…you are characterizing it as wrong. I can choose to pay extra for health insurance here. Its a completely different paradigm. They aren’t equivalent because I can actually access health insurance if I wanted to and its a completely different thing.
In America if you want to access healthcare (unless you qualify for medicare/medicaid) you not only have to pay your taxes: you have to pay a premium as well. So you do realize that according to your characterization "you are paying a premium’ then you are “paying a premium?”
You are defending a system where you pay for the same thing twice.
That’s right, if you opted for private insurance than I would say you are paying two premiums - a tax for the primary insurance, and a conventional premium for supplementary insurance.
I think it is clear that we are talking about the exact same thing, just that I call it insurance, and for whatever reason you do not. So be it.
…“insurance elements” is not “health insurance.” If you google “health insurance new zealand” you don’t get wiki pages that talk about “a mixed system” you get listing after listing of health insurance companies. I see you cribbed “insurance elements” from the wikipedia page. If you read further down to where they actually talk about health insurance:
These “insurance elements” are elements **outside **of the Universal Healthcare system. They aren’t part of it. I talked about this earlier. If you want faster treatment (for non-urgent care) or if you want a private room then private health insurance is an option.
…**you don’t have to pay tax **to access universal healthcare in New Zealand. If you are a NZ citizen or permanent resident you can access the system even if (somehow) you never managed to pay a cent of tax. Australian citizens who have lived here for two years can access the system. Refugees or victims of trafficking can access the system without having paid a cent of tax. Paying tax here is not a requirement to access the system. Universal healthcare and health insurance are not the same thing. No matter how much you insist that they are.
Except its clear that we aren’t talking about the same thing. There is a fundamental difference.
I presume the doctors in New Zealand are being reimbursed for their services, and I presume such money ultimately comes from taxpayers. A line-item tax is not necessary, as I understand it New Zealand funds the healthcare system through general taxation (personal & business income tax, GST, ACC levies). You do not pay a dedicated tax such as the American social security payroll tax; healthcare is essentially funded from the general treasury.
As such, it is quite impossible for somebody to avoid paying taxes while living in New Zealand. At the very least, when one makes purchases, they pay a tax.
Well, mere visitors should purchase health insurance. Some things are covered for tourists in NZ (accidents, mostly) but some are not (illnesses and such.)
This varies a lot from place to place. In Canada tourists are not covered at all; it would be very unwise to vacation here without supplemental insurance.
I don’t know of any country offhand that fully covers a tourists’ health care costs.
…except I know somebody who does exactly fit that criteria, they haven’t bought anything for many years now, they aren’t working but still has access to our healthcare system. Its not quite as impossible as you think.
But that doesn’t really matter because the principle doesn’t change. Paying taxes isn’t a **requirement **to access our healthcare system. Healthcare and healthcare insurance are two different things. The amount of tax I pay isn’t determined by risk factors like obesity or pre-existing conditions. It isn’t an insurance payment. Its tax. If you don’t understand the difference then I’m not even sure you understand what “single payer” or what “universal healthcare” actually means.
And even if you want to personally conflate taxes with insurance payments it is extraordinarily unhelpful to do that in the context of a debate.
…I don’t think its clear that I “do not wish to argue over it”. I am quite clearly here arguing with you over it. Its clear that I’m not going to concede the argument because the definition of taxes and health insurance show they are completely different things.
The differences: taxes are levied by a governmental organization: health insurance can be administered by government agencies, private businesses, or not-for-profit entities. Insurance works on the principle of “spreading risk”: its a fundamental part of what insurance is, and the level of “risk” dictates how much premium somebody would be expected to pay. Taxes are simply a mechanism for funding public expenditure. I’m overweight. I have higher risk factors. But I don’t have to pay more in tax in order to access our healthcare system. I’m not paying insurance. I’m paying my taxes.
Do you still not understand the difference, even though I’ve provided the two definitions that explain the differences? What is it that you don’t understand?
Very well, I had mistakenly drawn the inference that this line of posts had devolved into something “extraordinarily unhelpful” in the context of your debate thread, therefore it was no longer desirable to continue.
Based on my extremely fresh and limited knowledge about New Zealand’s healthcare system, your country still calculates risk and adjusts taxes (the premium) appropriately. This is especially conspicuous with regards to ACC earner’s levies. They do not adjust an individual’s tax rate according to an individual’s risk, but that is not a requirement of insurance. Rather, the taxes are raised and lowered to meet budget projections, and the budget projections are based on risk - determined by looking at actual expenditure for the previous year.
Indeed, the point of insurance is to spread the risk - the most efficient risk pool would have the largest number of people, each paying the same premium, such that the sum is exactly the amount needed to handle all the claims for the upcoming period.
If you are at a high risk of needing expensive medical care, you contribute to a demographic of people who are at a high risk of needing expensive medical care. Based on previous expenditures and trends within the demographic, the government will predict the relevant portion of the next year’s budget. Then they will adjust fiscal policy accordingly.
It is extraordinarily unhelpful in the context of debate to use your own personal definition of words instead of the universally accepted definitions. If you argue that “up is down” and that “left is right” then how is one supposed to reasonably argue with that?
It isn’t a premium. It isn’t “an amount of money paid to get insurance.” Its tax. Its a mechanism to fund governmental services.
Lets just be clear on what the The Accident Compensation Corporation actually is.
You don’t need to pay taxes or pay levies to access ACC. The international visitors who were injured during the eruption of Whakaari were eligible for ACC. If they were injured their medical care was paid for. If they lost a loved one they were provided with support. They got a $6000 funeral grant and were eligible for survivors grants as well.
You have a fundamental misunderstanding of how this all works that is compounded by your insistence on conflating concepts you understand with concepts that you don’t. The system you are used to operates under a completely different paradigm to universal healthcare systems. Recognizing that is the first step to understanding.
Premium has a specific definition that I’ve provided. It isn’t helpful to continue to use the word in a way that doesn’t match its definition.
These words don’t magically suddenly make “health insurance” equivalent to “healthcare.”
I haven’t yet been convinced that the universal definition of “insurance” excludes the likes of New Zealand’s healthcare system.
You say a tax cannot be a premium because a tax is not money paid to get insurance? Need I remind you, I am arguing that taxes can and do fund health insurance?
That is correct, apparently, but somebody needs to pay taxes or levies for you to access ACC. An individual needs not personally pay taxes - for example those internationals you mentioned.
Of course not! Healthcare is the provision of health services, whereas health insurance is the pooling of money to pay for healthcare, to spread risk across a population. I had said “universal healthcare” is a “health insurance system”. This is because “universal healthcare” doesn’t literally mean everybody receives every health service they need (nigh impossible or nobody would die), it means everybody has access to health services they need. You know, through insurance.
…you haven’t made a case that the likes of New Zealand’s healthcare system should be regarded as insurance.
I provided the definition of premium and pointed out you are using the word incorrectly. No need to remind me of anything: you are simply wrong here.
**Universality **is the key here. Hence the term universal healthcare. Everyone is covered. The distinction is important. Everything needs to be funded somehow. Taxes and levies are the ways that we have chosen to fund our system. But taxes and levies are not insurance payments.
Concession accepted. Now that you have conceded this it would be helpful if you would stop continuing to conflate the two.
Your own definition of insurance reads, “Health insurance is an insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over numerous persons. By estimating the overall risk of health care and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.”
New Zealand’s healthcare system covers “the whole or part of the risk of a person incurring medical expenses”. It also spreads the risk of incurred medical expenses over numerous persons, namely, the whole country. New Zealand developed a routine finance structure, in the form of taxes, to provide the money to pay for the healthcare benefits specified by law and regulations. Further, the fiscal policy of New Zealand is regularly adjusted (in part) to accommodate the changing risk of health care and system expenses over the risk pool (the entire populace). The benefit, that is, payment for medical care, is administered by a central organization.
How is that not health insurance?
If taxes are the sole source of the fund used to pay for insurance, then taxes are paid to get insurance. If taxes are paid to get insurance, then taxes are premiums. The New Zealand healthcare system is insurance. Taxes are the sole source of funding for the New Zealand healthcare system. Therefore, taxes are premiums.
You could say, taxes are the premium paid by the people of New Zealand to obtain health insurance coverage.
From the perspective of economics, you’re correct. It’s insurance. Of course it is. Banquet Bear doesn’t want to call it that because it sounds bad, and it can confuse someone from the USA who’s not familiar with the terms or, like you, is confused between the concepts of health care and health insurance. “Insurance” implies a direct payment for coverage; national single payer health insurance collects payments based on a country’s tax policy, which is why some people don’t want to call it insurance. It is, though; it’s just a (usually) indirect way of doing it.
What’s important, though, is not that argument. What’s important is that **the economic argument for universal health insurance is really, really strong. ** Health care is the kind of insurance that MOST benefits from being universal, because it is subject to enormous market failures that are not necessarily true of other forms of insurance.
Your reticience to accept the benefits of UHI really baffle me, to be honest, but if I can venture a guess as to why it is it may be because the big picture is being lost and the details are being too dwelt upon. Private health insurance doesn’t make economic sense. It just doesn’t. You cannot go totally private because the adverse selection effect causes it to instantly fail, so what happens is you will end up with a patchwork of other approaches that all have huge holes and problems. The existing American system, where a large chunk of people have government health insurance paid for by other people, another large chunk have employer-paid insurance with all the attendant problems and inequities there, and a bunch of people are screwed, is an absolutely inevitable result.
The idea that what works in every other industrialized country would not work in the USA is ridiculous. It is just so insanely preposterous; Americans are just as subject to the forces of economics as everyone else in the world, and this is fundamentally an economic question. Precisely how the details will shake out would be different in the USA of course, but that’s true everywhere. The systems in Germany, France, Australia, Japan and Canada are all different, often really significantly so, and often different even within those countries depending on jurisdiction. Where they are all similar is that they address the fundamental truth that universal coverage is more economically efficient than non-universal coverage. (It’s also, in my opinion, more fundamentally civilized and moral, but that is not my point here.)
I don’t think I have health insurance and healthcare confused, but if insurance implies a direct payment for coverage, then I will admit that New Zealand’s healthcare system is not insurance. Hopefully that puts an end to this semantic dispute.
This thread seems to be less about convincing people to support UHC, and more about convincing people to oppose it. With my admission that I cannot convince Banquet Bear to turncoat, and with the semantic dispute resolved, without further objection I will be bowing out.
I have [THREAD=891098]a thread[/THREAD] going already to convince me to support single-payer. I won’t mind if you copy-paste to that thread. Or if you really want to debate about universal healthcare (and not single-payer) in the United States, we could do that in a separate thread. Due to ignorance, absent a specific proposal I cannot hold a viable position in a debate where I have the burden of proof, as is the case in this thread.
Taxes are not premiums. Taxes are taxes. I’ve quoted the definition.
This is really bad logic. Fortunately you have already conceded you are wrong.
You not only could say it, you have said it. But just because you said it doesn’t make it any more correct.
The thread is actually about convincing people in UHC systems to abandon what we’ve got in favour of the system in the US. You’ve done a great job of convincing people that the US system is not the way to go.
That would be the thread where after four pages you had to admit you didn’t actually know what single-payer actually is.
Question about the system in New Zealand (and elsewhere).
You say taxes pay for UHC.
What Particular taxes go to pay for it?
Are we just talking the payroll taxes the government takes out of a workers paycheck?
Is it sales tax on goods and services?
Is it property taxes (taxes assessed on your property like homes, land, cars, and boats) or specific taxes on a certain product. For example in the US alot of taxes are on cigarettes and alcohol that pay for things.
Or do all the taxes get collected into one huge fund and then the government of NZ or elsewhere then decide how much to spend on UHC?