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Government funded healthcare: Good or bad?
brian80
Registered User regular
Registered User regular
In an attempt to broaden my horizons, I wish to hear the thoughts of the D&D community on the issue of government-funded (or universal) healthcare. So the question I ask is: Should health care in the U.S. be funded by our government?
I believe that universal healthcare would be a major boon to the American people, but am having trouble seeing the other (negative) side of the issue. The systems employed in the Netherlands and UK seem to work very well, and the US is left as the only wealthy, industrialized nation without a universal healthcare system. Even some lower-middle income countries have a healthcare plan in place for their citizens (see Thailand, Singapore).
What is your opinion on the matter?
I believe that universal healthcare would be a major boon to the American people, but am having trouble seeing the other (negative) side of the issue. The systems employed in the Netherlands and UK seem to work very well, and the US is left as the only wealthy, industrialized nation without a universal healthcare system. Even some lower-middle income countries have a healthcare plan in place for their citizens (see Thailand, Singapore).
What is your opinion on the matter?
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Also, I really like your sig, Quoth.
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Well, we could always close the stock income loopholes.
Considering that when you start seeing 100,000 USD in profit from stock options, the first 15% of that isn't counted towards taxes, and the percentage actually rises when you make more money, that would be a pretty fucking good source for funding programs.
Likely tax employers who don't provide health care coverage via a private insurance company. There really isn't a good way to do this since everything is so fucked up and complex compared to when employer related benefits started half a century ago. We could have been single payer with LBJ, now the best we can hope for is some sort of chimaera that is less horrific than things are at present.
Health Care is already impacting the American economy in exactly that way. American Businesses are paying for their employees health care right now, but doing it inefficiently.
Raise the capital gains rate to be in-line with the income tax, roll back the Bush tax cuts and if we need more then apply it as a progressive payroll tax. It won't be terribly painful because people are already getting gouged by health insurance monthly, and any gummint plant modeled after any extant system in other first-world countries would be cheaper than what almost everyone is already currently paying in the US.
We'll either
a) tax the wealthy
b) tax the middle class
c) run up the debt
d) print more money
If we choose option "a" we'll run out of money and then have to resort to b, c, and d.
If we choose option "b" we'll cripple people who work for a living even more and those who currently get corporate sponsored care are screwed even further.
If we choose option "c" our children and grandchildren are totally screwed.
If we choose option "d" our money becomes worthless and the price of everything increases.
Most proposals for it include all 4 options. If they claim we can do it without option "b" they are either foolish or lying.
Canada also has a higher overall tax rate, especially if you have kids or are married, and spends about 1/10 of what we do on military spending.
Our current system sucks but it's crony driven and corporate sponsored and hardly free market. Despite all this unless we cut military spending drastically we're stuck with it unless we want to completely destroy our economy.
We can't afford it.
I want you to back this up, because I'm pretty sure you're wrong.
Why did you overlook taxing businesses? Especially as they're already being raped by insurance company fees and would be penetrated shallower by any of the proposed governmental program's phalluses.
It is both cheaper and more effective to spend that money in providing regular, office-visit preventive and periodic care.
A typical office visit to get a prescrition for an infection will be billed at under a hundred dollars. The same person visiting the E-Room for the same purpose will be billed at about three hundred dollars or more.
Emergency rooms are expensive to build, maintain, staff, supply, clean, and provide utilities for.
The numbers used are cited from my own medical visits, and the insurance summaries I recieved which show the billable amounts. I didn't just make this stuff up.
Because the corporate rate in the US is already 35% for the big corporations and employee insurance negotiated at a bulk rate is a drop in the bucket compared to the cost of sustaining everyone in the country on corporate tax increases alone.
If the government continues to raise the tax rate on corporations they usually just cut jobs in response anyway.
If you double or triple the effective tax rate (from 10-15% to 25/28+) then you're just going to destroy the appetite of investors in those securities. Domestic investors will opt into interest-paying vehicles, as might foreign investors who might just say "fuck it I'm investing outside the U.S."
If you tax the shit out of busniess owners, they'll just take it out of their employee payroll, either in salary or benefits cuts.
So I can roll into an ER and get healthcare for free? This is news to me, and to think my boss pays like $8K per employee for health insurance and I still needs to pay premiums and co-payments and whatnot.
upshot: there's no free lunch. the looming healthcare crisis is going to be a significantly bigger shitstorm than Social Security dealing with the boomers.
Edit: And thank you to whoever liked my sig.
Yeah, they cut the private health insurance benefit. Which they charge you for in lower pay at the moment anyhow. So odds are the company gets a net boost to their funds from a lower rate needing to be paid out for employee health insurance coverage while employees don't see much overall change.
They become equivalent to what private schools are now.
But would that have a ripple effect of any kind?
A lot of businesses don't even offer health insurance benefits, when you increase their tax rate, affecting their profitability, they start firing. Or maybe they just close up shop. Now you have more unemployed people, who don't pay taxes.
If we're talking about a few percentage point increase on corporate taxes then it would balance out, but a few percentage points in the rate and "tax the rich" isn't going to make up for the overall cost of a UHC program.
That also excludes the extraneous hidden costs of taking money out of the top of the economy.
Note also that at the high end of the scale the US has the 2nd highest corporate tax rate in the world. You push them too far they just leave the country and conduct business elsewhere.
Depending on the state, businesses are compelled to have health insurance benefits. (I know IL requires it for places above either 30 or 50 employees) Plenty of places smaller than that to eek by, but they don't contribute near as much to the tax base as places that are already required to give some token measure of coverage.
You get paid roughly 1/3rd your overall cost to your employer in terms of benefits and liabilities and such. For some reason I don't think 2/3rds of payroll costs factor out to become a couple percentage points in the corporate tax rate.
This concerns me. But would the benefit outweigh the cost sufficiently to compel them to stay?
On a per capita basis, the US pays more than nations with good UHC systems.
If we switch to UHC, the added efficiency will allow us to do pretty much what we're doing now for less money. Are you trying to say that with UHC, we'll wind up paying more than we are now? Why do you say that?
Basically, we need to structure the taxes in such a way that they come from the same people, and in the same proportions, that are currently paying for private insurance. Read: corporations and rich folks. I don't see why this isn't doable.
For the record, I'm not wild about UHC either, but it'd be a big improvement from what we're doing now. I mean, at the very worst, it would be the same as we have now, and cost roughly the same, except all the people who are uncovered will suddenly be covered. I can think of worse things.
The top corporate federal tax rate in Canada is around 28%. That basically pays for their health-care program (28 billion dollars a year).
The top US rate is higher by about 7% and obviously we'd have and would need a much higher budget.
But the numbers don't add up when you factor in things like Social Security and Defense Spending.
Canada spends half as much on their military than they do on Health Care. Their budget is around 16 Billion.
The United States Military Budget is around 623 BILLION.
Corporate taxes and the Rich aren't going to be able to pay for Health Care in this country all by themselves. The taxation inevitably will fall onto the shoulders of the middle class and then we're right back where we started, except many people will have wait times on care instead.
Also isn't there a search feature to prevent these sorts of threads from popping up every 2 weeks?
Then how is it that corporations and rich people are paying for our health care as it stands at the moment?
Are you saying that people in the middle class will be paying more in taxes than they were for private coverage? Or are you saying that a given taxpayer is worse off paying money in taxes than they were paying the same amount for coverage?
The US is listed at 37th (between the Dominican Republic and Costa Rica on one side and Slovenia and Cuba on the other) in the WHO Health Care Rankings. Canada is 30th.
I think you're baiting me to give you the answer you want but I'll answer it anyway: Because they aren't covering the 40 million additional people that would be covered under UHC.
I already said our current system is a poor example of how health care should work and I also stated it isn't Free Market.
When we can cut our military budget to be proportional to our population to mimic a country like Canada or even the UK we might be able to afford UHC. Right now though I think it's all posturing.
As I said before, we can't afford it.
Almost everyone with whom I hang out works for a company employing fewer than 50 people. Certainly, this anecdotal evidence is of limited value, but I think the percentage of people employed by small business is not insignificant (I think it's like more than 1/3rd, I cannot find any handy stats). I'm in Austin, not some tiny hick town.
If you crank up the expenses seen by business they will just pass the buck. e.g. http://www.informationweek.com/story/showArticle.jhtml?articleID=205917177&cid=RSSfeed_IWK_All {informationweek link talking about how IBM responds to class-action overtime lawsuit by chopping all their salaries}
Restaurants (not big chains, but some place good where you actually want to eat their food) and bars often are small businesses that don't offer healthcare. How would placing a new burden upon them not directly result in them just closing up shop, or chopping payroll? And franchises, admittedly I don't know how these operate, but does McDonald's offer healthcare to anyone who actually touches food?
I think the average person who has a job would end up paying more money in taxes and get worse coverage in the form of wait times and lack of market choice.
Maybe you think that's a small price to pay to cover the rest of the country, but the root of the issue is what we have now is also unacceptable so I'm not going to defend it. I just don't think we should take it in the direction of more government intervention.
I think we should scrap the whole thing and start over.
Man if I were in a situation to pay a grand a month to some company for the same product I would be paying $500 per month to the government, I don't give a shit whether it's "free market" or "taxes".
This is, you'll note, the question between Canada's HC system and the US's. There isn't any "can't afford it" going on here.
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Yes they are. And they're paying out the nose for it since going to an emergency room to fix pneumonia is a hell of a lot more expensive than going to a pediatrician for the sniffles.
Where do you think the expense of your blue cross, blue shield coverage comes out of right now?
They're taxed a hell of a lot less than larger corporations which would be shouldering the lionshare of the burden so it really isn't going to impact them much. Meanwhile their employees get some/better coverage leading to more productivity over the long run.
Outta my payche.... Hey waitaminute! :P
Really? Could you send me a link? This guy says the rate spikes at around $75K taxable income, and above there it varies between 34% and 39%.
I question the findings of the wiki-pedia entry you cited and I'm curious about their longevity going forward as the demand for better coverage and increased funding gets louder in Canada. The savings of a transition away from insurance bureaucracy to government would be short lived because it's ludicrous to think that it wouldn't creep without severely cutting the scope. In 1948, Great Britain's National Health Service employed 350,000 staff members and managed 480,000 hospital beds. By 1991, it had 800,000 staff but only 260,000 beds.
Yeah the cost is cut in half until people realize they have to wait a month for care or they can't go to the dentist if they aren't children. Then that savings is promptly wiped out when demand for more coverage ensues and the administrative costs get more bloated. There also is no exit strategy, which at least is the case in a corporate care market. If the system fails in Canada, no one gets to choose another one.
I mean we're just talking about cost at this point as well. I also don't like the idea of the government telling me I have to wear helmets when I ride a bike to save on health care costs. Or that I can't drink or smoke if I want to, or taxes on those items. All of these in the name of out of control health care costs.
And the choice we have is not "free market" or "taxes" it's between "free market", "corporate care" or "taxes". I advocate more free market and less corporate care which I think would drive costs down and be more efficient than either system.
I think the trick to make healthcare cheaper and more efficient would be to break the AMA stranglehold on healthcare services. Maybe something better than going to WebMD but not as costly as a hospital or doctors office. Wellness clinics or something focussing on diagnosis, nutritional counselling, check-ups, vaccines, and preventative medicine that could then escalate difficult issues into the existing healthcare system. Though whenever this is suggested, doctors (and hospitals) go fucking apeshit.
Edit: That probably wouldn't work anyway unless you gave the visitors tax-incentives to go or something, since people tend to be real shitty about keeping on top of basic preventative medicine.