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As someone else with serious medical problems which have been paid for by public health systems, the financial difficulties of which are compounded by losing yo

As someone else with serious medical problems which have been paid for by public health systems, the financial difficulties of which are compounded by losing your ability to pay once ill, thanks! I would note though, for the purposes of fairness, it's a small percentage of your taxes that go to paying for such programs versus things like the military and interest on debt.

lotsofpulp 6y ago
US government healthcare spend is huge, it is not tiny compared to military. $1.1T according to this source in fiscal year 2018: https://www.taxpolicycenter.org/briefing-book/how-much-does-federal-government-spend-health-care https://www.taxpolicycenter.org/briefing-book/how-much-does-... This website states in 2018, the federal government spent $582B on Medicare, and $389B on Medicaid, plus all the tax exemption for employer sponsored health insurance and ACA subsidies to individual buyers, etc. https://www.thebalance.com/fy-2018-trump-federal-budget-request-4158794 https://www.thebalance.com/fy-2018-trump-federal-budget-requ... Defense and Homeland Security was only ~$630B or so.
- ccktlmazeltov 6y ago
  That's because of private healthcare that prevent them from properly negotiating prices. If universal healthcare was a thing these costs would be much lower.
  - AdrianB1 6y ago
    How is that?
    - QuixoticQuibit 6y ago
      Nation-sized leverage. The same reason why equivalent pharmaceuticals are cheaper elsewhere in the world.
      - barry-cotter 6y ago
        Quite. That’s why the US pays for more pharmaceutical and medical device R&D than anyone else. The US is where every pharmaceutical company makes the profits that incentivize further drug development.
        philjohn 6y ago
        Or, in the case of Valeant Pharmaceuticals they just jacked the prices up after buying smaller drug companies and getting rid of all the R&D teams ... that doesn't seem to have incentivized further drug development by them, did it?
        zaphar 6y ago
        You are speaking of a specific anecdotal experience and he is talking about the industry in aggregate. Neither of you are invalidating the other's point. The actual facts are in support of the posters point: https://www.abpi.org.uk/facts-and-figures/science-and-innovation/worldwide-pharmaceutical-company-rd-expenditure-by-country/ https://www.abpi.org.uk/facts-and-figures/science-and-innova... But your example is a real occurrence of abuse under the US system.
      - jfnixon 6y ago
        Nation-sized leverage? Piffle. Pass a law that Big Pharma can't price higher in the US than the lowest price negotiated elsewhere. Boom, problem solved.
        tobylane 6y ago
        From 2003 to maybe 2019 Medicare was explicitly forbidden from negotiating drug prices. Second bullet point in this https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Im... The first world has successfully encouraged the drug makers to sell their product cheaper in the third world. If you look on wikipedia drug articles you'll see the price for the generic in the developed and developing world.
  - tankenmate 6y ago
    It's not just that, the Medicare Prescription Drug, Improvement and Modernisation Act bars Medicare from negotiating drug prices.
- shoo 6y ago
  To add contrast, australia spends 32b on defence, 36b on education, 82b on health, 180b on social security & welfare, out of ~500b total government spend. https://mobile.abc.net.au/news/2019-04-03/federal-budget-2019-sliced-and-diced-interactive/10959808 https://mobile.abc.net.au/news/2019-04-03/federal-budget-201...
- treeman79 6y ago
  My issues have been insanely expensive to figure out. But treatment has been very cheap now that I know the issues and what pills work. Main problem was being dismissed for 3 years and doctors not taking to each other. I can see what people start going to alternative medicine. One of the treatment options is a specialized diet. So all the crazy diet people are actually circling around valid treatment options. Health care can be done cheaper. But when a doctor has 5 minutes, there is only so much that can be done.
- Retric 6y ago
  That 630B ish is figure is more spin than reality. Excluding say the coast guard is reasonable if you’re talking offensive military capacity but “Defense” should reasonably include CIA, NSA, border security, and anti terrorism expenditures etc. Further, related pensions and VA benefits are clearly part of the overall defense budget. Exact interest on past military spending is arguable, but those bills still need to be paid. PS: US healthcare expenditures is similarly a complex topic. Do you include the heath insurance costs of government contractors etc?
  - lotsofpulp 6y ago
    No matter how you cut, a very large portion of taxes paid goes towards healthcare. 30% for social security, 30% minimum for healthcare. Military and interest costs therefore are clearly not the bigger portions of spending. https://www.thebalance.com/u-s-federal-budget-breakdown-3305789 https://www.thebalance.com/u-s-federal-budget-breakdown-3305... > The government expects to spend $4.829 trillion in 2021.1 Almost 60% of that pays for mandated benefits such as Social Security, Medicare, and Medicaid. > Social Security will be the biggest expense, budgeted at $1.151 trillion. It's followed by Medicare at $722 billion and Medicaid at $448 billion.
    - Retric 6y ago
      Overall I agree, but I am pointing out how numbers are framed is really important. For example this puts Defense spending at 1T and heathcare at 1.7T, while leaving out several categories of both. https://www.usgovernmentspending.com/year_spending_2020USbn_21bs2n#usgs302 https://www.usgovernmentspending.com/year_spending_2020USbn_... I am not saying any specific number is correct, but that 1T figure excludes military pensions and heath care excludes related research spending. Neither includes any debt payments from past spending or projections of future obligations. In the end it is actually possible to construct a number for each where federal defense spending is greater than federal healthcare spending, but again I don’t agree with such categorizations. PS: This gets back to the oldest trick in “cutting“ spending, define a portion as something else. Similarly, define a category of taxes as “income taxes“ so you can exclude payroll taxes when talking about them.
- john-radio 6y ago
  You're assuming they're talking about America, but you're probably not talking to Americans, because: > if something were to happen to me or my fellow citizen, at least there wouldn't be millions of dollars in hospital bills to pay back and there would be aid for a home to avoid ending up on the streets Not trying to be an asshole, but that's not a description of the American system.
  - code_duck 6y ago
    It depends on your financial situation and what state you live in. Most of the places I’ve lived, such as Minnesota or Oregon, do have systems for emergency medical assistance. They also currently have great insurance for people who truly can’t afford it. People in middle income ranges are the worst off, though. Personally, I was just hospitalized with a bout of diabetic ketoacidosis, probably just a day away from going into a coma. I haven’t even had to see a bill. It was 100% paid by the state and federal programs. If I hadn’t set up insurance before going to the doctor, though, I’d have received ridiculously high bills, probably been provided less service, and it would be up to me to get it paid back. I had a situation before where I went to the ER while an insurance application was pending, and then after it was approved and I provided my info, the private hospital dilly dallied and sent it to collections anyway.
dragonwriter 6y ago
> I would note though, for the purposes of fairness, it's a small percentage of your taxes that go to paying for such programs versus things like the military and interest on debt. No, its not. US public healthcare spending (which in most states is the lion’s share of public welfare spending, and is also on the US is more than defense spending and is, in fact, pretty typical as a share of GDP, high as a share of taxes (because of the light US tax burden), and enormous per capita compared to other industrialized nations. Its small as a share of total national healthcare spending compared to other countries, because we have to even more private spending on top of it, and the whole healthcare system (or, rather, the literally hundreds of mutually-interfering public and private healthcare systems) is the single most inefficient healthcare delivery system in the world, but we spend plenty of money on it, just not well.

lotsofpulp 6y ago

US government healthcare spend is huge, it is not tiny compared to military. $1.1T according to this source in fiscal year 2018: https://www.taxpolicycenter.org/briefing-book/how-much-does-federal-government-spend-health-care https://www.taxpolicycenter.org/briefing-book/how-much-does-... This website states in 2018, the federal government spent $582B on Medicare, and $389B on Medicaid, plus all the tax exemption for employer sponsored health insurance and ACA subsidies to individual buyers, etc. https://www.thebalance.com/fy-2018-trump-federal-budget-request-4158794 https://www.thebalance.com/fy-2018-trump-federal-budget-requ... Defense and Homeland Security was only ~$630B or so.

ccktlmazeltov 6y ago
That's because of private healthcare that prevent them from properly negotiating prices. If universal healthcare was a thing these costs would be much lower.
- AdrianB1 6y ago
  How is that?
  - QuixoticQuibit 6y ago
    Nation-sized leverage. The same reason why equivalent pharmaceuticals are cheaper elsewhere in the world.
    - barry-cotter 6y ago
      Quite. That’s why the US pays for more pharmaceutical and medical device R&D than anyone else. The US is where every pharmaceutical company makes the profits that incentivize further drug development.
      - philjohn 6y ago
        Or, in the case of Valeant Pharmaceuticals they just jacked the prices up after buying smaller drug companies and getting rid of all the R&D teams ... that doesn't seem to have incentivized further drug development by them, did it?
        zaphar 6y ago
        You are speaking of a specific anecdotal experience and he is talking about the industry in aggregate. Neither of you are invalidating the other's point. The actual facts are in support of the posters point: https://www.abpi.org.uk/facts-and-figures/science-and-innovation/worldwide-pharmaceutical-company-rd-expenditure-by-country/ https://www.abpi.org.uk/facts-and-figures/science-and-innova... But your example is a real occurrence of abuse under the US system.
    - jfnixon 6y ago
      Nation-sized leverage? Piffle. Pass a law that Big Pharma can't price higher in the US than the lowest price negotiated elsewhere. Boom, problem solved.
      - tobylane 6y ago
        From 2003 to maybe 2019 Medicare was explicitly forbidden from negotiating drug prices. Second bullet point in this https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Im... The first world has successfully encouraged the drug makers to sell their product cheaper in the third world. If you look on wikipedia drug articles you'll see the price for the generic in the developed and developing world.
- tankenmate 6y ago
  It's not just that, the Medicare Prescription Drug, Improvement and Modernisation Act bars Medicare from negotiating drug prices.
shoo 6y ago
To add contrast, australia spends 32b on defence, 36b on education, 82b on health, 180b on social security & welfare, out of ~500b total government spend. https://mobile.abc.net.au/news/2019-04-03/federal-budget-2019-sliced-and-diced-interactive/10959808 https://mobile.abc.net.au/news/2019-04-03/federal-budget-201...
treeman79 6y ago
My issues have been insanely expensive to figure out. But treatment has been very cheap now that I know the issues and what pills work. Main problem was being dismissed for 3 years and doctors not taking to each other. I can see what people start going to alternative medicine. One of the treatment options is a specialized diet. So all the crazy diet people are actually circling around valid treatment options. Health care can be done cheaper. But when a doctor has 5 minutes, there is only so much that can be done.
Retric 6y ago
That 630B ish is figure is more spin than reality. Excluding say the coast guard is reasonable if you’re talking offensive military capacity but “Defense” should reasonably include CIA, NSA, border security, and anti terrorism expenditures etc. Further, related pensions and VA benefits are clearly part of the overall defense budget. Exact interest on past military spending is arguable, but those bills still need to be paid. PS: US healthcare expenditures is similarly a complex topic. Do you include the heath insurance costs of government contractors etc?
- lotsofpulp 6y ago
  No matter how you cut, a very large portion of taxes paid goes towards healthcare. 30% for social security, 30% minimum for healthcare. Military and interest costs therefore are clearly not the bigger portions of spending. https://www.thebalance.com/u-s-federal-budget-breakdown-3305789 https://www.thebalance.com/u-s-federal-budget-breakdown-3305... > The government expects to spend $4.829 trillion in 2021.1 Almost 60% of that pays for mandated benefits such as Social Security, Medicare, and Medicaid. > Social Security will be the biggest expense, budgeted at $1.151 trillion. It's followed by Medicare at $722 billion and Medicaid at $448 billion.
  - Retric 6y ago
    Overall I agree, but I am pointing out how numbers are framed is really important. For example this puts Defense spending at 1T and heathcare at 1.7T, while leaving out several categories of both. https://www.usgovernmentspending.com/year_spending_2020USbn_21bs2n#usgs302 https://www.usgovernmentspending.com/year_spending_2020USbn_... I am not saying any specific number is correct, but that 1T figure excludes military pensions and heath care excludes related research spending. Neither includes any debt payments from past spending or projections of future obligations. In the end it is actually possible to construct a number for each where federal defense spending is greater than federal healthcare spending, but again I don’t agree with such categorizations. PS: This gets back to the oldest trick in “cutting“ spending, define a portion as something else. Similarly, define a category of taxes as “income taxes“ so you can exclude payroll taxes when talking about them.
john-radio 6y ago
You're assuming they're talking about America, but you're probably not talking to Americans, because: > if something were to happen to me or my fellow citizen, at least there wouldn't be millions of dollars in hospital bills to pay back and there would be aid for a home to avoid ending up on the streets Not trying to be an asshole, but that's not a description of the American system.
- code_duck 6y ago
  It depends on your financial situation and what state you live in. Most of the places I’ve lived, such as Minnesota or Oregon, do have systems for emergency medical assistance. They also currently have great insurance for people who truly can’t afford it. People in middle income ranges are the worst off, though. Personally, I was just hospitalized with a bout of diabetic ketoacidosis, probably just a day away from going into a coma. I haven’t even had to see a bill. It was 100% paid by the state and federal programs. If I hadn’t set up insurance before going to the doctor, though, I’d have received ridiculously high bills, probably been provided less service, and it would be up to me to get it paid back. I had a situation before where I went to the ER while an insurance application was pending, and then after it was approved and I provided my info, the private hospital dilly dallied and sent it to collections anyway.

dragonwriter 6y ago

> I would note though, for the purposes of fairness, it's a small percentage of your taxes that go to paying for such programs versus things like the military and interest on debt. No, its not. US public healthcare spending (which in most states is the lion’s share of public welfare spending, and is also on the US is more than defense spending and is, in fact, pretty typical as a share of GDP, high as a share of taxes (because of the light US tax burden), and enormous per capita compared to other industrialized nations. Its small as a share of total national healthcare spending compared to other countries, because we have to even more private spending on top of it, and the whole healthcare system (or, rather, the literally hundreds of mutually-interfering public and private healthcare systems) is the single most inefficient healthcare delivery system in the world, but we spend plenty of money on it, just not well.