Philosophically, I like public roads, hospitals, schools, policing, rubbish collection, etc.
It’s simple game theory. When you’re the only game in town, you can charge as much as you want, and provide as little service as you wish.
If you want to be treated as a customer, you can use one of the concierge services, although paying for that in addition to insurance would make me feel like a sucker, too.
I just go on OneDoc and select one according to my preferences. Unbelievable!! I use CSS in Wallis and I can email and call them and get a reply very fast. I have the direct phone number of my guy at the insurance office. Maybe a perk of village living. To them I’m a client rather than an annoyance, unlike with Försäkringskassan in SE. If I wasn’t satisfied, I could select another one. Not quite possible in a socialist health care system.
And on top of that the US has a fully publicly funded system, Medicaid.
A huge contributor to the confusion in US discussion of the issue comes from the fact that the two countries we are closest to, Canada and UK, both have free-at-use systems. Too many Americans think that all other developed countries' systems are "100% free" and "just like the NHS", when they are arguably more the aberration when compared to DACH's sickness funds, France's 30% copays, and the Australian system that really, really, really encourages going private. This creates a weird feedback loop in which residents of other countries, in turn, get confused about their own systems when compared to the US's.
This means that even public healthcare systems must operate on a budget, the resources are still limited, and in actual practice this means that the public systems are also understaffed, often (if not, in fact, typically) more so than in US.
In my personal experience, wait times and availability of healthcare in public system in Poland are pretty dismal compared to US. I also heard similar opinions from most of my friends and colleagues who immigrated to US from Canada and UK; they universally say that they are actually able to get higher quality service in US with shorter wait times.
You cannot just throw catchphrases about “maximizing profits” and proceed as if it settles the issue, you have to actually argue that some other approach will bring better outcomes, and you need to argue why similar approaches to what you propose applied elsewhere have empirically not brought the outcomes you expect to see in US.
Often I get the feeling here that people in CH don't realize how good they have it ..
You're totally free to find a private clinic in Singapore (but let's face it most people who think they are affluent don't quite have the money for that and Google isn't forking over the money because you're not that important).
As others have told you, you are wrong. The Swiss system is almost identical to that of the US post-Obamacare, albeit with 100% mandatory enrollment (as in, the local canton picks a plan and sends you the bill) as opposed to the US's system in which a tax penalty is levied.
>no free market as the very strict rules they must follow are written in law, primes and services are also controlled by the state
Just where do you think the prices for plans on the various US states' exchanges come from? Out of thin air? Yes, insurance companies have some leeway, but not as much as you think.
60% (and, really, the 20% above and 20% below too) are from those upset that the US system isn't "free" because, as I wrote elsewhere, all they know of to compare with are the "free" UK and Canadian systems, so the whole world outside the US must be "free" and thus anything that isn't 100% "free" is fascism by billionaires, or something. When, really, the UK and Canadian systems are more aberrations than the US's is.
The remaining 20% are more like complaints about how different plans cover different things, or finding a doctor that accepts their plan, or unexpected difficulties with changing plans; that is, procedural issues. I don't mean to say that they are insignificant—I'm experiencing the last one myself—but they don't get the Internet mobs riled up as much as they get about the injustice of not having 100% "free" healthcare like "the rest of the world".
Are you going to try to defend the completely fictional numbers that end up on US hospital bills? And how those numbers drive the insurance protection racket? And how they'll say "but nobody pays that", when 1) ABSOLUTELY some people do end up paying full chargemaster rates, and 2) even a small fraction of chargemaster is usually a multiple of the actual cost of providing health care services
The system scales with the same people doing the same work for the same money, with or without taxes.
Roads, schools, and hospitals existed before taxes, and they will exist after them.
[1] AKA taxes.
I don't think it is unreasonable to suggest slavery subsidized not having an income tax.
Policing often depended partly on volunteers, while once again, rich people routinely hired private police/security/slave patrols and poor people got little protection comparatively.
Garbage collection was just people dumping their shit wherever they felt like it, including into water supplies.
All the same problems with schools too. Schools were for the rich or the religious, and even when the country saw a need for public schools they were a huge mess. (https://ushistoryscene.com/article/rise-of-public-education/)
Taxes gave us organized systems and standards that meant that services like roads and policing and trash collection were more consistent and a little less dependent on how much money you had. Things are so much better now thanks to taxes that I can't imagine anyone wanting to go back to how things were before them.
A steelman argument might be that tax-funded schools and mandated public education caused these things, but ultimately the root cause there would be greater access to education, not the taxes used to fund them. Improving educational outcomes is not dependent on taxes; we use laws to force people to buy automobile insurance and the same could be done with children’s education without the state in the payment loop. Indeed, private schools are routinely better for educational outcomes than the ones funded by taxes.
By this logic (that taxation is the basis for the progress in society) one should see greater technological and social advances and quality of life with increased taxation and more centralized standardization, but we don’t. Instead we got a forever drone war and the military-industrial complex.
For every GPS or space shuttle or NIST, there is also an Iraq or Vietnam or Afghanistan.
Increased taxation absolutely leads to greater technological and social advances and quality of life but only to the extent that those taxes are spent well and only up to a certain point. There's a point of diminishing returns for everything after all.
The nice thing about taxes is that we're supposed to be able to have some say in how they're spent, in order to make sure that spending is reasonable. It's a failure of our democracy that we don't have a better handle on massive wastes of spending (like Vietnam or Afghanistan), but not a failure of the very concept of taxation. Taxes are amazing, but the lack of oversight, transparency, and accountability is a real problem. Thankfully it's also one we have the power to fix (and if we don't, we'll need to accept that we have a very different form of government than we tell ourselves we've got)
There is no use of tax money that justifies institutionalized armed robbery, it is morally indefensible to violate consent using the threat of violence.
You could tax everyone only $1 and use it exclusively for neonatal care and it would still be morally repugnant.
If taxes truly represent the will of the people, and people truly believe they are good, they would pay them even if not placed at gunpoint.
“There is no worse tyranny than to force a man to buy something he does not want simply because you think it would be good for him.” —Heinlein
It seems to me that most of your arguments bring up wealth inequality. At that point, why bother with income taxes? Wouldn’t a simple wealth tax on assets over some threshold address the inequality more directly? If wealth redistribution is the goal, why should non-wealthy people pay any taxes?
I have to hand it too you for at least admitting your views there.
>If taxes truly represent the will of the people, and people truly believe they are good, they would pay them even if not placed at gunpoint.
People aren't like that though. If they were , we wouldn't have car clamps.
I don't think you can argue a tax paying for neonatal care is repugnant and at that same time argue people will pay for what is good.
Naturally not everyone in the country agrees with the vast majority of the people, but those that don't still reap the benefits and are free to try to come up with equal or better alternatives or to convince the rest of the nation to give up interstate highways, public schools, police protection for everybody, or publicly funded science.
If folks like you who don't want taxes ever manages to come up with something better I, and every one else, will be more than happy to keep all of our money to ourselves and still enjoy all of the benefits we get from taxation today. Until then, you've got a hard sell.
I just wish that there were places still unclaimed by any government where people who wanted no part in our tax funded society could go to fend for themselves as truly free people. I'd love to see what you guys manage to come up with. There's lots of room in space, but we'll probably need a lot more time and tax money to get there.
People still want roads and hospitals and schools, and the same money used to fund them today will be available to the same people consuming the services. Imagine how much more good people could do in their own communities if you stopped stripping a fifth of their paychecks to pay for foreign wars?
The difference is competition. There is no incentive whatsoever to do a good job or be efficient if there is no change in your funding for failure. There’s no reason to spend efficiently if it’s not your money.
It seems silly to me to force a common pool to pay for schools but not clothing, for health care but not food. Why not just raise taxes and get rid of checkouts at the grocery store?
Consumer choice is important. Critically so. If you centralize everything, it will invariably suck as much as possible.
What's stopping you doing good now?
I'd love to see what happens to a society that has to depend on the free market to provide quality services fairly, but I'm unwilling to give up what we have to experiment on ourselves without even one example of it working elsewhere.
> It seems silly to me to force a common pool to pay for schools but not clothing, for health care but not food. Why not just raise taxes and get rid of checkouts at the grocery store?
Taxes do pay for food and clothes, but only to a minimum in the form of public aid. You can get food stamps and even reimbursement for nice clothes for a job interview. That's a lot of what taxation does for us. It allows us to set a minimum standard for what Americans are entitled to as a citizen of a great country. Every last American citizen can get food, clothes, and an education no matter how much money they have. The more money you have the better those things are, but there's a baseline for everybody. Spreading the costs of those things over the entire wealthy population makes it extremely affordable, in fact it would cost us more if we didn't pay for them. That's also the argument for public healthcare. We're wasting money and having worse outcomes than other countries. Paying a lot more than others and getting a lot less in return is a very common problem in this country.
The idea that only people who want to send their kids to schools should ever pay for them sounds nice, but it would mean fewer kids getting an education and we all benefit when we're not surrounded by total idiots. Things are bad enough in that respect as it is. The average American adult's compitiency in math/science tops out at the 5th grade level! We can't afford to have more ignorance if we want to be competitive.
Nobody needs an inventive to avoid wasting money, because we all have things we'd rather be spending our money on and public money is no exception. We're fully incentivized to do good work because we want good results. We don't want to spend tax money on bridges that collapse or space satellites that explode or fail to transmit data back to Earth.
I fully agree that consumer choice is very important, and I wish we were much more aggressive about fighting against anti-competitive behavior and monopolies (actual or de facto). That said, some things are better left to the government alone. I certainly don't want 15 private toll roads running past my house. Other things like the postal service or internet service are so important that the government should be allowed to provide them even when/where it would never profitable to do so. They can fill in where private companies who care only about money never would.
The USA of course had taxes long before the 16th Amendment.
Is that a taxation problem or a corruption problem?
Fix the corruption first.
Which is illegal in most countries. Police the illegality (you probably need a well funded police force for that) and the corruption will reduce significantly.
It’s true that not all corruption can be stopped. But if you think privatising everything will make your dollars more efficient then you’re living in a fantasy world. Look at the mess that is the US healthcare system for a start: twice as expensive as every other country’s healthcare system and certainly not the best
How do you bootstrap non-corrupt police/prosecutors/judges/legislators to fight corruption, and how do you prevent the corrupt system from corrupting those people as well? If fighting corruption is so straight forward as merely giving money to police and telling them to enforce laws, then why do most countries around the world fail at it? Surely it's not for want of somebody having the idea to simply enforce anti-corruption laws. The idea is easy, but the idea is not the solution itself.
And I do mean most. Look at this map: https://en.wikipedia.org/wiki/Corruption_Perceptions_Index#/...
Several of the countries colored green on that map are generally acknowledged to be pretty damn corrupt, yet most are even worse.
https://en.wikipedia.org/wiki/List_of_current_members_of_the...
That's a good argument to pay them more. If we paid politicians nothing the only people that would be politicians would be those wealthy enough to pursue it as a hobby