empira

Sure, and I also drive on the sidewalk with my car because I'm so used to it when I walk.

Of course. And that is not the case at the moment. Microsoft will not get fine for 'avoiding' corporate taxe if what they do is legal. But governments will sure try to change the law so that they grab as much as is needed.

Well it all depends on your ideas about taxation, society and the role of government.

It is true that huge corporations already "give back" a lot of the money they collected under various forms (income tax, VAT, etc.)

But if you think that the role of government is necessary, then you agree that it should collect taxe to exercise this role. And money is taken where money is. We tax corporations because they make benefits, and a benefit is just a way of saying that even after deducting everything they can think of, they still have money they don't need. So why not take a part of it and re-invest it elsewhere where it is needed ?

Ultimately there is no proper justification for any tax, except its necessity to let society fonction properly.

I can tell you that on my side, it is expected that you are completely unreachable when you are not supposed to be working. That applies during your holidays, when you are sick (you still need to open the door to the work's doctor if he comes visit you) or before/after work hours and during the week-end. Not only your boss or collegues wouldn't try to contact you (or would not expect a response), but they would not even try, as it could lead to you (rightfully) complaining to HR.

The reality as always is more complexe. It is true that some role come with an (implied) expectation of general availibility. While it would be your right to decline any work-related phone call, I'm sure it could one way or another impact your relation with your boss, especially if 'it comes with the role'. I guess it all depends on what you want. If you don't want to be answering work calls during your holidays, you can always fake being unreachable. It's not unreasonnable to not have your phone with you at every moment. Or, if you don't mind being reachable, maybe arrange for a predefined time slot (from 9 am to 9.30 am every day) when they can call you, so that you don't have to worry about it all day.

My previously employer offers just that : you could spend money to 'buy' up to 10 (more) days of holidays per year (for context, you start with 20 mandatory days, plus 10 to 15 depending on your seniority and your age). It would cost you exactly what it would costs the company to pay you, and seems redondant with simply taking un-paid holiday. They were several benefits to this though : those extra days would become part of your offical compensation, so you are entitled to take them in the year, and you do not need his approbation. It is also slightly better for your pension and your taxes to buy those days rather than take un-paid holidays.

The drugs/treatment you mentioned where all developped thanks to public contributions, not purely private research.

HPV vaccines were first developed by the University of Queensland in Australia [1] and further improved by the the University of Queensland, Georgetown University Medical Center, University of Rochester, and the U.S. National Cancer Institute [1].

CRISPR was discovered by several researchers from the University of California, Berkeley, the Broad Institute of Harvard and MIT [2].

The public helped in the discovery of those treatments (through tax payer subsidies), and as such, in my view, are entitled to some kind of retribution. Having a form of universal healthcare, where the public can put pressure on companies to decrease the price of different treatment, is exactly that.

Regarding the velocity of innovation, I don't think it is hurt by a universal healthcare system. Everyone has access to those treatments, and so the profit on each instance of the treatment can be lowered while keeping the same total profit for the company manufacturing the pills.

What is the point to discover insuline if the price asked for a shot makes it impossible for some people to buy it ?

Even if some treatments, like drugs, can be made generic, and through that, have their price descrease in the futur, what about medical procedure ? Hip replacement won't suddenly or magically become cheaper in 5 years. Look at the price of stitches in the USA (For patients without health insurance, stitches typically cost $200-$3,000 or more, depending on the provider, the injury and the complexity of the repair [3]).

I do not propose to slash the profit of pharma companies. Like you said, academic studies consistently show that a reduction in current drug revenues leads to a fall in future research and the number of new drug discoveries [4]. Forbidding them one way or another to make a profit would be a net negative on the long term. But were our differences arise are in the implementtion of this principle. You propose, and correct me if I misunderstood, to let them set the price, and those how can will buy it. I propose to contain the cost so that all who need can afford it. The net result could be the same.

Price controls, like other types of controls, are a necessary evil in lots of case. It would be cheaper to allow companies to pollute everything and everyone, but we decided that society as a whole is better off with environmental controls. It would be cheaper to not test all those drugs and just let the market sort out which pills are working and which ones are dangerous, but we decided against it.

[1] https://en.wikipedia.org/wiki/HPV_vaccine#History [2] https://time.com/time-person-of-the-year-2016-crispr-runner-... [3] https://health.costhelper.com/stitches.html [4] https://itif.org/publications/2019/09/09/link-between-drug-p...

On the other hand, right now, only the rich, or those with good enough medical insurance (if your co-pay is more than you make in 6 months, are you really insured ?), have access to the expensive treatments. On a universal heathcase system, whatever the form it may take, more people would have access those expensive options. Is it better to sell your treatment to more people but at a smaller price tag, or to fewer people at a bigger one ? I guess the economics depend on each treatment.

Fostering innovation is of course important. Which is why you can deduct a lot of your R&D expenses from your taxes. Again, each country has its own tax code, so generalization might not be possible, but in a lot of cases, the hard work of finding new drugs is funded by the citizens, through tax breaks or research grants. The public sector, via universities and public labs, is a major player (although not the only one, of course) in the medical field.

Let's not forget that forcing people to stay with their employer to maintain insurance coverage is also a way to stifle innovation. How many of those workers could have and would have started a business, if not for the fear to loose everything in case of medical issues ? Surely the republicains would love to remove those kind of barriers to worker movement and innovation, wouldn't they ?

The universal healthcare system obviously isn't free. Altough some studies, and real life examples elsewhere in the world, showed it wouldn't be the money pit some imagine, it certainly doesn't run on love and compassion and fresh water only. The taxes in my country can show you that. But the social benefits and the peace of mind I enjoy are, in my very own and somewhat biased opinion, worth the cost.