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Author Topic: How Socialized Medicine might save American Capitalism
Pete at Home
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I dispise socialism. But I make a few exceptions. I accept a socialized mail system, since that's in the constitution. I accept a socialized military, since it's already there and happens to be the best military in human history. I accept a socialized road system, simply because I cannot think of any other way to make sure that everyone has a way to get from point A to point B. And in the present economic environment, I support socialized medicine because our economy will go bankrupt without it.

A collision of international trade pacts, the WTO, lack of socialized medicine is something else that is killing American business. Here's how it works. WTO makes most subsidies illegal. When we try to subsidize steel, WTO slaps us, and we get sanctions against US goods, which kills jobs. However, there are ways to subsidize industry without pissing off the WTO. Countries that socialize medicine, effectively subsidize industries, making their industries more competitive that American industries.

For example, US Automakers spend an average $500-1500 per car paying the health care costs of their workers. That money of course comes out of the price of the cars made in the USA, but not out of the cars made in countries that have socialized medicine. How are American workers supposed to make up for the fact that their competitors have an average $500-$1500 subsidy on each car because of health care? We have the 2nd hardest working people in the developed world, and *the* most effective work force of the world, but we cannot compete their socialized medicine tilts the playing field against us.

If we intend to stay in the GTO, NAFTA and other trade agreements with countries that have socialized health care, we need socialized health care or the trade deficit will devour the little that's left of our production. Lack of socialized health care is a major cause of the trade deficit because of the factors that I listed above.

If we simply put a value added tax on all goods in general (whether imported or not) we could end up paying for the health benefits of the whole country, and this would shift most of the cost of our medical care over to the countries that we are importing from. That burden-shift would also revitalize US manufacturing, who are being squeezed out through the same sort of capital flight effect that chased the middle class out of the inner-cities.

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The Drake
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I would fight a VAT tax for any reason, so I'll leave that part aside.

I DO NOT agree with any system under which the government mandates prices for individual procedures, or one in which private healthcare is eliminated. Having a tiered system has too many benefits for everyone.

Especially, we need to ensure that working people have better health coverage than those living on government assistance. It is a travesty that someone can work two jobs, 80 hours a week, and not be able to get anti-biotics to cure an infection.

I reserve judgement on whether everyone needs to have access to every procedure, no matter how experimental or costly.

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Mike_W
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While I agree that high health insurance costs are a big problem for large US manufacturers with long historys (and a lot of pensioners), I'm not sure you can blame the trade deficit today on this issue. You got here by maintaining an artificially high currency for a time, allowing China to maintain an artificially low one, and funding consumption by borrowing.

Even with free health care, not a lot of manufacturers could compete with Chinese labour costs averageing $1/hour.

The big automakers will deal with the health care issue in one of two ways; government relief or declaring bankrupcy.

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Zyne
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Your argument applies equally well to education, transportation, etc. ...
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Daruma28
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quote:
Originally posted by Zyne:
Your argument applies equally well to education, transportation, etc. ...

Only if you're a socialist.
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Zyne
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But other countries spread the cost of education and transportation among those best able to pay those costs, to the benefit of manufacturing firms who are threatened with competition from abroad.
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Digger
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"...spread the cost ... among those best able to pay those costs..."

I just want to clarify something - this is not a setup for a later pounce. But what exactly do you mean by this statement? Specifically, how do you determine who is 'best able to pay those costs'?

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Pete at Home
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quote:
I DO NOT agree with any system under which the government mandates prices for individual procedures,
Agreed, but drugs is another thing.

quote:
or one in which private healthcare is eliminated.
Of course. That's not socialist medicine, that's totaliatarian medicine.

quote:
Your argument applies equally well to education, transportation, etc. ...
-------------------------------------
Only if you're a socialist.

You have to be a socialist to not think that the public schools and the public ROADS should be shut down?

quote:
Having a tiered system has too many benefits for everyone.
Agreed. Trickle down economics is dead in America, and some say that it never existed, but you'd have to be a total fool to not see the signs of Trickle-down technology.

quote:
Especially, we need to ensure that working people have better health coverage than those living on government assistance. It is a travesty that someone can work two jobs, 80 hours a week, and not be able to get anti-biotics to cure an infection.
I don't see why we have to reserve antibiotics. You don't want a sick population incubating a potential plague, especially in the time of biotech. Development of those anti-biotics is heavily subsidized with public money. Why should they be reserved?

quote:
I reserve judgement on whether everyone needs to have access to every procedure, no matter how experimental or costly.
Look -- here's where Kerry really pissed me off. Americans are bad enough about wanting to eat their cake and have it too -- they don't need more leaders telling them that. You can't have socialized health care and keep the current highest standard. I'm talking about socialized primary care -- the basics. But anti-biotics are part of the basics; I'm a little surprised you want to reserve something like that. I'm talking OBGYNs, free birth control, trips to the family doctor, standardized procedures. Not transplants, cosmetic surgery, etc. You'll want medical insurance, but it will cost less since it will be more like fire insurance rather than something most people use every year.
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Pete at Home
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quote:
I would fight a VAT tax for any reason, so I'll leave that part aside.
Tell me ANY other way to share the burden between US manufacturers and foreign manufacturers that sell to the US without violating GTO and NAFTA treaties.

As far as I see, without a VAT, there's no economic reason for socialized medicine; it would just bankrupt the country if we had to pay for the whole thing with the dwindling number of businesses left in this country. The whole idea I've proposed is share the load with the world as they already do on us.

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Slander Monkey
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Pete said:
quote:
Look -- here's where Kerry really pissed me off. Americans are bad enough about wanting to eat their cake and have it too -- they don't need more leaders telling them that. You can't have socialized health care and keep the current highest standard. I'm talking about socialized primary care -- the basics. But anti-biotics are part of the basics; I'm a little surprised you want to reserve something like that. I'm talking OBGYNs, free birth control, trips to the family doctor, standardized procedures. Not transplants, cosmetic surgery, etc. You'll want medical insurance, but it will cost less since it will be more like fire insurance rather than something most people use every year.
I'm sitting here trying to imagine the monolithic monstrosity of a government agency that would result were health care to be totally socialized today... it's frightening to think of. However, basic primary care is one of those areas that is all bassackward in our private system. A "deductible" is as good as putting a sign on the hospital door saying "if you aren't near death or severely maimed don't bother coming in" for a lot of folks.

When you look at a place like Cuba, which seems to have a great health care system seemingly in spite of the lack of ultra-advanced pharmaceuticals and medical procedures, it makes plain old primary care seem all the more important. The one thing that they have over us is a high doctor/population ratio, and that indicates to me that regular face time with a competent doctor may be, practically speaking, more valuable than the most high-tech and effective life-saving drugs that our insurance premiums buy us over here.

I'm not entirely comfortable with "socialized healthcare" on the whole, but as Pete basically points out: the hole in the whole right now is the basic care. One thing I know for sure is that health insurance premiums are climbing fast (double digit fast), and the number of uninsured is growing similarly fast, so if we want all (or most) Americans to have access to some form of health care, something is going to have to change significantly, and soon. And as a small nod towards socializing the system we ought to at least recognize that the health care industry is so thoroughly regulated (mostly for good reason) that it's halfway to being socialized anyway...

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Mike_W
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One economic reason for socialized medicine is a lower overall cost to the economy, regardless of the funding model (VAT, payroll tax).

Medicine is not a great example of a competitive market- too many regulations and guilds that almost no one is willing to get rid of, and too little elasticity of demand. And, the US health insurance business is grossly inefficeint (a bigger "monstrosity" than you get with public insurance, believe it or not). It simply costs less, all else being equal, to deliver medical services in Canada or Western Europe.

That is not to say it is a panacea. Competition in health care is very good in specific areas like; development of medical technology, incenting speialists, and service delivery for capital intensive medicine (MRI, PET etc.). The US system is superior to ours (Canada) in these areas.

In the long run, multi tirr mixed models will be the way to go (as much as it drives many of my countrymen nuts).

[ May 13, 2005, 04:34 PM: Message edited by: Mike_W ]

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Pete at Home
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quote:
One economic reason for socialized medicine is a lower overall cost to the economy, regardless of the funding model (VAT, payroll tax).
The funding model makes all the difference in the world in a country that imports as many of its goods as the USA does. Every burden that we put on US companies but not their foreign competitors, gives the foreign competitors the advantage, putting more Americans out of work.

I don't buy into the fantasy that government can run medical services more efficiently than private industry can, because I'm not a socialist. (I don't mind the govt strong-arming the pharmaceutical companies, though, since they are already in bed with the government). I'm saying that even if it is less efficient, that passing our medical costs onto foreign imports will make it less espensive FOR US, and level the playing field for American business.

Like I said, if anyone knows anything other than a VAT or it's close twin, the national sales tax, that could equalize costs between American manufacturers and foreign imports, then I'm all ears. But there's no way in hell that the US could afford to sociallize medical care with the current dwindling Domestic tax base. Other than, say, totally disbanding our military and hoping that the Canadians will take care of us. [Cool]

[ May 13, 2005, 05:04 PM: Message edited by: Pete at Home ]

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Mike_W
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I know what you're saying Pete, and what I'm telling you is that, overall, a good case can be made for it being MORE efficient. Like I said, the health care sector isn't very competitive. We spend a lot less and, while service levels for specialty care are lower, the difference isn't just quantity...it's efficiency.

Now, funding with a VAT will make more sense as well. But, and I hate to burst your bubble, taxation differences are not the reason American manufacturers are in trouble..like I said, health care costs don't even start to make up the difference in costs with competitors in Asia. American taxes are low by the standards of the industrialized world.

As for disbanding the military..well...no. But you might spend less on it. Keep racking up debt at the current pace, and you wont have any choice in a few years.

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Pete at Home
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quote:
American taxes are low by the standards of the industrialized world.
True, but Taxes are more consistently enforced here than in most of the rest of the industrialized world. Add most of the industrialized world has some sort of VAT, and doesn't structure their retirement system quite as stupidly as we do, and has socialized health care.

Some businesses will still be more profitable in Asia, but there are also many advantages for operating in the US with American workers. It's not a panacea; there are other things we'll have to do to become more competitive, and in some senses, e.g. wages, certain countries will continue to have an advantage over us. But that's a disadvantage that we can live with. The ones I've mentioned are problems that will eventually kill us if we don't fix them.

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Pete at Home
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quote:
a good case can be made for it being MORE efficient. Like I said, the health care sector isn't very competitive. We spend a lot less and, while service levels for specialty care are lower, the difference isn't just quantity...it's efficiency.
I realize that there is a colorable argument to be made. It's arguable, and I'm dubious. But what I'm saying is that if we do the math, there isn't even a rational argument that socializing medicine paid for by a VAT would cost the country anywhere near as much as the status quo. You and I can agree to disagree about the fine questions of efficiency, but I'm just trying to establish the bleeding obvious (on which you and I seem to be agreed).

[ May 13, 2005, 06:14 PM: Message edited by: Pete at Home ]

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Mike_W
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Fair enough. But, the numers are pretty compelling to challenge your "dubiousness".

While other countries have VATs, many of them also have much higher levels of overall taxation, cancelling out any potential advantage. But, the economist and business consultant in me find VATs to be more efficient, and less harmful than most means of taxation, so, I'm on side. Anything to help you guys get the deficit under control.

Finally, I think we must disagree on the definition of "industrialized world" for you to believe this to be true:

"True, but Taxes are more consistently enforced here than in most of the rest of the industrialized world"

Maybe I should have said "industrialized west".
But, again, perhaps not germaine to the point.

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Pelegius
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Wow, Pete and I agree on something. That hasn't happened in a while. [Wink]

[ May 13, 2005, 07:02 PM: Message edited by: Pelegius ]

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Pete at Home
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[Smile] Don't mistake me for a conservative just because I oppose ssm -- most Democrats do. Try looking at my arguments on the "Poor" thread. Socialized medicine, public transportation ...

I'm not a Europhobe, either, even though I disagree with some European social policies. I actually like European football (what Americans call "soccer") far more than I like American football or baseball. I lived 8 years in Europe, and think that the US will never truly be civilized until we have a public transportation system like the Europeans have.

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Pete at Home
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quote:
Maybe I should have said "industrialized west".
Are France and Spain part of the Industrialized West? Those are the only two European countries that I've lived in.
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Mike_W
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Well, I don't know about Spain, but based on personal observations with my clients, taxes are collected just as "rigorously" in places like Canada, Germany, and the UK as the USA. And rates (with the exception of the UK) are significantly higher.

The US Sales Tax system, with federal, state, county, and municipal levels, is by far the most complex and expensive for business to administer though.

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Pete at Home
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I know that in France, that there's a huge grey market, with large numbers of persons paid under the table. The Economist ran an article on it.

[ May 17, 2005, 05:05 AM: Message edited by: Pete at Home ]

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Mike_W
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And in the US, there's also a large grey market (think illegal aliens). But, I have no idea about comparitive magnitude. I just wanted to point out that the US wasn't the only country on earth with the rule of law and vigorous tax authorities.
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witless chum
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When Pete's right, he's right. Based on the admittedly limited research I've done on Europeon national healthcare systems, it sounds like the best to me would a France -style (yes, the horror) system. Where the government sets a price it will reimburse all doctors for a procedure. Docs can charge more, if they like. I don't think there's anything that stops you from having private insurance and going to the best doctor around.

Sounds better than the Britain-style where you have all doctors basically working for the gov't.

I'm personally not that excited about the quality of American medicine versus Europeon, but that's probably a prejudice built on some ancedotal experiences. Which make me want to curse and hit the wall to think about, so France?

Bill Ford needs to get off his ass and bribe the right politicians to make this happen now. Before all our big-pension ladden manufacturers go bye-bye.

More socialized medicine, mule!

Dan

[ May 17, 2005, 07:15 AM: Message edited by: witless chum ]

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Pete at Home
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quote:
And in the US, there's also a large grey market (think illegal aliens).
I worked in collections for a cell phone company, and was constantly calling latinos that share a social security number with 17 other latino subscribers. You know what that means? It means that they are paying taxes and social security. And they aren't taking out of Social security. Without the illegales, the social security boat would already be sinking. So yes, there's some negligible grey market, but it's more than compensated by the illegals that put in and don't take out.
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Mike_W
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"but it's more than compensated by the illegals that put in and don't take out. "

Maybe it is and maybe it isnt. And maybe the large amount of American citizens/residents that I met when I was hanging around North Carolina who worked under the table is less than in France. You'd need a pretty solid study to figure it out, rather than your or my anecdotes.

My point, however, stands. America is not unique in enforcing tax laws (and having some of them circumvented).

Regardless, the competition is not Europe or Canada. It's Asia. We have a collective issue. Capitalism is quite safe. Capital is mobile. But, high paying manual labour jobs that will allow a middle class existence in North America and Europe are at risk, and we're not really sure how we might replace them, or how we will deal with the cost of transition.

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