Should The US Start Some Sort Of Universal Health Care System?

[Kane]

It seems that most developed countries, even the more conservative developed countries like Japan, have some sort of universal health care;

http://www.nchc.org/facts/Japan.pdf

The US seems to be the only developed advanced country that does not have at least some health care. There are definitely many advantages and disadvantages to universal health care but fact still remains: millions and millions of Americans have no coverage.

IMHO social security should be privatized and while it may not be enough to cover the cost of basic/total coverage, it would provide a good amount to help cover the cost. Social security is anyways in my opinion a waste of time. You don't even get much money back when you retire and many demographic studies show there will not be enough people in the future to help cover all Americans in the US. If we were to use the money we pay to social security into universal health care I do believe it would be more effective.

Even if we were to privatize the schooling systems this would be smarter than keeping health care entirely private. Millions of Americans cannot afford health care monthly while most working Americans can make enough money to send their kids to school monthly. $1,000 every month for better quality private schooling is far more economical than a $3,000++ health care which millions of Americans cannot afford. And the cost to a small business owner to have medical coverage is ridiculous.

That is not to say that the US shouldn't have private health care run alongside with universal health care for those willing to pay higher. Having private health care systems side by side can help alleviate the financial stress and reduce backlogs etc.

Privatized Health Care is not as much more 'competitive' since most research is conducted in universities. Canada has some of the top research facilities in the world (The University of Western Ontario is one example).
Incidentally, waiting lists are not horrendous but they are long if it is for non-emergency operations. However, the American system is not a good alternative.

In any case isn't the government's job to protect the people? Even if you are a conservative we all know that Law Enforcement, Military, etc. aren't privately run. The Law Enforcement's job is to enforce the law so that there is order and peace within society. Firefighter's is to help put out fires as well as rescue people and animals from ditches and horrible natural situations. Similarly it should be the doctor's job to protect the people from disease and health hazards. When you dial 911 2/3 of the services are paid by our taxes to the government (police and firefighters). Why can't the 3rd 911 option (ER and medical needs) be covered by the government?

I really think we need to put universal health care ahead of public education and more than anything else; that worthless system called social security .

 

[Makalakumu]

President Clinton attempted to fix this problem a while back. I think he had some good ideas...but the lobbies were very well funded...and they won that round.

Basically, what he and the other dems wanted to do was create a system where the government would bargain and pay and pay health care costs for every american. This program would get bids from multiple private companies in order to get everyone covered...keeping the competitive pressure and keeping costs low. If one wanted to opt out of the program, one could apply for a voucher that one could use to bid on an insurance plan of ones own chosing. The leftover costs would be kept by the person who opted out.

The main reason this plan was suggested is that health care costs were skyrocketing at that time and that Americans were paying more in health care then any other industrialized nation. Basically, 15% of our gdp was and is going to health care and that number is rising. The highest of other countries where a single payer system was instituted is 11%.

Our businesses are losing their competitive edge because of this. We can't compete with countries that have single payer systems. If we instituted a plan like this, we'd pump hundreds of billions of dollars back into our economy.

 

[sgtmac_46]

One question....What nation has the greatest and most effective medical care and research on the planet?

That's pretty much a rhetorical question as any objective observer would conclude that the US has the most advanced medical care and research on the planet. It's also expensive. Which begs the question, if the US has the best medical care, and we are the only nation not to have universal coverage as a result of a huge bloated bureaucracy, could the two possibly be linked. Are we really asking do we want the best health care, or the cheapest?

I, for one, am happy to work to pay for health coverage so that if I need medical care, it's the best. If you have to have surgery, do you want the best doctor or the cheapest? I know what I want, and i'm willing to pay for it. Those who desire everything be "paid for" by the government are usually ignorant of simple economics.

As UpNorth illustrated above, by noting "Clinton's Simple Plan", who's going to pay for it? I know who's going to pay for that bloated bureaucracy. The same people who pay for every other "universal" entitlement program....those of us who work will pay for those of us who won't. I, for one, can afford my families health care insurance. I can't afford yours too. At what point did we decide that universal free health care should be an entitlement? Isn't it enough that we have the best medical care on the planet, now we want it FOR FREE?!

"The American Republic will endure, until politicians realize they can bribe the people with their own money."
Alexis de Tocqueville

 

[arnisador]

We desperately need some kind of universal health coverage. It's a human rights issue.

I was speaking the other night with a martial arts instructor who wanted to open a full-time school. Health insurance issues kept him at his old job and left him doing the rats part-time only. Is this kind of thing good for business?

 

[sgtmac_46]

We desperately need some kind of universal health coverage. It's a human rights issue.

I was speaking the other night with a martial arts instructor who wanted to open a full-time school. Health insurance issues kept him at his old job and left him doing the rats part-time only. Is this kind of thing good for business?

It is most definitely not a human rights issue. Without the medical system we have now, many of the advances in medicine would not have even been invented. Again, who's going to pay for it? I can barely afford my medical coverage, why should I have to pay for someone elses? It's all an attempt to get something for nothing by those who feel society owes them for just having been born. What's furthermore, why should I have to get increasingly substandard care because someone else can't afford health insurance, just to be fair?

I'm glad your friend is wanting to start his own business, America is founded on that. My problem is, however, that it is a "BUSINESS" and economics do apply. He should consider the economic implications of doing anything like that. If he can make money, he should do it. If not, he should stick with the other job.

What's more, i'm not sure why i'm supposed to pay for this gentleman's health insurance because he's not happy with his lot in life and wants to pursue his hobby as a business, but doesn't think he can afford quiting his other job because he wants to keep his health insurance? Why would anyone start a business they couldn't make a living at? And if they do, why am I suddenly responsible for subsidizing it? Why is this a human rights issue again?

And for those who claim that many people can't work,those people already have free health coverage paid for by me and you. The idea of universal health coverage is one that seems good only on the surface.

I work two jobs, go to school AND have started my own business, just to keep health care coverage for myself and my family and provide for them. Working two jobs and my own business on the side puts me in a tax bracket where everyone else starts coveting my money for their pet projects and entitlement programs. Darn right i'm annoyed by that prospect. If they want health coverage, then let them do what I do and work for it.

I have not NEED of free healthcare so long as the government doesn't rob me of all my money to pay for everyone else's free healthcare. At that point, I guess, i'll be in the same boat as everyone else...Thanks a lot.

I have no interest allowing politicians to bribe me with my own money.

 

[BlackCatBonz]

Isn't it enough that we have the best medical care on the planet, now we want it FOR FREE?!

how are you so sure that you have the best medical care on the planet?
you stated that some doctors are cheaper than others, thereby saying that the quality of care you would receive from the cheaper doctor is not upto snuff. How could this be considered the best?

if someone you knew needed a liver transplant, but the cost of the surgery meant that person was going to die.......how is this the best medical care on the planet.

i live in Canada and by no means do i think we have the perfect system......but what i do know is this, if I, or a member of my family is injured or sick and they require treatment......they get it. If it requires the top orthopaedic surgeon at the hospital for sick children.....they get it.
if my daughter has an ear infection and needs a prescription for antibiotics...i dont have to worry about any kind of doctor bill.....i just go.

In my opinion the best medical care equals one that is easily accessible, and promotes a good relationship between doctor and patient that includes the time needed for both to develop a healthy living plan.

the best medical care in the world should be able to decrease the rate of morbid obesity which probably affects 30 million people......which are included in the approximately 130 million "obese" people. $70-100 billion dollars are spent annually in the US to treat it.
Could you imagine getting that ship under control so that those healthcare dollars could be spent somewhere else.....like maybe on the hardworking citizens that cant afford it, but could sure use it.

 

[arnisador]

It is most definitely not a human rights issue. Without the medical system we have now, many of the advances in medicine would not have even been invented.

I agree. But does it matter to someone who isn't getting them?

Again, who's going to pay for it?

The same people that pay for welfare and Social Security and such, I'd guess. It's always that way. You do it now through ER visits at county hospitals by those without insurance.

I'm glad your friend is wanting to start his own business, America is founded on that. My problem is, however, that it is a "BUSINESS" and economics do apply.

Yes...but let's be blunt: Health care economics truly is different. It's not a simple supply-and-demand situation, and since life is in the balance, no price is too high. It's just not the same as saying if the rent is too high he shouldn't do it.

What's more, i'm not sure why i'm supposed to pay for this gentleman's health insurance because he's not happy with his lot in life and wants to pursue his hobby as a business, but doesn't think he can afford quiting his other job because he wants to keep his health insurance?

A fair statement. But again, I'd ask if it isn't good for the economy to encourage people to start businesses--as you indicate, the nation is built on that sort of thing.

 

[sgtmac_46]

how are you so sure that you have the best medical care on the planet?
you stated that some doctors are cheaper than others, thereby saying that the quality of care you would receive from the cheaper doctor is not upto snuff. How could this be considered the best?

I'm not sure I can educate on the free market principle, but in short...you get what you pay for. The best doctor's are like the best athletes...They play where they get paid.

Let me give you an analogy. I once knew someone who worked for a company that employed truck driver's to deliver gasoline. They paid their driver's $6.00 an hour. Of what quality do you think those driver's were? I thought so.

if someone you knew needed a liver transplant, but the cost of the surgery meant that person was going to die.......how is this the best medical care on the planet.

So what your saying is...If one place has surgery that is first rate, but expensive, but if you receive surgery there you're going to recover nicely and a second place has poor medical care, but hey, "It's cheap". You can afford it, but you'll likely die, the cuttrate place is BEST?! Now that's some logic.

i live in Canada and by no means do i think we have the perfect system......but what i do know is this, if I, or a member of my family is injured or sick and they require treatment......they get it. If it requires the top orthopaedic surgeon at the hospital for sick children.....they get it.
if my daughter has an ear infection and needs a prescription for antibiotics...i dont have to worry about any kind of doctor bill.....i just go.

The difference, my Canadian friend, is that I can get world class health care, I don't have to wait months for surgery, and I can get ALL this...JUST BY MAINTAINING A JOB. I have no concerns with health care...because I pay for healthcare insurance. If someone is too lazy to work, why I should pay for theirs as well (As pointed out above, this does NOT include people who can't work, because they are ALREADY covered).

In my opinion the best medical care equals one that is easily accessible, and promotes a good relationship between doctor and patient that includes the time needed for both to develop a healthy living plan.

Well, that's nice...My definition of the best medical care is that which is NOT likely to kill me, and gives me the best chance of recovering from my illness...period. That is best.

the best medical care in the world should be able to decrease the rate of morbid obesity which probably affects 30 million people......which are included in the approximately 130 million "obese" people. $70-100 billion dollars are spent annually in the US to treat it.

Since those issues are lifestyle issues, not "medical care issues" your line of logic is a bit convoluted. It's also running contrary to your assertion...that I should pay for the result of another person's lifestyle.

Could you imagine getting that ship under control so that those healthcare dollars could be spent somewhere else.....like maybe on the hardworking citizens that cant afford it, but could sure use it.

I work hard, and I can afford it. I'm certainly not rich. Maybe your under the illusion that those "hard working citizens" are as hard working as they are.


And you haven't answered my most basic question....Why should I have to pay for it? The problem I have with the socialized medicine argument is that the people who support it think money comes from some sort of nebulous source. We just print more if it, and that's it. It has to come from somewhere. Who's going to pay for it again? Their answer usually is "Someone else".

 

[Jonathan Randall]

The same people that pay for welfare and Social Security and such, I'd guess. It's always that way. You do it now through ER visits at county hospitals by those without insurance.

Bingo! I'd submit that the true cost, both monetary AND social of not having some sort of basic healthcare level in America is far, far higher than the cost of having one would be. I've worked in medical billing for the past fifteen years and I can tell you that uninsured are not only billed at an exponentially higher rate for the same services that insured are, but they often, through no fault of their own, end up having to declare bankruptcy - in which case ALL of their services are a W/O.

There is also the moral component. We are a very wealthy nation and it is unconscionable to me that so many children do not have easy access to the services I took for granted as a child and that by the time many uninsured finally seek care (in an ER), it is too late for them or the cost of recovery is now 100 times greater than it would have been had they been able to have regular doctor visits. I don't drive on the Interstates in the Eastern part of the country, but I have no problem with paying for them because we are the same people and one nation.

 

[sgtmac_46]

I agree. But does it matter to someone who isn't getting them?

Then they know what they have to do to get coverage.

The same people that pay for welfare and Social Security and such, I'd guess. It's always that way. You do it now through ER visits at county hospitals by those without insurance.

Yes, so you want me to pay MORE...This time for otherwise able bodied people who won't pay for their own insurance.

Yes...but let's be blunt: Health care economics truly is different. It's not a simple supply-and-demand situation, and since life is in the balance, no price is too high. It's just not the same as saying if the rent is too high he shouldn't do it.

Health care economics is no different than any other business. You get what you pay for. Lets look at those bloated bureaucracies around the world that provide universal healthcare. If you had the choice, you'd be treated right here in the US. Healthcare coverage is expensive but attainable by the average American. Those that don't have it, are people who don't want to pay for because they believe some nebulous "other" should pay for it. What's more, i'm paying the price and the result of the Universal Healthcare System would be a reduction in the quality of care.

As you say "Life is in the balance"...namely mine and my families, who have healthcare insurance. So they can take a flying leap with their asinine universal coverage scheme.

A fair statement. But again, I'd ask if it isn't good for the economy to encourage people to start businesses--as you indicate, the nation is built on that sort of thing.

It isn't good for the economy to subsidize businesses who can't make a profit. That isn't business and it isn't what the country is founded upon. That's the beauty of owning your own business...you are responsible for you, your own success or failure. If you need healthcare, you don't have a boss to complain too....you are the boss. If he can't successfully make a profit on his business, why would he start one. Capitalism is a beautiful thing....so long as we don't misunderstand what it is and what it isn't.

That having been said, there are some excellent healthcare providers for small business that are affordable...and your friend can Cobra out for the next 6 months (I believe) and pay for his current healthcare from the company he's at. :asian:

 

[sgtmac_46]

Bingo! I'd submit that the true cost, both monetary AND social of not having some sort of basic healthcare level in America is far, far higher than the cost of having one would be. I've worked in medical billing for the past fifteen years and I can tell you that uninsured are not only billed at an exponentially higher rate for the same services that insured are, but they often, through no fault of their own, end up having to declare bankruptcy - in which case ALL of their services are a W/O.

There is also the moral component. We are a very wealthy nation and it is unconscionable to me that so many children do not have easy access to the services I took for granted as a child and that by the time many uninsured finally seek care (in an ER), it is too late for them or the cost of recovery is now 100 times greater than it would have been had they been able to have regular doctor visits. I don't drive on the Interstates in the Eastern part of the country, but I have no problem with paying for them because we are the same people and one nation.

If you have no problem paying for it, then start a private organization and give money to it to provide healthcare coverage for the uninsured and underinsured. From all the talk I hear about people having no problem with paying for it, you should be able to insure every person who doesn't have insurance in the country...and ALL that without having to pay for a bloated government bureaucracy, which would eat up much of the money anyway, AND without damaging the quality of care provided. I think we just solved the insurance problem in the US.

 

[BlackCatBonz]

I'm not sure I can educate on the free market principle, but in short...you get what you pay for. The best doctor's are like the best athletes...They play where they get paid.

Let me give you an analogy. I once knew someone who worked for a company that employed truck driver's to deliver gasoline. They paid their driver's $6.00 an hour. Of what quality do you think those driver's were? I thought so.

So what your saying is...If one place has surgery that is first rate, but expensive, but if you receive surgery there you're going to recover nicely and a second place has poor medical care, but hey, "It's cheap". You can afford it, but you'll likely die, the cuttrate place is BEST?! Now that's some logic.

The difference, my Canadian friend, is that I can get world class health care, I don't have to wait months for surgery, and I can get ALL this...JUST BY MAINTAINING A JOB. I have no concerns with health care...because I pay for healthcare insurance. If someone is too lazy to work, why I should pay for theirs as well (As pointed out above, this does NOT include people who can't work, because they are ALREADY covered).

Well, that's nice...My definition of the best medical care is that which is NOT likely to kill me, and gives me the best chance of recovering from my illness...period. That is best.

Since those issues are lifestyle issues, not "medical care issues" your line of logic is a bit convoluted. It's also running contrary to your assertion...that I should pay for the result of another person's lifestyle.

I work hard, and I can afford it. I'm certainly not rich. Maybe your under the illusion that those "hard working citizens" are as hard working as they are.


And you haven't answered my most basic question....Why should I have to pay for it? The problem I have with the socialized medicine argument is that the people who support it think money comes from some sort of nebulous source. We just print more if it, and that's it. It has to come from somewhere. Who's going to pay for it again? Their answer usually is "Someone else".

you do pay for those things......through taxes.
equating a truck drivers wages to the delivery of healthcare is a bit ridiculous....dontcha think?
And by your logic......there is no standard for quality medical care in the US. What if your super high paid surgeon is an alcoholic that pops amphetamines to keep his edge?
have you seen the rates for death due to misdiagnosis or mistreatment in the states recently? it's one of the top ten causes of death......it ranks higher than automobile accidents. Heck, you could almost say that the american medical system is the leading cause of death in the US.

 

[JAMJTX]

Should The US Start Some Sort Of Universal Health Care System?
It failed every where else, so why not have it fail here too? It's a great idea.

Canada has universal health care too. But if you look in the hospitals in the border states, they are all filled up with wealthy canadians who have the money to come here. Wealthy foreigners come from all over the world to the U.S. because they know we have the best medical system in the world.

In countries that have universal health care, you will find that the people pay an astounding amount taxes to support it, the medical systems are bankrupt and health care is rationed and you don't get to choose your own Dr. or get a sceond opinion if you think the Dr. might be wrong. In many of these countries, senior citizens do not get life saving treatment for illnesses that we can cure here.

What it amounts to is a government run HMO, and everyone knows how bad they turned out to be. I would much rather maintain my freedom and have my medical decisions made by myself and my chosen Dr and keep the government out of it.

 

[Jonathan Randall]

Should The US Start Some Sort Of Universal Health Care System?
It failed every where else, so why not have it fail here too? It's a great idea.

Canada has universal health care too. But if you look in the hospitals in the border states, they are all filled up with wealthy canadians who have the money to come here. Wealthy foreigners come from all over the world to the U.S. because they know we have the best medical system in the world.

In countries that have universal health care, you will find that the people pay an astounding amount taxes to support it, the medical systems are bankrupt and health care is rationed and you don't get to choose your own Dr. or get a sceond opinion if you think the Dr. might be wrong. In many of these countries, senior citizens do not get life saving treatment for illnesses that we can cure here.

What it amounts to is a government run HMO, and everyone knows how bad they turned out to be. I would much rather maintain my freedom and have my medical decisions made by myself and my chosen Dr and keep the government out of it.

I think that you are going on the assumption that ANY national healthcare plan must REPLACE private insurance and private healthcare and must also be serviced strictly by government run clinics and hospitals. It does not have to be and SHOULD not be setup this way. It is a floor, IMO, not a ceiling. There is NOTHING wrong with wealthy members of a community paying for premium service at their own discretion. Also, do some checking on HMO's and their waiting periods and denials of service to PAYING customers.

In regards to it failing everywhere else, I have friends from countries with universal healthcare and they love it. It definitely has some drawbacks, some a necessary component, other problems that can be eliminated with a proper setup, but to call it an absolute failure is inaccurate. We do pay for not having it in indirect and social costs, IMO, as much as those nations pay for having it.

There is so MUCH money in the business opposed to national healthcare that right wing talking points are paid for and distributed by conservative foundations. I really get after my left leaning friends for opposing items simply because they originate either with the current Admin. or from the conservative perspective, but the opposite is just as frequent.

 

[sgtmac_46]

I think that you are going on the assumption that ANY national healthcare plan must REPLACE private insurance and private healthcare and must also be serviced strictly by government run clinics and hospitals. It does not have to be and SHOULD not be setup this way. It is a floor, IMO, not a ceiling. There is NOTHING wrong with wealthy members of a community paying for premium service at their own discretion. Also, do some checking on HMO's and their waiting periods and denials of service to PAYING customers.

Wow, you actually believe that the government will run this program differently than any other bureaucracy they've gotten ahold of? How polyannic. It isn't just going to be the wealthy paying for this project, as the term "Wealthy" is pretty nebulous. It's going to be me. So, instead of being able to afford "premium" healthcare, i'm forced to buy in to this government boondogle. Thanks.

In regards to it failing everywhere else, I have friends from countries with universal healthcare and they love it. It definitely has some drawbacks, some a necessary component, other problems that can be eliminated with a proper setup, but to call it an absolute failure is inaccurate. We do pay for not having it in indirect and social costs, IMO, as much as those nations pay for having it.

lol. "They may love it" but if you had the choice, where would you get surgery?

There is so MUCH money in the business opposed to national healthcare that right wing talking points are paid for and distributed by conservative foundations. I really get after my left leaning friends for opposing items simply because they originate either with the current Admin. or from the conservative perspective, but the opposite is just as frequent.

talking points aren't necessary to ask the obvious questions "Who's going to pay for it?"

 

[Jonathan Randall]

Wow, you actually believe that the government will run this program differently than any other bureaucracy they've gotten ahold of? How polyannic. It isn't just going to be the wealthy paying for this project, as the term "Wealthy" is pretty nebulous. It's going to be me. So, instead of being able to afford "premium" healthcare, i'm forced to buy in to this government boondogle. Thanks.

lol. "They may love it" but if you had the choice, where would you get surgery?

talking points aren't necessary to ask the obvious questions "Who's going to pay for it?"

I think that the anti-healthcare people are taking as a baseline for their talking points a government managed healthcare system rather than a form of basic national health insurance. Sure there will be inefficiencies, just as there are in all govt. work from builing highways to maintaining the armed forces. I would like to point out that our health system began having so many problems when, in the late seventies on, it became a for profit business. Now the free market is great, but it does have its downsides.

I have private insurance to the max and even if we had a national floor of basic healthcare, I would not be effected. Again, you are making the jump from some sort of national health insurance for those unable to get it to socialized medicine.

My point was that we already pay for NOT having it.

 

[arnisador]

I've worked in medical billing for the past fifteen years and I can tell you that uninsured are not only billed at an exponentially higher rate for the same services that insured are, but they often, through no fault of their own, end up having to declare bankruptcy

I've read about this in the Wall Street Journal. It's amazing what the uninsured are charged for health care! If you don't have a big company negotiating for you, you can easily pay ten times the cost charged to others.

There is also the moral component. We are a very wealthy nation and it is unconscionable to me that so many children do not have easy access to the services I took for granted as a child

I absolutely agree. This is the heart of it for me. It's a moral issue; a human rights issue.

By the way, the Interstate Highway system is technically a Dept. of Defense project--or at least it was initially (roads strong enough to allow for tanks etc. to be shifted around the country).

 

[arnisador]

I think JAMJTX makes some good points. But, I'd still like to see us try.

I think sgtmac_46 makes a good point that the U.S. is the tops for health care quality (though some people are now going to India for a bargain). But getting health insurance for small companies is not so easy, as insurance is about spreading risk...hard to do in a small company.

Suppose some jerk doesn't get health care for hsi or her kids. The kids suffer. Is that fair? I understand that Ireland has, or used to have, full health coverage for those under the age of majority. Is that a fair compromise?

 

[sgtmac_46]

I think that the anti-healthcare people are taking as a baseline for their talking points a government managed healthcare system rather than a form of basic national health insurance. Sure there will be inefficiencies, just as there are in all govt. work from builing highways to maintaining the armed forces. I would like to point out that our health system began having so many problems when, in the late seventies on, it became a for profit business. Now the free market is great, but it does have its downsides.

I have private insurance to the max and even if we had a national floor of basic healthcare, I would not be effected. Again, you are making the jump from some sort of national health insurance for those unable to get it to socialized medicine.

My point was that we already pay for NOT having it.

That leap is not very far. You still haven't told me WHY you and I (who have health insurance) should pay for OTHERS who don't. That's all i'm waiting for.

 

[sgtmac_46]

I think JAMJTX makes some good points. But, I'd still like to see us try.

I think sgtmac_46 makes a good point that the U.S. is the tops for health care quality (though some people are now going to India for a bargain). But getting health insurance for small companies is not so easy, as insurance is about spreading risk...hard to do in a small company.

Suppose some jerk doesn't get health care for hsi or her kids. The kids suffer. Is that fair? I understand that Ireland has, or used to have, full health coverage for those under the age of majority. Is that a fair compromise?

It might possibly be a fair compromise. I have less of a problem with that than the idea of paying for health insurance for every man woman and child in the country, whether they need it or not.

"Hey, here's your voucher for the money you gave us so you can spend it on what you want, minus the cut we took for processing it through a bureaucracy" Hey, thanks....

Here's an even better system....How about the US government get in to the health care business like any other company. Those that don't have coverage can pay the US government as a provider, and the US government can roll all profits over to providing coverage. This doesn't cost me a dime, you a dime, and the people who use it pay for it. It doesn't get any fairer than that. As a provider of services, the US government doesn't have to worry about a profit margin, they can simply pay out what they get in.