22 ms·

In the US, both college education and healthcare have become enormous taxpayer wealth extraction schemes. Everyone has a "right" to education and healthcare, t

In the US, both college education and healthcare have become enormous taxpayer wealth extraction schemes. Everyone has a "right" to education and healthcare, therefore we should subsidize it with taxpayer money. That is as far as the politics go. We have stupidly funded the demand side of the equation to where both education and healthcare are incredibly bloated behemoths capable of absorbing all the money thrown at them. All perfectly justified. Where the taxpayer money should have gone: on the supply side. For example, the number of UC campuses in California should have doubled as the population doubled. The last UC campus to open was Merced in 2005. Before that was Irvine and Santa Cruz in 1965. And we wonder why tuition keeps increasing? 1) Demand increases with population increase. 2) Demand increase with more people seeking 4 yr degrees. 3) Demand increases with the US subsidizing the ever living shit out of college tuition. 4) Supply stays relatively constant. Similarly Obamacare drove the demand side by subsidizing health insurance and onboarding millions of new members. It did almost nothing on the supply side - same number of hospital beds and doctors. Insurers and medical groups made a killing as the price of their services grew dramatically. In both cases, political stability was achieved in shoveling taxpayer money at education and healthcare without increasing competition. This is a very clever way for existing vendors in healthcare and education to soak the government. Solution: drive prices down by investing in supply of education and healthcare.

giantg2 4y ago
"Drive the price down by increasing seats and then fostering competition between schools." The seats have increased dramatically. You won't be able to create efficient competition. The value shoppers already go to state schools. The other people are looking for a specific "quality" or just plain emotion (my family went here, this school is prestigious, etc). Supply isn't the real issue in most disciplines. The problem is the demand side individuals making economically dumb choices (sometimes semi-forced by the larger societal situation).
- mixmastamyk 4y ago
  Handing out bales of money in the form of guaranteed loans enables this price insensitivity and accelerates price increases.
missedthecue 4y ago
Schools compete not on price but on other factors. That's why they want to build massively expensive campuses and elaborate facilities, because that is what students base their decisions on. If schools competed on price, everyone would be going to state colleges c̶o̶m̶m̶u̶n̶i̶t̶y̶ ̶c̶o̶l̶l̶e̶g̶e̶. I'm not sure how you compel schools to compete on price, because the consumers don't care about price. They'd rather get they "good college experience" for $50k a year than the "sufficiently good education" for $7k a year, even though both options are available to choose.
- spijdar 4y ago
  Not to nitpick a tangent, but community colleges, at least where I live, are only 2 year institutions, and don't provide full BS/BA degrees, just Associate degrees, which don't really open the same doors as the Bachelor degrees. I really wish we had 4 year institutions managed like our community colleges, though. I remember my 2 years there much more fondly than I do my time spent at a "real" university.
  - missedthecue 4y ago
    Right, perhaps it would have been better to say state school.
    - School-Cotton 4y ago
      Where does the local state university cost $7k/yr?
      - irowe 4y ago
        Yeah that does seem a little low. US News and World report has average in-state tuition at $10,423/yr [1] [1]: https://www.usnews.com/object/image/00000183-138c-db49-a3a3-33bcb4e00000/bc-infographics-tuition-optimized.png https://www.usnews.com/object/image/00000183-138c-db49-a3a3-...
        4y ago
paulpauper 4y ago
5. And we wonder why tuition keeps increasing? 1) Demand increases with population increase. 2) Demand increase with more people seeking 4 yr degrees. 3) Demand increases with the US subsidizing the ever living shit out of college tuition. 4) Supply stays relatively constant. Demand is increasing due to the college wage premium, which keeps widening with no end in sight even despite Covid and online learning. The college wage premium is the number one culprit for all these problems . For whatever reason, employers derive enough benefit from college grads to pay them waaaayyy more than high school grads https://greyenlightenment.com/2022/09/22/blame-college-wage-premium-for-tuition-surge-not-government/ https://greyenlightenment.com/2022/09/22/blame-college-wage-... The vast majority of people attend college to earn more money and be employable, as a sort of ticket the middle class. If college degrees only paid slightly more than high school instead of 2x more, demand would probably fall a lot, so would borrowing and tuition. Same for unemployment: high school grads have to 2x the unemployment rate. Maybe the onus is on employers: start finding ways to find hire more high school grads for better paying work...huge labor pool of high school grads..they cannot all be bad.
- pclmulqdq 4y ago
  The college wage premium is either reversing or pretty much gone by now. Plumbers and landscapers out-earn English and History majors now. It's only degrees that prepare you for specialized fields that still have an edge.
  - paulpauper 4y ago
    It's fallacious to compare the lowest paying college degrees to the highest paying of trades work as evidence of the premium reversing. Someone could just as easily compare an engineer, lawyer, or doctor who makes $250k/year to someone who works at McDonald's and makes $25k/year. A plumber with many years of experience on average makes $50-53k/year. This is respectable, but this is after many years. College grads by comparison on average make $55k out of college, whereas an apprentice makes $30k .
    - pclmulqdq 4y ago
dudeinjapan 4y ago
In education, "supply" itself is not the issue; there are more than enough spots at state, etc. universities. Its supply of prestigious universities, which is controlled by a cartel. Similar to diamonds, which are neither precious nor rare, yet prices are outrageous because they are controlled by a cartel. If/when I become President of the United States, I will hold back all education dollars on cartel-controlled education institutions, and heavily tax their endownments.
- deleted 4y ago
  [deleted]
- testfoobar 4y ago
  This is funny and true. The competition and prices all originate from elite institutions. I wonder if it legal to completely clone a curriculum? Like could you clone an MIT EECS education? Down to the coursework? Or alternatively - force elite schools to license and manage franchisees? I'd vote for you.
  - dudeinjapan 4y ago
    Alright! Every vote counts! > is it legal to completely clone a curriculum? Gray area. I'm no lawyer but AFAIK professor's syllabus/tests/etc. (being written documents) are subject to automatic copyright, I imagine the university is the holder of the copyright given that the prof is an employee. That being said, how many profs clone their syllabus/coursework directly from textbooks? The content of most online universities (Khan Academy, Coursera, etc.) is already superior to Ivy League based on first-hand experience of both. The bigger problem IMHO is that very little of the overall $$$ and energy at Ivy League is actually spent on course content. For many profs, esp. in STEM, teaching undergrad courses is a "chore" / distraction from their research work. I think there is opportunity to make a "lean-and-mean" physical university (perhaps online hybrid) with minimal admin overhead, which a degree could be on-par with MIT in terms of prestige. Is anyone doing this?
    - 2snakes 4y ago
halffaday 4y ago
I think credit deserves some blame. Schools charge the maximum they expect students to be able to pay, and when students have significant leverage through the bank, those costs rise with it. Very similar conditions in housing. I think administrative bloat is a consequence rather than a cause. Now that the faculty lounge has replaced the factory floor as a reliable voting demographic for you-know-who, I don’t think the subsidies and waste will stop anytime soon.
treeman79 4y ago
Solution. Stop government funding.
- 8f2ab37a-ed6c 4y ago
  Good luck finding a politician who will kill the dream of everybody going to college. The optics of that are pretty awful.
  - wernercd 4y ago
    People went to college before the guaranteed "right" to go to college. It was also more affordable then - for some strange reason. Removing government help won't end the college dream... but it might, in time - since it took time to get this fucked up - restore some semblance of reasonable to the equation.
  - MisterMower 4y ago
    It’s not a dream. It’s a nightmare for most folks. A girl I knew went to school for speech therapy. Decent grades. Good school. $80k debt for undergrad. Couldn’t get a job with a bachelor’s degree, so she racked up $100k getting a master’s degree. She’s 25 years old making $30k a year working for an agency that pairs her with kids that need help. She has no conceivable way to pay that loan off on that salary. She will never qualify for a mortgage with that kind of debt to income ratio. The university promised this hopeful 18 year old child a dream job and a good wage to go with it and instead they basically destroyed her future. The fraud universities are perpetuating makes the banks look like a freaking soup kitchen. The first politician who recognizes that this is modern day feudalism and has the guts to call it as such is going to be very successful.
- zoolily 4y ago
  For public universities, declining state government funding is the primary reason for tuition increases. Funding for the state university nearest me declined from the state providing more than over 75% of the budget in 2005 to under 25% last year, while the number of staff decreased. Unsurprisingly, tuition increased to make up much of that gap in funding.
jmeister 4y ago
Some progressives are waking up and taking action: https://en.wikipedia.org/wiki/Supply-side_progressivism https://en.wikipedia.org/wiki/Supply-side_progressivism
WalterBright 4y ago
Is it any surprise that the more the government gets involved in a particular industry, the more expensive it gets?
- Eisenstein 4y ago
  They aren't getting involved in an industry. When they do, it is to build public schools, which seems to be a great idea. What they are doing is submitting to public demand that education be accessible to everyone by paying for it, or by lending people the money for it. It is like saying that food stamps are 'government getting involved in the grocery industry'. If one counts subsidies, then the government is involved in most industries in some way. I think that by looking for an excuse as to why the government messes up everything and using that as a way to remove government from things, you haven't changed the need for that thing, you just make it so that in order to fill a public need the government has to enable it in some way that is probably less efficient -- like giving out lots of loans for education, or by having people forgo basic care and then ending up in the hospital with a huge bill that the government pays for because they cannot. There is usually a medium between these things and it would be great to get off of our collective ideological horses and find them instead of blasting rhetoric at each other.
  - WalterBright 4y ago
    It's not ideological. All you have to do is look at the results. Lending people money for college led to huge increases in tuition.
    - Eisenstein 4y ago
      It seems ideological to me because the government was specifically mentioned. If it were a non-profit guaranteeing all college loans, would 'non-profit' have been mentioned instead of government? I doubt it.
      - WalterBright 4y ago
        There were and are non-profits scholarships. They simply aren't big enough to have the effect that government has.
narrator 4y ago
The American solution to something being too expensive is to spend twice as much money on it.
- testfoobar 4y ago
  This solution certainly appears to apply to healthcare, education and public infrastructure. I believe the reason is that since we print the global reserve currency, we can always borrow money at the Federal level and spend more.
  - imtringued 4y ago
    That makes no sense. Why would you squander an opportunity like that on corruption?
JamesBarney 4y ago
I agree with a lot of what you're saying but the evidence that Obamacare ballooned healthcare expenses isn't there. Obamacare also has a huge positive impact besides just access to healthcare. For instance I couldn't have started a startup without it, and it's much easier to hire contract workers because of it.
- mjevans 4y ago
  I'm still so irked that they didn't go full single payer and put everyone into one coverage pool. Still, the supply side support necessary would also be an issue. For markets where the local going rate is expensive enough it would make a ton of sense to allocate military medical units to supplant the local market until more doctors of that type were in the area. If it takes long enough the military supply might even retire from the forces to open practices in that area.
- _hyn3 4y ago
  My insurance is literally more than 3x higher than it was 15 years ago. It's literally more than my mortgage, and I don't live in a shanty.
  - hmmmmmm111 4y ago
    What do you think the difference in premiums are between a 20 year old and a 35 year old? What about between 35 and 50? I mean I know only two interesting facts about you, the difference in time, and I already know a common sense reason why your price today is much higher than it would be when you were 15 years younger, in “literally” any time in history, and perhaps it was always about 3x more expensive premiums.
    - lotsofpulp 4y ago
      Young people subsidize older people due to the Affordable Care Act forcing it. https://www.healthcare.gov/how-plans-set-your-premiums https://www.healthcare.gov/how-plans-set-your-premiums > Age: Premiums can be up to 3 times higher for older people than for younger ones. It is actually very available information. See age rating factors in these pdfs: https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcrates2023.pdf https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcra... For example, in New Jersey, a gold metal level plan would cost a 64 year old 3 * $730.86 ~ $2,200 per month, which legally has to cover 80% of a person’s expected healthcare costs. For a silver level plan, ~$1,300 per month will cover 70% of the healthcare costs. That just shows how much more healthcare people need as they get older.
8f2ab37a-ed6c 4y ago
There's a question around whether people actually want a higher supply of quality institutions, or simply more access to the high-end ones that everybody is competing over. The latter would be self-defeating, because by definition they would no longer be elite or luxury. What would happen if suddenly hundreds of additional institutions as good as MIT, Stanford and Harvard appeared out of thin air in the US? Wouldn't we quickly revert back to the current state of things, once US News and marketers figured out a way of creating another "Top 100" hierarchy of schools, with parents shoving their kids into violin practice, water polo and building-orphanages-in-Nicaragua photo ops to make it into the new top 5 luxury brand name universities? The scarcity IS the product of these institutions. This is the nature of positional goods.
joe_the_user 4y ago
No doubt education and health care have become corrupt feeding frenzies for bureaucrats mediating these industries. However, your cry, "competition", is exactly the rallying cry of these bureaucrats. Neither education nor health care make sense to organize by competition - the consumer lacks the ability to make the informed choices that an effective market requires. Obama care, in fact, contained a variety of pseudo-competition schemes to bring down costs, all of which predictably failed. And we're seen the disaster of various for-profit colleges.
regular 4y ago
zamfi 4y ago
Your overall point, about limited supply / increasing demand, is not wrong. However — > For example, the number of UC campuses in California should have doubled as the population doubled. Maybe. But the number of students at UC campuses in California has doubled since 1965 — even though the number of campuses hasn’t. I think the issue is that demand has more than doubled as the population of California has doubled—because college is more of a requirement than ever.
nradov 4y ago
We have a shortage of doctors because Congress has refused to fund more residency program slots. This has held down Medicare costs, but as the population ages appointment wait times are increasing and existing doctors are burning out from excessive work. https://savegme.org/ https://savegme.org/ While more healthcare supply is definitely needed, this is ultimately a bottomless pit. Patients with complex chronic conditions have essentially infinite demand for healthcare services. The majority of those chronic conditions are caused by lifestyle issues including overeating, lack of exercise, and substance abuse. As a society there has to be a limit to what percentage of our GDP that we devote to healthcare.
- imtringued 4y ago
  This reminds me of a doctor that did ten thousand heart surgeries and quit because people kept coming back for their second or third bypass. It's pointless because you're not addressing the source of the problem.
deleted 4y ago
[deleted]
specialist 4y ago
> both college education and healthcare have become enormous taxpayer wealth extraction schemes Yup. Early 70s, we started transformation from a manufacturing to a rent seeking economy. Cleverly branded as "supply side", "knowledge worker", and "service industry". I still can't get over the fact that I have to spend money to use my money. Even more so the less money a person has. https://wtfhappenedin1971.com https://wtfhappenedin1971.com
colinmhayes 4y ago
> It did almost nothing on the supply side This isn't really true. Obamacare was integral to the push toward increased capitation. Health care insurance paying for services provided instead of patients covered leads to incredibly perverse incentives that have been a huge part of why costs are so high. Capitation solves that by aligning provider incentives with patient incentives; provide timely, high quality care and not unnecessary treatments.

giantg2 4y ago

"Drive the price down by increasing seats and then fostering competition between schools." The seats have increased dramatically. You won't be able to create efficient competition. The value shoppers already go to state schools. The other people are looking for a specific "quality" or just plain emotion (my family went here, this school is prestigious, etc). Supply isn't the real issue in most disciplines. The problem is the demand side individuals making economically dumb choices (sometimes semi-forced by the larger societal situation).

mixmastamyk 4y ago
Handing out bales of money in the form of guaranteed loans enables this price insensitivity and accelerates price increases.

missedthecue 4y ago

Schools compete not on price but on other factors. That's why they want to build massively expensive campuses and elaborate facilities, because that is what students base their decisions on. If schools competed on price, everyone would be going to state colleges c̶o̶m̶m̶u̶n̶i̶t̶y̶ ̶c̶o̶l̶l̶e̶g̶e̶. I'm not sure how you compel schools to compete on price, because the consumers don't care about price. They'd rather get they "good college experience" for $50k a year than the "sufficiently good education" for $7k a year, even though both options are available to choose.

spijdar 4y ago
Not to nitpick a tangent, but community colleges, at least where I live, are only 2 year institutions, and don't provide full BS/BA degrees, just Associate degrees, which don't really open the same doors as the Bachelor degrees. I really wish we had 4 year institutions managed like our community colleges, though. I remember my 2 years there much more fondly than I do my time spent at a "real" university.
- missedthecue 4y ago
  Right, perhaps it would have been better to say state school.
  - School-Cotton 4y ago
    Where does the local state university cost $7k/yr?
    - irowe 4y ago
      Yeah that does seem a little low. US News and World report has average in-state tuition at $10,423/yr [1] [1]: https://www.usnews.com/object/image/00000183-138c-db49-a3a3-33bcb4e00000/bc-infographics-tuition-optimized.png https://www.usnews.com/object/image/00000183-138c-db49-a3a3-...
      - 4y ago

paulpauper 4y ago

5. And we wonder why tuition keeps increasing? 1) Demand increases with population increase. 2) Demand increase with more people seeking 4 yr degrees. 3) Demand increases with the US subsidizing the ever living shit out of college tuition. 4) Supply stays relatively constant. Demand is increasing due to the college wage premium, which keeps widening with no end in sight even despite Covid and online learning. The college wage premium is the number one culprit for all these problems . For whatever reason, employers derive enough benefit from college grads to pay them waaaayyy more than high school grads https://greyenlightenment.com/2022/09/22/blame-college-wage-premium-for-tuition-surge-not-government/ https://greyenlightenment.com/2022/09/22/blame-college-wage-... The vast majority of people attend college to earn more money and be employable, as a sort of ticket the middle class. If college degrees only paid slightly more than high school instead of 2x more, demand would probably fall a lot, so would borrowing and tuition. Same for unemployment: high school grads have to 2x the unemployment rate. Maybe the onus is on employers: start finding ways to find hire more high school grads for better paying work...huge labor pool of high school grads..they cannot all be bad.

pclmulqdq 4y ago
The college wage premium is either reversing or pretty much gone by now. Plumbers and landscapers out-earn English and History majors now. It's only degrees that prepare you for specialized fields that still have an edge.
- paulpauper 4y ago
  It's fallacious to compare the lowest paying college degrees to the highest paying of trades work as evidence of the premium reversing. Someone could just as easily compare an engineer, lawyer, or doctor who makes $250k/year to someone who works at McDonald's and makes $25k/year. A plumber with many years of experience on average makes $50-53k/year. This is respectable, but this is after many years. College grads by comparison on average make $55k out of college, whereas an apprentice makes $30k .
  - pclmulqdq 4y ago

dudeinjapan 4y ago

In education, "supply" itself is not the issue; there are more than enough spots at state, etc. universities. Its supply of prestigious universities, which is controlled by a cartel. Similar to diamonds, which are neither precious nor rare, yet prices are outrageous because they are controlled by a cartel. If/when I become President of the United States, I will hold back all education dollars on cartel-controlled education institutions, and heavily tax their endownments.

deleted 4y ago
[deleted]
testfoobar 4y ago
This is funny and true. The competition and prices all originate from elite institutions. I wonder if it legal to completely clone a curriculum? Like could you clone an MIT EECS education? Down to the coursework? Or alternatively - force elite schools to license and manage franchisees? I'd vote for you.
- dudeinjapan 4y ago
  Alright! Every vote counts! > is it legal to completely clone a curriculum? Gray area. I'm no lawyer but AFAIK professor's syllabus/tests/etc. (being written documents) are subject to automatic copyright, I imagine the university is the holder of the copyright given that the prof is an employee. That being said, how many profs clone their syllabus/coursework directly from textbooks? The content of most online universities (Khan Academy, Coursera, etc.) is already superior to Ivy League based on first-hand experience of both. The bigger problem IMHO is that very little of the overall $$$ and energy at Ivy League is actually spent on course content. For many profs, esp. in STEM, teaching undergrad courses is a "chore" / distraction from their research work. I think there is opportunity to make a "lean-and-mean" physical university (perhaps online hybrid) with minimal admin overhead, which a degree could be on-par with MIT in terms of prestige. Is anyone doing this?
  - 2snakes 4y ago

halffaday 4y ago

I think credit deserves some blame. Schools charge the maximum they expect students to be able to pay, and when students have significant leverage through the bank, those costs rise with it. Very similar conditions in housing. I think administrative bloat is a consequence rather than a cause. Now that the faculty lounge has replaced the factory floor as a reliable voting demographic for you-know-who, I don’t think the subsidies and waste will stop anytime soon.

treeman79 4y ago

Solution. Stop government funding.

8f2ab37a-ed6c 4y ago
Good luck finding a politician who will kill the dream of everybody going to college. The optics of that are pretty awful.
- wernercd 4y ago
  People went to college before the guaranteed "right" to go to college. It was also more affordable then - for some strange reason. Removing government help won't end the college dream... but it might, in time - since it took time to get this fucked up - restore some semblance of reasonable to the equation.
- MisterMower 4y ago
  It’s not a dream. It’s a nightmare for most folks. A girl I knew went to school for speech therapy. Decent grades. Good school. $80k debt for undergrad. Couldn’t get a job with a bachelor’s degree, so she racked up $100k getting a master’s degree. She’s 25 years old making $30k a year working for an agency that pairs her with kids that need help. She has no conceivable way to pay that loan off on that salary. She will never qualify for a mortgage with that kind of debt to income ratio. The university promised this hopeful 18 year old child a dream job and a good wage to go with it and instead they basically destroyed her future. The fraud universities are perpetuating makes the banks look like a freaking soup kitchen. The first politician who recognizes that this is modern day feudalism and has the guts to call it as such is going to be very successful.
zoolily 4y ago
For public universities, declining state government funding is the primary reason for tuition increases. Funding for the state university nearest me declined from the state providing more than over 75% of the budget in 2005 to under 25% last year, while the number of staff decreased. Unsurprisingly, tuition increased to make up much of that gap in funding.

jmeister 4y ago

Some progressives are waking up and taking action: https://en.wikipedia.org/wiki/Supply-side_progressivism https://en.wikipedia.org/wiki/Supply-side_progressivism

WalterBright 4y ago

Is it any surprise that the more the government gets involved in a particular industry, the more expensive it gets?

Eisenstein 4y ago
They aren't getting involved in an industry. When they do, it is to build public schools, which seems to be a great idea. What they are doing is submitting to public demand that education be accessible to everyone by paying for it, or by lending people the money for it. It is like saying that food stamps are 'government getting involved in the grocery industry'. If one counts subsidies, then the government is involved in most industries in some way. I think that by looking for an excuse as to why the government messes up everything and using that as a way to remove government from things, you haven't changed the need for that thing, you just make it so that in order to fill a public need the government has to enable it in some way that is probably less efficient -- like giving out lots of loans for education, or by having people forgo basic care and then ending up in the hospital with a huge bill that the government pays for because they cannot. There is usually a medium between these things and it would be great to get off of our collective ideological horses and find them instead of blasting rhetoric at each other.
- WalterBright 4y ago
  It's not ideological. All you have to do is look at the results. Lending people money for college led to huge increases in tuition.
  - Eisenstein 4y ago
    It seems ideological to me because the government was specifically mentioned. If it were a non-profit guaranteeing all college loans, would 'non-profit' have been mentioned instead of government? I doubt it.
    - WalterBright 4y ago
      There were and are non-profits scholarships. They simply aren't big enough to have the effect that government has.

narrator 4y ago

The American solution to something being too expensive is to spend twice as much money on it.

testfoobar 4y ago
This solution certainly appears to apply to healthcare, education and public infrastructure. I believe the reason is that since we print the global reserve currency, we can always borrow money at the Federal level and spend more.
- imtringued 4y ago
  That makes no sense. Why would you squander an opportunity like that on corruption?

JamesBarney 4y ago

I agree with a lot of what you're saying but the evidence that Obamacare ballooned healthcare expenses isn't there. Obamacare also has a huge positive impact besides just access to healthcare. For instance I couldn't have started a startup without it, and it's much easier to hire contract workers because of it.

mjevans 4y ago
I'm still so irked that they didn't go full single payer and put everyone into one coverage pool. Still, the supply side support necessary would also be an issue. For markets where the local going rate is expensive enough it would make a ton of sense to allocate military medical units to supplant the local market until more doctors of that type were in the area. If it takes long enough the military supply might even retire from the forces to open practices in that area.
_hyn3 4y ago
My insurance is literally more than 3x higher than it was 15 years ago. It's literally more than my mortgage, and I don't live in a shanty.
- hmmmmmm111 4y ago
  What do you think the difference in premiums are between a 20 year old and a 35 year old? What about between 35 and 50? I mean I know only two interesting facts about you, the difference in time, and I already know a common sense reason why your price today is much higher than it would be when you were 15 years younger, in “literally” any time in history, and perhaps it was always about 3x more expensive premiums.
  - lotsofpulp 4y ago
    Young people subsidize older people due to the Affordable Care Act forcing it. https://www.healthcare.gov/how-plans-set-your-premiums https://www.healthcare.gov/how-plans-set-your-premiums > Age: Premiums can be up to 3 times higher for older people than for younger ones. It is actually very available information. See age rating factors in these pdfs: https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcrates2023.pdf https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcra... For example, in New Jersey, a gold metal level plan would cost a 64 year old 3 * $730.86 ~ $2,200 per month, which legally has to cover 80% of a person’s expected healthcare costs. For a silver level plan, ~$1,300 per month will cover 70% of the healthcare costs. That just shows how much more healthcare people need as they get older.

8f2ab37a-ed6c 4y ago

There's a question around whether people actually want a higher supply of quality institutions, or simply more access to the high-end ones that everybody is competing over. The latter would be self-defeating, because by definition they would no longer be elite or luxury. What would happen if suddenly hundreds of additional institutions as good as MIT, Stanford and Harvard appeared out of thin air in the US? Wouldn't we quickly revert back to the current state of things, once US News and marketers figured out a way of creating another "Top 100" hierarchy of schools, with parents shoving their kids into violin practice, water polo and building-orphanages-in-Nicaragua photo ops to make it into the new top 5 luxury brand name universities? The scarcity IS the product of these institutions. This is the nature of positional goods.

joe_the_user 4y ago

No doubt education and health care have become corrupt feeding frenzies for bureaucrats mediating these industries. However, your cry, "competition", is exactly the rallying cry of these bureaucrats. Neither education nor health care make sense to organize by competition - the consumer lacks the ability to make the informed choices that an effective market requires. Obama care, in fact, contained a variety of pseudo-competition schemes to bring down costs, all of which predictably failed. And we're seen the disaster of various for-profit colleges.

regular 4y ago

zamfi 4y ago

Your overall point, about limited supply / increasing demand, is not wrong. However — > For example, the number of UC campuses in California should have doubled as the population doubled. Maybe. But the number of students at UC campuses in California has doubled since 1965 — even though the number of campuses hasn’t. I think the issue is that demand has more than doubled as the population of California has doubled—because college is more of a requirement than ever.

nradov 4y ago

We have a shortage of doctors because Congress has refused to fund more residency program slots. This has held down Medicare costs, but as the population ages appointment wait times are increasing and existing doctors are burning out from excessive work. https://savegme.org/ https://savegme.org/ While more healthcare supply is definitely needed, this is ultimately a bottomless pit. Patients with complex chronic conditions have essentially infinite demand for healthcare services. The majority of those chronic conditions are caused by lifestyle issues including overeating, lack of exercise, and substance abuse. As a society there has to be a limit to what percentage of our GDP that we devote to healthcare.

imtringued 4y ago
This reminds me of a doctor that did ten thousand heart surgeries and quit because people kept coming back for their second or third bypass. It's pointless because you're not addressing the source of the problem.

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specialist 4y ago

> both college education and healthcare have become enormous taxpayer wealth extraction schemes Yup. Early 70s, we started transformation from a manufacturing to a rent seeking economy. Cleverly branded as "supply side", "knowledge worker", and "service industry". I still can't get over the fact that I have to spend money to use my money. Even more so the less money a person has. https://wtfhappenedin1971.com https://wtfhappenedin1971.com

colinmhayes 4y ago

> It did almost nothing on the supply side This isn't really true. Obamacare was integral to the push toward increased capitation. Health care insurance paying for services provided instead of patients covered leads to incredibly perverse incentives that have been a huge part of why costs are so high. Capitation solves that by aligning provider incentives with patient incentives; provide timely, high quality care and not unnecessary treatments.