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> Society should find a better way to pay for ambulances Society has this figured out, at least a decent solution that works until we find a perfect one. Only
by otherme123 3mo ago
> Society should find a better way to pay for ambulances
Society has this figured out, at least a decent solution that works until we find a perfect one. Only the US society seems to be unable to find a solution.
- wisty 3mo agoAnd the US also pays a TON of tax dollars to a broken, overregulated system. IIRC if you look at the cost of Medicaide, Medicare, VA, and other federal and state spending it's the same as most other countries per capita or as a percent of GDP. The US taxpayer pays about as much as Canadians to fund their public system, then pays the same amount again for private cover since it's not universal. No I'm not making a typo. Medicare, Medicaide, and the US system is such a rip off that per capita Americans are paying similar tax dollars to their joke of a public system. But no one wants to fix it. US doctors are overpaid. US nurses are over paid. Dug companies. Admin. Lawyers. Everyone who makes the system work, and everyone who makes the system a mess are paid a fortune for it.
- master-lincoln 3mo agoThat's what a government would be for. You vote neo-liberal, you get it... (I consider both the US democrats and republicans neo-liberal)
- bestouff 3mo agoI think only the US consider the US Democrats as leftists.
- natebc 3mo agoOnly the rightists do and among them really only the loud redfaced ones.
- philipallstar 3mo ago[flagged]
- jeremyjh 3mo agoThe US has always been a nation of immigrants, but now its largely a nation of ignorance.
- philipallstar 3mo agoAll nations are nations of immigrants other than maybe the cradle of humankind. They stop being that generally when the state and benefits get so expensive that administrating them and paying for them becomes a huge burden. The original immigrants to America fought the land and many died to tame it. Coming now to take is not the same thing. Particularly when you can fly in, give birth to an American, and fly out again.
- jeremyjh 3mo agoImmigrants provide a net economic benefit on average. If they work here, they spend here. They tend to be younger and with our aging demographics it’s really important that we have more young people entering the workforce.
- philipallstar 3mo agoThis is just GDP, which isn't that relevant. If you add a million people and only one of them works, GDP will still go up. It doesn't take into account the following: - no-one's talking about immigration in general. They're talking about mass immigration. So any general "look how immigration can be good" is not addressing the issue. - mass immigration means that housing becomes scarce, driving up prices. This again makes GDP look good, because stamp duty revenue goes up and so do estate agent fees. But all the many negative externalities, such as everyone is now buying houses 10 years later, and leaning on their parents, and their dwellings are all being subdivided because even a tiny place is now worth renting out or selling, are totally ignored. The housing costs drive every other cost up. Minimum wage / living wage needs to skyrocket just to combat this one thing, both because people need more money to pay for their own accommodation, and people need to afford goods and services that are all also being made more expensive because their salary costs need to increase for the same reason. - mass immigration spikes up demand for power. Power is often a large capital investment, which means that the country borrows a load of money from Macquarie Group to build it, with lots of interest paid back over decades. Seems to generate GDP as people are being paid to build things; actually a net negative all told over the lifetime of the investment. - the same as power but for water. - the same as power but for roads. Traffic and congestion are now being actively managed by computerised systems because there are so many cars on the road. - the same as power but for pollution. Another negative externality of driving up population for GDP reasons. Every person imported is more pollution generated in and by the local country. It's important we have young people entering the workforce. But adding more people from external sources is not sustainable. When they all get old do we import more people? Or should we just be repurposing the millions of young people who are doing less important but less icky jobs to do the jobs that we're currently getting immigrants to do. "Who will pick the cotton?" is not a good question.
- refurb 3mo agoThe Democratic Party spans from slightly right to ragging left that even European leftists look at with confusion.
- Symbiote 3mo agoWhat's the name of the far left grouping?
- opo 3mo agoThis is a common claim, but it is a misleading simplification of US politics and European politics. (In simple terms, many of the economic positions taken by the Democratic Party would be considered centrist in Europe, but if you include positions that have been taken on immigration, identity politics, criminal justice, reproductive rights, etc. it would not.)
- cucumber3732842 3mo ago>But no one wants to fix it. US doctors are overpaid. US nurses are over paid. Dug companies. Admin. Lawyers. Everyone who makes the system work, and everyone who makes the system a mess are paid a fortune for it. 17% of GDP is healthcare. So between 1:10 and 2:10 people in this country are making more than they otherwise would (note I did not say wealthier) because the system is screwed up and hoovers up more of everyone else's wealth than it ought to. Slavery was 12% and (while obviously geographic concentration of industry plays a lot into it) it took a war for them to take a haircut.
- uoaei 3mo agoEarnings represented by GDP are not distributed evenly across a given population. That 17% of extra earnings goes to relatively few people in the States (I'm putting this very mildly, the concentration in reality is insanely lopsided).
- deleted 3mo ago[deleted]
- cucumber3732842 3mo agoThe US healthcare industry is ~10% of the workforce. More if you include people affected by the supply distortions thereof (all those techbros working for agentic penis pump startups). The fact that that pie is not sliced evenly does not change the fact that is an integer multiple larger than it ought to be.
- pjc50 3mo agoPossibly reasonable point about labour supply ruined by an absurd analogy with slavery.
- nekusar 3mo agoNot at all. Systemic inertia is unimaginably strong. I easily see that changing the USA to be more socialist, especially in areas where game theory indicates its the best solution, will likely take a civil war. That also aligns with Marx's writings, that the capitalists will not acquiesce without a fight, and a big fight at that. The slavery and Civil War connection is a comparison of similar economic magnitudes.
- nkrisc 3mo agoMost doctors and nurses are not overpaid. Certain specialities probably are overpaid (orthopedics), but others like pediatricians or general practitioners usually aren’t. And nurses!? From the nurses I know they are underpaid for what they deal with. The ones making loads of many are willing to travel around the country and uproot their life once or more every year. Not exactly a lifestyle without its drawbacks.
- wisty 3mo agoEveryone is gonna say nurses are underpaid. It's a caring, female dominated profession, it's a motherlove sentiment. And they are not paid as well as doctors. Yeah, most pink / blue collar workers in the US are badly underpaid, but IIRC ones in the health sector are some of the best off, relative to medium salaries. Compare teachers and nurses. In most countries they make about the same AFAIK (and I'd say nurses do deserve more, telling a parent Billy did badly on a math test has got to be easier than explaining a bad medical test). But in the US it's about 75k vs 95k. There's a huge premium for working in health in the USA, EVEN in the underpaid blue collar end. Doctors make out even better in the US, and the c suite in health can have salaries that are just insane.
- nkrisc 3mo agoI don’t dispute this, but I also don’t think it matters. An underpaid profession being paid more then a severely underpaid profession doesn’t make the former overpaid.
- refurb 3mo agoCanadians don’t get the same care as Americans. McKinsey did a nice analysis of what is driving US healthcare costs. It compares category spending to OECD then compared price and volume. Turns out the US pays a bit more for drugs (relative to total spend), a little more for inpatient care and a TON more for outpatient care but half of the increase is volume, not price. As someone who works in healthcare globally, the difference in US care is stark. Americans get much early and more access to new technology than other countries. If your lymphoma has returned and you have a 20% of living more than a few years the best care is CAR-T with cure rates close to 60%. Check out CAR-T rates in the US versus Europe, it’s almost 3x. The US started using it in 2014 and Singapore just started paying for last year (11 years later). Even in Europe adopt only ramped up in the last 5 years. So yes prices are higher, but a big part is more aggressive care with more expensive treatment.
- dghlsakjg 3mo agoA good tell that someone is utterly full of shit on Canadian healthcare is that they generalize all of Canada. “Canadian health care” is not a thing. Each province administers its own completely independent system. Someone on PEI is in a healthcare system that has as much to do with Alberta’s healthcare system as it does their neighbours in Maine. As a result, anyone referencing Canadian healthcare is talking about a dozen or so unrelated systems that do things very differently. The closest it comes is that there are interprovincial billing systems so you don’t have to do the paperwork to get covered for an urgent visit out of province, and not all provinces are signed on. You can safely dismiss anyone that has reduced that complexity, or is completely ignorant of it. It’s a great way to tell when a foreigner is spouting talking points they picked up from an unreliable source and did not do even a minimal fact check on. “Canadian health care” as it is talked about in the US media is frequently fiction for propaganda purposes. Canadians almost always talk about problems within a province. What's happening in the Maritimes has nothing to do with BC. The feds set a minimum standard for a province to qualify for federal funding, and that's about the limit of their influence. No idea if the rest of his statement is poorly sourced propaganda as the first sentence.
- refurb 3mo ago
- Sohcahtoa82 3mo ago> US doctors are overpaid. US nurses are over paid. Median pay for a Nurse Practitioner is $132K/yr [0]. I think that's reasonable. Average pay for physicians ranges from $220-450K depending on specialty. [1] Personally, I think doctors should be paid more than software engineers, so I think those numbers are all reasonable, especially when you consider what it takes just to enter the field. Nurses require a Master's degree. Physicians need a Bachelor's degree PLUS another 4 years of med school AND THEN a residency program that lasts 3-9 years depending on specialty before they finally earn their medical license. IMO, the idea that nurses and doctors are overpaid is quite simply ludicrous. [0] https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-... [1] https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm#tab-5 https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.h...
- sgerenser 3mo agoYou might find those salaries reasonable, but they’re probably double what those same occupations pay in many other (first world) countries with lower healthcare costs. Maybe the trade off is worth it, but it’s not something that can be ignored when people complain about how much more expensive healthcare is in the U.S. compared to Europe (for example).
- Sohcahtoa82 3mo ago> but they’re probably double what those same occupations pay in many other (first world) countries with lower healthcare costs You'll find that salaries across the board are lower in other countries. Software developers in Europe make half of what they do in the USA. In exchange, they get far better benefits. Also, physician salary only makes up about 8% of total healthcare costs [0]. Cutting salaries in half wouldn't significantly lower our healthcare costs. [0] https://www.medicaleconomics.com/view/physician-pay-makes-up-about-8-of-total-healthcare-costs https://www.medicaleconomics.com/view/physician-pay-makes-up...
- sgerenser 3mo ago
- x______________ 3mo ago> Only the US society seems to be unable to find a solution. Unwilling. It's absolutely feasible to find a solution, as seen everywhere else in the world.
- 3D30497420 3mo agoEven some parts of the US have found solutions. From the article: > In Tulsa and Oklahoma City, meanwhile, the government buys staffed unit-hours from an ambulance operator, while households can prepay a few dollars a month on their utility bill and owe nothing if the ambulance ever comes.
- pornel 3mo agobilled for buying unit-hours from an operator... that's very carefully worded to make it sound like a corporation<>customer relationship and not socialism.
- toomuchtodo 3mo agoLots of policy in the US is hacking around the lizard brain idea of "We cannot have nice things because someone who doesn't deserve it might get it." My favorite example is universal school breakfast and lunch. Without fail, someone will argue that some kids don't deserve it. It doesn't matter that all of the data shows it is more economically efficient and the benefits to kids is overwhelming.
- sleight42 3mo agoYou essentially described the Republican and Libertarian perspectives in the US. The Republicans seem to see it as immoral to potentially give a few people support they don't need even if that means that most of the people who need the support actually get it. And, instead, they believe that having an inconsistent array of private interests will somehow be more able to service an enormous population than having an organization (like government...) that is large enough to match that population's needs. The Libertarians seem to either genuinely not care about the rest of the world or, more often than not, seem to be naive about how life can be for the less privileged. It's the lie of the "rugged individualist" in America. Most "successful" people come from successful families. Social mobility, in the US, is part of that lie. Here, we celebrate the person who rises from poverty to become wealthy as a member of a sports team, or as an actor, or similar, while disregarding that these massive successes are outliers. I'm so often disappointed in my own country.
- LtWorf 3mo agoYou see, it's better to die than to help the coloured neighbour who lives across the highway. I don't believe in this but that's USA society.
- philipallstar 3mo ago[flagged]
- gessha 3mo agoSurrounded by the barbarian warmonger nations of Canada and Mexico, the US has to increase its military budget to close to a trillion to pay for wars it definitely hasn’t been single-handedly starting since the 1970s while the USAID budget which is 5% of the military’s which tries to eradicate tuberculosis and malaria needs to go. Makes total sense.
- philipallstar 3mo agoYou're arguing against a point I didn't make.
- hilariously 3mo agoIn FY 2024, 0.3% of federal spending was by the US Agency for International Development ($21.7B) https://usafacts.org/explainers/what-does-the-us-government-do/agency/us-agency-for-international-development/ https://usafacts.org/explainers/what-does-the-us-government-... The war in Iran in MAY was reported at 29 billion dollars. It's probably been a bit more since then. Justifying stupid actions because you hate brown people isn't good for any of us.
- philipallstar 3mo ago> Justifying stupid actions because you hate brown people isn't good for any of us. What a strange non sequitur.
- refurb 3mo agoCanada doesn’t pay for ambulances unless it’s truly an emergency. Think you’re having a heart attack but you’re not? Time to pony up hundreds of dollars