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And that really is a priority discussion. Universal healthcare, say Medicare for All style, does not have to mean higher taxes. And it would make a big differ

And that really is a priority discussion. Universal healthcare, say Medicare for All style, does not have to mean higher taxes. And it would make a big difference to gig workers and the ones working for the likes of Walmart. A very high percentage of Walmart employees need government assistance due to their income not actually being enough to pay the laborer what their labor costs them to deliver. At a minimum, labor needs to exist reasonably and show up for work. Healthcare is a part of that, right along with the basics. All of us are subsidizing labor for a few of us to put profit, or more peak profit in the bank. The priority discussion boils down to what makes the most sense for the nation. Do we cut back on the military industrial complex? Maybe we decide subsidizing labor makes sense. That would also mean not shaming and blaming people who seek and obtain help from the government. Doing that is baked in right now, in that no matter what those people do, a large percentage of them will need help. Or, we simply change nothing and yes, taxes are higher, but the national spend is lower overall. Many of us will benefit. We could prioritize it so employers are more on the hook in various ways. Some of them will not be viable. Even if they all are, we may not have enough jobs. Government could be an employer to make sure everyone has a work opportunity that pays enough to exist and show up for work. There are many options. Not all mean higher taxes, but all that discussion means a national priority talk also has to happen. If we do nothing, our priority is not having people make it, exist reasonably and show up for work. Predictably, lots of people are not making it, may do crime, are homeless, may not have health care, maybe will show up for work, if they can get it. If our priority becomes about people existing reasonably and showing up for work, we will see that, but will have higher taxes, or back off some other things we currently make a priority.

sokoloff 6y ago
> Universal healthcare, say Medicare for All style, does not have to mean higher taxes. How would that be? It seems like it certainly would to me. Maybe by less than employees plus employers currently pay in aggregate healthcare costs, but I can't imagine a way where the government pays for Medicare-for-all and taxes don't go up. Do you have a specific idea in mind that I'm missing?
- deleted 6y ago
  [deleted]
- munk-a 6y ago
  I suspect that was a misstatement - I haven't seen a proposal that avoids higher taxes without a large debt being written against something else (i.e. redirecting funding from the military). It is, however, accurate to say that personal out-of-pocket expenses wouldn't increase for most individuals. The cost per patient for government funded healthcare is expected to significantly undercut private costs per patient due to some efficiencies of scale and removal of some pretty big market friction points - so less money would end up being extracted from the economy to pay for an equivalent level of care. In short - you can buy a banana for a dime or give the government a nickle and get a "free" banana.
  - maxerickson 6y ago
    Medicare just forces providers to take less money than insurance companies, it's efficient in some sense, but it's not operational efficiency. I'm super glad my mom has Medicare! But she isn't benefitting from it being efficient, she's benefitting from it setting the rate it pays and requiring providers to accept it.
    - munk-a 6y ago
      To clarify a bit these market insights don't just come from comparisons to medicare but by comparing patient care costs to similarly developed nations and trying to account for factors like the obesity epidemic - the US just pays a lot more for a patient to get treatment than similar countries.
- sprite 6y ago
  You would be able to cut out an entire for profit insurance industry, I would also think people would be more inclined to go to see a doctor before a minor issue turns into a major one than they are now.
- ddingus 6y ago
hash872 6y ago
>Do we cut back on the military industrial complex? The US spends $676 billion on defense, almost the exact same amount on Medicare, $1 trillion on Social Security, and $409 billion on Medicaid. Social welfare spending is a much, much larger portion of the US budget than military spending. Here are the numbers straight from the Congressional Budget Office https://www.cbo.gov/system/files/2020-04/56324-CBO-2019-budget-infographic.pdf https://www.cbo.gov/system/files/2020-04/56324-CBO-2019-budg...
- ddingus 6y ago
  Yes, and so? Did that Trillion not come from people contributing? You know it did. And still, we can and should totally question our current spend.
  - hash872 6y ago
    To answer the second sentence, no, I don't know that. Boomers are taking out 5 times as many benefits as they paid in, it is absolutely not paid for (many Boomers believe otherwise!)
    - ddingus 6y ago
      Let's say for a moment that is true. ( and we can ignore under payment of benefits, like the social security tax cap being at a hundred some thousand dollars.) How does that impact the discussion? Do we think we need another problem by not actually paying those benefits? Secondly, back to the first question, so? What's our priority? Right now that priority is not healthy people, able to show up for work, existing reasonably. Does that make the best sense? I don't think so.
      - hash872 6y ago
        I don't really understand what you're trying to say here. I am personally pro-a larger welfare state- I wanted to specifically engage with one wrong thing you said, that the US somehow spends more on the military than social welfare. In fact, this is a common misconception- the United States spends several multiples more on social welfare than its military. In fact, the US spends about as much just on healthcare for the elderly as it does its entire military budget. This is simply a statement of fact, not meant to be an anti-social welfare political statement from me

sokoloff 6y ago

> Universal healthcare, say Medicare for All style, does not have to mean higher taxes. How would that be? It seems like it certainly would to me. Maybe by less than employees plus employers currently pay in aggregate healthcare costs, but I can't imagine a way where the government pays for Medicare-for-all and taxes don't go up. Do you have a specific idea in mind that I'm missing?

deleted 6y ago
[deleted]
munk-a 6y ago
I suspect that was a misstatement - I haven't seen a proposal that avoids higher taxes without a large debt being written against something else (i.e. redirecting funding from the military). It is, however, accurate to say that personal out-of-pocket expenses wouldn't increase for most individuals. The cost per patient for government funded healthcare is expected to significantly undercut private costs per patient due to some efficiencies of scale and removal of some pretty big market friction points - so less money would end up being extracted from the economy to pay for an equivalent level of care. In short - you can buy a banana for a dime or give the government a nickle and get a "free" banana.
- maxerickson 6y ago
  Medicare just forces providers to take less money than insurance companies, it's efficient in some sense, but it's not operational efficiency. I'm super glad my mom has Medicare! But she isn't benefitting from it being efficient, she's benefitting from it setting the rate it pays and requiring providers to accept it.
  - munk-a 6y ago
    To clarify a bit these market insights don't just come from comparisons to medicare but by comparing patient care costs to similarly developed nations and trying to account for factors like the obesity epidemic - the US just pays a lot more for a patient to get treatment than similar countries.
sprite 6y ago
You would be able to cut out an entire for profit insurance industry, I would also think people would be more inclined to go to see a doctor before a minor issue turns into a major one than they are now.
ddingus 6y ago

hash872 6y ago

>Do we cut back on the military industrial complex? The US spends $676 billion on defense, almost the exact same amount on Medicare, $1 trillion on Social Security, and $409 billion on Medicaid. Social welfare spending is a much, much larger portion of the US budget than military spending. Here are the numbers straight from the Congressional Budget Office https://www.cbo.gov/system/files/2020-04/56324-CBO-2019-budget-infographic.pdf https://www.cbo.gov/system/files/2020-04/56324-CBO-2019-budg...

ddingus 6y ago
Yes, and so? Did that Trillion not come from people contributing? You know it did. And still, we can and should totally question our current spend.
- hash872 6y ago
  To answer the second sentence, no, I don't know that. Boomers are taking out 5 times as many benefits as they paid in, it is absolutely not paid for (many Boomers believe otherwise!)
  - ddingus 6y ago
    Let's say for a moment that is true. ( and we can ignore under payment of benefits, like the social security tax cap being at a hundred some thousand dollars.) How does that impact the discussion? Do we think we need another problem by not actually paying those benefits? Secondly, back to the first question, so? What's our priority? Right now that priority is not healthy people, able to show up for work, existing reasonably. Does that make the best sense? I don't think so.
    - hash872 6y ago
      I don't really understand what you're trying to say here. I am personally pro-a larger welfare state- I wanted to specifically engage with one wrong thing you said, that the US somehow spends more on the military than social welfare. In fact, this is a common misconception- the United States spends several multiples more on social welfare than its military. In fact, the US spends about as much just on healthcare for the elderly as it does its entire military budget. This is simply a statement of fact, not meant to be an anti-social welfare political statement from me