I feel like throw-away statements like this almost come out of a different era, like the platform Reagan ran on, "government isn't the solution, it's the problem" or whatever.
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.
> "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.
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.
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.
>>You can't start any economic argument by saying that paying any cost is a must. You will get fleeced.
>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.
I've never seen a plausible explanation of why a health care system would work for 60 million (UK) but not for 300 million (US).
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.
>I've never seen a plausible explanation of why a health care system would work for 60 million (UK) but not for 300 million
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.
The services could be worse but aren’t necessarily worse. It’s foolish to think that any government service is worse than a private one. Also, universal healthcare doesn’t necessarily mean government run.
It’s foolish to believe that private enterprise is always more efficient than a government run program and it’s foolish to think that government is always more efficient. One should not live in a world of such extremes.
Sometimes government is the efficient solution. Sometimes private enterprise is.
Like the real life experience of those private Russian mercenaries who went up against the US military in Syria?
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.
It's not a great comparison for a lot of reasons (not least of which the first being that Medicare is legally not able to negotiate drug prices), but despite all of that, yes Medicare is dramatically more efficient.
Medicare is the core of all regulatory and pricing issues in the healthcare space. And if medicare were expanded to the entire population of the us, its expenditures could be 40-45% of gdp.
> Medicare is the core of all regulatory and pricing issues in the healthcare space.
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.
Medicare is the reason there is fee-for-service, which is the biggest administrative overhead design if there is one. Also all private insurance works based of of medicare in the rates they pay, the way they code themselves etc.
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.
> 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
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.
... in an open market.