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Re:No One Goes There Anymore by code_duck on Saturday May 16, 2020 @09:49PM (#23208778)
As someone else with serious medical problems which have been paid for by public health systems, the financial difficulties of which are compounded by losing your ability to pay once ill, thanks! I would note though, for the purposes of fairness, it's a small percentage of your taxes that go to paying for such programs versus things like the military and interest on debt.
Re:No One Goes There Anymore by lotsofpulp on Saturday May 16, 2020 @10:07PM (#23208866)
US government healthcare spend is huge, it is not tiny compared to military. $1.1T according to this source in fiscal year 2018:

https://www.taxpolicycenter.org/briefing-book/how-much-does-...

This website states in 2018, the federal government spent $582B on Medicare, and $389B on Medicaid, plus all the tax exemption for employer sponsored health insurance and ACA subsidies to individual buyers, etc.

https://www.thebalance.com/fy-2018-trump-federal-budget-requ...

Defense and Homeland Security was only ~$630B or so.

Re:No One Goes There Anymore by Retric on Sunday May 17, 2020 @06:16AM (#23210978)
That 630B ish is figure is more spin than reality. Excluding say the coast guard is reasonable if you’re talking offensive military capacity but “Defense” should reasonably include CIA, NSA, border security, and anti terrorism expenditures etc. Further, related pensions and VA benefits are clearly part of the overall defense budget.

Exact interest on past military spending is arguable, but those bills still need to be paid.

PS: US healthcare expenditures is similarly a complex topic. Do you include the heath insurance costs of government contractors etc?

Re:No One Goes There Anymore by lotsofpulp on Sunday May 17, 2020 @09:15AM (#23211749)
No matter how you cut, a very large portion of taxes paid goes towards healthcare. 30% for social security, 30% minimum for healthcare. Military and interest costs therefore are clearly not the bigger portions of spending.

https://www.thebalance.com/u-s-federal-budget-breakdown-3305...

> The government expects to spend $4.829 trillion in 2021.1 Almost 60% of that pays for mandated benefits such as Social Security, Medicare, and Medicaid.

> Social Security will be the biggest expense, budgeted at $1.151 trillion. It's followed by Medicare at $722 billion and Medicaid at $448 billion.

Re:No One Goes There Anymore by Retric on Sunday May 17, 2020 @10:21AM (#23212184)
Overall I agree, but I am pointing out how numbers are framed is really important. For example this puts Defense spending at 1T and heathcare at 1.7T, while leaving out several categories of both. https://www.usgovernmentspending.com/year_spending_2020USbn_...

I am not saying any specific number is correct, but that 1T figure excludes military pensions and heath care excludes related research spending. Neither includes any debt payments from past spending or projections of future obligations. In the end it is actually possible to construct a number for each where federal defense spending is greater than federal healthcare spending, but again I don’t agree with such categorizations.

PS: This gets back to the oldest trick in “cutting“ spending, define a portion as something else. Similarly, define a category of taxes as “income taxes“ so you can exclude payroll taxes when talking about them.

Re:No One Goes There Anymore by ccktlmazeltov on Saturday May 16, 2020 @10:33PM (#23209010)
That's because of private healthcare that prevent them from properly negotiating prices. If universal healthcare was a thing these costs would be much lower.
Re:No One Goes There Anymore by tankenmate on Sunday May 17, 2020 @06:44AM (#23211077)
It's not just that, the Medicare Prescription Drug, Improvement and Modernisation Act bars Medicare from negotiating drug prices.
Re:No One Goes There Anymore by AdrianB1 on Sunday May 17, 2020 @05:32AM (#23210814)
How is that?
Re:No One Goes There Anymore by QuixoticQuibit on Sunday May 17, 2020 @05:38AM (#23210843)
Nation-sized leverage. The same reason why equivalent pharmaceuticals are cheaper elsewhere in the world.
Re:No One Goes There Anymore by barry-cotter on Sunday May 17, 2020 @05:49AM (#23210881)
Quite. That’s why the US pays for more pharmaceutical and medical device R&D than anyone else. The US is where every pharmaceutical company makes the profits that incentivize further drug development.
Re:No One Goes There Anymore by philjohn on Sunday May 17, 2020 @08:04AM (#23211398)
Or, in the case of Valeant Pharmaceuticals they just jacked the prices up after buying smaller drug companies and getting rid of all the R&D teams ... that doesn't seem to have incentivized further drug development by them, did it?
Re:No One Goes There Anymore by zaphar on Sunday May 17, 2020 @10:22AM (#23212186)
You are speaking of a specific anecdotal experience and he is talking about the industry in aggregate. Neither of you are invalidating the other's point.

The actual facts are in support of the posters point: https://www.abpi.org.uk/facts-and-figures/science-and-innova...

But your example is a real occurrence of abuse under the US system.

Re:No One Goes There Anymore by jfnixon on Sunday May 17, 2020 @08:45AM (#23211580)
Nation-sized leverage? Piffle. Pass a law that Big Pharma can't price higher in the US than the lowest price negotiated elsewhere. Boom, problem solved.
Re:No One Goes There Anymore by tobylane on Sunday May 17, 2020 @10:40AM (#23212330)
From 2003 to maybe 2019 Medicare was explicitly forbidden from negotiating drug prices. Second bullet point in this https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Im...

The first world has successfully encouraged the drug makers to sell their product cheaper in the third world. If you look on wikipedia drug articles you'll see the price for the generic in the developed and developing world.

Re:No One Goes There Anymore by code_duck on Sunday May 17, 2020 @10:11PM (#23217482)
That's the problem... The political conditions that preclude passage of such a law.
Re:No One Goes There Anymore by shoo on Saturday May 16, 2020 @11:33PM (#23209360)
To add contrast, australia spends 32b on defence, 36b on education, 82b on health, 180b on social security & welfare, out of ~500b total government spend.

https://mobile.abc.net.au/news/2019-04-03/federal-budget-201...

Re:No One Goes There Anymore by treeman79 on Saturday May 16, 2020 @11:40PM (#23209392)
My issues have been insanely expensive to figure out. But treatment has been very cheap now that I know the issues and what pills work.

Main problem was being dismissed for 3 years and doctors not taking to each other.

I can see what people start going to alternative medicine.

One of the treatment options is a specialized diet. So all the crazy diet people are actually circling around valid treatment options.

Health care can be done cheaper. But when a doctor has 5 minutes, there is only so much that can be done.

Re:No One Goes There Anymore by john-radio on Sunday May 17, 2020 @11:31AM (#23212644)
You're assuming they're talking about America, but you're probably not talking to Americans, because:

> if something were to happen to me or my fellow citizen, at least there wouldn't be millions of dollars in hospital bills to pay back and there would be aid for a home to avoid ending up on the streets

Not trying to be an asshole, but that's not a description of the American system.

Re:No One Goes There Anymore by code_duck on Sunday May 17, 2020 @03:58PM (#23214871)
It depends on your financial situation and what state you live in. Most of the places I’ve lived, such as Minnesota or Oregon, do have systems for emergency medical assistance. They also currently have great insurance for people who truly can’t afford it. People in middle income ranges are the worst off, though.

Personally, I was just hospitalized with a bout of diabetic ketoacidosis, probably just a day away from going into a coma. I haven’t even had to see a bill. It was 100% paid by the state and federal programs.

If I hadn’t set up insurance before going to the doctor, though, I’d have received ridiculously high bills, probably been provided less service, and it would be up to me to get it paid back. I had a situation before where I went to the ER while an insurance application was pending, and then after it was approved and I provided my info, the private hospital dilly dallied and sent it to collections anyway.

Re:No One Goes There Anymore by dragonwriter on Sunday May 17, 2020 @02:06PM (#23213838)
> I would note though, for the purposes of fairness, it's a small percentage of your taxes that go to paying for such programs versus things like the military and interest on debt.

No, its not. US public healthcare spending (which in most states is the lion’s share of public welfare spending, and is also on the US is more than defense spending and is, in fact, pretty typical as a share of GDP, high as a share of taxes (because of the light US tax burden), and enormous per capita compared to other industrialized nations. Its small as a share of total national healthcare spending compared to other countries, because we have to even more private spending on top of it, and the whole healthcare system (or, rather, the literally hundreds of mutually-interfering public and private healthcare systems) is the single most inefficient healthcare delivery system in the world, but we spend plenty of money on it, just not well.