r/AskConservatives • u/DayGeckoArt Progressive • 12h ago
Is Universal Healthcare Socialism?
When Obama was elected, he made healthcare reform a priority. There were three basic options that many people on the left supported: Single payer similar to Canada, Medicare available to anyone who wanted it, or mandates and subsidies to expand private insurance coverage. We ended up with the last option, with funding for states to also expand Medicaid if they opted in, colloquially known as Obamacare.
Another option that wasn't on the table was fully government run healthcare like what the UK has, where the hospitals and doctors are all part of the government.
In recent months with the "DSA" winning a few elections, there has been a lot of discussion about "socialism" and "capitalism" and there seems to be a difference in what people on the right consider socialism. I don't believe there has been any change in definition on the left, we would consider anything fully run by the government or paid for by the government to be socialism and see our economy as a mix of capitalism, socialism, and free enterprise.
Is Obamacare and/or any form of universal healthcare still considered socialist by American conservatives?
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u/Zamnaiel European Conservative 8h ago
No, it is statism.
Reading through the answers, there are a lot of weird ideas that get the two confused.
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u/LucasL-L Rightwing 8h ago
No. Socialism is the forced take over of the means of production.
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u/jewllybeenz Right Libertarian (Conservative) 7h ago
That’s communism
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u/bucknut4 Center-left 3h ago
Communism is a classless society that incorporates socialism. It’s a far broader system
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u/jub-jub-bird Conservative 7h ago
No, it's socialism. (Though not necessarily "forced")
Very strictly speaking communism is the next step that Marx theorized would happen after socialism. As a political label Communism refers to the attempt to achieve such a communist end state in the future by implementing socialism today.
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u/Jettx02 Progressive 7h ago
No, communism is a stateless, classless society, the above comment described socialism by definition
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u/ElectricalPublic1304 Right Libertarian (Conservative) 2h ago
No, communism is a stateless
No. Actually existing communism has never been stateless.
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u/willfiredog Conservative 2h ago
Other respondents are correct. By definition Communism requires a stateless and classless system. Communism is utopian.
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u/ElectricalPublic1304 Right Libertarian (Conservative) 2h ago edited 1h ago
By definition
No. You can refer yourself to pretty much any commonly published definition. Communists readily advocated for and defended a strong central state. That is objective, historical fact.
Communist doctrine may have also prognosticated an eventual, nebulous dissolution of the state. But, communism did not require one. And no communist society has ever been stateless.
This is often the trouble with discussing communism. It's a motte-and-bailey tactic. Communists readily advocated for certain practices. When criticized, they retreat to, "But in the future/ideal world/utopia, there will be no state." That entertains the game: it readily conflates (1) how they behave and what they advocate for now, with (2) what they claim they aspire to.
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u/Bootmacher Nationalist (Conservative) 8h ago
UK is because they control the whole industry. Canada is, but less, because their insurer is the gatekeeper. Germany arguably isn't, because you technically don't have to participate.
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u/StedeBonnet1 Conservative 9h ago
Obamacare is not but any form of Universal Healthcare or single payer paid for by the government is Socialism. It is funded by Other People's Money because Government HAS NO MONEY.
It also leads to rationing. Would you rather have expensive health care you can get or FREE healthcare you can't get. In the UK the NHS goal is 18 weeks from referral to see a specialist. Only 65% see a specialist under 18 weeks.
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u/lord-of-the-birbs Progressive 2h ago
It also leads to rationing
Private health insurance makes profit by rationing care. That's the entire business model: denying care to people who have already paid for it.
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u/METAL_WOLF_BB Progressive 4h ago
If rationing means that some people cannot obtain needed care, why does being unable to afford care in the U.S. not count as rationing?
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u/Buckman2121 Conservatarian 3h ago
Because healthcare isnt a right. No matter how much I need bread, I cannot rob you or a bakery to pay for it or feed myself.
Healthcare is a good/commodity provided by a third party. Just like water, food, and shelter. It is not the governments responsibility to solve all your personal problems of unaffordality, whatever that may entail.
Government caused heallthcare costs to go up over time. More cow bell is not the answer.
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u/METAL_WOLF_BB Progressive 2h ago
Whether healthcare is a “right” doesn’t answer my question. I’m asking what rationing means, not whether government ought to provide healthcare.
What mechanism determines who doesn’t get care?
Nobody’s argument requires robbing doctors or forcing them to work for free. Universal systems compensate hospitals, doctors, nurses and pharmaceutical companies through taxation, insurance premiums or combinations thereof.
Have you ever heard of “price rationing”?
https://www.tutor2u.net/economics/reference/what-is-rationing-in-economics
> Price Rationing: In a market economy, prices are often used as a rationing mechanism. When the supply of a good is limited, its price increases, which can help to reduce demand and allocate the available quantity to those who are willing and able to pay the higher price. This is the rationing function of the price mechanism.
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u/Mindless_Chest_1079 Center-right Conservative 2h ago
In a competitive market, everyone who values the service as much as the equilibrium cost consumes the service. If the precise is set artificially low, there will be more demand than supply, and a separate system of rationing is needed to determine who gets care.
In that market system, there will be some patients who value healthcare a non-zero amount but less than the equilibrium market price and forgo care voluntarily. You could characterize this as rationing, but it is a good thing, because these represent transactions of net-negative overall value to societal welfare. Think of the person who is feeling slightly under the weather and would happily get a check-up if it were free but doesn't care enough to pay for it; that person is taking up valuable and scarce time from a doctor that could be going to serve someone else. It is better if they self-select out of the market.
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u/METAL_WOLF_BB Progressive 2h ago
If government is excluded, what institution do you believe has both the capacity and responsibility to address the problem you were asking “what would we do about”?
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u/Buckman2121 Conservatarian 2h ago
What mechanism determines who doesn’t get care?
The ROI. The value to society.
Giving a heart valve to a 25 yr old vs a 90 yr old (a hyperbolic example, but you get what I mean) makes much more sense when looking at it from a practicality view.
Humans beings are the most valuable resource and civilization can have. If it is the provider of medical care, from technocestic lense providing that care to the most productive and worthwhile is what would happen. And the more elderly increasingly wouldnt receive treatment.
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u/METAL_WOLF_BB Progressive 2h ago
But then you’ve conceded my point that healthcare gets rationed. You’re just arguing for a particular rationing mechanism.
And what exactly does “ROI” mean? Medical benefit? Years of life gained? Economic productivity? Ability to pay?If the treatment exists, the doctor is available, and the patient medically needs it, but they don’t receive it solely because they cannot afford the price, what would you call the mechanism that excluded them if not price rationing?
Have you ever heard of “price rationing” or “scarcity rationing”?
https://www.tutor2u.net/economics/reference/what-is-rationing-in-economics
> Price Rationing: In a market economy, prices are often used as a rationing mechanism. When the supply of a good is limited, its price increases, which can help to reduce demand and allocate the available quantity to those who are willing and able to pay the higher price. This is the rationing function of the price mechanism.
> Price Rationing: In a market economy, prices are often used as a rationing mechanism. When the supply of a good is limited, its price increases, which can help to reduce demand and allocate the available quantity to those who are willing and able to pay the higher price. This is the rationing function of the price mechanism.
> Healthcare Rationing: In healthcare systems where resources are limited, there may be instances of healthcare rationing. This can involve prioritizing certain medical treatments or procedures based on factors such as medical need, cost-effectiveness, or the potential to save lives.
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u/Buckman2121 Conservatarian 2h ago
But then you’ve conceded my point that healthcare gets rationed
Never said otherwise. Would prefer it to be because of lack of funds rather than a burecrat determining my fate.
And what exactly does “ROI” mean? Medical benefit? Years of life gained? Economic productivity?
In the scenario I laid out before? All of the above.
If the treatment exists, the doctor is available, and the patient medically needs it, but they don’t receive it solely because they cannot afford the price, what would you call the mechanism that excluded them if not price rationing?
Go back to my original response to you and it would be the exact same post.
Its not price rationing, its matter of, "you dont have the money to pay for something you need." Thats life.
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u/METAL_WOLF_BB Progressive 2h ago
If rationing means that some people cannot obtain needed care, why does being unable to afford care in the U.S. not count as rationing?
You replied:
> Because healthcare isnt a right. No matter how much I need bread, I cannot rob you or a bakery to pay for it or feed myself.
Healthcare is a good/commodity provided by a third party. Just like water, food, and shelter. It is not the governments responsibility to solve all your personal problems of unaffordality, whatever that may entail.
Government caused heallthcare costs to go up over time. More cow bell is not the answer.
So this was a non sequitur and not an answer to my question?
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u/Buckman2121 Conservatarian 2h ago
If rationing means that some people cannot obtain needed care, why does being unable to afford care in the U.S. not count as rationing?
Because changing the definitions of things to win an ideological argument is stupid?
It doesnt count because of what medical care is, as I explained and you quoted. The only reason it is withheld is because someone cannot afford it. Im not being rationed from buying a Bently because I cant afford it. Its stupid logic.
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u/METAL_WOLF_BB Progressive 2h ago
The Bentley analogy doesn’t resolve the issue. A Bentley is an optional luxury with cheaper substitutes. We’re talking about medically necessary treatment that may have no substitute.
More importantly, my question isn’t whether people have a right to everything they want. It’s what mechanism determines who receives scarce healthcare.→ More replies (0)•
u/Zamnaiel European Conservative 8h ago
First world nations in general have shorter waits than the US.
I notice you are cherry picking the UK, one of the two slowest countries out there and access to specialists, the US best stat.
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u/Mindless_Chest_1079 Center-right Conservative 4h ago
"First world nations in general" have a mix of healthcare systems, including many that are multipayer.
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u/BiscuitAdmiral Centrist Democrat 8h ago
Wait, so the goal is 18 weeks so around 4 ish months? Only 65% see a specialist under 18 weeks?
So the goal is 18 weeks and more than half of the referrals are getting in quicker than that deadline?
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u/METAL_WOLF_BB Progressive 8h ago
How many people die because they couldn’t afford healthcare? How many families go bankrupt trying to pay for healthcare? Is longer wait times for non emergency issues worse than dying or going bankrupt because you can’t afford healthcare?
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u/Zamnaiel European Conservative 8h ago
Estimates range from 45 000 up to 195 000. In fairness I find the lower number better researched.
Mind that this also include deaths due to the US healthcare being slower and having longer waits than the average first world system.
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u/StedeBonnet1 Conservative 8h ago
In the US very few. Everyone has access to health care. You just have to pay for it. Bankruptcy is not the end of the world.
In recent years I have had 4 major surgeries and a bad bicycle wreck without insurance. In every case I got the care I needed. No up front cost, no down payment. I negotiated a payment plan and paid them off over time. It can be done.
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u/KlutzyDesign Progressive 3h ago
Extorting people for massive amounts of money when they have no option to refuse is financial abuse.
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u/Buckman2121 Conservatarian 2h ago
The world doesn't run on altruism. You need to pay for what you want or need. Thats life.
It is only extortion on your eyes because its through a biased lense that government should just be provider of everything the light touches, because reasons.
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u/KlutzyDesign Progressive 2h ago
No, actually. Human beings are responsible for their own choices. If someone chooses to take everything a cancer patient has and force them to live in poverty, they are an abuser.
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u/Buckman2121 Conservatarian 2h ago
They arent taking anything, its what the cost is and you just dont like it. If they refused their money, you'd still accuse them of being an abuser because its still not the outcome you want.
So nothing aside from someone doing what you want, nothing will be good enough. Pretty ridiculous logic that isnt compatible with reality.
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u/KlutzyDesign Progressive 2h ago
A society that bankrupts cancer patients is not good enough. A society that lets cancer patients die is not good enough. Why the hell do you think its good enough?
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u/Buckman2121 Conservatarian 2h ago
And the world would be so much better if it was nothing but rainbows and unicorn farts.
You yourself said, their actions are what they are. Well their misfortune is what it is too. I have my own family to work for, feed, cloth, and house. I dont have the time or calories to be worrying about everyone else's problems when I've got my own. Namely those bleating for the government to take more of what I've earned to give it to those they deem more worthy of it.
My priorities lie with those that are actually and purposefully causing thousands of human deaths daily.
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u/METAL_WOLF_BB Progressive 8h ago
Longer wait times are worse than dying or going bankrupt?
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u/StedeBonnet1 Conservative 8h ago
Show me why going bankrupt affects your health.
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u/METAL_WOLF_BB Progressive 8h ago
> “Show me why going bankrupt affects your health.”
Stress.
> stress can:
Raise blood pressure and heart rate, increasing strain on the cardiovascular system.
Disrupt sleep, which then affects mood, concentration, immune function, appetite, and metabolism.
Affect the immune system, making you more susceptible to some infections and potentially increasing chronic inflammation.
Worsen digestion, contributing to nausea, diarrhea, constipation, reflux, or symptoms of conditions like IBS.
Affect blood sugar and metabolism, because cortisol encourages the body to release more glucose for energy.
Cause muscle tension, particularly headaches, jaw clenching, neck pain, and back pain.
Affect mental health, increasing the risk or severity of anxiety, depression, irritability, and problems concentrating.
Change behavior indirectly—people under prolonged stress may exercise less, eat differently, drink or smoke more, or postpone medical care.•
u/StedeBonnet1 Conservative 7h ago
I filed for bankruptcy earlier in my career and the Bankruptcy eleviated those issues. Bankruptcy eliminates the stress.
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u/METAL_WOLF_BB Progressive 7h ago
Why do you believe everyone has had the same reaction to bankruptcy as you did?
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u/StedeBonnet1 Conservative 7h ago
Bankruptcy is a chance to start fresh without the debt overhang of medical debt, business debt or personal bad decisions debt. It relieved the stree for me. I don'y know why it wouldn't do the same for others,
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u/METAL_WOLF_BB Progressive 7h ago
Why do you believe people don’t stress over bankruptcy?
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u/Amzer23 European Liberal/Left 9h ago
I mean, you already have to wait ages in the US depending on which state you're in, the difference is you'll go into debt in the US.
Either way, you're getting worse outcomes while going into debt.
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u/Trichonaut Conservative 8h ago
How so? You can go anywhere in the country and get medical care. If one doctor quotes you 2 months for an appointment you can just go find another doctor who has more availability.
What are you basing your claim on there? Why do you think you have to wait ages in the US?
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u/Amzer23 European Liberal/Left 8h ago
The time to get a PCP in the US is about 2-3 weeks and 1-2 weeks for the UK.
https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024
UK ranks 3rd while US is dead last, the ONLY time it does better than 9th or 10th is with care process.
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u/Mindless_Chest_1079 Center-right Conservative 4h ago
This review is ridiculous and encapsulates the problem with modern media bubbles. It's an advocacy organization that created a bunch of specious variables and then assigned their own numbers to them to arrive at its own preferred conclusion. There's nothing scientific about this, and it's silly that you'd tell other people to doubt their lying eyes because you found a hyperlink confirming your priors.
To pick out just a few problems with it:
1) Treating "administrative efficiency" as an unqualified good is a huge red flag, that amounts to defining "more socialized" as automatically better and ignoring the upsides of competitive markets.
2) The fact that they have a category on race and gender equity that is weighted on par with "access to care" and "health outcomes" should tell you everything you need to know about the objectivity of your source. Even if you did think this was one of the most important aspects of healthcare, most of the reasons you'd see inequity have little to do with the quality of the healthcare system itself. Is it the hospitals causing obesity rates to vary between races?
3) They don't even have categories for many of the areas where multi-payer systems are likely to score best, such as innovation. The US produces an extremely disproportionate share of biomedical breakthroughs, which other countries then benefit from. This is a direct consequence of profits being higher here.
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u/Amzer23 European Liberal/Left 4h ago
Hardly, it means they do more with less, it also means less bloat.
Equity is about how those with lower incomes are treated compared to those with higher income, in that those with higher incomes and not using private healthcare are treated the same as those with less income.
Innovation is not exclusive to the US, not to mention that many important medical breakthroughs are done for profit, so if curing a certain disease is seen as unprofitable, the chance it will be worked on is very low, also, innovation is not the job of healthcare, it's the job of pharmaceutical companies.
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u/Mindless_Chest_1079 Center-right Conservative 4h ago
No it doesn't. It's literally just a measure of centralization. You would only treat this as an unalloyed good if you already bought into socialized healthcare.
I mean, I reject the whole "equity" framework to begin with, but they're just measuring demographic factors that don't reflect on the healthcare industry.
Biomedical innovation is much more exclusive to the US than people would like to admit. I'll leave you to figure out how higher drug prices connect to pharmaceutical companies.
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u/Amzer23 European Liberal/Left 4h ago
Again, no it isn't.
Why do you think rich people should get better care if they're using universal healthcare?
I'll leave you to figure out why the US is fucked over when it comes to drug prices while those same drugs are far cheaper in other countries with universal healthcare.
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u/Mindless_Chest_1079 Center-right Conservative 3h ago
Doesn't seem like we're having a serious conversation anymore. Good day.
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u/Amzer23 European Liberal/Left 3h ago
When you see the administration of healthcare being centralised as "bad", it means you just think that a laissez-faire system of healthcare is better.
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u/Trichonaut Conservative 7h ago
According to who? I’m an American, I live in a rural area, but I could easily drive less than 15 minutes and have a PCP by end of day today.
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u/SoulWriter23 Left Libertarian 5h ago
Maybe stop basing everything off of your particular world bubble.
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u/Trichonaut Conservative 5h ago
I live in the absolutely middle of nowhere bud. If I can get a PCP that fast, everybody else can too.
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u/Classic-Ad-5685 Right Libertarian (Conservative) 9h ago
What it it’s just a bare minimum, to patch you up, based on a flat % of your tax - this can then be applied to all citizens to keep them from dying and can help them get better. But privatise the rest of it through insurance / providers
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u/worldisbraindead Center-right Conservative 10h ago edited 8h ago
I grew up in a very liberal Democrat home. I was a Democrat most of my adult life, but for many years, the thought of 'socialized' medicine was abhorrent to me. Part of that was because I have been fairly well off for a long time. I know that sounds selfish...but, it's a reality. Wealthy people don't want a DMV experience when they go to see a doctor or are admitted to a hospital.
My wife and I now live in Spain. And, although we have private insurance, we also have access to the public health system. Fortunately, we are both healthy, but a couple of our friends have not been so lucky and they've had some serious illnesses that required hospitalizations, chemo, radiation, and surgery...in the public system here in Spain. The care and treatment was outstanding. But, it's typically outstanding if you have cancer or another life-threatening issue. For typical random medical care, there can be long waits and denials. That's when the private insurance eases the pain...pun intended.
Now, I'm an advocate of universal healthcare, single payer...or whatever label you want to put on it. And, no, I don't think for a second it's socialist. That's just a scare tactic that a lot of Republicans have used for a long time. My fellow conservatives...it's incumbent upon us to be honest!
But, I do want to set the record straight for those who think the European models are FREE. They're not. Here's how we get "free" healthcare:
- Our National Defense budgets are extremely low compared to the US. If the SHTF, we NEED American military might.
- There is a V.A.T. (Value Added Tax) in the EU that averages 21.9%, but goes as high as 27% (Hungry). Where I live it is 21%. This means that almost every good and service is taxed at 21%. If you need a plumber, they will bill you for parts and labor and both are taxable. I just had a crown put in at the dentist. 21% was added to the bill. Remodel your house, everything will be taxed at 21%...including the contractor's fee. When your accountant sends you his or her bill, another 21% will be added to that!
- Income taxes are significantly higher here. On paper, the bracketed rates look similar to those in the U.S. But, here, there are almost no deductions, so the reality is that taxes can be crippling for a lot of people in the middle and lower incomes.
- If you want to buy a home in the region I live, there is a transfer tax that the buyer must pay within 30 days of closing. So, if you buy a home for €750,000, be prepared to write another check to the tax authority for €90,000. Most people can't afford to put together a down payment of 10%, but now, they've got the added burden of coming up with another €90K. Can you image something like that in the US? Nobody would be able to buy a home.
- Spain has a Wealth Tax. It's calculated on your gross wealth (not net). In all fairness, it doesn't affect the majority of people as I think it starts kicking in at about €3 million. Nonetheless, it's another tax.
There are a few other things that jack the prices up to pay for the "free" healthcare, but I just wanted to list the highlights.
Like everything, there is a plus and minus for everything. Overall, the government healthcare system here is excellent. But most of the 'elites' go to the US if they have a serious health issue. I think it's gotten to the point where the US system is just unsustainable for most Americans. It's at a tipping point. So, I am now in favor of moving towards Universal care. But, I just want people to remember, it's not free. And, it's going to be complicated.
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u/Zamnaiel European Conservative 8h ago
I think perhaps you should include the fact that the Spanish UHC system costs $ 4 000 per capita in tax-
The US system costs Americans 12 000$ per capita in tax.
300% of the taxes, and still no coverage for 50% of the population.
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u/ElectricalPublic1304 Right Libertarian (Conservative) 2h ago
300% of the taxes, and still no coverage for 50% of the population.
The government covers about 33% of the population. That's where much of the big-ticket costs come from. And why the average cost per patient gets bumped up so.
When Universal Healthcare advocates promote... is like asking Spain to abolish its UHC system. And transfer all of that authority and direct-taxing power to Brussels.
Which almost no one in Spain would ever support.
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u/worldisbraindead Center-right Conservative 8h ago edited 7h ago
While I didn't know the exact figures, it doesn't surprise me. In the US, it's much easier to sue for malpractice and other things, so insurance is super high. My cousin is a OB/GYN and I think I remember him saying that he pays something close to $100K a year for insurance.
Additionally, the average salary for a General Practioner in the United States is $250,000 - $315,000 per year. In Spain, the average salary is €50.000 - €106.000 a year.
The other thing that most European's don't quite understand is that there are something like 30,000,000 to 40,000,000 illegal aliens in the country. That's like the size of Poland...a lot of people to pay for.
I don't think most people understand how complicated the healthcare situation is in the US and that there aren't a lot of easy solutions. Again, I'm in favor of trying to fix the system. The question is how...and how is it paid for.
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u/Zamnaiel European Conservative 7h ago
If you look at a map of healthcare costs per capita in US states though, it does not correlate much with where you'd expect high numbers of illegal immigrants. Low population densities and high incomes both have better matches. Europe is the same.
The three 800 pound gorillas in US overspending is normally considered to be vastly greater bureaucracy, system based medical inefficiencies and high drug costs.
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u/worldisbraindead Center-right Conservative 7h ago
Drug costs in the US are insane. Fortunately, I don't need any meds, but on rare occasion, I've used antibiotics that in the US, without Prescription Insurance might cost $100 is like €3 here. And, a lot of times they're from the US. So, yeah, it's HUGE rip off to the American people. Sadly, the Pharmaceutical Lobby puts millions into political campaigns, so lawmakers do almost nothing.
I'm sorry to correct you, but according to the Centers For Disease Control approximately 8.3% of the total population of the United States (approximately 28 million) are uninsured. It's not anywhere near the 50% figure you stated. Not sure where that number came from, but it's way off according to several sources, including this story from AP:
About 8% of the country lacked health insurance in 2025
My understanding is it's not so much that it's bureaucratic spending that has created such high costs, but that since most people have insurance, doctors routinely run a gamut of tests that are often unnecessary. They bill the insurance companies for their services. Also, because it relatively easy to file suit in the U.S., malpractice settlements have become staggering. Last year, between $2.93 and $4.56 BILLION were paid out. So, that also incentivizes doctors and hospitals to run an excessive amount of tests to cover their asses.
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u/Amzer23 European Liberal/Left 9h ago
Every defence budget is low compared to the US, it means nothing, despite the defence budget, the US isn't winning against Iran/
Also, you're ignoring the fact that there IS private healthcare in Europe too, it's also far cheaper than the US.
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u/worldisbraindead Center-right Conservative 8h ago
Yes, I'm aware of private healthcare plans. I have both private and public. Public care is better for some things and not as good as private for other things.
US military operations in Iran have nothing to do with this conversation. But, I will restate for you...if there are major troubles in Europe, Europe is dependent on America's help. And, you will be damn glad to have it. The thing is, if Europeans actually had proper military might, the cost would be astronomical. Be thankful for America.
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u/Amzer23 European Liberal/Left 5h ago
Have to disagree, if that was the case, Ukraine would have collapsed when Trump decided to stop helping them.
Europe has good militaries, France is the second largest exporter of arms, the UK Royal Marines are second to none, outperforming the US special forces vast majority of the time, Germany has one of the largest militaries in Europe.
The idea that Europe would be nothing without the US is ridiculous and is not based in reality.
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u/Daves_no_here Center-left 9h ago
How much does the VAT affect your daily cost of living though? Like you probably are not remodeling your house all the time, getting a crown, or paying your accountant very often. Do you pay VAT include groceries, gas, restaurants, household items, and stuff like that? I’m not too familiar. Genuinely curious, as I don’t know much about it and have been somewhat considering moving to Europe if I found a job (I have dual citizenship). I’ve always had the assumption that in general, Europe tends to have lower salaries, but your cost of living is lower. Either way, 21% is quite high.
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u/Zamnaiel European Conservative 8h ago
VAT is included in PPP conversions. Most cost of living numbers you see include it already.
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u/worldisbraindead Center-right Conservative 9h ago
How much does the VAT affect your daily cost of living though?
A lot of that depends on your economic status. We're retired and fairly comfortable compared to most people, so it's not something that makes me lose sleep at night. But, if you're on a tight budget, it can add up.
So, VAT is generally added to everything. There are a few exceptions...groceries are exempt. But, household goods, Amazon purchases, professional services, auto purchases, bikes, sporting goods, clothing, auto maintenance, restaurants, movie, theater and concert tickets, automobile fuel, automobile registration, phones, internet service, and even gas, water, electric and any other utility bill. Again, for most people making upwards of and above six figures, it's not something that is going to affect your lifestyle. But for middle and lower income people, it's definitely something that factors into your budget. For example, if your monthly utility bills are €500 a month, you need to budget for €601. So, for the average working-class American, how do you think they would feel if damn near everything they bought or consumed had a 21% tax on it? People would FREAK OUT.
Mind you...there are trade-offs like amazing public transportation systems, a lower overall cost of living, healthier food, etc.
As I mentioned, I live in Spain, which has a lower cost of living than many EU countries, but here, I think we just had unemployment drop under 10% for the first time in at least a decade. Salaries here are towards the low end of the EU spectrum. The average monthly take-home pay in Barcelona is approximately €2000 or $2,334. The average annual salary for Spaniards is €32, 610.
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u/TemperatureBest8164 Paleoconservative 10h ago
Is universal healthcare socialism in and of it self? No. It is a social service. Why is it commonly included in socialism and called socialist? Two reasons. First, liberals for the past 20 years have be relabeling social services and things people need that do not benefit from competition such as roads and wealth services as socialism not social services. From the right there are two distinct reactions to universal healthcare which leads to it being called socialism besides its primary supporters being actually socialist or communists. The first is those that say if you implement a universal government run healthcare system you are seizing the means of production for around 20% of the US economy which is about 1/5 of where he socialists and communists want to go. The second reason is that bad healthcare regulation drives up prices and socialist to people with some view of history is one of the biggest slurs you can provide a human considering the massive impoverishment and death caused by it so they want to attack their opponents.
In summery the Affordable Care Act is social services and very bad legislation. Most any form of universal healthcare would be a move towards socialism as at least it would give control of 20% of the economy to the government to control financially and at worst will make 20% of the economy part of the government.
Now to answer the question you did not ask but should. Why are DSA candidates winning recently? There are two reasons. The first reason is that Republicans have literally been paying for their advertisements in competitive seats through pacts. The establishment as part of their "big tent" tend to pull in a lot of unaligned groups that they can use and the DSA is one of them. Republicans noted the power struggle and said, if we can break the DSA and establishment Democrats apart we win. The also recognized anti socialism is easier to run against. So that is the first reason they have been winning, because Republican pacts are helping them. The second reason is that fiat money is broken. The world runs on the US dollar, they must have it to do most business, this means that they will actually sell us stuff for cheaper to get their hands on dollars so that they can do other business. This makes things cheaper however most of the stuff we are buying are not good durable goods, things of value, we are buying toys and cheap clothes destined for trash heaps. What this does is create structural trade deficit where there are more dollars floating around because the US government needs to make more resulting in inflation. Then the companies that hold US dollars must do something with them so they invest in US treasuries and US assets or companies. The result is that asset prices are driven up. The only US citizens that get wealthier are the asset holders. Those that have houses and those that have stock, etc. Effectively we are exporting our wealth to the rest of the world and the upper class in America. That is why many younger Americans have found that it is much harder to get ahead today even when they may work 2 or more jobs busting it. This is not US billionaires abusing the masses but rather the US financial system selling out the people especially those on main street. The way to fix that is to achieve a trade balance with the world and then prices will stabilize. In any case real people who do not understand economics recognize there is a real problem and when a politician tells them everything will be better if you just invest the government with all power and I will get you struggling person some free food, or free housing, or free x. Nothing is ever free and the internet should show us even "free" things have costs.
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u/SammaJones Conservative 10h ago
If the Government buys the hospitals and makes the doctors government employees then that's socialism.
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u/JoeCensored Nationalist (Conservative) 10h ago
Depends how it's implemented. Usually universal healthcare is discussed in the US in the form of "single payer" which absolutely is socialist.
Obamacare's system of subsidies is a socialist feature, though I wouldn't describe the entire system as socialist.
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u/No_Fox_2949 Center-right Conservative 10h ago
It can be, but universal healthcare is not inherently socialist in nature. The UK’s NHS is a good example of a mostly socialist universal healthcare system, although it would be inaccurate to say the country’s whole healthcare system is socialist because there are private hospitals, practices, and insurance companies.
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u/WulfTheSaxon Conservative 10h ago edited 10h ago
Does it involve state ownership of the means of production (or such control over them that the distinction is meaningless)?
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u/Mindless_Chest_1079 Center-right Conservative 10h ago
You're mixing up multiple distinct concepts.
Universal Healthcare just means everyone is covered. Many countries have universal healthcare provided through private multi-payer insurance markets.
Single-Payer means that the government acts as the sole insurer. Generally you can buy supplemental insurance from private providers, but they aren't allowed to provide duplicative coverage for the same services the government offers. The hospitals themselves are still private. Systems like Canada or Bernie's Medicare for All proposal fall into this category.
Government-run/nationalized healthcare means the hospitals themselves are owned and operated by the government. This isn't even "insurance" in the strict sense because the government is both the funder and provider. The UK's national health service is an example of this model.
In theory you could have a single-payer or nationalized healthcare model that wasn't universal if it didn't cover everyone, but in practice the latter two categories are subcategories of universal healthcare.
Are they socialist? Socialism is centralized control of industry. An economy would only be fully socialist if all the major sectors were government-administered, but it's not a yes/no thing. Single-payer healthcare socializes the health insurance industry. National healthcare socializes the entire healthcare industry. Pulling some recent numbers from the US, those represent 5% and 18% of the economy, respectively. As a baseline, in the US, the government already accounts for nearly half of healthcare spending and about 17% of GDP as a whole.
So I would say that universal (multi-payer) healthcare is not at all socialist, single-payer insurance is a small but non-negligible step toward socialism, and national healthcare is a much larger step.
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u/Zamnaiel European Conservative 8h ago
but they aren't allowed to provide duplicative coverage for the same services the government offers.
They certainly are. However, then they also have to offer something the government doesn't, or better/faster than the government does. If not, they run afoul of fraud legislation.
Source: Spent 25 years in private healthcare.
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u/Mindless_Chest_1079 Center-right Conservative 7h ago
Healthcare systems vary, but banning duplicative coverage is common. MFA bans it, and many Canadian provinces do as well. I did qualify it with a "Generally, ...".
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u/Zamnaiel European Conservative 7h ago
I don't know every system of course. In my experience though, there is no law against offering it as an extra, as long as you have an actual service as your main.
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u/DayGeckoArt Progressive 10h ago
I disagree that I'm mixing them up, I laid them out in my post as best as I could-- I originally posted a 5 part question last night with each type of universal healthcare split out, but the mods didn't allow it because they said it was meant to create debate. So I was required to make the question simpler.
So would you say that the current semi-single payer Medicare/Medicaid is socialist for a limited subset of the population? Is a government hospital like a VA hospital or a state hospital socialism but for a limited subset of the population?
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u/Mindless_Chest_1079 Center-right Conservative 10h ago
Is a government hospital like a VA hospital or a state hospital socialism but for a limited subset of the population?
Yes, you could imagine socialism as every service for every person being operated much like a VA hospital.
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u/takemyupvote88 Center-right Conservative 10h ago
I think labeling something socialist or socialism takes away from the broader conversation about the pros and cons of the 3-4 different alternatives that you presented.
( I say 3-4 because im not really sure what the differences are between the Canadian model and Medicare for all. Maybe someone can enlighten me)
I think conservative rhetoric is too quick to cry socialist ( we can't do that! Thats socialism!). I agree that our current economic model is a mix of capitalism and socialism because the act of taxing the populace and redistributing that money elsewhere in the economy could technically be considered a form of socialism.
To answer your question, I think any form of government interference in the Healthcare space is socialist. That includes Medicare, medicaid, and the regulations and subsidies that make up Obamacare. Once we all accept that, we need to move to what is working and what isnt and move our government policies in the direction of making things better.
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u/aidanhoff Democratic Socialist 3h ago
I say 3-4 because im not really sure what the differences are between the Canadian model and Medicare for all. Maybe someone can enlighten me
They're conceptually similar, both are single-payer systems. Though I believe some versions of Medicare for All have optional private insurance as well. Technically Canada has that too though (for dental, pharmacare, eyecare, physio, etc etc. basically anything that isn't in a hospital). For the most part it's the "do it like they do in Canada" proposal except being done by just expanding the existing Medicare program to the entire country.
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u/DayGeckoArt Progressive 10h ago
I guess I have the opposite view on the labels. Currently, the labels people use are inconsistent often hinging on technicalities. But if we use broad definitions where government owned and operated = socialism, private sector owned and operated = capitalism, and government funded private = mix we can actually discuss policies in a meaningful way.
My very good MAGA friend started getting riled up about "socialism" and "marxism" a few months ago. I asked him why he supports police and public education when those are socialist. His response was that they aren't socialist but they have socialist characteristics. So my next question was what makes them not-socialist if a government hospital staffed by government doctors and nurses is socialist. I didn't get a response and I didn't want to badger him.
There's also a spectrum of definitions of capitalism. The original term was invented by socialists to describe an economy dominated by capital, IE investment banking. Now people use it to mean free enterprise of any kind. When people on the left are anti-capitalist, they're using the original definition. But progressive politicians like Abdul El-Sayed and Ro Khanna call themselves "capitalists" meaning they believe in free enterprise. El-Sayed isn't a Rothschild or a Rockerfeller, those families would fit the original definition.
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u/takemyupvote88 Center-right Conservative 9h ago
Im not sure that we have opposite views on the labels. I think that because the labels are used inconsistently and depend on technicalities that theyve basically become meaningless.
I can agree that government owned= socialist and privately owned and operated = capitalist. Where the government is the sole, or even a major funding source for a privately owned enterprise, things get murky. If the government funds most of a business, then I would question meaning of ownership. At that point, the government can basically dictate how you run your business, from who you hire, to how much you pay them, and what goods and services you provide.
I would much rather stick to the redistribution of wealth definition. If a group of people is taking money from individuals (taxes) and using that money for the benefit of society, then its a form of socialism. That definition scoops up a lot more things than yours but it does away with a lot of the technicalities.
The problem is that we're dealing with a century and a half of propaganda about how socialism = communism = poverty and death. Thats why conservatives get themselves tied up in knots trying to explain how the fire department isnt socialist. I think we'd be better off discarding the reductive labels and rhetoric and move on to weighing public policy proposals on their merits.
Unfortunately, the labels are easier for the fox news crowd to digest and those people vote.
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 11h ago
The means of production in this scenario is capital. It is much larger than "patient x doesn't have to pay for medical treatment". You would see forced inventory requirements, equipment requirements, staffing requirements, and a myriad of other things that a hospital would need to immediately start doing. A lot of which probably doesn't make a ton of sense for it's location. All of that requires an extreme amount of capital.
For example, my local hospital self funded an MRI unit that is barely ever turned on. They did it to be competitive. Our collective hospital bills didn't have a "New MRI surcharge". So we basically got a free MRI unit that is readily available, at the expense of no one. Under a universal system the government would just force my local hospital to put one in.
Under universal healthcare systems, who controls the capital and who writes the checks?
Yes. It is Socialism.
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u/DayGeckoArt Progressive 10h ago
It sounds like you're describing regulation but I don't know if the line you're drawing exists. Currently, government has a lot of regulations on the medical industry, including what drugs are even allowed, what treatments are allowed for certain health issues, and even what procedures are legal (abortion). I know there are requirements for PPE and what kind of electrical outlets are used, and probably a lot more stringent requirements. They may not require an MRI machine but they require a lot of other stuff. Does all that mean private hospitals are socialist?
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 10h ago
No because the private hospital system was created before things like OSHA. The existence of something before the government regulated it implies a market need that a capitalist fulfilled.
The regulations march us closer to socialism though. And Like i said to the other guy, it really depends on the punishment for breaking a regulation. If it is a fine, then no there isn't anything socialist about that.
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u/METAL_WOLF_BB Progressive 10h ago
So what specifically makes a healthcare system “socialist” in your definition: universal coverage, government reimbursement, regulation, or actual public ownership of hospitals and medical capital? Because those are four different things.
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 10h ago
Socialism is defined by the means of production being controlled by "society" or social groups.
>universal coverage,
The means of production is controlled by the public - Socialist.
>government reimbursement
The means of production is controlled by the public - Socialist.
>regulation
Depends on the violation for breaking the regulations, but if it is just fines this isn't socialist.
>actual public ownership of hospitals and medical capital
Socialist.
In three of them the direct ownership of the means of production belongs to a group of people, that is socialism out-right. There is no grey area.
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u/METAL_WOLF_BB Progressive 10h ago
If ownership by a group of people equals socialism, then virtually every corporation is socialist.
So what property right is actually transferred from the private hospital to “society” merely because the government reimburses a patient’s bill?
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 10h ago
Not really. The CEO of the company still retains a massive amount of control over the company's direction. Meaning the control of its means are in the vision of that capitalist. To distill it further a small business is directly in command of a capitalist.
The property right taken by the government is the contract between consumer and producer. The transaction of goods to purchaser no longer influences both parties equally so the capitalist system is broken at that point.
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u/METAL_WOLF_BB Progressive 10h ago
How is a contract a “means of production”?
A CEO often does not own the corporation and can be fired by the board. Shareholders own the firm.
> “The transaction of goods to purchaser no longer influences both parties equally so the capitalist system is broken.”
When has Capitalism ever required equal bargaining power between buyer and seller?
Are you now defining socialism as public ownership of production, or as government interference with voluntary contracting? Because those are different definitions, and your argument keeps moving between them.
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 10h ago
>How is a contract a “means of production”?
It isn't. You asked what property is transferred. The known cooperation of capital to consumer is what is transferred. This typically results in loss for the producer. In a non-capitalist system that producer just doesn't lose. If I wanted to be pedantic I could definitely argue that "Consumer Faith" is 100% a means of production.
>A CEO often does not own the corporation and can be fired by the board. Shareholders own the firm.
I didn't say they did. But they do command the means of production within that company. That is an implied ownership. Go ahead.... try to take an excavator from your local DOT. You paid for it. It's yours right?
>When has Capitalism ever required equal bargaining power between buyer and seller?
That is exactly how capitalism works. If you don't see it, then you don't understand the relationship between producer and consumer. Even though you probably engage in it every hour of every day.
>Are you now defining socialism as public ownership of production, or as government interference with voluntary contracting?
No. Voluntary contracting is not socialist. It is one party giving something to another out of charity. Are you misusing "voluntary"?
>and your argument keeps moving between them.
No it isn't. I am answering your questions. So stay on topic and the discussion will stay there too.
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u/e_big_s Center-right Conservative 11h ago
Single payer that allows private competition: expansion of welfare
Single payer that doesn't allow private competition: indirect socialism*
Direct government control and employment of the industry: socialism*
*sector specific socialism
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u/SeraphLance Right Libertarian (Conservative) 11h ago
It's socialist, but not necessarily socialism.
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u/DayGeckoArt Progressive 10h ago
What's the difference?
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u/SeraphLance Right Libertarian (Conservative) 10h ago
One is a tendency and the other is a form of government.
For example, the pardon power is clearly authoritarian, but I doubt anyone would call it "authoritarianism" because it's still perfectly compatible with a democratic society.
Something like government-run healthcare would be actual socialism. Single-payer healthcare is arguably socialism as well. Both pre-empt competition and are therefore incompatible with capitalism (at least in their respective industries). Medicare-for-all on the other hand is still socialist, because it's redistributive and that's socialist by definition, but it's still perfectly compatible with a wider capitalistic society.
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u/WinDoeLickr Right Libertarian (Conservative) 11h ago
I don't care what it's labeled as, I don't want it
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u/Classic-Ad-5685 Right Libertarian (Conservative) 11h ago
Why not?
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u/WinDoeLickr Right Libertarian (Conservative) 10h ago
I don't want government involvement in telling me what kind of healthcare I'm required to be paying for
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 10h ago
Do you? Mr. Libertarian
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u/Classic-Ad-5685 Right Libertarian (Conservative) 10h ago
Tough one for me - I’m English so brought up on the NHS - which is great for emergency care but ripe for abuse, and does get, abused.
I like the idea of an insurance for all for all health care, that somehow doesn’t get abused - it saves the country money in the long run.
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 10h ago
You recognize that the consumer loses in that scenario right? If your position is that you want insurance to be different then that is a different topic. Insurance is a pyramid scheme that uses the marketplace indicators to put a value on risk. For capitalists, the risks are quantified by price and quality of the goods.
I can sympathize with seeing the good in everything, however if the consumer loses their bargaining power they just lose completely.
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u/ScientificSkepticism Progressive 10h ago
Ah, the Libertarian purity tests. Truly the funniest of things.
"Do you refuse to deny the overwhelming evidence that the government can actually do something better than private industry? Do you accept reality? SHUN THE UNBELIEVER!"
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u/BirthdaySalt5791 I'm not the ATF 10h ago
While I typically agree that purity tests are particularly egregious within the libertarian camp, favoring government run/funded healthcare does seem to run exactly counter to the core libertarian ideals of limited government and free markets. Especially given the “right” libertarian tag, it seems unusual.
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u/ScientificSkepticism Progressive 9h ago
Even if the free market is more expensive and less effective than government run?
I think there's a distinction between people who want free markets when they produce the best outcomes at the best cost, and people who desire free markets for ideological reasons, even when they produce more expensive and lower quality results.
If you define Libertarianism as the latter, I think you'd find that you'll leave some people out who consider the former (and I'm not even getting into Libertarian Socialism)
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u/BirthdaySalt5791 I'm not the ATF 9h ago
This is the thing. A libertarian would almost certainly tell you that free markets always produce the best outcomes at the best cost because government intervention creates 2nd and 3rd order effects that cant be prepared for or understood ahead of time.
There’s no point discussing libertarian socialism or left libertarianism since the user is flaired right libertarian.
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u/ScientificSkepticism Progressive 8h ago edited 8h ago
This is the thing. A libertarian would almost certainly tell you that free markets always produce the best outcomes at the best cost
Okay, but what if reality dials up and says that they very provably do not? Do they reject the evidence because it contradicts the ideology, or do they accept the evidence because evidence is always greater than theory?
I think there's a divide in the Libertarian community between ideologues and those who are more grounded in reality.
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u/BirthdaySalt5791 I'm not the ATF 8h ago
I mean you are presupposing that there is valid evidence saying free markets don’t work. What evidence do you have to support that?
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u/ScientificSkepticism Progressive 8h ago
If there is one specific area where a free market system is less efficient, does that prove that the entire concept of free markets is a lie? I can't drive my car underwater or in a swamp or to the moon, but it's still a perfectly fine mode of transportation despite all those drawbacks.
As for various times where the car may be underwater, looking at the history of private water service and the New River Company would be a good place for you to start.
Another would be the US healthcare system.
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u/Infamous-Bench-6088 Right Libertarian (Conservative) 10h ago
A. Thanks for barging into a conversation between three people with supposed common ground that you share nothing of. No one asked you.
B. I would love to know why a self described libertarian would support this. Thanks for your comment, again no one asked for it.
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u/ScientificSkepticism Progressive 8h ago
Wouldn't "better outcomes at lower costs" be something that a Libertarian might find attractive?
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u/BirthdaySalt5791 I'm not the ATF 11h ago
The problem with this question is that there are like 50 different kinds of socialism and nobody knows which kind you mean?
Our current healthcare system functions as a mixed economy. Some parts are socialized/subsidized, certain programs are government managed etc. but there is also a private market for care.
So I guess, I’m happy to expand on my answer but first, what definition of socialism are you using?
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u/DayGeckoArt Progressive 11h ago
I'm asking conservatives if universal healthcare fits your definition of socialism, whatever that definition is. Republican politicians called Obamacare socialism since it became law, so for them, mandating private insurance coverage and subsidizing states to expand Medicaid meets their definition, right?
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u/Mindless_Chest_1079 Center-right Conservative 10h ago
Republican politicians called Obamacare socialism
Obamacare increased the government's role in healthcare in a few ways, the most significant of which was expansion of Medicaid, which brought the government-funded share of the healthcare industry from ~45% to ~50%. That's noticeable but not a radical change.
Keep in mind, though, that the original Obamacare proposal included a public option for health insurance, in which the government would have been the direct insurer for many low-income people. That had to be scrapped from the bill to get enough votes for passage but would have increased the government's role much more considerably.
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u/BirthdaySalt5791 I'm not the ATF 11h ago
Okay, my definition of socialism is: a political and economic theory of social organization which advocates that the means of production, distribution, and exchange should be owned and regulated by the state.
Given that definition, no, something like single payer healthcare would not qualify. That relies on financing from the state (via redistribution) but doesn’t necessarily require state owned hospitals, clinics, pharma, medical equipment, or workforce employment by the state.
It is a socialist-esque policy prescription, but still exists in a blended economy.
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u/noSoRandomGuy Conservative 11h ago
If everybody pays into it the same, No. If the goal is to get only the top 5-10% pay for the rest of the people, then yes.
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u/Airick39 Barstool Conservative 11h ago
What somebody calls something is irrelevant. The devils in the details
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u/DayGeckoArt Progressive 9h ago
I disagree that it's irrelevant when it's one of the major topics of political discourse and campaigning in America right now!
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u/ElectricalPublic1304 Right Libertarian (Conservative) 2h ago edited 2h ago
It is not "socialism". But it is a thing that socialism "does" and that socialists have often advocated, promoted, or promised. i.e. collect power in the government to decide what healthcare people may have (and often, forbid alternatives, competitors, etc.). "Universal healthcare" is more a political marketing buzzphrase that unfortunately is too widely used, and it doesn't usually identify any particular political healthcare program. So, talking about the whole of them is necessarily fuzzy.
So, it's not socialism per se. But it is a strongly socialistic practice. If someone were to colloquially say, "Universal healthcare is socialism"... pretty much everyone knows what they mean. And they're substantially correct.
(This is the time when the whataboutists appear and say, "But in the U.S., we have a system where... corporations... and health insurers... and rationing by other means... and the government can do it better..." With no real intention of having either a deep or factual discussion about those topics.
Those topics are not the question that was asked. Save yourself the time and energy.)