[Amezarak]

It certainly matters to the poorer people who could buy more stuff if their tax burden was shifted more fairly. This has concrete effects: VAT has no impact on a wealthy person say, stocking every room in his house with a 80” 4K TV, while it makes a big difference to the poor person who wants just one TV. The effect compounds over time, obviously, and for more important purchases as well.

The US state and federal governments spend 1.5 trillion per year on Medicaid, Medicare, CHIP, and VA health care. The actual number is even higher than this by a fair margin because many US health systems are owned by local governments, and US government employee health spending isn’t accounted for either. With 330million US citizens, that means per capita US government health care spending is 4500. Most countries are able to fund their entire public health care systems with very similar per capita numbers; America doesn’t have universal public healthcare because the system is broken, not because it needs the money. So very high consumption taxes aren’t the reason Europe can afford good health policies - the American government already spends the same amount, and could stand to dramatically increase income taxes on high earners.