> For example, universal health care and education are public goods that generate more market wealth in higher productivity than they cost in taxes collected to pay for them,
Oh really? Always?
I ask because the French and German govts spend about 8% of their GDP on healthcare and cover a huge fraction of their population. The US govt spends about 8% of GDP on healthcare and covers a much smaller fraction of its population. Since the US GDP/person is larger, the US govt is spending over twice as much per covered person on healthcare.
Even if we assume that the French and German govt's spending generates more market wealth than the taxes collected, it's unclear that the US govt's healthcare spending does.
That's why I wanted a very different "health care reform".
I wanted to give Obama complete power over the money that the US govt is currently spending on healthcare wrt the folks it currently covers. Yes, employees (state and local too), Medicare, VA, Indian Health Service (which is a real horrorshow), and possibly even folks who work for companies that get >80% of their revenue from govt contracts.
That's a huge fraction of the population.
We then see what happens over 6 years.
And, since govt health care advocates insist that govt healthcare is 30% cheaper, we cut the per-person budget 5%/year in years 3-5. (That's just over 20% total.) He can either return that money to the general fund or use it to cover additional people - the only hard constraint is the per-person budget.
Why are you complaining about Universal healthcare when both your examples of low costs France and Germany include universal healthcare? All evidence I have seen suggests that the US government would save money by moving to a well regulated universal healthcare system.
PS: Much of the savings of a universal healthcare system only works as you cover everyone. EX: Massively reduced paper trails, subsidizing the cost of medical school etc. As long as the government only covers a subset of the population it can't realize a wide range of cost saving options.
> Why are you complaining about Universal healthcare when both your examples of low costs France and Germany include universal healthcare?
I'm pointing out that experience with US govt healthcare suggests that universal healthcare provided by the US govt is likely to be very different from what other countries have done.
Remember - we don't get France or Germany running US govt healthcare - we get the US govt doing it.
> PS: Much of the savings of a universal healthcare system only works as you cover everyone. EX: Massively reduced paper trails, subsidizing the cost of medical school etc.
Sorry, but the "paper trail" argument doesn't fly. You have to track medical histories, which contain far more.
And, we already subsidize medical schools. More to the point, that spending is in the noise. If Obama wants to spend more money there, he'll lose at most half to the remaining private sector and can easily reduce the losses to 0. (As a condition of receiving "extra aid", folks can be obligated to work for ObamaCare for n years, just like the military academies. And, if you find that folks are unwilling to take the deal, that's worth knowing.)
I find the lack of interest in the trial period interesting. Most folks jump at the chance to prove themselves. Few think that they should be given complete control without any previous experience, let alone negative experience.
I agree that the US government has shown a remarkable ability to mess things up but we have also been running a huge healthcare system for a while so extending Medicare to everyone would be far simpler than a totally new system.
As to savings on "paper trail" is really a savings on the billing with 5 different insurance companies the doctor needs to handle each one separately and have separate negotiations on cost etc. Also because the government is covering everyone doctors and hospitals spend less time trying to bill people who can’t pay etc. And becomes the government has such close ties with the doctors they don’t need to closely examine every single treatment just a random sample to avoid fraud.
PS: lack of interest in the trial period interesting I am pointing at the Medicare system as the trial period. The government already spends 50% of every healthcare dollar so it's not exactly a new player in the system. Medicare is actually run at lower cost than most private insurance companies. There is even a standard idea of supplemental coverage which private company’s already understand and are used to.
> I agree that the US government has shown a remarkable ability to mess things up but we have also been running a huge healthcare system for a while so extending Medicare to everyone would be far simpler than a totally new system.
Except that the goal isn't "simpler", it's better. My offer lets you do what you want. If you think that extending medicare to federal workers is best, great. (I predict that they'll revolt because I've never run into anyone with experience with both who would give up private for medicare.)
> As to savings on "paper trail" is really a savings on the billing with 5 different insurance companies the doctor needs to handle each one separately
Except that it doesn't actually work that way, and the cost isn't significant. (Big doesn't imply significant.)
> lack of interest in the trial period interesting I am pointing at the Medicare system as the trial period.
And medicare is widely regarded as a disaster. I offer a chance to fix it and single payer advocates run away.
However, if you think that medicare is fine, then my offer lets you extend it to federal workers, the VA, and so on. And we get to observe.
And you get to deliver on the promise of lower costs. Since medicare isn't cheaper (I'll deal with overhead below) and delivers worse care....
Of course, you also have the problem that doctors who have a choice tend to flee medicare. If the private insurers are so hard to deal with, what does that say about govt?
> Medicare is actually run at lower cost than most private insurance companies.
Actually, it isn't. Medicare spends less money on one specific category of "overhead", but it spends far more on others. (Govt's overall spending per covered person is basically the same as the private system's spending. Medicare is actually worse than average for delivery vs cost.)
For example, the credible total medicare fraud estimates range from $150B to $250B/year. (The low number is from AG Holder, who said "more than".)
This is despite the fact that folks who raise disputes with medicare are less likely to win than folks who have disputes with the private system. What a deal - more fraud and more denied coverage.
The total profit of the private system is >$10B/year. And no, adding "executive salaries" doesn't significantly change that number.
The medicare fraud number alone dwarfs the supposed overhead of the private system, and the private system is bigger than medicare.
I'm sure that you've seen the "free medical equipment" ads on TV. That equipment isn't free, it's paid by medicare/medicaid. Care to argue that it's mostly medically necessary?
Free rein lets you fix this, if it can be fixed. However, until you do....
Oh really? Always?
I ask because the French and German govts spend about 8% of their GDP on healthcare and cover a huge fraction of their population. The US govt spends about 8% of GDP on healthcare and covers a much smaller fraction of its population. Since the US GDP/person is larger, the US govt is spending over twice as much per covered person on healthcare.
Even if we assume that the French and German govt's spending generates more market wealth than the taxes collected, it's unclear that the US govt's healthcare spending does.
That's why I wanted a very different "health care reform".
I wanted to give Obama complete power over the money that the US govt is currently spending on healthcare wrt the folks it currently covers. Yes, employees (state and local too), Medicare, VA, Indian Health Service (which is a real horrorshow), and possibly even folks who work for companies that get >80% of their revenue from govt contracts.
That's a huge fraction of the population.
We then see what happens over 6 years.
And, since govt health care advocates insist that govt healthcare is 30% cheaper, we cut the per-person budget 5%/year in years 3-5. (That's just over 20% total.) He can either return that money to the general fund or use it to cover additional people - the only hard constraint is the per-person budget.