Re: What you thinkmnemeNovember 6 2012, 23:30:01 UTC
Am curious as to who this is.
FWIW, I am much more pro-legalization and anti-sales tax than I am anti-sin tax -- but it -is- a logical (and not entirely obvious) consequence of my core beliefs, so I put it in.
Part of the problem is that there are ways to discourage/mitigate self-destructive behavior other than tax and ban -- social services can often do a better job, for less.
Another is that the "sins" we tax can often be used in a non-self destructive (or at least not self-destructive in a way that puts a burden on society) manner.
A third is that sin taxes just aren't that effective. If we look at cigarette and alcohol taxes, I'd have to guess (educatedly) that smoking and drinking are -far- more popular with people near or below the poverty line than those above it. But they are hit far harder by the appropriate sin taxes--which serve, rather to keep them away from such vices, to instead make it harder to reach a level of affluence such that they have better things to do.
Now, it's possible that non-regressive sin taxes are possible (tax the production of destructive goods to pay for some of the damage they cause). I doubt it would work, since the costs would end up getting passed directly on to the consumer, but it would be interesting; I just don't think the math works.
Re: What you thinkcrash_mccormickNovember 7 2012, 02:30:41 UTC
Sin Taxes do work but they are not universally effective. In the cases I am aware of they are a complex function of rates relative to incomes, addictiveness, and other social pressures.
I know people who were able to make the change with varying difficulty for financial reasons.
OTOH I am comfortable with targeting money from behaviors with social costs to those activities. Tax gambling to fund treatment programs based on their effectiveness, etc.
The issue of how we fund health care is related. Sadly people are almost never willing to start out from the "You are poor, you get sick, you die" position and then add services and distribute costs honestly until they reach a level of support they are comfortable with.
Re: What you thinkebartleyNovember 7 2012, 05:32:21 UTC
When you look at it closely, health care winds up presenting us with a choice: either (1) we forbid people to pay for treatments that could save their lives / health / comfort, or (2) we accept that your chance of surviving medical difficulties / retaining or regaining well-being depends on your ability to pay. We can forestall this choice much of the time by cost-shifting onto third parties - and we do, and most of the arguments about health care boil down to how often and when we should do so; fairly few take the position that the government should never pay for health care. But resources are ultimately limited, and unless we make self-pay and medical tourism illegal Bill Gates's hypothetical son is likely to live longer when struck by a rare disease than my son is.
We cringe away from honestly on health care and funding health care because we're ultimately faced with an unpleasant choice. And IMO it is right that we cringe at the thought of telling people they can't buy something which might save their life, or their child's life, and it is also right that we cringe at the thought of someone's survival depending on one's ability to pay. But those are the choices we've got, and cringing from both of them doesn't make the choice go away. Being dishonest doesn't help.
Re: What you thinkmnemeNovember 7 2012, 06:15:45 UTC
In the end, unless we're going for the (harmful, IMO) "the nail that sticks up gets hammered down" style of equality (where one tries to make everyone equal regardless of circumstances rather than try to make sure everyone -starts- from a relatively fair starting point), there's no point to prohibiting treatments for rich people.
This does mean, yes, that rich people are going to have a better chance of surviving expensive diseases than poor people. This is fine--if anything, it's a positive overall good, since treatments that sick rich people fund eventually filter out to the rest of the population -- just like technologies invented for space travel have eventually resulted in a massive series of public goods (GPS, satelite internet/tv/radio/phone, hubble, filter-down technolgoies, etc) even if some of the motivations for funding it weren't sensible overall.
Where we tend to fall down is more in the middle ground; making sure everyone can get -some- access to public funding when they need it, and that people aren't unfairly punished just for getting sick faster/more often than other people who make the same choices. We should have -no- uninsured children, very few uninsured adults, and people should not be put into situations where they, for (theoretically) sensible financial reasons, choose to get sicker and hope they recover rather than seeking treatment/diagnostics that might make them well but -will- severely impact their ability to get by. People will still die, and some of those will die because it's simply not possible for them to afford the treatments needed to keep them alive -- but that should be the edge case, not the norm.
Worldwide, the NHS comes close on cancer care on occasion, saying that they'll withhold the normal chemotherapy care if you self-pay for additional therapies not on their pharmaceutical list. And I believe self-pay is still illegal in parts of Canada, though medical tourism is perfectly legal.
Re: What you thinkmnemeNovember 7 2012, 06:03:35 UTC
It's worth noting that targeting money from one tax source (like sin taxes) into a theoretical related destination (like sin treatment/medical costs) is a laudible idea but does tend to fall down in practice as the money gets rerouted.
They do need to be balanced (and I'm not convinced they are) against the way in which sin taxes tend to (like all regressive taxes) keep poor people poor.
Re: What you thinkbarking_iguanaNovember 7 2012, 11:43:00 UTC
I believe research has shown the increasing taxes on cigarettes to be responsible for a very large part of the decline in smoking rates. And, I would guess, on the amount smiked by those who still smoke.
Re: What you thinkmnemeNovember 7 2012, 17:52:24 UTC
Fair enough. WRT sin taxes (and here one gets into a question of desirability -- I applaud the decline in cigarette smoking because I dislike the smell of smoke and because it's a highly addictive habit that shortens people's lifetime; I don't want people going back to 1900s level drinking but believe, from experience, that it can much more easily be engaged in in a moderate, not other-people-harming (or self-harming) fashion) a lot depends on the harm they do (regressive taxation) against the good they do.
FWIW, I am much more pro-legalization and anti-sales tax than I am anti-sin tax -- but it -is- a logical (and not entirely obvious) consequence of my core beliefs, so I put it in.
Part of the problem is that there are ways to discourage/mitigate self-destructive behavior other than tax and ban -- social services can often do a better job, for less.
Another is that the "sins" we tax can often be used in a non-self destructive (or at least not self-destructive in a way that puts a burden on society) manner.
A third is that sin taxes just aren't that effective. If we look at cigarette and alcohol taxes, I'd have to guess (educatedly) that smoking and drinking are -far- more popular with people near or below the poverty line than those above it. But they are hit far harder by the appropriate sin taxes--which serve, rather to keep them away from such vices, to instead make it harder to reach a level of affluence such that they have better things to do.
Now, it's possible that non-regressive sin taxes are possible (tax the production of destructive goods to pay for some of the damage they cause). I doubt it would work, since the costs would end up getting passed directly on to the consumer, but it would be interesting; I just don't think the math works.
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I know people who were able to make the change with varying difficulty for financial reasons.
OTOH I am comfortable with targeting money from behaviors with social costs to those activities. Tax gambling to fund treatment programs based on their effectiveness, etc.
The issue of how we fund health care is related. Sadly people are almost never willing to start out from the "You are poor, you get sick, you die" position and then add services and distribute costs honestly until they reach a level of support they are comfortable with.
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We cringe away from honestly on health care and funding health care because we're ultimately faced with an unpleasant choice. And IMO it is right that we cringe at the thought of telling people they can't buy something which might save their life, or their child's life, and it is also right that we cringe at the thought of someone's survival depending on one's ability to pay. But those are the choices we've got, and cringing from both of them doesn't make the choice go away. Being dishonest doesn't help.
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This does mean, yes, that rich people are going to have a better chance of surviving expensive diseases than poor people. This is fine--if anything, it's a positive overall good, since treatments that sick rich people fund eventually filter out to the rest of the population -- just like technologies invented for space travel have eventually resulted in a massive series of public goods (GPS, satelite internet/tv/radio/phone, hubble, filter-down technolgoies, etc) even if some of the motivations for funding it weren't sensible overall.
Where we tend to fall down is more in the middle ground; making sure everyone can get -some- access to public funding when they need it, and that people aren't unfairly punished just for getting sick faster/more often than other people who make the same choices. We should have -no- uninsured children, very few uninsured adults, and people should not be put into situations where they, for (theoretically) sensible financial reasons, choose to get sicker and hope they recover rather than seeking treatment/diagnostics that might make them well but -will- severely impact their ability to get by. People will still die, and some of those will die because it's simply not possible for them to afford the treatments needed to keep them alive -- but that should be the edge case, not the norm.
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Worldwide, the NHS comes close on cancer care on occasion, saying that they'll withhold the normal chemotherapy care if you self-pay for additional therapies not on their pharmaceutical list. And I believe self-pay is still illegal in parts of Canada, though medical tourism is perfectly legal.
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They do need to be balanced (and I'm not convinced they are) against the way in which sin taxes tend to (like all regressive taxes) keep poor people poor.
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