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Russia is spending more of GDP, US 3.3%, Russia 5.3%, but Russia's GDP is so low that US spending is still nearly nine(!) times higher in actual dollars [1]. A

Russia is spending more of GDP, US 3.3%, Russia 5.3%, but Russia's GDP is so low that US spending is still nearly nine(!) times higher in actual dollars [1]. A Russian spent dollar probably gives more bang for the buck, but US military spending is still very high. The single-pay system can be made to work. Others make it work, and a lot cheaper, but you have to accept that you need change. US health care is imo absurdly expensive and not that good (I have experienced it). But that discussion seem to always fall into the realm of doctrine rather than what is good and possible when it comes under discussion. [1] https://en.wikipedia.org/wiki/List_of_countries_by_military_expenditures https://en.wikipedia.org/wiki/List_of_countries_by_military_...

adventured 9y ago
> A Russian spent dollar probably gives more bang for the buck, but US military spending is still very high. You of course didn't support that claim at all. Most US military spending goes to soldier-related costs. How do you propose to slash that given how dramatically higher the US median wage is compared to Russia? Other than of course to perhaps cut the number of US soldiers in half. > The single-pay system can be made to work. Others make it work, and a lot cheaper Of course it can work. It can't work with US costs what they are. You need to go tell US nurses they have to take a 1/3 pay cut, to match up with what nurses in France and Germany are making. Then you need to go tell radiologists that they have to take a 70% pay cut to match up with French radiologists. Then you have to go tell pharma they're getting a 2/3 cut. Then you have to tell average hospital workers they're getting a 20% pay cut. Then you have to close 1/3 of all hospitals. Then you have to substantially expand wait times to match eg Canada, aka rationing the care. Then you have to tell hospital admin they're getting a 50% cut in their budget. Then you have to fire 500,000 people that are employed directly or indirectly in the health insurance industry. Then you have to slash the payouts for all sorts of highway robbery prices in medtech / devices / supplies related to the healthcare industry, which will can hundreds of thousands of more employees. You have to successfully adjust all of that, lower the costs, then figure out how to create new economic growth with the cost savings to re-employ all those lost jobs, wages, taxes (all that lost income tax, which will shoot a hole in the side of social security & medicare/medicaid). IE you have to find a trillion dollars in savings across dozens of economic segments. Which is another way of saying: a lot of people are going to lose a lot of jobs and income. It's an extraordinarily complicated and expensive problem to resolve without rattling the entire economy to its core. Oh yeah, then you have to dramatically raise taxes on the US middle class (which pays very little in taxes vs most developed nations) to match up with what countries with single payer systems do; and explain to the middle class that they're going to be better off with socialized healthcare, and that the increased taxes will be off-set by the government healthcare vs the old private insurance approach. Then you also have to significantly raise taxes on the top 25%, which pay most of the taxes in the US. No problem eh.
- m_mueller 9y ago
  I'd suggest not to use the model of centralistic and rather socialistic nations like France as a model for the US. Not that I don't like that model, I just don't think it's a good fit. Instead look at Switzerland for example. Leaving foreign politics away it almost seems like a shrunken down version of the US, both politically and economically, with just a few major differences: * even more locally organised. County sized administrations have about the same independence as US states. * instead of spending our (similar) tax rates on the military, it is spent on superb health care (imagine a souped up version of Obamacare with regulated prices), schools and a social net. Look at the numbers though - I think it works, that is, innovation and the economy in general are strong thanks to a more stable middle class (that doesn't experience negative social mobility due to health care problems and overpaid schools plus gets an influx from people at the poor end that make it by means of a helping hand at child age). * and no, I would argue Switzerland is not significantly less diverse with about 30% immigrant population. We have about the same proportion of backwards rightwing pseudo conservatives as a counterreaction, but they are bound to a political system that makes getting absolute majorities in the parliament near impossible (and also relatively useless alone thanks to referendums that serve as a moderation tool). See also again the difference in how middle class is kept going, which makes a Populist power grab much less likely.
  - adventured 9y ago
    We could redirect 50% of our military spending to single payer and it would not even remotely fix our problems. That amount of money would make single payer work in just California (ie 10% of the nation). We probably need to be spending $200+ billion more just on our existing medicare + medicaid + VA health systems as it is. People that keep saying things like that about military spending, don't seem to understand that the biggest problem the US has, is for single payer to work millions of Americans are going to have to lose big time, to the tune of a trillion dollar cut affecting millions of incomes & jobs that feed off the system bloat. You either need to come up with trillions of dollars in new funding to do single payer, or you need to tell millions of Americans they're going to be fired and or take big pay cuts (plausibly both). I agree, there are better systems than France. My only reference to France, is about competitive salaries in the healthcare industry. Wages in that industry have to come down by a lot to match comparables in eg France, Germany, UK. When people talk about single payer re the US, they focus on drug prices and insurance industry costs. They ignore that essentially every cost in the US system is inflated, including routine labor and dozens of side connected feeder industries (everything from saline supply to the cost of hospital beds to labor costs in elderly care). Most of the cost bloat in the system is made up of salaries for workers such as nurses, doctors, hospital workers, admin and health insurance employees. You could slash pharma costs nearly in half in the US and only save ~$150 billion of the $1 trillion we have to cut out of our costs to get cost competitive again. Every one of these cuts will have substantial economic consequences; cut pharma in half, lose a million high paying jobs directly & indirectly that support the tax base that pays for the single payer system (ie you have to figure out how to replace that; which would occur, but it'd take lots of time). That said, the way the US is actually going to go, is we're going to do a slow mediocre drift into single payer, through gradual expansion as the existing convoluted system fails one tier after another (essentially failing up the economic chain; the middle class will gradually all be pulled into government healthcare by necessity as the system collapses). Maybe out of desperation they'll use medicare as the platform, since the politicians in Washington DC can never agree on anything it's most likely our result will be to use something that already exists and just enlarge it.
m_mueller 9y ago
The way that the US is spending money (e.g. building a 1.5tn fighter jet that can hardly fight and a 35bn aircraft carrier that can't launch) I would actually start getting worried about adversaries with just a tenth of the US budget. To put it differently, if the Swiss, population 8M, can figure out how to transport 1.8x the amount of rail passengers compared to the entire US (no, not by capita, in absolute numbers [1]), it could also happen that a smaller budget military outmaneuvers US army, navy and marines. That being said, conventional armies made for symmetric warfare seem just about as useless now as at the height of the cold war. But not even the security of the nuclear arsenal seems a high priority in US politics today. [1] https://en.m.wikipedia.org/wiki/List_of_countries_by_rail_usage https://en.m.wikipedia.org/wiki/List_of_countries_by_rail_us...
- adventured 9y ago
  Your arguments rest on irrational statements. The US isn't spending $1.5 trillion on the F35. First, the costs will be spread over decades; second, the US will never order even half the planes in question; it never does when it comes to large systems orders. In 10-15 years they'll be slashing the buying down toward zero as with the F22 (as the military chomps at the bit to move on to new programs), the F35 program will cost half as much as claimed presently, as most of the cost projections are based on maintenance costs over 30 years for thousands of planes that will never be purchased (we're going to buy thousands of F35s over decades? yeah right). That aircraft carrier will launch. Every country that has ever built one has had significant problems doing so, the US has a long successful history of building & deploying aircraft carriers, the latest one will be no different regardless of temporary problems.
  - m_mueller 9y ago
    You aren't reading favourably. It could well be that the whole stealth superiority fighter concept is outdated due to new cheap sensor technology (and its use in AA defense systems) and the whole concept of carrier groups could soon be outdated due to something new, like undetectable diesel/electric submarine drones that cost a 3 orders of magnitude less, thus could be built as swarms that become impossible to deal with. My main point is, don't just look at the spending. And (I think your comment is symptomatic), don't forget the damn nukes, those things should be the biggest worry of all.
vacri 9y ago
As an example of how low it is, Russia's GDP is barely more than Australia's and is below Canada's. How the mighty have fallen.
- thriftwy 9y ago
  It was never large to begin with. USSR thought that Russians don't need money and then Putin thinks exactly the same.

adventured 9y ago

> A Russian spent dollar probably gives more bang for the buck, but US military spending is still very high. You of course didn't support that claim at all. Most US military spending goes to soldier-related costs. How do you propose to slash that given how dramatically higher the US median wage is compared to Russia? Other than of course to perhaps cut the number of US soldiers in half. > The single-pay system can be made to work. Others make it work, and a lot cheaper Of course it can work. It can't work with US costs what they are. You need to go tell US nurses they have to take a 1/3 pay cut, to match up with what nurses in France and Germany are making. Then you need to go tell radiologists that they have to take a 70% pay cut to match up with French radiologists. Then you have to go tell pharma they're getting a 2/3 cut. Then you have to tell average hospital workers they're getting a 20% pay cut. Then you have to close 1/3 of all hospitals. Then you have to substantially expand wait times to match eg Canada, aka rationing the care. Then you have to tell hospital admin they're getting a 50% cut in their budget. Then you have to fire 500,000 people that are employed directly or indirectly in the health insurance industry. Then you have to slash the payouts for all sorts of highway robbery prices in medtech / devices / supplies related to the healthcare industry, which will can hundreds of thousands of more employees. You have to successfully adjust all of that, lower the costs, then figure out how to create new economic growth with the cost savings to re-employ all those lost jobs, wages, taxes (all that lost income tax, which will shoot a hole in the side of social security & medicare/medicaid). IE you have to find a trillion dollars in savings across dozens of economic segments. Which is another way of saying: a lot of people are going to lose a lot of jobs and income. It's an extraordinarily complicated and expensive problem to resolve without rattling the entire economy to its core. Oh yeah, then you have to dramatically raise taxes on the US middle class (which pays very little in taxes vs most developed nations) to match up with what countries with single payer systems do; and explain to the middle class that they're going to be better off with socialized healthcare, and that the increased taxes will be off-set by the government healthcare vs the old private insurance approach. Then you also have to significantly raise taxes on the top 25%, which pay most of the taxes in the US. No problem eh.

m_mueller 9y ago
I'd suggest not to use the model of centralistic and rather socialistic nations like France as a model for the US. Not that I don't like that model, I just don't think it's a good fit. Instead look at Switzerland for example. Leaving foreign politics away it almost seems like a shrunken down version of the US, both politically and economically, with just a few major differences: * even more locally organised. County sized administrations have about the same independence as US states. * instead of spending our (similar) tax rates on the military, it is spent on superb health care (imagine a souped up version of Obamacare with regulated prices), schools and a social net. Look at the numbers though - I think it works, that is, innovation and the economy in general are strong thanks to a more stable middle class (that doesn't experience negative social mobility due to health care problems and overpaid schools plus gets an influx from people at the poor end that make it by means of a helping hand at child age). * and no, I would argue Switzerland is not significantly less diverse with about 30% immigrant population. We have about the same proportion of backwards rightwing pseudo conservatives as a counterreaction, but they are bound to a political system that makes getting absolute majorities in the parliament near impossible (and also relatively useless alone thanks to referendums that serve as a moderation tool). See also again the difference in how middle class is kept going, which makes a Populist power grab much less likely.
- adventured 9y ago
  We could redirect 50% of our military spending to single payer and it would not even remotely fix our problems. That amount of money would make single payer work in just California (ie 10% of the nation). We probably need to be spending $200+ billion more just on our existing medicare + medicaid + VA health systems as it is. People that keep saying things like that about military spending, don't seem to understand that the biggest problem the US has, is for single payer to work millions of Americans are going to have to lose big time, to the tune of a trillion dollar cut affecting millions of incomes & jobs that feed off the system bloat. You either need to come up with trillions of dollars in new funding to do single payer, or you need to tell millions of Americans they're going to be fired and or take big pay cuts (plausibly both). I agree, there are better systems than France. My only reference to France, is about competitive salaries in the healthcare industry. Wages in that industry have to come down by a lot to match comparables in eg France, Germany, UK. When people talk about single payer re the US, they focus on drug prices and insurance industry costs. They ignore that essentially every cost in the US system is inflated, including routine labor and dozens of side connected feeder industries (everything from saline supply to the cost of hospital beds to labor costs in elderly care). Most of the cost bloat in the system is made up of salaries for workers such as nurses, doctors, hospital workers, admin and health insurance employees. You could slash pharma costs nearly in half in the US and only save ~$150 billion of the $1 trillion we have to cut out of our costs to get cost competitive again. Every one of these cuts will have substantial economic consequences; cut pharma in half, lose a million high paying jobs directly & indirectly that support the tax base that pays for the single payer system (ie you have to figure out how to replace that; which would occur, but it'd take lots of time). That said, the way the US is actually going to go, is we're going to do a slow mediocre drift into single payer, through gradual expansion as the existing convoluted system fails one tier after another (essentially failing up the economic chain; the middle class will gradually all be pulled into government healthcare by necessity as the system collapses). Maybe out of desperation they'll use medicare as the platform, since the politicians in Washington DC can never agree on anything it's most likely our result will be to use something that already exists and just enlarge it.

m_mueller 9y ago

The way that the US is spending money (e.g. building a 1.5tn fighter jet that can hardly fight and a 35bn aircraft carrier that can't launch) I would actually start getting worried about adversaries with just a tenth of the US budget. To put it differently, if the Swiss, population 8M, can figure out how to transport 1.8x the amount of rail passengers compared to the entire US (no, not by capita, in absolute numbers [1]), it could also happen that a smaller budget military outmaneuvers US army, navy and marines. That being said, conventional armies made for symmetric warfare seem just about as useless now as at the height of the cold war. But not even the security of the nuclear arsenal seems a high priority in US politics today. [1] https://en.m.wikipedia.org/wiki/List_of_countries_by_rail_usage https://en.m.wikipedia.org/wiki/List_of_countries_by_rail_us...

adventured 9y ago
Your arguments rest on irrational statements. The US isn't spending $1.5 trillion on the F35. First, the costs will be spread over decades; second, the US will never order even half the planes in question; it never does when it comes to large systems orders. In 10-15 years they'll be slashing the buying down toward zero as with the F22 (as the military chomps at the bit to move on to new programs), the F35 program will cost half as much as claimed presently, as most of the cost projections are based on maintenance costs over 30 years for thousands of planes that will never be purchased (we're going to buy thousands of F35s over decades? yeah right). That aircraft carrier will launch. Every country that has ever built one has had significant problems doing so, the US has a long successful history of building & deploying aircraft carriers, the latest one will be no different regardless of temporary problems.
- m_mueller 9y ago
  You aren't reading favourably. It could well be that the whole stealth superiority fighter concept is outdated due to new cheap sensor technology (and its use in AA defense systems) and the whole concept of carrier groups could soon be outdated due to something new, like undetectable diesel/electric submarine drones that cost a 3 orders of magnitude less, thus could be built as swarms that become impossible to deal with. My main point is, don't just look at the spending. And (I think your comment is symptomatic), don't forget the damn nukes, those things should be the biggest worry of all.

vacri 9y ago

As an example of how low it is, Russia's GDP is barely more than Australia's and is below Canada's. How the mighty have fallen.

thriftwy 9y ago
It was never large to begin with. USSR thought that Russians don't need money and then Putin thinks exactly the same.