Our taxes fund more public health dollars per capita than almost anywhere else in the world. Medicare and Medicaid spending is higher than DOD budget, and that’s before you include medical research funded by NIH and DOD or VA spending.
The issue is that our prices are out of control because of regulatory capture and downstream inability of the government to negotiate lower prices.
What we need are price controls.
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It’s working as intended.
There’s a lot of money to be made in making sure the US Govt isn’t paying minimum dollar for goods and services, be it healthcare or military spending.
It’s about stealing everything they can between those that need and those that provide.
Insurance companies. Middle management. It’s everywhere. Needless spending that’s made up to create “industry”.
This industry should never have existed in the first place. It’s akin to fire departments standing in front of a burning home until the owner pays up, and if they don’t they get robbed while the place burns.
That was determined by the public to be greed driven, robbery and also fucking illegal.
But the insurance industry does it daily for generations, constantly creating scenarios where people die or become destitute and yet it’s legal?
Somebody explain.
look, your argument is fair but inaccurate. When the Insurance company’s negotiated rate on a heart attack is 14k, but the hospital bills you 300k, then the problem is we’ve allowed for private healthcare to make more sense and forced government funded healthcare to be overly complex.
Let me repeat this but in capitalism, we have DONE THIS PURPOSELY so that private healthcare companies can make money.
That’s what happens if you don’t have public health care.
A small insurer or even an uninsured person cannot bargain with large pharma companies. If they try to, the pharma company will just not sell the product, because it’s more expensive for them to lower the prices for everyone compared to losing one small customer.
But if your whole country’s health system bargains at once, it can get much better deals, because not taking a deal means for the pharma company that they’ll lose access to millions of potential customers.
That’s why for example in Europe Insulin costs about 10% per dose compared to what people in the USA have to pay.
“The issue is that our prices are out of control because of regulatory capture and downstream unwillingness of the governmemt to negotiate lower prices.”
FIFY!
It’s not about unwillingness. Negotiating lower prices requires collective bargaining. In the US there are so many different insurance companies and each one has to negotiate prices for its relatively small pool. Contrast that with countries like Canada which have a single system, giving them the ability to negotiate prices for the whole country.
I wouldn’t call it unwillingness, Obama did try to create a public option.
Our tax dollars fund more corporations than other countries. The military spends so much because they pay private companies for their equipment, which is sold at inflated costs because they can. The US spends a shit ton on health care because private companies inflate their prices because, again, they can. The government/insurance companies don’t even pay the full price that’s listed on the bill, but they still use the original numbers.
You can’t compare our spending to other countries. The US spends more because they pay inflated prices. Citizens spend less because we can’t afford to get health care.
so if they put such a generous amount in, why isn’t healthcare free then, like in Europe? if i have the flu and go to the doctor, even the medication they prescribe is subsidised, i pay max 6 bucks for everything
Insurance companies. Because of the way they operate, healthcare providers are forced to raise prices as high as possible so that they can actually afford to operate once the insurance companies negotiate the lowest price for care they can.
And then the insurance companies charge consumers high prices anyway and pocket the difference.
Indeed, what good is all that public health spending when health corporations and orgs are determined to maximize profit, and no authority is willing to curtail their efforts
It’s not regulatory capture, it’s a complete lack of federal regulatory guidelines in regard to the insurance industry.
for a medical service provider to be insured (and thus not be destroyed by the first malpractice suit they lose) they need insurance, the insurance companies have their own stipulations onto the healthcare provider, like all their stuff being certified, now guess who owns the respective certification companies? letting them charge whatever they damned well please…
it’s straight up duopolistic markets
I don’t like paying taxes, but holy hell not having the things they’re supposed to pay for sucks. You ever use a toll road or get caught in an intentional speed trap? Holy hell it sucks. And also we’re only kinda sure our food is safe and our medicine works. But the cops have tanks and the beef and gas are subsidized
I mean toll roads make sense, I’m not sure why we’re expected to pay to use public transport but not roads, when roads are far more expensive to maintain and us driving literally causes them to be damaged.
If roads and parking are free then public transit should be free. Otherwise toll roads are fine by me, although they’re technically a regressive charge in the US and Canada since you’re kind of forced to use a car in most areas… I mean car dependence itself is a giant regressive charge so that’s just one part of it.
But assuming we had actual functional transportation infrastructure, toll roads would actually be preferrable near more densely populated areas since it makes you think twice about using your car instead of taking a train or biking.
The way toll roads work in a lot of places is that they are built with public funds, then a private operator gets a lease for a set amount of time and gets the lion’s share of the revenue.
And yes, public transport should be free.
Won’t that encourage overuse of transport, which will actually make it harder to reach emissions targets and similar?
It’ll encourage the use of public transport over private vehicles (provided there is a good public transit network present). Public transport has got better efficiencies, and if it can supplant individual transit to a good degree, that’s not a bad thing.
As far as ‘overuse’ goes: how many people do you know who just travel on public transport for the fun of it? Even in places where people can travel for a flat monthly fee, very few people spend any more time on public transport than they need to. I doubt that free public transport would substantially change that.
Few people just like to hang out on trains, although I do remember the one guy on Reddit who did all his coursework while cruising around Switzerland and then got trapped in a railyard. However, plenty of people will choose a long commute or to visit a more distant destination if it’s cheap enough. Extreme example, but I once knew a person that drove a full 2 hours each way to work. Through a far more densely populated area.
I don’t and couldn’t really have empirical evidence that people would overuse free public transit, but the I think the theory is strong. Generally, people will travel less if travel is more expensive. If travel is provided at cost instead, they’ll avoid it unless the value to them of the travel exceeds the cost to other people to provide it and bear the side effects.
Another thought: Flights In some places there’s a government air carrier, and they fulfill the same basic function of getting people from point A to point B. Usually they’re not considered public transport, but then you have cases like the small arctic communities in my country, which are filled with very poor people and can only be accessed by plane. Should we make an exception? That’s where things might get complicated.
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Why shouldn’t you pay for using car infrastructure? You’re damaging the environment and damaging the roads, it’s a lot more sensical for the cost to be put on you, the driver, instead of burdening everyone else with higher income/sales taxes.
Funding for the development and maintenance of roads in the U.S. come from a variety of taxes such as vehicle registration fees, wheel taxes and taxes on gasoline and motor fuel. So , we do pay for using car infrastructure
Yes, but not nearly enough. Those kinds of taxes are extremely low (especially compared to e.g. the EU) and form only a fraction of the costs of car infrastructure.
All those hundreds of billions to trillions of dollars in infrastructure bills, all the regular car infrastructure maintanence costs, a large chunk is paid for by taxes that everyone gets regardless of how much they use a car. And all the extra non-tax costs (in both time and money) that non-drivers have to pay because car-dependent infrastructure fucks up transportation for everyone else, that is a massive charge.
Even in the EU, car related taxes can’t pay for all the car related infrastructure. Building and maintaining roads is crazy expensive.
People who don’t drive don’t pay any of those taxes that were used as examples. I’d love to see the numbers that you’re basing your argument on.
Let me google that for you: https://frontiergroup.org/resources/who-pays-roads/
There are literally tens of thousands of articles like this one.
TLDR:
- less than 50% of car infrastructure cost is paid for by driving related taxes
- An average of $1100 in general tax per household per year is used to subsidise driving
- Car infrastructure receives more subsidies from general tax than transit, passenger rail, cycling and pedestrian programs combined.
No, drivers pull their own weight in regards to car related taxes.
The point the seems to have missed you is that taxes should be what pays for the road
I just said – you’re burdening other people with taxes for damage that you cause. Car infrastructure meant for drivers destroys the fabric of cities/towns, destroys the environment, and costs a shit ton of money on top of that.
Using more toll roads and similar things means you can “tax” people a lot more proportionately to how much they use cars on public infrastructure, instead of punishing people that don’t use cars or use them less than others. It would be entitled to assume that everyone else should pay more taxes because you want to use an expensive destructive and dangerous mode of transportation rather than just take public transport or bike.
I also find it hilarious how my state gives tax credit for using/owning an electric car, but not for not using any car at all… this kind of shit is representative of the norm across most of the US, car drivers are directly subsidized by non-drivers.
(It’s obviously a lot more complicated than “make more toll roads” since some jobs actually need vehicles, plus it’d make sense to mostly do it around densely populated areas)
I pay for schools i dont go to, hospitals in places ill never go to, roads i dont use. The point of taxes is to pay for the things that better everyone even if you yourself dont personally use them.
Okay, but schools and hospitals don’t destroy the fabric of cities and don’t destroy the environment. Schools and hospitals actually improve society a lot and SHOULD be subsidized.
A majority of the money spent on car infrastructure does NOT go to improving society. In the current state of things, cars harm society, and the majority of people using cars don’t need cars. Most of the money spent on car infrastructure should be put into actually making transportation not car-dependent, and as I said earlier car drivers should subsidize this.
It would be great if we could shift to a better system integrating better and much more robust public transit, but in much of the U.S. driving a car is the only option. I understand being upset with the system we have, but taking out your frustrations on many people who don’t really have a choice is counterintuitive.
Wait but cars don’t damage the road (much) - trucks do. We should all be mad we are so heavily subsidizing the cost of moving goods to our grocery stores, construction sites, and anywhere else.
The simple answer is to make commercial/industrial users pay fairly. Practical studies have shown that road damage is related to the fourth power of vehicle weight. The damage attributable to private cars is less than a rounding error compared to commercial vehicles, and commercial users have the most directly-atttibutable profit from road use.
Based and accurate
Canada doesn’t have tolls. And, at least in BC, good transportation.
We do have taxes on car ownership, though, at least where I live.
It’s just a matter of how much they want to invest in what.
In many cases toll roads mean that the government didn’t want to/wasn’t able to invest in building a road, so they let a private for-profit company do it for “free” (meaning without tax money) and that company then recoups their investment using toll.
Some times toll roads are used to steer traffic. Some cities for example have a city toll that’s meant to discourage commuters from using their car to get into the city and instead get them to use public transport.
The first case means the country doesn’t raise enough tax, wastes too much tax money or has other priorities than road infrastructure.
The second case is totally valid since it uses tax to discourage unwanted behaviour.
A controversial take apparently, but yes. A big part of the reason everything was able to become car-centric is because we’re effectively subsidising driving by providing the infrastructure for free, both parking and road.
You can also go the route of a hypothecated tax by mileage, which is probably more convenient.
Toll roads are a kind of tax.
True
[Slaps hood]
This baby can bomb soooo many third world countries
The black community frowns on this flagrant attack against our neighborhood.
Lemme see them hands.
Notice that taxes don’t have the same vile vitrol against them outside of America? They get something for their money.
One of my theories is that not only is it about how these taxes get used (as in the OP), but also in the US you have these constant reminders, it’s not added to your restaurant bills or supermarket prices until the end, you have to calculate it yourself all the time and that keeps it front of mind. I never used to even think about tax until I started my own business (since now I don’t have to pay it for business expenses). When something costs 100€ it costs 100€, you don’t think about the fact 20 of them are tax because you, as a consumer, pay 100 and that’s that. Same with salary, it gets taken at the source and once a year you just need to verify, and usually you get some money back making it a positive experience.
Yeah I never understand why tax is not included in the sales price, just seems arbitrary to exclude that. It is definitely been uncomfortable, back in the days when I used to use cash, and I would have just enough for like a burger or something,
Only to realize that I had enough for the price on the menu but I didn’t have enough for the tax. It’s just annoying
A society requires governance. Staff to set and enforce rules, staff and supplies to execute services which provide social and physical infrastructure.
Certain things every community needs: Healthcare, education, transportation, utilities, support services for special needs, safety, rehabilitation for rule breakers, etc.
A government can figure out how to provide these services (with in-house or out-sourced expertise) and provide you with one bill (taxes). Or they can privatize a service, meaning you still need it and they may regulate it, but you’ll be paying someone else for that service.
The value of taxes should be considered in this light. How much do I pay for all the services me and my community needs, and what portion of that is taxes. Then compare to other countries to see how well our governance system is functioning.
Does privatization save cost? What balance of regulation keeps things affordable vs driving up expenses? What balance of in-house expertise vs outsourcing is the most functional? What is the cost to quality of life having to pay bills to 15 organizations vs one? Where is there an extra heavy burden of cost and what can we do through regulation to fix it? These are the questions we should be interested in when it comes to governance, an elected official’s personality or opinions should be negligible factors.
I pretty much agree, taxation is only theft in america, and the only reason for that is because we are getting anything for our taxes outside of a bunch of dead third world children. Which doesn’t really help me put food in my stomach, or treat the stuff in my brain that causes memory problems and could possibly kill me when I turn 40.
We also have a constant drumbeat about how taxes are evil coming from politicians and pundits that represent half the political spectrum, all because they’ve discovered it’s a good way to turn people against the other half.
I know the point you’re trying to make, but generalisations like these aren’t helpful. After all, the UK have voted for the Tories for around 13 years, who are notoriously a low-tax party, and have a lot of support from wealthier people and self-employed people that don’t like their money aiding others.
They shafted that notoriety by imposing the highest tax burden since the Black Death.
Arguably, the Conservatives under Boris were a populist party that exiled the vast majority of conservative MP’s that still believed in traditional conservatism. Pair this with Brexit, and we ended up in a position where the only path forward is higher taxes or (further) financial ruin.
The party will always be one of low taxes, and conservative values, but not until Sunak is out, and the rats leave the ship. Funny enough, the skilled trades and southern professionals still see the Tories in that light, even though they’re basically the Brexit Party right now…
Yeah but fuck Britain.
We know what it’s really all about, they are afraid of immigrants and foreigners. The taxes are just an excuse.
You don’t see the temporarily embarrassed millionaire phenomenon over there. I mean the leftist party there is literally called Labor and is still much further to the left than the Democrats are, here A labor movement idea is too toxic to consider simply because too many dumbasses will happily lick boots leaving falsely, that they will be the ones wearing the boots someday.
It’s not even a nice military though! Failed audit after failed audit showing billions of dollars not accounted for. When you enlist, one of the trainings you get is how to sign up for WIC, because they don’t even pay you enough to feed a family (at first) if you lay down your life. This country is a joke from the outside, and a nightmare to live in.
In the 2000s, military applications were through the roof. I went to a poor urban school. And the promises of joining the military was discipline and support. We were already on WIC and couldn’t find a job, what makes this any different?
A decade later, all my friends who joined the military are struggling in dead end jobs and constantly complain about the lack of support. And they’re worse off than before… Just now with trauma.
Me here in a third world country, you guys are getting stuff for your taxes.
Not in Sweden, no. But we are technically third world I guess
Hmmm , Google says you get universal healthcare coverage…
They’re referring to the original use of first / second/ third world countries which has nothing to do with economic prosperity or development, and just where they were in a war.
Tell that to our doctors
Are you implying your doctor tries to hand you a bill when you leave their office? I have no clue what your statement could possibly mean.
The doctor decides if you’re ill and if so what treatment you get. If they want to brush you off and say you’re fine, they can and do. Or they can decide if you get “treated” with a “take these painkillers and go home” rather than look at the cause of the issue.
If you’re ill and turn to healthcare for help, but you get none, are you then recieving “universal healthcare”?
I suspect you understand this, but pretend otherwise.
I honestly had no clue what you were talking about when you said “Tell that to our doctors” in response to “Google says you have universal healthcare”.
Honestly, what you describe that doctors do is the norm in the US and, as far as I know, most places. On top of that, we have to pay for health insurance out of pocket either partially or fully before receiving any treatment (premiums), when receiving treatments (copays), and after meetimg our deductible (co-insurance). Then they start to pay, but it starts all over again in the new year. So don’t get sick if you have the budget insurance.
And then those insurance companies can limit the types of treatment the doctors can prescribe or make them jump through hoops before prescribing those treatments.
So … Yeah. I’d like to have what Sweden’s got.
Edit: I didn’t even touch on PBM, private equity in clinics and hospitals, surprise billing, arcane rules to limit foreign trained doctors from practicing in the US, under funding of residency, not training enough doctors for our aging population and much much more
I would have joked that at least everyone can join the military but they said I was too fat to join back when I was 19 when I was only 25lbs overweight. Isn’t it your job to whip my fat ass into shape? What the fuck am I paying you for?!
I’ve seen how veterans are treated. There’s no way I’d join the military even if I didn’t find it ethically unacceptable.
https://www.youtube.com/watch?v=znfZnSRcaeY
Gave up my girlfriend and my family
traded them in for an M16
Afghanistan Pakistan Yemen Iraq
I don’t care if I ever come back
From poor families how far we roam
So the rich kids can just stay at home
When I come home with PTSD
The VA hospital won’t care for me
I’ll probably end up homeless out in the dark
To get played on screen by Marky Mark
Country Joe and the Fish - Fixin’ to Die Rag
Come on mothers throughout the land
pack your boys off to Viet Nam
come on fathers don’t hesitate
send your sons off before it’s too late
and you can be the first ones on your block
to have your boy come home in a box
When I came back from Luang Prabang
I didn’t have a thing where my balls used to hang
But I had a wooden medal and a fine harangue
Now I’m a fucking hero
Mourn your dead land of the free
If you wanna be a hero, follow me
Mourn your dead land of the free
If you wanna be a hero, follow me
Holy shit van ronk’s not just the stonewall guy he’s worth taking seriously. Thank you for this!
Veterans get that free healthcare the rest of us need. The inadequate, short-funded, free healthcare you get as an afterthought
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I always find it amusing when Americans can only come up with paying less taxes as the answer, then they don’t understand why they get less services. It’s almost like you should expect more from the tax dollars you already spend. But I guess that’s the point of this post and I’m just beating a dead horse.
what you’re missing is the fact that most of us pay for healthcare through our employer. Clearly a win, yes? no. no it is not.
For those of us “lucky” americans that did the FUKCING MATH, i pay more in healthcare + taxes when you account for the $12,000 deductibles annually and (AND!!!) the cost of the privilege for having insurance of anywhere 600-1600 per month. Nevermind the fact the stupid private party insurance gets to decide if “I” am allowed to get a procedure. So i pay for someone else to make a decision that my doctor determines is necessary, which is declined (of course), then appealed (and denied), and now somehow i’m hooked on some fucking opiate because the pain is so great while I wait for Jim at statefarm to approve my necessary procedure. Oh, somewhere in there lets throw in a termination from my employer for showing up high on synthetically prescribed heroin (dilaudid) and now i’ve lost said insurance that i’ve paid 12000 into.
Or I could pay less in taxes by just hoping I will live longer that the conservative (and even some democrats) party dies a horrible death. All without the needed medication and coverage that is keeping me alive… am I winning yet?
So there you have it, those not paying for insurance are winning the war against… fuck, i don’t know anymore, what are we fighting? Right, right, the evils of socialized healthcare and “higher taxes”.
yes, i am ok. no the dilaudid story is true but it is not me, it was someone i knew… guy voted trump until he took care of his own mental issues permanently and fought you all the way.
For future reference:
Have your doctor write the literal phrase “medically necessary” on the order. If denied, contact the insurer and ask for the License Number of the Doctor who refuted the necessity. Keep in mind, if they’re NOT a doctor it is ILLEGAL for them to make a medical decision.
If they actually get back to you with a license number, you can use that to pull the credentials of the person denying the claim. Present that information to your doctor and I’m sure they’ll help write you up a nice paper to send into the medical review board of the state they’re licensed in.I’ve had to use this method twice with my wife’s healthcare. Approvals came within an hour of requesting the license number of the person on their end making medical decisions. The key being the phrase. A doctor’s order, or prescription, is a legal document. Your doc putting that phrase means “I believe in this treatment so much, I’m willing to bet my license that they need it.”
YMMV as I’ve only had to deal with BlueCross and they hate when I call.
Great trick, thanks for this.
yeah, thanks. I know most of the tricks now with cigna and bluecross. i just hate dealing with it and it shouldn’t be necessary.
feels good to vent though.
As an American I’ve been taking a truly radical position of openly demanding higher taxes. Like fuck you none of us pay enough. It’s easy to say tax the rich, but they’ll get tax cuts real fast if we don’t break the taboo on raising taxes.
I always find it amusing when Americans can only come up with paying less taxes as the answer, then they don’t understand why they get less services.
The ones for whom “less taxes” are always the answer know that they’ll get less services. They are fine with that as long as it means the minorities they hate will also get less services. Particularly if they suspect that those minorities can’t weather the lack of services as well as they can.
These are the people who filled in municipal swimming pools with concrete instead of letting black people use them too.
That’s my argument. There’s no need to raise taxes. It’s all scare tactics from the GOP. In Texas, a hot topic last election was our increased property taxes. The democratic nominee for governor proposed legalizing weed and using those tax dollars to lower property taxes. He lost the “moderates” when he proposed stricter gun control the last time he ran and they never got over it. Conservatives would rather pay extra money and complain about it than legalize the devil’s lettuce.
Politics is theatre. They use buzz words to win the ignorant votes. I don’t think we’ll ever see a return on our taxes because of how much it would take to completely flip the system. Businesses would go bankrupt if we had access to socialized programs, and that goes against the capitalism that the country stands on.
Removing tax havens within the country would also do a fair bit, and people wouldn’t notice any difference from that, except that there is a lot more money that the country could spend on more useful things.
Too bad spending money is considered “free speech” and all those tax haven dollars are used to buyout the people with the power to fix that problem
What would be considered corruption in most of the world is just the modus operandi of US politics.
The irony is that western free nations owe their safety to America’s military, and by extension this sacrifice of the American people, if you follow the post’s logic
Name three nations the US has couped to replace their democratically elected leader with a corrupt autocrat that sold gladly his people to US interest in exchange of power.
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The benefits the grandparent commenter pointed out aggregate to North America, Western Europe and Oceania, while the costs you point out are imposed elsewhere.
What does that have to do with their point though? They’re saying that the rest of the West enjoys their prosperity because of the American military, and I don’t think they’re wrong. The coups and corruption elsewhere around the world are what enabled the prosperity.
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This trend starting to buck has provided more military engineering jobs than any bullshit the US military has ordered in decades. Come on Europe, get afraid. Buy some more weapons. Heh.
We don’t pay taxes to the UK so it’s not all bad.
Fun fact, they were kinda paying us up until about 15 years ago. Last payment for the lend-lease program from WW2 was December 2006.
nice military
is it? they’re never home, so we don’t really know
Literally, in that most soldiers at “home” are homeless…in America anyway.
And can’t afford the therapy that they need after the horrors the regime put them through.
I walked out in '03 when Bush ran the green screen and I put it together he was flat out lying. I ain’t “serving” that one when there’s no protection for anyone but the oil billionaires feasting in the des(s)ert of our deaths. I also had just discovered the 9/11 was completely fraudulent and that even AC predicted it. Sure, vague poetic shit but Back to the Future hit that shit with a bullseye spelled out a hundred times. Don’t mind the pictorial art painted over the Cross of the dollar. I got refs if you’re curious about any of that. Glad I’m not one of them and I feel zero regret at all for my choice.
Huge swaths of Southeast Asia, South America, the Middle East, Hawai’i, and even North America’s own Indigenous peoples can all affirm that the US military is indeed very nice and only ever acts in self defense.
I mean if the 1% paid their share of taxes proportionate to their income we could live in a utopia :)… But nah… That one polical side that should not be named will continue making the poor poorer and pocketing the money for themselves.
How high are the taxes in Scotland?
Looks like they’re lower than The US, for the lower income me brackets, and comparable to the higher brackets
https://www.mygov.scot/income-tax-rates-and-personal-allowances
Same as US + health insurance premium
Nope, noticeably lower. In theory it should be similar, but the US system is (particularly) dysfunctional in a few ways.
Americans have accepted this idea. To our detriment. And to the detriment of the underdeveloped world. It’s a wicked system. God damn it we’re foul.
That are the reasons why I like paying taxes. Because a functioning society is a great thing.
