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I see any suggestion to the contrary of Socialized medicine being downvoted. Honest question. How do you propose to expand healthcare with 130% Debt to GDP and

I see any suggestion to the contrary of Socialized medicine being downvoted. Honest question. How do you propose to expand healthcare with 130% Debt to GDP and 8.9% inflation? It seems we are broke and there is a demand from the HN community to spend more? Feels like hitting the accelerator as one drives off a cliff and invokes memories of Thelma & Louise

jjoonathan 4y ago
We pay nearly double for our privatized monstrosity, compared to the most expensive socialized systems. Such savings! So cheap! Very efficient! Can the treasury possibly bear the expense of spending less than double? ------ Yeah, a transition is going to be an expensive shitshow and now is not a good time, but just about any other time in the last decade was a good time and in a year or two it will be a decent time again. We'd better rip this bandaid before it soaks all our blood out.
- justinzollars 4y ago
  Politics aside, money puts a cap on everything: wars, social services, etc. The issue at hand is to take something the public spends nothing on, that the government gets for "free" and to put that on the public balance sheet - a huge cost. I guess we could balance that out with a tax, but who would like that? And even if we were to raise taxes - it wouldn't help our balance sheet since we already spend 30% more than we take in. Looking at the balance sheet as it stands today, we can't even afford what we currently spend. And inflation is on the rise. I just don't see it ever happening. Save a collapse and total reset of the current monetary system.
  - jjoonathan 4y ago
    > Politics aside, money puts a cap What part of "we pay nearly double" didn't make it through? We can't afford the enormous premium we are paying for privatized care. > I guess we could balance that out with a tax Payroll tax. In the vacancy left by private insurance. Scribble off one memo line, write in another. Come on, this is a 101 level objection.
    - justinzollars 4y ago
      > Come on, this is a 101 level objection. You are obviously a very smart guy, jjoonathan. Why do you suppose the Democrats didn't even propose this when they had 60 Senate votes, the Presidency and the House? If its a 101 level problem why do you think that is?
corrral 4y ago
We would have to colossally and uniquely fuck up any version of "socialized" medicine for it not to be a substantial net savings.
stephen_g 4y ago
We have a hybrid system here in Australia where there are tax benefits for having private health insurance but we also have a high quality public system. The public system actually comes out consistently as being more efficient than the private one, so the cost to society is less. The rebates for private health insurance (to convince people to take out private insurance to “take pressure off the public system) have actually made things worse, for most people it’s subsidised by 30% by the Government (and you avoid an extra health levy), but over the last decade or two, the premiums have just gone up significantly and the amount of things covered has been dropping. It would have been better to just put that money into the public system (which is a bit overstretched due to underfunding). So mostly the subsidy has just gone into profits for insurers. It’s hard to get people to take out the private insurance without it and tax offset, but as I said before, since the public system is more efficient, the cost to society would be less without subsidising private insurance.
killjoywashere 4y ago
"Socialized" explicitly means government ownership of the means of production (1-3). Weaker definitions include ideas like regulation, administration, or control. But let's stick with ownership. Your word, so let's work with that. If the government owns the system, the government can establish all sorts of controls (4). What do you think the margin is in these sectors (% is of $3.5T in 2017) Hospital care (33%) Physician and clinical services (20%) Retail drugs (10%) Other health, residential personal care services (5%) Nursing care facilities (5%) Dental (4%) Home health (3%) Other professional services (3%) Other non-durable medical products (2%) Durable medical equipment (2%) (1) https://www.britannica.com/topic/socialism https://www.britannica.com/topic/socialism (2) https://www.merriam-webster.com/dictionary/socialism https://www.merriam-webster.com/dictionary/socialism (3) https://en.wikipedia.org/wiki/Socialism https://en.wikipedia.org/wiki/Socialism (4) https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf https://www.cms.gov/research-statistics-data-and-systems/sta...
p0lp0t 4y ago
LinuxBender 4y ago
I agree and have always felt all of this is the wrong debate. The focus should be on fixing the root cause of most medical issues. "An ounce of prevention...." yada yada... Just Type-2 diabetes alone will bankrupt the US by 2040 or sooner according to the CDC as reported in an interview on Joe Rogan. [1] There are a myriad of other CDC studies that show us going bankrupt sooner regardless of who pays for medical issues. I have no idea where all this money will come from short of conquering some other countries. For me personally, I will just focus on proactive measures. Here [2][3] are a couple of the reports. As a side note I am about to go feed Thelma and Louise. Ill pet them and say hi for you. [1] - https://www.youtube.com/watch?v=5LTWJOi3bCo https://www.youtube.com/watch?v=5LTWJOi3bCo [video] [joes t-shirt nsfw, minimize browser] [2] - https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html https://www.cdc.gov/media/releases/2017/p0718-diabetes-repor... [3] - https://diabetesjournals.org/care/article/41/5/917/36518 https://diabetesjournals.org/care/article/41/5/917/36518

jjoonathan 4y ago

We pay nearly double for our privatized monstrosity, compared to the most expensive socialized systems. Such savings! So cheap! Very efficient! Can the treasury possibly bear the expense of spending less than double? ------ Yeah, a transition is going to be an expensive shitshow and now is not a good time, but just about any other time in the last decade was a good time and in a year or two it will be a decent time again. We'd better rip this bandaid before it soaks all our blood out.

justinzollars 4y ago
Politics aside, money puts a cap on everything: wars, social services, etc. The issue at hand is to take something the public spends nothing on, that the government gets for "free" and to put that on the public balance sheet - a huge cost. I guess we could balance that out with a tax, but who would like that? And even if we were to raise taxes - it wouldn't help our balance sheet since we already spend 30% more than we take in. Looking at the balance sheet as it stands today, we can't even afford what we currently spend. And inflation is on the rise. I just don't see it ever happening. Save a collapse and total reset of the current monetary system.
- jjoonathan 4y ago
  > Politics aside, money puts a cap What part of "we pay nearly double" didn't make it through? We can't afford the enormous premium we are paying for privatized care. > I guess we could balance that out with a tax Payroll tax. In the vacancy left by private insurance. Scribble off one memo line, write in another. Come on, this is a 101 level objection.
  - justinzollars 4y ago
    > Come on, this is a 101 level objection. You are obviously a very smart guy, jjoonathan. Why do you suppose the Democrats didn't even propose this when they had 60 Senate votes, the Presidency and the House? If its a 101 level problem why do you think that is?

corrral 4y ago

We would have to colossally and uniquely fuck up any version of "socialized" medicine for it not to be a substantial net savings.

stephen_g 4y ago

We have a hybrid system here in Australia where there are tax benefits for having private health insurance but we also have a high quality public system. The public system actually comes out consistently as being more efficient than the private one, so the cost to society is less. The rebates for private health insurance (to convince people to take out private insurance to “take pressure off the public system) have actually made things worse, for most people it’s subsidised by 30% by the Government (and you avoid an extra health levy), but over the last decade or two, the premiums have just gone up significantly and the amount of things covered has been dropping. It would have been better to just put that money into the public system (which is a bit overstretched due to underfunding). So mostly the subsidy has just gone into profits for insurers. It’s hard to get people to take out the private insurance without it and tax offset, but as I said before, since the public system is more efficient, the cost to society would be less without subsidising private insurance.

killjoywashere 4y ago

"Socialized" explicitly means government ownership of the means of production (1-3). Weaker definitions include ideas like regulation, administration, or control. But let's stick with ownership. Your word, so let's work with that. If the government owns the system, the government can establish all sorts of controls (4). What do you think the margin is in these sectors (% is of $3.5T in 2017) Hospital care (33%) Physician and clinical services (20%) Retail drugs (10%) Other health, residential personal care services (5%) Nursing care facilities (5%) Dental (4%) Home health (3%) Other professional services (3%) Other non-durable medical products (2%) Durable medical equipment (2%) (1) https://www.britannica.com/topic/socialism https://www.britannica.com/topic/socialism (2) https://www.merriam-webster.com/dictionary/socialism https://www.merriam-webster.com/dictionary/socialism (3) https://en.wikipedia.org/wiki/Socialism https://en.wikipedia.org/wiki/Socialism (4) https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf https://www.cms.gov/research-statistics-data-and-systems/sta...

p0lp0t 4y ago

LinuxBender 4y ago

I agree and have always felt all of this is the wrong debate. The focus should be on fixing the root cause of most medical issues. "An ounce of prevention...." yada yada... Just Type-2 diabetes alone will bankrupt the US by 2040 or sooner according to the CDC as reported in an interview on Joe Rogan. [1] There are a myriad of other CDC studies that show us going bankrupt sooner regardless of who pays for medical issues. I have no idea where all this money will come from short of conquering some other countries. For me personally, I will just focus on proactive measures. Here [2][3] are a couple of the reports. As a side note I am about to go feed Thelma and Louise. Ill pet them and say hi for you. [1] - https://www.youtube.com/watch?v=5LTWJOi3bCo https://www.youtube.com/watch?v=5LTWJOi3bCo [video] [joes t-shirt nsfw, minimize browser] [2] - https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html https://www.cdc.gov/media/releases/2017/p0718-diabetes-repor... [3] - https://diabetesjournals.org/care/article/41/5/917/36518 https://diabetesjournals.org/care/article/41/5/917/36518