4 ms·

Early 90’s during the Clinton administration (and the dot com boom) appeared to be the best run US budgeting process I have ever seen.

doctorpangloss 10mo ago
another POV is he was extremely lucky Pfizer decided to NOT commercialize its GLP-1 drug (https://www.statnews.com/2024/09/09/glp-1-history-pfizer-john-baxter-jeffrey-flier-calbio-metabio/ https://www.statnews.com/2024/09/09/glp-1-history-pfizer-joh...) in 1992. What if it had commercialized GLP1s? The law that prevented Medicare from paying for weight loss drugs like GLP1s, the MMA, was passed in 2003. So Medicare would have to pay. YEAR NOM. ADJ 23 NET NET ($B) ($B) 10% 100% 1998 69.2 129.4 102.6 -138.6 1999 125.6 229.7 202.9 -38.3 2000 236.2 417.9 391.1 149.9 2001 128.2 220.6 193.8 -47.4 Okay, only 4 surplus years. 10% uptake of GLP1s, okay, they'd be in surplus. 100% uptake, it would be a deficit. Any number of things could have happened. This was just one thing that definitely was completely in control of people - it was in the control of Pfizer's commercialization team - it wasn't some unforeseeable crisis. My point is, the little HN takes here and there like yours, better to not make them, because frankly you don't know anything about the budgeting process or governance, so why say anything at all?
- detourdog 10mo ago
  I don't doubt he was lucky which is why I parenthetical referred to the dot com boom. I don't quite understand the relevancy of GLP1s to his luck. I think obesity wasn't what it is today back in the 90's. I think the saying is Luck rewards the prepared.
- BobbyJo 10mo ago
  I mean, luck is always a part of it, but you need responsible policy too. The US was lucky from 2010 to 2020, with the the economy growing basically that whole stretch, and we still ran a massively growing deficit the entire time because we decided to try and reform the middle east while lowering taxes.
  - doctorpangloss 10mo ago
    would his policy have been to pay for GLP1s? Yes. And is that a little more than a hypothetical? yes. People who don't know US budgets don't know what drives faster-than-GDP growth in expenses (it's real estate, biotech and college).
    - detourdog 10mo ago
      I'm unable to follow the point of the significance of GLP1s. I also wouldn't describe the expense as biotech I think healthcare is a better description. Finally the US's current healthcare system is truly broken. Our elected officials choose to ignore the issue and act as if we are fortunate to have this system. Which must be the least efficent way to deliver healthcare.
    - BobbyJo 10mo ago
      > People who don't know US budgets don't know what drives faster-than-GDP growth in expenses (it's real estate, biotech and college). That's just wrong. Social Security, Medicare, debt interest, and the military eclipse everything else. Discretionary spending outside the military is only like 15% of the budget. Also, why are you even connecting GLP1 drugs and the 90s federal budget surplus? The drugs didn't exist back then, and the government isn't paying for everyone to take them now, so I have no idea why you'd even draw a connection there.
      - doctorpangloss 10mo ago
        Because new drugs are what make the federal spending pie larger. Slower growth also does. Wars can also make budgets balloon, but then you’d be like “well Clinton wouldn’t want wars.” Okay, so would he want faster medical progress? Of course, and that turns out to be budget busting! The drugs could have existed back then. You’d have to read the link. And today they do, and under Clinton, would he pay? All great things to talk about. I am trying to have an interesting conversation and instead it’s just, downvote this downvote that.
        10mo ago
marcosdumay 10mo ago
Yes, but global reserves are the domestic total foreign debit, and the government does not control that one. (I mean, it can weight in how it grows, but it's not the one that makes it.)
- detourdog 10mo ago
  I think what you are saying is the sum total of global economic activity from the US point of view is foreign debt. The US has no direct control over this debt other than control of printing treasuries. Is that fair interpretation.
  - marcosdumay 10mo ago
    The world's dollar reserves are the US foreign debit. The US government didn't create that debit. It's not the government's debit. They can influence people, but they don't control that one.

doctorpangloss 10mo ago

another POV is he was extremely lucky Pfizer decided to NOT commercialize its GLP-1 drug (https://www.statnews.com/2024/09/09/glp-1-history-pfizer-john-baxter-jeffrey-flier-calbio-metabio/ https://www.statnews.com/2024/09/09/glp-1-history-pfizer-joh...) in 1992. What if it had commercialized GLP1s? The law that prevented Medicare from paying for weight loss drugs like GLP1s, the MMA, was passed in 2003. So Medicare would have to pay. YEAR NOM. ADJ 23 NET NET ($B) ($B) 10% 100% 1998 69.2 129.4 102.6 -138.6 1999 125.6 229.7 202.9 -38.3 2000 236.2 417.9 391.1 149.9 2001 128.2 220.6 193.8 -47.4 Okay, only 4 surplus years. 10% uptake of GLP1s, okay, they'd be in surplus. 100% uptake, it would be a deficit. Any number of things could have happened. This was just one thing that definitely was completely in control of people - it was in the control of Pfizer's commercialization team - it wasn't some unforeseeable crisis. My point is, the little HN takes here and there like yours, better to not make them, because frankly you don't know anything about the budgeting process or governance, so why say anything at all?

detourdog 10mo ago
I don't doubt he was lucky which is why I parenthetical referred to the dot com boom. I don't quite understand the relevancy of GLP1s to his luck. I think obesity wasn't what it is today back in the 90's. I think the saying is Luck rewards the prepared.
BobbyJo 10mo ago
I mean, luck is always a part of it, but you need responsible policy too. The US was lucky from 2010 to 2020, with the the economy growing basically that whole stretch, and we still ran a massively growing deficit the entire time because we decided to try and reform the middle east while lowering taxes.
- doctorpangloss 10mo ago
  would his policy have been to pay for GLP1s? Yes. And is that a little more than a hypothetical? yes. People who don't know US budgets don't know what drives faster-than-GDP growth in expenses (it's real estate, biotech and college).
  - detourdog 10mo ago
    I'm unable to follow the point of the significance of GLP1s. I also wouldn't describe the expense as biotech I think healthcare is a better description. Finally the US's current healthcare system is truly broken. Our elected officials choose to ignore the issue and act as if we are fortunate to have this system. Which must be the least efficent way to deliver healthcare.
  - BobbyJo 10mo ago
    > People who don't know US budgets don't know what drives faster-than-GDP growth in expenses (it's real estate, biotech and college). That's just wrong. Social Security, Medicare, debt interest, and the military eclipse everything else. Discretionary spending outside the military is only like 15% of the budget. Also, why are you even connecting GLP1 drugs and the 90s federal budget surplus? The drugs didn't exist back then, and the government isn't paying for everyone to take them now, so I have no idea why you'd even draw a connection there.
    - doctorpangloss 10mo ago
      Because new drugs are what make the federal spending pie larger. Slower growth also does. Wars can also make budgets balloon, but then you’d be like “well Clinton wouldn’t want wars.” Okay, so would he want faster medical progress? Of course, and that turns out to be budget busting! The drugs could have existed back then. You’d have to read the link. And today they do, and under Clinton, would he pay? All great things to talk about. I am trying to have an interesting conversation and instead it’s just, downvote this downvote that.
      - 10mo ago

marcosdumay 10mo ago

Yes, but global reserves are the domestic total foreign debit, and the government does not control that one. (I mean, it can weight in how it grows, but it's not the one that makes it.)

detourdog 10mo ago
I think what you are saying is the sum total of global economic activity from the US point of view is foreign debt. The US has no direct control over this debt other than control of printing treasuries. Is that fair interpretation.
- marcosdumay 10mo ago
  The world's dollar reserves are the US foreign debit. The US government didn't create that debit. It's not the government's debit. They can influence people, but they don't control that one.