Health Care for Everyone

[Eunos_Cosmo]

@Danoff

Mostly because I'm curious: How would you propose the government perform its lawful (lawful according to you) responsibilities (such as defense, I believe that was one that you support) without taxation? Or do you support some amount of taxation?

 

[Danoff]

Mostly because I'm curious: How would you propose the government perform its lawful (lawful according to you) responsibilities (such as defense, I believe that was one that you support) without taxation? Or do you support some amount of taxation?

Seems like a bit of an aside, but there are other ways to achieve revenue than straight taxation. I've listed a few of them elsewhere recently (I can't think of the thread). I do not think that you can morally force someone to defend your country, which is essentially what not only drafts but also taxing to spend on defense.

Defense is an interesting one, because it seems to be the one thing that most Americans are happy for their tax dollars to go to (or at least it has very wide support among the population), and yet everyone thinks that it is absolutely out of the question that it would be something people would voluntarily contribute to. I know the notion of voluntary support for defense is pretty out there, and I don't even think it's necessary (since there are other ways to fund the government), but when you think about it there is more support for that in this country than to shelter and feed the homeless or to provide medical care to the needy - but these are things the government does less of, and so you see charitable contributions to it.

Maybe the US wouldn't need such a huge defense budget if we didn't have such a huge defense budget.

 

[Eunos_Cosmo]

Seems like a bit of an aside, but there are other ways to achieve revenue than straight taxation. I've listed a few of them elsewhere recently (I can't think of the thread). I do not think that you can morally force someone to defend your country, which is essentially what not only drafts but also taxing to spend on defense.

Defense is an interesting one, because it seems to be the one thing that most Americans are happy for their tax dollars to go to (or at least it has very wide support among the population), and yet everyone thinks that it is absolutely out of the question that it would be something people would voluntarily contribute to. I know the notion of voluntary support for defense is pretty out there, and I don't even think it's necessary (since there are other ways to fund the government), but when you think about it there is more support for that in this country than to shelter and feed the homeless or to provide medical care to the needy - but these are things the government does less of, and so you see charitable contributions to it.

Maybe the US wouldn't need such a huge defense budget if we didn't have such a huge defense budget.

I didn't mean for it to seem like a leading question. I must have remembered something wrong. What other ways could a government fund itself?

 

[Danoff]

I didn't mean for it to seem like a leading question. I must have remembered something wrong. What other ways could a government fund itself?

There are several options. The government has two departments that I know of that run revenue positive. One of them is the IRS, an that's cheating because they collect taxes. The other is the patent and trademark office, which funds itself entirely (and then some) on fees from applicants for patents and trademarks. Fees are used in national parks, the DMV, courts, basically tons of places where services are rendered. Another funding mechanism is provide a stable currency. This one is somewhat controversial, but currency deflation is problematic, so maintaining inflation at a low but steady rate is actually beneficial for economic stability, and it's a service that can be provided by the government, and which essentially nets revenue based on GDP. There is also endowment, such as national parks, and other nationally owned land - which can be a revenue source as well. The US government owns very large oil reserves, and other natural resources. These resources can represent steadily paying investments, either through liquidation, direct leases, or by providing some sort of consistent utility.

Here's another super controversial one that I'm going to toss out, and which has no business in this thread at all, a poll tax. You want to vote? You pay to defend.

 

[Eunos_Cosmo]

There are several options. The government has two departments that I know of that run revenue positive. One of them is the IRS, an that's cheating because they collect taxes. The other is the patent and trademark office, which funds itself entirely (and then some) on fees from applicants for patents and trademarks. Fees are used in national parks, the DMV, courts, basically tons of places where services are rendered. Another funding mechanism is provide a stable currency. This one is somewhat controversial, but currency deflation is problematic, so maintaining inflation at a low but steady rate is actually beneficial for economic stability, and it's a service that can be provided by the government, and which essentially nets revenue based on GDP. There is also endowment, such as national parks, and other nationally owned land - which can be a revenue source as well. The US government owns very large oil reserves, and other natural resources. These resources can represent steadily paying investments, either through liquidation, direct leases, or by providing some sort of consistent utility.

Here's another super controversial one that I'm going to toss out, and which has no business in this thread at all, a poll tax. You want to vote? You pay to defend.

I see a big shortfall in this scenario. Per this, the entire US oil production in 2018 was about $180bn. (And at this level of production, its harming oil prices from what I remember) I can't see the other options producing anywhere near that (though I have no idea what providing a stable currency is worth). I full respect that the current federal budget is a result of its gargantuan size, but could we trim even the military alone down to less than $200bn? I have my doubts, especially considering how entangled the MIC is in our economy. Poll tax would be incidental pocket change unless you charged hilariously large amounts.

I guess the question is: How much does it cost to run/administer a government serving 320 million people? with the follow up being, how does one pay for it?

 

[Danoff]

I see a big shortfall in this scenario. Per this, the entire US oil production in 2018 was about $180bn. (And at this level of production, its harming oil prices from what I remember) I can't see the other options producing anywhere near that (though I have no idea what providing a stable currency is worth). I full respect that the current federal budget is a result of its gargantuan size, but could we trim even the military alone down to less than $200bn? I have my doubts, especially considering how entangled the MIC is in our economy. Poll tax would be incidental pocket change unless you charged hilariously large amounts.

I guess the question is: How much does it cost to run/administer a government serving 320 million people? with the follow up being, how does one pay for it?

As I've said elsewhere, it's not something we could do overnight. First step we should move to a sales tax instead of income. Second, we need to move toward fees and away from the general fund. Third, we need to reduce debt and entitlements. And then we'd have to systematically shrink sales tax with the end goal of being funded by all of these other measures. Maybe we never get there, maybe it takes 200 years, but a moral government should be the goal.

Regarding "how much does it cost", that's entirely determined by what you think must be done - to which my answer is substantially different from most.

 

[Eunos_Cosmo]

As I've said elsewhere, it's not something we could do overnight. First step we should move to a sales tax instead of income. Second, we need to move toward fees and away from the general fund. Third, we need to reduce debt and entitlements. And then we'd have to systematically shrink sales tax with the end goal of being funded by all of these other measures. Maybe we never get there, maybe it takes 200 years, but a moral government should be the goal.

Regarding "how much does it cost", that's entirely determined by what you think must be done - to which my answer is substantially different from most.

What is a government other than the morality of it's populace in a free society? Let's say you get to this idealized government and it's all working as you imagine it. The market will always produce winners and losers. How do you prevent the people who end up off less fortunate than others from voting into power somebody who will enact new entitlements all over again? I can't, in my mind, imagine a free society in which the unfortunate completely accept their place and never use their power to help themselves at the expense of the fortunate. Rand, as I mentioned, deus ex Machina'd it with the whole Gulch thing. I can't square your moral puritanism with the fallible nature of humans.

I don't disagree with your aspirational intent, I just see a limit to its feasibility.

edit: Sorry if this is getting off topic.

 

[Danoff]

What is a government other than the morality of it's populace in a free society? Let's say you get to this idealized government and it's all working as you imagine it. The market will always produce winners and losers. How do you prevent the people who end up off less fortunate than others from voting into power somebody who will enact new entitlements all over again? I can't, in my mind, imagine a free society in which the unfortunate completely accept their place and never use their power to help themselves at the expense of the fortunate. Rand, as I mentioned, deus ex Machina'd it with the whole Gulch thing. I can't square your moral puritanism with the fallible nature of humans.

I don't disagree with your aspirational intent, I just see a limit to its feasibility.

edit: Sorry if this is getting off topic.

I'm gonna take this to the appropriate thread.

 

[Daz555]

As I've said elsewhere, it's not something we could do overnight. First step we should move to a sales tax instead of income. Second, we need to move toward fees and away from the general fund. Third, we need to reduce debt and entitlements. And then we'd have to systematically shrink sales tax with the end goal of being funded by all of these other measures. Maybe we never get there, maybe it takes 200 years, but a moral government should be the goal.

Regarding "how much does it cost", that's entirely determined by what you think must be done - to which my answer is substantially different from most.

Can you clarify what you mean by sales tax in this context. I ask because a basic sales tax is not progressive so I struggle to see how it could be set it a level which would balance the books whilst at the same time not drive the poor into starvation. Unless perhaps you are referring to a progressive sales/consumption tax which would address that particular concern?

 

[Danoff]

Can you clarify what you mean by sales tax in this context. I ask because a basic sales tax is not progressive so I struggle to see how it could be set it a level which would balance the books whilst at the same time not drive the poor into starvation. Unless perhaps you are referring to a progressive sales/consumption tax which would address that particular concern?

I'm gonna take this to the Libertarian thread too.

 

[Danoff]

If you want to know what the problem with the state of the US healthcare "system" is, I can sum it up in a recent exchange I had.

"So the $740 there on the bill is the insurance rate. Insurance almost never covers this, and we're assuming yours doesn't. The doctor doesn't feel that it's right to charge people that rate, so your bill would be $300 assuming it's entirely an out-of-pocket expense".

 

[ryzno]

If you want to know what the problem with the state of the US healthcare "system" is, I can sum it up in a recent exchange I had.

"So the $740 there on the bill is the insurance rate. Insurance almost never covers this, and we're assuming yours doesn't. The doctor doesn't feel that it's right to charge people that rate, so your bill would be $300 assuming it's entirely an out-of-pocket expense".

So cash, is, king!

 

[Danoff]

So cash, is, king!

Yea, often you can negotiate a cash rate if you bypass your insurance entirely. If they can save the processing, and you'll pay right there on the spot, they usually cut the bill in half. But I've never heard one of them indicate that they'd go through the entire process of trying to bill the insurance company for a rate that they admitted isn't fair for customers. That's pretty brazen.

 

[PocketZeven]

Yea, often you can negotiate a cash rate if you bypass your insurance entirely. If they can save the processing, and you'll pay right there on the spot, they usually cut the bill in half. But I've never heard one of them indicate that they'd go through the entire process of trying to bill the insurance company for a rate that they admitted isn't fair for customers. That's pretty brazen.

That is indeed the root of the problem of the US healthcare system. Another reason why in my opinion the government should step in. Simply because the government has a position of power to negotiate rates.

 

[ryzno]

That is indeed the root of the problem of the US healthcare system. Another reason why in my opinion the government should step in. Simply because the government has a position of power to negotiate rates.

They(gov) might also be the reason the prices are so high. Big pharma, lobbying, taxes and stuff...

 

[Danoff]

That is indeed the root of the problem of the US healthcare system. Another reason why in my opinion the government should step in. Simply because the government has a position of power to negotiate rates.

Actually they need to step out, and allow greater competition in the insurance market, and allow people to go cash only without penalizing them.

Edit:

Oh, and stop giving health insurance a bypass from income tax, so that it gets decoupled from your employer.

 

[Joey D]

That is indeed the root of the problem of the US healthcare system. Another reason why in my opinion the government should step in. Simply because the government has a position of power to negotiate rates.

Probably not well though. Remember this is the same government that can't negotiate a trade deal to save its soul. If the US government was better at being a government, I'd say you might be onto something, even if I wouldn't agree with it. But our government is horrid at being a government and operating efficiently. When it comes to my healthcare, I don't want an inefficient behemoth trying to control it. All they'd end up doing is making a bad healthcare system worse.

Our system is already overly complex when it comes to specialties and referrals, especially with insurance plans like Medicare/Medicaid and TriCare (a veteran's insurance). I can't imagine the headache it would cause if every US citizen had to go through that.

Also, I assume several docs would just quit being doctors altogether too. As it stands right now many docs hate seeing Medicare/Medicaid patients because they don't get paid as much and the hoops they have to jump through are insane. If they had to do that for everyone, I could see them finding a new profession.

However, if I'm going to be selfish, I'd almost welcome a government healthcare system since it's complexity would mean I'd have some awesome job security.

 

[PocketZeven]

They(gov) might also be the reason the prices are so high. Big pharma, lobbying, taxes and stuff...

No the owners do. Purely for profit.

 

[Eunos_Cosmo]

If you want to know what the problem with the state of the US healthcare "system" is, I can sum it up in a recent exchange I had.

"So the $740 there on the bill is the insurance rate. Insurance almost never covers this, and we're assuming yours doesn't. The doctor doesn't feel that it's right to charge people that rate, so your bill would be $300 assuming it's entirely an out-of-pocket expense".

Healthcare is routinely the segment of the economy which adds the most jobs. I wonder how many of those jobs are insurance actuaries, agents, brokers, etc. I respect that we have large and aging group (boomers) and that its essentially inevitable that we would need more healthcare professionals. At the same time, I wonder how much of those jobs goes to the direct engorgement of the health insurance industry and its incomprehensibly dense legalese and shenanigans.

 

[PocketZeven]

Healthcare is routinely the segment of the economy which adds the most jobs. I wonder how many of those jobs are insurance actuaries, agents, brokers, etc. I respect that we have large and aging group (boomers) and that its essentially inevitable that we would need more healthcare professionals. At the same time, I wonder how much of those jobs goes to the direct engorgement of the health insurance industry and its incomprehensibly dense legalese and shenanigans.

Probably not well though. Remember this is the same government that can't negotiate a trade deal to save its soul. If the US government was better at being a government, I'd say you might be onto something, even if I wouldn't agree with it. But our government is horrid at being a government and operating efficiently. When it comes to my healthcare, I don't want an inefficient behemoth trying to control it. All they'd end up doing is making a bad healthcare system worse.

Our system is already overly complex when it comes to specialties and referrals, especially with insurance plans like Medicare/Medicaid and TriCare (a veteran's insurance). I can't imagine the headache it would cause if every US citizen had to go through that.

Also, I assume several docs would just quit being doctors altogether too. As it stands right now many docs hate seeing Medicare/Medicaid patients because they don't get paid as much and the hoops they have to jump through are insane. If they had to do that for everyone, I could see them finding a new profession.

However, if I'm going to be selfish, I'd almost welcome a government healthcare system since it's complexity would mean I'd have some awesome job security.

Healthcare is inherently complex. But as long it helps people to jobs and not to monstrous profits to big Pharma.

 

[Danoff]

An extended-family member of mine recently came out as transgender, currently undergoing hormone therapy to transition to female. This person is a staunch socialist, and advocate of universal healthcare, currently living in the US but searching for a way to leave the fascist misogynistic trump dictatorship in favor of a more civilized socialist nation. The primary destination, most recently, was Vancouver. The plan was to renounce US citizenship and become a Canadian citizen after immigration to Canada. There's a problem though...

Gender transition treatment, according to my family member's research, is not considered an emergency medical need in Canada, and so the wait list for getting the necessary hormone therapy is prohibitively long in Vancouver. I have not verified this, I'm just passing along what I'm being told. I believe this information was obtained during a preliminary trip to scout for residency. This has extinguished all plans to leave the US.

If this is true, the irony here is steeeeeep. The US and its evil anti-trangender, non-universal healthcare system has to remain home for now so that my relative can get the desired healthcare. Can anyone in Canada shed some light on this?

 

[PeterJB]

I believe gender reassignment surgery comes under the banner of cosmetic surgery, or at least in the UK, i.e. it's considered optional and not a medical necessity, therefore, no NHS coverage. It takes a long time to get approval/permission to go through with it because you have to take a huge amount of psychological tests to determine if you're mentally fit to go through with such an operation.

 

[Joey D]

The primary destination, most recently, was Vancouver.

I hope they have an absolute boat load of money and a job lined up. According to a friend of mine who's from there, Vancouver is the most expensive place to live, even by Canadian standards. He moved to Calgary because the cost of living was absolutely insane in Vancouver proper. He put it on par with living in San Francisco or LA.

So your relative is looking at getting a costly surgery, in a city that's insanely expensive to live in, and may or may not be able to get papers to work? That seems like a bold move Cotton.

I know two transgender people. One of them went to Buenos Aires for their surgery and the other went to Thailand, Bangkok specifically. It probably doesn't take a huge amount of reasoning to conclude that the person who went to Argentina had a vastly better experience and better outcomes than the person who went to Thailand. Although, I believe the person who traveled to Bangkok paid less than $5,000 to get everything done (not sure what that all entailed though).

When it comes to sex reassignment surgery, I'm not sure I'd classify it as necessary. Hormone replacement therapy and talk therapy are, as far as I know from working in healthcare, the only two methods that most insurances cover for gender dysphoria. To me that makes sense and I'm not sure any universal health plan should cover sex reassignment surgery.

 

[Danoff]

When it comes to sex reassignment surgery, I'm not sure I'd classify it as necessary. Hormone replacement therapy and talk therapy are, as far as I know from working in healthcare, the only two methods that most insurances cover for gender dysphoria. To me that makes sense and I'm not sure any universal health plan should cover sex reassignment surgery.

I believe the immediate future medical plans are for hormone therapy, and eventually "removal of the source of testosterone" is the way it was put. I think it may have been simply hormone therapy that was not readily available, but I'm not 100% on that.

 

[killerjimbag]

An extended-family member of mine recently came out as transgender, currently undergoing hormone therapy to transition to female. This person is a staunch socialist, and advocate of universal healthcare, currently living in the US but searching for a way to leave the fascist misogynistic trump dictatorship in favor of a more civilized socialist nation. The primary destination, most recently, was Vancouver. The plan was to renounce US citizenship and become a Canadian citizen after immigration to Canada. There's a problem though...

Gender transition treatment, according to my family member's research, is not considered an emergency medical need in Canada, and so the wait list for getting the necessary hormone therapy is prohibitively long in Vancouver. I have not verified this, I'm just passing along what I'm being told. I believe this information was obtained during a preliminary trip to scout for residency. This has extinguished all plans to leave the US.

If this is true, the irony here is steeeeeep. The US and its evil anti-trangender, non-universal healthcare system has to remain home for now so that my relative can get the desired healthcare. Can anyone in Canada shed some light on this?

Renouncing their US citizenship.
That does not qualify for entrance to Canada. We are not a Socialist country. Please don't even assume we are. Our Prime Minister is doing a good job at screwing our country.Healthcare in Canada is not free as my tax dollars pay for my health care. It is not a free for all system.It should not be used or abused by people from other countries because they don't like a leader or are a Socialist. Venezuela is doing pretty good at Socialism perhaps they can try that country. But to answer your question,yes some of it is covered. Not that I agree with it,but it is. When they get blood work,they will still be a Male no matter what changes they have.
http://www.health.gov.on.ca/en/pro/programs/srs/

 

[PocketZeven]

If this is true, the irony here is steeeeeep. The US and its evil anti-trangender, non-universal healthcare system has to remain home for now so that my relative can get the desired healthcare. Can anyone in Canada shed some light on this?

Not from Canada But does she herself think about universal healthcare not covering it? And is the out of pocket cost the same or lower/higher then us?

Healthcare in Canada is not free as my tax dollars pay for my health care. It is not a free for all system.It should not be used or abused by people from other countries because they don't like a leader or are a Socialist. Venezuela is doing pretty good at Socialism perhaps they can try that country. But to answer your question,yes some of it is covered. Not that I agree with it,but it is. When they get blood work,they will still be a Male no matter what changes they have.
http://www.health.gov.on.ca/en/pro/programs/srs/

People need to differentiate between a social democracy and a socialist nation. Using these 2 as they are the same, is causing confusion.

 

[PocketZeven]

double post

 

[ROAD_DOGG33J]

People need to differentiate between a social democracy and a socialist nation. Using these 2 as they are the same, is causing confusion.

What are the differences between the two?

 

[UKMikey]

People need to differentiate between a social democracy and a socialist nation. Using these 2 as they are the same, is causing confusion.

What are the differences between the two?

Democracy.

 

[Grand Prix]

I hope they have an absolute boat load of money and a job lined up. According to a friend of mine who's from there, Vancouver is the most expensive place to live, even by Canadian standards. He moved to Calgary because the cost of living was absolutely insane in Vancouver proper. He put it on par with living in San Francisco or LA.

So your relative is looking at getting a costly surgery, in a city that's insanely expensive to live in, and may or may not be able to get papers to work? That seems like a bold move Cotton.

You're not too far off.

The housing market has been completely messed up, with wealthy Chinese people treating Vancouver houses as a trading commodity. They'll buy a house, evade the non-vacancy tax by hiring someone to/have a family member live there, wait a few years, and then sell it for profit. A brother of mine recently bought a house in Tsawwassen (about an hour's drive from downtown Vancouver) and even that was quite expensive. He still could only find one that was at the end of a T-Junction, however. This is one of the reasons why: https://www.thespruce.com/feng-shui-tips-for-a-t-junction-house-1275208

Even apartment rent is expensive.