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The US spends about half ($1 Trillion) of our federal taxes directly on Healthcare programs, between Medicaid and Medicare. We can afford to do that because of

by hodwik 11y ago

The US spends about half ($1 Trillion) of our federal taxes directly on Healthcare programs, between Medicaid and Medicare. We can afford to do that because of broad private-industry spending in R&D, Universities, Telecom, and other forms of central infrastructure. The value that those programs provide to our population are measurable and direct. China, on the other hand, still having widespread government ownership of the economy, spends a significant portion of it's taxes on managing (mismanaging) their infrastructure and intellectual resources. That unfortunately only leaves about 6% of their $2.2 Trillion budget for healthcare, all the while, not having a private healthcare industry to fill the gaps. If you've been paying attention to China at all in the last few years, you would be well aware of their many literal bridges to nowhere, empty cities, and "san gong" spending. Zhu Lijia, a professor of clear governance at the Chinese Academy of Governance 国家行政学院, puts "san gong" spending (or spending on luxury yachts, private planes, lavish dinners, etc.) at 1 trillion yuan, or 30% of total government expenditure.

fweespeech 11y ago
> The US spends about half ($1 Trillion) of our federal taxes directly on Healthcare programs, between Medicaid and Medicare. http://kff.org/medicare/fact-sheet/medicare-spending-and-financing-fact-sheet/ http://kff.org/medicare/fact-sheet/medicare-spending-and-fin... 23% of the Budget http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Docid=200 http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Doc... Receipts for 2014 was ~$3 Trillion. http://www.cbpp.org/research/policy-basics-where-do-our-federal-tax-dollars-go http://www.cbpp.org/research/policy-basics-where-do-our-fede... > Medicare, Medicaid, CHIP, and marketplace subsidies: Four health insurance programs -- Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and Affordable Care Act marketplace subsidies -- together accounted for 24 percent of the budget in 2014, or $836 billion. 1) So how exactly did you conclude "half"? 2) Where exactly did you get $1 trillion from? Even with four programs which are often confused into just "Medicare and Medicaid" we don't hit that number. 3) How can you expect me to take you seriously at this point? ----- > We can afford to do that because of broad private-industry spending in R&D, Universities, Telecom, and other forms of central infrastructure. The value that those programs provide to our population are measurable and direct. http://chinaglobalinsight.com/wp-content/uploads/2015/05/China-RD-Spending.pdf http://chinaglobalinsight.com/wp-content/uploads/2015/05/Chi... > China’s investment in research and development (R&D) is second only to the United States. Here, we analyse the data to give a snapshot of how and where the money is spent. By Xiaole Ni. http://www.forbes.com/sites/gordonchang/2015/05/24/did-china-just-launch-worlds-biggest-spending-plan/ http://www.forbes.com/sites/gordonchang/2015/05/24/did-china... > Wednesday, the Chinese central government announced both the allocation of 1.13 trillion yuan ($185.8 billion) for upgrading internet infrastructure and the creation of a 124.3 billion yuan fund for affordable housing. These expenditures follow Monday’s authorization of six new rail lines costing 250 billion yuan. ----- > China, on the other hand, still having widespread government ownership of the economy, spends a significant portion of it's taxes on managing (mismanaging) their infrastructure and intellectual resources. That unfortunately only leaves about 6% of their $2.2 Trillion budget for healthcare, all the while, not having a private healthcare industry to fill the gaps. If you've been paying attention to China at all in the last few years, you would be well aware of their many literal bridges to nowhere, empty cities, and "san gong" spending. Look, the gap isn't "mismanagement" its simply the fact they are per-person poorer than other nations and the US simply has to spend ridiculous amounts to get "average" results. You can't, mathematically, spend 17% of your GDP on healthcare without US level incomes and still pay for everything else. http://www.bloomberg.com/news/articles/2012-08-29/china-health-care-spending-may-hit-1-trillion-by-2020 http://www.bloomberg.com/news/articles/2012-08-29/china-heal... > Aug. 30 (Bloomberg) -- Health-care spending in China will almost triple to $1 trillion annually by 2020 driven by an aging population and government efforts to broaden insurance coverage, according to a McKinsey & Co. report. > China will spend more on drugs, medical devices and hospital treatments as it lifts spending to 7 percent of gross domestic product, from 5.5 percent, or $350 billion, in 2010, McKinsey said yesterday. This will make it the biggest market globally by 2020 after the U.S., which in 2009 spent $2.5 trillion, or 17.6 percent of its GDP, on health care, said the consulting company. Seems to me, they are catching up as fast as a low-per-capita income country cound for healthcare spending. The sheer waste in the US healthcare system is truly phenomenal compared to its quality. I have an uncle who is a doctor who is literally planning to retire to another country because he believes he can get better quality care for a third of the price as well as a lower cost of living. Quoting the US's outrageous spending as a percentage of GDP as "good" is nuts. http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wbapi_data_value_2013+wbapi_data_value+wbapi_data_value-last&sort=desc http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wba... The UK spends ~9.1% which is all China needs to reach as it becomes possible for them to get a quality, first world healthcare system. They don't need to spend 17.1% of GDP like the US does. Its obscene how badly mismanaged the US's system is. Hell, Israel is at 7.4%. http://www.washingtonpost.com/news/to-your-health/wp/2014/06/16/once-again-u-s-has-most-expensive-least-effective-health-care-system-in-survey/ http://www.washingtonpost.com/news/to-your-health/wp/2014/06... > The United Kingdom, which spends just $3,405 per person on health care, placed first overall in the comparison of 11 nations that include Australia, New Zealand, Switzerland, Canada, France, Germany and others. (Previous surveys examined smaller numbers of nations.) In 2004, the U.K. ranked third of the five nations studied.
- hodwik 11y ago
  It's clear that you've completely missed my substantive position, in fact, in a number of places you're supporting it. My "about half" number was intended to include Social Security, I misspoke. The point isn't about healthcare spending. It's about programs of "measurable and direct" outcome to the benefit of the population. (This distinction is common, as is evidenced by the Forbes Tax Misery Index -- http://www.forbes.com/global/2009/0413/034-tax-misery-reform-index.html http://www.forbes.com/global/2009/0413/034-tax-misery-reform...). Your R&D link doesn't at all respond to my point about R&D as a fraction of taxes, as it doesn't separate government-owned industry from truly private industry. Keep in mind that 74% of major companies in China are state-owned. Your quote -- "Wednesday, the Chinese central government announced both the allocation of 1.13 trillion yuan ($185.8 billion) for upgrading internet infrastructure and the creation of a 124.3 billion yuan fund for affordable housing. These expenditures follow Monday’s authorization of six new rail lines costing 250 billion yuan." -- directly supports my position that the government of China is forced to allocate tax capital to infrastructure expenses because they do not have adequate private infrastructural management. If China is planning to increase their Healthcare expenditure 10-fold, that will come at the expense of higher taxes, as again, they are not prepared for the private management of infrastructure. While the point about US healthcare "mismanagement" is largely irrelevant in a break-down of tax expenditure, it's worth responding to, as that is a commonly held misunderstanding about the American healthcare industry: That belief is largely derived from the fact that healthcare R&D, and the costs associated with it, are not factored into the international cost equation. Yes, American Healthcare is expensive, but it's also driving global healthcare outcomes forward. Those countries with low costs are benefiting directly from our healthcare expenditures, without paying their fair share, because they don't respect our patents, and push their costs off onto American tax payers by threatening to just steal our medicine if we don't give it to them at a price they agree with. To put a fine point on that, the US had 32,139 Biotechnological patents, and 43,317 Pharmaceutical patents from the period of 2001-2009. The UK produced 3,062 & 5,693 in that same period, that makes them fourth in the world, and they still produce roughly a tenth what we're producing in terms of medical R&D. Yes, their healthcare system can operate very cheaply, but it does so at the cost of innovation, and on the backs of the American medical system. Given that we are producing the vast majority of the world medical research, the impetus for increased costs in our healthcare system should be obvious -- we're producing most of the medicine. If we nationalize our medical system, yes, we could get prices down too, but we'd also be destroying the world's medicine R&D system in one fell swoop. (http://www.wipo.int/export/sites/www/ipstats/images/wipo_pub_931/f_2.gif http://www.wipo.int/export/sites/www/ipstats/images/wipo_pub...)

by hodwik 11y ago

fweespeech 11y ago

> The US spends about half ($1 Trillion) of our federal taxes directly on Healthcare programs, between Medicaid and Medicare. http://kff.org/medicare/fact-sheet/medicare-spending-and-financing-fact-sheet/ http://kff.org/medicare/fact-sheet/medicare-spending-and-fin... 23% of the Budget http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Docid=200 http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Doc... Receipts for 2014 was ~$3 Trillion. http://www.cbpp.org/research/policy-basics-where-do-our-federal-tax-dollars-go http://www.cbpp.org/research/policy-basics-where-do-our-fede... > Medicare, Medicaid, CHIP, and marketplace subsidies: Four health insurance programs -- Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and Affordable Care Act marketplace subsidies -- together accounted for 24 percent of the budget in 2014, or $836 billion. 1) So how exactly did you conclude "half"? 2) Where exactly did you get $1 trillion from? Even with four programs which are often confused into just "Medicare and Medicaid" we don't hit that number. 3) How can you expect me to take you seriously at this point? ----- > We can afford to do that because of broad private-industry spending in R&D, Universities, Telecom, and other forms of central infrastructure. The value that those programs provide to our population are measurable and direct. http://chinaglobalinsight.com/wp-content/uploads/2015/05/China-RD-Spending.pdf http://chinaglobalinsight.com/wp-content/uploads/2015/05/Chi... > China’s investment in research and development (R&D) is second only to the United States. Here, we analyse the data to give a snapshot of how and where the money is spent. By Xiaole Ni. http://www.forbes.com/sites/gordonchang/2015/05/24/did-china-just-launch-worlds-biggest-spending-plan/ http://www.forbes.com/sites/gordonchang/2015/05/24/did-china... > Wednesday, the Chinese central government announced both the allocation of 1.13 trillion yuan ($185.8 billion) for upgrading internet infrastructure and the creation of a 124.3 billion yuan fund for affordable housing. These expenditures follow Monday’s authorization of six new rail lines costing 250 billion yuan. ----- > China, on the other hand, still having widespread government ownership of the economy, spends a significant portion of it's taxes on managing (mismanaging) their infrastructure and intellectual resources. That unfortunately only leaves about 6% of their $2.2 Trillion budget for healthcare, all the while, not having a private healthcare industry to fill the gaps. If you've been paying attention to China at all in the last few years, you would be well aware of their many literal bridges to nowhere, empty cities, and "san gong" spending. Look, the gap isn't "mismanagement" its simply the fact they are per-person poorer than other nations and the US simply has to spend ridiculous amounts to get "average" results. You can't, mathematically, spend 17% of your GDP on healthcare without US level incomes and still pay for everything else. http://www.bloomberg.com/news/articles/2012-08-29/china-health-care-spending-may-hit-1-trillion-by-2020 http://www.bloomberg.com/news/articles/2012-08-29/china-heal... > Aug. 30 (Bloomberg) -- Health-care spending in China will almost triple to $1 trillion annually by 2020 driven by an aging population and government efforts to broaden insurance coverage, according to a McKinsey & Co. report. > China will spend more on drugs, medical devices and hospital treatments as it lifts spending to 7 percent of gross domestic product, from 5.5 percent, or $350 billion, in 2010, McKinsey said yesterday. This will make it the biggest market globally by 2020 after the U.S., which in 2009 spent $2.5 trillion, or 17.6 percent of its GDP, on health care, said the consulting company. Seems to me, they are catching up as fast as a low-per-capita income country cound for healthcare spending. The sheer waste in the US healthcare system is truly phenomenal compared to its quality. I have an uncle who is a doctor who is literally planning to retire to another country because he believes he can get better quality care for a third of the price as well as a lower cost of living. Quoting the US's outrageous spending as a percentage of GDP as "good" is nuts. http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wbapi_data_value_2013+wbapi_data_value+wbapi_data_value-last&sort=desc http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?order=wba... The UK spends ~9.1% which is all China needs to reach as it becomes possible for them to get a quality, first world healthcare system. They don't need to spend 17.1% of GDP like the US does. Its obscene how badly mismanaged the US's system is. Hell, Israel is at 7.4%. http://www.washingtonpost.com/news/to-your-health/wp/2014/06/16/once-again-u-s-has-most-expensive-least-effective-health-care-system-in-survey/ http://www.washingtonpost.com/news/to-your-health/wp/2014/06... > The United Kingdom, which spends just $3,405 per person on health care, placed first overall in the comparison of 11 nations that include Australia, New Zealand, Switzerland, Canada, France, Germany and others. (Previous surveys examined smaller numbers of nations.) In 2004, the U.K. ranked third of the five nations studied.

hodwik 11y ago
It's clear that you've completely missed my substantive position, in fact, in a number of places you're supporting it. My "about half" number was intended to include Social Security, I misspoke. The point isn't about healthcare spending. It's about programs of "measurable and direct" outcome to the benefit of the population. (This distinction is common, as is evidenced by the Forbes Tax Misery Index -- http://www.forbes.com/global/2009/0413/034-tax-misery-reform-index.html http://www.forbes.com/global/2009/0413/034-tax-misery-reform...). Your R&D link doesn't at all respond to my point about R&D as a fraction of taxes, as it doesn't separate government-owned industry from truly private industry. Keep in mind that 74% of major companies in China are state-owned. Your quote -- "Wednesday, the Chinese central government announced both the allocation of 1.13 trillion yuan ($185.8 billion) for upgrading internet infrastructure and the creation of a 124.3 billion yuan fund for affordable housing. These expenditures follow Monday’s authorization of six new rail lines costing 250 billion yuan." -- directly supports my position that the government of China is forced to allocate tax capital to infrastructure expenses because they do not have adequate private infrastructural management. If China is planning to increase their Healthcare expenditure 10-fold, that will come at the expense of higher taxes, as again, they are not prepared for the private management of infrastructure. While the point about US healthcare "mismanagement" is largely irrelevant in a break-down of tax expenditure, it's worth responding to, as that is a commonly held misunderstanding about the American healthcare industry: That belief is largely derived from the fact that healthcare R&D, and the costs associated with it, are not factored into the international cost equation. Yes, American Healthcare is expensive, but it's also driving global healthcare outcomes forward. Those countries with low costs are benefiting directly from our healthcare expenditures, without paying their fair share, because they don't respect our patents, and push their costs off onto American tax payers by threatening to just steal our medicine if we don't give it to them at a price they agree with. To put a fine point on that, the US had 32,139 Biotechnological patents, and 43,317 Pharmaceutical patents from the period of 2001-2009. The UK produced 3,062 & 5,693 in that same period, that makes them fourth in the world, and they still produce roughly a tenth what we're producing in terms of medical R&D. Yes, their healthcare system can operate very cheaply, but it does so at the cost of innovation, and on the backs of the American medical system. Given that we are producing the vast majority of the world medical research, the impetus for increased costs in our healthcare system should be obvious -- we're producing most of the medicine. If we nationalize our medical system, yes, we could get prices down too, but we'd also be destroying the world's medicine R&D system in one fell swoop. (http://www.wipo.int/export/sites/www/ipstats/images/wipo_pub_931/f_2.gif http://www.wipo.int/export/sites/www/ipstats/images/wipo_pub...)