It does more to fix the deficit that any other solution and it is non-regressive when the proper exemptions for food and clothing are factored in. It allows the government another fine-tuning tool for bad times by VAT holidays and exemptions for fuel and other consumables. It taxes consumption and rewards savings.
I believe in markets but I do believe health care is far different then Broccoli. I really don’t care if the system is private or public but it has to be national in other words insurance companies don’t get to underwrite risk and can’t deny service. The idea of consumer choice when no one knows what they need and treatment shouldn't be denied is simply not relevant.
We keep saying that, and we DO need a new source of revenue, but I doubt you'll see it. Not unless it comes with a serious claw-back on the income tax. If so, you could convince me.
We're on an unsustainable model as it is. Low Income Taxes (western world) Social Safety Net American Empire Cost of Healthcare The Value Added Tax can sustain all of the above. Without it one or more must be largely eliminated from the equation. My best guess is that a Value Added Tax is more politically doable than a general income tax rise. The social safety net is never going to get removed, there just aren't the votes to do that. Welfare Reform was the low hanging fruit and it has already been done a generation ago. Extended Unemployment is probably the next lowest hanging fruit but it is a drop in the bucket in terms of the overall deficit. American Empire? Well, maybe but I doubt it. Watch where the cuts go in two months and you'll get a good idea. I am guessing federal agencies and aid to local governments is where the hit will fall and some of the military cuts will be reversed. Cost of healthcare? Talk to a doctor who makes 375K a year for a 70 hour workweek and is always on call and also pays 150K of that for malpractice insurance. The HMO's and insurance companies have too much clout and the hospitals that have survived the shakeout are politically wiser and fight like badgers backed into their den when the government comes calling. It's going to be a VAT. It will be sold as the alternative to a general income tax hike by the people who sell it.
A tax on the wealthy would be something along the lines of an estate tax that actually taxes wealth. While people would scream bloody murder, some level of taxation based upon overall wealth held or transferred would not be a bad idea. Income and wealth may be related but they are two very different things.
While purchasing broccoli is a much simpler transaction that one involving healthcare services I would not argue against the government having a role in requlating either transaction. When buying brocolli, most people avoid buying more than they can eat before it goes bad. This is because the money they use to buy the brocolli is dear to them and they do not want to waste it on excess food that will only rot later. The main problem with the health care system is that unlike the brocolli, the waste (or rot) is someone else's problem. In other words, people have no problem using as much health insurance as they can get for their $15 copay. They do not care if their insurance company or some hospital bears the cost of a $500-1,000+ MRI as long as they do not pay for it directly. Doctors and hospital administrators also get compensated for the amount of service provided so from their perspective, more is better than less even if it may not add all that much value. While you may be critical of the insurance companies, it seems that they may be the only ones watching the store. Unless there is someone to look at the benefit of these services and weighs it against the cost, health insurance premiums and spending will only skyrocket. Ideally, the customer would have a stronger disincentive to use more care than is necessary but in practice this does not seem to happen (especially with the poor and elderly). The entitlement mentality of patients in general and the government in particular share much of the blame for our current problems. Obamacare with the federal government getting more involved seems to be a worse outcome that our existing system where 50 different states competed against each other, each with their own healthcare system. It is a very complicated system with many failings and there are many culprits to point fingers at. Fixing this problem is easier said than done. The right thing may not necessarily be the popular thing.
The problem with the broccoli analogy is that people can make a relatively solid prediction about the decay rate of broccoli and their planned future meals. They can make an informed decision. And if they are wrong in their decision, while they might be losing hard-earned money because the broccoli went bad (or left wanting some broccoli because they decided not to purchase it), it is not a life or death situation. The value of broccoli - whether eaten, discarded, or left in the produce aisle unpurchased - remains steady. Health insurance is fundamentally different because people can make neither accurate nor rational predictions of the value of their health at the time they are paying for the insurance, and the perceived value of the insurance changes with your health. Your good health often flies under the radar... and then you find a lump. Or your kid coughs up blood out of nowhere. I agree that the system needs to move away from fee-for-service and move more toward better analysis and outcome-based payments. Try to do that, though, and people scream, "OMG!! Death panels!!11!" And while higher deductibles and/or co-pays can help people make more informed decisions about how much care they need, the average patient is not informed enough to make a proper (in the medical sense) decision about the best course of treatment. When you are talking about a person's health, they will tell you to do whatever it takes to make them healthy. My grandmother used to say, "If you've got your health, you've got everything." We thought it was a weird old-person saying at the time, but man, as I get older, I start to see how true that is.
There in the nutshell is the problem. Neither the person being treated or the Insurance company is in a position to make decisions on treatment.
How about the mileage tax I heard someone chirp about. Yeah u go tell the blue collar joe who drives 50 miles per day for his union shift in manhattan that he gets to pay an extra tax. The squeeze is on.
Anyone else notice how much the gubmint took out of their recent paychecks with their TAX INCREASE?! I didn't. Thanks, Obama!
Heh. I remember people talking about Reagan running for a third term. Imagine that, a man that old, who was already showing signs of Alzheimers by the end of his second term. Obama on the ohter hand looks like he could serve for another twenty years.
