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Also, not all of the admin overhead would disappear if we got rid of means testing. I don't have the expertise to come up with a specific number, but I'd wager that getting half the admin costs back would be the absolute best case. I still support simplifying means testing for benefits programs, but not because it's going to magically free up a consequential amount of money.

> Also, not all of the admin overhead would disappear if we got rid of means testing.

Exactly. The same conversation happens with discussion about eliminating private health insurance: Other countries with nationalized health care still have their own overhead. It's less than the overhead of a private healthcare system, but not by as much as everyone assumes. You could completely eliminate the overhead of private health insurance in the United States and it would only change the situation by a couple percent, though most people assume it would be much, much more.

Precisely, people on the left wildly overestimate the admin overhead while people on the right wildly overestimate the fraud.

In the end, we have a gradually increasing idea of what the "basics" are which we should provide the poor / the elderly / everyone, and a decreasing working-to-retired ratio.

That is - the spend side is increasing faster than the income side. Europe is about 10 years ahead of us on this problem, but we are catching up fast.

>Precisely, people on the left wildly overestimate the admin overhead

Public or private? I've never seen "the left" criticize admin overhead in public services.

McKinsey estimates healthcare profit pools will reach $819 billion in 2027.

They don't criticize it, but believe UBI will "almost pay for itself" by not requiring aa much overhead. Which it won't, not even remotely close.

I think the other problem with UBI, besides the fact that we can't afford it .. is that its probably actually bad for society.

Many problems come from an increasing lack of purpose in society. Getting paid to do nothing will not solve that for probably 99% of the population. Lots of idle time for lots of bored people is like pouring gasoline on a fire.

UBI isn’t “getting paid to do nothing”, it is “removing rapid clawback from means-tested welfare so that there isn’t a significant range in the working poor to middle income range where additional outside income as reduced impact because it is offset by welfare clawbacks.”

It really depends on who you ask.

Mechanically the other problem would seem to be, if you listen to someone like Gary Stevenson, that it only works if you ratchet up taxes on the top end.

Otherwise broad flat cash distribution from the government generally causes inflation and all the money ends up workings its way up to the wealthier. So if you do not tax it back, it actually ends up being regressive.

The mechanism is something like - the poorer you are, the higher % of your income, by necessity goes to spending on basic needs. You have a zero or negative savings rate. The richer you are, the opposite. You have savings you put into income producing assets (stocks which are fractional ownership in companies, real estate, etc).

So if everyone gets $25k/year, the bottom end will spend it all on goods & services (food, clothing, rent) that are owned/produced by the wealthy. And it compounds as the wealthier then are able to buy more and more income producing assets from the middle class.

> Mechanically the other problem would seem to be, if you listen to someone like Gary Stevenson, that it only works if you ratchet up taxes on the top end.

That’s not what I'd call a problem (its part of most concrete UBI proposals), but, yes, whether you look at it through a classic fiscal lens or a macroeconomic impact lens, you have to raise taxes concurrently if the UBI is significantly greater in aggregate payments than the means tested welfare it replaced (which it must be to maintain the same base benefit level, and many proposals would increase the base benefit level), and any sensible implementation will do it progressively starting somewhwere above the middle of the income distribution.

It's only a problem insomuch that I don't trust government to properly implement and maintain UBI&taxes in unison.

Politicians need to win elections every 2-6 years, and honestly most of them aren't that bright.

There's a much easier way to solve that problem than UBI. Just adjust the numbers

Its actually simpler on both an initial and, even moreso, ongoing basis to eliminate multiple means tested programs and replace them with a single UBI with clawback through progressive taxes than to adjust the numbers in all of them in a way which has the same effect and then administer that on an ongoing basis througn the separate bureaucracy attached to each program. (Especially since the UBI itself, as well as the clawback, can be built into the tax system simply by “adjusting the numbers” in that system. Which is why “negative income tax” is a name under which a policy identical to UBI+tax financing has been proposed.

Negative income tax is probably a more straightforward to implement this.

Explaining to middle class people that they are going to get $20K UBI but their taxes are going up $18K isn't going to go well.

Remember whenever you setup a "good" government program thats dependent on 1-2 other "bad" government programs in unison (UBI + progressive tax increases) then the risk is future admins remove the medicine but keep the candy. Then the whole thing becomes unaffordable and the good program gets wound down.

Or you end up with crazy stuff like the UK triple lock pensions.

That is a very good point.

Two mitigations would be gradual adjustments, and a willingness to delay reductions a bit.

People shouldn't be sweating bullets about help being pulled prematurely as a direct result of trying to get past the need for it. Or have the marginal impact of increasing their earned income actually reduce total help+income.

I know somebody in an extremely bad health situation, and dealing with both of those perverse issues. Attempting employment would carry a lot risk. And with kids to be cared for, playing roulette in an already challenging situation is a real barrier. (In this case, it isn't government help, but a situation with similar logic.)

A large number for sure, and completely agree likely too much.

However that's against a projected total spend of $6 trillion in 2027, so 13% accounting for all profit for every level in the medical system (insurers, providers, pharma, medical equipment, etc) .

If you were to wipe that to 0, maybe medical costs go down 13% in US. I don't think US is seen as obscenely expensive and bad value (outcomes per spend) because of a 13% difference.

For example per capita medical spending is 2.3x higher in US than UK, so wiping out all profit will bring us to.. about 2x UK costs.

It's a deeper structural problem of utilization (lifestyles, behavioral), high labor costs (AMA cartel), incentives (pay for treatment not outcomes), etc.

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