I'm so angry with the U.S. and Chinese governments right now!

[Irvrobinson]

People are generally supportive of other people spending money.

Yeah, there was a pretty funny movie about that.

 

[lovinthehd]

People are generally supportive of other people spending money.

Or is it some people are generally fine with spending other people's money....like in audio recommendations? That was a fun movie - https://www.imdb.com/title/tt0102609/

 

[GrimSurfer]

Or is it some people are generally fine with spending other people's money....like in audio recommendations? That was a fun movie - https://www.imdb.com/title/tt0102609/

May be GO-NAD should change the title of this threat to "I'm so angry at Canada..." because it seems they're spending less per capita than the US.

What social injustice! And from a liberal government, no less.

 

[lovinthehd]

Just some facts to consider. I got many of them from:

https://www.kff.org

At first I didn't trust that link, because it's the family foundation of a health care empire, but I cross-checked some of the facts with US gov sources, and they appeared to be quite accurate. I liked the KFF site better only because the information is much better organized.

So... it would appear that the Medicare and Medicaid programs currently cover 135 million people at a cost of ~$1.3T. (It does seem weird to round to the nearest $100 billion dollars, but whatever.)

The Veterans Administration provides benefits to another 9 million people:

https://www.va.gov/vetdata/docs/Quickfacts/Homepage_slideshow_06_04_16.pdf

https://www.va.gov/budget/products.asp

At a cost of $200B.

So there are currently about 144 million US citizens covered by government healthcare at a cost of about $1.5T. The current estimated population of US citizens is 328 million, so the covered group is 44% of the population. (Some people get supplemental coverage for Medicare, but that's only about a $30B industry, and I'm including rounding errors greater than that, so I'm ignoring it.) I figure the currently covered fraction of the population is probably unhealthier than US citizens on average, due to the nature of the before-listed programs, so the incremental cost of covering everyone will probably be lower per capita.

The private health insurance industry had revenues of about $840B in 2017, covering 176 million people, making the private companies look more efficient than the government, but I suspect a lot of this coverage is inadequate. So let's fudge the whole thing and say that covering everyone in the US under Medicare and Medicaid would just double government healthcare spending to $3T, with a budget gap of about $800B, assuming you confiscated all private premiums and put the private insurance companies out of business in this sector. Let's also assume that the insurance companies employees who were unemployed would find jobs with the USG and states, so the net unemployment would be irrelevant in this discussion as a budget factor.

$800B is significantly bigger than the total US defense budget, and I probably underestimated everything, especially first-year costs.

Medicare for All looks like it needs a massive overall national spending increase at the Federal level. But I'm sure the Europeans and the Canadians will be in full support of it! ;-)

Have you used Ballmer's USAFacts site? usafacts.org

 

[Irvrobinson]

Have you used Ballmer's USAFacts site? usafacts.org

No, but now I've bookmarked it. Thanks.

 

[GO-NAD!]

I agree with Irv, especially on the latter point about country population. You could also add landmass to the equation too, as this drives up the cost of public infrastructure and administration.

Russia fits conveniently into this frame, but is more an example of failure than success (making it a uselessly low comparison). The UK's population and area is simply too small. Germany has a greater population but its land area is still too small.

Canada, with the Germany's population, would be of the scale where a reasonable comparison could be made. But this is not reality.

Brazil might be the closest, but many wouldn't like this as a comparison because it doesn't support the thesis that America is broken...

Even after considering all this, Canada and the US score essentially the same on the UN Human Development Index. This is remarkable, given the immensely larger population of the US.

Can you imagine the cost of infrastructure and administration in Canada, with 1/10 the population of the US and a larger land mass? With a sparsely populated northern region, it's astronomically expensive to provide services to vast areas of the country. I'm still having difficulty accepting the excuse of a large population for the inability to have a more equitable spread of prosperity. Are there any studies indicating this to be the reason?

Yes, Canada and the US are side-by-each on the HDI. Of course, amongst the "upper echelon" of countries, there isn't much difference from 1 to 20, or so.

How about looking at the Inequality-Adjusted HDI: Canada is #12, while the US is #25. Or, how about the "World Happiness Report"? Canada is #7 and the US is #18. I'm certainly not going to claim that Canada is a "better" country, but we do have, on average, three more years of life span to think about it...

 

[GO-NAD!]

May be GO-NAD should change the title of this threat to "I'm so angry at Canada..." because it seems they're spending less per capita than the US.

What social injustice! And from a liberal government, no less.

View attachment 28616

As in another aspect of life, it's not how much you spend (or are endowed with), it's what you do with it.
I can assure you, I hardly qualify as a SJW, That's funny though...

 

[Irvrobinson]

I'm still having difficulty accepting the excuse of a large population for the inability to have a more equitable spread of prosperity. Are there any studies indicating this to be the reason?

An excuse? No, it's the scope of the problem. The US population makes the scope of the solution 8-9x that of Canada. Or are you arguing that the difficulty of a solution does not scale with scope?

How about looking at the Inequality-Adjusted HDI: Canada is #12, while the US is #25. Or, how about the "World Happiness Report"? Canada is #7 and the US is #18. I'm certainly not going to claim that Canada is a "better" country, but we do have, on average, three more years of life span to think about it...

The World Happiness Report? That's ridiculous. Everybody knows the US is too full of cranky old men to score very well.

As for the three additional years of life expectancy, I'm not surprised at all. I've been to Canada numerous times, and one difference that strikes me is the relative lack of obesity in the population. I think the difference is striking. In the US more than a third of the population is obese, except for flyers of Southwest Airlines, where I'm convinced it's more like 75%. ;-) Fat people tend to be less healthy and die younger.

 

[GrimSurfer]

As in another aspect of life, it's not how much you spend (or are endowed with), it's what you do with it...

You should turn you attention to your home province:

From Wikipedia: Nova Scotia's per capita GDP in 2010 was $38,475, significantly lower than the national average per capita GDP of $47,605 and a little more than half of Canada's richest province, Alberta. GDP growth has lagged behind the rest of the country for at least the past decade.

 

[GO-NAD!]

An excuse? No, it's the scope of the problem. The US population makes the scope of the solution 8-9x that of Canada. Or are you arguing that the difficulty of a solution does not scale with scope?

I'm under no illusion that it wouldn't be difficult. Impossible? With everything the US has accomplished over the past couple of centuries, I find it hard to believe that it's impossible. Of course, it would require some unity and agreement in the direction you want to go. That's sorely lacking right now and you aren't alone in that. There elements of discord all across the western world, to varying degrees.

 

[GO-NAD!]

You should turn you attention to your home province:

From Wikipedia: Nova Scotia's per capita GDP in 2010 was $38,475, significantly lower than the national average per capita GDP of $47,605 and a little more than half of Canada's richest province, Alberta. GDP growth has lagged behind the rest of the country for at least the past decade.

Yes, I'm aware of that, thank-you. I was actually born and raised in Newfoundland, which is in even worse shape. Back in the 1990's, it was all rosy in Newfoundland. Oil prices were good and the revenues were streaming in and the province became a net contributor to federal revenues. Then the government went on a spending spree - paving every road and cow path, major infrastructure projects and a pony for everybody. I just shook my head, because I could see what was coming. Sure enough, oil prices tanked. Simultaneously, a huge hydroelectric project was started in Labrador that has turned into a monstrous boondoggle.

Atlantic Canada's economy is primarily resource based - farming, fishing, forestry mining, etc. Somewhat similar to the Appalachian states, in that regard. Although there are pockets of high tech, they're small. Our major export is actually people. Learned people. Nova Scotia - with a population of less than a million - has 10 universities. Newfoundland has a population of less than a half million and has one university - but it's the largest one east of Montreal. Also like Appalachia, Atlantic Canadians serve in the military in numbers well out of proportion to our percentage of the national population. Alberta is rich because they are like Texas, in that they've had a huge oil industry for decades. So, the happy accident of living on top of lots of prehistoric plants and animals has made them rich. And, guess where a significant proportion of oil industry workers come from. So, our populations are steadily shrinking, which doesn't help.

Two of Canada's largest banks were founded in Halifax - The Bank of Nova Scotia (of course) and The Royal Bank of Canada. Due to the vagaries of business and physical proximity to markets, they moved their head offices to Montreal and Toronto, respectively, a century ago. Who knows? If they had stayed put, Halifax might be the major financial hub in Canada, instead of Toronto.

All that said, I only see a tangential relationship between NS's GDP and the topic of discussion.

 

[Trell]

...
I'm certainly not going to claim that Canada is a "better" country, but we do have, on average, three more years of life span to think about it...

Some posters in this thread seems to have a real hard time accepting that the US more than double health care costs (as % of GDP) is not commensurate with the health outcome in the general population when compared to other advanced countries. I intended to not reply any further on this topic in this thread, until I saw your post and could not resist

 

[Trell]

Yes, I'm aware of that, thank-you. I was actually born and raised in Newfoundland, which is in even worse shape. Back in the 1990's, it was all rosy in Newfoundland.

This reminds me of a course I took decades ago in anthropology, given by the author himself:

Cato Wadel: Now, Whose Fault is That? The Struggle for Self-Esteem in the Face of Chronic Unemployment

"This book is about the problems faced by able-bodied men who are forced to live off public welfare, or "on the dole." Based on the author's daily interactions with a hundred unemployed men in one Newfoundland village, this sensitive probe takes on a narrative form centered on one man and his family, and his struggle to maintain their self-esteem in the community. For, to be excused for being unemployed, a man must constantly show his desire to work.

ISERBooks. Softcover. Published in 1973. 150 pages. ISBN 0-919666-05-1. "

I remember him as an excellent lecturer.

 

[highfigh]

People are generally supportive of other people spending money.

And spending other peoples' money. They feel nothing- it's not theirs. Most of the time, the questions about paying for higher costs start with "Well, can't you just...?".

 

[highfigh]

Some posters in this thread seems to have a real hard time accepting that the US more than double health care costs (as % of GDP) is not commensurate with the health outcome in the general population when compared to other advanced countries. I intended to not reply any further on this topic in this thread, until I saw your post and could not resist

We have a huge percentage of the US population that are hooked on drugs and they aren't necessarily gainfully employed, nor do they have insurance, get regular checkups and they certainly skew the results of any studies. I watched a TV show that, with whatever slant it has, showed that Portland, Oregon's heroin addicts are 94% White. They talked to dealers, showed drug busts where 20+ pounds of Meth was seized, along with large sums of cash, weapons and they rode in cars driven by addicts, with other addicts who were looking for a fix.

The link shows that the US has more than 20 million addicts, excluding tobacco and other links show that they cost more than $750B in annual medical treatment.

https://www.addictioncenter.com/addiction/addiction-statistics/

If the addicts could be excluded from the stats, I'm sure the US could be a much more affordable place for medical care.

In the '70s, England had a huge number of able-bodied people 'on the dole', receiving ~70% of their working wages. At the same time, musicians like the Beatles, Led Zepplin, Rolling Stones, Bowie and others left the country because the income tax was so high. The Stones' 'Exile On Main Street' was recorded in France during this time.

At this point, the US is looking for people to fill job openings. Many are in skilled trades because the 2008 economy caused so many to become unemployed, but also because people aged out of the work force, went into other fields or started their own companies, so they no longer show up in the unemployment data. Now, it's hard to fill the new openings because of a tremendous lack of people who have the training, desire to work with their hands and poor work ethic.

 

[highfigh]

I'm under no illusion that it wouldn't be difficult. Impossible? With everything the US has accomplished over the past couple of centuries, I find it hard to believe that it's impossible. Of course, it would require some unity and agreement in the direction you want to go. That's sorely lacking right now and you aren't alone in that. There elements of discord all across the western world, to varying degrees.

WRT to getting things done, you may be forgetting about the US Millennials & GenZ crowd- they're against things that were popular, done, accepted or learned in the past.

 

[Irvrobinson]

Some posters in this thread seems to have a real hard time accepting that the US more than double health care costs (as % of GDP) is not commensurate with the health outcome in the general population when compared to other advanced countries. I intended to not reply any further on this topic in this thread, until I saw your post and could not resist

I don't have a difficult time accepting that. I'm just not willing to accept the massive increase in government spending - and the reduction in benefits for those in private plans - to achieve Medicare for All. I think you are unwilling to accept that the pricing policies that work for countries with 5-20 million people are probably not achievable for countries with well over 300 million people.

 

[GrimSurfer]

All that said, I only see a tangential relationship between NS's GDP and the topic of discussion.

It's not tangential in the least. You said:

As in another aspect of life, it's not how much you spend (or are endowed with),it's what you do with it...

You've been dismissive of the problems of size, and quite critical of quality of life issues in the US. Fair enough -- except you have difficulty facing the very real problems of your birth province and home province.

So your argument that it isn't what you have but what you do with it doesn't bode well for Nova Scotia does it? After all, it was home to most of Canada's wealth in the 1800s and founding province of two of Canada's major banks.

Yet it all slipped away. Perhaps it was bad luck. Or perhaps it was the province's history of electing left leaning governments with a taste for deficit spending, pork barrelling, and the "dole" (if I get that regionalism right).

Now all of this would matter for naught if we were talking broadly about where the world is today, but you turned it into a dissertation on liberalism and the failures of the US.

Perhaps it would be better to discuss the issues of how we all got here than to make this an issue of comparative politics. 'Cause your arguments have serious gaps... probably because you have a narrow view of the broader issue of the shortfalls of liberalism now playing out in Canada, Germany, UK, and other places.

I say this as a PBS watching, NPR listening, social liberal retiree... in case you incorrectly assume I'm a MAGA hat wearing, gun totin' 'Merican... which I'm not.

 

[Trell]

I don't have a difficult time accepting that.

That is great.

I'm just not willing to accept the massive increase in government spending - and the reduction in benefits for those in private plans - to achieve Medicare for All.

This is what you believe, but personally, I think you are wrong. We all have opinions, though, and that is what it should be, and I just mark it down as political differences.

I think you are unwilling to accept that the pricing policies that work for countries with 5-20 million people are probably not achievable for countries with well over 300 million people.

Now we enter the realm of specious arguments that somehow USA is so exceptional that somehow science does not work to evaluate US health care in comparison to other countries. I clearly disagree with this view, and to be honest, I think it is intellectually indefensible.

 

[GrimSurfer]

Now we enter the realm of specious arguments that somehow USA is so exceptional that somehow science does not work to evaluate US health care in comparison to other countries. I clearly disagree with this view, and to be honest, I think it is intellectually indefensible.

I'm probably the last guy who would normally come to Irv's defense, but that's not what he said or implied.

Nobody is saying the US is exceptional. What Irv is saying is that the complexity of scale can affect costs and outcomes. So comparing the US system to countries 1/10th its population assumes that costs and efficiencies are scaleable.

This is nonsense, as it overlooks the challenges and opportunities of administering support by totally different governance systems to a populace whose demographics are significantly different.