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Check the obesity rates in America relative to other countries…probably not the sole reason for the change in the 80’s, but it no doubt contributed.
Not that you actually care to have an honest discussion, but every time that line takes a turn to the right it correlates with some big brained government intervention that added all kinds of administrative bloat. It also conveniently starts only after Medicare became a thing.
https://amomentinhealth.substack.com/p/doctors-administrators-and-healthcare
As far as the government goes, the inefficiency is a feature, not a bug. Inefficient by design and that inefficiency is dealt with by adding more people to do things in inefficient ways. Nobody with the power to make things more efficient has any incentive to do it. Who's volunteering to have their budget cut? I can and do see twice as many patients in the same amount of time when working anywhere else besides the VA. Me and every doc there could tell you easy fixes to many of the problems, but again, we've been totally cut out of the decision making process.
Things like DOGE and just slashing budgets doesn't help because the processes remain inefficient and the incentives haven't changed for the decision makers, so the people who are left to do the work just get burned out working at capacity and not being able to keep their head above water. When it gets bad enough, the budget comes back, rinse and repeat....
And as broken as that system is, for me it's still preferable to working in a for profit setup where the incentives are even more screwed up. The government at the end of the day still wants me to take care of patients even if they make it incredibly hard to do it. The private sector doesn't even pretend to care, they just want me to document everything properly so they can max bill for every encounter. Whether the patient gets better or not is irrelevant.
And once again, if me and a bunch of other doctors decided we wanted to step out and do it our way and fix all this, we can't, it's illegal, because the admins and their lobbyists convinced everyone that we're the bad guys that can't be trusted with any vested financial interest, while the MBAs and MHAs who never have to look a patient in the eye can be trusted to do the right thing.
Self employed here. No health insurance either. Why not? Because I'm not gonna spend $9k-$12k in premiums only to be told I have to pay $3k-$7k out of pocket before they'll pay a dime.
I go to the doctor once a year, get blood work once a year, and the meds I take cost me about $200 every 3 months. I basically spend $1200 a year on health care. It just doesn't make financial sense for me to buy insurance....
That's right where I was. Even with 2 hernia surgeries, throat cancer and a really fucked up back, I ended up paying about half of what I would have with Insurance. Now I am forced to pay for Medicare. These "college educated" morons that call for medicare for all, don't realize that I pay for that. I could go on a real stem winder about how they made my back issues worse because of medicare, but the dim witted brats will not hear of it. Once they find out that 1. You have to pay for it and 2. Senator Horseshit gets to decide what treatment you're going to get. They're going to blow an o-ring when that shit hits em in the face.
I almost hope they get what they are asking for.
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Other countries on that chart have their own version of "medicare", none of them are perfect.
The lobbyists, with their vested financial interests, have corrupted what can be a good system, into something that enriches their backers. There are lobbyist in other countries, but they don't seem to have the same influence over policy decisions in those countries.
A handful of years ago I was at Midwest Ear Nose Throat for sinus issues. There was a procedure they’d do right in the office. I asked about paying for it without insurance. That was going to cost $3,000 per nostril. With insurance it would be my $25 copay. If I’m willing to pay out of pocket for the procedure instead of them filing with insurance and fucking around shouldn’t my cost be lower? I’m literally asking to not have the extra administrative costs.
*Remove wealth from lower/middle class
I can't speak to that particular event but that was not my experience. I am feeling like we are hijacking the thread. These issues have been covered many times on here.
We're spending wayyyyyy to much money
Biden's fault.
National debt per capita is 119,000.
$16,000 per citizen alone in interest payments.
but yea let’s hand out corporate tax breaks and loop holes and shoulder more of the load onto the American people.
Thanks baby boomers you’ve had control of the country for 40 years and have driven us off a cliff.
So you think the deficit problem is a because there isn't enough revenue?
Right now the payments on interest on the debt is the second biggest expenditure behind social security. My fear in the future is seeing cuts to medicare and social security citing interest payments as the primary reason. So tax cuts for the wealthy and corporations ends up screwing the middle and lower class yet again.
The debt is projected to be near 100% of GDP by 2028 and 50 trillion by 2034.
I think it’s overly simplistic to say it’s all one or all the other. When expenditures are double what’s coming in it’s a multitude of things. But for sure we need to increase revenue and scrutinize what we are spending on.
The first places I would look is government bailouts and corporate tax exemptions. People build businesses here because it’s a great place to live. Not the other way around.
Eagle mountain Utah gave meta a 20 year tax exemption for the data center being built there. Guess what that just resulted in? A 183% increase in residents property taxes. This is the kind of shit that is ruining us. We’ve deified corporations in this country.
$104bn- Interest
$141bn- Social Security
$55bn- Veterans Services
$174bn- Medicare
$474 billion without including any discretionary spending including defense.
What do you suggest we axe out of the above expenditures?
I vote for hindsight budgets, so last year's revenue plus no more than 1% is this year's budget. And if there's debt, then at least 10% of that goes towards debt until it's paid in full. Revenue in 2025 was about $5.2 trillion with spending at about $7 trillion. Entitlements were at $4.2 trillion and everything else defense, education, infrastructure, interest, etc at about $2.8 trillion, so my painful preference would be about a 15% reduction to entitlements and 40% to everything else.
It would trigger a depression that would cause a downward snowball effect of decreasing revenue that leads to less spending that would lead to job losses and it would probably last a decade before it started to stabilize, then would very slowly build at a more controlled pace. It'd be a 20 year event and a lot of people would die, but unfortunately significant pain is the only true educator of the extra-dumb and that's who we've become.
Pit Row
"It'd be a 20 year event and a lot of people would die"
That's putting it mildly. If we try to fix the deficit with only looking at spending, we would no longer have a military to protect us once we ditch their benefits and pay. All those enemies we made along the way would circle us like vultures. Our entire elderly and poor population would be decimated with no healthcare. They would flood the ER's and it would bankrupt the healthcare system. Hyperinflation would occur and our currency would go the way of the sovereign bolivar. The depression you speak of would be far beyond imagining.
The USA and the current world order would no longer exist if that happened. I know I'm sounding hyperbolic, but at least we can all sleep well at night knowing our oligarchs got their tax breaks.
Your budget wouldn’t even keep up with inflation.
I definitely do not agree on the military part and it reads like silly fear mongering. We'd still have a robust military when going from a $940 billion budget to a $564 billion budget. It would still be more than Russia and China combined. We would be just fine. It's the same thing when we hear about the mass exodus of California, but then come to find out it's 1% and everything is the same, or like how we hear that social security is bankrupt and runs out of money, then come to find that actually there's still plenty of revenue coming in, we'd just need to take a 22% pay cut. That will kill people too, but it's still just 22% and they could work on that by creating a bell curve on payouts so that millionaires see a reduction.
But regardless, if you can't live within your means, then it's just fighting an unstoppable hourglass. That hardship is coming no matter what and it only gets harder the more time goes by. You won't be able to convince me that continuing to wait is ever going to be the better choice, because that's what we've been going for forty years and it's only been getting worse and worse and worse. All you'd be doing is appealing to my fear and trying to elicit an irrational decision, which isn't going to happen and nothing good comes from it.
inflation is a scam, but if we must indulge in it, then we can true up every decade or whatever. It's an easy one to address.
Though I agree with you that giving corporations tax breaks is stupid...it's evidence of cities/municipalities competing for the economic growth. But I would have to ask how does eagle mountain (or any other city, county, or state) residents property taxes have anything to do with the FEDERAL deficit?
Of those? Probably Veterans Services...Americans have paid into SS and Medicare their entire lives, and they deserve to get their money back...so the cuts are going to have to come from every other federal government department and agency (including defense)...start cutting spending...drastically. It's going to hurt, everyone will feel it...but that pain will be nothing compared to what we will feel if nothing changes. I'd say start with mandatory 25% cuts this year, then increase it another 25% over the next five years...reduce spending by 50% over the next 5 years...
We are among the wealthiest countries in the world (if not the wealthiest)...that fact that we can't live within our means and are spending double our revenue isn't a revenue problem, so more revenue won't fix it. the only thing that will fix it is to reduce spending DRASTICALLY.
I had a client that was W2'd just under $2M/year...and he was nearly $600K in debt (not including his $1.2M mortgage), and was increasing his credit card balances every month because he was spending more than he was making...Does that guy have a spending problem or an income problem? Spending...if someone can't live off of $2M/year, then they have a spending problem. That is the federal government at this point...if we can't function off off a half trillion in revenue a month, we have a spending problem...no American should have to pay more of their money to a dysfunctional and irresponsible government.
Let's look at other things before we decide to not honor the commitment we made to our vets, like spending millions to train monkeys to play the price is right video game, maybe we could cut that kind of stuff first..
its just illustrative of the breaks large corporations get in this country simply because they are.
Yes its cities/ municipalities are competing. but it simply could just be illegal to give them the tax breaks, no? that kind of solves that easily. We are being exploited by these insanely large and powerful corporations that are buying city councils and selectmen throughout the country to do there bidding against the populous. We need to reign things in a little bit is really all I'm saying. It's pervasive at all levels of gov't, from state and local to Congress, corporate influence has grown too large and is often over ruling the will and wishes of the people. It's unAmerican.
Three things to know about the $40 trillion federal debt
https://www.npr.org/2026/08/20/nx-s1-5939473/40-trillion-federal-debt
That's just not how things work. Even the Cato Institute uses a 10 year plan to even approach a balanced budget. Your scenario begins the cuts on day 1. Nobody is silly enough to think that wouldn't completely collapse the country. You can't just remove 400 billion from a military budget overnight. That money goes to contracts that are already signed, food, lodging, medical care, maintenance etc. It would collapse under it's own weight and be a paper army within years.
Removing healthcare coverage for tens of millions through "cuts" would also be immediately catastrophic. At first ER's would be overrun by people with the sniffles who then wouldn't pay the bill (sound familiar?). Then costs for private insurance would become even more unaffordable to cover those losses. The system would break down within years.
I'm not saying there;s not a problem, just that your solution would be catastrophic.
I agree regarding SS and Medicare. Those are "self funded" and shouldn't be touched.
Regarding the solution, the biggest problem with our spending comes down to healthcare in my opinion. Many of the expenses are related to our incredibly inefficient system enriching insurance and other leaches in our "private" healthcare system. Medicare, Medicaid, Veterans Services, Health etc are all significantly inflated due to everyone in our system getting their little piece of the pie without adding any real value.
Yeah I just completely disagree with the language being used, "catastrophic", "no longer have a military to protect us", "entire elderly and poor population would be decimated with no healthcare", "bankrupts the healthcare system".....I don't agree with any of that, which is why I gave the examples of the "MASS EXODUS OF CALIFORNIA!!" and "SOCIAL SECURITY IS BANKRUPT!!!" all of that stuff is a scare tactic that causes everyone to freeze and just keep doing what we're doing. In changeless language.
The reason why things would be serious be literally because we pee'd when we've heard that same hyperbole going back decades, and it's because we listened to those scare tactics that things are worse today than yesterday, and if we keep listening, they will be worse tomorrow than they are today.
And, feel free to taper over a ten year plan, I don't care. We'll be over $50 trillion in debt by then and we'd also gambling with nobody changing course over those ten years, which they would the moment there was any suffering and then the fear mongering about a total collapse and china picking over our dead carcass would easily get everyone to jump on board and the spending train would continue. But, we're nowhere near being emotionally prepared for a reconciliation of either a fast or slow method, so it's all pointless. Someday it will happen when we have no choice in the matter and it will be even worse by then.
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