Agreed!
Yes. My ass is my cite and my cite beats AI. The AI’s first sentence was a denial, followed by non sequitors. “Pick a number between -1 and 10”, would also be a superior methodology. Grumble mumble freaking AI.
Here’s the basis of my calculation. I take the percentage of GDP that the US devotes to healthcare (16.7% in 2023, the highest among advanced nations) and subtract out Peterson-KFF Comparable Country Average of 11%. 16.7-11 = 5.7, which I round down to 5 then add a, “Possibly” qualifier because this is rough. Thinking it over, I’d rather subtract out the 2nd place country, which would be Switzerland at 12%. 16.7-12 = 4.7: concatenate that to 4%. But 4% is really false precision, so I’ll keep my estimate of 5 +/-2.5%
Let’s see if we can improve on my double blindfolded dartboard estimate. We can!. Here’s a study addressing the question.
They started from the premise that the US spends twice as much per person on health than the average of peer nations. That base would be 16.7/2 = 8.3% of US GDP. Of that 30% was excessive administrative costs. That works out to 8.3*.3= 2.5% of GDP. Let’s take that figure. Much better than my 5% estimate and still incredibly high. The cite also suggests my take was misleading, since US excessive costs also reflect higher prescription drug costs and higher wages for physicians and nurses (25% in total). Incidentally 40% of excessive US costs were mystery meat for the purposes of the study so my 5% figure wasn’t wholly implausible. But again, let’s stick with 2.5%
The 23% underinsured figure looks like an underestimate. Here’s their definition:
Who Is Underinsured?
For our analysis, people who are insured all year are considered to be underinsured if their coverage doesn’t enable affordable access to health care. That means at least one of the following statements applies:
Out-of-pocket costs over the prior 12 months, excluding premiums, were equal to 10 percent or more of household income.
Out-of-pocket costs over the prior 12 months, excluding premiums, were equal to 5 percent or more of household income for individuals living under 200 percent of the federal poverty level ($29,160 for an individual or $60,000 for a family of four in 2023).
The individual or family deductible constituted 5 percent or more of household income.
Because out-of-pocket costs occur only if a person uses their insurance to obtain health care, we also consider the deductible when determining whether someone is underinsured. The deductible is an indicator of the financial protection that a health plan offers as well as the risk of incurring costs before a person gets health care.
Their study provided a decent baseline, but it didn’t adequately address this:
We do not, however, consider the risk of incurring high costs owing to an insurance plan’s other design features, such as out-of-pocket maximums, copayments, or uncovered services, since we do not ask about these features in the survey.
You only know if your insurance is inadequate if you get really sick, and most people aren’t really sick in a given year. There’s a lot packed into that last disclaimer.
Anyway, I hope it’s clear that my allegations were very rough. Genuine thanks for bringing a cite. Citations aren’t just a game of gotcha: they provide a basis for discussion and calibrating certainty (very low in my above post).
Abortions and Prison are the expensive alternatives once all the cheap solutions are ignored.
There have been multiple studies and this is across the spectrum - poor and unpowerful people do it, too. This idea that rich people are uniquely evil is ridiculous.
I didn’t say they were; but they are the group that was specifically being talked about.
I’m not sure what problem you are trying to solve. Increasing voter turnout/participation is a different issue than ensuring the voters that do turn out vote the way you want them to. The profligate spending on politics has little to do with getting people to participate and much to do with getting the ones that do to vote a particular way. Increasing voter turnout in this situation is not so much about increasing participation levels in democracy, it’s about getting people to turn out to vote the way you want.
That’s why the Republicans have gone all out on reducing voter access. They have realized the marginalized are less likely to vote for them, so they want to exclude the marginalized. That means lower overall voter turnout.
Replacing donor money with government subsidies and tax credits is interpreted as limiting people’s access to and ability to persuade voters, i.e. free speech.
It’s hard to eliminate bribery from politics when it’s difficult to distinguish bribery from aiding in promoting their message.
Corruption on politics is hard to curb when voters elect the guy who eliminates all the independent oversight, and uses the government to punish the groups and people that legally prosecuted him before he was elected.
Elect the most corrupt person you can find is not a method for reducing corruption. It’s a way to turn the government into the largest personal grift ever.
This is an interesting thread, and I think it demonstrates that there aren’t really a lot of low-hanging-fruit problems that we can just grab and solve.
Also, while I do take the “cui bono” point, I think it also pays to look at global best practices and see what is out there. Aside from the tax prep issue (which I agree can be solved for most people in the US), most “developed” countries still struggle with these problems, and even when they have solutions, they still struggle to pay for them (how many “developed” countries have a balanced budget and an affordable cost of living?). Thus, I don’t really buy the “rich people don’t want to solve these problems” take on things in general, although in particular cases, that is absolutely so.
Here are my takes on the individual issues raised, in order of highest solvability/savings to lowest:
Homelessness
During the pandemic, several municipalities placed the unhoused in hotels in order to minimize the spread of covid. This proved to be a useful technique and has in some cases led to more permanent programs of this nature. We can house the majority of the unhoused if we have the will. As has been pointed out above, however, the feedback loop of moral hazard is bound to be an issue, and there are those for whom such programs will not work. I have not seen any statistics on how much money would be saved, but even if it turns out to be a loss, I doubt it is a significant one, and such programs would also have nonquantifiable benefits to society. Ultimately, putting someone in a hotel room or its equivalent is not as complicated or expensive as the next issue…
Medical care system rationalization
We can reduce a significant amount of waste in the US system and get that percentage of GDP spent closer to that of other countries. We have a dumb system. But medical care is just plain expensive under our current technological paradigm, and this is going to be a hardship for every country as populations age. Countries that have low-cost medical care typically have higher taxes, and some countries like Japan with older populations have unsustainable debt-to-GDP ratios. I don’t see a way out of this quandary, currently.
High incarceration rates
According to Gemini,
Also, Gemini says that the state prison population is 1,079,467 (88.3%), while federal is 143,300 (11.7%).
My reading on this topic tells me that while the high incarceration rate of the US is sad, most of the people in prison aren’t in there for superficial reasons. If a country has a lower incarceration rate than the US, then either they have a smaller ratio of criminals to the general population, or they are letting more of the bad guys out. Here again, I don’t see an obvious solution.
This could solve the large majority of cases, but nothing can solve the problem totally, as there are several types of homeless people. The hardest ones are the mentally ill and drug addicted.
End the war on Drugs- not that all drugs should be legalized, but more medical solutions, less prisons- about half of our prisoners are in for Drug related issues.
We tried this recently in Oregon. Most recreational drugs were decriminalized. The result was that an open air drug market soon formed on the streets. They tried suppressing it, but actually just moved it to a different location. The market was seen as bad, so they ended up recriminalizing drugs.
What they needed to do was what they did with marijuana. Create a complete industry for recreational drugs, including producers and shops. And maybe safe places to consume them, although those aren’t needed for mj. Unfortunately, the bad experience they just had will likely prevent any future attempts to decriminalize drugs.
Right.
As dtilque notes, ending the War on Drugs is complicated. The government would have to set up markets and regulate them (e.g., cannabis); otherwise, we’d just have people dealing random junk in the streets (shit cut with other bad shit).
I refer again to my stat above: very few people are in the hoosegow for taking a puff of ganja; most are what may reasonably be referred to as “bad dudes,” whether their crimes are drug-related or not.
You’re assuming the only value of a college degree is to find jobs. College education, when done right, can increase exposure to multiculturalism and provide education needed for real world success. Classes to teach skills like critical thinking, introspection, science literacy, interpersonal communication, etc.
Yes, but we could put more addicts in rehab instead of prison. Ending the “war on drugs” does not mean legalizing anything (but pot), it means less severe sentences and more treatment-mandated felony , which would direct them to substance use disorder or mental health treatment in lieu of up to three years in jail or prison."
Right. I think here is where we need to look at global best practices and see how other countries manage to both lower incarceration rates combined with lower recidivism. I think the kind of thing you are saying would be a piece of that puzzle.
My original point was more to counter the naive assumption (held by many but particularly Liberals like myself) that we could easily reduce the incarceration rate by letting out all the pot smokers, nonviolent offenders, etc. The real problem is how to deal with the bad people most effectively.
Legalization of psychedelics and of opiates would probably make us better off than we are with those things being illegal. Psychedelics because there really is no sane reason for them to be illegal in the first place; opiates because the unregulated illegal ones are so horribly problematic (fentanyl).
I feel like legalizing coke could be asking for trouble.
Definitely.
And to some extent some amount of Sentence Commutations for the non-violent offenders should be considered.
That is what it has become in practical terms in today’s world.
No, it hasn’t. That is what it has become in popular discourse, but a university degree still provides an actual education, too.
Let’s be honest though. For most people, the value of those skills and exposure is because they often lead to good jobs.
Oddly, people want to eat and have a home, thus a decent job. But rich kids with no need for a real job go to college and get degrees, and once in a while a Senior citizen will go back to college.
I wasn’t saying otherwise. If you polled a random sample of college students I’m sure the majority/plurality would say they’re in college for job purposes.