U.S. federal judge rules Obamacare unconstitutional

[riclag]

First year in my life not having  medical insurance so I'm forced to pay a $700 penalty(ACA mandate tax)Next year free,except if individual states choose to impose a mandate(California without doubt would go that route).

[Thakkar]

US per capita healthcare spending is the highest in the world. The next highest country, Switzerland, spends 40% less and has 14% higher life expectancy. 

 

[bkkcanuck8]

54 minutes ago, Thakkar said:

US per capita healthcare spending is the highest in the world. The next highest country, Switzerland, spends 40% less and has 14% higher life expectancy. 

 

Statistics can be deceiving if you try to take it and relate it to one factor when life expectancy is related to many factors.  You have a lot of obese people in the US and a tonne of them that are morbidly obese ...  Yes there are some with a healthier lifestyle but the sheer numbers of them they would likely have an impact on those stats. 

 

Besides, do you want that number of people above retirement age... having a lower average lifespan might be better for the US economy ????

 

Cross streams here, there are many younger UK citizens that would probably prefer that statistic these days... they might not have started this path to brexit ????

 

Oh now that I think of it, the Republican Party should be doing all it can to raise the life expectancy - keep on hearing about demographic shifts...  I just hear the Progressives go 'Shhhh....'.

Edited December 17, 2018 by bkkcanuck8

[lannarebirth]

23 hours ago, bristolboy said:

Nonsense. The vast majority of legal experts disagree with the judge's decision and expect it to be overturned on appeal. The reason being that when Congress changed the law, it did it in a very specific way and changed only that part. The consistent judicial rule is that when Congress changes a small part in any law and doesn't state that it has something to do with other parts of the law, then the law stands in its modified form. The very right wing judge in this case ignored that legal principle.

You have a point but the only reason the law was upheld to be constitutional in the first place was due to the mandate which Justice Roberts construed to be a tax conferring a back door constitutionality to the law. If that provision is removed I'm not sure the original argument upholding the ACA holds up.

 

I get that's it's popular with many and that pre existing conditions ought to be insurable but that shouldn't have a bearing on a court review and judgement.

[NotYourBusiness]

On 12/17/2018 at 7:05 AM, samran said:

Spoken like someone who knows absolutely nothing about healthcare economics.

 

The US spends near DOUBLE on health care as a % of GDP than their OECD counterparts for worse outcomes. And it becuase ‘free markets’ aren’t so free when it comes to the provision of healthcare.

 

The provision and consumption of health care is like no other product. 

 

On the supply side: Doctors and health care providers are essentially oligopolies. Doctors take years to train, and if you need a specialist there isn’t generally too many of them about. 

 

Basic economics dictates that if you let oligopolies loose they will charge well more than ‘normal’ prices.

 

On the demand side, functioning free markets require choice on the consumer side for the product we are wanting to buy.

 

It isnt like buying a car where you have plethora of choice. 

 

Unfortunately, when we consume medical products, we don’t get to choose for if we are being treated for cancer or a broken bone. You don’t get to chose your ailments most of the time. And the need and timing of ‘consuming’ medical care is mostly out of your hands. 

 

On top of that, people tend to underinsure, underestimating the risk of getting sick. 

 

Add in the fact that the US insurance pool is less balanced with younger and healthier people not paying into it, you’ve got a recipe for expensive health outcomes.

 

Im very pro free market, not there is not a one piece of evidence it works on health care. But Americans have had 60 years of indoctrination that any single payer system means ‘socialism’, so like you, they poo their pants at the sound of it.

 

Oh, and by the way, your $10 tooth extraction is courtesy of the Thai government. Dental students are near fully subsidised so they don’t come out of school full of debt. 

 

So so you can thank ‘socialism’ for making that visit to the dentist cheaper for you..

 

OK. Thanks for your answer and let's take this one by one.

 

Quote

The US spends near DOUBLE on health care as a % of GDP than their OECD counterparts for worse outcomes.

Right, But the big question is WHY?

 

Quote

And it becuase ‘free markets’ aren’t so free when it comes to the provision of healthcare.

This is very true, but it is only because if choices we have made that make it not a free market. If I have $100 in my pocket, I can only get a procedure priced at $100. If I have $100 in my pocket and the government pays 90% of my bill, then I can afford $1,000 procedure. Worse, the guy performing it will think his procedure is worth $1,000, when it is really only worth $100. Any kind of subsidy distorts price discovery, and is no longer a free market. We definitely don't have a free market in healthcare. Let's make it one.

 

Quote

The provision and consumption of health care is like no other product. 

Nope. Provision and consumption of health care is subject to the same basic economic rules as everything else if we would just allow it to, which we don't.

 

Quote

On the supply side: Doctors and health care providers are essentially oligopolies. Doctors take years to train, and if you need a specialist there isn’t generally too many of them about. 

 

Basic economics dictates that if you let oligopolies loose they will charge well more than ‘normal’ prices.

Nope again. FIrst, may I assume by "normal prices" you mean free market prices, right? Ok! Oligopolies can only charge what the market will bear. Subsidies (insurance) won't fix your issue, see above. And now that you mention it, doctors take years to train, but why is that? What is the result of all this training? Doctors who push prescription drugs as the only solution. Few know that systematic reviews of hospital charts found that even properly prescribed drugs (NOT INCLUDING misprescribing, overdosing, or self-prescribing) cause about 1.9 million hospitalizations a year. Another 840,000 hospitalized patients are given drugs that cause serious adverse reactions for a total of 2.74 million serious adverse drug reactions. About 128,000 people die from drugs correctly prescribed to them EACH YEAR. 

 

We agree on one thing. We are paying sky high prices for a horrible situation.  And your answer is even more regulation. You are so far into the maze that you can't find your way out.

 

Quote

On the demand side, functioning free markets require choice on the consumer side for the product we are wanting to buy.

 

It isnt like buying a car where you have plethora of choice. 

 

Unfortunately, when we consume medical products, we don’t get to choose for if we are being treated for cancer or a broken bone. You don’t get to chose your ailments most of the time. And the need and timing of ‘consuming’ medical care is mostly out of your hands. 

 

On top of that, people tend to underinsure, underestimating the risk of getting sick. 

 

Add in the fact that the US insurance pool is less balanced with younger and healthier people not paying into it, you’ve got a recipe for expensive health outcomes.

Yes correct we dont have many choices ánd the government has worked hard to make it so. One of myriad good example, one of the first guys to promote keto diet for diabetics (a low cost and drugless treatment that is gradually gaining acceptance because it works) was sued by a medical board for "practicing medicine without a license". His reply was "Hey Diabetes Association of America, how many people have YOU cured?" See diabetes-warrior.net

 

Yes people tend to under-insure because it is so expensive. Let's see the prices for insurance if Everyone self insures. Hard to imagine right now but how would it look once medical costs drop 90%?

 

There should be no "insurance pool".

 

Quote

Im very pro free market, not there is not a one piece of evidence it works on health care.

We don't have a free market in health care and you are making conclusions from this disaster? Not clever.

 

Quote

Oh, and by the way, your $10 tooth extraction is courtesy of the Thai government. Dental students are near fully subsidised so they don’t come out of school full of debt. 

 

So so you can thank ‘socialism’ for making that visit to the dentist cheaper for you..

Amazing. If this true then you have found the solution to everyone's problems thanks! This is all we need to do!

 

In case if isn't obvious, a free market in health care would mean health care would be no different from your local auto mechanic, and even that is a bad example because auto insurance drives up prices there to astronomical levels as well. No FDA, no doctor degree, no drug laws, no right or wrong treatment. Up to the patient to get, or not get, any treatment they so choose at the price they are willing and able to pay. Then let's see the price for healthcare. If you can't live with that, I understand, it's ok, I am fine. Just realize that the market is not free DUE TO THE CHOICES WE MAKE, and no other reason. Stop kidding yourself that "healthcare is different". It's not.

 

I took a long time to write this, and very sorry it will be my last post on this subject.

 

[bristolboy]

13 minutes ago, NotYourBusiness said:

 

OK. Thanks for your answer and let's take this one by one.

 

Right, But the big question is WHY?

 

This is very true, but it is only because if choices we have made that make it not a free market. If I have $100 in my pocket, I can only get a procedure priced at $100. If I have $100 in my pocket and the government pays 90% of my bill, then I can afford $1,000 procedure. Worse, the guy performing it will think his procedure is worth $1,000, when it is really only worth $100. Any kind of subsidy distorts price discovery, and is no longer a free market. We definitely don't have a free market in healthcare. Let's make it one.

 

Nope. Provision and consumption of health care is subject to the same basic economic rules as everything else if we would just allow it to, which we don't.

 

Nope again. FIrst, may I assume by "normal prices" you mean free market prices, right? Ok! Oligopolies can only charge what the market will bear. Subsidies (insurance) won't fix your issue, see above. And now that you mention it, doctors take years to train, but why is that? What is the result of all this training? Doctors who push prescription drugs as the only solution. Few know that systematic reviews of hospital charts found that even properly prescribed drugs (NOT INCLUDING misprescribing, overdosing, or self-prescribing) cause about 1.9 million hospitalizations a year. Another 840,000 hospitalized patients are given drugs that cause serious adverse reactions for a total of 2.74 million serious adverse drug reactions. About 128,000 people die from drugs correctly prescribed to them EACH YEAR. 

 

We agree on one thing. We are paying sky high prices for a horrible situation.  And your answer is even more regulation. You are so far into the maze that you can't find your way out.

 

Yes correct we dont have many choices ánd the government has worked hard to make it so. One of myriad good example, one of the first guys to promote keto diet for diabetics (a low cost and drugless treatment that is gradually gaining acceptance because it works) was sued by a medical board for "practicing medicine without a license". His reply was "Hey Diabetes Association of America, how many people have YOU cured?" See diabetes-warrior.net

 

Yes people tend to under-insure because it is so expensive. Let's see the prices for insurance if Everyone self insures. Hard to imagine right now but how would it look once medical costs drop 90%?

 

There should be no "insurance pool".

 

We don't have a free market in health care and you are making conclusions from this disaster? Not clever.

 

Amazing. If this true then you have found the solution to everyone's problems thanks! This is all we need to do!

 

In case if isn't obvious, a free market in health care would mean health care would be no different from your local auto mechanic, and even that is a bad example because auto insurance drives up prices there to astronomical levels as well. No FDA, no doctor degree, no drug laws, no right or wrong treatment. Up to the patient to get, or not get, any treatment they so choose at the price they are willing and able to pay. Then let's see the price for healthcare. If you can't live with that, I understand, it's ok, I am fine. Just realize that the market is not free DUE TO THE CHOICES WE MAKE, and no other reason. Stop kidding yourself that "healthcare is different". It's not.

 

I took a long time to write this, and very sorry it will be my last post on this subject.

 

Your is probably the only honest argument against universal health care. (It could never fly because the obvious brutality that would follow.)  But of course, that's not what opponents of the ACA are proposing, So given the reality of how medical care works, and the fact the systems in other developed nations universally work better. government imposed universal health care would be a big improvement.

 

I shoud add, though, that what you propose takes no account of public health issues. Issues which aren't profitable for insurance companies to address.

Edited December 18, 2018 by bristolboy

[ricklev]

I beseech  you all. Please reveal more of this one true God I've heard you worship and which you call  "The Free Market"!  Is He a real God and not one made by desperate men?

Edited December 18, 2018 by ricklev

[ricklev]

Does He speak of what is just and moral among men or does He live in the clouds above?

Sent from my SM-J710F using Thailand Forum - Thaivisa mobile app

[samran]

1 hour ago, NotYourBusiness said:

 

OK. Thanks for your answer and let's take this one by one.

 

Right, But the big question is WHY?

 

This is very true, but it is only because if choices we have made that make it not a free market. If I have $100 in my pocket, I can only get a procedure priced at $100. If I have $100 in my pocket and the government pays 90% of my bill, then I can afford $1,000 procedure. Worse, the guy performing it will think his procedure is worth $1,000, when it is really only worth $100. Any kind of subsidy distorts price discovery, and is no longer a free market. We definitely don't have a free market in healthcare. Let's make it one.

 

Nope. Provision and consumption of health care is subject to the same basic economic rules as everything else if we would just allow it to, which we don't.

 

Nope again. FIrst, may I assume by "normal prices" you mean free market prices, right? Ok! Oligopolies can only charge what the market will bear. Subsidies (insurance) won't fix your issue, see above. And now that you mention it, doctors take years to train, but why is that? What is the result of all this training? Doctors who push prescription drugs as the only solution. Few know that systematic reviews of hospital charts found that even properly prescribed drugs (NOT INCLUDING misprescribing, overdosing, or self-prescribing) cause about 1.9 million hospitalizations a year. Another 840,000 hospitalized patients are given drugs that cause serious adverse reactions for a total of 2.74 million serious adverse drug reactions. About 128,000 people die from drugs correctly prescribed to them EACH YEAR. 

 

We agree on one thing. We are paying sky high prices for a horrible situation.  And your answer is even more regulation. You are so far into the maze that you can't find your way out.

 

Yes correct we dont have many choices ánd the government has worked hard to make it so. One of myriad good example, one of the first guys to promote keto diet for diabetics (a low cost and drugless treatment that is gradually gaining acceptance because it works) was sued by a medical board for "practicing medicine without a license". His reply was "Hey Diabetes Association of America, how many people have YOU cured?" See diabetes-warrior.net

 

Yes people tend to under-insure because it is so expensive. Let's see the prices for insurance if Everyone self insures. Hard to imagine right now but how would it look once medical costs drop 90%?

 

There should be no "insurance pool".

 

We don't have a free market in health care and you are making conclusions from this disaster? Not clever.

 

Amazing. If this true then you have found the solution to everyone's problems thanks! This is all we need to do!

 

In case if isn't obvious, a free market in health care would mean health care would be no different from your local auto mechanic, and even that is a bad example because auto insurance drives up prices there to astronomical levels as well. No FDA, no doctor degree, no drug laws, no right or wrong treatment. Up to the patient to get, or not get, any treatment they so choose at the price they are willing and able to pay. Then let's see the price for healthcare. If you can't live with that, I understand, it's ok, I am fine. Just realize that the market is not free DUE TO THE CHOICES WE MAKE, and no other reason. Stop kidding yourself that "healthcare is different". It's not.

 

I took a long time to write this, and very sorry it will be my last post on this subject.

 

Like Bristolboy, I commend you on being honest with your perspective - I suspect you are a libertarian in your leanings. Nothing wrong with that. In some areas I am as well, just not in this issue. 

 

But my position stands - and it is based on pretty basic economic orthodoxg. And 19 out of 20 OECD countries have set up their medical systems based on this same logic. 

 

Markets are ‘good’ when it creates the lowest prices giving consumers the most choice. It doesn’t here. 

[NotYourBusiness]

14 hours ago, Thakkar said:

US per capita healthcare spending is the highest in the world. The next highest country, Switzerland, spends 40% less and has 14% higher life expectancy. 

 

 

Thanks for this, and the elephant in the room seems to be Chile. Far and away the lowest cost and highest life expectancy. Clearly worth a lot more investigation.

[bkkcanuck8]

2 hours ago, NotYourBusiness said:

Quote

The US spends near DOUBLE on health care as a % of GDP than their OECD counterparts for worse outcomes.

Right, But the big question is WHY? 

I will take a stab.

 

Insurance itself distorts the market.  If insurance covers 80% or 90% then rise in price of $1 is only $0.20 to the person making the decision about the purchase and the price willing to pay for that service.  Then with big ticket items and no guarantee of collection - the cost charged is often double what you would be charged if you walked in with cash and negotiated that they would get that cash at that point. 

 

A simple example would be the price (about 15 years ago+ maybe) of getting an MRI at Buffalo MRI.  The listed price on the wall was $800.  But if you don't have insurance and you are paying out of pocket you are eligible for a discount of $350 (out of pocket cost $450).  If you were a Canadian you get a Canadian discount of a similar amount.  So who pays the $800.  Insurance covers that.  Of which if it covers 80% of the cost, you are out of pocket $160.

 

A much larger portion of what you pay for Medical services in the US is actually Administration (considerable amount more than Admin costs within lets say Canada).

 

 

 

 

 

 

[NotYourBusiness]

Quote

Insurance itself distorts the market.

Thank you, my point exactly.

[bristolboy]

1 minute ago, bkkcanuck8 said:

A much larger portion of what you pay for Medical services in the US is actually Administration (considerable amount more than Admin costs within lets say Canada).

That's not true for Medicare, Medicaid, and people getting their insurance on the healthcare exchanges. Medicare has a 2% administrative costs. Medicaid 4-6%. Insurance companies offering care on the ACA exchanges are limited by law to 1%. 

[samran]

4 hours ago, NotYourBusiness said:

 

Thanks for this, and the elephant in the room seems to be Chile. Far and away the lowest cost and highest life expectancy. Clearly worth a lot more investigation.

Simply, the negotiating power of a single buyer against the drug companies and service providers.

 

In Australia, the weight of the federal government means that deals can be done to reign in the price of medicines and services that smaller, more diffuse providers could never harness.

 

A professional, independent non-partisan organisation makes recommendations to the federal government. If approved, the drugs go on the Pharmaceutical Benefits Scheme (PBS) and are either provided at either free at the point of delivery or highly subsidized if sold from the pharmacy.

 

The drug companies hate it. But they live with it. They get access to a market of 25 million people to sell to.

 

You can still choose your doctors. Doctors are independent contractors, not state employees. The better ones still drive Mercedes and send their kids to the best schools. Kids still fight to get into Medical school.

 

We've been through the ringer with the Australian health system, including two bone marrow transplants. Nothing but professional, clean and cutting edge stuff.

 

Nothing, and I mean nothing is rationed. 

 

Most we ever paid was $20 per day for the carpark at the hospital. Always more than happy to pay my Australian taxes.

 

 

Edited December 18, 2018 by samran

[bristolboy]

This is by far the best article I've read explaining why the decision of that judge in Texas won't stand:

The Latest Ruling Against Obamacare Is a Bridge Too Far—Even for SCOTUS

https://slate.com/news-and-politics/2018/12/obamacare-ruling-texas-john-roberts-scotus.html

[Peasandmash]

soon the dirty black stain in America's economic underwear will be washed completely away. ????

Long Live President Donald Trump!

4 More Years!

[bristolboy]

5 hours ago, bkkcanuck8 said:

I will take a stab.

 

Insurance itself distorts the market.  If insurance covers 80% or 90% then rise in price of $1 is only $0.20 to the person making the decision about the purchase and the price willing to pay for that service.  Then with big ticket items and no guarantee of collection - the cost charged is often double what you would be charged if you walked in with cash and negotiated that they would get that cash at that point. 

 

A simple example would be the price (about 15 years ago+ maybe) of getting an MRI at Buffalo MRI.  The listed price on the wall was $800.  But if you don't have insurance and you are paying out of pocket you are eligible for a discount of $350 (out of pocket cost $450).  If you were a Canadian you get a Canadian discount of a similar amount.  So who pays the $800.  Insurance covers that.  Of which if it covers 80% of the cost, you are out of pocket $160.

 

A much larger portion of what you pay for Medical services in the US is actually Administration (considerable amount more than Admin costs within lets say Canada).

 

 

 

 

 

 

The publicly listed prices of hospital services is far more than insurers pay. In fact, if you are taken to a hospital for an emergency and you don't have insurance, the charges will be astronomical.

Edited December 18, 2018 by bristolboy

[roobaa01]

unconstiutional thats what the usa most successful donald trump said from the beginning but hapless without brain obama care nonsense claims the opposite.

 

and here we are newly elected waste ocasia-cortez cannot follow or yoga thus she needs time off instead of working.

 

wbr

roobaa01

[Jingthing]

The publicly listed prices of hospital services is far more than insurers pay. In fact, if you are taken to a hospital for an emergency and you don't have insurance, the charges will be astronomical.

Yes the retail prices are much higher than what insurance pays.

Sent from my Lenovo A7020a48 using Thailand Forum - Thaivisa mobile app

[Jingthing]

soon the dirty black stain in America's economic underwear will be washed completely away. [emoji120]
Long Live President Donald Trump!
4 More Years!

So I can put you down for Medicare for all then right?

Sent from my Lenovo A7020a48 using Thailand Forum - Thaivisa mobile app

[direction BANGKOK]

I think the reason the money spent on health care is relatively ineffective is due to insurance company profit margins. Insurance companies are built to deny the claims they exist to pay out. I have always felt the only solution is to ban insurance. 

Edited December 18, 2018 by direction BANGKOK

[bkkcanuck8]

On 12/17/2018 at 4:40 PM, riclag said:

First year in my life not having  medical insurance so I'm forced to pay a $700 penalty(ACA mandate tax)Next year free,except if individual states choose to impose a mandate(California without doubt would go that route).

So, unless you are individually wealthy -- you are basically putting all the risk on other people to pick up the tab if you have a very expensive emergency...  In Singapore they require an individual deduction of 20% of income go into a locked account (matched by 13% by the employer) which is there to buy insurance, pay for medical services and if not used rolled over into retirement (FYI: not personal experience - so it might not be totally accurate) -- This is because the government (which has a reputation of being run like a company) is doing it's best to protect itself from having to pick up the cost -- or pass it on to other taxpayers.  

 

To a certain extent the individual mandate penalty could be considered the government forcing you to pay the cost of the government insuring itself against those that don't have medical insurance when they [statistically] eventually end up in a public hospital for emergency (very expensive). 

[JAG]

2 hours ago, Jingthing said:

So I can put you down for Medicare for all then right?

Sent from my Lenovo A7020a48 using Thailand Forum - Thaivisa mobile app
 

Sadly, I doubt there is any treatment, let alone a cure...

[attrayant]

1 minute ago, bkkcanuck8 said:

Just make it legal to terminate the old and the sick if they get sick without being able to pay for it

 

That's what we had before the ACA.  Insurers could deny coverage for pre-conditions and refuse to insure people on whims.  Insurance companies were the original death panels.

[Thakkar]

9 hours ago, NotYourBusiness said:

 

Thanks for this, and the elephant in the room seems to be Chile. Far and away the lowest cost and highest life expectancy. Clearly worth a lot more investigation.

Re: Chile 

I thought so too, so I looked into it, a bit. Helpful and brief explainer here In the New England Journal of Medicine:

https://www.nejm.org/doi/full/10.1056/NEJMp1514202

 

It seems they started out with a semi-free market system and found that helthcare is not like other markets. They ended up with a convoluted system (still, less so than ACA, or maybe convoluted in different ways, I couldn’t decide) with various refulatory regimes that took a lot of “free” out of the “free market”

 

The article fails to explain why their costs are so much lower, though one clue is that, unlike most other jurisdictions where medical lobbies prevent foreign doctors from practicing, Chile imports a lot of Ecuadorian and Cuban doctors for hardship posts outside major cities who work at government clinics for low pay. Still, that doesn’t tell the whole story.

 

in any case, the system, while so far, while providing good outcmes, seems unsustainable, and is unpopular.

[bkkcanuck8]

4 minutes ago, attrayant said:

 

That's what we had before the ACA.  Insurers could deny coverage for pre-conditions and refuse to insure people on whims.  Insurance companies were the original death panels.

No.  They would end up in emergency rooms of public hospitals (very expensive treatment for non emergency problems).   Public hospitals are not allowed to refuse care, which means that anyone without insurance would not be able to pay and would end up with it being covered by tax dollars or inflating/padding bills paid for by insured people.  Private hospitals can turn away non-emergency related cases but they must still accept emergencies.  If health issues are not treated while it is much more cost effective, they will end up in emergency rooms.  The insurance death panels relate to non-emergency but critical medical coverage (i.e. cancer treatment).

[attrayant]

14 minutes ago, NotYourBusiness said:

What is immoral is BORROWING money to pay for services today, and this money must be repaid by future generations, your children and grandchildren, with interest, and without their consent.

 

I think we're straying from the topic, because this was already common practice before the ACA.  In fact it's one of the things that was bankrupting sick people who had to borrow to pay off their medical bills.  This was an impetus for the ACA.

 

Generally, debt is not inheritable.  Borrowing certainly isn't immoral, so what's the immoral part?

[NotYourBusiness]

28 minutes ago, attrayant said:

 

I think we're straying from the topic, because this was already common practice before the ACA.  In fact it's one of the things that was bankrupting sick people who had to borrow to pay off their medical bills.  This was an impetus for the ACA.

 

Generally, debt is not inheritable.  Borrowing certainly isn't immoral, so what's the immoral part?

Yes I agree that this was done before ACA. USA is the worst offender bar none. All the more reason to get government OUT of the healthcare business.

 

Generally, personal debts are not inheritable. Government debt will be carried forward endlessly until it is paid off, with interest. So YES, for government debt, your children WILL inherit your debt. They will want to ask you WHY you placed them in debt bondage without their consent, and what will you say?

[samran]

*Deleted post edited out*

 

You are a bit off in your analysis. 

 

In Australia - health care is funded by a 3% levy on income. It’s called the Medicare levy. It’s a seperate line item basically - it is our insurance premium. It isn’t an inter generational payment. 

 

At at the end of the day, medical costs for Australia are about 60% of what Americans pay. And we get better health outcome.

 

There is no better argument for maintaining it. 

 

Our system is cheaper and better due to the superior purchasing power of a single buyer. The states are in charge of delivery mainly and do so using funding mechanisms which are cutting edge. 

 

We dont expect - or load - employers with paying for employees premiums. It’s an effective tax on them. Our labour market is more flexible as a result. Employees aren’t beholden to an employee for their ‘benefits’. 

 

That chart you see is a factor of a couple things stemming from the GFC. 

 

1) a massive stimulus right at the start of the GFC. Treasury’s advice was ‘go hard, go early, go households’

 

Right at the start of the GFC, australian house holds were given a few thousand dollars directly to help maintain consumer confidence and a whole bunch of shovel ready projects were kicked off. Rebuilding public schools and the like. So future investments. 

 

It has prevented Australia from going into recession - the only major economy which avoided one. People stayed in work, kept paying taxes and we avoided people in their 40s and 50s being thrown on the long term unemployment scrap heap (which happened on the early 90s. Many people in that age bracket then never worked again).

 

2) it also reflects a massive drop off in mining royalties. 2008/09 was the end of the commodity super cycle and the federal coffers were overflowing up until that point.

 

Federal treasury as well as the reserve bank have a deliberate policy maintaining small budget surpluses over the course of business cycles, and has largely adhered to that. Surpluses are starting to accrue - things balance out. Our debt as a proportion of GDP is one of the lowest in the OECD, and we also have one of the lowest overall tax rates in the OECD.

 

It also doesn’t reflect off balance sheet items and savings. We have effectively privatised our pensions via compulsory contributions to our choice of managed funds. As a result Australia (25m people) has the third highest funds under management globally. We also have a sovereign wealth fund - the future fund - which pays for government employee liabilities. 

 

Our government - by any global standard - is very efficient. 

[bristolboy]

3 hours ago, roobaa01 said:

unconstiutional thats what the usa most successful donald trump said from the beginning but hapless without brain obama care nonsense claims the opposite.

 

and here we are newly elected waste ocasia-cortez cannot follow or yoga thus she needs time off instead of working.

 

wbr

roobaa01

Aren't you the person who predicted that Trump would be getting a Nobel Prize for his achievements in North Korea?

And when the Supreme court rejects the ridiculous ruling of that Texas judge, will you concede that "hapless without brain" applies to Trump?