99 $T - trillion, (not billion) $99e12 - budget deficit over the next 70 years or so, for health care and Social Security spending. It that's not a sign that government "insurance" programs are broken, what is? I'll focus on health care here, but much the same is true of social security.

Merely increasing spending - cutting elsewhere (typically military spending) - won't fix this. Demand for health care is quite elastic, and if "someone else" is willing to pay more, consumption will simply expand. The same goes for cutting health care costs, by the way - if it's cheaper, people will consume more. (Some go so far as to claim there'll be "economies of scale" - that health care will get cheaper in volume, or that bureaucrats wielding the clout of millions of consumers will be able to force lower pricing on providers. At best they'll displace costs from one area to another, while introducing huge inefficiencies.)

No, the only real solution is to eliminate the "someone else pays" aspect. Privatize health care as much as possible.

Defenders of big government mentally jumped to "Oh, so you just want to let poor people die, don't you, you heartless scum!" I guess that makes them feel all warm inside. Odd how their defense of "the poor" somehow entails forcing the huge majority "non-poor" into the same program. Of course it's not really odd - their objective is to coerce those who are able to pay for their own care to pay for an equal level of care for the poor. Too bad if that that ends up costing more AND rationing care for those who could have afforded better - after all, why should earning more money translate into better health care? Besides, people need health care rationing, or they might waste money trying desperately to save their own life or that of a loved one - e.g. paying twice as much for a treatment only 10% more effective. What a waste!

Everyone should be allowed to deposit as much tax-free money as they like into health savings accounts, retirement savings accounts, catastrophic medical insurance and life insurance. At most, government might send people a letter once a year telling them about how much they should be putting into savings and insurance, to maintain their current quality of life.

Yes, I hear you still yelling "BUT WHAT ABOUT THE POOR!" Well, with the lower health care costs that will come from private payers, the most common treatments will be much cheaper. Some recent trends look promising - health care provided in pharmacies, physician's assistants, etc. Government could take a role however. It could limit payments for "malpractice" to a sensible level. It might be sensible to reform health insurance - insurance companies wouldn't be liable for pre-existing conditions, but would be liable for all conditions arising in their subscribers, even if they subsequently "leave" that company.

If we really must tax and spend some, do it through private charities, via dollar matching. Monitor newer charities to make sure they aren't just stealing funds, but don't over-burden charities with red tape. Of course, using tax money will cut into people's willingness to pay for chartible causes, so I expect this will be worse than spending no tax money at all.


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