4 ms·

Government debt swells as choices get harder

11 points by gibsonf1 17y ago

forinti 17y ago
Obama should call Castro for tips on running a health care system on a shoestring. Just kidding, sort of.
jpcx01 17y ago
Not a problem. Lets just pass 1 more stimulus plan (to make it a trifecta) and then implement national health care. Because we all know the best way to lower prices is increase demand. No doubt this problem is going to catch the country completely by surprise in the next 3-5 years. Paul Krugman will be shocked, just shocked, that the government is out of money.
- DanielBMarkham 17y ago
  In the immortal words of Monty Python during the killer rabbit incident: "run away!" I blame myself as a partial culprit. Boy was I a sucker. Even though I am an independent, I have picked a party to vote for based on which one I thought would keep spending under control. I used logic, reason, historical trends, etc. Boy was I a sucker. Seems like each side is playing "who can run the biggest debt up" game. One bunch takes it to new levels, and the next bunch tries to outdo the first. Not only is the slope of the equation bad, the first derivative is bad too. I honestly don't see a political way out of this. For the first time, I wrote a letter to my senator and asked him to do what he could about spending. Don't make a scene, I said, and don't play politics with this. Just try to do the right thing. In reply I got a form letter with a political speech in there about how he's such a great guy for voting for such great bills. sigh
  - TomOfTTB 17y ago
    As a Californian I think there is a political way out. Calfiornia has gone down the road that the U.S. is headed down so you can sort of see the results. Basically what has happened here is that conservatives who believed in small government lost out to liberals who promised the government would solve everything. Those conservatives then becamse "social conservatives" and started focusing on a bunch of hedge issues while promising to spend as much as the liberals (which is basically where the U.S. is now). Now we're out of money and those "social conservatives" are now turning back into "fiscal conservatives" because the public has finally started to realize spending like there's no tomorrow doesn't work. For the record I think there's one more step here where liberals start to become more fiscally conservative and focus on ideals that don't cost anything to change like gun control. Think Clinton era liberalism. But that's just my opinion. So really the political answer to the problems the U.S. now has is to get into enough financial trouble to give political cover to those politicians who would propose spending cuts.
  - fauigerzigerk 17y ago
    I think the last president who kept spending under control was Clinton. Did you vote for him Daniel? ;-) But seriously, I wonder if this is really the right time to keep spending under control. And that's not a rhetorical question. I'm really not sure. At the start of the great depression they did keep spending under control, but that turned out to be an expensive disaster. On the other hand we seem to be sliding straight into 1970s 2.0 with stagflation, big fat government and oil shock 3.0. One helpful aspect of the current situation may be that US government debt is denominated in USD. So inflation will help to lower the debt burden without leading to default. And it's not just about government debt, which is pretty average in the US, but also about household debt, which is at catastrophic levels.
pj 17y ago
The United States spends $2.5 trillion a year on health care, more than any other rich nation, and yet has poorer outcomes. About $700 billion is wasted each year. The reason is simple: Artificial controls on supply and demand of medical professionals: http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm I can't count the number of friends I have had who applied to medical school and were denied entry due to insufficient seats. There are vastly more individuals qualified to be doctors, many I would much prefer to have as doctors than I have had in the past, but with these artificial limits on supply - governed by the AMA itself - there will always be a shortage of medical care and high medical care costs. Furthermore, the healthcare industry lobbies congress to prevent individuals for caring for their own health. We cannot for example buy our own insulin without first getting a prescription from a doctor. We cannot get our own blood tests or request our own CAT scans. We are forced, by law, to visit a doctor before we can manage our own health. As long as doctors are the gatekeepers to health and the supply of doctors is limited by doctors themselves, there will continue to be healthcare problems in the United States. Our society has pitted the doctor in a competitive role against the patient through litigious means and pharmaceutical industry pressure on doctors to overprescribe unnecessary medications. It's a horrible situation, but the solution isn't difficult to implement for anyone except the medical industry itself. They don't want to lose the power and control they have over every single life in America. Visit most countries outside the U.S., Canada, and the UK and you can walk into nearly any pharmacy and purchase the drugs you need to survive, cure disease, and prevent pregnancy for a tiny fraction of the cost Americans pay and without the time delay of a doctor's appointment or the added cost of the doctor's visit itself. And healthcare for the average citizen is higher in these countries. Infant mortality is lower and people live longer.
- Dilpil 17y ago
  I've always suspected this was part of the reason. How different are these sorts of things in countries with lower costs?
  - pj 17y ago
    In most countries in the western world, except for the United States, and recently Canada, medical care is available for free. In Spain for example, women can get birth control pills without a prescription. They visit the doctor, not because they have to, but because they know the doctor can offer them expert advice. There is still the option to pay for a private doctor if you want to. There are sometimes longer wait times for public doctors vs. private doctors, on the order of weeks, but if you've ever made an appointment for a specialist anywhere in the United States, you know that wait times can be months! Not only that, but HMO's require two doctors visits to see a specialist -- the first to get a referal, the second to actually see the doctor. Even if the patient knows the patient needs to see a specialist. Most GP's simply do not have the experience to treat complicated diseases -- this is not a problem in itself, there should always be specialists, as there are DBA's, UI designers, and language specialists in computer programming. When I was traveling in Europe, my backpack was stolen, along with my presecription medications -- this happens frequently actually. I was distraught that I would have to return home to get more medicine, however, I walked into a pharmacy and without even speaking the same language, managed to get the right pills and dose for $5, compared to the $40 it costs without insurance in the U.S. and $15 with insurance. Needless to say, before returning home, I stocked up! My Spanish friends were appalled that in the United States I had to pay for these drugs at all. "The government should pay for them!" They said. Another story: An American friend of mine who was studying in Spain relayed a story to me of a time she fell and hit her head and had to get stitches. She went to the hospital. She didn't have insurance. She wasn't Spanish. She was afraid the bill would be astronomical. After she was stitched up, she asked the staff where she had to go to pay and how much it was going to cost and they LAUGHED! They laughed at her for thinking she had to pay for such care. In other countries, medical care is thought to be a basic human right. In the USA, we have the right to life, liberty, and the pursuit of happiness. In most western countries, citizens have the right to life, liberty, the pursuit of happiness, and health. I believe our country will be much better off if we simply remove from our minds the constant worry of health related issues. If we know we can be cared for, if we don't have to worry about insurance and doctors appointments and the costs required to just stay alive, our creativity can flourish. Another story, one of my friends, whose father was a doctor in new orleans spoke of a patient with diabetes who was having problems with her feet. Diabetics can lose their feet if they aren't careful. Medicare only allowed her 11 doctor visits a year. She needed another visit though because her feet were getting bad. The doctor had to deny her visit because medicare wouldn't cover it. Due to inadequate treatment, treatment that could have fixed the problem with her feet -- her feet had to be amputated -- because medicare wouldn't pay for the visit. As you can imagine, her medical care costs were then much higher than had she simply had the preventative care she needed. This friend of mine was one denied entry into medical school and she was absolutely brilliant and had been shot in the leg, so she really understood the value of doctors. I think the health care situation in the United States is much worse than Americans know. Those who make the policies have plenty of medical care. The politicians and the doctors get all the medical care they need. Politicians don't travel around the world and see the conditions of average citizens in elsewhere, so they don't know the full impact of the policies they create. It's a horrible state of affairs in the United States. It's abominable really. It is perhaps the worst part of life in the United States relative to the rest of the world and the desire for power and financial gain is at the root of it.
hooande 17y ago
It's probably worth noting that the US also currently has the highest GDP of any country in history. While our debt is catastrophically high, we also produce more per person than any nation our size.
- halo 17y ago
  It's difficult to judge. The US has the highest GDP, but it's also the largest western country in terms of population, which makes direct comparison difficult. It does not have the highest GDP per capita (see http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nominal%29_per_capita http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nom... and http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP%29_per_capita http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP...).
  - lliiffee 17y ago
    The only country above the US that isn't an oil exporter is Luxembourg, which has a population about %0.1 of the US-- its basically a single, medium/small city. I bet if Beverly Hills became its own country, the per capita GDP would also be impressive!
martythemaniak 17y ago
The solution is marvellously simple: "But the larger problem, as in California, is that the public also recoils from spending cuts and tax increases" The American public needs to stop acting like a bunch of petulant, whiny children and start paying up.

11 points by gibsonf1 17y ago

Obama should call Castro for tips on running a health care system on a shoestring. Just kidding, sort of.

Not a problem. Lets just pass 1 more stimulus plan (to make it a trifecta) and then implement national health care. Because we all know the best way to lower prices is increase demand. No doubt this problem is going to catch the country completely by surprise in the next 3-5 years. Paul Krugman will be shocked, just shocked, that the government is out of money.

DanielBMarkham 17y ago
In the immortal words of Monty Python during the killer rabbit incident: "run away!" I blame myself as a partial culprit. Boy was I a sucker. Even though I am an independent, I have picked a party to vote for based on which one I thought would keep spending under control. I used logic, reason, historical trends, etc. Boy was I a sucker. Seems like each side is playing "who can run the biggest debt up" game. One bunch takes it to new levels, and the next bunch tries to outdo the first. Not only is the slope of the equation bad, the first derivative is bad too. I honestly don't see a political way out of this. For the first time, I wrote a letter to my senator and asked him to do what he could about spending. Don't make a scene, I said, and don't play politics with this. Just try to do the right thing. In reply I got a form letter with a political speech in there about how he's such a great guy for voting for such great bills. sigh
- TomOfTTB 17y ago
  As a Californian I think there is a political way out. Calfiornia has gone down the road that the U.S. is headed down so you can sort of see the results. Basically what has happened here is that conservatives who believed in small government lost out to liberals who promised the government would solve everything. Those conservatives then becamse "social conservatives" and started focusing on a bunch of hedge issues while promising to spend as much as the liberals (which is basically where the U.S. is now). Now we're out of money and those "social conservatives" are now turning back into "fiscal conservatives" because the public has finally started to realize spending like there's no tomorrow doesn't work. For the record I think there's one more step here where liberals start to become more fiscally conservative and focus on ideals that don't cost anything to change like gun control. Think Clinton era liberalism. But that's just my opinion. So really the political answer to the problems the U.S. now has is to get into enough financial trouble to give political cover to those politicians who would propose spending cuts.
- fauigerzigerk 17y ago
  I think the last president who kept spending under control was Clinton. Did you vote for him Daniel? ;-) But seriously, I wonder if this is really the right time to keep spending under control. And that's not a rhetorical question. I'm really not sure. At the start of the great depression they did keep spending under control, but that turned out to be an expensive disaster. On the other hand we seem to be sliding straight into 1970s 2.0 with stagflation, big fat government and oil shock 3.0. One helpful aspect of the current situation may be that US government debt is denominated in USD. So inflation will help to lower the debt burden without leading to default. And it's not just about government debt, which is pretty average in the US, but also about household debt, which is at catastrophic levels.

pj 17y ago

The United States spends $2.5 trillion a year on health care, more than any other rich nation, and yet has poorer outcomes. About $700 billion is wasted each year. The reason is simple: Artificial controls on supply and demand of medical professionals: http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm http://www.ama-assn.org/amednews/2008/06/23/prsb0623.htm I can't count the number of friends I have had who applied to medical school and were denied entry due to insufficient seats. There are vastly more individuals qualified to be doctors, many I would much prefer to have as doctors than I have had in the past, but with these artificial limits on supply - governed by the AMA itself - there will always be a shortage of medical care and high medical care costs. Furthermore, the healthcare industry lobbies congress to prevent individuals for caring for their own health. We cannot for example buy our own insulin without first getting a prescription from a doctor. We cannot get our own blood tests or request our own CAT scans. We are forced, by law, to visit a doctor before we can manage our own health. As long as doctors are the gatekeepers to health and the supply of doctors is limited by doctors themselves, there will continue to be healthcare problems in the United States. Our society has pitted the doctor in a competitive role against the patient through litigious means and pharmaceutical industry pressure on doctors to overprescribe unnecessary medications. It's a horrible situation, but the solution isn't difficult to implement for anyone except the medical industry itself. They don't want to lose the power and control they have over every single life in America. Visit most countries outside the U.S., Canada, and the UK and you can walk into nearly any pharmacy and purchase the drugs you need to survive, cure disease, and prevent pregnancy for a tiny fraction of the cost Americans pay and without the time delay of a doctor's appointment or the added cost of the doctor's visit itself. And healthcare for the average citizen is higher in these countries. Infant mortality is lower and people live longer.

Dilpil 17y ago
I've always suspected this was part of the reason. How different are these sorts of things in countries with lower costs?
- pj 17y ago
  In most countries in the western world, except for the United States, and recently Canada, medical care is available for free. In Spain for example, women can get birth control pills without a prescription. They visit the doctor, not because they have to, but because they know the doctor can offer them expert advice. There is still the option to pay for a private doctor if you want to. There are sometimes longer wait times for public doctors vs. private doctors, on the order of weeks, but if you've ever made an appointment for a specialist anywhere in the United States, you know that wait times can be months! Not only that, but HMO's require two doctors visits to see a specialist -- the first to get a referal, the second to actually see the doctor. Even if the patient knows the patient needs to see a specialist. Most GP's simply do not have the experience to treat complicated diseases -- this is not a problem in itself, there should always be specialists, as there are DBA's, UI designers, and language specialists in computer programming. When I was traveling in Europe, my backpack was stolen, along with my presecription medications -- this happens frequently actually. I was distraught that I would have to return home to get more medicine, however, I walked into a pharmacy and without even speaking the same language, managed to get the right pills and dose for $5, compared to the $40 it costs without insurance in the U.S. and $15 with insurance. Needless to say, before returning home, I stocked up! My Spanish friends were appalled that in the United States I had to pay for these drugs at all. "The government should pay for them!" They said. Another story: An American friend of mine who was studying in Spain relayed a story to me of a time she fell and hit her head and had to get stitches. She went to the hospital. She didn't have insurance. She wasn't Spanish. She was afraid the bill would be astronomical. After she was stitched up, she asked the staff where she had to go to pay and how much it was going to cost and they LAUGHED! They laughed at her for thinking she had to pay for such care. In other countries, medical care is thought to be a basic human right. In the USA, we have the right to life, liberty, and the pursuit of happiness. In most western countries, citizens have the right to life, liberty, the pursuit of happiness, and health. I believe our country will be much better off if we simply remove from our minds the constant worry of health related issues. If we know we can be cared for, if we don't have to worry about insurance and doctors appointments and the costs required to just stay alive, our creativity can flourish. Another story, one of my friends, whose father was a doctor in new orleans spoke of a patient with diabetes who was having problems with her feet. Diabetics can lose their feet if they aren't careful. Medicare only allowed her 11 doctor visits a year. She needed another visit though because her feet were getting bad. The doctor had to deny her visit because medicare wouldn't cover it. Due to inadequate treatment, treatment that could have fixed the problem with her feet -- her feet had to be amputated -- because medicare wouldn't pay for the visit. As you can imagine, her medical care costs were then much higher than had she simply had the preventative care she needed. This friend of mine was one denied entry into medical school and she was absolutely brilliant and had been shot in the leg, so she really understood the value of doctors. I think the health care situation in the United States is much worse than Americans know. Those who make the policies have plenty of medical care. The politicians and the doctors get all the medical care they need. Politicians don't travel around the world and see the conditions of average citizens in elsewhere, so they don't know the full impact of the policies they create. It's a horrible state of affairs in the United States. It's abominable really. It is perhaps the worst part of life in the United States relative to the rest of the world and the desire for power and financial gain is at the root of it.

hooande 17y ago

It's probably worth noting that the US also currently has the highest GDP of any country in history. While our debt is catastrophically high, we also produce more per person than any nation our size.

halo 17y ago
It's difficult to judge. The US has the highest GDP, but it's also the largest western country in terms of population, which makes direct comparison difficult. It does not have the highest GDP per capita (see http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nominal%29_per_capita http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28nom... and http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP%29_per_capita http://en.wikipedia.org/wiki/List_of_countries_by_GDP_%28PPP...).
- lliiffee 17y ago
  The only country above the US that isn't an oil exporter is Luxembourg, which has a population about %0.1 of the US-- its basically a single, medium/small city. I bet if Beverly Hills became its own country, the per capita GDP would also be impressive!

martythemaniak 17y ago

The solution is marvellously simple: "But the larger problem, as in California, is that the public also recoils from spending cuts and tax increases" The American public needs to stop acting like a bunch of petulant, whiny children and start paying up.