From: fslsh@ocs01.lerc.nasa.gov (Lennart S Hultgren)
Subject: Re: I desperately need lower taxes.
Organization: NASA Lewis Research Center
Date: Thu, 16 Apr 1992 15:46:06 GMT

In article <1992Apr15.071821.29555@eua.ericsson.se> euafri@eua.ericsson.se (Fredrik.Ostman) writes:
[Stuff deleted]
>
>Yes it does. Imagine the cure of a common cold costs $1,000,000,000.
>Every Swede has two colds a year. Can we actually afford to pay
>$18,000,000,000 every year? Would it be easier to pay it via taxes,
>raising the amount to, say, $25,000,000,000 because of the inefficiency?
>
>Surgery won't cost more because you pay it without involving the taxman.
>It will cost less.

On this side of the atlantic it has been estimated by some that up to
25% (at least that what I heard on TV News) of the total cost of the
health care in US represents administrative costs with much of it
caused by the doctors and hospitals needing to process insurance
claims and payments by *many* different insurance companies.  That may
be an overestimate but it is clear that things are not always
efficient because the taxman is not involved.

Physicians and hospitals also pass on the costs on providing health
care for the uninsured -- usually provided in the *very* expensive
emergency care unit even when not called for since there are
restrictions about turning away patients from those units -- to paying
customers thus leading to higher price of the insurance to both
employer and employee, higher deductibles and copayments.

Personally, I still prefer the US system with private insurance -- in
particular the fee-for-service plans -- since `socialized' medicine
usually leads to health care rationing and less choice.  However, the
system here needs some reform since i) we probably already pay to much
in passed-on costs for uninsured persons, ii) unemployment = soon no
insurance = real problem, and iii) if you have a catastrophic illness
or accident you still may get totally whiped out even if you are
insured.  What is probably needed here is some kind of limited base
insurance avaible to all supplemented by private insurance.  Whether
the taxman or just the legislator should be involved in this is still
an open question.

I am sorry if this has started to sound like an entry in
american.health.insurance.reform.talk.talk.talk, however the US health
care system and its merits and problems is a valid comparison point
since you obviously want to dismantle the current Swedish one.

Simple statements that things will cost less because the taxman is not
involved just does not cut it.  One usually ends up paying through the
nose one way or another anyway.  The big difference between Sweden and
US for middle income wage earners (setting aside all arguments about
efficiency and fairness) is probably not the *total cost* you actually
end up paying through taxes and fees for health, education, and such,
but that in Sweden the goverment takes a big cut up front and deliver
services to you whether you like or need it or not but over here you
have more choice where you want to put your money, take risks, etc.
You also have to take more responsiblity for your own situation and
future since there is very little of a societal safety net here.

--
Lennart S. Hultgren           | SnailMail: Mail Stop 5-9   | Any similarity of 
Email: hultgren@lerc.nasa.gov | NASA Lewis Research Center | my views and those
Voice: (216) 433-6070         | Cleveland, OH 44135        | of my employer are
FAX:   (216) 433-8864         |                            | purely accidental
Newsgroups: soc.culture.nordic