Occhidiangela,Oct 31 2005, 06:05 AM Wrote:National health care, as a system, is a matter of opportunity cost if we assume even modestly responsible governance (perhaps a bad assumption) and thus finite resources.
In the American case, you cannot overlook the issue of taxation and taxes, a critical concern of American societal structure since the nation's inception.
Since a public system requires tax revenue to support, one needs to get "buy in" from the electorate if a truly "democratic" or "republican" system is to serve its citizens. If the case can be made to show that the tax burden will be "reasonably fair" and the actual costs reduced over the current system, I think such a system would be approved. That case has yet to be made, or made well enough to satisfy the electorate, and those who shoulder the majority of the tax burden.
increasing the tax flow to pay for a system that, once implemented, won't be replaceable and can be, with even moderate PR campaigns, an excuse for an ever increasing tax bill due to "need to afford the health care" for _X_ reason.
Occhi
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This country (NZ) has a number of examples of non-privatised public goods. Some have turned out well, some have not.
Accident insurance: A government monopoly, funded via approx 0.9% income tax. Able to achieve economies of scale in:
- promotional advertising of risk reduction (whereas an individual company would not recoup the whole benefit)
- research into risk prevention
- removal of all litigation (you cannot sue for work injury / accident, you get compensation via govt. agency, sometimes 'unfair' amounts)
- smaller claims get paid out (whereas under a legal system the lawyer costs would provide a larger barrier to the majority of claims at the small end).
- reduced court burden.
- Unfortunately rates are based on 'industry' so you can't show that you have a better than industry level of safety to get a discount. (But not sure that you would get that under a privat esystem either...?)
Healthcare (free doctors visits, free medical care (limited only by waiting list length):
- As Occhi noted the funds channelled into it are ever increasing
- Really needs some form of limit to usage.
- Politically difficult to change
- Bulk of populace doesn't understand that the money going into healthcare comes from somewhere (i.e. their own pockets). Joe Bloggs thinks that the govt magically prints their own money. Someone else here seems to think that is a good idea too :P
Unemployment benefit (Enough to live on indefinitely)
- Have third / fourth generate beneficiaries :-(
- Means people getting off the benefit face high marginal tax rate (since they are losing the benefit and the 40 hours a week leisure time in exchange for an amount of money probably slightly above the benefit)
- Altered from original purpose of a tide-over between employment, o a safety net for the 'unemployable'
- places a financial large drag on the business sector, reduces NZ competitiveness
Education (including pre-school to tertiary)
- People end up taking degrees in "surfing" and other things that are not business oriented
- Provides a reliable set of standard that allow assessment of an individual by potential employers.
Superannuation (Yes, over here the govt. pays you when you retire too)
- Too prone to political manipulations. Super was set at 65% of median wage from 60 years of age, is currently at 60% from 65. Talk of it being unsustainable mean that it may be removed altogether eventually (aging population supported by shrinking workforce). Projection of two workers per superannuitant by 2020... (if each worker is paying the current top tax rate of 39%, and superannuitant is getting 60% median wage, then there is 8% remaining :huh: )
- Is essentially just the 'old persons' version of the unemployment benefit.
- Govt. can achieve economies in scale for their investments (particularly compared with a low income worker), and due to the longer timeframes and large number of participants can get higher return by placing funds in higher risk investments than an individual may be willing to.
--Edit My post count is too high in this thread