Cheers. Probably makes sense considering the "freedom" mentality in the US where everyone has to work for himself compared to the welfare state mentality in Europe.
Actually makes me feel a bit good for paying my taxes :)
If you'd pay more taxes, would you also simply donate more toward such efforts? If not, would you donate under some Kickstarter-like scheme in which pledges of donation were only enforced in the event that some threshold were met?
> If you'd pay more taxes, would you also simply donate more toward such efforts?
I currently am, but to Watsi.org. It gives me a bigger bang per dollar compared to the amount of middlemen in the US healthcare model.
I've thought about several ways to drive down the healthcare in the US, and it seems the only sure fire method is for politicians to get into office who believe in single payer. To that end, I use my wealth to max out my contributions to campaigns and PACs (if applicable) of candidates who support that goal.
> Congratulations on your income!
No need for that at all. I only mention it because, so often, I hear people say, "I'm tired of taxes! Less taxes! You already tax me enough!". To which I say, "Its complicated". I mention it because there are people out there (like myself) who do not mind paying taxes.
With my tax dollars, I buy civilization. I would like to buy more civilization for my fellow humans, but I need their help as well, otherwise my efforts are wasted into the ether by themselves.
Charities and donations will not truly solve the problem.
United States needs major reforms:
1. implement what I term socio-capitalism (private property and enterpreneurship is protected, but there is a social safety net in the form of universal health care and unemployment benefits) -- U.S. already made the first step with "Obamacare", but there is a lot more to do;
2. reform the government to reflect the Swiss model 1:1, and institute direct democracy, as well as make lobbying highly illegal.
Admittedly reforming the government will be a very difficult task, for those in power will fight by every means available to preserve it. The good news is, it could be done through the current political process.
She/he could do that, but it wouldn't make a large impact. I think the OP meant that they'd rather pay more taxes with the assumption that everyone else is paying more taxes too. That would make a large impact.
It's the same reason why it's not hypocritical for the super rich to desire higher taxes on the rich, yet still pay the minimum legal requirement.
I find it shocking that anyone wants to trust the American Government with their health..
That seems to be extremely idiotic given the record the American Government has when dealing with Health Care, pick either Medicaid, Medicare or the VA system.... You want that on a National "Universal" Scale... are you a sadist or something?
Most of the current problems with Health care costs in this nation are directly attributable to government policies dating back to the 40's
That's because your information on Medicare is wrong. I and many others would be happy with Medicare for everyone. It's well run and more efficient than private insurance. Expanding Medicare to everyone would give it even more bargaining power and price controls.
Medicare also has a payout problem so bad that doctors refuse to accept. Many providers have stop taking Medicare, I know my grandmother has all kinds of problems find places outside of the Hospital to take medicare
Price Controls have never worked in the history of man kind, we have a over all provider shortage now, if you remove the incentives and make being a Doctor a low paying job no one will spend the money to become a doctor. Price control always result in any less supply or lower quality or both...
That is what Medicare will get you, EXTREME wait times, it will take you weeks or months to be able to see a doctor, but hey it will be free, who cares if you die while on a wait list.....
Your theory falls apart to the evidence of health systems in basically every other OECD country.
A theory that fails to match the data in any case doesn't seem to be much of a theory, is there something I don't know about that's happening in other counties?
My guess is that doctors in other countries have less choice. In the US a doctor can opt out of Medicare and offer concierge services instead. Which many of them have done because Medicare reimbursements are much lower than in the private market.
US doctors also can make money through self-referrals such as ordering a test be done through a clinic in which they are an owner.
I supposed we could try to outlaw that practice, but a whole lot of doctors would lobby like hell to prevent that bill from making it through Congress.
There are base prices for operations, doctor visits and the like. But doctors can choose to charge above this price (and mostly do so in places like Paris, where rent is too high to charge just base price).
Doctors have to declare whether or not they do this. So if you're a price-sensitive person you can lookup doctors "inside" or outside the system.
In my experience, there are longer waits for things like optomotrists, but that's more due to government-mandated limits on how many can graduate in a year than the price controls (that you can opt out of anyways).
General practitioners are fine though. Like "call for an appointment, show up the next day" sort of fine. And even in big cities I would always end up at a doctor charging "base" price. The visits would end up only costing something like 7 euros.
Yep, Medicare is very efficient. Medicaid, on the other hand, is state by state, and is oftentimes run very poorly. I would love to have Medicare for all.
What are you talking about? I said it probably makes financial sense too. I know the HN community abhors things like budgets getting in the way of universal healthcare & longer unemployment benefits, but there's a limit to what can be spent.
Let me just say we should be spending a lot less money on war and a lot more money on welfare. Yet let me also say that the genesis of many ghettos was in a "war on poverty" that pushed for low-income housing. You're not being immoral by trying to evaluate each side and it certainly does not make me a rugged individualist.
I wasn't referring to you in particular, but Americans as a whole. The thought that if you work hard, you will always succeed. This is not the case, of course. I agree with your post.
We have several hundred million Americans which are all willing to work very hard, but there is not enough work for them, and what work there is, is not paid sufficiently to be able to live comfortably, or even normally.
And here is where the entire concept of if you work hard, you will always succeed shatters: there are roughly 300 million Americans. The industry in which they could have (and many have) worked hard has systematically been outsourced, destroyed, under the idea that "we're going to design it, and they are going to build it, somewhere else, cheaper". Capitalism, except that most of those ~300 million people do not really have the means (intellectual, financial, you name it) to be scientists and engineers.
To make matters worse, the American culture has a strong bias towards low-brow making fun of engineering and science (a prominent case in point: "The Big Bang Theory", or shoving sports, in particular "football", down everyone's throats at the expense of more intellectual programs). For instance, "geek" and "nerd" are very American terms which I'm not aware of existing in Europe, where being an engineer or a scientist is celebrated and prestigious.
It's the perfect storm, and one which has been systematically brewed for the last 60 years of American history. Anthropologists and sociologists rejoice, for you now have a lifetime opportunity to observe what happens when you have a laissez-faire, hardcore capitalism system without checks and balances.
They kinda are. There are a number of things that have been done elsewhere in the world with success, but when it comes to America, we have to be unique and special.
Unemployment benefits aren't the same as welfare they're paid into by your employer so when you're laid off you can maintain some kind of salary while you find work elsewhere. There are tax based welfare systems in place in the United States that provide assistance to people in poverty but it isn't the same system as "unemployment" (as it's generally referred to here)
At least in Washington State, unemployment payout is almost immediate, within two weeks of losing your job. You can use the time before it runs out to apply for other federal or state assistance programs. These may take longer and have more complex qualifications.
> You can use the time before it runs out to apply for other federal or state assistance programs.
Which if you are a non-disabled, employable (whether or not employed) adult without dependents, in most parts of the US, are extremely limited, quantitatively and, often, temporally, as well.
My only first hand experience is with Washington. When I was furloughed in 2008 it was relatively easy and pain free to receive benefits, at least by government standards. My room mate at the time was only able to find part time work in retail at the end of unemployment and was easily able to obtain supplemental food assistance from the state. I won't argue the rules and regulations are a complex mess. For example, I would think it would be easy and in the governments best interest to try and transition people from the unemployment program into school/university programs, but that is near impossible with the way the regulations are written.
Different states have different time frames and may have conditions on those.
I was laid off a while back. Because I got a severance package comparable to 1.5 months salary, I couldn't get unemployment assistance for 1.5 months plus 4 weeks - even then I had to document that I had applied to a minimum of 3 jobs a week from the day I was laid off.
If you have children, you may qualify for whatever your states implementation of Temporary Assistance for Needy Family (TANF) is -- which has a work requirement.
If not, your jurisdiction may have a "General Assistance" program, but these tend to be very small benefits, and often restricted in how long someone deemed "employable", whether or not they actually can find employment, can be on them (either in total, or within a given period; e.g., some jurisdictions have something like a 3-months in any 12-month period limit.)
> As much as people outside the US like to think it's some sort of heartless society, the US has a substantial safety net setup.
The US has an extraordinarily weak social safety net compared to most other developed countries.
Not deeply familiar with either, but on review of a brief overview of the Japanese system it seems substantially more robust than the US system (though it also seems to have many similar structural difficulties.)
"I am for doing good to the poor, but I differ in opinion of the means. I think the best way of doing good to the poor, is not making them easy in poverty, but leading or driving them out of it. In my youth I traveled much, and I observed in different countries, that the more public provisions were made for the poor, the less they provided for themselves, and of course became poorer. And, on the contrary, the less was done for them, the more they did for themselves, and became richer."
If you want to argue that a very weak social Assagai net is a good thing, feel free. "Ben Franklin said so based on, at best, personal anecdotes" probably isn't the most compelling argument for that position but, in any case, e point is that the US system is weak, whether that's desirable or not, contrary to the upthread suggestion that it is substantial.
I actually argue to replace all Social Safety Nets, all Universal Healthcare, every government program with UBI...
I do not believe the government should provide Food, Home, or Healthcare assistance to any. I do however believe every person should enjoy basic income level to buy those things for themselves
Quoting an 18th century politician citing 18th century anecdotal evidence does not convince anyone who does not already occupy that viewpoint. Especially from outside of the US where the degree of unquestioning reverence, whatever their virtues, given to your founders can come across a little odd and parochial.
They were men that agreed and disagreed with each other on lots of matters, not Gods.
In California, one of the most generous states with welfare, here's what it looks like for a single person with no children:
WORK REQUIREMENT
Non-assistance CalFresh recipient over age 17 and under age 50 must satisfy the ABAWD work requirement as a condition of eligibility unless they meet specified exemption criteria or live in an area where the ABAWD work requirement is waived. ABAWDs cannot receive CalFresh (food stamps) for more than three months in a 36-month period unless they meet this requirement or are excused from it. The ABAWD work requirement is met by performing one of the following:
Working at least 20 hours per week in paid or volunteer employment;
Participating at least 20 hours per week in an allowable work activity such as vocational training or basic education programs; or
Participating in workfare (i.e., community service). The number of hours of participation in workfare is determined by dividing the CalFresh allotment by the higher of the state or federal minimum wage.
Max benefit: $174 a month(!)
Compare Germany:
If a worker is not eligible for the full unemployment benefits or after receiving the full unemployment benefit for the maximum of 12 months, he is able to apply for benefits from the so-called Arbeitslosengeld II (Hartz IV) programme, an open-ended welfare programme which, unlike the US system, ensures people do not fall into penury. A person receiving Hartz IV benefits is paid 404 EUR (2016) a month for living expenses plus the cost of adequate housing (including heating) and health care. Couples can receive benefits for each partner. Germany does not have an EBT (electronic benefits transfer) card system in place and, instead, disburses welfare in cash or via direct deposit onto the recipient's bank account.
Not only that, in Germany you have universal health care, while in California (or anywhere else in the US) you will be uninsured (you can still be treated in the ER of any hospital, but that's not going to help in preventative situations).
Read my original post. Medicaid is available to low income individuals. In fact, it was expanded (in most states) up to ~175% of the federal poverty level. You can get it even when you have a job!
Have you tried to get Medicaid in a state? Because I have for a family member (Indiana). There's a waitlist, and even on it, your monthly out of pocket costs are very high (the person in question had zero income, and was still required to cough up $400-$1000 for prescriptions and copays, with no income!).
Note that this varies from state to state considerably. So, in some states, the experience may be very different. (Especially as to the monthly out of pocket once you qualify.)
I realize that. That was my comment's point. Refurb made a broad generalization ("Medicaid is available to low income individuals.") that is factually inaccurate across most of the US states.
I am sure they do, I never argued that I like our Current mix of heavily government regulation, mandatory 3rd party billing, and a variety of other fucked up policies imposed by government.
It is likely that single paying would be provide lower cost then what we pay today, I think it is highly unlikely it would result in better care. For example in many places in the EU semiprivate rooms are only for those Rich people that pay for their care, the "free" sick people are put in "efficient" open-plan hospital ward with many more people
Also there would be a huge drop in medical research, in addition to government regulation driving up costs, the US Health System more or less carries the rest of the world for R&D, companies charge the US exorbitantly because in the rest of the world there are price controls, once they stop being able to exploit the US Health Consumer because we also have price controls they will simply stop or slow their R&D to safer avenues and take less risks..
There are also 1000's of other reason why a US Universal Healthcare system will be vastly different than any thing any other nation has tried.
One big one is our obesity problem, once we have Universal Healthcare, are you then going to support Universal Diets, and Universal/Mandatory Exercise??
> One big one is our obesity problem, once we have Universal Healthcare, are you then going to support Universal Diets, and Universal/Mandatory Exercise??
I would add a tax onto activities that increase healthcare costs, yes. I'm not stopping your from doing it, I'm just bringing the externality into the equation.
If you speed, we ticket you. If you speed too much, we raise the price of your insurance. And so on. This is no different. Risks have costs, and you pay for the risk you create (when a choice is provided).
Fucking authoritarians. I really do not have much else to say, I can not have a reasonable conversation with people that believe the government should control everything.. Including what the fuck I eat and tax (aka Punish me if I make the "wrong" choice by their standards
Getting on welfare and Medicaid is not as simple as you seem to think nor is it quick. Also if you are a male without any kids in most states you are out of luck.
And in the USA you might not get any benefits at all, depends how long you worked, if you previously got benefits and how you lost the job (fired vs let go vs quit, etc)
How is it that people don't starve, especially the ones with mental health problems?
Or does it happen and just is so accepted it is not worth reporting?
Uh, some people do not want to panhandle or turn to prostitution, or religion for that matter, they try to maintain what little self-respect they have in that state of mind.
There is often help for families but not individuals without children.
When I was homeless and living out of my car I actually had a hard time getting food stamps back then (this was a long time ago). First I had the problem I was in a southern state which are mostly Republican controlled and don't want to help people. Secondly I had an impossible time proving I didn't have income (how do you prove a negative?) Then the problem I didn't have an address. Oh there was also a problem someone had the same name as me elsewhere in the state and was already getting benefits.
I showed the case worker my car I was living out of and eventually she put in some kind of emergency request so a few days later I got something.
If it had gotten any worse I would have had to turn to a church charity for help, fortunately did not come to that. It is no accident the states set it up that way so you have to turn to religion, it is disgusting.
Largely through private charity. People with mental health problems also tend to die fairly young on the streets. I live somewhere with a friendly climate to the homeless, and the chronic homeless are mostly well under 40 or retirees who can no longer make rent.
Depends on a bunch of factors. I've seen people who have reapplied and received it for years. I think the cutoff is 2 years under any circumstances. You have to prove that you're actually looking for a job to continue extending.
