4 ms·

It's kind of a relative quantity though, so the numbers might not necessarily be as comparable. The value of a dollar in India might be much higher. $1 is almo

It's kind of a relative quantity though, so the numbers might not necessarily be as comparable. The value of a dollar in India might be much higher. $1 is almost 70 indian rupees, and the distribution of rupees might be slightly more equitable among the population of India.

jrochkind1 8y ago
True, but it's the distribution of wealth _between_ the U.S. and India that I'm thinking of. They can't afford to give most of their population needed heart surgery even when they've made it 100x cheaper than it is here. Here health care is destroying us too, but _most_ (not all) people who need heart surgery still get it. Sometimes it destroys them financially (not saying health care works here either), but they get the surgery. And our economy does not crash. So far. India literally can't afford to give them the surgery.
- omegaworks 8y ago
  >India literally can't afford to give them the surgery. This is what's hard to conceptually grasp about nationalized healthcare. The concept of "a nation can't afford" does not make sense because a nation-state with control of its own currency can simply create and allocate the currency to serve this purpose. I'm not sure why this is not on the table.
  - iguy 8y ago
    No, I disagree. The money represents the real output of the economy. This can be moved around to some degree (switch a bicycle factory to making surgical tools, etc) but fundamentally only so much stuff is produced. Printing more money doesn't change this. Economic growth does, but not overnight. And figuring out how to do equivalent things with less input (whether it's model-Ts, or surgery) is an important part of that. To take an extreme example, every space-X launch costs $50 million. If I say that America could not afford to give everyone an orbital holiday, this is not a statement about fiat dollars. It's a statement about the enormous resources, and chiefly the labor of an enormous team of people (including all the suppliers, and their suppliers) required for each such trip.
  - tomp 8y ago
    > The concept of "a nation can't afford" does not make sense Of course it makes sense. In any healthcare system (yeah, even pricate insurance) there are tradeoffs to be made, because the reality is that resources (hospitals, doctors, time, not necessarily just money) will always be finite. For example, having a breast scan every year might save more people than having it every 5 years, but at some point the marginal returns will be so small that it makes more sense to focus resources on other things.
  - vidarh 8y ago
    Because money is just a proxy for resources. Printing more money does not create more of everything else, so it drives inflation and effectively acts as a tax on all other economic activity. You can print more, but you need to be aware that what you are doing has that effect, and if you overdo it you'll cripple your economy just the same as if you increase tax rates too much.
  - kbutler 8y ago
    I originally thought this comment deserved downvoting, because "we'll just print money" shows a lack of understanding about the role fiat currency plays in an economy. However, I realized that this comment is a valuable addition to the discussion, because it expresses an increasingly common misconception. So thanks for posting it. Yes, the nation can just print money, but will anyone accept it? When the supply of money increases, but economic output and resources are held constant, prices increase. Imagine if the resources available in the economy are worth M currency. If the government just creates 10M currency, that doesn't mean more things are available to buy, just that each unit of currency is now only worth 1/10 of what it was before, so prices rise. But because people expect that, they try to get rid of the currency even faster, so prices rise even more than the increase in the money supply. This results in "hyperinflation" - prices rising more than 50% per _month_ - see https://en.wikipedia.org/wiki/Hyperinflation https://en.wikipedia.org/wiki/Hyperinflation for accounts of governments who have tried the "create and allocate currency" approach. There's a great "Planet Money" episode on the hyperinflation of Brazil, which started when the country decided they could just print money to build a beautiful new capital city, and how it persisted for decades because it destroyed people's faith in the currency as a store of value, until Brazil created a new stable currency and convinced people they would no longer just print money to spend. https://www.npr.org/sections/money/2010/10/01/130267274/the-friday-podcast-how-four-drinking-buddies-saved-brazil https://www.npr.org/sections/money/2010/10/01/130267274/the-...
    - noir_lord 8y ago
      Printing more money also doesn’t affect external costs. If that heart bypass machine is coming from Germany or Japan printing more rupees isn’t going to make it anymore affordable either. However with abundant natural resources and a large population you could maybe be a self-sufficient economy in close to absolute terms. I’m not sure what the Indian balance of trade currently is but they seem to be rapidly developing in a lot of ways.
    - omegaworks 8y ago
      I knew I'd get this kneejerk reaction to "simply create and allocate the currency," I was holding out hope that responders would finish reading the sentence. What I said was: >a nation-state... can create and allocate the currency to serve this purpose. I totally agree with you in a general sense. Creating and allocating currency and distributing it to the general population equally will cause the scenario you describe. "More dollars chasing fewer goods," as Greenspan described[1]. However, if we take the hypothetical scenario that the government agrees to pay exactly the current cost of the procedure at Narayana for medical procedures, none of what you described will come to pass. Wait times at Narayana might increase because more people might come in to have the services performed, but it will not cause runaway across-the-board inflation. 1. https://www.youtube.com/watch?v=DNCZHAQnfGU https://www.youtube.com/watch?v=DNCZHAQnfGU

jrochkind1 8y ago

True, but it's the distribution of wealth _between_ the U.S. and India that I'm thinking of. They can't afford to give most of their population needed heart surgery even when they've made it 100x cheaper than it is here. Here health care is destroying us too, but _most_ (not all) people who need heart surgery still get it. Sometimes it destroys them financially (not saying health care works here either), but they get the surgery. And our economy does not crash. So far. India literally can't afford to give them the surgery.

omegaworks 8y ago
>India literally can't afford to give them the surgery. This is what's hard to conceptually grasp about nationalized healthcare. The concept of "a nation can't afford" does not make sense because a nation-state with control of its own currency can simply create and allocate the currency to serve this purpose. I'm not sure why this is not on the table.
- iguy 8y ago
  No, I disagree. The money represents the real output of the economy. This can be moved around to some degree (switch a bicycle factory to making surgical tools, etc) but fundamentally only so much stuff is produced. Printing more money doesn't change this. Economic growth does, but not overnight. And figuring out how to do equivalent things with less input (whether it's model-Ts, or surgery) is an important part of that. To take an extreme example, every space-X launch costs $50 million. If I say that America could not afford to give everyone an orbital holiday, this is not a statement about fiat dollars. It's a statement about the enormous resources, and chiefly the labor of an enormous team of people (including all the suppliers, and their suppliers) required for each such trip.
- tomp 8y ago
  > The concept of "a nation can't afford" does not make sense Of course it makes sense. In any healthcare system (yeah, even pricate insurance) there are tradeoffs to be made, because the reality is that resources (hospitals, doctors, time, not necessarily just money) will always be finite. For example, having a breast scan every year might save more people than having it every 5 years, but at some point the marginal returns will be so small that it makes more sense to focus resources on other things.
- vidarh 8y ago
  Because money is just a proxy for resources. Printing more money does not create more of everything else, so it drives inflation and effectively acts as a tax on all other economic activity. You can print more, but you need to be aware that what you are doing has that effect, and if you overdo it you'll cripple your economy just the same as if you increase tax rates too much.
- kbutler 8y ago
  I originally thought this comment deserved downvoting, because "we'll just print money" shows a lack of understanding about the role fiat currency plays in an economy. However, I realized that this comment is a valuable addition to the discussion, because it expresses an increasingly common misconception. So thanks for posting it. Yes, the nation can just print money, but will anyone accept it? When the supply of money increases, but economic output and resources are held constant, prices increase. Imagine if the resources available in the economy are worth M currency. If the government just creates 10M currency, that doesn't mean more things are available to buy, just that each unit of currency is now only worth 1/10 of what it was before, so prices rise. But because people expect that, they try to get rid of the currency even faster, so prices rise even more than the increase in the money supply. This results in "hyperinflation" - prices rising more than 50% per _month_ - see https://en.wikipedia.org/wiki/Hyperinflation https://en.wikipedia.org/wiki/Hyperinflation for accounts of governments who have tried the "create and allocate currency" approach. There's a great "Planet Money" episode on the hyperinflation of Brazil, which started when the country decided they could just print money to build a beautiful new capital city, and how it persisted for decades because it destroyed people's faith in the currency as a store of value, until Brazil created a new stable currency and convinced people they would no longer just print money to spend. https://www.npr.org/sections/money/2010/10/01/130267274/the-friday-podcast-how-four-drinking-buddies-saved-brazil https://www.npr.org/sections/money/2010/10/01/130267274/the-...
  - noir_lord 8y ago
    Printing more money also doesn’t affect external costs. If that heart bypass machine is coming from Germany or Japan printing more rupees isn’t going to make it anymore affordable either. However with abundant natural resources and a large population you could maybe be a self-sufficient economy in close to absolute terms. I’m not sure what the Indian balance of trade currently is but they seem to be rapidly developing in a lot of ways.
  - omegaworks 8y ago
    I knew I'd get this kneejerk reaction to "simply create and allocate the currency," I was holding out hope that responders would finish reading the sentence. What I said was: >a nation-state... can create and allocate the currency to serve this purpose. I totally agree with you in a general sense. Creating and allocating currency and distributing it to the general population equally will cause the scenario you describe. "More dollars chasing fewer goods," as Greenspan described[1]. However, if we take the hypothetical scenario that the government agrees to pay exactly the current cost of the procedure at Narayana for medical procedures, none of what you described will come to pass. Wait times at Narayana might increase because more people might come in to have the services performed, but it will not cause runaway across-the-board inflation. 1. https://www.youtube.com/watch?v=DNCZHAQnfGU https://www.youtube.com/watch?v=DNCZHAQnfGU