Brad Wardell's views about technology, politics, religion, world affairs, and all sorts of politically incorrect topics.
I don't think so
Published on September 30, 2003 By Draginol In Politics

There was a report, repeated often on the news today, that there are now 44 million Americans without health insurance.

So what?

No, seriously. What exactly does that mean? Does it mean you can't get medical care? No. What it means is that if you need medical care that you are responsible for paying for it yourself.  In other words, there are 44 million Americans whose health care isn't pay for by someone else (i.e. such as their employer as part of their compensation package).

Until I was 23, I was one of those millions without medical insurance. I went to the doctor, got inoculations, got prescriptions when I was sick like everyone else. The difference is that my mom paid for it instead of some insurance company.

Don't get me wrong, not having health insurance means that you feel the expense of doctors ($150 for a visit sometimes). Ones prescriptions can be costly ($120 for pills). And of course if there was some catastrophic accident it would have certainly wiped us out financially.

But let's keep things in perspective, free medical care isn't a right. That's because it doesn't exist. Someone is paying for that medical care. It ain't free. But when you hear reports on the number of uninsured, the implication is clear -- that more people being uninsured is a bad thing and that the government should do something about it.

I agree it's better to have insurance than not to be insured. But why is it the government's job to pay for health insurance? What does the government paying for something actually mean? It means ones fellow citizens are paying for your medical care. I don't see that as very fair to the rest of society. Especially on a federal (national) level. 

My employer pays for my medical care. It's part of my compensation package. In other words, it's part of my salary. If my employer didn't pay for it, I would either have to pay for it myself, find a job that does pay for it, or choose to go without it.  Turning it into an entitlement, however, puts us further onto the slippery slope of where some distant group of people are deciding what is and isn't a necessity.  I'd say food and shelter rank above health insurance as a necessity. Are we going to start guaranteeing those things? That is, that all Americans are automatically provided the same food and shelter so that we can all have it?

The problem with equality is that it bumps into freedom pretty hard. I don't think it's the federal government's business to be deciding what is and isn't a basic material necessity. That goes for health care or anything else for that matter. We all make personal choices that lead to prosperity or ruin. I am in favor of some basic "safety net" to soften the results of poor life choices but we have to draw the line. Universal health care mandated by the government is where I draw the line.

 


Comments
on Sep 30, 2003
I think it all boils down to a notion of services, and how many services is the government supposed to provide.

At the bare minimum, there is basically no government: you build your own roads, you fight your fires and neighbours, you educate your children.
Then people may decide to pool resources together, and that some services are due to every citizens. Of course each citizen has some duties, the most important ones being voting and paying taxes (that is participating to society). But then each citizen may expect the government to invest for his safety, be it from terrorists, natural events, or (maybe) health problems. So the question is basically, as you rightly say, where to draw the line. And people are always going to disagree about this. As you said, free medical care, like free security, or free education, do not exist: someone is paying for it. You say "I don't think it's the federal government's business to be deciding what is and isn't a basic material necessity." But then who should decide ? The government seems to be the democratically elected body ... why shouldn't it decide whether to pay for health care, education, or war ?

Another question one could ask is how good the health system is working altogether. Are people ready to pay for it (either through taxes if it is funded by the government, or by themselves if it is voluntary) ? Is the service provided of good quality ? Some interesting indicators to watch for instance are life expectancy, infant mortality rate, and so on. I think they tell a lot about the health state of a country. Then one may do some correlation analysis with how health care is provided. I would really be curious about its results.
on Oct 01, 2003
One possible option is a two tier health system.

In the UK every person is entitled to free health care. This is under a national Health system, which people contribute taxes (11% of your pay to be precise!) to pay for. Many people also have private health care on top of this. The UK people decided that free basic health care was a right which should apply to everyone no matter what their income. Poor or rich you can use the NHS for medical care. It's not much different in philosophy to using the free schools. Many people (especially the richer ones) could argue that they'd prefer the 11% of their pay back and they'll pay private medical insurance. We live in a democracy though and if poorer people (who do indeed have the vote) vote 11% of everyones pay packet to pay for a National Health Service then the people have spoken.

Paul.
on Oct 01, 2003
That's kind of the downside of a democracy. People who don't contribute to the treasury are still allowed a say in how that treasury is spent.

It's like having a neighborhood association of 100 homes where 51 homes don't pay in but still get to insist that there be a public pool built, paid for by raising the dues on the 49 people who actually pay but are against the pool idea.
on Oct 01, 2003
Medical insurance is a basic human right in the Netherlands. Yes, it has to be paid. Everyone must be insured here. One pays about 30 dollar a month. The rest is paid by the employer or one of the social security systems we have here when one is unemployed.

The risk is too high to be uninsured because the health services are extremely expensive.

We have chosen to make health services accesible to everyone years ago, because a good healt should have nothing to do with how much money you have.
on Oct 01, 2003
This is sadly true, Draginol. People who have the most influence in a democracy, by sheer numbers or other means, will be able to orient the whole nation.

I do not know however how to fix such a thing.
on Oct 01, 2003
Oh. BTW: Like the UK we can have extra healt insurance on top of the existing one to pay for additional or alternative services.
on Oct 02, 2003
I'm a believer in the treat everyone equally policy.

If I get taxed at 25%, then someone on 5 times my salary should also get taxed at 25% and someone on 5 times lower salary should get taxed at 25%.

If someone gets free medical insurance then everyone should get free medical insurance.

If someone gets x pounds in social security, then everyone should get x pounds in social security.

It would mean much higher tax rates, but everyone would get social security and free medical insurance. 100% taxation would end up being like a pure communist system, 0% taxation would be like a pure capitalist system. The actual level would be decided by the population and would settle on the level which gave the best balance between incentive to work and support of the poorer voters.

What I don't agree with is preferential treatment of one fraction of the population more than another.

Paul.

a simple example
if 3 people earn 10k, 25k and 100k, all get taxed at 50%, all get equal social security then they actually earn
27.5k, 35k, 72.5k. In reality 60% of tax would go to other things (free medical, roads, ...) and maybe only 40% to social security => 14k, 21.5k, 59k
on Oct 03, 2003
In our tax system the percentage of tax you pay partially depends on the height of your income. The reason is that for people who have a low income - of lets say $1000 a month - a tax of 25% (like you suggest) is felt as a greater burden than the same percentage of $5,000. So, the percentage of tax increases when you earn more.

Also, the percentage depends on whether you have a partner (that includes marriage ) or not, or whether you have children or not, or whether you are divorced or not, or wheather you are older than 65 or not. The reason behind that is that if one needs to feed more mouths with a single income then your costs will be higher and therefore you have less to spend on tax. If more people in an economic unit (that includes marriage and partnership) then wages of someone earning an additional income will be charged higher.

In addition employees ar not allowed to work more than 40 hours a week. Any payed overtime will be charged more. There is a maximum amount of overtime. It is allowed to pay overtime in days off. The reason behind those is that this system should cut down unemployment. It also generates more spare time. During the years this is becoming more and more popular. We used to work 6 days a week. Government regulations cut that back to 40 hours a week. These days most companies consider 36 hours per week full time. And a lot of people decide to work even less. For some of those the weekend starts at friday. Others work half time.

If an employer decides to pay "in natura" (for a company car for an example) then part of that too will added to your income as well. The reason for that is that by paying you in natura you the employer is actually increasing your income. This wasn't taxable before but these days it is considered a way to avoid tax and therefore it should be charged.

I probably forgot a few more rules. And I didn't even mention "Collective Labour Contracts" which unions and the government decide upon for a given sector yearly. That will not change the amount of tax, but it does change the number of days off, vacation bonus and other secundary advantages.

You may or may not approve all this, but remember that a democracy decided all this. In the beginning most of these rules came about because of poverty and bad labour circumstances. Now we are dividing the wealth.
on Oct 03, 2003
"If more people in an economic unit (that includes marriage and partnership) then..."
should read:
"If more people in an economic unit (that includes marriage and partnership) are working then..."

Sorry about that.
on Oct 07, 2003
Madice,
thanks for yuor input. I am very much aware of the current system, I just feel that a simpler system would actually work as well while costing much less to administer. Lets take your examples.

example 1:
current system => 1000 a month paying 25% tas and someone on 5000 a month paying 40% tax
=> 750 a month versus 3000 a month with 2250 to the tax man
my system => everyone at 50% tax
=> 500 a month versus 2500 a month with 3000 to tax man. give 750 back equally
=> 875 a month versus 2875 a month!

Wow poorer person is richer BUT everyone was treated equally!!!!!!!

example 2: single v married. both on 2000 a month.
current system => single taxed at 30%, couple taxed at 20% (in reality a large allowance before tax)
=> 1400 a month versus 1600 a month with 1000 to tax man
my system => everyone at 40% with everyone getting equal social security
=> 1200 a month v 1200 a month with 1600 to tax man (return 600 to 3 people)
=> 1400 a month v 1600 a month

completely equal with everyone treated equally!!!!!!

I do agree with you that the rules can get more complicated with benefits in kind (company cars, extra time off, reduced working hours) but the basic principle could be applied and could work. As a mathematician I find the current system totally silly. It's not economically correct. It looks like it was either designed by accountants to keep themselves in business, or by politicians to confuse the public and allow for incompetance and corruption to go unnoticed.

Paul.
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