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It's hard to envision any good outcome with the current system. But if we pass a universal healthcare like Medicare for all, and forgive student loans, and a nu

by dv_dt 7y ago

It's hard to envision any good outcome with the current system. But if we pass a universal healthcare like Medicare for all, and forgive student loans, and a number of other measures like girding against climate change, then for the first time in long time I could a positive trend for the majority US residents.

jorblumesea 7y ago
Sure, but that would require progressive policies implemented by electing progressive politicians. US voters seem to screw themselves over time and time again by voting for the status quo or in some cases regressive politicians. So long as people keep voting for those who promise no change, why would anyone expect anything to improve?
rayiner 7y ago
The “majority of US residents” have private healthcare and don’t have student loans. That majority will pay more taxes to make life better for the minority of people who don’t have those things. I’m in favor of universal healthcare, but billing it as something that will help the majority is disingenuous. This is the most likely outcome. Costs stay the same or go down a little bit, but nowhere near what it would take to make costs competitive, even as a percentage of GDP, with Europe. That means taxes will have to go up, and by a lot because our public sector is so inefficient compared to Europe. (It costs is 7 times more to build a mile of subway than France, why on earth would you expect building a hospital to be any different?) These taxes will have to be paid by the middle class—because that’s how it’s done in Europe. It’ll be totally unfeasible to have much higher capital gains or corporate taxes than France. (Which has low business taxes and pays for universal healthcare through regressive taxes.) At the end of the day, the middle class household making $80k/year will pay a lot more taxes, and their out-of-pocket healthcare spending won’t go down by much, because they had employer-paid healthcare to begin with. But the hourly workers and those folks will be able to see doctors! And that will be a good thing. But it will also be quite unpleasant for the majority of people who we’re doing okay under the current system.
- xrd 7y ago
  Honest question: do you think there is a different solution that would work to prevent situations like these people in VA? I feel like one of the responsibilities and benefits of living in a modern society is that you should be sheltered from these kinds of problems, and that comes with a cost, as you note, in higher taxes. It sounds like you don't feel that way, and that's fair, but I want to make sure there is not another solution you think would work where the OP recommendation would not. But, I look around most US major cities and see the rampant homelessness and drug addiction and (often the same people with) mental health crisis, and it scares me for the future of our country. I did not see any of that in Europe a few weeks ago, even in cities like Barcelona and Greece, situated in countries that have "bad" unemployment and "bad" economies.
  - rayiner 7y ago
    I’m in favor of higher taxes for more public services. Then again I’m a high income professional living in a blue state, so my taxes are already at European levels. (Maybe not France but probably Germany or the Netherlands.) At the same time, the left is trying to pull a fast one on the American public. They are acting like universal healthcare will be this win-win situation. But lots of people will lose. Our neighbors, who have solidly middle class jobs but good health insurance benefits, will end up paying more in taxes than they will save in out of pocket health expenses. (Back when I had an entry-level engineering job in Atlanta, I made about $60k per year with full benefits and no premium contribution. Circa 2008 me would be worse off under universal healthcare.) Even at the aggregate level, the idea that savings on premium contributions will offset the increased taxes is a fantasy. It assumes our costs will go down to European country levels. I have zero reason to believe that will be true. The US public sector is fantastically inefficient. The New York MTA spends twice as much to move a passenger one mile as compared to London, and building a mile of subway costs seven times as much. The US spends more on social welfare than Canada per person already, and that doesn’t even include universal healthcare. It is pure fantasy to assume we can get universal healthcare without European level taxes—20% payroll tax, 20% VAT, the works—on the middle class. I think it’s worth it, because I think providing for the most vulnerable trumps having more TVs per capita. But it’s dishonest to pretend like it won’t require a major hit to material standard of living. The CBO estimates it will cost $3 trillion a year to provide universal healthcare. You will notice that no Democratic candidate has proposed raising taxes sufficiently to come anywhere near raising the required revenue. That is very telling.

by dv_dt 7y ago

jorblumesea 7y ago

Sure, but that would require progressive policies implemented by electing progressive politicians. US voters seem to screw themselves over time and time again by voting for the status quo or in some cases regressive politicians. So long as people keep voting for those who promise no change, why would anyone expect anything to improve?

rayiner 7y ago

The “majority of US residents” have private healthcare and don’t have student loans. That majority will pay more taxes to make life better for the minority of people who don’t have those things. I’m in favor of universal healthcare, but billing it as something that will help the majority is disingenuous. This is the most likely outcome. Costs stay the same or go down a little bit, but nowhere near what it would take to make costs competitive, even as a percentage of GDP, with Europe. That means taxes will have to go up, and by a lot because our public sector is so inefficient compared to Europe. (It costs is 7 times more to build a mile of subway than France, why on earth would you expect building a hospital to be any different?) These taxes will have to be paid by the middle class—because that’s how it’s done in Europe. It’ll be totally unfeasible to have much higher capital gains or corporate taxes than France. (Which has low business taxes and pays for universal healthcare through regressive taxes.) At the end of the day, the middle class household making $80k/year will pay a lot more taxes, and their out-of-pocket healthcare spending won’t go down by much, because they had employer-paid healthcare to begin with. But the hourly workers and those folks will be able to see doctors! And that will be a good thing. But it will also be quite unpleasant for the majority of people who we’re doing okay under the current system.

xrd 7y ago
Honest question: do you think there is a different solution that would work to prevent situations like these people in VA? I feel like one of the responsibilities and benefits of living in a modern society is that you should be sheltered from these kinds of problems, and that comes with a cost, as you note, in higher taxes. It sounds like you don't feel that way, and that's fair, but I want to make sure there is not another solution you think would work where the OP recommendation would not. But, I look around most US major cities and see the rampant homelessness and drug addiction and (often the same people with) mental health crisis, and it scares me for the future of our country. I did not see any of that in Europe a few weeks ago, even in cities like Barcelona and Greece, situated in countries that have "bad" unemployment and "bad" economies.
- rayiner 7y ago
  I’m in favor of higher taxes for more public services. Then again I’m a high income professional living in a blue state, so my taxes are already at European levels. (Maybe not France but probably Germany or the Netherlands.) At the same time, the left is trying to pull a fast one on the American public. They are acting like universal healthcare will be this win-win situation. But lots of people will lose. Our neighbors, who have solidly middle class jobs but good health insurance benefits, will end up paying more in taxes than they will save in out of pocket health expenses. (Back when I had an entry-level engineering job in Atlanta, I made about $60k per year with full benefits and no premium contribution. Circa 2008 me would be worse off under universal healthcare.) Even at the aggregate level, the idea that savings on premium contributions will offset the increased taxes is a fantasy. It assumes our costs will go down to European country levels. I have zero reason to believe that will be true. The US public sector is fantastically inefficient. The New York MTA spends twice as much to move a passenger one mile as compared to London, and building a mile of subway costs seven times as much. The US spends more on social welfare than Canada per person already, and that doesn’t even include universal healthcare. It is pure fantasy to assume we can get universal healthcare without European level taxes—20% payroll tax, 20% VAT, the works—on the middle class. I think it’s worth it, because I think providing for the most vulnerable trumps having more TVs per capita. But it’s dishonest to pretend like it won’t require a major hit to material standard of living. The CBO estimates it will cost $3 trillion a year to provide universal healthcare. You will notice that no Democratic candidate has proposed raising taxes sufficiently to come anywhere near raising the required revenue. That is very telling.