[Oriz]

Originally Posted by timberline742

Depends on what is done with the money.

In most all of the developed world, a single payer system delivers coverage for everyone, with a lower per person cost, and better overall results. It is the fiscally sound decision. I can't think of any place in the world that moved from a single payer system to a system like ours and saved money and/or improved results. It just doesn't happen.

What does that have to do with what I said? I always said that I believe if done right, single payer can be beneficial. I come from a country with universal health care(not completely single payer but nowhere near as privatized as the US) and I don't think people should file bankruptcy cause they got sick. But again, you gotta find the money for it somewhere else. You don't tax people at 50% of their income, people that work hard deserve to keep more than half of their money, period.

[mdovell]

Originally Posted by cgregor

Sorry, but subsidizing the supply in health care simply shifts the cost; it does not ipso facto lower the price. You might want to start with any of the five studies done on Vermont's single payer system to see how costs get reduced. Dr. William Hsiao's was the seminal one. Even the most critical of the group, the Valere study, agreed single payer would be cheaper than maintaining the present system.

I get what you are saying but we can easily lower health care prices easily by reversing the subsidy. It doesn't shift the cost. When there is competition as in real competition and the incentives to compete then prices drop.

When President Carter deregulated the airlines the prices of airline fees dropped like a rock. Yes you can argue that airplane food is bad today but the fact of the matter remains is that if you can compete in price then prices will drop. The same went for rail and trucking.

[cgregor]

Well put, mdovell!

However, to get competition in the health care field would mean breaking the drug companies' patent stranglehold, and you know how likely that is to happen!

Ditto with insurance companies giving up their right to 15% of premiums for "administrative costs," versus Medicare A's 2% for administrative costs...

[mdovell]

One of the major issues frankly is that we moved from a first to invent to a first to patent system. What this means is companies can patent things and license them or simply sue other companies that might happen to make the same things. The issue with this is frankly who honestly is going to research each individual thing made to see if it is patented. The answer is either to ask that anything patented must be made to warrant (no patent trolls) or we simply get rid of the system.

Drugs have a patent I believe of seven years. Now companies can see what other companies are trying to do but not how they will do it.

If deals were made to say lower the clinical drug trials in exchange with shorter patents we could see more drugs come to the market faster.

The other odd part on this is privacy. What if instead of an employer mandate for insurance we simply mandated employers must have a doctor or nurse on staff. Employers would then compete to have the best ones.What if a doctors exam was as frequent as an employment annual review? This would eliminate any lag of those with insurance that simply put off getting exams.

[FreddyG62]

The prospect of ShumlinCare Single Payer was/is a major reason for me to start planning an early retirement so my wife and I can get the heck out of this socialist utopia, aka The State of Vermont and head South.

[timberline742]

Originally Posted by cgregor

Well put, mdovell!

However, to get competition in the health care field would mean breaking the drug companies' patent stranglehold, and you know how likely that is to happen!

Ditto with insurance companies giving up their right to 15% of premiums for "administrative costs," versus Medicare A's 2% for administrative costs...

This. Remove the bloated administration (improve efficiency by doing so), and remove the profit, and costs will drop. Simple.

[timberline742]

Originally Posted by Oriz

What does that have to do with what I said? I always said that I believe if done right, single payer can be beneficial. I come from a country with universal health care(not completely single payer but nowhere near as privatized as the US) and I don't think people should file bankruptcy cause they got sick. But again, you gotta find the money for it somewhere else. You don't tax people at 50% of their income, people that work hard deserve to keep more than half of their money, period.

You say "period" but other places, with more successful systems, disagree.

There is no somewhere else. We, the people, pay for the healthcare. We do already. Under any scenario we will pay for the healthcare. Either now, or by kicking the costs down the road to our children by borrowing. There is no way around it. People pay.

The question then becomes how to do it efficiently and less expensively. Having artificially low (they are artificially low because we borrow for everyday non ER needs) taxes and proclaiming "yay, we aren't taxing 50%" is just idiocy... we are already paying, whether it is now or later. I, personally, would like honesty in our budgeting.

[Oriz]

Completely agree. Debt needs to be reduced.

However so do taxes.

How do you do it?

You spend less.

[cgregor]

"Spending less" doesn't do it when an economy is at the Zero Lower Bound (ZLB).

Taxes are imposed on the transfer of money-- sales, wages, inheritance, etc.-- and property.

When the transfers slow down, tax revenue falls. For example, some $30 billion in corporate income is parked offshore because it would be taxed if it is brought home, so some $5 to $10 billion in tax revenue is lost.

That $5 to $10 billion will be spent by the government-- defense, highways, government paperwork, Social Security retirees, private aerospace contractors, you name it-- and each person who receives that money will spend most of it-- certainly if they are in the bottom 80%. The people to whom they pay it will also spend it, and so it goes around and around. This is called the "multiplier effect." And almost every time it goes around, it gets taxed again-- unless it falls into the hands of the superrich (Mitt Romney paid no taxes for ten years before he ran for President, doing such things as illegally setting up $1 million IRA accounts for his kids) or hedge fund managers (Jack Strauss made $9 billion in 2009 and didn't pay a penny, because Congress gave his ilk a break).

When the tax money isn't there to spend, a lot of people suddenly get very poor or unemployed, which is why we had the Great Recession up until just a few months ago.

It's contrary to logic that when times are bad the government should spend more, but then it's also contrary to logic to anyone who can see the shape of the land around them that the Earth is actually round.

[Sierrajeff]

Originally Posted by cgregor

Taxes are imposed on the transfer of money-- sales, wages, inheritance, etc.-- and property.

Taxing income and consumption is inefficient and (often) reinforces economic cycle problems - as evidenced by the massive cutbacks in state and local spending across the country since 2007.

I like the "tax 'bads' not 'goods'" movement - instead of taxing people's income [basically, taxing people's daily activity and labor, because income is simply an economic manifestation of one's labor] or consumption of physical goods [taxing people on things they need simply to live, such as food], tax 'bads' - tax pollutors for the "right" to pollute, tax inefficient energy systems, tax junkyards and increase landfill fees, etc.

In addition to removing the disincentive to improve one's income, and removing the way that tax revenues depend upon, and reinforce, economic cycles, taxing "bads" can also help us achieve improvements in our world.

Here's a link to a 2009 Vermont-specific report:
Gary Flomenhoft: Tax bads not goods! A Green Tax Shift for Vermont

and a UVM "green tax" study:
Gund Institute for Ecological Economics : University of Vermont