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Alabama has GDP per capita higher than Finland? Hard to believe.... Maybe you can afford Universal Health Care after all...

by belter 10mo ago

skirge 10mo ago
then prices will decrease and thus GDP will be lower, isn't it?
MostlyStable 10mo ago
This is actually the reason why I'm a proponent of the US Federal government doing far _far_ less. Things like Healthcare and other safety net things (along with most other things) should be done at the state level, and the the fact that European nations, which are near universally poorer than all US states, are able to do these things, are the proof that this would work. I'm convinced that the federal government doing more and more things is the root cause if the increasing toxicity of American politics. The further removed a populace is from their representatives the less control they have and the worse they feel. Everything should always be done at the most local level that it is possible to do it. Some things have to be done at a relatively high level, but Americans have increasingly been jumping straight to "this is a job for the federal government" when very often state, or even city governments in some cases, would be perfectly capable.
- mothballed 10mo ago
  The federal government has no constitutional authority to provide universal health care, per the 10th amendment which leaves an extremely narrow constraint of enumerated powers to the federal government and the rest left to the people and the states. However, the feds already siphon about as much tax as the populace can bear just on accomplishing what it is allowed to do, so there is basically nothing left for the states to implement these kind of measures.
  - MostlyStable 10mo ago
    Yes, if the states were to take over many of these things, obviously federal taxes would need to dramatically decrease (luckily, the vast majority of federal spending is doing the things that I think states should do anyways, so you'd be simultaneously dramatically decreasing federal taxes and federal spending). You couldn't just have the states take over these responsibilities and have nothing else change. My suggestion is in fact a pretty radical change in how the US federal government works. I'm not under any illusion that this is likely to happen. The ratchet of power unfortunately only goes in one direction.
- phantasmish 10mo ago
  Our GDP would drop several percent if we fixed our healthcare system. Part of why we look richer on paper is that we light a lot of money on fire for exactly nothing.
  - jandrewrogers 10mo ago
    Not really. That money didn't appear out of thin air. It would be lit on fire for some other purpose instead.
    - phantasmish 10mo ago
      Ah, there’s always zero-sum competition for housing to eat up any excess that might otherwise go to savings. That’s true. Money gets freed up across the board, you spend it on housing or lose ground in the housing competition. Good ol’ red queen’s race.
- embedding-shape 10mo ago
  > which are near universally poorer than all US states, are able to do these things What do you mean that the countries are poorer? Are you just thinking about the gross salary people get per month, or is there something else in this calculation? The fact that people get health care, parental leave, can freely move between countries, able to afford having a child, have emergency services that arrive relatively quick and all those things mean that a country is not poor, and the countries that don't have those, are "poorer", at least in my mind. When I think "poor country" I don't think about the GDP, but how well the citizens and residents are protected by ills.
  - jacobgkau 10mo ago
    I know you've made a handful of comments all to this effect throughout the thread, but it's really not helpful in this particular comment chain. Yes, we know your quality of life in Europe is great. Yes, we know life is more than just GDP. "What we mean that the countries are poorer" is obviously GDP in this comment chain, and this comment chain is not disputing your quality of life, it's pointing out that we (collectively) have the money to have that quality of life here in the US, too.
    - kakacik 10mo ago
      But thats a flawed metric. How much cash do you need saved to send 2 kids to university in US vs typical Europe, without burdening them for their best years of life with crushing debt? How much is left afterwards? How much after acquiring some long term illness with expensive treatment or being in bad accident? Don't think that due to being young this ain't your concern, all elders have messed up health in many ways. Retirement. And so on. These are direct costs and its all about money. Ie US couple with teens just about to go to college with say 500k are same or poorer than similar family in Europe having say 200k savings, or will be after few years. Or maybe not, depends. I'd say its uncomparable directly, or very, very hard. You can say visit both places and walk around and see the general state of the country and its people, compare capitals. This is where money is spent (or not). Not going into happiness, stress levels, depression/anxiety and meds consumption, obesity levels or longevity, that would be too easy I agree. Although this is also money related, more than anything else.
bluebarbet 10mo ago
Above all it's great example of why we'd do well to drop our quasi-religious fetishization of GDP as an indicator.
- nradov 10mo ago
  Who is fetishizing GDP? I've never seen public policy be set based on the goal of maximizing GDP to the exclusion of all else. You're arguing against a strawman.
mikkupikku 10mo ago
The American government spends an incredible amount on healthcare already. If it were competently administered, it would already be enough money to cover universal healthcare.
- hvb2 10mo ago
  It's the cost of procedures/medication Example: https://worldpopulationreview.com/country-rankings/cost-of-insulin-by-country https://worldpopulationreview.com/country-rankings/cost-of-i... And why, in free market land, is a buyer of services and medication, not allowed to negotiate prices?
  - nradov 10mo ago
    Which buyer are you referring to? Consumers paying cash can negotiate as much as they want, and often secure large discounts. Commercial health plans also negotiate hard with their network providers, although some of them play unethical tricks with PBMs to artificially inflate prescription drug prices. Medicare and Medicaid don't really negotiate with providers, they just set rates by arbitrary fiat and providers can take it or leave it. Medicare does have some statutory limitations on how they can negotiate drug prices, though.
  - mikkupikku 10mo ago
    Its the cost of keeping American doctors living in mansions big enough to house a whole village.
    - nradov 10mo ago
      Which doctors? Some specialists do quite well but many primary care physicians earn less than software developers, especially once you account for education expenses and ongoing mandatory professional expenses. What is the correct amount for them to earn anyway?
      - mikkupikku 10mo ago
        The ones in my town, I know where they live, up by the lake.
bpt3 10mo ago
We already do have universal health care for the most expensive groups to insure (lower income households and the elderly), and technically have it for everyone in that hospitals aren't allowed to deny life saving care to anyone regardless of their ability to pay (which is expensive, short sighted, and quite inadequate overall). Adding the rest of the population to the existing public insurance system would not cost much financially, but it would be a political catastrophe for whatever party implemented it if it didn't go well. In short, I don't think anyone seriously argues the US can't afford universal health care, but the real and perceived risk of change is seen as too great politically.

Alabama has GDP per capita higher than Finland? Hard to believe.... Maybe you can afford Universal Health Care after all...

by belter 10mo ago

Alabama has GDP per capita higher than Finland? Hard to believe.... Maybe you can afford Universal Health Care after all...

skirge 10mo ago

then prices will decrease and thus GDP will be lower, isn't it?

MostlyStable 10mo ago

This is actually the reason why I'm a proponent of the US Federal government doing far _far_ less. Things like Healthcare and other safety net things (along with most other things) should be done at the state level, and the the fact that European nations, which are near universally poorer than all US states, are able to do these things, are the proof that this would work. I'm convinced that the federal government doing more and more things is the root cause if the increasing toxicity of American politics. The further removed a populace is from their representatives the less control they have and the worse they feel. Everything should always be done at the most local level that it is possible to do it. Some things have to be done at a relatively high level, but Americans have increasingly been jumping straight to "this is a job for the federal government" when very often state, or even city governments in some cases, would be perfectly capable.

mothballed 10mo ago
The federal government has no constitutional authority to provide universal health care, per the 10th amendment which leaves an extremely narrow constraint of enumerated powers to the federal government and the rest left to the people and the states. However, the feds already siphon about as much tax as the populace can bear just on accomplishing what it is allowed to do, so there is basically nothing left for the states to implement these kind of measures.
- MostlyStable 10mo ago
  Yes, if the states were to take over many of these things, obviously federal taxes would need to dramatically decrease (luckily, the vast majority of federal spending is doing the things that I think states should do anyways, so you'd be simultaneously dramatically decreasing federal taxes and federal spending). You couldn't just have the states take over these responsibilities and have nothing else change. My suggestion is in fact a pretty radical change in how the US federal government works. I'm not under any illusion that this is likely to happen. The ratchet of power unfortunately only goes in one direction.
phantasmish 10mo ago
Our GDP would drop several percent if we fixed our healthcare system. Part of why we look richer on paper is that we light a lot of money on fire for exactly nothing.
- jandrewrogers 10mo ago
  Not really. That money didn't appear out of thin air. It would be lit on fire for some other purpose instead.
  - phantasmish 10mo ago
    Ah, there’s always zero-sum competition for housing to eat up any excess that might otherwise go to savings. That’s true. Money gets freed up across the board, you spend it on housing or lose ground in the housing competition. Good ol’ red queen’s race.
embedding-shape 10mo ago
> which are near universally poorer than all US states, are able to do these things What do you mean that the countries are poorer? Are you just thinking about the gross salary people get per month, or is there something else in this calculation? The fact that people get health care, parental leave, can freely move between countries, able to afford having a child, have emergency services that arrive relatively quick and all those things mean that a country is not poor, and the countries that don't have those, are "poorer", at least in my mind. When I think "poor country" I don't think about the GDP, but how well the citizens and residents are protected by ills.
- jacobgkau 10mo ago
  I know you've made a handful of comments all to this effect throughout the thread, but it's really not helpful in this particular comment chain. Yes, we know your quality of life in Europe is great. Yes, we know life is more than just GDP. "What we mean that the countries are poorer" is obviously GDP in this comment chain, and this comment chain is not disputing your quality of life, it's pointing out that we (collectively) have the money to have that quality of life here in the US, too.
  - kakacik 10mo ago
    But thats a flawed metric. How much cash do you need saved to send 2 kids to university in US vs typical Europe, without burdening them for their best years of life with crushing debt? How much is left afterwards? How much after acquiring some long term illness with expensive treatment or being in bad accident? Don't think that due to being young this ain't your concern, all elders have messed up health in many ways. Retirement. And so on. These are direct costs and its all about money. Ie US couple with teens just about to go to college with say 500k are same or poorer than similar family in Europe having say 200k savings, or will be after few years. Or maybe not, depends. I'd say its uncomparable directly, or very, very hard. You can say visit both places and walk around and see the general state of the country and its people, compare capitals. This is where money is spent (or not). Not going into happiness, stress levels, depression/anxiety and meds consumption, obesity levels or longevity, that would be too easy I agree. Although this is also money related, more than anything else.

bluebarbet 10mo ago

Above all it's great example of why we'd do well to drop our quasi-religious fetishization of GDP as an indicator.

nradov 10mo ago
Who is fetishizing GDP? I've never seen public policy be set based on the goal of maximizing GDP to the exclusion of all else. You're arguing against a strawman.

mikkupikku 10mo ago

The American government spends an incredible amount on healthcare already. If it were competently administered, it would already be enough money to cover universal healthcare.

hvb2 10mo ago
It's the cost of procedures/medication Example: https://worldpopulationreview.com/country-rankings/cost-of-insulin-by-country https://worldpopulationreview.com/country-rankings/cost-of-i... And why, in free market land, is a buyer of services and medication, not allowed to negotiate prices?
- nradov 10mo ago
  Which buyer are you referring to? Consumers paying cash can negotiate as much as they want, and often secure large discounts. Commercial health plans also negotiate hard with their network providers, although some of them play unethical tricks with PBMs to artificially inflate prescription drug prices. Medicare and Medicaid don't really negotiate with providers, they just set rates by arbitrary fiat and providers can take it or leave it. Medicare does have some statutory limitations on how they can negotiate drug prices, though.
- mikkupikku 10mo ago
  Its the cost of keeping American doctors living in mansions big enough to house a whole village.
  - nradov 10mo ago
    Which doctors? Some specialists do quite well but many primary care physicians earn less than software developers, especially once you account for education expenses and ongoing mandatory professional expenses. What is the correct amount for them to earn anyway?
    - mikkupikku 10mo ago
      The ones in my town, I know where they live, up by the lake.

bpt3 10mo ago

We already do have universal health care for the most expensive groups to insure (lower income households and the elderly), and technically have it for everyone in that hospitals aren't allowed to deny life saving care to anyone regardless of their ability to pay (which is expensive, short sighted, and quite inadequate overall). Adding the rest of the population to the existing public insurance system would not cost much financially, but it would be a political catastrophe for whatever party implemented it if it didn't go well. In short, I don't think anyone seriously argues the US can't afford universal health care, but the real and perceived risk of change is seen as too great politically.