Should the US expand Medicaid to 400% of the Federal Poverty Level

[Theo520]

They are scarce by design. Production will not exceed what they can sell at the cost that is being demanded. The idea of the super high pricing has little to do with actual production costs, and more to do with either passing on R and D, or as we have seen proven in court, profiteering. True, you shouldn’t have to go to Canada, or order illegally, some drugs. But if the life of a loved one was at stake, who wouldn’t?

No, I don’t blame people for going to Canada, it is the only rational decision. Changing our policies could dramatically reduce the US price of many of those drugs. The drug companies would probably spend less on marketing and their R&D costs would be distributed over global sales, not just US sales.

 

[RCIAGraduate]

In theory, couldn’t we just replace private funding with expanded subsidies for the National Institutes of Health? If raising taxes can help ensure a floor of coverage and care for people, may I ask why not? Perhaps there is a “goldilocks” zone where we can pay for what we need while staying competitive? Or would raising taxes possibly risk future growth and opportunity (but what about our obligations for those in need. some of whom are in situations through no fault of their own like being born in the “wrong” family, community with the “wrong” genetics)?

 

[Socrates92]

Of course, but that does not refute my point. There is no reason to believe that roads would cease to exist, if governments ceased to “care” for them. The private sector could just provide a more efficient means of pricing out the use of the roads.

Under my ideal model, roads would be privately owned, and companies/individuals would be billed according to their use of the roads. This would be based on the actual incurred maintenance costs per use (ie: semis would not pay the same rate as cyclists). And of course I would not avoid paying for upkeep simply because I didn’t personally drive on them. The travel costs incurred by business would simply be included in their other operating costs and priced into their business model. Would this increase cost of goods? Probably not. Especially if, as should happen, other taxation currently allocated to road upkeep were done away with (which may not happen, but that’s a political question, not an economic one). This would also provide an incentive to economize on usage - thereby reducing both unnecessary weardown and congestion.

You could also reasonably expect quality improvements. With government roads, there is no real incentive to provide upkeep in a timely manner. If roads were privately owned, failing to upkeep/taking too long on construction would = lost revenue. Unfortunately, there is no pay to opt out of taxes if the government sucks at upkeep.

I’m ok with arguments that this might not have worked too well in the past, but I don’t think that argument holds much water in the modern age. Companies like Walmart and Amazon wouldn’t simply throw up their hands and go out of business if we taxpayers ceased to subsidize their road usage, believe me.

 

[Socrates92]

In other words, of course I will be paying for roads regardless. That is not the question. The question is through what method will I (and everyone else) be paying for them. Property taxes are, imo, a pretty nonsensical and inefficient method when compared to a model based on actual usage.

The fact that others require roads to deliver my groceries, for example, should simply be seen for what it is, a cost of doing business in the grocery industry. As such it should be priced into food prices the same way most other business expense is (ie: the one’s we taxpayers don’t subsidize).

 

[DarkLight]

The worry is that the economic equilibrium could very well mean a large part of the population is simply unable to care for themselves. Economics doesn’t care if you can work or not; it doesn’t care if people starve or die of easily treatable conditions. If people dying off leads to better economics, that’s what pure economics will do.

There’s a reason we got away from a lot of unregulated stuff - because people did die due to poverty. People died of, say, radiation poisoning because it was more economical to use poisonous chemicals to make a better match than to create a safe working environment. And with the demands of the job they were hardly able to get other options!