Hospital Bill, German style

[DFW]

63. Thanks for the well-wishes

It is NEVER "free." And paying for medical care through a nationwide tax hike specifically for that purpose is certainly one way to finance health care. It will be unwieldy, and there will be massive fraud and clever schemes to defraud the government of tens of billions. HOWEVER, given our defense budget, that is a price we as a nation should be willing to pay. Also, I'd say any such law should make sure that a conviction for any such fraud carries a mandatory no-parole 30 year sentence--THAT should give a few potential crooks pause!!

We would have to, like many other nations, discourage "medical tourism," making it difficult for someone to travel to the USA, showing up and saying "treat me at no cost," and then running back home. Reciprocal agreements with nations with similar systems could be worked out (UK, France, Canada, e.g.).

We would have to word any such legislation carefully so that the voices of the health care industry that we now have, screaming about their disappearing profits, are drowned out by people's gratitude for the government saving their lives. We would also have to insure that our top surgeons and specialists continue to be very well compensated so that they stay in the USA, and others who want to come are welcome (yes, Donald, some of them may be from India, just suck it up). We would also have to make sure that the tax rise is logical, well-calculated, and not like the government heroin that VAT has turned out to be in Europe. That is, NOT gradual, but one big painful jolt that affects all, but mostly the higher brackets that can handle the bite better because, well, they are the higher brackets. NOT just "the rich," whatever thatis supposed to mean. EVERYBODY is subject to needing health care at some point. We should all be in on this. It will NOT be easy or cheap. If one takes an internet-given statistic that 15% of US households earn $200,000 gross income, and a $500 supplemental tax is put on them, it will bring in $9 billion. We probably need a hundred times that to even contemplate setting up the care-without-catastrophe system. Ergo, the higher brackets will need to contribute way more. How much more? Again, looking up one set of statistics, half a percent of Americans earn $1 million a year. That is 1.75 million people. It seems like a lot to me, but what do I know? Take it at face value. So tax their million at 2%, or $20,000 extra per year. That brings in another $35 billion. We're still a long way from $900 billion. Where will the rest come from? Hell if I know. We can't afford to encourage capital flight, but maybe a tiny add-on to corporate taxes, especially if they are relieved from contributing health insurance to their employees? They should go for that. I'm sure we can somehow afford it, but I am not an economist, and I don't know how to put that together in such a way that the nation--workers and employers--will go for it without cheating or leaving. I'm fairly confident that whatever we initially take in to finance such a scheme, it won't be enough. Good luck running for re-election while telling your voters they will have to cough up more to make this plan work.

It will never be "free," no matter what. Workers who construct hospitals and repair them need to be paid. Utilities that supply electricity and water need to be paid. Those who provide the food and medicine need to be paid. The accountants who make the place run need to be paid. Physicians, nurses, interns and orderlies need to be paid. The IT people who come make sure the computers are accurate need to be paid. But as it is now, the burden is shared unfairly. No citizen of a country such as ours should have to suffer financial detriment due to medical needs. But, though it won't be free, it should be at no cost to patients, and the same goes for medicine. A deal would have to be made for private medical researchers to richly reward them for successful innovations and breakthroughs, Incentive is a must. We can't leave innovation or research to chance.

But we need some financial genius types to work out how to get this done, and some sly politicians to tell people in Los Angeles and New York City, already among the most highly taxed people in America, why their taxes are going to go up a even a little more because some money-losing hospital in Fargo, North Dakota need to be kept open, because people in North Dakota are Americans. too. This is something for a group of highly intelligent, benevolent, and knowledgeable Senators and Congresspeople to work on for nine months or more to get it right, and I haven't the faintest clue what "right" looks like or costs.

A national health insurance law would also have to infuriate some religious groups as well. No making a woman die because state abortion laws say she has to. No making a physician fear arrest and prison because he saves a woman's life for the same reason. No refusing blood transfusion to a dying child because the parents' religious beliefs say God doesn't want it. Etc. Universal Health care means just that. No citizen refused. If God wants to deny someone care that means the difference between life and death, let him show up with a court order. If not, then it's just some mortals claiming to act on his behalf without a notarized power of attorney. Such people should be under a national restraining order.

All this without a LARGE number of people of both parties in our Congress willing to tackle the issue seriously is just a pipe dream, and we ain't got 'em. Anyone who has an idea how to convince a couple hundred million people who have never "been there" and "done that" to vote for such a measure, I have a couple of addresses in Washington to send it on to. Unfortunately, I don't have enough of them. I like your idea. but I am not Captain Picard, and I don't know how to "make it so." "Tax the rich" will just piss off the rich, and there aren't enough of them anyway. I say, "involve the rich, and somehow get them aboard as allies, and we might get somewhere.