4 ms·

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

by 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.
    - BobbyJo 10mo ago
      You made a claim (budgeting wasn't good, they were just lucky) and backed it up with a strange hypothetical (if GLP1 drugs were released it would have driven the deficit higher). Your connection between the two is that new drugs are a primary driver of the federal deficit, which just isn't supported by the the reality of where the US government spends money. I don't know what interesting conversation you expect from any of that. If you can show why you think drugs are driving the deficit, that'd be interesting.
      - doctorpangloss 10mo ago
        Sure, here is a great and very influential article about technological innovation explaining faster than GDP growth of govt health spending: https://www.aeaweb.org/articles?id=10.1257/jep.6.3.3 https://www.aeaweb.org/articles?id=10.1257/jep.6.3.3 It was written contemporaneous to Clinton. You are welcome to read about the budgetary process of the Clinton years, healthcare was THE primary issue. Like why am I talking about this stuff, and why was everyone talking about it under Clinton? Because we’re all stupid? Military spending is PERCEIVED to be something about the budget, but it is ALL ABOUT HEALTHCARE, it has been since 1965 in this country, and it is all about healthcare everyone else in the developed world, acutely so in Europe and Japan.
        BobbyJo 10mo ago
        You're glossing over the leap between "is a driver of spending increases" and "is a primary driver of spending increases". IIRC healthcare costs rising has far more to do with an aging population than new drugs, so, again, I'm not seeing a strong link between new drugs and the government deficit.
detourdog 10mo ago
A really important detail that I don't think gets enough mention is that the second gulf war was paid for off the books. The war was not part of the federal budget.

by BobbyJo 10mo ago

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.
  - BobbyJo 10mo ago
    You made a claim (budgeting wasn't good, they were just lucky) and backed it up with a strange hypothetical (if GLP1 drugs were released it would have driven the deficit higher). Your connection between the two is that new drugs are a primary driver of the federal deficit, which just isn't supported by the the reality of where the US government spends money. I don't know what interesting conversation you expect from any of that. If you can show why you think drugs are driving the deficit, that'd be interesting.
    - doctorpangloss 10mo ago
      Sure, here is a great and very influential article about technological innovation explaining faster than GDP growth of govt health spending: https://www.aeaweb.org/articles?id=10.1257/jep.6.3.3 https://www.aeaweb.org/articles?id=10.1257/jep.6.3.3 It was written contemporaneous to Clinton. You are welcome to read about the budgetary process of the Clinton years, healthcare was THE primary issue. Like why am I talking about this stuff, and why was everyone talking about it under Clinton? Because we’re all stupid? Military spending is PERCEIVED to be something about the budget, but it is ALL ABOUT HEALTHCARE, it has been since 1965 in this country, and it is all about healthcare everyone else in the developed world, acutely so in Europe and Japan.
      - BobbyJo 10mo ago
        You're glossing over the leap between "is a driver of spending increases" and "is a primary driver of spending increases". IIRC healthcare costs rising has far more to do with an aging population than new drugs, so, again, I'm not seeing a strong link between new drugs and the government deficit.

detourdog 10mo ago

A really important detail that I don't think gets enough mention is that the second gulf war was paid for off the books. The war was not part of the federal budget.