I think, at least as implemented. Our county roads have a tragedy of the commons situation where you could use the road and then some totally unrelated grandma gets dragged out of her house for not paying for it, despite the fact she's never even been on the road -- to me that seems strictly worse "tragedy of the commons" than even the public access private easement because at least under the private easement I can't initiated violence on unrelated persons for other people using the road.
It would seem quite hypocritical (and ironic) indeed to me for proponents of public roads to damn private roads under the idea of tragedy of the commons, so I'm not sure it's a valid indictment here that the tragedy of the commons is somehow becoming even more unsolved when roads are privatized.
It seems bizarre to damn some methods of private roads for not solving something you claim has no solution, then just glance over the ones that mitigate it.
You've shown no reason why you can't "get around government" but rather just dismiss the ways that just did.