David Leyonhjelm on super and welfare: Two wrongs make a right

This was an op ed in The Financial Review.

It is wrong that we are forced to deposit a prescribed amount of our earnings into a particular type of account and are prevented from withdrawing it until we reach a certain age. It is also wrong that people who are able to save prior to retirement, but who choose not to do so, get an age pension funded by others.

If the first wrong (forcing everyone to save) reduces the second wrong (the irresponsible receiving tax-funded age pensions), then it’s worth doing. That’s the logic of our superannuation regime.

Such logic can and should apply more broadly.

It is wrong that people who are able to save to prepare for future ill health, but who choose not to do so, receive public health services. This wrong could be reduced by obliging people to save and use the money to cover future health costs.

Some think we already do this through the Medicare levy, but they are wrong. The levy is not an insurance premium and only covers a small fraction of public health costs. It is really just another tax on income.

We already have forced saving through the superannuation regime, with bipartisan agreement that the compulsory rate of saving should rise. Given this, it would make sense to compel people to draw down these savings before they are granted access to public health services.

Singapore has had a similar scheme for many years, where it is considered a great success.

Such an approach would not affect the poorest in society who are unable to accumulate superannuation savings. They would continue to have immediate access to benefits in instances of ill health and remain eligible for the age pension upon reaching the appropriate age.

It would only affect those who are able to save but who currently choose not to, and might prompt some of these people to undertake additional precautionary saving, to reconsider any unhealthy practices, and to avoid unnecessary visits to the GP. Any of these changes would reduce costs on taxpayers.

Alternatively, it would simply put off the day that taxpayers are required to cover the health expenses of the irresponsible.

Like many developed countries, Australia has a massive and growing budget problem because of health and social welfare commitments. In 2013, federal government expenditure on health was $61 billion and social security and welfare $132 billion, of which assistance to the aged comprised $51 billion. Combined, they account for over 50% of total federal government expenditure, far exceeding defence or any of the other big ticket items normally associated with governments.

Future demand for age pensions will be limited by superannuation savings, but state and federal budgets will be overwhelmed within a generation unless there are major changes to the funding of health.

Already a common topic of discussion among the baby boomer generation is whether they have accumulated enough super or will be forced to rely on the pension in retirement. This is as it should be. The age pension, while modest, whittles away at the natural incentives to save for retirement. As such, it is important that only those who absolutely need it are eligible.

Using our system of compulsory savings accounts to achieve independence from taxpayers makes sense. But for those in their twenties and thirties, saving for a distant retirement is not a high priority. Using the funds to cover health expenses is far more relevant.

Of course this would require a phase-in period. Compulsory superannuation, which began in 1992, is only now starting to make a real difference. Funds managers should also compete more transparently on cost and performance than they do now, so account holders can choose a fund that suits them. Earnings in the savings accounts should ideally be tax free, and insurance should play a part for those who have not accumulated a high balance.

But if it is wrong to force people to save, it is also wrong that others pay for the health and retirement of those who refuse to save. Two wrongs can make a right.

David Leyonhjelm is the Liberal Democrats’ Senator-elect for NSW.

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144 Responses to David Leyonhjelm on super and welfare: Two wrongs make a right

  1. Singapore has had a similar scheme for many years, where it is considered a great success.

    Hey, that’s what I said!

    If this keeps up – and the LDs stay away from life issues altogether, refusing to comment on things where the State has no place anyway – then I may yet vote for them.

  2. Notafan

    Whatever it takes to dismantle the health beaucracy, stop overservicing and malingering especially by those chasing the DSP.

  3. Percy

    I’m a fan of the HSA idea, or a combined HS/Super Account. Such products shouldn’t be too hard a political sell. After all, if somebody supports the Superannuation scheme, what logical reason do they have to oppose a similar Health Savings scheme?

  4. rebel with cause

    You could apply the same logic to schooling: it is wrong that people who could afford to pay for their own kids education, but who choose not to do so, get their kids educated for free.

  5. Alfonso

    Dave has to run a mile from easily avoided, massive risk…….you believe helmetless bikey neurological risks are just part of the great taxpayer funded eternal care responsibilty.

    Grow up LDP, or insure for your own easily avoided no helmet risks….which you can’t afford.

  6. TerjeP

    What a lot of people miss and don’t appreciate is that the public cost of health care means the Medicare levy is effectively 9% with the levy charged only being the tip of the proverbial iceberg. What this means is that if the government moved health care back to the individual it could cut 9% points of income tax or increase the super guarantee levy or some mix there off. It could also increase the repayment rate on HECS.

    Letting people dip into their super to pay for their own health care, or let them pay for their own insurance out of tax cuts if they prefer to preserve their super, or let them book costs against HECS if they are young and poor, opens the entire system up to price mechanisms and choice.

    If Singapore has run a similar such a system for years then why not Australia?

  7. rebel with cause

    Grow up LDP, or insure for your own easily avoided no helmet risks….which you can’t afford.

    Yes because a cradle to grave welfare system and free public healthcare is totally affordable as long as you force people to wear bike helmets.

  8. Johno

    If this keeps up – then I may yet vote for them.

    If you don’t vote for the LDP if you can, who else would you vote for?

    Labor lite aka the Liberal Party!

    The Liberal Party needs to understand that it can’t take its base for granted. It has to start enacting liberal policies you it will lose votes to the LDP.

  9. Bruce

    Compulsory superannuation is not people saving…it is employers putting in the money on top of wages. Singapore’s highly successful system requires employees to match the compulsory contribution made by employers with the employee’s contribution being deducted on pay-day and paid into the National Fund. Employees can borrow against their super build up to finance essential housing needs – repaying the loans also from wages.

    It is a great system with employers and employees jointly sharing the cost. Here it is only the employer bearing the cost.

  10. TerjeP

    It has to start enacting liberal policies you it will lose votes to the LDP.

    It’s already losing members to the LDP.

    :-)

  11. H B Bear

    My understanding is that compulsory superannuation wasn’t making much of an impact on the numbers of people drawing the aged pension, despite the rapidly increasing foregone revenue through concessional tax rates. Many baby boomers still entire retirement with significant mortgage debt that is then paid down with whatever superannuation they have accumulated. There is still no effective mechanism to prevent double dipping.

    My sneaking suspicion is that if you transferred the 9% SGC back to people as income they would probably just use it to bid up the price of housing even further than the current stratospheric levels.

  12. sdfc

    opens the entire system up to price mechanisms and choice.

    Yeah, because health spending is discretionary.

  13. Baldrick

    The more I hear from David Leyonhjelm the more I’m impressed. They may even get my vote at the next election.

  14. Tel

    Grow up LDP, or insure for your own easily avoided no helmet risks….which you can’t afford.

    Not that it’s any business of yours what I can afford, but I can easily afford the “no helmet risk” that you describe since statistically helmets don’t change your risk and the additional exercise of doing more riding generally improves life expectancy and quality.

  15. Tim

    Yeah, because health spending is discretionary

    Some of it is. Like the bit caused by riding a bike without a helmet and getting a head injury. Eating to much. Or drinking or smoking till your body fails. Though those last two are over-funded by the existing sin taxes.

  16. Tim

    And more to the point, people with a personal stake in the cost will apply a price pressure to service providers. Even competition for service, with the artificial limits on supply of medical services removed.

  17. tomix

    So, LDP loves poor people, but let’s tax the rich and irresponsible.

    Where have I heard that before?

  18. jupes

    Singapore has had a similar scheme for many years, where it is considered a great success.

    Wow. A libertarian praising Singapore. Take note Dot.

  19. 2dogs

    Some think we already do this through the Medicare levy, but they are wrong.

    The Medicare Levy Surcharge does do that, but the problem is that those who are obliged to buy health insurance this way, are not obliged to actually use it: they can still go to a bulk billing doctor, for example, or entering as a public patients in hospital. They save on premiums
    (because if reduced claims) and excesses in this way.

    What needs to happen is for the private insurance to be linked to the Medicare number in the back office processing, when used for the surcharge exemption. Any Medicare card use then gets back charged to the insurer. If there are things the insurer doesn’t cover, only a partial exemption to the surcharge should be available.

  20. I came across an article on the actuality of slavery in the Southern US a couple weeks ago. What gets missed these days in our perspective on slavery is the responsibilities that were expected and imposed upon a master.

    A slave was cared for for life. In ‘sickness and in health, for richer or poorer’ didn’t only apply to the lady of the house, but the whole household of which slaves were considered a part.

    Their labour was owned, but they could work extra and earn additional income, of which the master received a portion.

    You read articles like David’s above and are reminded that we really haven’t changed all that much. Rather than individual people being responsible for slaves, we have a distant government carrying out the same functions, deciding what one can keep and what provision must be made for ones later years.

    At least in those days the system led towards those in slavery learning the lessons required to save and support oneself. Today, the system pushes people towards dependancy.

  21. sdfc

    Sorry Tim but you don’t risk lung cancer or a head injury because you reckon you can always rely on public health care.

    The information asymmetries are too great in health to blame high costs on restricted supply.

  22. .

    sdfc
    #1181309, posted on February 7, 2014 at 7:55 pm
    opens the entire system up to price mechanisms and choice.

    Yeah, because health spending is discretionary.

    Yes, it is. You asserting that it isn’t doesn’t make it so.

    sdfc
    #1181342, posted on February 7, 2014 at 8:25 pm
    Sorry Tim but you don’t risk lung cancer or a head injury because you reckon you can always rely on public health care.

    The information asymmetries are too great in health to blame high costs on restricted supply.

    No they’re not. You’re just coming up with crackpot theories without any evidence.

    Yes because a cradle to grave welfare system and free public healthcare is totally affordable as long as you force people to wear bike helmets.

    Lulz…bikes were around for over a century before some knobs in Parliament decided to wrap everyone up in cotton wool. Were we crushed by unaffordable health care costs and welfare BEFORE OR AFTER those laws were passed?

    If this keeps up – and the LDs stay away from life issues altogether, refusing to comment on things where the State has no place anyway – then I may yet vote for them.

    Your position is absurd, you want people to do so, but if you were to ask them why they have that position you won’t vote for them.

    tomix
    #1181321, posted on February 7, 2014 at 8:06 pm
    So, LDP loves poor people, but let’s tax the rich and irresponsible.

    Where have I heard that before?

    You’re kidding aren’t you? The Liberals support income tax rates of 45%, luxury car taxes and the like. The LDP wants a 20% tax rate on income over 40k.

    Wow. A libertarian praising Singapore. Take note Dot.

    Their tax system is enviable but kowtowing to the Yew family approving their social policy is anathema.

  23. sdfc

    So let me get this right Dot. If you’re crook the option of going untreated is a rational choice and patients have as much medical knowledge as doctors and nurses?

  24. Roger

    And it’s equally wrong that political candidates receive generous subsidies from tax payers who didn’t even vote for them but who yet have no say in the matter. But that didn’t stop Sen elect Levonhjelm from pocketing such funding. He lost me right there.

  25. rebel with cause

    He lost me right there.

    Liar.

  26. .

    sdfc
    #1181378, posted on February 7, 2014 at 8:50 pm
    So let me get this right Dot. If you’re crook the option of going untreated is a rational choice and patients have as much medical knowledge as doctors and nurses?

    Go to bed. It works most of the time.

    If not:

    You’re probably gonna die, or

    If you need surgery, the wait in public hospitals can kill you.

    The idea most people lack the knowledge to judge how sick they are or what they have roughly got with a mild illness “I’m crook, doc” is utter bullshit, and it was even before the information age.

    The only solution you have is mandatory doctors appointments and scans, since people won’t know when to go to the doctor.

    Pure idiocy and we can ignore your comments on this thread.

  27. .

    Roger
    #1181379, posted on February 7, 2014 at 8:50 pm
    And it’s equally wrong that political candidates receive generous subsidies from tax payers who didn’t even vote for them but who yet have no say in the matter. But that didn’t stop Sen elect Levonhjelm from pocketing such funding. He lost me right there.

    Hey arsehole…the ALP, Greens and LNP can pay it back…then so will we.

  28. Tel

    Some think we already do this through the Medicare levy, but they are wrong. The levy is not an insurance premium and only covers a small fraction of public health costs. It is really just another tax on income.

    As far as I’m concerned, a contract is a contract. It’s written quite clearly on my tax return that this I’m paying for medical cover, and I don’t see why it would be the business of the buyer to figure out what exactly their payment covers. Personally I would estimate that I pay a lot more than I use, but anyhow, I pay exactly what I’m asked to pay. A deal’s a deal, buddy.

  29. JC

    Yeah, because health spending is discretionary.

    It depends, SDFC. Lots of things are discretionary in medicine. My wife for instance is going to have a key hole operation on her hip to shave a part of the bone which is protruding into the tendon or whatever. Not everything is cancer and serious illness.

  30. sdfc

    You’re probably gonna die, or

    So if the sick or injured can’t afford it they should just die and the majority who go to a doctor just have a cold.

  31. sdfc

    JC

    So if you can’t afford healthcare you should just live in pain. Very productive.

  32. Tel

    So, LDP loves poor people, but let’s tax the rich and irresponsible.

    You have to tax the rich, it is Willie Sutton’s Law. There’s no profit robbing the widows and orphans. This is not a political matter, it’s a practical matter.

    If you can figure out some arbitrary justification for taxing the rich, thus satisfying both Willie Sutton and the morally upright voters, you are onto a winner. This is both a political matter, and a practical matter.

  33. Tel

    So if you can’t afford healthcare you should just live in pain. Very productive.

    Not if the LDP drug policy was put into effect.

  34. sdfc

    What drug policy is that Tel?

  35. JohnA

    It is wrong that people who are able to save to prepare for future ill health, but who choose not to do so, receive public health services. This wrong could be reduced by obliging people to save and use the money to cover future health costs.

    Some think we already do this through the Medicare levy, but they are wrong. The levy is not an insurance premium and only covers a small fraction of public health costs. It is really just another tax on income.

    We already have forced saving through the superannuation regime, with bipartisan agreement that the compulsory rate of saving should rise. Given this, it would make sense to compel people to draw down these savings before they are granted access to public health services.

    Such an approach would not affect the poorest in society who are unable to accumulate superannuation savings. They would continue to have immediate access to benefits in instances of ill health and remain eligible for the age pension upon reaching the appropriate age.

    It would only affect those who are able to save but who currently choose not to, and might prompt some of these people to undertake additional precautionary saving, to reconsider any unhealthy practices, and to avoid unnecessary visits to the GP. Any of these changes would reduce costs on taxpayers.

    He has it the wrong way around, and his logic fails.

    If those who have no savings because they are “poor” through no fault of their own are given favoured treatment by comparison with those who have no savings by their own choice the question remains: how does a government apply consistent rules to distinguish the two classes, and apply a penalty to the “indolent”?

    And as soon as you ask the question, you discover that people in class two can make themselves appear to be in class one.

  36. JC

    So if you can’t afford healthcare you should just live in pain. Very productive.

    SDFC

    David Leyonhjelm is describing the Singapore system which I believe has three layers of coverage. It works very well and people there don’t go without healthcare- rich or poor. It’s actually quite quite market friendly.

    Stop being an idiot by implying that only a sovietized model works.

  37. sdfc

    I’m talking to you not David. You responded to my argument that health spending is not discretionary remember.

  38. A libertarian praising Singapore.

    Singapore has the distinct advantage of not being a democracy.

  39. Tel

    The only solution you have is mandatory doctors appointments and scans, since people won’t know when to go to the doctor.

    Sure everyone knows when to go to a doctor… every time they need a medical certificate. You know perfectly well that sleeping off the flu would be a better idea, but you stagger into the local medical center, say, “Feels like a flu.” the doc says, “Yup, lots of people getting it, here’s a certificate, thanks for the fifty bucks. Would you like any drugs with that?”

    You reply, “No thanks I’ll just sneeze on a few more people on the way home so you have plenty of customers.”

    Even worse if you don’t drive and need to use public transport to get to a doctor.

    Come to think of it, even worse if you do drive while dopey with flu and fail to hit the brake in time.

  40. You responded to my argument that health spending is not discretionary remember.

    It is. You can choose to be ill or injured, or seek help from some other source.

    It’s daft in a lot of cases, but it is discretionary.

  41. JC

    It would only affect those who are able to save but who currently choose not to, and might prompt some of these people to undertake additional precautionary saving, to reconsider any unhealthy practices, and to avoid unnecessary visits to the GP. Any of these changes would reduce costs on taxpayers.

    Yes and yes. If people choose not to provide for themselves despite having the ability to do so, then fuck them. They ought to be used an example of the consequences. We don’t have enough of that in todays social make up. People need to be aware of the consequences by having others as an example.

  42. If those who have no savings because they are “poor” through no fault of their own are given favoured treatment by comparison with those who have no savings by their own choice the question remains: how does a government apply consistent rules to distinguish the two classes, and apply a penalty to the “indolent”?

    Is there a relationship between fault and indolence?

  43. sdfc

    So cancer, diabetes etc are discretionary diseases and car accidents are discretionary injuries. It’s wacky time at the cat.

  44. Tel

    What drug policy is that Tel?

    Seems to have fallen off the bottom of their website, fortunately the Internet never forgets :-)

    http://web.archive.org/web/20130428213809/http://ldp.org.au/federal/policies/pressReleases%202007.html#18_Oct_07

    LDP CALLS FOR TOLERANT DEBATE ABOUT DRUG LAWS
    The Liberty & Democracy Party (LDP) today agreed with the Prime Ministers move to make drugs part of the election debate.

    “When the Prime Minister says that we should treat drugs more like we today treat smoking his point is not without merit”, said Terje Petersen.

    “We agree that it is fair enough to suggest that people should choose health lifestyles for themselves. However that is probably the point at which the Liberty & Democracy Party parts company with the Prime Minister.

    “For many years John Howard’s rhetoric has been about small government, individual choice and personal responsibility. These are ideals that I strongly agree with and so does the LDP. However when it comes to the use of soft drugs the Prime Minister clearly abandons his principles and becomes authoritarian. When it comes to matters of lifestyle John Howard unfortunately makes his personal views political.

    “The Liberty & Democracy Party does not argue for a complete free for all. We know that policy needs to balance personal freedom against other considerations. For instance children need to be protected. However in doing so we should not treat adults like children.

    “We believe that the evidence in favour of regulation needs to be very strong before we abandon the ideals of individual responsibility. And history clearly shows that prohibition causes many significant problems of its own. John Howard goes too far in his assertions that the government must protect us from ourselves.

    Hear! Hear!

  45. .

    You’re being silly. Car accidents get treated with emergency triage procedures. Doctors would insist on this ethically regardless of your arguments.

    Yes I get the point that nearly everyone cops the treatment for serious conditions which require more than bedrest and are beyond self diagnosis, but you can’t make people get a diagnosis for them in the first place, and privatised health insurance and reducing moral hazard is the best way to minimise this. Why can’t you get your fat head around that?

  46. sdfc

    So Tel. Patients are better placed to know what medicines to use than doctors.

  47. entropy

    Wouldn’t the discretionary bit be about who you go to see, SDFC? Not much choice in the sticks, but choice is why most people prefer cities.

  48. .

    Yep Tel

    Another issue with drugs is that ehtics committees (what a sullen bunch of moochers and self appointed grandees they are) decide for terminally ill patients what is best for them.

    They’re not allowed to try to save their lives, and at the same time, the current law stops them from popping their own clogs.

    Legally, they must suffer and must not experiment with possibly life saving drugs.

    It’s for their own good.

    When are people going to wake up? When you become an adult, you don’t want mummy and daddy running your own life, but millions are prepared to vote for governments that do just the same?

    Madness.

  49. entropy

    So Tel. Patients are better placed to know what medicines to use than doctors.

    unfortunately, true more often than it should be.

  50. sdfc

    So Dot emergency treatment should be on government tick. Who’s to say what is a serious condition?

  51. .

    sdfc
    #1181453, posted on February 7, 2014 at 9:34 pm
    So Tel. Patients are better placed to know what medicines to use than doctors.

    Doctors misdiagnose and patients know their bodies better. I would also say that a pharmacist knows better about what medicine to use in a lot of the cases. The pharmacist is the one who stops the doc. prescribing incompatible, possibly lethal drug combinations.

    That knowledge is transferable. Hence the answer to your question may often be a “yes”.

  52. entropy

    Maybe SDFC I have that view growing up in a pharmaceutical dynasty.

  53. sdfc

    Are talking about colds again Dot?

  54. rebel with cause

    Of course healthcare has a discretionary component:

    If a woman is experiencing chronic back pain, her physician may recommend that she consider surgery, but whether she checks into the hospital or not will depend on a host of factors. In addition to weighing the clinical pros and cons, she may take into account her lifestyle, the distance she would have to travel for care, her out-of-pocket expenses, and perhaps her fear of surgery.

    If a women falls and fractures her hip, however, the pain she experiences and the fact that she cannot walk will cause her to go to the emergency room, where an X–ray will clearly show the problem, a correct diagnosis will be made, and she’ll be admitted to the hospital for treatment. This will happen regardless of whether she has insurance with a high deductible and even if she greatly dislikes being in the hospital.

    The difference between the two, health care professionals say, is that one procedure is discretionary, and the other simply is not

    .

  55. sdfc

    So pharmacists should diagnose things like epilepsy and cancer.

  56. .

    No sdfc you have tin ears.

    I said the doc. wouldn’t charge for that service.

    You read into this “hence it must be nationalised”

    There is no need for it at all. They would charge more elsewhere.

    You seem to think the Government exists to make people charge for every good and service.

    You are the kind of pillock who would have regulated Google’s business model out of existence.

    Before you start crapping on about Google being trivial, you have prattled on about the importance of ‘da information’ at length here.

  57. .

    sdfc
    #1181469, posted on February 7, 2014 at 9:41 pm
    So pharmacists should diagnose things like epilepsy and cancer.

    No one said that. (To be clear this is where specialists come into play, anyway.)

    You’re either a mendacious troll or a stupid fuck.

    Somehow you think your mentally insipid trolling (ala verballing) justifies regulating healthcare. It’s irrelevant, dishonest and trivial garbage.

    Pick one of the aforementioned options and fuck off.

  58. rebel with cause

    Pretty much every health care economist would disagree with you sdfc:

    The challenge lies in sorting out where consumers can best control their own demand, health care experts say. The use of the term discretionary in health care tends to be very informal, says Mark V. Pauly, PhD, a professor in the health care systems department at the University of Pennsylvania’s Wharton School. “We often hear that emergency care is not discretionary, for example, but other care is. But in point of fact, a lot of care in emergency rooms isn’t of that high of value and when you impose cost sharing for emergency room care, people decide not to visit. Based on economic theory, cost sharing impacts care to which consumers attach low value — if they aren’t willing to pay for it out of their deductible, they must be attaching low value to it.”

    Others agree that everything in health care is potentially discretionary. “That includes heart surgery and cancer treatment — unless it is for me, my wife, or my kids,” says Tom Getzen, executive director and CEO of the International Health Economics Association. “There really isn’t a simple way of defining it. You often think about a basic set of health care that everybody should have, and anything else is discretionary,” continues Getzen, who is also a professor in the department of insurance at Temple University. “But in practice, it’s not so much that certain procedures are discretionary, it’s that they are discretionary for certain people.”

  59. .

    You are as thick as pigshit, sdfc.

    Who’s to pay?

    There is no need for it at all. They would charge more elsewhere.

    I don’t care if you are too dumb to get this. Your lack of a functioning brain doesn’t mean the industry ought to be nationalised or heavily regulated.

  60. .

    It’s obvious, isn’t it rebel?

    Surgery is risky and you can die simply from anesthetic overdose. The risk of MRSA in hospitals today, even well run, new, private hospitals (not for profit and for profit) means that everyone views surgery not as a potential magic bullet with a high chance of working but like one that also has a low probability (but catastrophic outcome) of ‘blowing up in your face’.

  61. entropy

    No, SDFC, pharmacists make sure doctors don’t kill patients with the wrong drugs, or force the doctor to think about whether that new pill they are over subscribing might cause some nasty side effect when interacting with one of the thirteen or fourteen other prescriptions she has loaded poor old Mavis up with.

  62. sdfc

    Why the aggro Dot? I relish making an argument, you just come off as feeling threatened.

    You’re theory seems to be that doctors will treat emergency treatment as a loss leader and charge the longer-term ill more to recoup their losses. Where has the argument that healthcare is discretionary gone?

  63. sdfc

    So we should all self diagnose and go to pharmacists for treatment entropy?

  64. .

    You’re theory seems to be that doctors will treat emergency treatment as a loss leader and charge the longer-term ill [WTF - where did I say that?] more to recoup their losses. Where has the argument that healthcare is discretionary gone?

    You can’t even restate my argument accurately. You dishonest sack of shit.

  65. sdfc

    What is your argument then? Health spending is discretionary because….

  66. Mater

    There are other things that could be undertaken to immediately address costs in the health system. For example, the referal system. Explain to me if you can, why, after a full joint reconstruction do I need to go back to a GP to get a new referal to attend my final review with the surgeon just because the first one (which initiated the operation) is more than 12 months old? The first one, I understand but I had been under the Surgeons care for the entire 12 months.
    Stupid and wasteful. I happily spend my own money on my families health needs but I resent being held to ransom like this.

  67. .

    FFS if it wasn’t discretionary, people wouldn’t smoke, they’d get yearly checkups etc.

    Your point is irrelevant as the most important part of the health system doesn’t need nationalisation, and the evidence is actually against you.

    You listen up champ and you listen up good. *You* have not provided evidence. *You* have not provided a rigorous economic analysis of why your case is so friggin’ compelling.

    What kind of dopey argument says that any spending is “non discretionary” anyway? Some people value enjoyment more than a long life. This should be obvious to all but the most brain damaged of commentators. Or is the mortality curve for 16-25 year old males, although an observable reality, just “insecure and aggro”? Your arugment is a complete farce.

    ‘ooh, ooh, I’m a boring fuck and everyone has the same preferences as me…I feel compelled to buy health services and my lackwitted perception is that it runs more efficiently when it is nationalised or heavily regulated…so let it be written, so let it be done’

    That is your argument.

    Why in christ’s name does non discretionary spending need to be regulated you imbecile? I need to eat food, so why not nationalise that or regulate it so heavily I can’t feed myself. I don’t know as much as farming as an ag. science grad nor do I know about nutrition like a Ph D in nutrition.

    Shit, why can I even buy food in this country without a licence and a fucking TAFE Cert III in nutritional food procurement?

    You really are an ivory tower buffoon.

    Fucking deadshit.

  68. sdfc

    An excellent example of waste Mater. Well done.

  69. sdfc

    People don’t smoke because there is universal public health Dot, that’s ridiculous.

  70. .

    sdfc
    #1181525, posted on February 7, 2014 at 10:18 pm
    People don’t smoke because there is universal public health Dot, that’s ridiculous.

    WTF are you even on about you imbecile? How have I ever claimed the opposite (moral hazard encourages poor choices) doesn’t exist or is false? How did any of what I said contradict my position on that?

    How in christ’s name is any of that an argument for more public spending?

  71. rebel with cause

    People don’t smoke because there is universal public health

    Nice straw man. Nobody had made this argument.

  72. sdfc

    You’re all over the place Dot. Any argument worth making should be able to be summarised in a paragraph.

  73. rebel with cause

    I can’t believe we are having an argument about whether healthcare has a discretionary component when even the public health system has a list of surgeries and procedures it won’t provide at all, and another list of procedures classified as ‘elective’. FFS.

  74. sdfc

    So rebel disease or injury are discretionary.

  75. rebel with cause

    So rebel disease or injury are discretionary

    No, but what you choose to do about them is.

  76. sdfc

    So if you have a broken leg or cancer not to seek treatment is equivalent to not buying a tellie.

  77. .

    No, I was succinct and to the point. You have made numerous erroneous claims and had a thoroughly deserved bucket of shit poured on you.

    To summarise for your tiny brain why you are wrong, and to remark why you choose such an imbecilic position:

    Your argument means people should have involuntary check ups for one. You have not provided a valid theoretical model or any evidence. You insist that involuntary health care must be nationalised or highly regulated when it is not necessary at all to function. You have assumed, without evidence, that certain types of spending is non discretionary, and ignored social realities. The idea that basic needs (based on information asymmetry) ought to be regulated is so ridiculous that logically we’d be issued food by experts or require training to purchase, catch, kill or grow our own food. The whole reason you brought this ridiculous “argument” up was because you thought moral hazard was not relevant. Again you are ignoring the evidence. Your whole agenda is simply to justify more and more spending and any ALP policy at any cost.

    David Lleyonhjelm is correct.

    But if it is wrong to force people to save, it is also wrong that others pay for the health and retirement of those who refuse to save.

    …and you are ideologically opposed to people paying for their own healthcare and retirement, based on the laughable arguments noted above, such as a denial that moral hazard exists in our socialised healthcare system.

    You either want someone else to pick up the tab, or economically illiterate or are making money off this scam.

  78. sdfc

    You have made numerous erroneous claims

    Let’s narrow it down. What erroneous claims?

  79. .

    “I am personally offended by anyone making the (ultimately true) quip that seeking cancer treatment may be as matter of fact as deciding on what consumer good to buy or not, ergo we must socialise the medical system”

    Yep, great argument, sdfc. Keep ‘em coming.

  80. sdfc

    It’s you who suggested most health spending is discretionary.

    What would you do if you had a sick two year old? Discretionary to take them to the doctor?

  81. rebel with cause

    sdfc, I can only conclude that you are being deliberately obtuse. Discretion isn’t just ‘do I get healthcare or not?’. If you know anyone at all getting treatment for cancer you would know that there are a variety of choices patients will face – do I have another round of chemo? Do I go under the knife again if they didn’t get it all the 1st time? etc etc. Some people even elect not to get treatment for cancer on the grounds they consider the proposed treatments worse than the disease.

  82. JC

    SDFC

    you game playing rat, the move towards a free market in health would be done in stages and would most likely take a good amount of time to reach the final hurdle.

    If things don’t change we’re going to get there in the long run as the system will go broke, unless of course you think the entire tax take ought to go on healthcare.

    Is not incumbent on us to prove to you the free market works. It’s really up to you to explain why competitive forces in healthcare can’t function and why the soviet model works best. You buy food that is essentially free market produced, so why do market forces stop at the doctors door?

  83. JC

    sdfc, I can only conclude that you are being deliberately obtuse.

    He’s been like this for years. He either plays dumb or in fact is a very stupid person.

  84. sdfc

    No one’s playing dumb. What is discretionary health spending.

  85. rebel with cause

    What would you do if you had a sick two year old? Discretionary to take them to the doctor?

    How sick? Who defines what is ‘sick’?

  86. sdfc

    Let’s put this in economist talk. Is the health demand curve nearer horizontal or vertical.

  87. rebel with cause

    How do you know when you need to go to the doctor sdfc? Be specific.

  88. sdfc

    When I take my sick two year old to a doctor and he says its not quite pneumonia.

  89. JC

    So what you’re saying, SDFC is that on your present income you wouldn’t take you sick kid to the docs unless it was relatively free… or someone else helps pay for it. Is that correct?

  90. .

    sdfc claimed erroneously, by statement or omission, that:

    1. Everyone has the same preferences for risk, healthcare and longevity of life.
    2. That moral hazard in our healthcare sector was miniscule.
    3. Information asymmetry made medicine costly, including waste like multiple referrals.
    4. Such waste is actually a function of regulation for the sake of “non discretionary spending”, which he supports (not claimed, but carries on from 3.).
    5. Doctors prescribe the right drugs without oversight from pharmacistsand know more about their patients than the patient.
    6. His verballing that we recommend pharmacists do cancer diagnosis etc, when no one claimed that (and which actually is where specialists should come in).
    7. We shouldn’t buy non-discretionary goods without expert help (ergo buying food should be licensed, or food rationed to us by experts!).
    8. That spending in any way is non-discretionary and everyone has a corner solution with regards to healthcare.

    Put a fork in him folks, he’s done.

  91. sdfc

    Not everyone is on my income JC. I have private health insurance.

  92. rebel with cause

    No, how do you make the decision that your kid is sick enough to need to see the doctor?

  93. sdfc

    That moral hazard in our healthcare sector was miniscule.

    So you continue to hold the ridiculous view that smokers smoke because of universal public healthcare. Bizarre.

  94. sdfc

    Rebel, we did when he got home from an outing and she sat down in the front doorway.

  95. Poor Old Rafe

    It is a pity that sdfc derailed the threat when it got into the nuts and bolts of health care, it would really help to go back to the arguments in David’s post and start over again.

  96. .

    “Hey guys, I’m not playing dumb but a near vertical demand curve means we should nationalise this healthcare stuff eh?”

    Fucking laughable.

    So what you’re saying, SDFC is that on your present income you wouldn’t take you sick kid to the docs unless it was relatively free… or someone else helps pay for it. Is that correct?

    Yep. Even though he purports to have quite a large tax bill every year. He wants to help himself by paying more taxes.

    “If I pay more taxes, I am more willing to pay for a service!”

    This is glue sniffing, ivory tower stuff right here.

  97. JC

    1. Everyone has the same preferences for risk, healthcare and longevity of life.

    Bullshit. No one wants to die of course, but we make choices in life which we all know impacts longevity.

    2. That moral hazard in our healthcare sector was miniscule.

    Bullshit. SDFC, you’re an idiot if you believe this.

    3. Information asymmetry made medicine costly, including waste like multiple referrals.

    SDFC WTF? WTF?

    7. We shouldn’t buy non-discretionary goods without expert help (ergo buying food should be licensed, or food rationed to us by experts!).

    You idiot, SDFC. People self diagnose all the time.

    8. That spending in any way is non-discretionary and everyone has a corner solution with regards to healthcare.

    You’re right, stick a fork in him.

  98. .

    sdfc
    #1181591, posted on February 7, 2014 at 11:01 pm
    That moral hazard in our healthcare sector was miniscule.

    So you continue to hold the ridiculous eminently sensible view that smokers some smokers smoke because of the perceived risk amelioration due to universal public healthcare. Bizarre.

    No, it isn’t bizzare at all. It is true. Whether you like it or not.

  99. .

    You idiot, SDFC. People self diagnose all the time.

    EXACTLY! otherwise they wouldn’t bother going to the doctor in the first place

    I agree Rafe but this whole ridiculous argument is because of a refusal to believe in moral hazard – it is politically inconvenient for sdfc.

  100. JC

    So you continue to hold the ridiculous view that smokers smoke because of universal public healthcare. Bizarre.

    You’re looking at this from the wrong angle dickweed. Lets assume there was a free market in healthcare insurance like there is life insurance.. or at least far less intervention. So go off and buy a health insurance plan. You smoke and the plan is either 2k for non smokers and 3K for smokers. You really think this wouldn’t have a marginal impact on smoking rates? If you do you ought to be flogged.

  101. sdfc

    So health is a moral issue Dot?

  102. .

    “Moral hazard”

    Duh…morals…

    Give up you fucking stooge.

  103. JC

    So health is a moral issue Dot?

    You need to divide up two things when discussing this, SDFC. Healthcare and healthcare insurance aren’t the same fucking things.

  104. 2dogs

    It is a pity that sdfc derailed the threat when it got into the nuts and bolts of health care, it would really help to go back to the arguments in David’s post and start over again.

    Yep, nothing sdfc has said here goes against Leyonhjelm’s proposal.

  105. sdfc

    No we’re talking about universal health insurance JC.

  106. rebel with cause

    Rebel, we did when he got home from an outing and she sat down in the front doorway.

    Sorry, I didn’t realise this was your actual kid we were talking about, rather than a hypothetical child. Hope she is OK.

  107. sdfc

    That’s because I agree with him in part 2dogs.

  108. sdfc

    She is fine rebel, that was a fair few years ago. I remember thinking at the time that a hundred years ago without antibiotics she live or she dies.

  109. LABCR-TV

    I have always said:
    ‘Two wrongs don’t make it right, but they make it even’.

  110. Tel

    Has anyone ever considered that if the Outdoor Recreation Party merged with the Sex Party and took a lenient view toward Biker’s basic rights of association… they would become… wait … for … it …

    The Rootin, Tootin, Shootin, Scootin Party.

    I want to vote for one of those. So much freedom in such a small package.

  111. Tel

    Everyone has the same preferences for risk…

    You don’t get out much, do you?

  112. Tel

    So Tel. Patients are better placed to know what medicines to use than doctors.

    True by definition. Patients must live with the consequences so they are automatically responsible for the decision. Some patients might choose to consult one, two or several doctors in the process, they may consult their grandmother or the stars for that matter, but under all circumstances only one person accepts the consequences.

  113. JC

    Everyone has the same preferences for risk…

    You don’t get out much, do you?

    SDFC doesn’t go sky diving every weekend even though he thinks it’s as risky as watching cricket on TV.

  114. Tel

    JC, someone who dies of boredom is still dead right?

  115. Monkey's Uncle

    It’s you who suggested most health spending is discretionary.

    What would you do if you had a sick two year old? Discretionary to take them to the doctor?

    Assuming the sick two year old is you, sdfc, I would probably have you euthenased.

    Other than that, you seem to believe that providing one single example of a health care expenditure that is not particularly discretionary refutes the general hypothesis that the majority (but by no means all) health spending is discretionary. What a genius!

  116. sdfc

    What are you talking about JC?

    You need to catch up MU.

  117. rebel with cause

    David’s proposal is pretty statist.. I think that private charity would play a big role in a freer health system.

  118. Squirrel

    I note the Singapore example, but it’s probably not all that relevant to us as I understand Singaporean politicians are somewhat less prone than ours to go buying popularity with other people’s money. My concern with a proposal such as this is that, over time, too many people would be exempted – not because they are truly unable to make some provision, but because they fall into a favoured demographic/electoral category – thus increasing the burden on others who may be no better off, but not favoured by the politicians.

    I imagine the proposal would be seriously popular with some Financial Review readers – I can almost hear them licking their lips at the thought of the money they could cream off from such a savings pool. I will believe genuine competition in such areas when I see it.

    There should be considerable scope to make savings in public funding of health, which would do more than this nice idea.

  119. 2dogs

    My concern with a proposal such as this is that, over time, too many people would be exempted

    Bracket creep will bring more people in over time than leak out through claims of victimhood.

  120. Adam d

    Sdfc is probably the most annoying troll I have witnessed, so congratulations for that. You remind me of my 6 year old a complete ignorance wrapped in an unnatural confidence but you have successfully ruined this discussion, for me at least.

    No health should be free, you should pay a modest amount up front and be liable for cost later on (like a hecs debt.

  121. Alfonso

    Ah, Liberts dream time again. While they all are furiously claiming other people’s money to cover their medical expenses for their right not to wear a seat belt. David is going to have to sort out a response the suburbs can relate to common sense before next election.

  122. Paridell

    Like Paul Howes, Mr Leyonhjelm appears to have written in all innocence of the history of this question, as detailed recently in “Evicting Nana II – is the age pension really welfare?” In short, over generations Government took the money in taxes in the name of funding social security, spent it on other things, and is now increasingly reluctant to repay it.

  123. incoherent rambler

    There should be considerable scope to make savings in public funding of health, which would do more than this nice idea.

    +1
    Can we have a head count of the number of “not a service provider” in Commonwealth, State and Private systems (including health funds) for aged.

  124. Grigory M

    In short, over generations Government took the money in taxes in the name of funding social security, spent it on other things, and is now increasingly reluctant to repay it.

    Well said, Paridell. Should be a liberty quote.

  125. Squirrel

    “Paridell

    #1181859, posted on February 8, 2014 at 9:34 am

    Like Paul Howes, Mr Leyonhjelm appears to have written in all innocence of the history of this question, as detailed recently in “Evicting Nana II – is the age pension really welfare?” In short, over generations Government took the money in taxes in the name of funding social security, spent it on other things, and is now increasingly reluctant to repay it.”

    Excellent point. Admirable, in theory, as the proposal may be, it also sounds costly to administer. Even though it would be a less than pure way to gather extra funds, bumping up the Medicare levy and the surcharge for those who don’t have private cover, would be much simpler, and might have the desired effect if it was done with the message – “we’re doing this because costs are rising at an unsustainable rate”.

  126. johanna

    The problem with Mr Leyonhjelm’s thesis re healthcare is that it only looks at one side of the problem. As Mater and others have pointed out, it costs a lot more than it should. Bureaucratic overheads and requirements, people who know perfectly well that they have the flu and just need to spend a couple of days in bed but need a certificate for work, hospitals where a day in a crappy bed with awful food costs more than the best hotel on the planet – the list goes on.

    Nobody in their right mind (apart from the very wealthy) could realistically attempt to save against that cost structure. You could lose your house in a couple of weeks.

  127. Monkey's Uncle

    In short, over generations Government took the money in taxes in the name of funding social security, spent it on other things, and is now increasingly reluctant to repay it.

    This is not surprising, when you consider the fact that politicans with an eye on reelection in the short term often find that it is more popular to bring forward more spending and goodies into the short term instead of saving and investing for longer term needs. People that were old enough to vote at the time should bear more responsibility for those decisions than subsequent generations that were not old enough to vote at the time and had no say. No doubt much of the money that was spent instead of saved at the time was spent on things that were popular with and benefited sections of the electorate at the time. Why should those same people then expect to benefit later on as though the money had been saved rather than spent? That is having your cake and eating it. And why should subsequent workers and taxpayers effectively have to make good the shortfall because previous taxpayers largely elected to spend rather than save the money?

  128. johanna

    Monkey’s Uncle – because the goodies that were on offer were not available to them, perhaps? Why would oldies be significantly swayed by promises of free child care or tax rebates for having children?

    Punishing a class of people because of how and why you think they voted is not only logically unsustainable, it has nothing to do with good public policy.

  129. Monkey's Uncle

    Monkey’s Uncle – because the goodies that were on offer were not available to them, perhaps? Why would oldies be significantly swayed by promises of free child care or tax rebates for having children?

    Red herring. Just because things like “free child care” etc. were not popular or in demand in the past does not mean there were not other things that governments spent money on that were popular. Everyone on both sides of the discussion are agreed that money was spent instead of saved for longer term needs. Obviously it was spent on something and some benefited at the time. You are dancing around the point here.

    Punishing a class of people because of how and why you think they voted is not only logically unsustainable, it has nothing to do with good public policy.

    No. Rewarding a group of people collectively on the basis that one assumes they acted responsibly when it is not logically possible that all of them did so is not economically sustainable, or intellectually sustainable. And it is not really about me making assumptions about how others voted so much as it is about me simply following the arguments of those on the other side of the debate through to their logical conclusions.

    I have no particular desire to punish anyone. Those who really need assistance should still get it. I would just rather the debate started from more honest premises.

    As much as people complain about political correctness on the left, the truth is that among sections of the right the level of mindless tribalism, identity politics and thought policing is often just as repressive. Apparently anyone that lives past a certain age is automatically a saint who lived a blameless life.

  130. johanna

    “Apparently anyone that lives past a certain age is automatically a saint who lived a blameless life.”

    Please provide a citation. AFAIK, nobody said that.

    The rest of your post is gibberish.

  131. Monkey's Uncle

    Please provide a citation. AFAIK, nobody said that.

    No shit. That is because the nature of political correctness, in its various forms, is that it is often not stated explicitly but is rather an internalised form of self-censorship or restriction on thoughts and opinions.

    The rest of your post is gibberish.

    Screw you too darling. Thanks for confirming that you cannot refute anything I said.

  132. Monkey's Uncle

    Why would oldies be significantly swayed by promises of free child care or tax rebates for having children?

    I was talking about policies the oldies voted for in the past when they were younger, and the money was being spent rather than saved, little miss obtuse. Not what policies they would be more like to support now that they are old.

  133. johanna

    Please explain how people who are now 65-70+ would have been interested in child care promises made 20 years ago.

    My essential point remains – as a recipe for public policy, your tendency to punish people because of what or why you imagine they voted for a particular government in past elections is nonsense.

  134. Monkey's Uncle

    Please explain how people who are now 65-70+ would have been interested in child care promises made 20 years ago.

    I will avoid falling into your trap of defining the issue in such artificially narrow terms as you have set them. For future reference, I will never submit to any request to “please explain” a straw man argument you have set up. Please go screw yourself love.

    But on the broader point of whether people are responsible for past government policies, the point is simple. Those who were old enough to vote clearly had more say in past government policy than those who were not old enough to vote. Does that mean everyone that age is equally to blame? No. Does that mean everyone behaved irresponsibly and no one tried to promote sounder policies? No. Does that mean others are not also complicit, such as governments in power at the time? No. It just means that, on average, those who were old enough at the time to have a say or make a difference should bear more responsibility for those decisions than those who were not old enough or even around and therefore had no say in such matters. Making future taxpayers responsible for making good on those losses is not equitable or sustainable.

  135. Monkey's Uncle

    My essential point remains – as a recipe for public policy, your tendency to punish people because of what or why you imagine they voted for a particular government in past elections is nonsense.

    It has been said that the one virtue of democracy is that people largely get the government they deserve. And that democracy survives only until people work out they can simply vote themselves more loot at someone else’s expense. Yet according to you, people bear no responsibility for the choices they make in elections, or even for properly informing themselves about the issues or the demands they make of governments. Everyone is equally a helpless victim of evil government. Accordingly, I have amended your post to more accurately reflect what you are trying to saying.

    Your tendency to hold people responsible for their choices instead of allowing people to play the victim will not fly among my crowd

    There. Fixed it.

  136. johanna

    You don’t get it, never will. I can’t be bothered arguing with someone who thinks that whole classes of people should be punished because of what he imagines their prior motivations might have been.

    Go ahead and “cap” this if it makes you feel good.

    I’m gone.

  137. Monkey's Uncle

    It is more than a bit whiney and sniveling that you see the whole issue in terms of “punishment”. All I am saying is that some people might not be as entitled as they claim to be when it comes to public funds. That is punishment? And I am really such an awful, nasty, meanie for daring to suggest that people accept some responsibility for their own choices in life instead of acting like helpless victims of evil government.

    But really, who is actually being punished here. If future taxpayers have to pay the price for poor past policies, policies that they may have had no say in, they are really the ones being punished. It would seem you are okay with whole classes of people being punished in that respect.

    I’m gone.

    Thank God for that. Don’t let the door hit your arse on the way out. Go back to your own little world of comfortable delusions.

    As Ayn Rand said, you can ignore reality but you cannot ignore the consequences of ignoring reality. People can ignore the reality that they didn’t really pay for the cost of these programs, but collectively we cannot continue to ignore the consequences of ignoring the reality that there is no money set aside to do so and most governments will go broke.

  138. Ed

    Means testing against residential homes is the sort of bloody minded, anti-middle class bastardry that you would have expected from the Gillard administration. They probably didn’t do it because they hadn’t gotten around to it yet.

    But they were a political singularity. It’s not only nasty it’s a political non-starter.

  139. Ed

    It is more than a bit whiney and sniveling that you see the whole issue in terms of “punishment”. All I am saying is that some people might not be as entitled as they claim to be when it comes to public funds.

    Yeah, little old ladies living in the family home. That’s who you want to deny the pension to.
    What a piece of work you are.

  140. Demosthenes

    Means testing against residential homes is the sort of bloody minded, anti-middle class bastardry that you would have expected from the Gillard administration.

    It’s like you didn’t even read the thread.

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