Where would you like your tax dollars to go?

[popeyespappy]

Implementing a single payer healthcare system in the US is probably harder than balancing the budget.

How would you do it?

Find out how much it would cost to provide reasonable health care for people and set a tax to cover the cost making sure that the wealthy actually pais and didn't mamage to weasel out of it.

According to the article I just read America spent $3.35 trillion on healthcare in 2016. According to them that's $10,335 per person. That's $3.35 trillion divided by everybody so it includes a bunch of people that needed reasonable healthcare, but didn't get it because they couldn't afford it. If they had gotten care the bottom line would have been larger. The article also said we could expect a 4.8% inflation rate for healthcare. Tie that to a 0.7% population growth rate and by 2050 we are looking at $20.9 trillion total and $50,886 each per year not including the percentage of people that don't get healthcare today. That is unsustainable so I guess we'd be safe calling it unreasonable.

So how do you determine what it would take to provide reasonable care for people? A large percentage of the cost is driven by care for old and dying people. A few years back we lost my 95 year old uncle. The bill for his healthcare the last for weeks of his life was probably more than the cost for the previous 95 years. Is that reasonable? Do we just tell our parents and grand parents sorry we can't afford you so just go home and die?

Do we just set an arbitrary number? Do we just say healthcare in Germany costs half of what it does here so we are going to set medicare taxes to raise $1.675 trillion (a huge fucking increase) and call it good? The revenue target might be reasonable, but I don't know if many of our healthcare providers could survive if we cut their revenues in half. I was at the smaller of our two local hospitals last Friday. While there I walked through the doctor's parking area. I was surprised by the large percentage of old Buicks and worn old Toyotas I saw. Our doctors and hospitals have to carry huge amounts of liability insurance to protect them. Many of the doctors graduate college with a medical degree and hundreds of thousands of dollars worth of debt that most doctors in Germany don't have. How do we insure they make enough revenue to survive? Many healthcare providers, especially the young ones don't make so much money that they can afford to see their income cut in half. How do we protect them?

It's a complex problem. There is no easy way to implement a sustainable single payer system in the US without putting the health of our healthcare system at risk. It can be done, but it is going to require some fundamental changes in other areas such as education and tort reform. Changes like that take time and careful planning. I have my doubts whether or not our elected government is up to task even if they had the will.