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(This
article originally appeared in the Huffington Post on September 25, 2009.)
http://www.huffingtonpost.com/nathan-lewis/does-hong-kong-have-the-w_b_299907.html
I support a fully British-style
government-operated health care system for the U.S., which many find a little
odd given my otherwise libertarian leanings.
The
United States was founded on libertarian principles. There wasn't even an
income tax for the first 124 years of U.S. history -- to 1913 -- and even
that took a Constitutional Amendment, as it was deemed unconstitutional
before.
The
U.S. has been something of a disappointment to us libertarian types since
1913. Today, we get more enthused by the example of Hong Kong. Over the last
fifty years, it has evolved from a tiny exporter of cheap consumer junk to
one of the wealthiest and most prosperous places in the world.
Hong
Kong was one of the first places to adopt the kind of "flat tax"
system that people like Jack Kemp or Steve Forbes have long advocated. The
top income tax rate in Hong Kong is 17% for individuals, and 17.5% for
corporations. There is no sales tax, VAT, payroll tax, capital gains tax,
inheritance tax, tax on dividends or interest income. There is also not much
of anything in the way of a government pension system, like our Social
Security.
The
bottom 60% of earners pay no income tax at all. The top 100,000 taxpayers pay
57% of all taxes.
Even
after sixty years, the entire tax code is 200 pages long.
Info on Hong Kong's tax system.
Hong
Kong is the last place you'd think of as having a "nanny state."
However,
Hong Kong has a system of government-operated hospitals,
which constitutes the majority of the health care system. People also have
the option of a private hospital if they wish. There are more than fifty
public hospitals, and twelve private ones.
Hong
Kong's 6 million people are one of the healthiest populations in the world.
The life expectancy is 84 for women and 78 for men, the second-highest
worldwide.
Here
is how it looks to a Hong Kong citizen:
To
many of us who have worked and lived overseas, the Hong Kong health care
system was the ultimate social safety net that never failed to lend us a
strong sense of security. It was comforting to know that if we ever fell ill,
we could always return home for care.
I was
rushed to hospital after a bad car accident in Hong Kong many years ago. None
of the nurses or doctors asked me if I had insurance coverage, or enough
money to pay the bill. They just gave me the medical care I needed. The next
morning, a stern-faced hospital administrator came to visit me in the ward. I
did not know what to expect until she asked me if I needed social service
assistance for myself and family.
I
stayed in hospital for a week and was charged only for the meals. The total
bill was HK$35 [US$4], and the food was actually not bad at all.
There
must be millions of other people in Hong Kong who, like me, look upon our
health care system as sacrosanct. Any attempt to tamper with it would arouse
our strong suspicions and deep concerns.
http://english.sina.com/1/2008/0312/149936.html
This
system of government-operated hospitals, open to all citizens, costs the Hong
Kong government about 3% of GDP. Three percent! Private hospitals, used
mainly by the wealthy, and all other health care services bring Hong Kong's
total health care spending to about 6% of GDP. Compare that to about 16% in
the U.S. today, and rising.
Three
percent of GDP is less than half of the 7.5% of GDP that is already being
spent by U.S. governments on health care.
There you have it. In terms of both cost and effectiveness, the Hong Kong
system of public hospitals is one of the best in the world. It does not
interfere in any way with Hong Kong's libertarian approach to economic policy
in general.
Indeed,
you could even say that it helps. Hong Kong corporations have no excessive
health care burdens. Workers are happier and more productive. You might even
argue that, when people aren't worried about health care, they are more
likely to set off on their own and start the kind of entrepreneurial
businesses that have made Hong Kong great.
We
don't have a government here in the U.S. that is capable of anything but
stealing taxpayer money. However, other people in other places, like Hong
Kong, have faced problems like our own and solved them brilliantly.
Nathan
Lewis
Nathan
Lewis was formerly the chief international economist of a leading economic
forecasting firm. He now works in asset management. Lewis has written for the
Financial Times, the Wall Street Journal Asia, the Japan Times, Pravda, and
other publications. He has appeared on financial television in the United
States, Japan, and the Middle East. About the Book: Gold: The Once and Future
Money (Wiley, 2007, ISBN: 978-0-470-04766-8, $27.95) is available at
bookstores nationwide, from all major online booksellers, and direct from the
publisher at www.wileyfinance.com or 800-225-5945. In Canada, call
800-567-4797.
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