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> There's a good argument to be made for a larger sum for the disabled who cannot work. But I'd be extremely opposed to any regional adjustments. If individual

> There's a good argument to be made for a larger sum for the disabled who cannot work. But I'd be extremely opposed to any regional adjustments. If individual cities and states want to supplement the UBI, then that's up to them, but people moving out of high-cost areas and into low-cost ones is part of the natural ebb and flow that keeps the cost of living reasonable. And can you imagine what a CoL adjusted UBI for San Francisco would look like? A massive ripoff of the rest of the country. I don't know what the solution is here but if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am sure I'd be broke even with any supplement in San Diego but at least I'll be broke in San Diego. Edit: I cannot support any discrimination in basic income based on "ability to work". I'd rather the whole thing fail. I'd rather we never have basic income implemented at all than this bastardization go through. Personally, I'm all for death panels. We should not try to keep everyone alive at all costs. If I get in a freak accident and it'd cost me $10M+ to keep me alive with little to no chance of a full recovery, please let me die. Something we need to discuss separately from universal basic income is the need to reduce cost in healthcare. I'd gladly support expanding Medicare to everyone without having to qualify. We would need significantly greater penalties for Medicare fraud and add incentives for whistleblowers and make it easier to report fraud. I'm OK with "lite" Medicare that drops expensive procedures and lets patients suffering from rare cases fending for themselves in order to cut costs especially if there is little chance that the patient will ever recover fully.

marcoperaza 10y ago
My preferred approach for health insurance is to eliminate all of the regulations about what insurance plans must cover, and any other rules that prevent high-deductible catastrophic insurance from being available on the market. You could then buy a very cheap plan that covers everything once expenses exceed, say, 20k, and be responsible for everything before that out of your pocket. Then, unlike now, people would actually factor in cost into their decisions about which doctors and hospitals to visit, which would hopefully drive down wasteful spending. The other thing I'd support is removing medical licensure from the law. People would still be free to visit only AMA-approved physicians, but there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US. >I don't know what the solution is here but if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am sure I'd be broke even with any supplement in San Diego but at least I'll be broke in San Diego. Sure, and when the people of California realize that they're attracting all of the deadbeats from around the country, they'd be forced to adjust.
- newjersey 10y ago
  I can support letting the bottom fall out like this provided we had full single payer coverage for everyone. Any additional coverage can then be whatever you want with the only protection from law being protection from false advertising. I can also support removing the ama-fia's control on licenses but I'm afraid we'll just replace it with something similar when it comes to which providers are eligible to reimbursements from the new single payer healthcare system.
  - marcoperaza 10y ago
    My idea is that these catastrophic insurance plans would be affordable by anyone with their basic income. Debt financing could cover anything below the deductible, for the indigent. Getting such loans would also be easier because of the UBI. Again, people would be financially responsible for their own healthcare, which restores sane incentives, but it wouldn't be possible for it to financially destroy them. No need for a single payer system if this works as I envision it.
    - mapt 10y ago
      "Debt financing" and plans that may be absent or sometimes cover nothing much, is the dystopian nightmare we're trying to escape. Healthcare is not a normal consumer good subject to normal pricing pressures and amenable to substitutes. Single payer works extremely well.
  - 0606hn 10y ago
    As I stated in a response to the parent commenter, the AMA does not control the number of medical school seats/new physicians in the country. Indeed, medical licensing is done by the states and is not a federal process.
- 0606hn 10y ago
  > there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US. First, the AMA does not control the number of medical school seats in the country. Accreditation of US medical schools is done by the LCME, part of the AAMC. With some research, you'd find that the number of medical school seats is growing each year. Second, the limiting factor for physician training is NOT medical school but residency. In point of fact, the US imports residency trainees from overseas - we're not constraining ourselves artificially but instead of surplus training positions. Through a historical fluke, residency training depends on funds allocated by Congress through Medicare funding. I understand your frustration at healthcare costs, but please research these issues.
prostoalex 10y ago
> if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am guessing so would a lot of other people, which would create an opportunity of a lifetime for California landlords, adjusting the rents to the point where UBI would only offer marginal incremental benefit.
fapjacks 10y ago
San Diego is nice, but Hawaii is about as expensive and pretty much nicer.

marcoperaza 10y ago

My preferred approach for health insurance is to eliminate all of the regulations about what insurance plans must cover, and any other rules that prevent high-deductible catastrophic insurance from being available on the market. You could then buy a very cheap plan that covers everything once expenses exceed, say, 20k, and be responsible for everything before that out of your pocket. Then, unlike now, people would actually factor in cost into their decisions about which doctors and hospitals to visit, which would hopefully drive down wasteful spending. The other thing I'd support is removing medical licensure from the law. People would still be free to visit only AMA-approved physicians, but there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US. >I don't know what the solution is here but if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am sure I'd be broke even with any supplement in San Diego but at least I'll be broke in San Diego. Sure, and when the people of California realize that they're attracting all of the deadbeats from around the country, they'd be forced to adjust.

newjersey 10y ago
I can support letting the bottom fall out like this provided we had full single payer coverage for everyone. Any additional coverage can then be whatever you want with the only protection from law being protection from false advertising. I can also support removing the ama-fia's control on licenses but I'm afraid we'll just replace it with something similar when it comes to which providers are eligible to reimbursements from the new single payer healthcare system.
- marcoperaza 10y ago
  My idea is that these catastrophic insurance plans would be affordable by anyone with their basic income. Debt financing could cover anything below the deductible, for the indigent. Getting such loans would also be easier because of the UBI. Again, people would be financially responsible for their own healthcare, which restores sane incentives, but it wouldn't be possible for it to financially destroy them. No need for a single payer system if this works as I envision it.
  - mapt 10y ago
    "Debt financing" and plans that may be absent or sometimes cover nothing much, is the dystopian nightmare we're trying to escape. Healthcare is not a normal consumer good subject to normal pricing pressures and amenable to substitutes. Single payer works extremely well.
- 0606hn 10y ago
  As I stated in a response to the parent commenter, the AMA does not control the number of medical school seats/new physicians in the country. Indeed, medical licensing is done by the states and is not a federal process.
0606hn 10y ago
> there's no reason to give that guild a monopoly on providing health care. The artificial caps on medical school seats, imposed by the AMA, is one of the biggest reasons for the absurd cost of medical care in the US. First, the AMA does not control the number of medical school seats in the country. Accreditation of US medical schools is done by the LCME, part of the AAMC. With some research, you'd find that the number of medical school seats is growing each year. Second, the limiting factor for physician training is NOT medical school but residency. In point of fact, the US imports residency trainees from overseas - we're not constraining ourselves artificially but instead of surplus training positions. Through a historical fluke, residency training depends on funds allocated by Congress through Medicare funding. I understand your frustration at healthcare costs, but please research these issues.

prostoalex 10y ago

> if in this hypothetical reality, the garden state didn't supplement but California did then I'd move to California in a heartbeat. I am guessing so would a lot of other people, which would create an opportunity of a lifetime for California landlords, adjusting the rents to the point where UBI would only offer marginal incremental benefit.

fapjacks 10y ago

San Diego is nice, but Hawaii is about as expensive and pretty much nicer.