I’m pretty much on board with most of BB’s points, with the exception of welfare and health departments.
I think we don’t have anywhere close to enough government involvement in the health care industry. What we have right now is extremely expensive schools that graduate doctors with huge student loan debts, who then need to command huge salaries to repay them, and thus we charge huge prices for health care to cover those salaries. Without government sponsorship, health care will simply never be affordable under this plan. If we can’t put together a federal health care plan, we need to put together a federal doctor plan that addresses this problem. I’m perfectly okay with higher taxes related to this.[/quote]
Eh, or one could argue we have the problem we have now because of too much government involvement.
The first problem is that tax incentives have created the current employer insurance system that everyone loves to hate. Congress makes dollars spent by employers tax deductible, while dollars spent by an employee are not. This makes employers, who are not the consumers of the services, the buyers, and employees have no say (except, perhaps, in picking amongst a couple plans offered by employers). Right now, employers want to offer “benefits” because workers value them (because they are much more difficult/expensive to get for themselves), but they don’t generally care about service or the particular details of the programs.
Employee health accounts would solve this. They would need to be flexible enough to allow employees to come together to have the bargaining leverage with insurers and health providers that large employers can enjoy. Employers could compensate with direct funding of the accounts, to make them more like traditional health benefits, or simply through higher compensation (which employees would demand if they were purchasing their own health plans). This would also help out smaller employers to be able to provide benefits.
Another problem is in the state regulation of insurance companies – they are in the position of banks before the reform, in that they basically must operate separately in each state, and be subject to various rules and regulations in each state. A national system would be more efficient.
Another reason health are is expensive: too few doctors. And the AMA, which is basically a doctor’s union, is at fault here – it hasn’t certified a new medical school in approximately 30 years (going off of memory here), while there are approximately 3 applicants for every spot available in med school, and a growing population of people utilizing doctor services.
So, obviously complicated… but, start with: 1) Employees tax advantaged direct purchase of their own health care products; 2) Acknowledge the national marketplace for health and pre-empt state regulations; 3) Take away certification power from the AMA if they don’t increase the number of certified programs by at least 50% (arbitrary number, but you get the point.).
[quote]On the welfare issue… I think welfare is too limited. We don’t really pay welfare recipients enough to get onto their feet. While I agree we should pay welfare for a limited time, I think we pay welfare for such long periods of time because we simply do not pay people enough of it. I think at the very least, welfare should pay the equivalent of a full-time job at minimum wage. Again, I’m not opposed to raising taxes for this.
I’ve complained previously on a few threads about not wanting my taxes raised, but I really don’t mind being taxed so other people can have the basic necessities of life. I think that’s one of the things taxes are supposed to do. The homeless are needy, so raise my taxes to build more affordable housing. The uninsured are needy, so raise my taxes to give people health insurance. The single mother in a one bedroom apartment with four kids is needy, so raise my taxes to increase ADC benefits.
But some dipshit suburbioid asshole who can’t afford his daughter’s ballet classes and son’s gymnastics classes because he doesn’t make enough money? He’s not needy, fuck him – he’s just a self-centered dickhead who can’t figure out how to manage his money. If you want to raise my taxes so you can teach him to manage his money, I’d be a lot more supportive.[/quote]
Interesting points on welfare. I agree with the general idea - but I don’t know if simply throwing more money into benefits would suffice – and, unfortunately, it would exacerbate the incentive to cheat the system – and make people even more upset when the system was gamed, leading to a backlash against the whole idea (kind of like we had before).