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This article from Newsweek is worth sharing far and wide:

Has it ever occurred to you to negotiate with the pilot of the plane you just boarded about her pay?

Assuming the pilot was willing to take bids for her services, would you have any idea of how to evaluate the worth of that particular pilot compared to anyone else who might be at the controls? How long would it delay the flight while you and other passengers haggled over that fee?

And what of the risks in having a pilot focused on whether she negotiated good deals with her passengers, rather than getting everyone safely to their destination?

While haggling with pilots is absurd, the idea that individual Americans should negotiate the prices each pays for health care is getting a lot of serious discussion right now. The reason is the Affordable Care Act, a.k.a. Obamacare, which critics are desperate to find some way to stop.

Spoiler alert for those who will read the entire article: negotiating for health care in the same way you do for a used car is impossible. Also, health policy wonks won't find much new here, but for the layperson, this is a great summary as to why a single-payer, Medicare-for-everyone system is the only way to cover everyone and reduce the insane burden that American health care prices place on taxpayers:
Our universal single-payer health-care plan for older Americans, Medicare, has lower costs and lower overhead than the system serving those under age 65. If everyone in the U.S. was on Medicare, the savings would move the federal budget from deficit to surplus.

Of the 34 modern economies, the U.S. has by far the costliest health care system. For each dollar per capita that the other 33 economies spend on health care the U.S. spends $2.64, my analysis of Organization for Economic Cooperation and Development data shows.

Canada, Germany, and France each spend about 11.5 percent of their economy on health care, compared to 17.6 percent in the U.S.

We could have eliminated the income tax in 2010 had we adopted the Canadian, German, or French health-care systems.

I could share other parts of the article, but it is short and worth reading in full. If you have any conservative friends who think our current system is fiscally conservative, be sure to share this article. If you have any liberal friends who need more evidence to speak as to the virtues of single-payer, please share this article. I promise it is worth your time.

5:20 PM PT: Friends, I'm not saying we should eliminate the income tax. All that I was trying to do -- poorly, in retrospect -- was to suggest that the savings of a single-payer system, properly executed, might amount to almost the entirely of income tax collection in a given year. Yes, we should keep the income tax. Yes, this was a poor title choice. Yes, this article is still excellent and I hope you will share.

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Comment Preferences

  •  This makes no sense at all .. . (7+ / 0-)
    We could have eliminated the income tax in 2010 had we adopted the Canadian, German, or French health-care systems.
    I mean really, who's going to pay for our wars and surveillance society?  that stuff is not cheap.

    Especially considering that the Canadian, German, or French systems - which are (at least in part) paid for by the government, which would only add to the federal government expenditures.

    •  Yeah (2+ / 0-)
      Recommended by:
      Justanothernyer, james321

      I didn't quite follow that.  

      I think the argument is that the federal government raised about a trillion dollars in income taxes in 2010, on about a 15 trillion dollar economy (6.6%).  So if we adopted the Canadian health care system and got the same performance, we'd all be so much richer it's like we paid no federal income tax.

      Or in other words, if we had a single-payer system that was as effective as France, but charged the same prices as the USA and remitted the profits over to the Treasury, we could eliminate the income tax.  

      Since that's a tax on sick people, I don't believe it's a policy proposal.

      •  he's being dumb or disingenuous. (0+ / 0-)

        what would have to happen is a huge tax hike to cover the extra expenditures.  some people would see a drop in total spending as the tax hike would be less than the decrease in health care spending.

        that's what a non-dipshit would argue it.

  •  Not sure how that would work. (5+ / 0-)

    Canada has an income tax, and from what I can tell it has not been eliminated. And following up on RG's comment, Canada doesn't even have to pay for decades-long wars and stuff.

  •  james321 - I read the Newsweek article (6+ / 0-)

    First, if you paired single payer with abolishing the income tax you have a political winner that even the most avid conservative, who thinks single payer in the road to socialism, would be on board. My guess is that 80% of Americans would jump on that band wagon.

    The notion that all we need is single payer and the 2X costs per person with poorer outcomes as compared to the other members of the G8, would vanish demonstrates no actual understanding of the US health system. Of course a single payer system would save some money, as would negotiating drug prices, and removing health insurance companies from the mix. But each of those is small compared to the real reason why healthcare is 2X other developed countries. In the US we teach and practice medicine is a fundamentally different way than any other country in the world, including the other members of the G8. To have our costs similar to theirs we would need to teach and practice medicine like they do. This is in no way a knock on the medicine practiced in Western Europe, it's just that they practice a less expensive brand of medicine than we do. If we made a full court press to start that today, it would take a generation for it to become universal.  

    "let's talk about that"

    by VClib on Fri Jan 03, 2014 at 01:37:44 PM PST

    •  I call bullshit (0+ / 0-)

      One of my friends is a Harvard-trained doctor (Canadian, and now practicing back in Canada), who is associated with a university system and regularly lectures medical students.

      She has never referred to any significant difference, except in one case: that having to deal with the money. In Canada she (and her husband, also a doctor) don't have to worry about the stupidity of the American system when it comes to charging patients and dealing with insurance companies.

      •  If you presented with chest pain at a primary (2+ / 0-)
        Recommended by:
        johnny wurster, Susan G in MN

        care physician in London and one in New York your diagnosis and treatment would have some similarity but would be fundamentally different. Because so many Canadian physicians are trained in the US the differences aren't so stark. It starts with how we teach medicine in the US. I have spent a significant amount of time with clinicians in Europe and they just do things differently with much more attention to cost, because they have to, than we do in the US. The challenge that we have is that as medicine in the US becomes more of an assembly line than an art nearly all institutions are using screens that have the current standard of care that a physician should follow and it will be difficult to change the standard of care. That screen in New York has different protocols for both the diagnosis and treatment than the screen in London. That's why our costs are 2X everyone else. Changing to a European model will take time because the standard of care is different.

        "let's talk about that"

        by VClib on Fri Jan 03, 2014 at 05:46:14 PM PST

        [ Parent ]

        •  You said... (0+ / 0-)

          ...and I quote, "In the US we teach and practice medicine is a fundamentally different way than any other country in the world, including the other members of the G8."

          Canada, last time I checked, not only falls into the category of "any other country", it also is a member of the G8.

          In any event, the difference isn't as stark as you make it to be. In the US, the question is "We will do this test if you can afford it". In other countries it's "Do we, given best judgement, need to do the test?"

          And really, it's the same question: Does the cost-benefit analysis support doing this test or procedure?

          •  Northwatch - good point (0+ / 0-)

            I'll make Canada a separate case when I make that comparison. They are a hybrid and maybe a first place we can step toward given that they transitioned from a fee for service model like we have.

            A big part of the difference with our European friends is our practice of using expensive diagnostics routinely, but it also includes a higher frequency of invasive therapeutic procedures as well.

            "let's talk about that"

            by VClib on Sat Jan 04, 2014 at 08:04:02 PM PST

            [ Parent ]

  •  Income taxes (3+ / 0-)
    Recommended by:
    UntimelyRippd, james321, marleycat

    ...specifically, steeply-progressive income taxes with very high marginal rates, are important if for no other reason than to act as a check on excessive wealth.

    "If you are still playing for Team Republican and want to have any honor whatsoever, you need to leave the Republican Party now, apologize to America, and work to remove it from our political system." - Brad DeLong

    by radabush on Fri Jan 03, 2014 at 02:34:34 PM PST

  •  and how would we pay for government (3+ / 0-)

    without an income tax?  


  •  well, it got done from 1977 to 1912 (0+ / 0-)

    without one. I for one wouldn't be butthurt to see a per-trade fee charged on every share of stock sold every time it's turned over.

    LBJ, Van Cliburn, Ike, Wendy Davis, Lady Bird, Ann Richards, Barbara Jordan, Molly Ivins, Sully Sullenburger, Drew Brees: Texas is NO Bush League!

    by BlackSheep1 on Fri Jan 03, 2014 at 09:22:46 PM PST

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