# What problems could we solve in America, that could actually save money by solving the problem, but we still don't solve them **URL:** \ **Category:** Great Debates\ **Created:** [May 7, 2025, 4:49pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017 "2025-05-07T16:49:32Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![DemonTree](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/demontree/32/8646_2.png) [@DemonTree](https://boards.straightdope.com/u/DemonTree)\ **Post date:** [May 9, 2025, 11:37am UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/41 "2025-05-09T11:37:40Z")
> [@Horatius](#): > > And another factor is, the treatments will likely get cheaper over all, because under the current rules, a lot of people defer care until they really need it, even for minor things. When a few stitches can cost thousands, people might not go in for stitches. But when the cut gets infected, and they think they’re going to die, then they finally show up. What would have been a couple of hours, some stitches, and a bottle of antibiotics to take home suddenly becomes a major medical intervention. IIRC there was a study of this in America that found the opposite. Here it is: > **[Oregon Medicaid health experiment](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment)** > > The Oregon health insurance experiment (sometimes abbreviated OHIE) was a research study looking at the effects of the 2008 Medicaid expansion in the U.S. state of Oregon, which occurred based on lottery drawings from a waiting list and thus offered an opportunity to conduct a randomized experiment by comparing a control group of lottery losers to a treatment group of winners, who were eligible to apply for enrollment in the Medicaid expansion program after previously being uninsured. > The study'... Summary of results: > [@](#): > > In the first year after the lottery, Medicaid coverage was associated with higher rates of health care use, a lower probability of having medical debts sent to a collection agency, and higher self-reported mental and physical health.[[2]](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment#cite_note-QJE-2) In the 18 months following the lottery, researchers found that Medicaid increased emergency department visits.[[3]](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment#cite_note-Science-3) > > Approximately two years after the lottery, researchers found that Medicaid had no statistically significant impact on physical health measures, but “it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.”[[4]](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment#cite_note-roy-4)[[5]](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment#cite_note-rcp-5) And some specifics: > [@](#): > > Over an 18-month period following the lottery, Medicaid coverage increased emergency department use by 0.41 visits per person, a 40% increase. Researchers found increases across a range of different types of visits, including visits classified as preventable or primary care treatable, and across different subgroups.[[3]](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment#cite_note-Science-3) > [@](#): > > On average, Medicaid coverage increased annual medical spending by approximately $1,172 relative to spending in the control group.[[8]](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment#cite_note-NEJM-8) The researchers looked at mortality rates, but they could not reach any conclusions because of the extremely low death rate of the general population of able-bodied Oregon adults aged 19 to 64.[[5]](https://en.m.wikipedia.org/wiki/Oregon_Medicaid_health_experiment#cite_note-rcp-5) You’ve got to consider that healthcare doesn’t just magically become cheaper under a single-payer system. You have to actually find ways to cut costs. A part of that will come from reduction in bureaucracy (but now you have a large number of people out of a job), but the rest has to come from some combination of negotiating prices of prescription drugs, cutting salaries for doctors and other medical professionals, fewer beds in hospitals and fewer MRI machines etc leading to increased waiting lists, stricter controls on seeing a specialist (you have to be referred by your primary care doctor), and similar measures, all of which _someone_ is going to object to. ---
**Author:** ![Bear\_Nenno](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bear_nenno/32/3358_2.png) [@Bear\_Nenno](https://boards.straightdope.com/u/Bear_Nenno)\ **Post date:** [May 9, 2025, 11:43am UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/42 "2025-05-09T11:43:03Z")
> [@Wesley\_Clark](#): > > And the US spends about 4-5 billion a year on lobbying. > > But replacing all that money with matching funds for small donors, subsidies and tax credits for small donors would only cost ~$10-15 billion. Plus with less bribery in politics, there would be less giveaways to wealthy industries which would likely save more than $10 billion a year. But the US doesn’t spend that money. People and organizations spend that money. Their money. They’re spending that money because it benefits them. Why would they spend that money matching small donors who may or may not be donating along their own interests. You can’t just tell people how to spend their own money. Your post sounds like this coming out of the treasury. If you get rid of lobbying, then those billions go away. You can’t just divert it to something else. [quote] What about fully subsidized public college? I think it would cost ~$80 billion a year to give everyone access to free public undergraduate education, but wouldn’t society save more than that in the form of lower crime rates, lower levels of welfare usage, higher employment rates, people paying more in taxes, etc? [/quote] This would just result in more worthless degrees and the devaluation of a college education. It’s not going to solve problems like unemployment or crime. A better approach would be free trade school, not free college. Tax-payer money is better spent on creating more construction workers, mechanics, heavy equipment operators, technicians, medics, nurse aids, etc. even coding and app developing. Specific programs should be free, but not college in general. [quote] Homelessness is another issue. I think it’ll cost $20 billion a year to solve homelessness.[/quote] Building free houses will not solve homelessness. Crafter\_Man hits on one of the major hurdles, but they are endless. I think it’s a systemic problem that can only be solved indirectly by solving dozens of other problems. A problem where the solution saves money? Innocent people wrongly executed for crimes they never committed is a problem that could be solved by outlawing capital punishment. This would save approximately $10 - $100 million per state per year, depending on the state (and depending on the study). California estimates the penal system would cost $120 million less per year without a death penalty. North Carolina says they would save over $10 million per year. ---
**Author:** ![Dr.Drake](https://avatars.discourse-cdn.com/v4/letter/d/ad7895/32.png) [@Dr.Drake](https://boards.straightdope.com/u/Dr.Drake)\ **Post date:** [May 9, 2025, 2:16pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/43 "2025-05-09T14:16:19Z")
Yes, but that’s short-term thinking. In the long term, more people accessing care for prevention and early stages of disease SAVES money, because it’s when things have gone too far and are complicated that it gets expensive. Right now, people avoid the expense of “unnecessary” visits, such as preventive care. The way to compare this “experiment” would not be Oregon’s expenses before vs Oregon’s after, but over the long term. We have ample data from places like Oregon, though they’re not in the USA. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [May 9, 2025, 4:53pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/44 "2025-05-09T16:53:34Z")
> [@HMS\_Irruncible](#): > > My favorite one is probably income tax filing. Every year the government asks me to do a little math test. They already know the answers. If I get it wrong, they send me a nasty letter and possibly some penalties. Why? It should be like everything else, they send me a bill, and I either pay it or dispute it. > [@HMS\_Irruncible](#): > > I’ve been clear enough in my post to explain that this approach won’t cover all known income, so if you hadn’t noticed that, please notice it now. Not clear to me. But in any case if all you have is 1040 income then what’s the expense? Just prepare the form yourself. I do all my own taxes. Sure if you have a side job or a rental or a Sch C, you may prefer to pay a preparer- but the same would be in your system. ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [May 9, 2025, 5:20pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/45 "2025-05-09T17:20:45Z")
All I have is W2 and 1099 income - the government already knows the answers. Even for my gambling winnings ( if I have them) My choices are I can spend however long it takes to fill out paper forms or I can use software. If I choose the software, I might be able to find a way to file Federal taxes for free but I will have to pay for the state return. It’s not very much but if the government used the info they have and calculated my taxes I wouldn’t have had the problem I had a few years ago. My husband was expecting a single 1099 which we received. We filed our taxes and thought we were done. A year or two later, we get correspondence from the IRS. Apparently, the company sent two 1099s, but we only received one and though nothing of it since we only expected one. So now there were the taxes and interest and I think a penalty. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [May 9, 2025, 5:27pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/46 "2025-05-09T17:27:32Z")
> [@doreen](#): > > the government already knows the answers. Even for my gambling winnings ( if I have them) The government only knows about gambling winnings reported to them on a W2G. Not all winning are so reported- smaller winning os those in an illegal game, for example. ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [May 9, 2025, 5:54pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/47 "2025-05-09T17:54:56Z")
I’m not under the impression that anyone reports those anyway - do you know people who report winning even a large amount in an illegal Super Bowl box or winning $2 on a scratch off lottery ticket? If they do currently report it, they could make that correction when they get a bill from the government but I’m sure the number of people who ever report that sort of win are pretty close to zero. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [May 9, 2025, 6:03pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/48 "2025-05-09T18:03:42Z")
> [@Drum\_God](#): > > I think the real issue here is that powerful people don’t actually want to solve the problems you have listed. The issues with each “problem” are actually considered “features” by many people. Indeed, this is exactly it. And the plutocracy that is profiting handsomely off these problems have managed to bamboozle a majority of the public to support maintaining the _status quo_. For example a very large number of Americans – I suspect a majority – are terrified of any kind of health care reform, especially any move to universal health care. They’re convinced that their own health care will suffer, even if their own health insurance is overpriced crap. ---
**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\ **Post date:** [May 9, 2025, 7:43pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/49 "2025-05-09T19:43:20Z")
> [@DrDeth](#): > > Not clear to me. But in any case if all you have is 1040 income then what’s the expense? Just prepare the form yourself. I do all my own taxes. You can spend your time doing taxes if you like. I don’t get paid to do data entry for the government. It shouldn’t be my job to enter data that the government already has, and have them check my work for correctness. It should be exactly the opposite, like most other modern countries do. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [May 9, 2025, 7:54pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/50 "2025-05-09T19:54:51Z")
> [@HMS\_Irruncible](#): > > You can spend your time doing taxes if you like. I don’t get paid to do data entry for the government. It shouldn’t be my job to enter data that the government already has, and have them check my work for correctness. It should be exactly the opposite, like most other modern countries do. That’s an interesting observation. I’m in Canada, not the US, and such a scheme has been discussed here but AFAIK not yet implemented. It should only apply to taxpayers for whom all relevant income information has already been sent to the government. I appreciate the irony when I misplace certain income receipts so I have to call the government help line and they send me copies of the receipts **they already have** so I can enter the info on my tax return and send it right back to them! The problem is that the government doing your tax returns for you only works in a limited set of situations involving all sources of income being reported and no special deductions. It totally cannot work, for example, if you’re self-employed, because the government knows nothing about either your income or your deductible expenses. ---
**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\ **Post date:** [May 9, 2025, 9:13pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/51 "2025-05-09T21:13:27Z")
> [@wolfpup](#): > > The problem is that the government doing your tax returns for you only works in a limited set of situations involving all sources of income being reported and no special deductions. It totally cannot work, for example, if you’re self-employed, because the government knows nothing about either your income or your deductible expenses. Yeah, people keep saying that it won’t work in every situation, and I keep replying that it doesn’t have to work in every situation. Dunno what I expected. Send people a tax bill for their known income with a highly visible warning saying “if this bill doesn’t reflect all your income, you need to file the old way.” Easy peasy. I pay the government to do things for me, not for the privilege of doing things for them. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [May 9, 2025, 9:32pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/52 "2025-05-09T21:32:04Z")
I agree, and not really arguing with you about this. I was self-employed for quite a few years, and my taxes were such a nightmare that I used a high-powered accountant to do them. Now that I’m retired, all the information about the income that I get is directly available to the government, and there’s no reason they can’t just automatically file a return pending my approval or the addition of any addition/modification, which almost always there would never be. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [May 9, 2025, 10:40pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/53 "2025-05-09T22:40:25Z")
> [@doreen](#): > > I’m not under the impression that anyone reports those anyway - do you know people who report winning even a large amount in an illegal Super Bowl box or winning $2 on a scratch off lottery ticket? They are supposed to, but by no means all do. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [May 10, 2025, 2:13am UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/54 "2025-05-10T02:13:38Z")
> [@Bear\_Nenno](#): > > This would just result in more worthless degrees and the devaluation of a college education. Agree. Already, degree inflation has set in so much these days that a college degree today is often what a high school diploma was 50 years ago. IMHO, making college much cheaper would be a good idea, but making it _totally_ free tends to encourage a trash-it, not-valuable attitude. The other problem, though, is that if college becomes that much cheaper, competition for limited slots is going to intensify. You’d have a situation where poor people can now afford college but might still be unable to get in due to insufficient SAT scores or whatnot. Which is better than _neither_ being able to afford _nor_ being able to get in, but still means many might not get in. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [May 10, 2025, 6:26am UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/55 "2025-05-10T06:26:08Z")
> [@Velocity](#): > > IMHO, making college much cheaper would be a good idea, but making it _totally_ free tends to encourage a trash-it, not-valuable attitude. I think all the graduates of City College in New York especially in the '30s and '40s would disagree with you. Like my mother. Now if colleges were free I’m all for trade schools, properly regulated, being free also. College is very cheap in lots of European countries without its value being lost. When my daughter was in Germany on her Fulbright she got bored and went to get a Masters. It cost under $1,000. For taxes, the only complicated part of filling out taxes is complicated income and deductions. There is already free tax software for simple cases. How long can a return with only W2 and interest income take? Lots of the complexity comes from the complex tax code, but that’s another discussion. > [@DemonTree](#): > > You’ve got to consider that healthcare doesn’t just magically become cheaper under a single-payer system. You have to actually find ways to cut costs. Agree, and that’s where the savings will come. The medical system today has little incentive to cut costs. The MRI example is a good one. I’ve had a few, and the MRI clinic was not at all crowded. (To put it mildly.) Everything is siloed. I got to a good and very big clinic all over the Bay Area. I had to travel a half hour for one MRI test, not bad, but I bet there were similar machines in other clinics that were closer. Remember the article that showed that the prices for various treatments varied wildly within a single city? We can do better. I also believe a big reason for the closing of rural clinics is from them being starved of Medicaid funds by the states that refused to get money from the Feds. ---
**Author:** ![Saffer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saffer/32/6440_2.png) [@Saffer](https://boards.straightdope.com/u/Saffer)\ **Post date:** [May 10, 2025, 6:40am UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/56 "2025-05-10T06:40:26Z")
> [@PastTense](#): > > While I think a case can be made for legalizing marijuana the costs of the two major legalized drugs is extremely high–much higher than the costs of the drug war. Tobacco is associated with 490,000 or so deaths a year and alcohol with 180,000 or so. Alcohol is also associated with a lot of violence. Why add more substances with these kinds of massive costs? I’ve not got to the end of the thread yet, but you may be underestimating the costs associated with criminalisation. Making these things illegal means big profits for criminals. This is costly in many ways, not just law enforcement. ---
**Author:** ![Saffer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saffer/32/6440_2.png) [@Saffer](https://boards.straightdope.com/u/Saffer)\ **Post date:** [May 10, 2025, 6:44am UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/57 "2025-05-10T06:44:00Z")
> [@JohnGalt](#): > > Get rid of the one-cent and five-cent coins, since they both cost more to mint than their face value. They may nominally be worth less than the cost of production, but each coin enables transactions cumulatively worth far more than that over their lifetime. ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [May 10, 2025, 11:21am UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/58 "2025-05-10T11:21:45Z")
Only a small fraction of the cost of using small coins is the cost of production; instead much of the cost is of the labor using them both by customers and business. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [May 10, 2025, 8:38pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/59 "2025-05-10T20:38:50Z")
> [@Velocity](#): > > IMHO, making college much cheaper would be a good idea, but making it _totally_ free tends to encourage a trash-it, not-valuable attitude. Yes, I agree to a point- this is why I want all two year colleges to be free- but not the next two years, ect. You can learn a trade in a community college- nursing and some associated medical assistants for example. For many this is a better idea than getting a Liberal Arts degree. > [@Saffer](#): > > They may nominally be worth less than the cost of production, but each coin enables transactions cumulatively worth far more than that over their lifetime. Not really, at least for pennies. I mean if you round to the nearest penny in a normal grocery bill the amount is de minimis. Let us take a grocery bill of 124.64- round that to 124.65 and we get into sig figures. Remember- each 1.29 item wont be rounded to 1.30, the rounding will occur only on the final bill. Just like buying gas when the amounts used to given in tenths of a cent. > [@PastTense](#): > > Only a small fraction of the cost of using small coins is the cost of production; instead much of the cost is of the labor using them both by customers and business. Yep. And Canada has done this and it worked. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [May 10, 2025, 8:59pm UTC](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017/60 "2025-05-10T20:59:34Z")
> [@Velocity](#): > > IMHO, making college much cheaper would be a good idea, but making it _totally_ free tends to encourage a trash-it, not-valuable attitude. I’m pretty sure that would be a good thing, however. College _should_ be about getting a higher level of education, not a status symbol. [Previous page](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017.md?page=2) [Next page](https://boards.straightdope.com/t/what-problems-could-we-solve-in-america-that-could-actually-save-money-by-solving-the-problem-but-we-still-dont-solve-them/1018017.md?page=4)