We Can Get More Poverty Reduction for Less Taxes.

Areas where we help the poor more and spend less tax money:

1. Replace TANF, SNAP, Social Security, housing subsidies etc. with an NIT
2. Replace Medicare and Medicaid with High deductible health insurance with deductible based on income.
3. Even if we do not do number 1 above, change our largest welfare program, Social Security to stop giving more to high life time earners and give everyone the same like they do in Australia.
4. We should force local Government to allow sufficient building so people can move to were the jobs are. It is an infringement of rights for local voters to limit the rights land of owners to subdivide and build housing. The default should be to allow all residential building. Note there are a very few occasions were it is justified but you need very good reasons.

Which of these are Republicans or Democrats for?

On a Negative Income Tax

I'm updating this because Ed Dolan convinced me that what I describe is really not a Basic Income Guarantee (BIG) but Negative Income Tax (NIT).

People are contending that the Negative Income Tax (NIT) would cost more than the current system but if you design it as outlined below it would save money.

Each  adult US citizen would get $200/week. To lower the cost you would:

• Raise the tax rate on lower income people to consume the BIG more rapidly, low earners currently pay no income taxes. Income up to $26,000/year tax rate would be taxed at a 40% rate. So at $26,000/year of earnings the net effect of the BIG on their income would be zero. The tax rates on income above $26,000/year would then drop to the current rate and rise as the current rate does from there. 
• With the BIG you eliminate SS.There is Absolutely no need for SS with a BIG! Also you would eliminate the minimum wage.
• And you replace Medicaid and Medicare with something like this:

The state would provide insurance to all Americans but the annual deductible would be equal to the family’s trailing year adjusted income minus the poverty line income (say $25,000 for a family of 4) + $300. So a family of 4 with a trailing year adjusted income of $30,000 would have a deductible of $5,300. A family of 4 with a trailing year adjusted income of $80,000 would have a deductible of $55,300. Middle class and rich people could fill the gap with private supplemental insurance but this should be full taxed. This would encourage the middle class and rich, who are generally capable people, to demand prices from medical providers and might force down costs. They could opt to pay for most health-care out of pocket while the poor often less capable would be protected.
It is not a perfect plan but it might help. Some deregulation of health-care would also help the poor gain access. The gauntlet that Doctors have to run these days to get to practice seems like an anachronism in today’s world. Let smart people get to practice medicine after on the job training. Let the medical businesses decide who is qualified to practice medicine. 12 years of training to tell if my child has an ear infection is overkill and reduces access to health-care for the poor.
Another benefit of my plan is that it would encourage capable Americans (the rich and middle class) to be a counter weight politically against the providers.

Of course our politicians are too corrupt to set up such a program but any discussion of a NIT is pure theory anyway.

All of our debt and inefficiency problems come from rationally ignorant voters and corrupt politicians. With rationally ignorant voters, politicians almost have to be corrupt of ignorant to get elected.

NOTE: You would still need programs for the very disabled. but they are few enough that the problem is manageable.

NOTE: US Democrats seem to think the Europeans have a better welfare system than we do, and that may be true, but ours and theirs seem unnecessarily inefficient. An NIT might give the USA the world's best welfare system.

My Updated Healthcare Compromise

This is my new compromise between advocates of government provided health insurance and those against. My earlier version may have had a flaw incentive wise so I am changing it. This version moves close to that put out by the Niskanen Center see here.

The state would provide insurance to all Americans but the annual deductible would be equal to 60% of each family’s trailing year adjusted income minus the poverty line income (say $25,000 for a family of 4) + $300. 

Why 60%, because some research by the Democrats has shown tax revenues are maximized at 70%, meaning most people will not hugely cut back at working at up to a 70% marginal tax and the current top rate in some states is about 50% already. I took the mid point between the two at 60%. 

So a family of 4 with a trailing year adjusted income of $30,000 would have a deductible of $5,300 * .6 or $3,180. 

A family of 4 with a trailing year adjusted income of $80,000 would have a deductible of $33,180. 

Middle class and rich people could fill the gap with private supplemental insurance but this should be full taxed. This would encourage the middle class and rich, who are generally capable people, to demand prices from medical providers and might force down costs. They could opt to pay for most health-care out of pocket while the poor often less capable would be protected. 

 

It is not a perfect plan but it might help. Some deregulation of health-care would also help the poor gain access. The gauntlet that Doctors have to run these days to get to practice seems like an anachronism in today’s world. Let smart people get to practice medicine after on the job training. Let the medical businesses decide who is qualified to practice medicine. 12 years of training to tell if my child has an ear infection is overkill and reduces access to health-care for the poor. It appears that medical care could much cheaper than it is, see here.

Another benefit of my plan is that it would encourage capable Americans (the rich and middle class) to be a counter weight politically against the providers.

Also it seems worthwhile to me to maintain flexibility in the system. Our slightly more freedom oriented medical  systen looks not so great right now because we spend more than the other developed countries but things are still changing and our more flexibility may start to pay off at some point. 

Here are some possible avenues for that flexibility to pay off:

• Direct Primary Care (DPC) also called Concierge Medical Care. I've been reading good things about this recently.
• Medical Tourism groups like the Amish already do some of this already, and maybe surprisingly so do people from countries like the UK with Universal health insurance coverage. 
• Dean Baker's idea of allowing foreign providers to come into the USA market.

One, all or none of these things might workout and others not mentioned but it is worth maintaining some level flexibility and freedom.   

Here is an article that makes a strong case for a system similar to the one that I propose.  His plan suggests a  insurance for catastrophic events that cost more than, $50,000 combined with a large health savings account.

In addition since Government provided health insurance is paternalism it should provide insurance that experts would recommend and that means among other things insurance that only pays for care that shows a significant margin of cost benefit. So it should not cover procedures that the UK's NHS does not cover. There would be huge savings there.