Clearly what works in the rest of the civilized world (nationalized health care, nationalized high-speed rail, etc.) cannot compete with America's "exceptionalism" - note spellcheck doesn't like that word, or spellcheck...
Your argument is flawed. You are assuming door-to-door rail transit.
People who fly to a destination have to arrange for local transport - be it taxis, rentals, local sales reps, or friends & family.
If the point of highspeed rail is to replace airplanes and not, per se, for local commuters, then the extra needed 'to invest in more than the track' would be a parking garage at the terminus with car rental companies.
Heck, make it extremely competitive - make the termini the airports!!
(Along with the city centres' "Grand Central" station or equivalent, of course.)
...makes sense, if they only count half the electorate why pay full price.
FEI, Diebold CEO was Ohio state campaign chair for Bush in 04 and I think in 2000. Privately declared at Rep functions, "I will do whatever it takes to make sure Bush wins Ohio and the Presidency." Mission Accomplished in 2004.
Kerry shoulda challenged Ohio results - Rolling Stone expose showed vote fraud/disenfranchisement was well over his losing margin.
I lived in Mass during the debate and launch of this program and it was/is a joke.
While unemployed between jobs, as a healthy 30something non-smoking, no medical issues, male, I would have had to pay $350-400 per month as an individual for a plan without even basic prescription coverage. There is no competition in Mass since it is so highly regulated. There is an undeclared oligopoly on health plans of basically 3 groups = Harvard-Pilgrim/Partners, BlueCross/BlueShield, and Tufts that cover the non-poor. There are a few low-income plans, but very few and very limited (no assets, low income, etc.).
When I lost my job, the COBRA was $478 for an individual - I cannot even imagine what it woulda been for family. Who can afford that? If you go to eHealthinsurance.com you can find plans in neighboring New Hampshire for $100-150 per month with prescription coverage, catastrophic coverage and good deductibles. I used to live in California and paid $85/month for UCSF plan with full coverage. Clearly Mass's cost base is outrageous and out-of-control. So when I moved to Texas, I get excellent coverage, but for only $117 per month, I feel $100-150 per month with max $5,000 out-of-pocket per annum is very reasonable with prescription/procedure/visit copays.
The really sad thing is that the head of the Mass Program was the CEO of Tufts Health (at least when I left) and the committee tasked with figuring out what 'reasonable' premiums are were settling for $300 per month for healthy individual. And they were busy patting themselves on the back. How is that reasonable? Women are even worse off! They have way more visits (gyne stuff) than men do and their rates are higher - not to mention fear od detailing mother/sister/aunt with breast cancer.
Anyway, the point is much of the comments are correct in that:
- demand is inelastic (treatment or death?)
- UKs NHS doesnt pay doctors enough (fine with me, i dont want a doc who was in it for the money aka boob-jobber)
- nationalized health care that is simply a mandate for consumers to buy for-profit insurance (like Mass) does NOTHING to keep costs under control and actually reduces what little demand elasticity there is and offering 'tax credits' to offset the poor doesnt help the low-income person make the monthly premiums until April of the next year. (especially since the costs of policing the system will offset potential savings and will be paid through increased taxes anyway)
- a better plan is a personal insurance mandate coupled with companies' requirement to offer the health care coverage cash directly to employee and then there will be true price competition among insurers for individual plans.
- the best plan is to levee a 1.5% income tax (1.5% matching from employers with no cap like FICA) and expand Medicaid to cover all. I think employers would be Phase it in by age group over time like 60+ and 20 then 50+ and 30 then everyone - by mixing healthy and unhealthy offsets risk. Also 60+s earn heaps of money so income tax will fill coffers as young are usually very healthy. This would remove the burden from employers thus increase the purchasing power by grouping everyone together and make all of the budgets/expenditures of federal agency 100%/immediately transparent.
- sadly America's expanding obesity problem will make any solution fall apart rather quickly, unless the government was smart enough to impose a fat/smokers 'unhealth' tax. If you weigh too much for your height (with physician exception for heavily muscled people) then you must, rightly, pay a higher percentage of income since you will be a disproportionate burden through your own unhealthy choices. And even better, reduce the tax rate if you are healthy. This would be certified by physician at annually required checkup - invasive you say? corrupt you say? Well, multiple States have mandatory, annual auto inspections and economic studies have shown the benefits greatly outweigh the costs. Are we willing to submit to mandatory auto inspections
Slashdot Mirror
Clearly what works in the rest of the civilized world (nationalized health care, nationalized high-speed rail, etc.) cannot compete with America's "exceptionalism" - note spellcheck doesn't like that word, or spellcheck...
Your argument is flawed. You are assuming door-to-door rail transit. People who fly to a destination have to arrange for local transport - be it taxis, rentals, local sales reps, or friends & family. If the point of highspeed rail is to replace airplanes and not, per se, for local commuters, then the extra needed 'to invest in more than the track' would be a parking garage at the terminus with car rental companies. Heck, make it extremely competitive - make the termini the airports!! (Along with the city centres' "Grand Central" station or equivalent, of course.)
...makes sense, if they only count half the electorate why pay full price. FEI, Diebold CEO was Ohio state campaign chair for Bush in 04 and I think in 2000. Privately declared at Rep functions, "I will do whatever it takes to make sure Bush wins Ohio and the Presidency." Mission Accomplished in 2004. Kerry shoulda challenged Ohio results - Rolling Stone expose showed vote fraud/disenfranchisement was well over his losing margin.
I lived in Mass during the debate and launch of this program and it was/is a joke.
While unemployed between jobs, as a healthy 30something non-smoking, no medical issues, male, I would have had to pay $350-400 per month as an individual for a plan without even basic prescription coverage. There is no competition in Mass since it is so highly regulated. There is an undeclared oligopoly on health plans of basically 3 groups = Harvard-Pilgrim/Partners, BlueCross/BlueShield, and Tufts that cover the non-poor. There are a few low-income plans, but very few and very limited (no assets, low income, etc.).
When I lost my job, the COBRA was $478 for an individual - I cannot even imagine what it woulda been for family. Who can afford that? If you go to eHealthinsurance.com you can find plans in neighboring New Hampshire for $100-150 per month with prescription coverage, catastrophic coverage and good deductibles. I used to live in California and paid $85/month for UCSF plan with full coverage. Clearly Mass's cost base is outrageous and out-of-control. So when I moved to Texas, I get excellent coverage, but for only $117 per month, I feel $100-150 per month with max $5,000 out-of-pocket per annum is very reasonable with prescription/procedure/visit copays.
The really sad thing is that the head of the Mass Program was the CEO of Tufts Health (at least when I left) and the committee tasked with figuring out what 'reasonable' premiums are were settling for $300 per month for healthy individual. And they were busy patting themselves on the back. How is that reasonable? Women are even worse off! They have way more visits (gyne stuff) than men do and their rates are higher - not to mention fear od detailing mother/sister/aunt with breast cancer.
Anyway, the point is much of the comments are correct in that:
- demand is inelastic (treatment or death?)
- UKs NHS doesnt pay doctors enough (fine with me, i dont want a doc who was in it for the money aka boob-jobber)
- nationalized health care that is simply a mandate for consumers to buy for-profit insurance (like Mass) does NOTHING to keep costs under control and actually reduces what little demand elasticity there is and offering 'tax credits' to offset the poor doesnt help the low-income person make the monthly premiums until April of the next year. (especially since the costs of policing the system will offset potential savings and will be paid through increased taxes anyway)
- a better plan is a personal insurance mandate coupled with companies' requirement to offer the health care coverage cash directly to employee and then there will be true price competition among insurers for individual plans.
- the best plan is to levee a 1.5% income tax (1.5% matching from employers with no cap like FICA) and expand Medicaid to cover all. I think employers would be Phase it in by age group over time like 60+ and 20 then 50+ and 30 then everyone - by mixing healthy and unhealthy offsets risk. Also 60+s earn heaps of money so income tax will fill coffers as young are usually very healthy. This would remove the burden from employers thus increase the purchasing power by grouping everyone together and make all of the budgets/expenditures of federal agency 100%/immediately transparent.
- sadly America's expanding obesity problem will make any solution fall apart rather quickly, unless the government was smart enough to impose a fat/smokers 'unhealth' tax. If you weigh too much for your height (with physician exception for heavily muscled people) then you must, rightly, pay a higher percentage of income since you will be a disproportionate burden through your own unhealthy choices. And even better, reduce the tax rate if you are healthy. This would be certified by physician at annually required checkup - invasive you say? corrupt you say? Well, multiple States have mandatory, annual auto inspections and economic studies have shown the benefits greatly outweigh the costs. Are we willing to submit to mandatory auto inspections