Well, your wrong on all fronts.
Actually, I'm right on all fronts. Plus I know my grammar.
If we taxed 100% of all the income that everyone makes (not practical), and quit spending completely it would not cover our debt for more than three years.
Not actually true. Actually, just plain false. Have you been listening to right-wing sources? They lie. Try looking up the numbers yourself, from government sources.
Our problem is not from undertaxing as you suggest, it is from OVERSPENDING!
No. It's largely from UNDERTAXING, but it's partly just from STUPID -- not overspending but STUPID misallocation of money. I suggest you try studying some economic history, because you clearly haven't. Again, look up what was done under Eisenhower for a start.
The problem with medical expendatures is the US patients expect the best care.
No, it's really not. I've actually studied this. You may be a doctor, but you clearly haven't studied it.
The problem is caused substantially by selection bias in our medical payment systems, which are statistical effects which you won't see anecdotally because *you're seeing a biased sample of patients*. Single-payer systems eliminate the selection biases and the money spent on them. I mention one of them below (uninsured patient behavior); another is the money spent by insurance companies to make sure "somebody else" pays for any patients with actual illnesses. Another is the fact that the most expensive populations -- the elderly, veterans, the poor, and the disabled -- are
ALL PAID FOR BY THE GOVERNMENT ALREADY. The cost of adding everyone else, the "cheap population", is negligible, but it gives the government pricing power.
One thing you can see: consider your paperwork costs. Don't run your own office? *Find out* how much your paperwork costs are. Compare to other countries. First-world countries. In the US, doctors have huge paperwork departments to deal with multiple insurance companies, and the insurance companies have comparably huge paperwork departments. In "single-payer" countries, this paperwork simply *does not exist*, because there is only one insurance provider which deals with doctors (any other insurer deals directly with patients). Lots of secretaries out of a job, but that's a good thing. This is an example of STUPID spending.
The drug costs are another matter. Drug costs are regulated in every other country in the world. Here, they're both unregulated and supported by government-sponsored private monopolies (patents); and the government is prohibited from negotiating costs. And Americans are prohibited from importing drugs from abroad. As a result, highest drug costs in the world! Some argue that we need to do this to subsidize new drugs, but it would be cheaper just to use direct government grants. This is an example of STUPID spending.
Other countries that provide health care regulate it dramatically. Example: I have a friend who had to bring her mother to the US from Russia for cateract surgery.
You're comparing to Russia? Seriously, try comparing to Scandanavia, the UK, France, Germany, Switzerland, Japan, Canada, or Australia. Russia fell massively behind during the Brezhnev era, had a total economic collapse which Gorbachev did not manage to avert, and was then looted during the "privatization" period; it is now an underdeveloped country. Yes, the US (often) provides better medical care than Russia. We also provide better medical care than Burma and the Congo. Why compare apples and oranges?
Yes, other countries, even the first-world ones, do have regulations making the most expensive procedures difficult to get. Here, we simply make all procedures difficult to get unless you're rich, make even the most absurd procedures easy to get for the very rich, while spending a massive extra amount of money on paperwork. Predictably, this gives worse results than other prioritization systems.
She could not see at all. After waiting for 9 months for an appointment, they told her that the procedure to remove her cateracts was not necessary. Done here quickly and cost several thousand dollars.
If you're working poor, you won't be able to get cataract surgery here *either* -- over half the population of this country simply does not have several thousand dollars to spend!
On the other hand, you will be able to in the UK, France, Germany, Switzerland, Japan, Scandanavia, etc....
I am a doctor, and the majority of the costs in ER's are due to government regulation,
Not especially -- unless you mean the regulation which requires ERs to take everyone, of course, which is massively increasing ER usage. They've become the only way to get care for uninsured people, which is a nice way of backloading massive costs on hospitals, as uninsured people wait until they're sick enough to be admitted to the ER. There are studies showing how much this adds to the nation's health costs; you can look them up. This is an example of STUPID spending.
and CYA for malpractice. Many things that are easily treatable, predictably and inexpensively require very expensive equipment and exams to prove in a cout of law that their diagnosis and treatment was correct should anything be questioned later.
Yes. And you have another example of STUPID spending. Countries with single-payer systems do not have the same "courtroom defensive" CYA malpractice attitudes from doctors, because there is a different legal regime, where "This is the standard Medicare/NHS-approved procedure" is good enough for any court!
Incidentally, there is evidence that behavior commonly recommended to doctors by lawyers (never admit wrongdoing, do unnecessary tests) is actually *counterproductive* and gets doctors *sued more* and makes them *lose cases more often* than being forthright and straightforward and humble with their patients, but try to get the lawyers to admit that.
Sadly it does not appear that this mode of practicing medicine will change anytime soon!
But it could change. The arguing of medical cases in the law courts isn't done much in single-payer systems. Malpractice cases are then reserved for the genuinely abusive and deranged doctors (of which I've seen a couple). "The best" doesn't necessarily mean unnecessary tests (who likes unnecessary tests?) and in countries where the payment system and the legal regime is different, the mode of practicing medicine is different.
Oh, there's other stuff going on too, where the US just "does it stupid". In most first-world countries medical education is very cheap (heavily government-subsidized), so doctors don't feel the need to go into expensive specialties or collect huge salaries -- no school debt to pay off. It turns out this saves the government money in the long run, because rather than paying "medical costs" which include the doctors' interest on their school loans, that interest never gets charged.
I really have studied this... For the same amount of money the government currently spends on medical care, we could be getting universal coverage for all citizens, of a better quality, like Canada, the UK, France, Denmark, Switzerland, Japan, take your pick. This would have the nice side effect of removing the cost of health insurance from businesses and individuals, which would cause an economic boom in other areas, which would incidentally raise government revenue. The fact is that we're not getting our money's worth for our spending and those who have studied it mostly know why.
We don't get our money's worth for military spending either, obviously (or we wouldn't be losing wars repeatedly). More STUPID.
But on top of this, the government is also undertaxing. Well, actually, the Mitt Romneys of the country are undertaxed (15% top rate!) while working people are taxed at really quite high levels; an interesting "soak the poor" system which is really not healthy for the country at all. And all too many of the undertaxed superrich are using their money to attempt to get the government to funnel more money towards them and away from everyone else... and often to encourage STUPID spending, because they often have a hand in the companies which profit from it.
The new version of the Conservative party here (a merger of our old center-right Progressive Conservatives and much-further-right Reform Party) seems to have picked up some rather bad habits. I wonder where...
