www.ditl.org

*sigh* This will have to be as brief as necessity allows, as imperatrix mundi is on her way home and I have to get back to the yardwork.

Captain Seafort wrote:And? Big was arguing that surveys show people are happy with the current US system. I was explaining why that would be the case despite the system being a piece of shit.

The point is that it doesn't matter what you think of the current system, it matters what the people living under it think.

Captain Seafort wrote:And? Private health care over here is just as good as private health care in the US if you can afford it. The difference is the answer to the question "what if you can't afford it". Here and in Europe it's "accept a lesser but still acceptable standard of care". In the US it's "die".

And again, the first-hand testimony I've gotten about at least one major European system is that "acceptable" isn't an appropriate adjective. I'd never dream of questioning your expertise about the UKoGBaNI system, but I have direct evidence from a professional contradicting your statement about the entirety of continental Europe. Sorry, but his word trumps yours.

Captain Seafort wrote:My point was aimed demonstrating that the US public doesn't exactly have a great record when it comes to differentiating between good things and stupid things.

Agreed, nor does any public. This is completely inconsequential, though. You brought it up as part of an indictment of the American system, and it doesn't work. The whole point of a system based on public mandate is that it's based on public mandate - not "public mandate as long as Seafort agrees." I agree with you in my low opinion of the average brainpower of the typical human, but that is immaterial.

Captain Seafort wrote:We did bin the monarchy, although it was due to an idiotic Stuart rather than a nasty Tudor. It took us about a decade to realise it that this was a really bad idea.

Well, I'd say the big "O" had less-than-unanimous support, but no matter - you do have a monarch now, yes?

Captain Seafort wrote:On the contrary. One of the main arguments in favour of the US system is that privatised health care is of a superior standard to state-funded health care. This is true (although the degree is exaggerated) due to the fact that insurers can pick and choose who to insure. However, if you have the money there's nothing to stop you taking out private health insurance here. Ergo, it is not an either/or situation.

*sigh* Yes, there are all kinds of dodges to the question, but don't be cute - the real meat of the debate is NHS-type vs. private health care. One or the other. Yes, we could compare someone over there with NHS + private care with someone over here who has an HMO + supplemental, and I daresay the guy over here would "win" - but that's tangential at best to the real crux of this matter.

Mikey wrote:The point is that it doesn't matter what you think of the current system, it matters what the people living under it think.

That depends on what they think. If the opinion of the majority of the population has little practical impact on the lives of their countrymen, fair enough. If it gets people killed, then as Tsu said the opinion of the majority should be disregarded. If they don't like paying a bit more so that lives can be saved then a) that's their problem and b) they can go and fuck themselves with a cattle prod.

And again, the first-hand testimony I've gotten about at least one major European system is that "acceptable" isn't an appropriate adjective. I'd never dream of questioning your expertise about the UKoGBaNI system, but I have direct evidence from a professional contradicting your statement about the entirety of continental Europe. Sorry, but his word trumps yours.

A couple of questions:

1) Which country, and what's the problem(s) with it?

2) Does said system leave over 15% of the population up shit creek without a paddle?

If the answer to 2) is "no", then I'd still consider it superior to the US "system".

The whole point of a system based on public mandate is that it's based on public mandate - not "public mandate as long as Seafort agrees."

Actually I'd describe it as "public mandate unless it results in people dying necessarily".

Well, I'd say the big "O" had less-than-unanimous support, but no matter - you do have a monarch now, yes?

We do. As I said, we tried the alternative and realised what a bad idea it was.

*sigh* Yes, there are all kinds of dodges to the question, but don't be cute - the real meat of the debate is NHS-type vs. private health care. One or the other. Yes, we could compare someone over there with NHS + private care with someone over here who has an HMO + supplemental, and I daresay the guy over here would "win" - but that's tangential at best to the real crux of this matter.

On the contrary. One of the most frequent arguments I've heard against the US adopting an NHS or government-funded health care is that it would reduce the quality of care for everyone. This is bullshit because there's absolutely nothing preventing an individual taking out private health insurance. The key difference is the attitude to those who can't afford such insurance. The UK/European approach is to provide a safety net. The US approach is "fuck off and die".

Captain Seafort wrote:That depends on what they think. If the opinion of the majority of the population has little practical impact on the lives of their countrymen, fair enough. If it gets people killed, then as Tsu said the opinion of the majority should be disregarded. If they don't like paying a bit more so that lives can be saved then a) that's their problem and b) they can go and fuck themselves with a cattle prod.

Perhaps, perhaps not. However, a dissection of the merits and pitfalls of republican government is beyond the scope of this discussion and maybe for another thread. Likewise, a treatise of "Why Seafort thinks everyone who isn't British^* is an asshole" is probably more suited to an opus in league with Gibbon.
^* I may amend "British" to "English," because I'm not quite sure how you feel about the Scots, Welsh, or Irish.

Captain Seafort wrote:1) Which country, and what's the problem(s) with it?

Italy, evidenced by a physician who had worked in Sicily, Rome, and Napoli. The issue is that a set dollar amount for healthcare per capita was set per fiscal year; if that had been exhausted, you had to wait until the next fiscal year for diagnostics, non-emergency care, etc. The report came from my cardiologist, one Mariano F. Battaglia, M.D., F.A.C.C. It came up because he suggested a stress test and echocardiogram, and noted that because of the date and the number of different specialists I'd seen, if I were his patient in Italy I'd likely have to wait until the next fiscal year before I could have those tests done.

Captain Seafort wrote:2) Does said system leave over 15% of the population up shit creek without a paddle?

Well, it affects everyone, as described. The main issue he noted is that people tend to not seek care for anything that doesn't involve severe blood loss, amputation, or worse, because they're trying to bank their alloted care for when it's needed. When one of my kids has a fever longer than 12 hours, I take him or her to the doctor; in the system described above, I likely wouldn't in case I needed to "save" that allotment of health care. The fact that said fever may either be just an upper respiratory bug, or may be the onset of Lyme Disease which can leave a child arthritic and crippled if not treated soon enough is just a sad fact of the matter.

Captain Seafort wrote:Actually I'd describe it as "public mandate unless it results in people dying necessarily".

You can describe it as a cow's ass if you want; it doesn't change the fact of what it is. Whether that overarching is good or ill is, as I mentioned, not part of this discussion.

Captain Seafort wrote:We do. As I said, we tried the alternative and realised what a bad idea it was.

The fact that you guys couldn't handle a non-monarchial society is immaterial. The original point to this line of discussion was that monarchial government did some bad shit in your country's history, but you still have it. It's hypocritical to say that our government hasn't got everything right so it should be shitcanned, while you're unwilling to do so.

Captain Seafort wrote:This is bullshit because there's absolutely nothing preventing an individual taking out private health insurance.

Ah, here's the confusion. You believe you know what our system is like. The above was send in the context of instituting a NHS-type system in the U.S., and as such is completely wrong. Unlike the UKoGBaNI, we here in the States don't have money trees. If the average American's annual healthcare budget is spent on either private insurance or as taxes to support a NHS is immaterial - when it's spent, it's spent.

Mikey wrote:I may amend "British" to "English," because I'm not quite sure how you feel about the Scots, Welsh, or Irish.

A note: if you ever use the term "British" in relation to the Irish I strongly suggest you always refer to "Northern Irish". Call the wrong Irishman British and the response could be anything from a polite correction to a few pounds of semtex through your letterbox. Or worse.

Italy

Ah. Say no more.

It's hypocritical to say that our government hasn't got everything right so it should be shitcanned, while you're unwilling to do so.

It's not so much that your government has fucked things up so much as they fucked up the really important things. Health care being the biggest issue of the lot.

If the average American's annual healthcare budget is spent on either private insurance or as taxes to support a NHS is immaterial - when it's spent, it's spent.

Now we're getting into your fucked-up tax system as well as you fucked-up health "system". AFAIK the top rate of tax in the US is 25%, and the system as a whole is sufficiently convoluted that Deep Thought would have problems understanding it. Suffice to say that, in addition to the NHS being cheaper than the current US arrangements, by integrating the costs into the tax system it allows the burden to be spread more equitably. This significantly reduces the burden on the average individual. Of course, it's likely that implementing such a system is likely to raise the threshold at which an individual can afford private insurance, but not by nearly as much as you suggest.

Captain Seafort wrote:A note: if you ever use the term "British" in relation to the Irish I strongly suggest you always refer to "Northern Irish". Call the wrong Irishman British and the response could be anything from a polite correction to a few pounds of semtex through your letterbox. Or worse.

Are the citizens of Northern Ireland no longer Irish, or do the folks from the Republic not know that Northern Ireland is part of the United Kingdom?

Captain Seafort wrote:AFAIK the top rate of tax in the US is 25%, and the system as a whole is sufficiently convoluted that Deep Thought would have problems understanding it. Suffice to say that, in addition to the NHS being cheaper than the current US arrangements, by integrating the costs into the tax system it allows the burden to be spread more equitably. This significantly reduces the burden on the average individual. Of course, it's likely that implementing such a system is likely to raise the threshold at which an individual can afford private insurance, but not by nearly as much as you suggest.

#1 - Only an elite few with VERY high incomes pay that rate - a typical MMC household generally pays at about 11%, and then gets dependent and childcare credits, etc.

#2 - The right-of-aisle still holds considerable sway in parts of this country. "Spreading the burden more equitably" is not something of which they're generally in favor.

#3 - You may forget that you're talking about implementing a NHS on top of already-extant things like Medicare and Medicaid (the very fact of Medicaid decrying your assertion that the U.S. doesn't mind the uninsured dying in the street, but that's already an old saw.) The fact of a larger tax gap than you think combined with a higher institutional cost of federal programs means that the net change to an typical individual will be far less than you seem to think, no matter whether that money goes through the gub'mint first or straight to the insurers.

Overall, I'd love to see a UKoGBaNI-styled NHS. Unfortunately, you guys have hit a balance based on already-extant theories of taxation which don't exist here. Further, the reality is that any such system would likely end up being more like continental systems than what you guys in particular have, and I don't consider that an improvement. Lastly, I'm about as far left on this issue as it gets over here, and I'd still probably be considered rather conservative over there. Like I said: for good or ill, we are ruled by public mandate even if I don't agree with that mandate.

Mikey wrote:Are the citizens of Northern Ireland no longer Irish, or do the folks from the Republic not know that Northern Ireland is part of the United Kingdom?

No to both. The issue is that an Irish Republican, north or south of the border will take offence to being called British, and the reaction will vary depending on the individual.

#1 - Only an elite few with VERY high incomes pay that rate - a typical MMC household generally pays at about 11%, and then gets dependent and childcare credits, etc.

That's fucking stupid. I say that as someone who's pretty right-wing, at least by our standards. Out of curiosity, define "very". $100k? 150? 250?

#2 - The right-of-aisle still holds considerable sway in parts of this country. "Spreading the burden more equitably" is not something of which they're generally in favor.

True.

#3 - You may forget that you're talking about implementing a NHS on top of already-extant things like Medicare and Medicaid

Why would you need the Medics? The NHS would replace it.

The fact of a larger tax gap than you think combined with a higher institutional cost of federal programs means that the net change to an typical individual will be far less than you seem to think, no matter whether that money goes through the gub'mint first or straight to the insurers.

Again, true.

Further, the reality is that any such system would likely end up being more like continental systems than what you guys in particular have, and I don't consider that an improvement.

It works, and works well for them, although it appears that the Italians do it about as competently as they do anything else.

Captain Seafort wrote: That's fucking stupid. I say that as someone who's pretty right-wing, at least by our standards. Out of curiosity, define "very". $100k? 150? 250?

I'd have to check the tax code, which I can't right now, but I'd guess that a $100k per annum household would be in the range of 13% - 15%. Non-exempt capital gains are taxed at a flat 18%, regardless of income bracket. Of course, over here $100k per annum would put someone solidly in the UMC range at best - lower if they have kids to support. When I say "very," I'd venture half a mil, probably more.

Captain Seafort wrote:Why would you need the Medics? The NHS would replace it.

Eventually; but those things couldn't be done away with while the NHS was still being implemented - and at that stage, they'd both still need to be paid for.

Beg pardon, I was conflating tax bracket with actual taxes paid. The brackets may be more in line with what you're used to, as seen here; put taxes are paid according to those rates only on money within that bracket. In other words, a household married, filing jointly, which earned $69,000 taxable income after dependent deductions and all other credits wouldn't pay 15% of $69,000; they'd pay 10% of $17,000 and 15% of $52,000. So, actual taxes paid are generally significantly less than the the tax bracket of the payer.

Mikey wrote:...So, actual taxes paid are generally significantly less than the the tax bracket of the payer.

And yet, people still complain endlessly about how "high" the taxes are in America.

Psh. I can't be 100% accurate but I can give a rough idea.

We pay on a sort of "compound" system which usually leaves everyone, including myself, with a sore headache after trying to work it out. Fortunately, government employees tend to have it all done for me including public sector teachers.

We get a "Personal Allowance" which is an amount of money that we may earn without tax. I think its around £7,000-£9,000 now, where as it used to be around £5,000.

The basic tax rate is from £0-£35,000 and is at 20%. However, since the tax rate is compounded, you'd be taxed on your earnings ≤£35,000 AFTER having taken off you're £7,000 odd personal allowance. If you earned £35,000 exactly for example, you'd end up paying 20% on £28,000 of your income.

Then the higher tax rate is from £35,001 all the way up to £150,000. This is paid at 40%. once again, it's compounded and this is when things get even more complicated. For example, if I earn £60,000 as a headteacher which is on the middle to lower end of the scale according to some careers advice site I found ages ago I would pay tax as follows.

£7,000 : Untaxed
£35,000 : 20%
£18,000 : 40% (If I did my maths right)

And then the same happens for the additional tax rate, which is over £150,000 and taxed at 50%. The idea is that it's meant to be less painful for low income earners than a more simple system but unfortunately HM Revenue and customs seem to screw it up more often than not. Doesn't help that they have to add on pensions which are taxable, company cars which are taxable and various company claims which can in some cases also be taxable.

Honestly the US tax system isn't the problem, it's the management of it that causes trouble. If you cut out welfare and split it half with a work placement program and the other half with an NHS, you wouldn't even have to change the current tax rate.

Of course the bulk of our welfare collection is non-white so no politician is going to risk being called a racist for cutting the program.

Deepcrush wrote:Honestly the US tax system isn't the problem, it's the management of it that causes trouble. If you cut out welfare and split it half with a work placement program and the other half with an NHS, you wouldn't even have to change the current tax rate.

Of course the bulk of our welfare collection is non-white so no politician is going to risk being called a racist for cutting the program.

As we've discussed before; this really is a serious part of the matter. The welfare budget for FY 2011 is $495.6 billion dollars. Leave the $107.2 for family and children alone, and that leaves $388.4 billion.

Half of $388.4 billion this year would certainly help with starting a NHS.

Wasn't the start up proposal of NHS just over 100 billon year? Such a simple fix...

496 billon dollars though... Just imagine if that money was spent on education and healthcare and job placement...

Or infrastructure such as bridges or roads.

McAvoy wrote:Or infrastructure such as bridges or roads.

In likely ends, that would be a part of any job placement and as such would be covered under that billing.