The way that the US is spending money (e.g. building a 1.5tn fighter jet that can hardly fight and a 35bn aircraft carrier that can't launch) I would actually start getting worried about adversaries with just a tenth of the US budget.

To put it differently, if the Swiss, population 8M, can figure out how to transport 1.8x the amount of rail passengers compared to the entire US (no, not by capita, in absolute numbers [1]), it could also happen that a smaller budget military outmaneuvers US army, navy and marines. That being said, conventional armies made for symmetric warfare seem just about as useless now as at the height of the cold war. But not even the security of the nuclear arsenal seems a high priority in US politics today.

[1] https://en.m.wikipedia.org/wiki/List_of_countries_by_rail_us...

Your arguments rest on irrational statements.

The US isn't spending $1.5 trillion on the F35. First, the costs will be spread over decades; second, the US will never order even half the planes in question; it never does when it comes to large systems orders. In 10-15 years they'll be slashing the buying down toward zero as with the F22 (as the military chomps at the bit to move on to new programs), the F35 program will cost half as much as claimed presently, as most of the cost projections are based on maintenance costs over 30 years for thousands of planes that will never be purchased (we're going to buy thousands of F35s over decades? yeah right).

That aircraft carrier will launch. Every country that has ever built one has had significant problems doing so, the US has a long successful history of building & deploying aircraft carriers, the latest one will be no different regardless of temporary problems.

You aren't reading favourably. It could well be that the whole stealth superiority fighter concept is outdated due to new cheap sensor technology (and its use in AA defense systems) and the whole concept of carrier groups could soon be outdated due to something new, like undetectable diesel/electric submarine drones that cost a 3 orders of magnitude less, thus could be built as swarms that become impossible to deal with. My main point is, don't just look at the spending. And (I think your comment is symptomatic), don't forget the damn nukes, those things should be the biggest worry of all.

Well I do think the F35 and carrier approach is very soon to be outdated. Which is also why there's zero chance we're going to order thousands of F35s; 10 years out, they'll already be wanting to kill that program to replace it with something else as the obvious inbound threats to traditional fighters (various cheap autonomous tech) become more blatant. That of course won't stop them from spending as you know.

The carriers are not hard to sink; they never really have been for a major opponent. China and Russia have been able to sink them for a long time. They're not for fighting adversaries that can sink them. They're force projection, intimidation, and for fighting countries that aren't Russia or China. Carriers will be useful in their present role for a few decades to come yet (their current role is not for potentially fighting Russia or China; anyone that thinks that is seriously confused). Military tier nations in the capability realm of Iran, might pose a real threat to carriers in 15-20 years. The trick with US carriers, is that anyone (again, not named Russia or China) that actually sinks one has a full scale war with the US on their hands. In that sense, carriers are a taunting device: you can try to sink one, but if you succeed, your country is going to be massively attacked (you're going to trade sinking a carrier for losing all your airports, your power grid is going to be taken down, your airforce is going to be neutralized, your economy is going to grind to a halt, etc).

Any country that will dear to sink an US aircraft carrier will either have the means to wipe out most of US population too (Russia, China) or just won't care about the consequences (North Korea / Iran, if they think US is about to attack them). In neither case is taunting particularly efficient.

Switzerland: 15,940 mi²

Texas: 268,597 mi²

U.S.: 3,797,000 mi²

US has about the same population density as Switzerland in multiple areas that are at least as large: LA, Bay area and especially Philadelphia-DC-NYC-Boston.

So.. how does size exactly stop the US from having the to-date most efficient mass transport? I'm not talking LA-NYC, noone is gonna do that until someone builds vacuum tubes. First you need good local and regional travel.

Switzerland also has to build tunnels, because of the Alps. I am not an expert on US geography, but there seem to be places with many people and much easier terrain to build rails on.

How many trips cross Texas or the US? How many trips happen within a couple hundred miles of major urban centers?

As an example of how low it is, Russia's GDP is barely more than Australia's and is below Canada's. How the mighty have fallen.

It was never large to begin with. USSR thought that Russians don't need money and then Putin thinks exactly the same.

> A Russian spent dollar probably gives more bang for the buck, but US military spending is still very high.

You of course didn't support that claim at all. Most US military spending goes to soldier-related costs. How do you propose to slash that given how dramatically higher the US median wage is compared to Russia? Other than of course to perhaps cut the number of US soldiers in half.

> The single-pay system can be made to work. Others make it work, and a lot cheaper

Of course it can work. It can't work with US costs what they are. You need to go tell US nurses they have to take a 1/3 pay cut, to match up with what nurses in France and Germany are making. Then you need to go tell radiologists that they have to take a 70% pay cut to match up with French radiologists. Then you have to go tell pharma they're getting a 2/3 cut. Then you have to tell average hospital workers they're getting a 20% pay cut. Then you have to close 1/3 of all hospitals. Then you have to substantially expand wait times to match eg Canada, aka rationing the care. Then you have to tell hospital admin they're getting a 50% cut in their budget. Then you have to fire 500,000 people that are employed directly or indirectly in the health insurance industry. Then you have to slash the payouts for all sorts of highway robbery prices in medtech / devices / supplies related to the healthcare industry, which will can hundreds of thousands of more employees. You have to successfully adjust all of that, lower the costs, then figure out how to create new economic growth with the cost savings to re-employ all those lost jobs, wages, taxes (all that lost income tax, which will shoot a hole in the side of social security & medicare/medicaid).

IE you have to find a trillion dollars in savings across dozens of economic segments. Which is another way of saying: a lot of people are going to lose a lot of jobs and income. It's an extraordinarily complicated and expensive problem to resolve without rattling the entire economy to its core.

Oh yeah, then you have to dramatically raise taxes on the US middle class (which pays very little in taxes vs most developed nations) to match up with what countries with single payer systems do; and explain to the middle class that they're going to be better off with socialized healthcare, and that the increased taxes will be off-set by the government healthcare vs the old private insurance approach. Then you also have to significantly raise taxes on the top 25%, which pay most of the taxes in the US.

No problem eh.

I'd suggest not to use the model of centralistic and rather socialistic nations like France as a model for the US. Not that I don't like that model, I just don't think it's a good fit. Instead look at Switzerland for example. Leaving foreign politics away it almost seems like a shrunken down version of the US, both politically and economically, with just a few major differences:

* even more locally organised. County sized administrations have about the same independence as US states.

* instead of spending our (similar) tax rates on the military, it is spent on superb health care (imagine a souped up version of Obamacare with regulated prices), schools and a social net. Look at the numbers though - I think it works, that is, innovation and the economy in general are strong thanks to a more stable middle class (that doesn't experience negative social mobility due to health care problems and overpaid schools plus gets an influx from people at the poor end that make it by means of a helping hand at child age).

* and no, I would argue Switzerland is not significantly less diverse with about 30% immigrant population. We have about the same proportion of backwards rightwing pseudo conservatives as a counterreaction, but they are bound to a political system that makes getting absolute majorities in the parliament near impossible (and also relatively useless alone thanks to referendums that serve as a moderation tool). See also again the difference in how middle class is kept going, which makes a Populist power grab much less likely.

We could redirect 50% of our military spending to single payer and it would not even remotely fix our problems. That amount of money would make single payer work in just California (ie 10% of the nation). We probably need to be spending $200+ billion more just on our existing medicare + medicaid + VA health systems as it is. People that keep saying things like that about military spending, don't seem to understand that the biggest problem the US has, is for single payer to work millions of Americans are going to have to lose big time, to the tune of a trillion dollar cut affecting millions of incomes & jobs that feed off the system bloat. You either need to come up with trillions of dollars in new funding to do single payer, or you need to tell millions of Americans they're going to be fired and or take big pay cuts (plausibly both).

I agree, there are better systems than France. My only reference to France, is about competitive salaries in the healthcare industry. Wages in that industry have to come down by a lot to match comparables in eg France, Germany, UK.

When people talk about single payer re the US, they focus on drug prices and insurance industry costs. They ignore that essentially every cost in the US system is inflated, including routine labor and dozens of side connected feeder industries (everything from saline supply to the cost of hospital beds to labor costs in elderly care). Most of the cost bloat in the system is made up of salaries for workers such as nurses, doctors, hospital workers, admin and health insurance employees. You could slash pharma costs nearly in half in the US and only save ~$150 billion of the $1 trillion we have to cut out of our costs to get cost competitive again. Every one of these cuts will have substantial economic consequences; cut pharma in half, lose a million high paying jobs directly & indirectly that support the tax base that pays for the single payer system (ie you have to figure out how to replace that; which would occur, but it'd take lots of time).

That said, the way the US is actually going to go, is we're going to do a slow mediocre drift into single payer, through gradual expansion as the existing convoluted system fails one tier after another (essentially failing up the economic chain; the middle class will gradually all be pulled into government healthcare by necessity as the system collapses). Maybe out of desperation they'll use medicare as the platform, since the politicians in Washington DC can never agree on anything it's most likely our result will be to use something that already exists and just enlarge it.

US government spends more per person on heathcare than Canada. So, we could use their system for essentially zero extra cost per year post transition. The difference is US heathcare makes people rich, where US social security for example does not. This waste does not translate to better care just vastly more waste.

The VA hospital system is a US example demonstrating vastly lower costs with similar outcomes. Scale that to say all of Medicare + all government workers and costs drop enough to cover vastly more people. Now add in other programs like the Ryan White AIDS program which covers ~300,000 people with very high cost care and the supliments to Rural heathcare systems etc and heathcare would look very different and cheaper.

> US government spends more per person on heathcare than Canada. So, we could use their system for essentially zero extra cost per year post transition.

I've made that point numerous times in this thread. I think you're missing my point: the US has to slash a trillion dollars in expenses out of its system. That trillion dollars consists of jobs & people's income & tax base loss. It is not a zero cost transition, it's a massive cost transition. You're talking about it as though it would occur in a vacuum, it would not.

The VA system is not an example of lower costs. You're wrong, it's more expensive than both the private sector and medicare:

http://dailycaller.com/2014/06/02/report-va-health-care-has-...

Your comparing heathcare spending while ignoring age differences making that analysis meaningless. 4 to 40 year olds don't spend much on healthcare. Veterans are by definition old.

Further the UA is often covering the most expensive care such as hip replacements, the fact that it's a lower percentage of costs is a result of efficiency of the VA and waste in the rest of the system.

As to lowering costs, economically spending money on heathcare billing vs Rail is only different because Rail provides long term value. As long as total spending is unchanged there is no reason to suspect economic harm.

The VA system is only representing 1/3 of actual healthcare costs that vets are actually costing. That figure is then intentionally abused to represent that the VA system is less expensive. It's propaganda, nothing more.

> As long as total spending is unchanged there is no reason to suspect economic harm.

You mean other than the vast dislocation that health industry labor - and two dozen other industries reliant on that spending - would suffer? People taking pay cuts in healthcare, workers losing jobs in pharma & health insurance by the hundreds of thousands (high paying jobs at that). Your premise would only actually work that way in a simulation (and it'd be a really bad simulation, not accounting for anything in the real world), not in reality. In reality, there is dramatic economic friction that occurs when you fire someone and they have to retrain / find a new job, or when you cut their pay to bring costs in line. There are immense short-term and long-term costs to that upheaval, in reality. Such costs include: unemployment costs, job training, long-term unemployment costs, welfare benefit costs, tax base loss until jobs & incomes are recovered. The US economy is growing very slow, where's the evidence it can absorb such losses and then create a million new high paying jobs (simultaneously while automation is about to bear down on just about every category of employment)?

Your falling hard for the broken window fallacy. Transition need not be over a weekend, and the net gains from increased efficiency more than cover transition costs over time.

If the VA spent 1/2 as much money and covered 1/6 of the costs while provoviding the same benefit that would be a good thing. This analysis ignores survives provided because the only way to make them look bad is to pretend spending more money is somehow a good thing.

Again, broaden your view a bit. Switzerland has a very similar health care system with a similar cost structure and a similarly strong pharmaceutical lobby - just vastly better outcomes.