Should government tax revenues be more, less, or the same as now?

[fskimospy]

It's a complex issue and it comes down to how you define outcomes. The data I've seen shows that we do extremely well in outcomes when you look at something like 5 year mortality rates for a given cancer but poorly for overall health compared with other OECD countries.

The bottom line is that we are less healthy because we live less healthy lifestyles. We receive more and higher quality health care but that can't offset the effect of lifestyle factors on overall health. We also spend much more on end of life care which by it's nature has a minimal effect on health outcome numbers. We aren't getting a particularly good value for our money which is why I'm willing to trade lower quality and quantity for lower costs.

This is a common misconception. There are a number of OECD countries who compare quite favorably with the US on health outcomes like heart attacks, strokes, and cancer. (there are many different types of cancer however, and who is better varies) Health systems are generally not rated in a policy perspective by overall health because it is a poor indicator of what is actually happening when people interact with a health system. (ie: if you never even go to the doctor, why should it be counted against the health system?)

You might be interested to learn that recent health research shows that unhealthy people actually cost the system LESS money than healthier individuals. This is because...well.. unhealthy people tend to die before they consume as many health care resources. Our focus on end of life care is most certainly one driver of health costs, but it does not nearly explain the vast disparity in cost vs. quality. Interestingly enough, a single payer system would be far more able to control end of life costs in this way.

 

[the DRIZZLE]

This is a common misconception. There are a number of OECD countries who compare quite favorably with the US on health outcomes like heart attacks, strokes, and cancer. (there are many different types of cancer however, and who is better varies) Health systems are generally not rated in a policy perspective by overall health because it is a poor indicator of what is actually happening when people interact with a health system. (ie: if you never even go to the doctor, why should it be counted against the health system?)

You might be interested to learn that recent health research shows that unhealthy people actually cost the system LESS money than healthier individuals. This is because...well.. unhealthy people tend to die before they consume as many health care resources. Our focus on end of life care is most certainly one driver of health costs, but it does not nearly explain the vast disparity in cost vs. quality. Interestingly enough, a single payer system would be far more able to control end of life costs in this way.

Can you post some of the data you are referring to regarding outcomes from specific diseases? Single payer certainly could reduce end of life costs (death panels!) but we could do the same thing under the existing medicare system. The fact that we haven't shows there is no political will to do this. They Ryan plan would also work but through a different mechanism and was also skewered by the Dems.

 

[PokerGuy]

Can you explain how other states that spend vastly less than we do achieve similar levels of quality in health outcomes?

Yep, I'll do that as soon as you can find another country that has the same demographics, ethnic mixes, culture, diet, lifestyle, environment and crime rates to make a good comparison. We'll be waiting.

 

[fskimospy]

Can you post some of the data you are referring to regarding outcomes from specific diseases? Single payer certainly could reduce end of life costs (death panels!) but we could do the same thing under the existing medicare system. The fact that we haven't shows there is no political will to do this. They Ryan plan would also work but through a different mechanism and was also skewered by the Dems.

The Ryan Plan is nothing more than cost shifting onto the private health system, it addresses Medicare expenditures, but not total health system expenditures.

Sure, here's some OECD data on a bunch of different cancers and outcomes.

http://www.oecd.org/document/34/0,3746,en_2649_33929_37088930_1_1_1_1,00.html

Five year survival rates are usually considered the best measure for cancer, but there is some debate about the effects of early detection, as if you detect a cancer earlier you have a better chance of curing it but it also starts the clock ticking on terminal cancers earlier which skews results as well.

What you will generally find is that the US ranks among the best in most categories, but if you examine other OECD countries you will see they generally are within a few percentage points of us. When you relate outcomes to level of health expenditures however you find that the US is spending sometimes double or even more what these other countries are for a very marginal benefit.
http://www.kff.org/insurance/snapshot/oecd042111.cfm

 

[fskimospy]

Yep, I'll do that as soon as you can find another country that has the same demographics, ethnic mixes, culture, diet, lifestyle, environment and crime rates to make a good comparison. We'll be waiting.

Oh, you're on this 'nobody can ever know anything ever' kick again. I'm terribly sorry that you don't understand policy analysis, but I'm not going to be the one to teach it to you.

 

[Anarchist420]

That is an incredibly dumb comparison.

GDP of Grece in 2010: $300 billion
GDP of America in 2010: $14.5 trillion

They have 2% of our GDP, why would we compare debt levels in absolute terms with them?

What about GDP/capita and debt/capita? What about market distortions? Suppose the U.S. gov has mandates that cause higher prices and Greece has mandates that cause lower prices? Americans also spend a lot on explosives that don't last and that raises GDP.

Yep, I'll do that as soon as you can find another country that has the same demographics, ethnic mixes, culture, diet, lifestyle, environment and crime rates to make a good comparison. We'll be waiting.

Agreed. America is too heterogeneous and governments should not have a choice as to what people consume.

 

[fskimospy]

What about GDP/capita? What about market distortions? Suppose the U.S. gov has mandates that cause higher prices and Greece has mandates that cause lower prices?

/facepalm

 

[The-Noid]

Spending much less, revenue much more. How about that answer.

Long-term we literally need to spend approximately 25% less across the board and raise tax revenues by 25% according to the CBO. That assumes medical cost increases actually do shrink to 3%/annum by 2020 (hint, they wont.)

The good thing is based on these budget assumptions, the US debt will only be 139% of GDP when the next presidential election takes place in 2016. That to me seems sustainable!

Also, in no way do I blame Obama. This has been decades long failings in the making. At some point everything will come to a head, similar to Greece the rest of the Eurozone and soon Japan.

The great thing about markets is you can borrow, until you can't. No one wakes up one day and decides they are insolvent. The liquidity markets do that for you. If we have learned anything from the Eurozone it is that when it happens it comes quickly and abruptly.

 

[hal2kilo]

What about GDP/capita and debt/capita? What about market distortions? Suppose the U.S. gov has mandates that cause higher prices and Greece has mandates that cause lower prices? Americans also spend a lot on explosives that don't last and that raises GDP.
Agreed. America is too heterogeneous and governments should not have a choice as to what people consume.

lol wut?

 

[a777pilot]

There is only one sure way of getting our economy working agian....get rid of obama and those in Congress that support his failed ideas.

 

[FoBoT]

tax rates should be consistent over long periods of time and not be changed frequently for 'political' reasons. this makes is easier for citizens and businesses to plan

fluctuations in tax revenue should be adjusted for equally (50/50) between borrowing (deficit) and spending cuts, not just by borrowing as we do now

i support total overhaul of corporate and personal income tax system. a simple 10% of income flat rate for all (corporate and personal) and all types of income (capital gains or earned, etc) with no preference loop holes or exceptions/deductions

to make up the difference needed, institute a federal VAT or transaction tax on every monetary transfer made (ie i buy milk at walmart, i pay a small federal tax, General Electric buys 1000 tons of steel for a factory, they pay a transaction fee etc etc)

 

[fskimospy]

tax rates should be consistent over long periods of time and not be changed frequently for 'political' reasons. this makes is easier for citizens and businesses to plan

fluctuations in tax revenue should be adjusted for equally (50/50) between borrowing (deficit) and spending cuts, not just by borrowing as we do now

i support total overhaul of corporate and personal income tax system. a simple 10% of income flat rate for all (corporate and personal) and all types of income (capital gains or earned, etc) with no preference loop holes or exceptions/deductions

to make up the difference needed, institute a federal VAT or transaction tax on every monetary transfer made (ie i buy milk at walmart, i pay a small federal tax, General Electric buys 1000 tons of steel for a factory, they pay a transaction fee etc etc)

Your plan will almost certainly enormously raise your tax bill. Are you ok with this?

 

[evident]

federal water socialism eh?

 

[JSt0rm]

It's a complex issue and it comes down to how you define outcomes. The data I've seen shows that we do extremely well in outcomes when you look at something like 5 year mortality rates for a given cancer but poorly for overall health compared with other OECD countries.

The bottom line is that we are less healthy because we live less healthy lifestyles. We receive more and higher quality health care but that can't offset the effect of lifestyle factors on overall health. We also spend much more on end of life care which by it's nature has a minimal effect on health outcome numbers. We aren't getting a particularly good value for our money which is why I'm willing to trade lower quality and quantity for lower costs.

You need to show your data because there are a ton of western countries giving high quality healthcare to the majority of their citizens with far less waste then we do and lots of numbers to back that up all over the place.

 

[IronWing]

federal water socialism eh?

Jimmy Carter tried to end federal water socialism and it cost him the support of just about every Dem senator in the west. The issue did him more damage than the attack rabbits dreamed of doing.

 

[woolfe9999]

It's a complex issue and it comes down to how you define outcomes. The data I've seen shows that we do extremely well in outcomes when you look at something like 5 year mortality rates for a given cancer but poorly for overall health compared with other OECD countries.

The bottom line is that we are less healthy because we live less healthy lifestyles. We receive more and higher quality health care but that can't offset the effect of lifestyle factors on overall health. We also spend much more on end of life care which by it's nature has a minimal effect on health outcome numbers. We aren't getting a particularly good value for our money which is why I'm willing to trade lower quality and quantity for lower costs.

Our life spans are generally about 3 years shorter than in most European countries and IIRC Canada. Are our lifestyles worse? Obesity is much worse here, but then again, I think we have about 20% smokers here and it's about 35% in Europe. Let's say our lifestyles are overall somewhat less healthy here, and that accounts for the lifespan difference. That leaves roughly equal outcomes for healthcare if averaged out over the entire systems. Yet they spend about half on it.

 

[Siddhartha]

I think tax revenues should be less and a lot of government revenue should come from sales of military weapons, the National Parks system, and reduction of federal water socialism. Ideally, the state would be abolished. However, it can't all be done in one step.

From Obama's requested budget I figured out at least $1.9Tn that could be reasonably cut, $500Bn (guesstimate) of which includes his requested tax increases cut, Obamacare cut, and some new tax reductions. Those tax reductions are as follows:
reduction of the Corporate tax to a 13% flat marginal rate and removal of all employer/corporate deductions for health expenses;
repeal of capital gains taxes on precious metals;
repeal of the AMT (we didn't have it before LBJ was President);
increase of personal deductions including personal deductions for all medical expenses, combining the personal exemption and standard deduction into an automatic exemption;
allowing complete deductions of state and local property and income taxes (whenever applicable);
100% individual income tax free HSAs


There would be two tax increases: which would be a low fee on all goods flowing into and out of the country (that would replace the current tariffs and all quotas would be repealed so there would be no more protectionism).

Sar-Ox and Dodd-Frank need to be completely repealed also.

I think the above is generally reasonable considering what we could face if we don't balance the budget immediately. The poor would not suffer more than the wealthy under my budget which means there wouldn't be any riots. Some poor would suffer, but not as much as the MIC, Big Pharma, and protected, subsidized corporations would be cut off.

Your poll is really asking:
Would you rather pay less or more taxes?
Do you want free lunch?
Do you want to kill the Federal government?

 

[a777pilot]

Your poll is really asking:
Would you rather pay less or more taxes?
Do you want free lunch?
Do you want to kill the Federal government?

1. Less and based on something other than income and/or private property.

2. No.

3. Kill it? NO! I want a lot less of it.

 

[Craig234]

Jimmy Carter tried to end federal water socialism and it cost him the support of just about every Dem senator in the west. The issue did him more damage than the attack rabbits dreamed of doing.

It speaks pretty badly of American citizens that the fact a rabbit swam near his boat had a large political impact over actual policies like, say, energy independence.

 

[Anarchist420]

Would you rather pay less or more taxes? Do you want free lunch? Do you want to kill the Federal government?

I think no one should have to pay any taxes. Free lunches are good if they aren't paid for via theft. Yes, I want to the abolish the federal government.

federal water socialism eh?

Federal water socialism is where the federal government owns the offshores. It sucks that they do because that gives them control of resources. Most importantly, however, they aren't a legitimate entity.

 

[fskimospy]

I think no one should have to pay any taxes. Free lunches are good if they aren't paid for via theft. Yes, I want to the abolish the federal government.
Federal water socialism is where the federal government owns the offshores. It sucks that they do because that gives them control of resources. Most importantly, however, they aren't a legitimate entity.

This is so obviously trolling at this point.

 

[a777pilot]

It speaks pretty badly of American citizens that the fact a rabbit swam near his boat had a large political impact over actual policies like, say, energy independence.

Except that Carter had no energy independence plan.

 

[woolfe9999]

This is so obviously trolling at this point.

You're projecting far too much rationality on him by labeling him a troll. There is no doubt in my mind that he actually believes these things.

 

[modestninja]

The Ryan Plan is nothing more than cost shifting onto the private health system, it addresses Medicare expenditures, but not total health system expenditures.

Sure, here's some OECD data on a bunch of different cancers and outcomes.

http://www.oecd.org/document/34/0,3746,en_2649_33929_37088930_1_1_1_1,00.html

Five year survival rates are usually considered the best measure for cancer, but there is some debate about the effects of early detection, as if you detect a cancer earlier you have a better chance of curing it but it also starts the clock ticking on terminal cancers earlier which skews results as well.

What you will generally find is that the US ranks among the best in most categories, but if you examine other OECD countries you will see they generally are within a few percentage points of us. When you relate outcomes to level of health expenditures however you find that the US is spending sometimes double or even more what these other countries are for a very marginal benefit.
http://www.kff.org/insurance/snapshot/oecd042111.cfm

Thanks for the links. There looks to be a nice amount of data there.

 

[IronWing]

Federal water socialism is where the federal government owns the offshores. It sucks that they do because that gives them control of resources. Most importantly, however, they aren't a legitimate entity.

Oh, I thought you were writing about actual federal water socialism where the federal government built massive water projects across the west and sold the water at rates far below the construction costs, subsidizing favored users and passing these un-recovered costs onto taxpayers everywhere. My mistake for thinking you were referring to a real issue.