Bernie Sanders already gearing up for 2020? [W:59]

[Greenbeard]

Are we looking at the same page?

There is no 2016 at the top of it.

We must not be, since I'm looking at your link and you apparently aren't.

Second, derided by who? The Urban Institute which ridiculously assumed minimal if any savings (I've already contested this with you if so)?

Third, show me the numbers regarding this assertion that this specific iteration of the plan assumes more than 100% savings on prescription drugs specifically.

Color me unsurprised you missed this gaffe last year.

Sanders assumes $324 billion more per year in prescription drug savings than Thorpe does. Thorpe argues that this is wildly implausible. "In 2014 private health plans paid a TOTAL of $132 billion on prescription drugs and nationally we spent $305 billion," he writes in an email. "With their savings drug spending nationally would be negative." (Emphasis mine.) The Sanders camp revised the number down to $241 billion when I pointed this out.

Anyway, he's now calling for a 7.5% payroll tax (versus last year's 6.2%), which just happens to be what employers already spend on health benefits. So the idea that suddenly employers won't be paying for health care anymore doesn't make much sense.

 

[Surrealistik]

We must not be, since I'm looking at your link and you apparently aren't.

https://i.imgur.com/R8yLqdt.png

Color me unsurprised you missed this gaffe last year.

I indeed wasn't aware of the first draft of the plan which made those assertions. However, assuming total cost savings that ultimately approach Canada's per capita expenditures, an instance of SP that isn't even among the most efficient examples of the system, isn't particularly unrealistic.

Anyway, he's now calling for a 7.5% payroll tax (versus last year's 6.2%), which just happens to be what employers already spend on health benefits. So the idea that suddenly employers won't be paying for health care anymore doesn't make much sense.

From the white paper: An employer’s first $2 million in payroll would be exempt from this premium protecting small businesses throughout the country.

In otherwords, this would likely mean a significant reduction to the average payroll costs, but your usual disingenuous attempts to discredit Bernie's SP plans are noted.

 

[Greenbeard]

I indeed wasn't aware of the first draft of the plan which made those assertions.

Yes, I noticed you'll defend Bernie's proposals quite vigorously before looking into how they're proposed to work.

From the white paper: An employer’s first $2 million in payroll would be exempt from this premium protecting small businesses throughout the country.

In otherwords, this would likely mean a significant reduction to the average payroll costs, but your usual disingenuous attempts to discredit Bernie's SP plans is noted.

This may come as a surprise to you, but the 7.5% of compensation employers dedicate to health benefits is tax exempt today. All of it, for all employer sizes and payrolls. We're talking about turning it into taxable income--say, wages--before payroll taxes (including Bernie's new one) are applied to it.

 

[Surrealistik]

Yes, I noticed you'll defend Bernie's proposals quite vigorously before looking into how they're proposed to work.

Except I was never a defender of the first draft having never seen it as we've established, beyond advocating the general superiority of SP. The earliest specific proposal I was familiar with and defended is the follow up which featured drug expenditures savings revised down to $241 billion (which I do find high, but the numbers in their totality of per capita spending jive, at least after SP is fully established and transitioned to).

This may come as a surprise to you, but the 7.5% of compensation employers dedicate to health benefits is tax exempt today. All of it, for all employer sizes and payrolls. We're talking about turning it into taxable income--say, wages--before payroll taxes (including Bernie's new one) are applied to it.

#1: Compensation dedicated to health benefits is almost certain to be reduced substantially (if not eliminated entirely for many/most employers) in the event of SP.

#2: Of the remaining compensation benefits dedicated to health, where in the white paper (or elsewhere) does Bernie propose turning this compensation into taxable income?

EDIT: Nevermind, missed it; the passage was bisected between two pages.

#3: Even assuming they were made taxable (presumably for the benefit recipient as an in-kind increment to salary as opposed to the employer), one must demonstrate an overall increment of average costs.

#4: Small businesses comprise nearly half the American economy by GDP and ~90% of businesses, which means that, the impact of the $2 million exemption is substantial in terms of average payroll costs.

 

[cpwill]

Zero? Private industry employers devote 7.5% of the compensation package to health benefits. Bernie calls for a 7.5% payroll tax on compensation to pay for Medicare-for-all.

....that would not come close to funding Medicare-for-all....

 

[Greenbeard]

#1: Compensation dedicated to health benefits are almost certain to be reduced substantially in the event of SP.

#2: Of the remaining compensation benefits dedicated to health, where in the white paper (or elsewhere) does Bernie propose turning this compensation into taxable income?

#3: Even assuming they were made taxable (presumably for the benefit recipient as an in-kind increment to salary as opposed to the employer), one must demonstrate an overall increment of average costs.

#4: Small businesses comprise nearly half the American economy by GDP and ~90% of businesses, which means that, the impact of the $2 million exemption is substantial in terms of average payroll costs.

The entire point here is that the 7.5% of compensation that's currently either being put aside to directly finance health care claims or is being dedicated to fully insured premiums is liberated. I'm being generous here and assuming that employers take that liberated cash and give it back to their employees in the form of higher wages; one would assume that eventually would happen in a competitive equilibrium. Are you instead asking that I assume employers horde it or give to shareholders or whatever and everyone now makes 92.5% of what they did before (prior to the new 7.5% tax being applied)? That doesn't help the case.

Anyway, assuming it all goes back to the employee in the form of wages, that portion of the compensation package becomes, for the first time, subject to income and payroll taxes (the new and the told). There's a reason the employer-based system is so entrenched and it's that a dollar of tax-exempt health benefits is more valuable to the employee than a dollar of taxable wages. Simply not adding an additional payroll tax onto those newfound wages doesn't rectify the disparity. That said, the more one assumes "don't worry, the new tax won't really raise any more revenue" the more suspicious one should get of the whole thing.

 

[Surrealistik]

....that would not come close to funding Medicare-for-all....

There's more to the proposal than a 7.5% payroll tax; the white paper features the other revenue streams.

 

[Greenbeard]

....that would not come close to funding Medicare-for-all....

I concur, I'm just taking the Gospel of Bernie at face value to make a point.

 

[cpwill]

There's more to the proposal than a 7.5% payroll tax; the white paper features the other revenue streams.

I'm going back and scanning it now. On top of the 7.5% payroll tax, he's going to put an additional 4% tax on working families (so, up to 11.5%).... and then it looks like he double counts the "savings" from shifting employer expenditures from pre-tax income to taxes-paid.

So, if I'm an employer and I paid out $100,000 a year in pre-tax healthcare benefits, and now I'm paying $100,000 in taxes.... you don't get to double-tax that $100,000; it's already paid in taxes. But he seems to be suggesting you can.

And, then, of course, he wants to jack the top Income Tax rate up to 52%, jack the top Capital Gains tax rate up to 52%, and pretend that human beings don't respond to incentives, and investors and workers are too dumb to plan ahead (With the exception of some taxes being raised in a manner that featured clawbacks/post-facto, I'm unaware of this ever really working out, but, hey, we already established with the "tax savings" above, we're solidly in the realm of magic, here).

Oh. And then he wants to raise the death tax. Because having already worked an paid taxes on money when you earned it, and then when you invested it, isn't enough. Yeesh.

He also apparently wants to drive US businesses overseas and go after the banks. That ends well.


...And Holy ****. A Wealth Tax. FUUUUUUUUUUUCK that.

 

[Surrealistik]

The entire point here is that the 7.5% of compensation that's currently either being put aside to directly finance health care claims or is being dedicated to fully insured premiums is liberated. I'm being generous here and assuming that employers take that liberated cash and give it back to their employees in the form of higher wages; one would assume that eventually would happen in a competitive equilibrium. Are you instead asking that I assume employers horde it or give to shareholders or whatever and everyone now makes 92.5% of what they did before (prior to the new 7.5% tax being applied)? That doesn't help the case.

Anyway, assuming it all goes back to the employee in the form of wages, that portion of the compensation package becomes, for the first time, subject to income and payroll taxes (the new and the told). There's a reason the employer-based system is so entrenched and it's that a dollar of tax-exempt health benefits is more valuable to the employee than a dollar of taxable wages. Simply not adding an additional payroll tax onto those newfound wages doesn't rectify the disparity. That said, the more one assumes "don't worry, the new tax won't really raise any more revenue" the more suspicious one should get of the whole thing.

Of course the new tax raises more revenue in net; this is not disputed; instead of monies going to private insurers incentivized per what is essentially a tax subsidy to upkeep a criminally inefficient system, it instead goes to the government.

The fundamental point is that the average, overall cost to businesses in aggregate in terms of payroll is likely to be reduced.

If you were to effectively eliminate healthcare compensation expenses due to lack of necessity and tack on a 7.5% payroll tax that doesn't even apply to what is a majority of businesses (so worker take home pay in those cases is not affected beyond income taxes obviously, nor does the employer pay more), the result is an overall average increment to payroll expenses that is very likely to be less than the existing 7.5% expenditure, even after tax deductions.

 

[Phys251]

Nah; if the polling data supports a run as it presently does, then he should run (as much as I love Tulsi, she doesn't have nearly the same popularity or awareness/recognition atm). If he runs _contrary_ to polling at the time, then yes, you might have a point.

Keep in mind that the last two Democratic presidents were not well-known outside their states prior to the primary.

The internet may change that some, but I have a hunch that the 2020 nominee may again turn out to be someone we didn't see coming.

 

[Surrealistik]

I concur, I'm just taking the Gospel of Bernie at face value to make a point.

Ironic as you've yet to make one.

I'm going back and scanning it now. On top of the 7.5% payroll tax, he's going to put an additional 4% tax on working families (so, up to 11.5%).... and then it looks like he double counts the "savings" from shifting employer expenditures from pre-tax income to taxes-paid.

So, if I'm an employer and I paid out $100,000 a year in pre-tax healthcare benefits, and now I'm paying $100,000 in taxes.... you don't get to double-tax that $100,000; it's already paid in taxes. But he seems to be suggesting you can.

I assume by 'paying $100,000 in taxes', you mean you're paying taxes on $100,000, rather than paying out an amount equivalent to the benefits you purchased.

That said, I do find the double tax aspect a bit puzzling; there are other tax breaks/deductions he mentions as eliminating besides health care premiums, but payouts for insurance premiums themselves should indeed be reduced substantially under an SP system; this is about the only thing that I have questions about in terms of its assumptions/breakdown and what it exactly means.

That said, no doubt there will be some companies who retain health care benefits, but I'm not so sure they'd be to the extent featured in those calculations. A more detailed breakdown would be welcome.

And, then, of course, he wants to jack the top Income Tax rate up to 52%, jack the top Capital Gains tax rate up to 52%, and pretend that human beings don't respond to incentives, and investors and workers are too dumb to plan ahead (With the exception of some taxes being raised in a manner that featured clawbacks/post-facto, I'm unaware of this ever really working out, but, hey, we already established with the "tax savings" above, we're solidly in the realm of magic, here).

Oh. And then he wants to raise the death tax. Because having already worked an paid taxes on money when you earned it, and then when you invested it, isn't enough. Yeesh.

He also apparently wants to drive US businesses overseas and go after the banks. That ends well.


...And Holy ****. A Wealth Tax. FUUUUUUUUUUUCK that.

I'm fine with all of this; society costs, and the economies of those countries which have such schemes in place, or even more onerous ones, certainly haven't collapsed in practice.

Capital gain deductions and such, barring the primary market (venture capital/IPO) are nonsense, and I say this even as someone who gets most of his income via CGs and dividends.

 

[Phys251]

....that would not come close to funding Medicare-for-all....

The Progressive Left never pauses to consider how politically untenable a 10-15% payroll tax is, even in the bluest of states. Ever. Single payer's disaster at the Colorado ballot box last year should have been enough to make that point. The argument we keep getting is that it's going to pay for itself in the long term, which for most people it really will not do until late in life. Could be true for those who are unfortunate to rack up ten-thousand-plus-dollar medical bills under the current system, however.

 

[cpwill]

I assume by 'paying $100,000 in taxes', you mean you're paying taxes on $100,000, rather than paying out an amount equivalent to the benefits you purchased.

No. Bernie's plan is to take the $100,000 I'm currently spending on health benefits for my employees, and take it in taxes instead. All of it. Then he thinks he's going to get the tax benefit of that $100,000 no longer being tax free..... when he's already taken it in taxes. So he thinks he's going to tax.... tax revenue.

Or, more likely, he or whoever helped him compile this list just stacked things that had "the rich" and "employers" attached to it, without thinking too deeply about how they would impact each other or the decisions of those "rich" "employers".

That said, I do find the the double tax aspect a bit puzzling; there are other tax breaks/deductions he mentions as eliminating besides health care premiums, but payouts for premiums themselves should indeed be reduced substantially under an SP system; this is about the only thing that I have questions about in terms of its assumptions/breakdown and what it exactly means.

Depends. If we are willing to accept reduced access to actual healthcare, then yes, SP can return lower premiums over time, by charging us via lost benefits instead. If, however, we want to continue to insist on having large amounts of exotic/high-quality care available to us quickly, and having someone else pay for it, then no, we will continue to all try to beggar each other (and we will continue to succeed).

That said, no doubt there will be some companies who retain health care benefits, but I'm not so sure they'd be to the extent featured in those calculations. A more detailed breakdown would be welcome.

He claims it would be very small, and limited to things like plastic surgery. I don't think that's where he's drawing the number from.

I'm fine with all of this; society costs, and the economies of those countries which have such schemes in place, or even more onerous ones, certainly haven't collapsed in practice.

This is destructive, especially in the long term. Telling capital and your highly productive companies and people that the best way to succeed is to leave is a poor plan for a country who wants to continue to see dynamic economic growth.

Recommended Reading

Capital gain deductions and such, barring the primary market (venture capital) are nonsense, and I say this even as someone who gets most of his income via CGs and dividends.

Capital is far more mobile, far more fungible, and far more elastic than "earned" income is. Hiking capital gains tax rates up like this is a great way to convince it to invest elsewhere.

 

[cpwill]

The Progressive Left never pauses to consider how politically untenable a 10-15% payroll tax is, even in the bluest of states. Ever. Single payer's disaster at the Colorado ballot box last year should have been enough to make that point. The argument we keep getting is that it's going to pay for itself in the long term, which for most people it really will not do until late in life. Could be true for those who are unfortunate to rack up ten-thousand-plus-dollar medical bills under the current system, however.

That's the ugly math no one wants to really look at. If you want to get European level benefits, you have to tax the crap out of the middle class, just as Europe does.

 

[Phys251]

That's the ugly math no one wants to really look at. If you want to get European level benefits, you have to tax the crap out of the middle class, just as Europe does.

Obama knew this when he made his push for the Affordable Care Act. At most it put a modest tax increase on the middle class, which has hurt its popularity from the get-go, but those taxes and their effects are often wildly exaggerated. Example: Karen Handel wrongly says Obamacare tax increase largest ever in her lifetime | PolitiFact Georgia And the working class effectively got a tax cut, at least in the states that chose to expand Medicaid!

 

[cuban smokes]

Has trump accomplished anything that he promised, yet you would vote for him again. Now, what specific policies of Bernie's didn't you like, what policies would destroy this country?

I think he actually made grabbing ***** great again .............. I'm still trying ...........

 

[cpwill]

Obama knew this when he made his push for the Affordable Care Act. At most it put a modest tax increase on the middle class, which has hurt its popularity from the get-go, but those taxes and their effects are often wildly exaggerated. Example: Karen Handel wrongly says Obamacare tax increase largest ever in her lifetime | PolitiFact Georgia And the working class effectively got a tax cut, at least in the states that chose to expand Medicaid!

Getting pushed on to sub-par insurance because the government locks out your options is hardly a tax cut.

But yeah. Rhetoric around taxes, for some reason, is always hyperbolic.

 

[Surrealistik]

No. Bernie's plan is to take the $100,000 I'm currently spending on health benefits for my employees, and take it in taxes instead. All of it. Then he thinks he's going to get the tax benefit of that $100,000 no longer being tax free..... when he's already taken it in taxes. So he thinks he's going to tax.... tax revenue.

Or, more likely, he or whoever helped him compile this list just stacked things that had "the rich" and "employers" attached to it, without thinking too deeply about how they would impact each other or the decisions of those "rich" "employers".

Wait what.

Okay, so, you're spending $100k in benefits right? How are you paying a 100% tax on that? Being taxed on the 100k at your corporate rate whatever it ends up being in the final calculus as a consequence of the loss of the tax credit is not at all the same as taking all of that in taxes.

My understanding is that you no longer get a tax deduction for healthcare compensation, and, for each employee enrolled in SP, you pay 75% of the average healthcare compensation per employee, or you pay 7.5% payroll tax, excluding the first $2 million of payroll.

Depends. If we are willing to accept reduced access to actual healthcare, then yes, SP can return lower premiums over time, by charging us via lost benefits instead. If, however, we want to continue to insist on having large amounts of exotic/high-quality care available to us quickly, and having someone else pay for it, then no, we will continue to all try to beggar each other (and we will continue to succeed).

That's absolutely not how SP works in practice; SP doesn't unequivocally mean some loss in access/healthcare quality, and its cost savings originate from economy of scale and negotiation contingent with that economy of scale as opposed to some systemic and substantial compromise in quality. If you want to argue about the relative quality of care for developed SP countries vs the States, you certainly can, but this isn't the thread for it (beyond that I feel we've already had this back and forth). However, the point is taken that businesses might choose to absorb the penalties per that perception which I imagine isn't at all exclusive, though I can't imagine anything short of a substantial decrease in premium payouts nonetheless.

He claims it would be very small, and limited to things like plastic surgery. I don't think that's where he's drawing the number from.

What I mean is that spending on premiums would remain existent but not to the extent that the white paper assumes at 4.2 tril revenue over 10 years in light of SP; there are other elements he mentioned, such as omission of tax benefits for cafeteria plans and the like, but those don't seem to be equal to that amount. Again, I'd like to get more details; without further elaboration/breakdown this seems to be a case of double counting, at least to some extent, where high SP enrollment is assumed as well as premium spending at existing rates which seems impossible.

This is destructive, especially in the long term. Telling capital and your highly productive companies and people that the best way to succeed is to leave is a poor plan for a country who wants to continue to see dynamic economic growth.

Recommended Reading

Capital is far more mobile, far more fungible, and far more elastic than "earned" income is. Hiking capital gains tax rates up like this is a great way to convince it to invest elsewhere.

Plenty of developed countries with such burdens of taxation appear to be getting along just fine; I don't buy the trickle down nonsense, never have, and never will. Economies are chiefly demand driven, and true long term viability is found in ensuring monetary circulation, particularly in that the poor and middle class, as the greatest generators of demand by % of income spent, actually have disposable income to spend. The benefits of special tax treatment of capital gains and dividends overwhelmingly accrues to the wealthy who are the worst generators of demand and spending pound for pound, and therefore cultivates and encourages economic stagnation long term.

What you want to encourage is capital investment specifically, and that is very different from just keeping taxes low on the rich; the latter may result in capital investment, but not necessarily. Capital investment seems best achieved through targeted and specific tax breaks; this is why I'm a fan of CG tax treatment for IPOs and venture capital, but not secondary market gains.

 

[Kobie]

Funny how you call yourself a "moderate" and then turn around and say, "We lost so badly that we had 3 million more votes".

The irony of YOU making this statement almost burned my retinas clean off.

 

[cpwill]

Wait what.

Okay, so, you're spending $100k in benefits right? How are you paying a 100% tax on that? Being taxed on the 100k at your corporate rate whatever it ends up being in the final calculus as a consequence of the loss of the tax credit is not at all the same as taking all of that in taxes.

My understanding is that you no longer get a tax deduction for healthcare compensation, and, for each employee enrolled in SP, you pay 75% of the average healthcare compensation per employee, or you pay 7.5% payroll tax, excluding the first $2 million of payroll.

Keeping this to simple numbers.

You pay $1.33 million currently in labor costs. $100,000 of that is in pretax healthcare benefits. Amount that is left for further taxation: $1.23 million.

Bernie wants to impose a 7.5% payroll tax, instead. Result: of the $1.33 million going into labor costs, $100,000 is taxed. Amount that is left for further taxation: $1.23 million.

Bernie is trying to now go back and say "Aha! But the $100k is no longer pre tax, so we can (ignore the fact that we've already taken 100% of it, and) tax it too!"; double counting that $100k to get back up to $1.33 million available for further taxation. But it's not there. He already took it.

That's absolutely not how SP works in practice;

Suggest you Google up the British N.I.C.E.

Every SP system has to ration. Government resources aren't infinite, and they typically aren't effectively spent.

If you want to argue about the relative quality of care for developed SP countries vs the States, you certainly can, but this isn't the thread for it

That's a cost imposed by SP, on top of immediate fiscal costs, just as insist access is a cost of our current system.

What I mean is that spending on premiums would remain existent but not to the extent that the white paper assumes at 4.2 tril revenue over 10 years in light of SP; there are other elements he mentioned, like omission of tax benefits for cafeteria plans and the like, but those don't seem to be equal to that amount. Again, I'd like to get more details; without further elaboration/breakdown this seems to be a case of double counting, at least to some extent, where high SP enrollment is assumed, but also premium spending at existing rates which seems impossible.

Yeah - as I said, I think this is more of a list of "things i think could be good ideas" than an integrated plan.

Plenty of developed countries with such burdens of taxation appear to be getting along just fine

Their long term growth is lower, their overall unemployment is higher, their unfunded liability problems are generally even worse (relatively) than ours, and their standards of living are generally lower. No thanks .

I don't buy the trickle down nonsense, never have, and never will. Economies are chiefly demand driven

I will never understand the insistence that you do not need something to sell in order to sell it.

Expressed demand is a function of supply. Theoretical demand can spur investors to create supply, but remains useless until it is successfully expressed.

You can no more consume yourself rich than you can increase the food in your larder by eating it all.

And true long term viability is found in ensuring monetary circulation, particularly in that the poor and middle class, as the greatest generators of demand by % of income spent, actually have disposable income to spend. The benefits of special tax treatment of capital gains and dividends overwhelmingly accrues to the wealthy who are the worst generators of demand and spending pound for pound, and therefore cultivates and encourages economic stagnation long term.

And who are the most likely to invest that money back to where it is most productive.

Meaning, not here, if we are foolish enough to try to jack up taxes on it to 52%. Capital will flee, and it will be wise to.

 

[Kobie]

So, so funny... Trump won the legal way the electoral college vote. Someone was to dense to campaign in Michigan, Wisconsin but I don't have to tell the story.

Mr. Trump won held 306 electoral votes and Hillary only 232! And that equals President Trump!

You seem to be almost intentionally missing the point.

When Trump supporters try to claim that Trump won with the support of the people ... well, no he didn't. He won by the rules, but he didn't win with some sort of mandate. More people voted for not him than him. That is incontrovertible fact. It doesn't make him Not President, but it also doesn't mean the will of the people was realized. Like it or not, states that Hillary won by a lot are still populated by Americans.

 

[Kobie]

Sure they did. Please show me all of the polls predicting a Trump win. There aren't any!

https://realclearpolitics.com/elections/2016/

This is like talking to a child.

POLLS DON'T PREDICT WINNERS. POLLS DON'T PREDICT ANYTHING. THAT'S NOT THEIR PURPOSE.

 

[Kobie]

Flock the insurance industry, they still have homeowners, auto, theft, liability, life and plenty of other things to insure. When one creature goes extinct, another rises to fill the niche. When I was sweating through the back country of SE Asia, I dreamt of a better life. I've lived and still have a much better life. I made it happened and didn't whine about what was.

Reality is the healthcare insurance industry has failed Americans. Time for an alternative that works for Americans, all Americans. Some of us are optimists who believe we can do, the rest are whiners holding back progress from improving life. We can see where you stand.

You gotta remember, these are the same people who say we can't get rid of COAL even though technology has overshot it by decades and it employs a relative pittance of people. They are receiving their marching orders, bought and paid for by passe industries that deserve to go the way of the horse and buggy.

 

[Surrealistik]

Keeping this to simple numbers...

Okay, this is what you meant by double counting in the sense of a 7.5% payroll tax assuming your payroll is greater than $2 million; I'm not sure I entirely agree with this assessment, keeping in mind that you're probably not allocating healthcare benefits (or at most allocating only partial, supplementary benefits) for those employees that opt in to SP, even assuming you do have a large enough payroll to be taxed in the first place. What I want to be clear about is that you're not getting hit with a tax bill for $100,000 per your example, so much as that you're getting virtually taxed on it in terms of losing the deduction for that labour expenditure, and getting potentially taxed at the payroll level.

What I meant by 'double counting' myself is more the idea of what seems to be an assumption in the white paper of there being a substantial premium spending base left to tax per the elimination of those deductions in the event SP is passed; I have my doubts, but again, I'd need to see the breakdown.

Suggest you Google up the British N.I.C.E.

Every SP system has to ration. Government resources aren't infinite, and they typically aren't effectively spent.

That's a cost imposed by SP, on top of immediate fiscal costs, just as insist access is a cost of our current system.

Yes, rationing exists in _every_ system: with SP you get rationing on the public end rather than on the private end; neither has unlimited funds for healthcare expenditure.

That said, the publicly spent dollars of virtually every SP system are allocated clearly and substantially more efficiently than the privately spent dollars of the US system, even if you assume the quality of care is compromised (which there isn't really any evidence in support of; if anything, evidence exists to the contrary vis a vis most SP/UHC systems outside of some forms of cancer care).

Yeah - as I said, I think this is more of a list of "things i think could be good ideas" than an integrated plan.

Well I can't pass any definitive judgments without seeing the numbers, but the essential conundrum is that the projected numbers seem especially high given that SP coverage and premium spending should be negatively correlated to a pretty high extent; needs a breakdown.

Their long term growth is lower, their overall unemployment is higher, their unfunded liability problems are generally even worse (relatively) than ours, and their standards of living are generally lower. No thanks .

Long term growth over what time frame? WW2 and its impacts distorts anything over 40 years substantially and its effects continue beyond (kinda helps to be the sole superpower in the wake of a war where pretty much everyone was ravaged to varying extents except you).

From what I can see growth is pretty clustered amongst a subset of iconic, developed countries: https://data.worldbank.org/indicato...cations=US-CA-DK-NL-NO-JP-DE-FR-GB&start=1961

The HDIs of many such developed countries is higher, especially after you adjust for inequality (i.e. you look at how the average person lives as opposed to an ultra-rich minority skewing the average).

Their democracies are more integral.

Their corruption tends to be lower.

Their freedom of the press tends to be higher.

Their net debt to GDP ratios are better with few exceptions per the IMF.

They live longer, and they're even happier.

They have better intergenerational economic mobility (with the notable exception of the UK).

Hell, quite a few are more economically free overall, and some even have better median incomes and purchasing power.

https://en.wikipedia.org/wiki/Democracy_Index

https://en.wikipedia.org/wiki/Corruption_Perceptions_Index

https://en.wikipedia.org/wiki/Press_Freedom_Index

https://en.wikipedia.org/wiki/List_of_countries_by_public_debt

https://en.wikipedia.org/wiki/List_of_countries_by_Human_Development_Index

https://en.wikipedia.org/wiki/List_of_countries_by_inequality-adjusted_HDI

https://en.wikipedia.org/wiki/Socio...nited_States#Comparisons_with_other_countries

https://en.wikipedia.org/wiki/Index_of_Economic_Freedom

https://en.wikipedia.org/wiki/World_Happiness_Report

Not bad places to live overall.

Also, anecdotally as a dual citizen, I generally prefer Canada to the States, I'll be honest (my living arrangements reflect this accordingly).