Suck it, Bush!

[Arrian]

Ming

Kontiki - that's one of the two big reasons I'm for a national healthcare system. We're wasting a ****load of money, and it pisses me off.

-Arrian

[Arrian]

The cost being that you no longer have a choice to opt-out. You have to pay into the system.

Waaaah. I can't "opt out" of paying taxes for my government's assinine military adventures either. So be it.

-Arrian

[GePap]

Ming, the solution is more competition, not a single payer system.

Show me a single country that has done this and succeeded.

The most successful health care systems (ie. those with the best results for the lowest cost) are all centralized ones. Which of course makes perfect sense.

Maintaining people healthy (as opposed to treating illness, which is a more expensive proposition) is not something that falls easily under market theory. It is highly difficult to envision most human beings being rational consumers when it comes to their own health. People are either lacking the information they need to make good choices, or are likely to overspend because of the understandable fear of death. On top of this, a healthy individual is not going to be a regular consumer of the products of the health care industry - do you know of any business that thrives by ensuring that there not be repeat business?

[Boris Godunov]

The top rate in Canada, which kicks in at about 200k is around 40 percent.

You think 40% is a high top rate? Absurd!

Why, in the U.S., we used to have a top rate approaching 95%. And that was during the 1940s-50s, which I believe were the best times we ever had and things have been going to hell ever since... according to Republicans anyway...

The con job of thinking that taxing the ultra-rich more than 30% or so is too high really is amazing.

[Ramo]

You can't actually come up with a cogent reason for this can you?

Money is money. Excise taxes aren't my favorite kind of tax, but they beat a solid number of alternatives. You haven't made a case that excise taxes are the most awful revenue source ever.

The type of folks I'd be likely to vote for if they were to support a program like this wouldn't choose to provide funding for it from the most assanine source imaginable.

Yes, they would. Granted, most of them don't believe in making sure kids get health care. But if it were something that they did like, such as invading miscellaneous countries or walling up America, they'd want to fund it through some douchey mechanism like a sales tax which covers food.

[Ben Kenobi]

Waaaah. I can't "opt out" of paying taxes for my government's assinine military adventures either. So be it.

So you don't think people have a responsibility to manage their own health and that the government has to do it for them?

Perhaps the government should manage your bank account too, since you aren't responsible enough to manage your own affairs.

[Ben Kenobi]

Why, in the U.S., we used to have a top rate approaching 95%. And that was during the 1940s-50s, which I believe were the best times we ever had and things have been going to hell ever since... according to Republicans anyway...

You've been going on about the Gilded Age.

They had no income taxes whatsoever back then.

As for the 95 percent rate, I see no mention of Roosevelt in your post. Was Roosevelt an R?

[Ben Kenobi]

Show me a single country that has done this and succeeded.

Canada prior to Tommy Douglas.

The most successful health care systems (ie. those with the best results for the lowest cost) are all centralized ones. Which of course makes perfect sense.

You ask the wrong question. Why do we want a successful health care system? What we want are healthy people. Do you believe people are the healthiest today then they have ever been?

Maintaining people healthy (as opposed to treating illness, which is a more expensive proposition) is not something that falls easily under market theory.

Sure it does. We wouldn't expect the government to make healthy choices for us, like saying we have to go for a run every day of at least an hour.

It is highly difficult to envision most human beings being rational consumers when it comes to their own health.

That's because there is no motivation for them to be. If you make the cost of something 0, then demand will always outstrip supply. That's the real problem with the system, you need a market based system to accurately reflect the cost of health care. How do I know how much a heart surgery should cost? Under our system a government produces a fee-for-service of the costs that it is willing to pay for the surgery. Needless to say, the amount the government pays is less then the value of the service. This is why doctors and nurses leave Canada to work down south where they can make more money for doing the exact same thing.

People are either lacking the information they need to make good choices, or are likely to overspend because of the understandable fear of death.

You could argue the same with regards to money, that people rarely make rational choices. Just because people make choices that are not considered rationale, doesn't mean that we need the government to make the decisions for us.

On top of this, a healthy individual is not going to be a regular consumer of the products of the health care industry - do you know of any business that thrives by ensuring that there not be repeat business?

Dentistry? Optometry? The key is word of mouth. Car repairs? That's just three off the top of my head.

[GePap]

Canada prior to Tommy Douglas.

I don't know enough about Canada's ancient health care system, but someone will inevitable yprove you wrong, as always.

You ask the wrong question. Why do we want a successful health care system? What we want are healthy people. Do you believe people are the healthiest today then they have ever been?

People are healthier today than 100 years ago, or 1000, but the main reasons for this improvement in general health lie in improved sanitation, nutrition, and basic medicine. We could be healthier of course, which is the point of wanting effective health care.

That's because there is no motivation for them to be. If you make the cost of something 0, then demand will always outstrip supply. That's the real problem with the system, you need a market based system to accurately reflect the cost of health care. How do I know how much a heart surgery should cost? Under our system a government produces a fee-for-service of the costs that it is willing to pay for the surgery. Needless to say, the amount the government pays is less then the value of the service. This is why doctors and nurses leave Canada to work down south where they can make more money for doing the exact same thing.

Irrelevant. The point of a health care system is not profit for doctors, but improved patient care and better overall health for the population at large.

You could argue the same with regards to money, that people rarely make rational choices. Just because people make choices that are not considered rationale, doesn't mean that we need the government to make the decisions for us.

Yes, we could say the same for money, which is why we should actively discourage most people from playing around stock market.

And market theory is based on the notion that consumers are rational. If they are not, then you can't claim that the most efficient way to manage resources is with a market.

[Theben]

In 1993 the GAO told the Clinton administration that a single-payer system would save the govt 21 billion/year, mostly in preventitive costs.

[Boris Godunov]

You've been going on about the Gilded Age.

They had no income taxes whatsoever back then.

And what a ****ty time that was for most people. Of course, you stated your love for the Robber Barons in the other thread...

As for the 95 percent rate, I see no mention of Roosevelt in your post. Was Roosevelt an R?

What do you mean? Are you suggesting that I'm complaining about that rate?

[DinoDoc]

DD - I personally am not holding Canada's system up for emulation... I'm simply referring to it for shorthand comparison, seeing as they're our neighbors and have socialized medicine. Nothing more.

And I'm saying that if you are going to mention a sytem that you'd like people to look at, Canada isn't the one I would choose as it could be counter productive to your aim. Most Western Euro trash countries have a better system.

Re Ramo: How does using revenue from a tax who's sole reason for existance is to punish and eliminate a certain behavior (pushing the revenues you get from it down) to fund an expansion of a program who's costs will inevitably increase make any sense at all? I'm genuinely curious because in absense of any way to make sense of the decision from a practical standpoint, it really does seem like the most awful revenue source ever.

[Imran Siddiqui]

You think 40% is a high top rate? Absurd!

Wasn't the top rate in the US around 39% during the 90s?

As for the 95 percent rate, I see no mention of Roosevelt in your post. Was Roosevelt an R?

No, but Eisenhower was.

[Jon Miller]

So you don't think people have a responsibility to manage their own health and that the government has to do it for them?

A healthy, productive populace is in the government's interest. It isn't in the health industries interest (although it is in Doctor's interest).

JM

[Ramo]

Re Ramo: How does using revenue from a tax who's sole reason for existance is to punish and eliminate a certain behavior (pushing the revenues you get from it down)

Once more, the idea that a 61 cent/pack increase is going to eliminate the legal market for cigarettes is insane.

[q] to fund an expansion of a program who's costs will inevitably increase make any sense at all?[/QUOTE]

There's nothing setting the revenue source in stone. SCHIP will almost certainly be integrated into universal health care legislation later on this year, assuming that health care politics don't change significantly over the next several months.

Higher marginal income tax rates, probably capital gains and dividends rates, maybe estate tax rates are going to increase over the next few years. Whether health care for low income kids comes from that source or the tobacco tax is accounting trivia.