UBI should cover government-regulated and government-provided essentials to living.
Ex.:
* Government housing: $500
* Government basic food package - daily (1500kcal): $300
* x kJ electricity, x m3 water, x m3 gas, x bps internet connection: $500
* Clothing, hygiene, cleaning supplies: $50
* Universal healthcare: free (and free condoms)
* Free education (from abc to PHD)
This is not a comprehensive list, or even the right values, however you can guarantee a base-level of what is "living with dignity" and apt to participate in the democracy.
I doubt you'd have too many people deciding to live without a job. It's not the best life, but you can survive with some human dignity. Many around the world live with much less.
UBI isn't the American Dream, it's the safety net.
> UBI should cover government-regulated and government-provided essentials to living.
The reason you don't do this is that the government is not better at making diapers and laundry detergent than Procter & Gamble nor better at manufacturing Tylenol than Johnson & Johnson nor better at growing tomatoes than local farmers.
If you give people $300 then they can buy $300 worth of food. if you give people $300 worth of "government food" then they'll have $150 worth of actual food because half of the money will go to the agriculture companies with the best lobbyists, and the same lobbyists will get to choose what kind of food it is. Government cheese is not an ideal. Meanwhile if you have $300 then if you want to you can grow your own tomatoes in your back yard, eat those, and use some of the money for something else entirely.
Also, special fail for these:
> * Universal healthcare: free (and free condoms)
> * Free education (from abc to PHD)
Suppose the government could provide healthcare for $10,000/year. Okay, let them do that while giving everyone $10,000/year to buy it with. But don't force them to.
Suppose a private health insurance company could provide coverage for $5000/year with a $10,000 deductible, instead of $10,000/year with no deductible. You're taking more risk, but not that much more (best case you gain $5000/year, worst case you lose $5000/year). And overall you would expect it to be a gain because you're paying the first $10,000 out of pocket, which makes you price sensitive, which causes you to not waste money on unnecessary care, which lowers average costs.
It's the same thing for education. Give parents money and let them choose a school. Solves the entire mess with school quality being tied to home prices. Doesn't screw over parents who home school, because they still get the money. And if the government can provide the best schools for the best price, parents will choose them anyway. But if not, they shouldn't be forced to.
> provide coverage for $5000/year with a $10,000 deductible, instead of $10,000/year with no deductible.
that's the wrong way to think about it. The above makes an implicit assumption that by doing this you "save" $5000/yr because the insurance company is "more efficient".
That's wrong - you actually cost $5000 (this being the "profit" the insurance company makes if you _didn't_ need the medical treatment that year). Under the gov't version, if you were healthy, you're "free". You only cost when you actually need the medical treatment.
Healthcare should not be done under a private insurance model. Any profit made by the private insurer is a cost to providing medical treatment, and does not contribute to the outcome. By making medical treatment a tax payer funded scheme, the cost of an unhealthy society is spread out amongst all. Not only does this give the gov't buying pressure to lower the margins of all medical treatments, it also makes a policy pressure for gov't to give preventative measures for good health outcomes (like legislating low sugar foods, or incentivize exercise and good diet etc).
> Under the gov't version, if you were healthy, you're "free". You only cost when you actually need the medical treatment.
Government insurance is still insurance. It isn't that each individual costs the government $10,000, it's that most cost them nothing and one in ten gets cancer and costs $100,000. Insurance is the same. The large majority of the money isn't going to the insurance company, it's going to healthcare providers.
> By making medical treatment a tax payer funded scheme, the cost of an unhealthy society is spread out amongst all.
This is literally the definition of how insurance works. It's also why insurance sucks, because it allows people to make risky/unhealthy choices and socialize the costs of those choices, and therefore why high deductible insurance is more efficient by introducing at least some price sensitivity.
> Not only does this give the gov't buying pressure to lower the margins of all medical treatments
This is equivalent to legislating prices. They can already do this regardless, but it's a bad idea for the same reason price controls in general are. How do you determine what the price should be? Too high and you're overpaying, too low and you force providers to lower the quality of care to meet the price target. If this was so easy then why wouldn't the insurance companies be doing it too?
> it also makes a policy pressure for gov't to give preventative measures for good health outcomes (like legislating low sugar foods, or incentivize exercise and good diet etc).
Couldn't they do this anyway? Also, wouldn't they have the opposite incentives, because then the companies making blood pressure medicine or whatever would lobby against any such programs, and be more proficient lobbyists because they're already dealing with the government to begin with?
And if the government really is so much more efficient then they should easily be able to out-compete the insurance companies and other healthcare providing systems on fair terms in a competitive marketplace, right?
I get the impression you're idealising the free market. The numbers[1][2] speak for themselves in proving that universal healthcare is the most affordable way to provide good healthcare.
In the UK the NHS (2016) per capita cost was $4,192 (PPP) and in the US the per capita cost was $9,892 (PPP). The OECD life expectancy average for the same year in the UK was 81.2 in the US it was 78.6. Comparable healthcare outcomes for vastly different costs.
I don't know how the politics of healthcare and lobbying differ between the UK and the US but whatever they are the numbers show that Universal healthcare is better for everyone in spite of your (or really anyone's) arguments against it.
Average life expectancy is a really flawed metric to measure the effectiveness of healthcare systems, because there are a ton of non-healthcare related confounding variables that impact average life expectancy. Anyone that dies early brings down the average life expectancy, and that includes suicides, homicides, drug overdoses, and car accidents. The US has more traffic fatalities per capita than any other Western European nation. The US has more opioid deaths per capita than any other Western European nation. The US has more gun-deaths per capita than any other Western European nation. While each of those problems have their own political causes...none of them have much to do with the underlying healthcare system, so using it as a metric to measure the quality of the healthcare system in question is ill-advised.
All that being said, if we were to use this metric, for the sake of argument...these charts are quite illuminating, but not for the reasons you think.
If you plot them on a graph, you'll find that the most efficient healthcare system is actually one closer to the "idealized market"...in Singapore[1].
Also the comment to which you are replying is strictly talking about "government insurance". "Government insurance" is not the only way to deliver universal healthcare. Germany, Switzerland, Netherlands, Singapore all have thriving multi-payer systems. In Switzerland and the Netherlands, ALL insurance is private. In Singapore, while the government covers catastrophic care, 70% of total health expenditures are private. Singapore's approach is actually the closest to what a system might look like if you replaced healthcare-specific targeted subsidies with a UBI — most health expenditure is through compulsory health savings accounts.
The common theme is that there is some degree of government intervention/regulation and subsidy. Having the government be the sole payer is definitely an approach, but it's by no means the only approach, nor even the best approach.
"Universal healthcare" just means that everyone has healthcare, it doesn't necessarily mean that the government provides it for everyone. We have pretty close to "universal food" in most of the developed world, and the vast majority of the food system is delivered through the open market.
>"Average life expectancy is a really flawed metric to measure the effectiveness of healthcare systems, because there are a ton of non-healthcare related confounding variables that impact average life expectancy. Anyone that dies early brings down the average life expectancy, and that includes suicides, homicides, drug overdoses, and car accidents. The US has more traffic fatalities per capita than any other Western European nation. The US has more opioid deaths per capita than any other Western European nation. The US has more gun-deaths per capita than any other Western European nation. While each of those problems have their own political causes...none of them have much to do with the underlying healthcare system, so using it as a metric to measure the quality of the healthcare system in question is ill-advised."
A socialised healthcare system forces government and the healthcare service to write and maintain policies that consider the health of the nation. Where as a private insurance based service doesn't.
The US opoid crisis is a perfect example of this. Many of those addicts in the US moved on from prescription opoids that they had been prescribed unnecessarily to streets heroin because there was little concern of the wider public health implications. In the UK getting a prescription for addictive strength opoid pain killers has long been near impossible because the healthcare system has to be careful not to create another problem in trying to fix the first one because it's their responsibility to fix it which also means Doctors are not motivated to meet the patients wants (e.g pain free) and only fulfil their healthcare needs. This is why the UK didn't go through the same crisis
So I say that life expectancy is a good measure of healthcare systems because it forces policy makers at all levels to consider the wider impact of public policy on public health.
Again, it's debatable, but as I continued in my comment, even when charitably accepting your premise, your argument loses its strength.
A fully socialized healthcare system is one of many implementations of universal healthcare in the developed world today, and you'll have to find an answer for why the most efficient system in the world is the one that just happens to rely the most on consumer-driven market mechanisms.
Perhaps but then you also have to consider that Singapore is such an outlier that maybe comparing with them is overlooking what universal healthcare system is more likely to really be possible to politically implement.
Chasing that vision of efficency that Singapore shines a light on likely only serves to distract from other universal systems that are more commonly provided that are more realistically achievable.
Singapore is so far off the scale close to Hong Kong that it suggests they have political, social, geographical conditions that can not be replicated.
That’s not what “outlier” means. If every country attempted to implement Singapore’s system, and only Singapore succeeded, then you would be correct that it is an outlier. Instead, other nations settled for different systems and are generally satisfied. There lacks a political will to move out of the local optima.
Singapore’s path to its current system wasn’t by accident. It tried an NHS style system, which failed due to overuse, then tried a US-style system, which failed for obvious reasons, and then settled onto the system it has today.
The US is in the unique position that someone else has tried this model and we have enough data to prove its superiority. There also appears to be enough political will to reform the current system. There’s no point in settling for local optima when we have more than enough information to be able to go all the way...
There’s actually no evidence whatsoever that it “cannot be replicated”, there is little about Singapore, geographically that uniquely lends it to such a system. Suggesting otherwise is just ignoring an inconvenient data point. You’re also conveniently ignoring Switzerland, the Netherlands, and Germany which have a significant degree of privatization in their healthcare systems. Pure socialization isn’t the only way, it’s not even the best way.
So then what are the friction points of the Singaporean healthcare model that prevents other countries from adopting it?
If it were a Bill up for a vote by politicians in the US then what issues would they have with it?
Also comparing healthcare costs of Germany, Netherlands, and Switzerland with the UK from the links I posted earlier clearly shows that socialised healthcare is more efficient.
The per capita cost in Germany ia 32% higher than the UK, Netherlands it is 28% higher, and in Switzerland it is a whopping 88% higher compared to the UK.
Even France and Greece which are more socialist than the UK and both also have national insurance schemes are much better value than their private counterparts.
> So then what are the friction points of the Singaporean healthcare model that prevents other countries from adopting it?
The friction points aren't necessarily with the model itself, the friction is strictly political will. Democracy doesn't always seek out the most objectively superior solution, it simply seeks out the solution that the people want. Strict gun control might be a "superior policy", but that doesn't mean that people in America want that. Similarly, people in Denmark don't really want to change their system, even if there exists a superior system in Singapore.
In contrast, the US is in a unique position in that there is growing political will to change the status quo system, and the Singapore model happens to be one of the few that enjoys bipartisan approval. Also uniquely, the fully socialized single-payer system couldn't even get majority support among the Democratic Party. Indeed, the current nominee was the guy who explicitly campaigned on "the public option" rather than a strictly socialized system.
> If it were a Bill up for a vote by politicians in the US then what issues would they have with it?
The GOP's proposed Fair Care Act[1] happens to make one key change that moves the US closer to parity with Singapore: namely easing the rule that requires one to enroll in a high-deductible plan in order to qualify for an HSA — so that even those on low deductible plans may take advantage of the HSA. The American HSA is similar to the Singaporean Medisave system, which is a pre-tax savings account for healthcare spending only, where the savings are invested in funds. With American HSA's, they are private custodial mutual funds. With Singapore's Medisave, the fund is the Singapore sovereign wealth fund.
The Fair Care Act may get buy-in from the Left if it includes universal catastrophic coverage (analogous to Singapore's Medishield), and also making HSA contributions compulsory, just like Singapore.
Indiana's government offers its employees what is widely considered to be superior health insurance[2], in which the state deposits funds into HSA's equal to the annual deductible. This is very similar to Singapore's Medisave + Medishield system.
Another proposal that enjoys generally bipartisan approval: Medicare Advantage For All. Medicare Part C, or Medicare Advantage, is the part of America's Medicare system that is working best. Medicare Advantage plans have lower costs, broader benefits, and better health outcomes than traditional, single-payer Medicare. Today, almost 40% of Medicare enrollees are in a Medicare Advantage plan, as opposed to traditional "single-payer" Medicare[3].
So the political will is there, and the empirical results are proven by one of the US's very own states (run by the GOP, no less).
> Also comparing healthcare costs of Germany, Netherlands, and Switzerland with the UK from the links I posted earlier clearly shows that socialised healthcare is more efficient.
> The per capita cost in Germany ia 32% higher than the UK, Netherlands it is 28% higher, and in Switzerland it is a whopping 88% higher compared to the UK.\
> Even France and Greece which are more socialist than the UK and both also have national insurance schemes are much better value than their private counterparts.
"Cheaper" != "More efficient". While you're right that the nations that provide "socialized healthcare" can have lower costs per capita — Germany, Netherlands, Switzerland, and Singapore all enjoy higher average life expectancies than Denmark, UK, and Greece. Switzerland & Singapore both enjoy higher average life expectancies than Denmark, UK, Greece, and also France. The goal of these systems is to get the most bang for our buck, not strictly to just spend the least.
This is why Singapore's system shines — it enjoys the lowest per capita spending while enjoying the best health outcomes.
I'll close by saying that Singapore tried the UK's system[4] (listen at 12:35). The US also has a UK-like single-provider healthcare system, the VA — and that's been an abject failure[5]. The fact that this failure was reproduced twice, independently, suggests that UK's success might be the "outlier" (to use your framing). In contrast, we are yet to see a failed attempt at replicating Singapore's system, and thus cannot yet conclude that it is some sort of an anomaly.
Same story for education [1]. I won't be moved by cries of "we're exceptional" until the US actually tries adopting the policies that have worked so well for Europe and Canada.
This is the same old tired argument again and again. "European countries have lower costs, therefore socialism is better than capitalism."
There are two problems with it. First, the US system is completely broken. It isn't a free market system, it's a worst of both worlds compromised hellscape. It's like comparing the USSR to Colombian druglords as evidence that communism is a great system. The USSR isn't great, Colombian druglords are just awful.
Second, the European systems rely on the US to fund world medical research through its high medical costs. We're subsidizing them. That makes us look bad, but they're the ones free riding on our system. And it's obviously not possible for the US to pay lower prices by doing the same thing and offloading its medical research costs onto the US. What we could do is make the EU pay more of the R&D somehow -- that could lower our costs for sure, or improve outcomes world-wide because there is more R&D. But what does that look like? Higher costs in Europe, right?
Ultimately the problem with a private healthcare system is there is no incentive to provide appropriate affordable healthcare and every incentive to divide, marginalize, and monopolize markets in the aim of driving down competition and driving up profits.
Now that the US healthcare industry has grown so rich and powerful it can lobby and win against any serious political efforts to either increase market competition or socialise healthcare. I.don't. Know how you could politically fix a system that is essentially "every man for himself" the incentive for corruption is far too high when payouts equal political power.
I doubt the US is subsidizing medical research as much as you'd think. The Pharmaceutical industry for example is very profitable compared to other industries. A socialised healthcare service would enable more competitive prices eating into industry profits for these products due to market scale like we see in the UK due to the buying power of the NHS.
"Among the largest 25 companies, annual average profit margin fluctuated between 15 and 20 percent. For comparison, the annual average profit margin across non-drug companies among the largest 500 globally fluctuated between 4 and 9 percent."
> The large majority of the money isn't going to the insurance company, it's going to healthcare providers.
I have upvoted you but on HN, the prevailing belief is that doctors are gods and insurance companies are evil.
The data clearly shows that, on the average, insurance companies lose money while hospitals charge a 10000% markup - that's right, a 10000% markup.
I have written extensively on this topic (see my Quora) but I am finding it incredibly challenging getting people to see the reality.
Because I am often a contrarian here I am no alien to the downvote silence system here on HN - it's likely you can't respond to this comment of mine because HN won't let you for a few hours.
My email is in my profile, would love to connect with you - a person aware of reality.
you've cleverly argued in a way to make hidden the major point i wanted to make - which is that insurance companies making a profit is a loss to the payer. I'm purely talking about the insurance system, and not the medical provider system (hospitals/doctors etc).
> The large majority of the money isn't going to the insurance company, it's going to healthcare providers.
Any money going into insurance as profit is a loss to the payer - insurance doesn't _provide_ value. If the gov't is the one "doing the insurance" as you say, then any profit from that operation will count as a lowered cost of providing medical treatment.
> allows people to make risky/unhealthy choices and socialize the costs of those choices, and therefore why high deductible insurance is more efficient by introducing at least some price sensitivity.
so therefore, insurance companies will pick out the least risky people, least unhealthy, and not allow the sick into their programs. That is exactly what you see today, because those more ill people are what saps the profits.
The price sensitivity is at the wrong end - it should be at the medical provider end, not at the insurance end. Why do you think the cost for treatment is low when you're covered under medicare (for low income people)? It's because medicare is such a large buyer that hospitals are able to sell their services at that low a price.
> This is equivalent to legislating prices. They can already do this regardless, but it's a bad idea for the same reason price controls in general are
no it's not price control. It's buying power, from a single entity that is not profit-driven. The market for medical treatment is unchanged under my model. Insurance companies currently all own their own little monopoly in their region/network, and hence, there's no competition for pricing the medical treatment today. You are forced into the insurance's monopoly (or face the higher ticket price hospitals charge because they can).
> why wouldn't the insurance companies be doing it too?
> ... if the government really is so much more efficient then they should easily be able to out-compete the insurance companies
Insurance companies provide efficiency in operation vs gov't perhaps - i don't know. But what efficiency they provide is taken out as profit instead of being passed on to customers. And insurance company's efficiency is not in lowering the cost of medical care - it's in finding customers that don't cost them more than premiums they charge. They are more incentivized to keep medical costs high to force people onto insurance plans (that they negotiate using their purchasing power)!
There is no real place in the world for a profit-making medical insurance company imho. Or, if there is, they will be _in addition_ to a tax-payer funded universal healthcare system, and they can provide non-medically necessary operations that are not covered by the universal system.
It's really even worse than that. The amount of money spent on medical billing is just obscene. It isn't "profit" for anyone, but it's vast inefficiency.
> The amount of money spent on medical billing is just obscene. It isn't "profit" for anyone, but it's vast inefficiency.
Which is the thing caused by low deductible plans. If that sort of paperwork was only necessary in cases where you're already paying for $10,000+ in medical services, the fixed overhead isn't that significant. But with low deductible plans you pay it for every little thing that ought to cost $50, and then the $50 thing costs $550 because even walking in the door requires $500 worth of paperwork.
How much more efficient would it be if you just walked in with $50 in cash in most cases, which you can take out of the thousands a year you'd save in insurance premiums?
Extreme inefficiency. Extreme amounts of money spent simply on accounting and legal teams to keep track of all the plans, in companies which often have at least a dozen different plans per state. And every doctors' office and hospital and urgent care must hire or contract these services. Before beginning to serve a patient they and/or the patient must do paperwork to look up in-network specifics and insurance coverage terms.
It really is obscene and totally a waste, and it doesn't have to be this way. The notion that the free market does things more efficiently isn't always true, particularly in captive-market situations like healthcare, particularly in purely middleman industries like insurance which are actually incentivized to poorly allocate money to the alleged business purpose (covering medical services for people) because it increases their own profit margins.
> you've cleverly argued in a way to make hidden the major point i wanted to make - which is that insurance companies making a profit is a loss to the payer. I'm purely talking about the insurance system, and not the medical provider system (hospitals/doctors etc).
But then you're not addressing the majority of the problem, because insurance company profits are only a single digit percentage of premiums.
And even the "profits" aren't all waste, because you're paying money but not getting nothing in exchange.
If you want to have patients not paying directly for care then you need somebody to process claims, and those people need an office to work out of. The investors in the insurance company paid for that office. A lot of their "profit" is just the internal rent being paid on the building. If you move that function to the government, the cost doesn't disappear because the government still has to pay for buildings to operate out of to process claims payments to providers, which had previously been paid for by investors in exchange for profits.
Health insurance companies don't generally produce above-market returns on capital, so there is no real evidence that their "profits" are introducing any avoidable cost at all. It's just a method of paying for the things the investors' money bought.
Heck, there are non-profit health insurance companies that make no profits. Where are the savings, if some existed? (Answer: They still had to raise capital, but they used loans or bonds or spent labor begging for donations instead of selling shares, and that turns out not to be much different in efficiency.)
> so therefore, insurance companies will pick out the least risky people, least unhealthy, and not allow the sick into their programs. That is exactly what you see today, because those more ill people are what saps the profits.
The premise of insurance is that you don't know who those people are yet. If you already know then the event to be insured against effectively already happened. You can't expect to switch to lower deductible fire insurance after your house catches fire but before you file the claim. But equally, if you bought it to begin with the insurance company can't cancel your policy just because you're about to file a claim.
> The price sensitivity is at the wrong end - it should be at the medical provider end, not at the insurance end.
How is that supposed to help? The medical providers are the ones who profit from over-providing. They have no incentive to eliminate unnecessary costs -- to them the costs are profits.
> Why do you think the cost for treatment is low when you're covered under medicare (for low income people)? It's because medicare is such a large buyer that hospitals are able to sell their services at that low a price.
It's because Medicare pays below amortized cost and relies on private insurance to pay higher prices and cover the providers' fixed costs. That doesn't exactly work if you get rid of private insurance.
> no it's not price control.
So let's think about this. There is one buyer. If they won't buy from you, their own customers have no alternatives, so you can't make the case that they need to buy from you or their customers will switch to their competitor who does. If they won't buy from you, you have no buyers.
The buyer can set any price they want and the provider has to take it or go out of business. That's price controls.
> Insurance companies currently all own their own little monopoly in their region/network, and hence, there's no competition for pricing the medical treatment today. You are forced into the insurance's monopoly (or face the higher ticket price hospitals charge because they can).
The existing system is all messed up, nobody is denying that. But why not fix it? Require price transparency. Stop creating tax incentives for low deductible plans that make it so nobody has the incentive to shop around and then consequently nothing is configured to enable anyone to do that because nobody does.
> Insurance companies provide efficiency in operation vs gov't perhaps - i don't know. But what efficiency they provide is taken out as profit instead of being passed on to customers.
Not in a competitive market it isn't. If insurance companies were making above-market returns then it would be profitable for rich investors to start a new insurance company that takes their customers by charging lower insurance premiums and still makes at least the market rate of return, until such time as the efficiency is getting passed on to the customers.
> And insurance company's efficiency is not in lowering the cost of medical care - it's in finding customers that don't cost them more than premiums they charge.
Neither of those is true. If an insurance company can deny a claim for a legitimate reason then it saves them money, which in a competitive market is passed on to the customers.
And insurance companies can profit by identifying higher risk customers and charging them higher premiums. The insurance company's job isn't to avoid risk, it's to accurately price it.
Meanwhile the real efficiency doesn't come from the insurance company at all, it's from not using insurance for low cost routine care, which makes the patient price sensitive. Then the patient has the incentive to choose the provider with the better price and is inclined to refuse procedures that are unnecessary or not cost effective.
> not using insurance for low cost routine care, which makes the patient price sensitive
i would argue the patient cannot be price sensitive. The utility of staying alive is infinite - therefore, a patient will pay _any_ price for a procedure that saves them.
I don't want to see a world where going to the GP for a cold is not free. But that's the world we live in today.
The insurance efficiency, if any, is just a drop in the bucket i suppose - because the main issue i'm talking about is socializing healthcare, so that even healthy people pay a cost. And insurance _doesn't_ help with that (and having an insurance industry certainly prevents it from existing as well).
> i would argue the patient cannot be price sensitive. The utility of staying alive is infinite - therefore, a patient will pay _any_ price for a procedure that saves them.
The vast majority of healthcare is non-emergency care. It's either preventive health checkups, or planned treatments. The price elasticity of demand in healthcare is virtually identical to the price elasticity of demand in food. The utility of not starving to death is infinite — therefore a patient will pay _any_ price for food that nourishes them, right?
The huge flaw with that argument is that the value to the patient might be infinite, but the cost to provide it is not. In an open market, competition brings down the cost to the minimum possible value — unless you have barriers to entry or a cartel.
But none of these things are happening in US, you have double the cost of healthcare for a lower life expectancy than countries of comparable living standards who have universal healthcare.
What's going wrong with the system of perfect competition with insurance companies?
> What's going wrong with the system of perfect competition with insurance companies?
The biggest problem is the regulatory incentives for employer-provided insurance. This creates indirection (a corporation is choosing the insurance plan rather than the patient) and whatever is spent is tax exempt, which creates the incentive for employers to provide the most expensive low-deductible plans that are also the least efficient and involve the insurance bureaucracy in the smallest dollar value medical procedures.
> Any money going into insurance as profit is a loss to the payer - insurance doesn't _provide_ value. If the gov't is the one "doing the insurance" as you say, then any profit from that operation will count as a lowered cost of providing medical treatment.
The other users have already mentioned that insurance profit margins, on average, are about 5%. But you should also know that a lot of insurance carriers in the US are non-profit — including Blue Cross Blue Shield and Kaiser Permanente.
> The price sensitivity is at the wrong end - it should be at the medical provider end, not at the insurance end. Why do you think the cost for treatment is low when you're covered under medicare (for low income people)? It's because medicare is such a large buyer that hospitals are able to sell their services at that low a price.
That's true, in theory, but in practice Medicare fee schedules aren't that much better than private insurers.
Additionally, providers themselves are starting to charge out-of-network rates that are LOWER than Medicare fee schedules. For example, Wal-Mart has launched healthcare in Georgia, charging $25 for a cleaning[1], which is significantly lower than the amount for a cleaning (procedure code D1110) set by Medicare/Medicaid. You can look it up yourself by visiting the FAIR Health code lookup tool (https://www.fairhealthconsumer.org/dental/results), and setting the ZIP code to that of Carlton, GA (location of the Wal-Mart clinic), 30627. The average allowed amount is $64.
Finally, the US government has historically been pretty bad at setting prices, as a monopsony buyer. The US military spends more per capita on the military largely because it pays more per-soldier, per-fighter jet, etc than any other nation on the planet. You would think that, as the sole buyer of US defense sector fighter jets, it could negotiate better rates. The F-35 is expected to cost $1.5 trillion (!!) over its lifetime, and the US enjoys monopoly/legislative powers over that cost.
Another example: NASA's planned SLS moon mission is a bit of a disaster — way over budget and way behind schedule. Because the boosters aren't reusable, each launch is expected to cost $1B (with a B) dollars — EACH launch! Meanwhile SpaceX's target cost-per-launch is $50M.
So while you're right that, in theory, a monopsony can extract the lowest possible price, there's absolutely no guarantee of this, indeed American empirical evidence has at times proven otherwise.
this whole school choice and insurance choice neoliberal mantra is what has gotten us into this mess to begin with. The entire insurance sector is a huge waste of manpower and essentially just huge dump for the surplus of white collar university graduates that have nowhere to go.
There's not a single person on the planet who derives benefits from navigating the trade-offs of byzantine insurance plans, and school choice is a good way to speed up social and racial segregation and enabling quasi fraudulent religious schools that teach people nonsense.
It's time we do away with this altar of choice. I moved from Germany to the UK years ago, and I've never enjoyed anything more than the NHS because I literally do not have to waste a minute of my life on health insurance any more. I pay X amount of taxes, I go to the doctor, I get treated, I go home.
> The entire insurance sector is a huge waste of manpower and essentially just huge dump for the surplus of white collar university graduates that have nowhere to go.
US health insurance is garbage specifically because it's tied to employers and employers have strong tax incentives to use insanely inefficient low-deductible plans that both destroy price sensitivity and involve the insurance bureaucracy in small time medical procedures.
> There's not a single person on the planet who derives benefits from navigating the trade-offs of byzantine insurance plans
The cost difference between different insurance plans is thousands of dollars a year. It's one of the most financially impactful choices most individuals can make. Meanwhile if you don't want to make it then... don't? The government could easily recommend a specific plan and anybody who doesn't want to spend a few hours choosing for themselves a thing that could impact them to the tune of $100,000 over their lifetime could just choose that one and be done.
> school choice is a good way to speed up social and racial segregation
Sending kids to schools based on racially segregated school districts is the status quo. You're saying giving those parents the option to send their kids to the same school as the white kids is going to increase segregation? How is that supposed to work?
> enabling quasi fraudulent religious schools that teach people nonsense.
Those "schools" already exist. If they're dangerous enough to deny parents the right to use what is really their own tax money to send their kids to then they're dangerous enough to shut down entirely, right?
Unless you run into some questions of free speech and religious freedom doing that, but then I'm not sure how you were expecting to avoid them to begin with when using "we need to deny them the ability to do that" as an argument.
> I moved from Germany to the UK years ago, and I've never enjoyed anything more than the NHS because I literally do not have to waste a minute of my life on health insurance any more. I pay X amount of taxes, I go to the doctor, I get treated, I go home.
So buy a low deductible insurance plan that covers everything. It costs more than making individual choices, if you don't like to do that. But the cost comes either way -- either you pay with time or you pay with money.
(The status quo in the US is ridiculously broken because you pay with time but then it's still costs a ton of money for multiple independent reasons. Nobody thinks the status quo in the US is a good idea.)
School choice and medical choice are very different.
With school choice, parents do incredible amounts of research, and can send their kids to excellent schools wherever they live, or however bad their local school boards are. And yes, ALL parents invest in their kids' success, your (not OP's but generic reader's) stereotypes against minorities aside. It's a relatively efficient market. It benefits from choice + competition, with just transparency regulations (choice schools should be subject to FERPA, PPRA, public records laws, allow parent visits, etc.), and possibly governance regulations (not-for-profit school choice works best).
Medical choice comes up when I'm hit by a car. I don't have time to do research then, and it's the definition of an inefficient market. I go with whoever shows up, and worry about the bankrupting bills and/or malpractice lawsuits later.
Dumping private insurance 100% makes sense. It's pure overhead. It's a place conservatives deny science and evidence.
Providing school choice 100% make sense too. It makes for better schools. It's a place liberals deny science and evidence.
> And yes, ALL parents invest in their kids' success
Categorically false. Generic reader here, and I grew up in an abusive home with parents that could literally not have given two shits about my future, success or emotional well-being. For you to assert that they ALL do this is either an incredibly sheltered or willfully ignorant point of view.
The government gives you $300 and makes sure that enough healthy food is available for those $300. You don't get $300 worth of food. You get money. Cold hard cash. And the option to buy cheap food from the government.
Companies can also make cheap food targeting those $300, and I'm sure there already exists non-government government cheese.
About education and healthcare. The government just needs to provide the bare minimum. Broke an arm? Goverment will cast it. Still crooked? Get in the wait line or go work for money and get an insurance or pay for the surgery. Want a better education for your kids? Homeschool if you can, or just work for more money and pay for one.
> And the option to buy cheap food from the government.
But then why do you need this at all? There is already food available in the market. If you have $300 you can buy it. There is nothing the government needs to do other than give you the $300.
> The government just needs to provide the bare minimum. Broke an arm? Goverment will cast it.
There is a pretty good argument that the local government should provide emergency medicine for the same reason they provide fire departments -- you can't choose a provider while you're bleeding out. But most medical care is not provided under emergency conditions.
> Want a better education for your kids? Homeschool if you can, or just work for more money and pay for one.
But that's the problem. The government takes $10,000 from you and then gives it back if you use their schools. If you want to use your school and it only costs $8000, not only do you not get the $2000 back, you don't get any of it and end up having to pay $18,000 for what should have cost you $8000. So your school doesn't just have to be better than the government's school, it has to be so much better that it's worth paying twice. There is no legitimate reason to impose that requirement instead of allowing people who don't use the government's school to get back the money they saved the taxpayer.
Leave it to capitalism to inflate UBI out of usefulness. Let the market compete with the baseline, never replace it.
> you don't get any of it and end up having to pay $18,000
Well, supply and demand should work here, right? Isn't the market the mythical machine of just prices? If the market won't pay taxes + $8,000 for private school, there will be no schools for that price. If it does, it is worth it and you'll pay.
I'm very confident that all this quarantine will do is show the world that disrupting the market won't break the world. The world will just adapt. It should be the same with UBI.
UBI could just be a government guarantee that a citizen will never become homeless/neglected because of lack of work(by any cause, be it skill, opportunity or mental health). It's the new baseline.
"Losing everything" now would mean just going back to surfing the web and eating government cheese in some cramped apartment. Not homelessness, starvation, abuse and neglect.
> Leave it to capitalism to inflate UBI out of usefulness. Let the market compete with the baseline, never replace it.
Okay sure, but that's probably what would happen. So what do you do when the government tries to sell food and not enough people buy theirs for them to stay in the black? They'd have to raise prices to cover fixed costs and then have even fewer customers. Presumably once the price was so high they had literally zero customers then you could shut it down?
> Well, supply and demand should work here, right? Isn't the market the mythical machine of just prices? If the market won't pay taxes + $8,000 for private school, there will be no schools for that price. If it does, it is worth it and you'll pay.
The problem isn't that private schools aren't worth $8000, it's that they aren't worth $8000 more than public schools. Which leads people to send their kids to public school and waste money (public schools cost $10,000 instead of $8000) in order to get something worse (people don't value private schools at $8000 more than public schools but do value them at $2000 more).
> "Losing everything" now would mean just going back to surfing the web and eating government cheese in some cramped apartment. Not homelessness, starvation, abuse and neglect.
The UBI does that without the government providing anything but the money. If you have money you can buy food, housing and internet in the market from anyone you like.
> They'd have to raise prices to cover fixed costs and then have even fewer customers.
That's the part where government officials do their job and figure the best way to solve this. Subsidize regional staple foods, community farms, fix prices for some type of foods... The government doesn't actually have to have the food in warehouses, it only has to guarantee that you'll be able to buy healthy X/calories a day with those $300.
Maybe put out a weekly menu, with sources of cheap food?
For UBI to work as intended the government has to act as a guarantor that you'll be able to buy everything that UBI was meant to buy. Or else big daddy capital man will just find a way to consume those pennies and UBI becomes UB-bye.
No matter the amount of taxes, profit will still exist. The rich will still be rich. The rich can still do what they do. The difference is that they can't take from the poor. They have to do what capitalism really is about: provide value so that the market will pay you.
The government has an interest in long-term worker productivity, to increase its tax base. So what possible economic incentive would a government have not to return an injured worker to full productivity? Not taking investments like these is actuarially throwing money away.
Capitalism is just worse at providing universal services. Private mail can’t compete. Water is provided by private industry at rates thousands of times more. Could you imagine the harm caused by fire fighting becoming a protection racket?
Infectious disease is like fire: not a moral choice, it just spreads from person to person. I would be happy with my taxes doubling in exchange for getting sick less often, because I could surely make it up at work.
Fun fact: government cheese actually used to be pretty good, because it was made and stored in a cave the government owned. It turns out that caves are pretty close to the ideal place to make cheeses, so the government’s stuff wasn’t bad!
This feels like BS. Sorry! K12 is free. There should be no problem expanding to college and beyond. Also, see no reason to not have a good universal healthcare that is detached from your employer. These are smart ideas worth pursuing.
The cliche that total scientific socialism sounds great in theory but doesn't work in practice actually applies far better to laissez-faire capitalism (scientific socialism doesn't even look good on paper). Your arguments against free education and universal healthcare sound clever apriori, but they are completely at odds with the evidence. Countries with universal healthcare and robust public school systems invariably have better outcomes on both fronts.
No, you are describing a European social state like France (or where they would like to get to). This is anything but UBI.
1) UBI should be cash, the consumer chooses how to spend his dollar, giving him/her control, and keeping markets somewhat efficient.
2) It should be more like a dividend. We are all shareholders in USA inc. and get a percentage of it's GDP handed back to us. Not more bureaucrats and policies to decide what to funnel where.
I'd be curious to see it play out in a smaller country for a few years. The U.S. is a big place to gamble on it.
No one is saying flip the switch for 328.2 million, I know that, but at the same time it would be best to do an MVP on a smaller scale with, say, a population of 5 million and then learn and iterate from there.
Even when testing with 5 million though, you often have countries of that size having more of a shared culture that's tighter knit, such as the Nordic countries.
Perhaps somewhere like Singapore or Hong Kong could be a test. But there's so many variables again between so many countries. Perhaps a test case could be the whole state of Colorado, but then you have border permeability issues...
One of the problems with UBI on a small scale in the US is that it’s difficult to study the macroeconomic effects that people are so worried about. The studies on direct cash assistance in terms of social science are rather strong evidence in favor of what left leaning proponents claim. The reservations typically come from the American right which is more of a Social Darwinist party these days than a conservative one, which is closer to the Reagan Republican era GOP.
We probably need tens of billions of dollars to pilot UBI properly in the US across borders and to help setup the infrastructure to distribute the funds. But compared to another missile program, the social good of such a program is undeniable. Which is probably why it’ll be rejected in today’s hell world US politics.
One point to consider is that once UBI is rolled out, it can never be taken back, even if it is disastrous from a bureaucratic, economic, or social standpoint. I think the success of UBI is heavily dependant on the details of how it is funded and paid out, and getting people to decide on what the best method is will be more difficult than getting it accepted.
Even if it works brilliantly in other places, you'll still have a big part of the US saying "it'll never work here, we're too different" etc. Same arguments as the metric system that's been great everywhere for such a long time.
>Same arguments as the metric system that's been great everywhere for such a long time.
The biggest argument against the metric system is that it would cost trillions to retool all factories etc. to metric.
Secondarily, countries like Canada and the UK aren't 100% metric and use a weird sort of Frankenstein system (i.e. Brits measuring body weight in "stone"). And if anything that's worse than one or the other
One (edit: another) problem with that thinking is that the U.S. is a uniquely capable financial entity with an associated population, while your other examples are merely political entities.
To a certain extent we have an opportunity to experiment now. Might as well learn what we can.
Andrew Yang had the right idea with the Freedom Dividend. That's a smart way to frame it, and Alaska is an example of it working with an annual payout to residents ("Permanent Fund Dividend").
Based on what profit? The U.S. economy is on life support and its printing $3+ trillion deficits with massive incoming unfunded liabilities and a shrunken worldwide economy. We are due for a world of hurt and economic pain for the next decade.
I tend to agree - it should be Universal Basic Stuff (UBS). Particularly if housing is in a low cost of living area, then everything should get cheaper through automation. High End Manufactured housing [1], MOOCs, Telemedicine, Consumer Products will all get cheaper. Entrepreneurs in SV can create robots to automate the production of these things so even more UBS categories can be added. UBS assurances will avoid the inflationary effects of UBI.
Housing has been made artificially scarce by the small property owners (homeowners) who have the most to gain from the situation. The government could make housing 3x-5x cheaper in the space of a decade by greatly curtailing the authority of local zoning boards.
I think the hope would be to avoid trying to build Universal Basic Stuff housing in areas of the high cost of living areas. Encourage everyone to not cram into the most expensive cities.
Nobody is advocating for the removal of free markets in the existing housing market. They are advocating for the increase in the supply through removal in the artificial scarcity created by bad policy.
I think the idea here is that UBI replaces all of the other government welfare programs, no?
What happens when someone spends all their UBI on whiskey or oxy and consumes it all and is then hungry? Should we keep food stamps around? Why can't we do that part (universal food stamps) by itself?
I don't think the all-or-nothing approach of UBI makes a ton of sense. We can do things today like more free or subsidized food that would work exactly the same way as it would under UBI, with potentially more buy-in.
> What happens when someone spends all their UBI on whiskey or oxy and consumes it all and is then hungry?
What's the difference between that and the current reality? Food stamps can be sold and bought on the black market in exchange for drugs and alcohol; people who want whiskey will be able to get it. Whatever money is spent on enforcing the "sanctity" of food stamps could just go to more people directly.
And this is really the main point: the administrative burden all of these social programs incur, especially in terms of labor and office space, means that a very large sum of money is going into these programs that will never be seen by the people who need help. Just give everyone a check and be done with it.
To answer your main question: the person who blows their UBI suffers. They will be hungry for the rest of the month, and not many people will have sympathy for them because they already got their check. All mentally sane people realize this reality, and that is enough to prevent them from spending their UBI poorly. For the minority of people who are sadly physically addicted to drugs, there can be social programs specifically aimed at recovery and rehabilitation. This was another one of Yang's policies. UBI would help here too: let's say you spend 8 months at a government funded rehab facility while you kick your addiction to meth or heroine. At the end of the 8 months, you have $8000 waiting for you - to go forward, get a job, rent an apartment, and rebuild your life.
This is much cheaper than a bloated social program that ties your aid to measurable checkpoints, like how you have to prove you're looking for a job in order to keep receiving unemployment. Under UBI, the Fed just runs some script every month to raise a double somewhere by $1000; under unemployment they have to hire people to process your application, approve/deny it, review your weekly application submissions, hire someone else to distribute the money, hire a manager for all these people, pay an office to give these people a workplace, pay pensions and benefits for all these employees, etc.
If that’s the core argument for UBI i.e. it’s far more efficient, why do such proposed initiatives come with significant tax increases on the population? Your analysis should theoretically support a net decrease in spending on welfare (hence lower taxes) or best case, no additional increase. You would have a lot broader support if UBI wasn’t tied to egregious tax proposals like a wealth tax.
> If that’s the core argument for UBI i.e. it’s far more efficient, why do such proposed initiatives come with significant tax increases on the population?
This is really just a framing issue.
The way existing programs work, you get $12,000 in food stamps and housing assistance and student loan interest subsidies etc., and then they phase out at higher incomes.
With a UBI, everybody gets it, unconditionally. The "phase out" is taxes. You get $12,000, but by the time you've made e.g. $60,000/year in income, you've paid $12,000 in taxes to fund the UBI, and it cancels out. Opponents paint this as you've paid $12,000 more in taxes, but really it nets to zero. Meanwhile the person making $80,000 might "pay $16,000" in taxes, but it's really only $4000 because they still get the $12,000 UBI.
It's the same as having $12,000 in benefits which phase out below your income level, except that the accounting is much clearer so that you can easily see what the true marginal rates everyone is paying are, and you can't accidentally create ridiculous marginal rate cliffs by having independent programs phase out in the same place.
I’d guess that’s where the 5 million from Dorsey comes in. Figure the dollar amounts for replacing certain services. (I didn’t read the article, appologies If I’m way off.)
> why do such proposed initiatives come with significant tax increases on the population?
This depends on your definition of "population." If you consider billion dollar multinationals as part of the population, then yes, there are significant tax increases. You mention a wealth tax - first off, that's not a Yang policy, and I'm not aware of any prominent politicians pushing a wealth tax and UBI at the same time. However even if we consider Elizabeth Warren's wealth tax, that only kicks in once you start making over $50M / year, and there just aren't many people doing that. Is it really a significant increase if it only targets a few thousand people out of 330 million?
> Your analysis should theoretically support a net decrease in spending on welfare
Not exactly. It supports a net decrease in spending on welfare administration. Plenty of people, especially those leaning right-wing / libertarian / "small government", absolutely loathe the idea of useless government jobs, even though they would agree with purpose of the program (i.e. feeding the homeless, paying out unemployment, taking care of the elderly, etc.)
Even though spending would go up (although not really on the individual level, as AnthonyMouse points out), the political popularity of UBI would far surpass that of any individual social program, ensuring that it stays around for a long time and remains untampered. We are finding out how critical this is now, where states like New Jersey ended up having garbage unemployment programs due to ineffective management and states like Florida purposefully made applying for unemployment as difficult as possible to dissuade people from trying (to make their labor force numbers look better). The only social programs that have this "legendary" reputation among the public that protects them appear to be Social Security and Medicare: nobody can run and win on a platform aimed at destructing either. Destructing UBI would also be very difficult: people tend to get very angry when you promise to pay them, and then don't!
> "What happens when someone spends all their UBI"
I think that's the most important question.
I believe the story is that one will abuse whatever welfare they get. Whether it's stamps, credits, services or money.
Here in Australia they've been trialing a cashless debit card to control what people spend their welfare money on. Somehow, it's still costing _more_ than just giving people money and the recipients aren't happier either. Some are using the card to buy things like batteries and re-selling them to then buy their drugs and alcohol. So there's money spent to restrict the money, but the money is still abused. So why not just give them the money?
In the end - money is money. Poverty is literally only solved with money. Surprisingly, the cheapest and easiest way to solve someone's poverty is to just give them money. If they abuse it? Fine. They were going to do that anyway.
That's a big statement, with a lot of evidence against it. I recall an experiment where a homeless man was given $100,000, and was back on the streets in no time.
The idea that you "solve problems with money" seems to be an American disease. That we just haven't pumped enough money into the machine to make it work.
Homelessness and poverty are big, complex problems. Money is likely part of the solution, but so is education, and we aren't going to fix that with Yet More Money -- seriously, the US spends an insane amount on education to receive incredibly poor results.
> Surprisingly, the cheapest and easiest way to solve someone's poverty is to just give them money. If they abuse it? Fine. They were going to do that anyway.
I agree with you there. All the efforts to curb "abuse" have been an absolute waste of time.
The psychology of a large one time payment versus a passive, smaller one is absolutely immense and should not be equated. Native tribes have oftentimes given their youth large payments that get spent on expensive consumer goods that wind up back in pawn shops, but UBI experiments in Kenya and in low income areas around the world have shown dramatically different results with the hallmarks of upward mobility presenting (risk taking, lower stress, future orientation, etc.). Lottery wins are nothing like a permanent trust fund that pays out if you stay out of jail like in Yang’s UBI.
I read somewhere around 80%+ take the lump sum about 12 years ago. Given the risks of inflation over 25+ years it isn’t a bad idea. Most lottery winners get accosted by family members or spend like crazy with their money and wind up broke in the end. However, a great deal of them do at least take care of their health at least (getting teeth fixed was common). A mental trap of scarcity makes it difficult for the perpetually poor to think of money as nothing more than something to be spent rather than invested, but even here the HGTV dream home winner around 2007 sold the house to create... a construction company, which went bankrupt quickly.
Financial literacy can be taught over time though similar to helping people diet and control portions.
So what if someone spends it all on whiskey or oxy? They're maximising their own preferences. If they were addicted to alcohol, sudden withdrawal can kill.
One of the big reasons for UBI is the belief that an individual can better assess their own needs and wants, and procure them more cheaply than the government.
This is partly a moral/philosphical stand - the tension is between giving individual freedom in the form of money, or giving freedom via paternalistic methods where the government decides what is best for you. It can be argued either way.
I do agree it would be wise to have systems in place to trickle the money in daily instead of monthly - this would help your concern of people blowing all their money at once (but not prevent them spending on what was most important to them).
I also think that just UBI will never be enough - there is a place for targeted government support - healthcare, addiction (part of healthcare), mental health (also part of healthcare).
I agree very strongly with you, but I don't think that's where the parent poster was going.
Imagine we have a UBI, and we do all kinds of other smart things -- end the War on Drugs, establish Bismarck-style national healthcare[1], all that.
Let's do a thought experiment.
What happens when Alice blows all of her UBI on Lady Lee Vodka and Oxy. Nothing left for rent, food, the rest. Nobody else in the picture to help: no relatives, nada.
If we look at UBI as the only social assistance program, Alice dies on the street.
That's the reality, and we need to accept that.
Alternatively, we would need some sort of "backup" reserved for people that are not capable of caring for themselves.
Maybe something like restarting the mental hospitals that Reagan closed in the 80's after Geraldo -- and the rest of Our Friends In The News -- ran wild with the scandal of how awful those government-run mental hospitals were, with the end result being that a bunch of mentally ill folks got chucked out on the street.
Now, I don't know what the answer is. I really don't.
My concern is that I see a lot of people talking up only the benefits, and not in any way addressing the failure cases.
[1] Yields better results than single-payer, and is better at controlling costs.
I actually agree with both you and the parent poster - this is a real problem.
My position would be that you still need assistance programs as well as the UBI for people like the above, but I'd treat it as a health issue rather than a poverty issue.
I think this is where you really do need a paternalistic government for people who need the guidance, but it should be the exception, not the rule. Let's respect peoples choices for themselves and only step in if necessary.
I'd argue that Alice is either addicted or mentally ill, and supported living facilities or similar would be the way to go. She would still be entitled to her UBI, which would be her route out of the system once she no longer needs to spend it on drugs.
So I'd say that UBI will never completely replace all government programs, but it should be the default and go a long way to reducing the need for existing programs.
If I were implementing it, I'd start with a low amount (well below the cost of living) and increase it over time. I'd leave the current support programs in place. The current programs are means tested anyway, so the hope would be that as UBI increases, use of the current programs would reduce, and we would have time to reorganise them as needed.
This would also give us a chance to measure the effects and get real world data as to the impacts on society and government incoming/spending.
I guess the real question would be how much it would all cost. My gut feeling is that short term it would decrease productivity as people wouldn't feel the need to work so hard, but long term it would increase productivity as people will be able to invest more in themselves.
Alice could get a job and then lose it all on vodka and oxy. I don’t see why UBI needs to ensure that she doesn’t do foolish things with her money.
People are going to make bad decisions, unfortunately. You can’t live in a free society if you don’t let people make unfortunate, bad decisions that harm themselves.
If you think all people should be protected from their bad decisions then you’re basically sliding straight down the slope into totalitarianism.
In a free society, some people will make bad decisions and their lives will be miserable but hopefully many more will make better decisions.
In the course of their self-harm though they also tend to damage society. The starving addict doesn't just lay down in the street and die. They beg and they steal because they're desperate. They rip copper out of buildings while just harming themselves. And maybe eventually they're arrested and live off the state anyways (at much increased prison rates).
How far do you let them sink before you need to step in.
Yang’s UBI was never intended as a replacement for a safety net which was gravely miscommunicated / twisted by our outrage media dynamics. What he’s advocated for are completely universal programs without means testing that build on top of UBI as a presumption such as his (somewhat weak, yes) disability program. His entire thesis of the economy is that people both rich and poor are suffering enslaved to a dehumanizing economy that ironically destroys human potential and suffocating itself (the very opposite of one trend of capitalism in the past few hundred years) and destigmatizing assistance across all lines is important toward resolving the human toll politically.
"One of the big reasons for UBI is the belief that an individual can better assess their own needs and wants, and procure them more cheaply than the government"
Perhaps, but many of the major problems we have today are tragedy of the commons situations, and that's precisely when we need government to step in, not just leave it up to individuals.
Food stamps have similar problems to money. Food stamps are sold or the items purchased with food stamps are. The resulting money is used to buy oxy and whiskey. Food stamps are just another currency with a terrible exchange rate.
Appoint a guardianship or place them in a group home. Addiction isn't going to be solved by food stamps. Give them treatment and if they keep relapsing, then declare them incompetent.
> I don't think the all-or-nothing approach of UBI makes a ton of sense. We can do things today like more free or subsidized food that would work exactly the same way as it would under UBI, with potentially more buy-in.
Who is suggesting that this is the final form and cannot be ammneded? If anything, I think Dorsey just did what should have been done with the first wave of the vast amount of Campaign funds the 'Yang Gang' raised and actually create a through analysis along with coherent and cogent overview on the means by which it would initially be deployed with all of its cost-risk benefit analysis.
At which point it could then be vetted and and scrutinized via public discourse and eventually be further refined after some changes or be deemed worth a first trial process. I dislike Democracy as a system of governance on just about every aspect, but perhaps this is one of the few usecases it may have as we transition to this model at scale and will require the participation of everyone for it to succeed?
But your position is like following the fallacy that software is 'done' once its beta has been released... that's just not how this works. And the maintenance of this deployment is just as important, or more so depending on its application, as the creation of its earliest iteration.
You're a Cryptocurrency/Bitcoin person, don't you think Aurora was worth it, even though it failed? It showed us what had utility and what seemed sound in a theoretical sense and accepted via convention only to have it be stress tested and fail in practice.
As for subsidizing food, even further no less, is to undermine not just how broken it is but also how one of the biggest reasons the Global Ag/Food Industry not only relies on a system that often yields a near destitute farmer, but is also ultimately built on an expendable and often mistreated and undervalued labor force.
Just look at how meat packer workers are deemed expendable during COVID but required to remain at work due to being an 'essential worker' and a critical link in the Supply Chain, the deaths be damned. We can always get another low skilled, desperate worker to replace them.
You must understand that peril exists for a farmer everyday, getting injured on the job is the norm, working with those (ever compounding) injuries is enshrined within their very culture and it seems near exploitative when properly viewed for what it is as bankruptcy and suicide are often the alternatives to not meet one's obligations in that Industry (see wide scale suicide in Indian Cotton farmers in the 2000s, and the displacement and disenfranchisement of small farmers in the US in the 80-90s caused by large Big Ag-tech, Drug companies and Massive Food consortia).
Food has value that far exceeds its current fiat denominated Market valuation, it is specifically because Governments all over the World subsidize it so heavily (in various ways) and in turn obfuscate the externalities of not just growing a crop but also getting it to Market that it can and often forces a farmer to operate at a net-loss. If you allowed for freer access of Markets that create a means for producers to exchange their products with chefs/restaurants directly as well as the end consumer you'd have a more functional Market based form of price discovery. I should know, I've been both.
So I can tell you right now from both a Biological/Ecology sense as well as a Farmer POV tomatoes will NEVER truly be a $0.99/lbs product if properly priced, they are extremely heavy feeders that will require large preps and amendments to the soil upon planting, and ideally crop rotation as well as lots of labor during and after harvest, but also materials to trellis, prune, the labor costs for pest prevention, weeding, storage, transport etc...
In short, less subsidies could actually create not just more accurate pricing (as food prices are at very skewed Historical lows) but potentially also a greater supply overall as the incentives for growers/producers have been created to profit from a newly created venture if they can deliver to Market a desirable product at a desirable price.
> * Government basic food package - daily (1500kcal): $300
I agree with UBI, but basing it on only 1500kcal will give a slight advantage to smaller people over those of us who are a bit more, er... calorically expensive.
Maybe at least make it 2000kcal to hit the median calorie requirement.
Everybody should also have a computer and a fast internet connection to access knowledge.
People should also get free books.
People should also get free fitness coaches, so they can be healthy.
People should also be entitled to a job, so they can have a sense of purpose.
We can spend days thinking about what should be a right that everyone should have for free. The only problem is figuring out who should pay for these things and what’s the correct price of things without a market
Even at $1500/mo, this will cost at least $150B/mo. That’s almost additional $2T/yr. This is still not taking in to account free medical care and education. How do you think govt will pay for this? I think UBI is possible sometime in future when US GDP grows by another 50% and if somehow not all gains gets concentrated to top 1000 richest people which ironically UBI proponents like Dorsey, Altman etc are part of.
Remember that you get the money back. You're sitting there in the middle saying, $150B/mo? I don't want to have to pay that in taxes. I'd have to pay like $1500/mo more in taxes! But then you'd receive $1500/mo. It cancels out, so it doesn't matter.
You're really only making net transfers to the bottom half, and even most of those aren't for the entire amount. Someone at the 25th percentile gets $1500 but would be paying $750 in tax themselves.
Meanwhile it replaces what the people at the bottom were already getting in food/housing/other assistance. So it really "costs" almost nothing. It may even reduce costs, because now you don't need a wasteful means testing bureaucracy to process and determine eligibility for dozens of separate government benefits that no longer exist.
That looks like very bad math. If you are paying $1500/mo in taxes, you are not in majority. And if you get back that money then who is really paying government bills? The UBI is additional expense and needs to come from extra income to government. I can see the argument that top 1% should pay for it by taxing the hell out of them. Unfortunately that back fires as we have seen in heavily taxed countries and still I don’t think even those extra taxes would be enough to cover it.
A weird nit pick, the GP commenter was just using an easy-to-conceptualize number. Let's use real numbers:
In 2018, the household income quintiles were as follows[1]:
Lowest quintile mean: $13,775
Second quintile mean: $37,923
Third quintile mean: $63,572
Fourth quintile mean: $101,570
Highest quintile mean: $233,895
There were about 159M employed persons in the US in the most recent high[2], about 50% of the US population. We want our UBI to cover everybody.
To make this simple, because quintiles comprise an equally populated group of people, let's imagine that instead of there being ~32M people per quintile, that our nation has 10 people, where 5 people don't work, and each of the remaining 5 falls into one of the quintiles.
If we wanted to define a UBI of $18,000 per person, we need to somehow come up with $18,000 * 10 == $180,000 to distribute to everyone equally.
If we fund this progressively, each individual would have to pay:
Unemployed #1: 0
Unemployed #2: 0
Unemployed #3: 0
Unemployed #4: 0
Unemployed #5: 0
Lowest: $8,000
Second: $12,000
Third: $18,000
Fourth: $33,000
Highest: $103,000
Total revenue: $180,000
Then consider that everyone here is receiving back 18,000 under the UBI. The highest quintile earner’s net take-home is, thus 233,895-103,000+18,000 == $148,895, which effectively renders their net tax rate approx 36%. If you run this breakdown across all quintiles:
You'll notice that the median worker pays nothing, net-net. They pay about $1,500/month, and get back $1,500/mo. The bottom 2 will get back more than they pay. The top 2 pay a tax rate that’s comparable to today’s.
The 5 unemployed persons all get $18,000, and because the lowest quintile still ends up with more than that after their taxes, there isn’t a disincentive to work.
We can play with different levels of progressivity and generosity, but the idea is the same. We can scale up from single-person quintiles to million-person quintiles, but the percentages don't change.
Ex.:
* Government housing: $500
* Government basic food package - daily (1500kcal): $300
* x kJ electricity, x m3 water, x m3 gas, x bps internet connection: $500
* Clothing, hygiene, cleaning supplies: $50
* Universal healthcare: free (and free condoms)
* Free education (from abc to PHD)
This is not a comprehensive list, or even the right values, however you can guarantee a base-level of what is "living with dignity" and apt to participate in the democracy.
I doubt you'd have too many people deciding to live without a job. It's not the best life, but you can survive with some human dignity. Many around the world live with much less.
UBI isn't the American Dream, it's the safety net.