No, it doesn’t. That’s a central part of how any government functions, and in fact is calling all taxation theft since there’s no point in taking money and not giving it to someone.
Which would be national disaster since most roads would either not exist or be barely there; and the roads that do exist would mostly be subject to extortionate tolls since people would have no choice to pay and the cost for a single company to keep a road open would be very large. And bad roads drag the economy of a nation down.
private companies get money from people by providing a service or product that the consumer wants more than they want their money. It is a mutually beneficial transaction. If you don’t like that service or product, you can fire them and choose another vendor.
public companies force people to give them money at the point of a gun. you have no choice. you must give it whether you like the service or not.
Or by deception or by force. The only reason they don’t use force on a regular basis is because the government stops them; in places and times where it doesn’t, they have no problem with profiting using force and coercion.
No. It’s called paying what you owe; “Taxes buy civilization”. People who call taxes theft want the benefits of living in a civilized society without paying for it.
When the product or service is healthcare, your choices are extremely limited. There are only a few qualified providers in any given area, and unless you pick one of them, you die.
So we’re pretty much dealing with an unbalanced market here where the consumer does not have free and unfettered choice of competing suppliers. The question then becomes whether the best delivery model is a for-profit provider who has every incentive to charge more and deliver less, or a not-for-profit provider whose mission is to provide universal service.
There must be some fairly good for-profit hospitals, but it is true that the ones with the strongest reputation are all non-profit (Massachusetts General, Mayo) or governmental (UCSF Medical Center, National Institutes of Health Clinical Center).
Getting beyond hospitals, the situation is dreadfully complex. For example, some physicians who practice in non-profit hospitals are employed by for-profit group practices, while others work for non-profit group practices. Patients often don’t realize it.
While I am generally skeptical of for-profit health care (or health insurance), whether a health care organization is governmental, for-profit, or non-profit is not the most important thing for you to consider as a patient.
There are things government isn’t so good at. For the same money, I am going to eat better in DC’s Chinatown than in the National Gallery of Art cafeteria. But health care – like education – is a strong point for the non-profit and governmental sectors.
Like every free country, we have a mixed economy. I’m for that.
And where do you think that money comes from? I don’t want to get into a whole lesson on the fractional reserve banking system. But it is sufficient to say that the system works because we have a strong central government.
Look, John Galt. The government takes money from everyone in order to provide services that benefit society as a while. The only people I know who think taxation is theft are right wing tea party nutjobs and MBA type douche bags who think they “made the right choices in life” by choosing to be born to affluent, white parents who sent them to the best colleges so they could study finance or accounting and become middle managers in some large corporation.
You actually have it backwards. In most modern societies, people expect that certain services will be available if and when they need them. Police, fire, national defense, roads. And for the most part, it is very difficult to impossible for any citizen to “opt out” of those services in any meaningful way. Even if you decide you don’t want to pay for police or fire protection, there is an inherent benefit to society to not letting people commit crimes against you or allow your house to burn down. Your criminal could easily commit a crime against someone else or your house fire could spread to your neighbors.
With health care, we also expect that if you are sick or injured, you will be taken to a hospital and receive some level of treatment. So right now, all those millions of uninsured people are going to the emergency room where their bills are picked up by taxpayers and people who actually have health insurance. So that is the real group who is getting robbed to pay for another group.
To say that our current health care represents the “free market” is absurd. Most people who have health insurance have it through their employers who heavily subsidize it. It’s not practical for me to “shop around” and get Blue Cross because it would cost a lot more than the Cigna health care my employer provides and would not provide much additional benefit.
Oh sorry big nit pick efficacious, is the word you are looking for I think. Efficiency is about little it costs not how well it is invested. I can invest my money for free by giving it to someone with a plan but that is probably not going to get me a good return.
Well most people expect the government to offer services just like a company, the choices you have are simple, don’t vote for them or change to another jurisdiction that you like better.
There are many services where a consumer can decide for themselves how much to spend as everyone’s basic needs are pretty much all the same.
Clothing? sure an Armani suit will be look simply spiffing but a £10 coat will keep you warm and dry just as well.
Food? an oven roasted Turbot will set me back the best part of £40 but £4 worth of sea bream is just as nutritious (and tasty…but that is another thread)
Car? a £500 banger moves you from a to b just as an audi RS6 will.
In each case above, being unable to afford the most expensive option will have no bearing on your life at all. and are perfect candidates for a free market model.
Ultimately you are never going to be hit, out of the blue, with a life-threatening situation where you are forced to buy and consume a Rolls-Royce or 50 year old bottle of the Macallan.
However, for some services there is a real asymmetry of need and ability to pay with catastrophic consequences should the worst happen.
Crime and judiciary, god forbid you end up being the subject of an horrific crime that costs millions to investigate and try. In a free market do the police slap you with a massive bill?
Military, you live on a remote archipelago close to belligerent neighbour. You require greater military protection and expenditure than the rest of the USA. In a free market what then? Those hellfires have to be paid for you know, that’s coming out of your own pocket my friend
Healthcare is (or for the USA…should) be treated the same.
Through no fault of your own you, or your family may contract a terrible disease that costs more than any reasonable people would consider affordable. should we charge you accordingly and ruin you?..tough shit…should’ve been luckier, healthier or richer! or should we use taxes to smooth it out?
For some reason the USA seem content with spending more per capita on healthcare than the rest of the world and getting less out of it. The irony is that your government already has to spend more, per capita, of your tax dollars on healthcare than us in the socialist republic of the UK and yet you don’t cover all of the population and many that you do cover get partial, shoddy treatment and end up financially ruined as result.
Increasing healthcare costs is good for Job Creators and the other best Americans. If you don’t understand that, that just means you’re too dumb to buy stock in Pfizer, Aetna, WellCare, etc.
As for the meme that lazy teat-sucklers should get good healthcare, this is a non-starter even if the care were magically free. It’s the threat of untreated disease that forces these people into the low-wage workplace. And their poor health reminds better Americans how lucky they are.
Disclaimer: The above paragraphs are exaggerated, and you will find no Dopers who admit to thinking that way. Even Americans who do think that way may not fully acknowledge it even to themselves – it’s largely subconscious. But read carefully between the lines on the more vile right-wing posts. You’ll see the exaggerated view is not so far off.
In the “government option” examples I have seen, they do not. The federal run insurance program charges actuarial premiums that cover its adminitrative costs and medical loss and their subscribers get the same subsidy for picking the federal option as they would for picking the Aetna option. Theoretically, all the providers in any given bracket other than platinum (and maybe gold) will have similar medical loss and the differences in price are the results of differences in administrative costs and profits. The federal option has much slimmer administrative costs and no profit so they will generally provide the best value and effectively become monopolies at all but the very highest levels of coverage.
Can you name one in existence today that is closer to a private health care system? What are the healthcare outcomes in those places like?
Corporations are not individuals. They no more spend “their” money than the government spents “their” money. The only difference between government spending and corporate spending is the profit motive. Corporate spending has to provide some return on investment. Government spending does not.
And when they take it, it becomes theirs, no?
Gee, that sounds like insurance or any number of other social cost sharing schemes invented throughout history.
a la carte government is a pretty stupid idea. It is used by people who think they can make their costs seem social and other people’s costs seem individual.
WTF is the difference between having a private company hired by the governemnt charge tolls for roads and just having the government charge tolls for roads?
Nope. I have lived in places with government run trash service and in private trash service.
What you end up with in BOTH cases are monopolies. Except when the monpoly is run by a private company, they charge monopolistic prices and the alternatives are all more expensive because some other trash company would have to drive a truck into your neighborhood just to service your house. Of course you have the ability to say “fuck it, I’ll pay more because I’m just THAT pissed off at my trash comapny” I’ve never been pissed off enough at my city trash service to want to pay someone else to do it.
Why? Why can’t we contract that out to Blackwater and the hessians? I mean they would de able to do everything cheaper because it would be “their” money right?
If you posted this exact post on some sites, they might not object to most of that post.
The tragedy is that you even have to put a disclaimer in!
I just think it is a sad,sad situation. For such a rich country to put millions through misery and ruin for such petty ideological reasons is a crying shame. One hopes that Obamacare* is * the thin end of the wedge and the USA will see the light but I don’t hold out much hope. Like the death penalty and guns the fundamental problem is cultural and that takes a long. long time to change.
Healthcare, particularly advanced healthcare, is most decidedly a private good. i.e the benefits go primarily to the individual who consumes the good. There are few, if any externalities. Taxation should most definitely not be used to pay for a private good. Why does the UK system depend so heavily on imported doctors?
That’s nonsense. The health of the populace affects society in general; the sick and the dead don’t contribute much to the economy or the rest of society. And our present system is a major economic burden; we’re costing ourselves enormous amounts of money thanks to our hatred of helping people.
And I think that human life is more important than economic dogma. As I said earlier, I have no interest in dying in order to satisfy some abstract point of political or economic dogma.
My daughter does research in behavioral economics, and has done some experiments which demonstrate that people are actually more careful with other people’s money than they are with their own. Strike one.
Second, the people who work in healthcare are not the owners of healthcare. Why is an employee of a private hospital going to be any more careful of MegaCorps money than a public employee is going to be? Strike 2.
Plus, I would guess you’ve never been on a trip or dinner paid for an expense account. And surely you remember the CEOs who threw lavish parties on the company dime.
The Bay Area (and LA) has some toll lanes that let you use the carpool lane by paying a fee collected from your toll transponder - we use FastTrack. It is doable, but very expensive to set up.
But there is a bigger problem. Whoever collects the tolls knows that you were in that lane at that time. Do you really want a government or a company knowing exactly where you are driving at every minute. That is far worse than 1984.
Do you love Big Brother?
The problem with this approach as stated is that it would double the capacity of the healthcare system, which would be very inefficient. One of the reasons for high costs now is that every hospital feels it needs expensive machinery to be competitive. This would make it twice as bad. It would be far more reasonable and cheaper for the government to buy up hospitals and clinics. I’m not saying that it is a good idea, but it would be at least not certain to fail.
Oh, I did think about that. I have a feeling some of these hospitals might sign contracts with the goverment for shared use. The whole system would have to be revamped which is no small feat but the owners of these hospitals would still be able to make good money.
I honestly believe this country is spending twice what is hould be on healthcare when all costs including present taxes subsidizing county hospitals.
If we ever get this right all this money could be going back into the economy buying goods and services. It might amount to 5% of the conomy that could be saved.
The AMA is a huge lobby - the 11th largest single organization in terms of dollars - and have by far the most to lose in a government healthcare takeover. The rest of the world largely already has universal healthcare so it’s not like physicians can make more money elsewhere (except for a very few). If the US healthcare system enters the 21st century, party’s over. Interestingly, though, they have quite recently begun to favor Democrats.
This is a smart idea, but I doubt it works quite like that. If it did, the growth of Kaiser Permanente, often pointed to as a model for humane cost containment, instead would have made California health care more inefficient. I find this hard to accept.
Phillip Longman’s proposal for gradual creation of a civilian clone of VA’s system calls for taking over financially distressed hospitals. Without such a VA clone option, there is political pressure to keep such hospitals open at taxpayer expense. I know that such campaigns rarely prevent an individual distressed hospital from closing – all they do is drag it out. But distressed hospitals, as a class, cost money in that they are a strong argument for keeping medicare reimbursement high.
Also, where I live at least, there are big Blue Cross reimbursement differences between the financially strong prestige hospitals associated with the University of Pennsylvania and Thomas Jefferson University, vs. most of the others. That’s because Blue Cross can’t plausibly threaten to cut out the prestigious hospitals from their preferred provider organizations, since then the patients would go to other insurers. So what happens now, when weak hospitals close, is that it pushes patients into more expensive care. If the weak hospitals instead became VA clones, price pressure would go the opposite way.