Megan McArdle links to a recent Matthew Yglesias post on nationalized health care. Here’s the key part of the excerpt she quotes:
In effect, a highly centralized state run health care system is able to put a cap on how much demonstrative caring can be done through the health care system.
She replies to a hypothetical example of how the government would cap such demonstrative caring through health care with this:
But after the legal revolution of the 1970’s, American public services look, well, like American ones: unable to deny anything to anyone. What would actually happen in the case Matt describes is that the patient would form an activist group, sue, get the treatment, and use the government settlement to buy the kids organic fruit and a trip to Disneyland.
Bingo. This is why I don’t trust the argument that nationalized health care would result in no further government funding for infant circumcision. One boy would get a UTI that results in a kidney infection. The lawsuit shows up, the verdict ignores logic, and we’re back to funding infant circumcision. And we probably end up with pressure to perform it on all male infants because it will save the government money in the long run. We can’t legislate away unintended consequences.
The single-payer system doesn’t guarantee there won’t be more government funding for infant circumcision, but it does tilt the odds in favor of those who oppose the practice for reasons I’ve already explained.
And no matter how poorly designed it may be, it’s hard to imagine how it could be any worse than the privately mismanaged system we have right now.
Possibly, on the first. There is evidence from some states. But there’s always talk of exemptions for religion and need. I’m not okay with the former, and I’m only okay with the latter when it’s legit. I suspect we’ll see many, many diagnoses of phimosis in newborns.
On mismanagement, we’ve mostly been there before. I stand by my position that government interference and detachment from costs through all-inclusive insurance policies are the bulk of the problem today. We can discuss again, if you want. After all, I have plenty of free time. But I don’t think you want that, which I understand.
Let me ask a question, though, something more general. With circumcision, it should be the boy’s choice. We both agree, he probably won’t want it if given the choice. If he does, he can choose it as an adult.
What about health care? For those of us who don’t want government health care, do we get to opt out of not only receiving it, but also paying for it?
I suspect we’ll see many, many diagnoses of phimosis in newborns.
We’re seeing many, many (bogus) diagnoses of phimosis in newborns right now and nothing is being done about it.
We can discuss again, if you want.
I don’t see any point in having another debate. Blamewise, you’re willing to give private insurers the benefit of the doubt (because of your ideological bent) whereas I’m not….that’s basically what it comes down to.
For those of us who don’t want government health care, do we get to opt out of not only receiving it, but also paying for it?
In my view, direct taxes (taxes on personal income and residential property) should be abolished and replaced with a national sales tax and/or some other indirect tax. There’d be no way to “opt out” under such a plan, nor should there be.
A national sales tax is a bad idea, for multiple reasons. (efficiency, primarily)
There’s no valid reason to not be able to opt out of anything nationalized. The only two reasons for nationalizing and forcing compliance are that someone else knows better what I should do and access to my money is necessary to pay for such certainty. As you can imagine, I reject both.
A national sales tax is a bad idea, for multiple reasons.
As an alternative to the direct taxes people pay right now, a national sales tax is a terrific idea.
Once direct taxes (and the police state apparatus needed to collect them) have been eliminated, the government won’t be able to threaten folks with jail time or eviction from their homes for nonpayment anymore.
This argument alone trumps all of the lame arguments that have been made by those who want to preserve the status quo.
There’s no valid reason to not be able to opt out of anything nationalized.
Allowing people to “opt out” (something unheard of as far as I know) would make the system unworkable.
Making the system unworkable is a very valid reason for disallowing “opting out”.
As I already said, “opting out” wouldn’t be possible anyway with a national sales tax, so it’s an entirely moot issue from where I stand.
I don’t want to preserve the status quo. I don’t like direct taxes, either, or the police state apparatus involved. But a sales tax won’t eliminate that police state apparatus, as long as it’s possible for businesses to cheat.
A national sales tax would also require a Constitutional amendment. The 16th Amendment would need to be repealed. Otherwise, we’d end up with a sales tax and income tax.
But a sales tax won’t eliminate that police state apparatus, as long as it’s possible for businesses to cheat.
Huh?
The 16th Amendment would need to be repealed.
The 16th Amendment SHOULD be repealed but it doesn’t need to be.
A provision could be incorporated into the national sales tax law rendering it inoperative as long as the income tax law remained in effect.
In any event, this doesn’t diminish the validity of the national sales tax concept itself.
The police state mentality for taxes will pursue compliance on collecting/reporting sales tax. It’s not going to the honor system.
A national sales tax law wouldn’t trump the Constitution.
Would a national sales tax exempt any items? Different rates for different categories?
The police state mentality for taxes will pursue compliance on collecting/reporting sales tax.
I have no sympathy for business owners who cheat on their business-related taxes.
A national sales tax law wouldn’t trump the Constitution.
No comprende.
Would a national sales tax exempt any items? Different rates for different categories?
What if it did? What’s your point?
I have no sympathy for businesses who cheat, either. But it’s no different than people who cheat on their taxes. The point is that arguing that eliminating direct taxes would reduce the police state is inaccurate. If you mean that reducing the police state’s affect on individuals, okay. But that’s not what you wrote, so I inferred a general dislike of the police state. (With which I concur.)
If you just have a general dislike of businesses, okay. I’ll disagree completely because I don’t believe evidence supports such a position. But it’s worth being clear on.
When I wrote that a national sales tax law wouldn’t trump the Constitution, I mean two things. First, a law saying that the income tax can’t be collected, imposed, etc. would be ruled unconstitutional, if challenged by anyone, because the law contradicts the clear language of the Constitution.
Second, it’s possible that a sales tax would be ruled unconstitutional, requiring a new amendment to implement it without court challenge.
My point on exemptions within a sales tax is that it makes it more complicated, less efficient, and opens it to all sorts of political whim. Basically, special interest lobbying would create a complete mess of the situation. We’d be right back to favored groups getting a break on what they like and unfavored groups getting hosed on what they like.
For example, there’s no legitimate rationale for imposing a higher tax on certain boats. Yet we do it anyway because wealthier people buy those boats. It’s a punishment for being wealthy. Politicians always sell it as a way to generate revenue on luxuries. What it does is decrease consumption of those boats.
Maybe that’s desirable, but there’s no basis for asserting that. People who want an item are punished for wanting it. More importantly, since purchases decrease, the ship-builders and sellers and repair shops and so on are harmed. They can’t sustain their business enough to stay open.
A national sales tax would be used like that across the economy.
But it’s no different than people who cheat on their taxes.
All Americans have (or should have) a right to personal privacy. The income tax law makes a mockery of that right.
All Americans have (or should have) a right to own their own home. Residential property taxes turn home owners into de facto renters, thus depriving them of that right.
If you mean that reducing the police state’s [effect] on individuals, okay.
Of course I meant the police state’s effect on individuals.
The term “police state” refers to a government that oppresses its people (common folk, in other words), not businesses.
If you just have a general dislike of businesses, okay.
I have a dislike of dishonest businesses, not businesses in general.
First, a law saying that the income tax can’t be collected…
I never said that the national sales tax law should contain such a provision.
I said it should contain a provision that renders it inoperative as long as the income tax law remained in effect so there’d be no chance that we’d wind up with a national sales tax and an income tax at the same time.
Second, it’s possible that a sales tax would be ruled unconstitutional…
Highly unlikely since the states already have sales tax laws on the books right now.
Once again, this doesn’t diminish the validity of the national sales tax concept itself.
I said it should contain a provision that renders it inoperative as long as the income tax law remained in effect so there’d be no chance that we’d wind up with a national sales tax and an income tax at the same time.
I misunderstood. I apologize.
I think we’re in agreement on basics (privacy, etc.). The only thing left is a national sales tax discussion. I’ve hit a few points, but I’ll do some more research and write an entry on it. If you want, we can debate the details then. Sound good?
Sounds good to me.