Medicare should cover children. Then we'd be covering children and the elderly. I think that seems fair--children deserve healthcare (just like education) as a fundamental right. It shouldn't be dependent on their parents.
We can argue about what to do with the parents but in the mean time we're going to let children suffer? That's lunacy. I don't even have children and I'll gladly pay taxes to prevent child suffering. How is anyone against that?
Let's argue about what to do with the parents but not let kids suffer
Like let's say there's two parents, the primary income earner dies, there's not enough in savings, so single parent now needs support. I don't think that's anyone's "fault".
On the other hand, we could look at a case where there's a family who's never made enough money to support their kids and keeps having more. You can take away the kids and fine the parents for fraud. (Obviously should issue a warning before this)
But I think that for some parts of this, tying the benefits to the child just reduces the opportunities for abuse. Medical care for children is a pretty straight forward one. You make it universal and the taxes are progressive such that you make it a wash for middle or upper middle income families and a loss for upper income families. So everyone gets the benefits but that creates an efficient system where we don't really need to do means testing on the child at time of their medical checkup. Same thing for something like food programs. Both of these can even utilize the existing schools so we don't need to build new facilities. For food, you just make it so access to the cafeteria is free. Provide breakfast, lunch, and dinner.
Will people abuse the program? Absolutely. Nothing is 100% bulletproof. Will the cost of abuse outweigh the costs needed to avoid the abuse? Probably not. Will the costs of avoiding the abuse outweigh the costs of a child going hungry? Absolutely not.
I think this last part is important to note because frequently the complaints about these systems leverage the fact that the system is imperfect. We then spend years arguing about how to make it perfect (which is literally an impossible task) and meanwhile we leave the most important part of the problem unsolved, causing damage. If we are unable to recognize that perfection is impossible then our conversations just become silly as we love to "play devil's advocate" or "steelman" arguments. That adversarial nature is a very helpful tool for refinement, but it also can't serve as a complete blocker either.
I disagree with this ownership, as it's pretty bad or at least not as good as what the children could have. Think about how few children received an education before the state took ownership. This doesn't mean I don't understand why it is the way it is. A large part of it in America is for religious reasons: "don't teach my children your Satanic ways." But even without religion, most people have ideas about how their children should grow up and don't trust other people to raise them better than themselves. Even if someone is a shitty parent and recognizes it, they still might prefer more control over less control because they care more about being a parent than their children.
I think, moving back to the topic of the state providing childcare, there's also two more reasons this can be bad. Too often, child support payments end up being misused to fund the parent's lifestyle and leaving the children without basic necessities. You can instead just give the children food/clothing/shelter directly, but you kind of have to provide the bigger, stronger adults in their lives the same things. This creates a perverse incentive for neglectful people to have children. They don't care about the children, just the ticket to free food/housing. Second, people who grow up poor have a lot of disadvantages in their future. Do we want to be creating a financial incentive so that a greater fraction of our population grow up disadvantaged? If the state is not cool with eugenics or taking away children from poor people, then poorer people who would otherwise choose not to have children will suddenly find it more financially feasible. Because the tax dollars came from a richer couple, maybe that richer couple now do not feel they can maintain their lifestyle with another child. Of course, you probably end up with more total children, but the balance has shifted and more people in your society will end up in the lower classes.
America has universal public education because it started with the “Old Deluder Act”: the state wanted people to be literate so they could read the Bible.
The exact opposite of your allegation above: “Think about how few children received an education before the state took ownership. This doesn’t mean I don’t understand why it is the way it is. A large part of it in America is for religious reasons: ‘don’t teach my children your Satanic ways.’”
There is a presumption at law, however, that parents generally want what is best for their children, and the state has a certain standard it must prove if it wants to claim otherwise. So if parents want to teach their children a certain ideology, that is assumed to be in the children's best interest, unless the state can prove otherwise.
Overall, I'd say most parents want what is best for their children and do their best to provide that.
No body goes to the doctor because they want to.
I'll dare say it would be a net positive to even expand this to the undocumented.
Many of them have dependents, it's not going to be great if your dad can't afford his insulin and is thus unable to work to provide for you.
This includes a large percentage of our farm workers who are literally getting sprayed with pesticides all day. That's another issue, but when they get sick they more than deserve treatment.
And finally, the vast majority of illnesses can be treated cheaply if irregularly do your checkups. It can cost society $200 today for a doctor visit , or 30k for an ER stay in 3 years.
That said, I think this should be handled on a state by state basis. If the people of Alabama don't believe in single-payer healthcare, or they want to forbid using single pair healthcare for contraceptive or something, that shouldn't stop a progressive state from implementing it.
Not sure what gives you this idea. The major political party in power in the US today campaigned in large part on cruelty and removing subsidies and social benefits from people. There are a huge number of people who would bitterly fight against providing health care to children. It's the same mentality that bitterly fights against free school lunch for children.
Parents need to be responsible for their children. The state should only step in if they fail in their responsibility.
How is it folks like yourself can understand these concepts across a myriad of domains, including things like wildlife and their rehabilitation, and the importance of fostering self-sufficiency, but not this?
It’s not kindness to create people dependent on the state, or to advantage businesses that do not pay a living wage by subsidizing their employees.
Hell, look at what we’ve done to the cost of education by creating government-backed loan programs that simply allow universities to charge as much as students can afford to mortgage from their future.
And how did personal responsibility make housing unaffordable?
>Parents need to be responsible for their children. The state should only step in if they fail in their responsibility.
How neat and tidy.
>How is it folks like yourself can understand these concepts across a myriad of domains, including things like wildlife and their rehabilitation, and the importance of fostering self-sufficiency, but not this?
What are you talking about? Everyone who's poor and powerless should be helped. More importantly, though, they shouldn't be taken advantage of by wealthy interests. That includes animals, that includes expectant mothers who don't make enough money to survive because the "money to survive" dial was cranked up to 100 in the last five years. But please, lecture us some more about how that's HER fault.
>It’s not kindness to create people dependent on the state, or to advantage businesses that do not pay a living wage by subsidizing their employees.
It's also not kindness to raise their rent for no other reason than you can.
>Hell, look at what we’ve done to the cost of education by creating government-backed loan programs that simply allow universities to charge as much as students can afford to mortgage from their future.
And we could end it all tomorrow by saying "the US government must fund university education". You know, like they do in Europe, or like we did a few decades ago in the United States. You're pointing to a radically predatory policy decision, designed to benefit rich people, and saying: "See? Government doesn't work!" But that's "conservatism" for you: say government doesn't work and then get elected and prove it.
I don't know if you truly believe that education costs would come down if we stopped shunting students into indentured servitude (guess which loans are the only ones that can't be discharged in bankruptcy? What a curious law of the universe that must be!), but if that's the case, then I have a fabulous bridge I'd be willing to part with for a modest price.
I will never stop fighting against people who wield the power of the state to punch down and then point the finger at those same people and blame them. It's disgusting, it's abhorrent, and it must stop.
I can see that. Your ideology creates the problems you think we just need more of your ideology to solve.
You’re not some warrior for freedom or the oppressed, you’re just another person that mistakes enabling for actual care, and thinks serving the interests of the powerful is revolutionary.
So sure, let’s build a system that forces everyone into the workforce, benefits employers who pay too little, and produces worse outcomes for children.
How revolutionary.
What stops someone from saying “I’m an undocumented provider with 500 kids. Pay me 500 x AMOUNT”.
Public schools have residence and identity requirements. What’s an undocumented childcare provider going to have?
This isn't entirely true, there are entire industries catering to the worried well, eg expensive precautionary full-body MRIs with unclear scientific backing, whatever it is Bryan Johnson is doing and selling these days, etc.
And exactly what counts as need flexes and changes depending on circumstance and who is asking. "Do I need a doctor for this" is not a question that everyone answers the same way.
Such a tiny percentage of people actually want to do stuff like that.
Even without factoring in cost, most people shrug it off until it’s bad.
Practically every other country has figured this out, it’s not impossible
https://doi.org/10.1001/jama.2012.36756
There are certain preventive care procedures that are proven to be effective based on reliable evidence. Everyone should get those, and for anyone with health insurance they're covered at zero out of pocket cost.
https://www.healthcare.gov/coverage/preventive-care-benefits...
The majority of healthcare spending goes to chronic conditions caused primarily by lifestyle factors such as substance abuse, over eating, poor sleep, and lack of exercise. The healthcare system can't deal effectively with lifestyle problems. Those are more in the domain of public health, social work, and economic policy.
I routinely go to specialists for things I don't need to, because I make enough money that it's better than waiting for the issue to go away on its own.
Now imagine expanding that to the entire country, when they don't have skin in the game.
For working class people , the skin in the game is having to miss a day of work, etc. Theirs still an opportunity cost
So Medicare as-is for kids wouldn't be significantly cheaper than ACA for kids.
To make it cheaper, you'd need to either substantially increase the subsidy on Medicare, or decrease US medical costs (administration costs, drug costs, doctor salaries, etc)
Medicare and COBRA are not similar costs. My parents pay half what I would pay if I took COBRA and they have a better plan. Neither of them were struggling before they retired and I'll put it this way, they bought a second home in retirement.
One of our parents pays about $20k/yr all in for ACA - $12k/yr of premiums and $8k/yr on top of that (all unsubsidized)
Her (also unsubsidized) Medicare would be $6.5k/yr partA premium + $1.6k partA deductible+ $2.3k partB + $1k partD + $5k medigap, or about $16.5k total. She has no work credits for Medicare subsidy.
If you have subsidy from free partA premiums, then Medicare is about twice as cheap as unsubsidized ACA, yes. If you don't have subsidy for either, it's a little cheaper, but not by a ton.
So if you just stuck kids on existing Medicare pricing with no work credit for partA, then it would not be substantially cheaper than unsubsized ACA.
No they don't. A lot of the "Medicare for All" crowd assumes that "medicare for all"/universal healthcare is free or at least very low cost rather than something that's in the ballpark of unsubsidized individual/family healthcare plans which is the reality at least within a few years of leaving the professional workforce.
OTOH, very few children have enough individual income to be disqualified from Medicaid, but it's based on household income.
My handwavey plan for universal federalized healthcare includes using the child's income as a qualifier for Medicaid, phased in so the system will hopefully adjust over time rather than get overloaded to collapse. Also reduce the Medicare eligibility age over time. A solution that takes decades to roll out leaves a lot of unsolved problems, but adding a large number of people to an existing program in one fell swoop feels like it's going to be a negative too.
https://www.healthcare.gov/medicaid-chip/childrens-health-in...