—- As someone that has been in healthcare for 12 years it’s broken because of the corporate structure and administrative state of companies. The payors and providers share the same incentive to raise rates because they each collect a percentage of premiums. This is a solved problem in every OCED country in the world except here. RFK isn’t going to fix this, he hasn’t even labeled the problem correctly. He has some ok ideas around nutrition but the rest of his ideas range from futile to dangerous.

—- Corporate tax contributions aren’t at fair levels the national debt is increasing even while spending isn’t. They get access to markets created by society and government and yet as debts increase their ratio of tax payments is going down. The fair level would cover social service costs. I haven’t even gotten to the companies that receive subsidies or pay workers so little that they are in social support.

That would be scaling with population, not GDP.

> The payors and providers share the same incentive to raise rates because they each collect a percentage of premiums

This must be an oversimplification. Why would insurers ever reject a claim, or spend time negotiating lower rates, if they're only incentivized to see health costs increase?

Inflation. What paying workers costs. What is considered an “acceptable” level of poverty vs abject poverty as we get richer. New, expensive medical procedures. And as the world gets richer, defense gets more expensive.

We can’t pay 1930 salaries to workers, field a 1930s army, nor would we consider it humane for our elderly to end up with an impoverished 1930s standard of living with 1930s medical care.

Inflation is misleading for these purposes, too, because it includes hedonic adjustments. So a new better procedure or bigger apartment costing 40 pc more might only be 10 pc higher from an inflation point of view, even though you can’t really buy the old one.

Re: insurers— it is an oversimplification. Suffice it to say they are at scale where they have market power and thus don’t price where p=mc, and the regulatory pressures and price opacity push them even further away from efficiency. They are not completely insulated from costs or market pressures, but it’s fairly close.

GDP without qualification is 'real GDP', not 'nominal GDP', i.e it's already adjusted for inflation. I agree that costs need be adjusted for inflation

Nah.. I can't intuit what you are thinking or arguing. But I already addressed much more than you responded to. e.g.:

> > Inflation is misleading for these purposes, too, because it includes hedonic adjustments. So a new better procedure or bigger apartment costing 40 pc more might only be 10 pc higher from an inflation point of view, even though you can’t really buy the old one.

Educating kids the way we did in 1910 would certainly be cheap, but I don’t think anyone in the country is looking for that.

This is Baulmol's Cost Disease (https://en.wikipedia.org/wiki/Baumol_effect) in action, and it's something that advanced economies must take into account.

A barber today is not much more productive than a barber in 1900, but a haircut today costs much more than a haircut in 1900, even adjusted for goods inflation. Why is today's haircut evidently more expensive?

The answer lies in the labour supply. If haircuts didn't cost more today than in 1900, would-be barbers would work in goods-producing sectors that have seen real productivity growth and consequently 'naturally' improved wages.

In some sectors, this has led to the replacement of labour with capital. Domestic help was once hired by the ordinary middle class, but now we have kitchen and household appliances instead. We see fewer expensive hand-crafts and more factory-produced goods. Even fast food joints try to replace human service with ordering kiosks.

This replacement is much more difficult in the government sector, where transfer payments tend to relate to income rather than absolute provision of hard goods and where health-care and education are two of the sectors most affected by the Baulmol effect.

After the economic boom due to rising productivity, there weren't enough dirt poor people willing to work for peanuts, and today things like minimum wage and various benefits programs make it easier to not work for so little money a middle class family can easily afford it.

People would rather buy cheap factory goods than the more expensive hand made ones because they prefer to spend money on other things instead.

Google says the average barber haircut in 1900 for a man (women often did their hair at home) was 25 cents, which is just shy of $10 adjusted for inflation. Most places around me offer basic haircuts for $20.

In 1900, only the state of Minnesota had a requirement for barbers to be licensed (it was the first state to do so, in 1897). No beautician school requirement, no licensure payments, no state or federal income or sales taxes.

In short, it's surprising that the rise in cost of a haircut hasn't been higher.

I think there's something to Baulmol's theory, but there's a lot of hand waving that isn't really supported as well by the examples given here or elsewhere that I've seen. That, or the effect isn't all that it is claimed to be; it's almost tautological that as supply of workers for a low paying job dries up, the wages for the job have to go up to retain workers.

For reference, a visit to a family doctor is 30€, 28€ is reimbursed (you pay 2€ effectively)

It's not about poor areas. My city is middle-class AF and there's a 8€ barber there.

It's just that they have a list of exactly one haircut they apply to everybody, and a few more shaving styles.

Barbers are crazy priced (because hipsters and whatnot) and the typical chain (Jean Louis David) is 30€ or so.

That's precisely the Baulmol effect. When your next-best job is subsistence farming, being employed as domestic help is a step up. When your next-best job is (e.g.) something relatively well-paid in a factory or a phone exchange, being domestic help is no longer so attractive.

> That, or the effect isn't all that it is claimed to be; it's almost tautological that as supply of workers for a low paying job dries up, the wages for the job have to go up to retain workers.

I think we agree here. The mechanism of the Baulmol effect is pretty boring and pedestrian, but the outcome is surprising in aggregate. It's "why are we paying X times more for the same number of teachers?" and "why are there fewer tailors and more fast fashion?" and "why can't I find a handyman who won't refuse to fix something around my house because the job is 'too small'?" all wrapped up in one.

This implies that higher productivity gains result in higher wages, which is historically not the case. This explanation appears to only establish a weak correlation (productivity->wages) and stick to it where other factors like cost of living better explain even regional differences. Or what do i miss?

Unfortunately, MD compensation has more to do with a bottleneck in residency spots (post-medical school training), part of which may be artificially tight from lobbying efforts, but also there are real physical barriers to scaling up medical education. there are only so many operating rooms where a resident can be safely assigned and supervised.

However, I think there is a grain of truth to MD's perception of the Baulmol effect, just in the opposite direction. Despite claims of healthcare being privately-funded, about half of healthcare dollars in the US originate with a government agency of some form. This does not taking into account the fact that healthcare organizations don't pay taxes (501c3), get government-provided free labor (aforementioned residents), and have a workforce educated through government financing. Though not one-to-one, our salaries are impacted by what medicare/medicaid sets as procedure-related reimbursements. Though no MD could live off of medicare payments alone (I think total reimbursement for a PCP visit is $125), its a proxy, and is one of the big reasons why proceduralists (surgeons, anesthesiologists) make more than the thinking specialties (infectious disease, rheumatology). So - I think Baulmol here works in that the public/govt who agree to some compensation for MDs that is commensurate with other high-paying fields. There may be some perception that top students would actually choose ibanking over neurosurgery based on compensation, so the public is willing to pay in the same ballpark. Whether that belief is true is another conversation - and whether we really should be sending top students to medicine (where they tend to despise their job and look elsewhere for intellectual stimulation) is another story as well.

Too often the enemies of the deep state wind up dead under suspicious circumstances. I see no reason why any of the new guard will be exempt from those methods.

There are fewer kids to educate, but all the school funding formulas are based on number of kids, so as there are fewer kids, there are less federal and state funds for the kids (but schools have a lot of fixed costs). And there is a lot more legally mandated costs for special education than in previous decades due to legally mandated “Individual Education Plans”.

This means less resources overall, and especially less resources for higher achieving kids. Rich people who can supplement their kids’ education will benefit, and lower class kids who used public education systems to break their families out of the lower class will be less likely to succeed.

https://www.axios.com/2024/07/03/education-enrollment-cliff-...

> By the numbers: The U.S. is expected to reach "peak high school graduate" in 2025, when around 3.9 million young people will graduate, per WICHE.

>By 2037, there'll be only about 3.5 million high school graduates, WICHE projects — a 10.7% decrease.

GDP per se, maybe not, however we should still expect it to scale with the costs of services and goods that are correlated.

Ex: If the dollar price of rent doubles, then dollar expenditures to keep the elderly from dying in ditches will likewise double, even with no change in population.

It doesn't have to. But GDP is a good proxy for the tax base. If the problem is deficits and spending isn't increasing linearly with GDP, that suggests the problem is with taxation. Not spending.

Spending is related to debt only inasmuch as it exceeds taxation.

This happened, I believe, in FY 2024 [1][2].

We're currently running a 6.5% primary deficit/GDP [3]. With real GDP growing around 2.5% a year [4], that means we need to cut about 4% of GDP, or $1.2tn [5], to stabilise our debt/GDP ratio. That's two Medicaids [6]. (Which would probably trigger a recession.)

[1] https://comptroller.defense.gov/Portals/45/Documents/defbudg... $842bn

[2] https://budget.house.gov/imo/media/doc/the_baseline_and_inte... $870bn

[3] https://bipartisanpolicy.org/report/deficit-tracker/

[4] https://fredblog.stlouisfed.org/2024/06/how-much-did-the-us-...

[5] https://fred.stlouisfed.org/series/GDP

[6] https://www.pgpf.org/article/budget-explainer-medicaid/

For simplicity, imagine one program like food stamps. It costs X dollars per person on the program.

The cost of that program should scale with inflation and population. If taxes and government should scale with GDP, that implies either making more programs or expanding existing ones. As an example, you'd increase the amount of people eligible for food stamps as the population became wealthier.

I can understand that as an argument but implying that the government isn't growing because the relationship to GDP hasn't changed seems to prove the opposite to me.

The federal budget, if the size of government remained static, should be Inflation * Population increase, shouldn't it?

GDP is rising faster than inflation so the services that the government provides should take less, as a percentage, of the population's money.

The logic for food stamps does not really apply to other programs though. The amount of calories people need is constant, so supplying a given population with enough food to survive should be easier as time goes on. However for most things, we're not aiming for a fixed outcome but one that scales with GDP. For example medicine - providing people with 1970s levels of care would certainly be cheaper adjusted for inflation than it was in the 1970s, but providing access to modern medicine in modern hospitals performed by current doctors is substantially more expensive, and providing 2050 medicine will be more expensive still.

The standard of medical care you'd receive today for the same price, scaled by inflation, is higher than it was in the 70s.

You are literally just suggesting we spend more no matter what. Obviously, there is a massive difference in types of spending right? And we have an incredible amount of bad spending. In fact, in places like public education and health, we continue to spend more to get worse outcomes.

You're making large, sweeping generalizations and most of the positions espoused are more political than scientific.

Conservatively, 20% of the nation's wealth goes to the top 1%. The people who need it the least.

I can buy the argument that we could be more effective with spending, but not with the idea that we need less wealth transfer from rich to poor.

You understand that firing a program manager doesn't de-obligate the spending of the program he managed, right? Because I'm seeing a lot of people online who don't seem to grasp that.

This is only true if the value of government services increases over time and not just their cost. If GDP doubles and the government then spends twice as many real dollars to provide the same level of services as before, all you've done is cut efficiency in half.

That does seem more intuitive, but I think throwing GDP in the mix is intended to measure something different—kind of our theoretical ability to bear the cost.

>but if GDP per capita increases, you could also expect better tech/productivity to allow gov spending per capita to decrease.

To some degree, yes. But, this potential decrease is limited by the proportion of our spending represented by direct transfers, such as Medicaire and Social Security.

Social security is a direct transfer, but it's also... not a very well-targeted program. The nominal purpose is to prevent indigent retirees from being on the street, but then it not only makes payments to the retired Bill Gates, those payments are larger than the payments people who had made less money will receive. A major efficiency improvement would cause everyone to receive the same payments. That would face obvious opposition from the affluent retirees who are currently receiving payments and spending them on luxury vacations etc., but it could certainly save a lot of money without at all compromising the goal of the program.

But, on the substance, you're correct that it was a horrible example, because the outlay is influenced by a highly inefficient system. Feel free to ignore.

My larger point to OP was that, the higher the proportion of our spending that is represented in transfers, the less likely it is that the same general technology and productivity gains that lifted per capita GDP would likewise decrease government spending per OP's assertion.

But, I missed the mark a second time in my comment by failing to mention that very little of those private sector productivity gains would flow to any government spending by osmosis. Beyond true direct transfers, other services would require regulatory change (to your point) or a review of specific government processes.

So, in any case, there's little reason to believe that per capita GDP increases would cause a corresponding reduction in government spending. They're coupled very loosely, if they are at all.

There are a lot of other de facto transfer payments in the government, but those programs do have the potential for significant efficiency gains, because they're not just transfer payments. They're each making relatively small payments and then have associated eligibility and means-testing bureaucracies. They would also be better replaced with tax credits for the same people for exactly that reason, but in a comparison against the historical programs, the current programs should be benefiting from significantly improved administrative efficiency as a result of computers etc.

And the budget items that aren't direct transfers generally aren't individually large budget items (the military being an obvious outlier), but cumulatively they're still most of the budget.

Your point that the current programs should be (emphasis mine) benefiting from improved efficiency "as a result of computers, etc" suggests that we are in agreement that it's not automatic (since it's not happening). Likewise, we agree that direct transfers are the larger individual items.

But, that's not to say that I agree with you 100%. For instance, recent data suggests that only 0.5% of the money paid to Social Security recipients goes to administrative costs [0]. So, I don't want to overlook the programs that are administered efficiently. And, if by "monstrous" you mean we pay out a lot of money, then this is only a potential issue relative to what we take in. That is, the implication is always that cutting benefits is the answer.

So, the other third rail seems to be having the wealthy pay more by raising caps on FICA or otherwise. I mean, at what point do we consider that billionaires and centibillionares are increasingly common, and we're well on our way to minting a trillionaire? Yet, we're considering cuts to programs that contribute to mere subsistence for others? (I'll leave aside the irony that it's the would-be trillionaire who may well drive the cuts, because it's almost too rich).

>They would also be better replaced with tax credits

I'm not sure that adding to our already insanely complex tax code/bureaucracy gains us much, or that it would approximate needs as accurately as the current means testing approaches (even if it were more efficient).

[0]https://www.cbpp.org/research/social-security/top-ten-facts-...

You can argue that the increase in government productivity wouldn't be exactly the same percentage change as the increase in private sector productivity, but it's highly implausible that it would be zero.

> that it's not automatic (since it's not happening)

That's not necessarily what's happening though. Some of the efficiency improvements have been realized by the government. But instead of taking the efficiency improvement as lower spending, other spending increased to consume the surplus.

> For instance, recent data suggests that only 0.5% of the money paid to Social Security recipients goes to administrative costs

That doesn't necessarily imply a high level of efficiency given the massive outlay though. "Oh, it's only 0.5%... of $1.5T." That's still billions of dollars in overhead. If you could cut the overhead in half you could save billions of dollars.

It's also not even accounting for all of it because a lot of the overhead from Social Security comes from the administration of the tax, which falls under the IRS. Which then uses the same trick where they hide a huge administrative budget by comparing it to the entirety of all income taxes paid by everybody to turn a large number into a small percentage. And then the separately budgeted federal law enforcement resources that go into investigating social security fraud etc.

It's easy to make something look more efficient by shifting its costs into someone else's budget.

> And, if by "monstrous" you mean we pay out a lot of money, then this is only a potential issue relative to what we take in.

Well no, any given program should have to stand on its own. Just because you could hypothetically collect more tax revenue doesn't mean you should raise taxes, nor does it mean that you should spend the money on program A instead of program B. For example, which is a better use of tax dollars, sending a social security check to millionaires, or increasing the child tax credit?

> So, the other third rail seems to be having the wealthy pay more by raising caps on FICA or otherwise.

The far better solution is to eliminate FICA whatsoever and put Social Security and Medicare into the general budget. Having a separate tax for them is an anachronism and it would eliminate the wailing about the "social security trust fund" which was never anything but Congress immediately spending the money when social security was collecting a surplus and funding the shortfall out of general revenues (or, let's face it, deficit spending) now that it isn't.

> I mean, at what point do we consider that billionaires and centibillionares are increasingly common, and we're well on our way to minting a trillionaire?

Why does anyone think this has much to do with taxes? Taxes in general are a percentage of profits. If someone's company becomes worth three trillion dollars and as a result they now have $800B, is the problem actually that the government took 30% of it instead of 38% or something like that? No, the problem is that the market is so consolidated there is a three trillion dollar corporation roaming around, which there still would be even if you changed who owns it unless you do something about that, which is a competition problem rather than a tax problem.

> Yet, we're considering cuts to programs that contribute to mere subsistence for others?

The point is that the program's budget is so expansive because it's cutting larger checks to affluent people who are not relying on it for subsistence.

> I'm not sure that adding to our already insanely complex tax code/bureaucracy gains us much, or that it would approximate needs as accurately as the current means testing approaches (even if it were more efficient).

You don't have to create a separate tax credit for each individual program. The programs all do the same general thing: Transfer payments to lower income people. Create a single refundable credit in the combined amount that everybody gets (and parents can claim on behalf of minor children) and it replaces all the different programs at once.

I agree that it's likely not technically $0.00. But, as the entirety of the rest of your comment suggests, many of the opportunities for increased efficiency will come from structural or other changes, specific to how we administer these programs.

>Some of the efficiency improvements have been realized by the government...other spending increased to consume the surplus

I would have to see the data on all three assertions here: that we have realized significant efficiency gains; that they were owed in any significant way to private sector gains; and that we simply spent the gains. Actually, that last point is likely incalculable, as it'd be buried in overall increases in spending, which is a separate issue in any case.

>doesn't necessarily imply a high level of efficiency given the massive outlay though

But it does. I rightly focused on percentages, not size, to convey efficiency. You can argue that even tiny improvements in efficiency can yield meaningful numbers when the outlay is massive, which you also did...

>"Oh, it's only 0.5%... of $1.5T.

but it's impossible for either of us to know how much room is there. We can reasonably say, however, that 0.5% reads as "impressive", given that it's far below the percentages for private retirement annuities (see previous citation), and there's numerically just not a lot of room there.

>lot of the overhead from Social Security comes from the administration of the tax, which falls under the IRS.

As it should, since tax collection is the IRS's function. Look at it this way, if instead this were on the SSA's budget, people would say the IRS was pushing off its collection budget onto the SSA, and they'd be more correct.

Same with some part of fraud enforcement falling to the federal law enforcement budget (i.e. the actual LE-related part). The SSA does have its own investigation office, as it should. That office then coordinates with federal law enforcement, as needed to enforce the law.

So, you can't simply zero out the federal LE budget there and I'm sure you don't want to replicate an entirely new SSA-only LE apparatus within the SSA.

>Which then uses the same trick where they hide a huge administrative budget by comparing it to the entirety of all income taxes paid

But, it's not a trick. Income taxes paid is a relative proxy for the number of taxpayers involved, the implicit complexity of tax returns, etc.—all related to the IRS's function. Now we can say the administrative overhead is 80% of taxes paid or 0.5% or whatever as a way to measure relative efficiency. There's nothing nefarious going on here.

>The far better solution is to eliminate FICA...Having a separate tax for them is an anachronism

It's an anachronism with value, in that it represents what's supposed to be happening here. But, now that it is off of that original design, we do need to recalibrate, particularly WRT to having the wealthy more fully subsidize the program; whether that's by increasing the corporate share, raising the cap on collection and reducing the max benefit, or adding it to the overall general tax. I do think keeping it separate has the benefit of clarifying the subsidy effect and the focus on subsistence. I also think it's protective of its intent, because adding it to the general budget/tax collection is the gateway to nullifying the subsidy effect as the wealthy continue to lobby for (and receive) tax cuts.

You could perhaps set a baseline percentage of the general tax for this purpose, but it gets really murky, really fast.

>Why does anyone think this has much to do with taxes?

Because, as it is, there are maximums and loopholes, etc. that mean the wealthy and these massive corporations pay a much lower percentage of their profits in taxes. I'm all for anti-trust for multiple reasons, but litigation and restructuring our economy are not the most efficient paths for addressing this tax problem. Increasing the corporate tax rate is.

>cutting larger checks to affluent people who are not relying on it for subsistence

I'm not sure an increased budget size, owed to higher payments to wealthier people, is really the issue here. Remember, that the point is subsistence and that we don't know who is going to end up wealthy. So, we try to calibrate how much we collect over the working lifetime of each person by collecting based on what they're making at any point.

So, wealthier people are likelier to receive higher payments, but we do cap their payments. So, I'm not sure exactly what you're proposing as the efficiency gain here. Are you saying don't pay people anything if, at the end of their lives, it turns out they don't need it? If so, that sounds like means-testing and the current lack thereof is exactly why the SSA is as efficient as it is today. So, I don't see what we gain by adding means testing, simply so we can say the budget is lower. It's likely a net efficiency loss.

>Create a single refundable credit

You won't find me arguing against simplifying the tax code, but I have a suspicion that it's not quite this simple. Too many variables, including people's specific circumstances (and regular changes therewith) affect this. For instance, how does a tax credit help when someone suddenly needs (or no longer needs) SNAP benefits? OK, so you start prepaying the credit as-needed, then try to settle up at tax-time (oof) or just carve it out of the tax credit altogether and keep SNAP. But, you can start pulling threads like this everywhere and what you weave out of those threads is a picture of how we got here (e.g. the problems we're trying to address). I agree that improvements can be gained by looking at the entire system in hindsight versus its piecemeal construction, but I'd wager the solution set is far more complex than simply moving everything to a single tax credit.

See the CPROFIT, CPATAX and FCTAX charts.

These are very similar taxes: A business takes its revenue and subtracts its expenses, the tax rate is applied to what's left. The distinction is that VAT is paid to the jurisdiction where the corporation's customers are, whereas corporate income tax is paid to the jurisdiction where the corporation files paperwork. It should be obvious what happens when you do the latter: International corporations start filing their paperwork in the countries with lower tax rates.

To fix this you need to tax corporations using a different kind of tax which is tied to some actual activity happening within the jurisdiction, which is what the US has been doing piecemeal rather than all at once, with corporate income tax playing a smaller role as time passes.

Under classical economics, there's also another effect at work. Corporate income taxes are capital taxes, whereas the VAT is a consumption tax.

Under "spherical cow in a vacuum" economics, capital taxes wind up reducing wages in equilibrium. The idea here is that investors care about their after-tax return, and if corporate taxes (on profits) go up they'll simply forego less-profitable investments to keep the marginal return on capital at the right level. With less capital investment, workers are less productive, and under the same spherical-cow assumptions workers are paid in proportion to their marginal productivity.

Conversely, VAT is assessed on consumption but not investment because corporations receive a VAT rebate on their inputs. The same "taxes are a disincentive" effect orients the economy towards investment (on the margin) and away from consumption. Capital intensity, productivity, and wages increase in equilibrium.

Reality's messier, of course, and economic academia engages in lively debate about the real incidence of all of these taxes.

A lot of government service does not scale that way. When a veteran needs help getting groceries, or getting to the VA, or has to go into long-term care, for example, there isn't technology to scale up a human being helping them with the groceries, or the transportation, or the nursing.

The government mostly serves human beings and the options for scaling that problem domain (which aren't dehumanizing) are limited.

Moreover, a major role of the government is record keeping, which computers have made dramatically more efficient. Many of those roles have in fact been replaced in the government, with the savings being reallocated to new spending rather than returned to the public. And many of them haven't been but could be; take any instance of something that could reasonably be done via a government website only the website doesn't support it or is broken so instead the government is still paying a large staff to do it manually.

Besides the fact that they don't work yet (source: I'm working on it ;), a self-driving car can't bring the food to the door because the veteran is in a wheelchair. It can't knock on the door, have short chat, ask about the wife (who is deceased five years), and when necessary... Call elder care services when the veteran says he just talked to her yesterday.

None of this is part of the formal job description; it's the stuff that keeps real human beings from "falling through the holes" of the social safety net.

There's a lot of the web of government support of people that doesn't scale because the human-to-human contact is part of the point.

They don't work everywhere all the time. They clearly exist; they're out there on the roads.

> a self-driving car can't bring the food to the door because the veteran is in a wheelchair.

It could, however, deliver the veteran to their appointment, in the many cases where the path between their home and the VA is one of the ones a self-driving car can already navigate.

Grocery delivery, by contrast, could still be done by a person, but modern logistics technology allows that person to deliver groceries for multiple people with one trip to the store.

> It can't knock on the door, have short chat, ask about the wife (who is deceased five years), and when necessary... Call elder care services when the veteran says he just talked to her yesterday.

That is an entirely different service. To see why, consider the veteran who has that problem but has never needed (or anyway requested) to have groceries delivered.

I am also not sure if grocery delivery is as big of a problem as we are talking about? Does the government even provide grocery delivery?

Meals on Wheels served 2.2 million Americans in 2022.

There's a lot of the process of elder care that robots can't do yet (and won't be able to do in the next five years) while America's median population age continues to increase. These are human problems best solved by human interaction.

> That is an entirely different service

Personal experience suggests otherwise. A "soft wellness check" is something Meals On Wheels specifically does; they can notify an out-of-state loved one if they notice the client isn't coming to the door or picking up the meals. They can also make the human-being call to say "Everything's mostly fine but your uncle seems kind of... out of it? Not sure if anything's up."

What's the argument that corporations should be laying a lower share of the GDP? Due to their greater proportionate wealth, corporations and the wealthy can better afford to pay. They also tend to disproportionately benefit from the government.

Government organisations don't have the same profit incentive as they aren't in a competitive market, nor are there any personal incentives for executives to achieve these efficiencies. Government does eventually implement productivity improvement however it lags behind the private sector, with investment in productivity only occuring once risk has effectively been eliminated.

I've worked in both sectors, and people working in each sector are equally frustrated with inefficiency and seek to improve things. The problem with government isn't really the people nor the agency nor the sector, it's that the organisation and it's people only gain rewards by improving the status of the politician running the agency.

Nowadays saying that $X billion is being spent is more important than whether it successfully achieved the outcome. The effect of this is that one politician can announce $X billion to more efficiently achieve the same outcome as another politician announcing $2X billion at half the productivity and the second politician sounds like (or can easily be spun to sound like) they are achieving more/ care more than the first. The end result is massive expenditure on very little.

The book “Tax Free Wealth” covers this and points out that the tax code looks pretty similar across all western countries when it comes to the way the activity the code is trying to stimulate.

I personally don’t like the tax code being used for such manipulations regardless of the motive behind it.

it’s absolutely wild to me how people fail to see how much more companies benefit from taxes.

Eh, we're going to see a lot of scrutiny on proven vaccines and other proven medications that RFK harbors a lot of delusional beliefs about, because he's a conspiracy addled pudding-brained nutjob.

Over time it _can't_ scale linearly with population, unless you decide to not adjust for inflation. It _could_ scale with population and inflation, assuming that you agree that you don't want more services from your government.

Don't forget, a percentage of that GDP increase is just inflation.

Most people, as they get richer, want to have services increase, as they can afford to pay more. For example, they go to nicer restaurants, nicer hotels, maybe they get a massage, where previously they would not have, etc.

This is largely also true of a population. We expect that our children will be better educated. We expect better roads/bridges/other infrastructure. Heck, we might even expect better public infrastructure such as trains, buses, etc.

By design, GDP measurements are adjusted for inflation, unless you're looking at 'nominal GDP' (which nobody does because it's pointless).

> Most people, as they get richer, want to have services increase, as they can afford to pay more

This makes sense. But I'm not sure how many people believe that they're getting what they pay for, esp when it's not actually paid for, but financed

This is such an unbelievably lazy response. Every single person in existence thinks there’s some amount of government waste that we wish were cut and either returned to the citizens or put to better use elsewhere.

The interesting and important question which GP poijted out—and which you completely dodged—is where and what should be cut. DOGE is looking at the set of government spending that accounts for less than 9% in aggregate of the entire federal budget. At best if they found that 10% of this money was abuse, it would account to less than 1% of the overall federal budget.

This isn’t about reducing government spending. If it was, they’d be going after larger targets. It’s about fulfilling their long-stated wet dream of finally drowning the government in a bathtub.

Except for the parts for the government that can shoot you or kick down your door. Those parts are sticking around for sure.

Whether all that was sincere or not is not the question: that was the promise I learned. 'Common defense' is well taken care of ... unlike 'general welfare' and/or liberty, particularly for 'our posterity'

I’d forgotten about “general welfare” and now I wonder how that got in there considering it didn’t really make it anywhere else in the founding vision.

Maybe they didn’t intend it like our modern reading at all?

This is false on a substantive level. The parent challenged (1) the premise that federal spend should scale and with GDP and (2) whether current healthcare cost levels are justified.

It's also notable that you redacted a key part of the parent's quote. Here's the full quote:

> Given the complexity in the details, I don't think a 'serious discussion' about this is even possible in this forum. But if the question is 'do you think an effort should be made to look for things to cut', I'd say 'yes, of course.'

Using that as an excuse to ignore the actual question which was asked so you can throw yourself the softest of softballs is what is unbelievably lazy.

You'll only learn how they really think when you see election outcomes, or which side they're standing on when it's 'ok' to dissent, and by then it's too late.

As an analogy, if someone comes in and says global warming isn’t happening, the goal isn’t to eviscerate that opinion. That is the outcome of the opinion being wholly inconsistent with the corpus of scientific data collected up to this point.

Bad takes get the respect they deserve. If getting hammered with difficult questions in response is too much to handle, maybe it’s time to reevaluate them. If you aren’t the type to reconsider opinions in the face of difficult questions, you’re sadly correct that an open forum for discourse probably isn’t the right place for you to be.

The stakes are too high at this point. We’re diving headfirst into a climate crisis, the U.S. government is possibly irreversibly on the path to a complete authoritarian takeover, we’re on the verge of allowing the destruction of our remaining natural heritage, and crucial functions of our government are being dismantled without any scrutiny while being egged on by the least well-informed half of the electorate. I am done pulling my punches on those who champion this shit.

I'm not saying any opinions need to be coddled. I'm saying that while you may interpret your interactions as 'eviscerating', I doubt if others interpret it that way.

> the goal isn’t to eviscerate that opinion. That is the outcome

Are you sure that's the outcome?

> If getting hammered with difficult questions in response is too much to handle, maybe it’s time to reevaluate them

Right.

The fact that DOGE is only focused on the items it has access to is not a logical critique of DOGE’s effort.

So people who are currently struggling, and rely on government assistance to get by? They will struggle more. People who fall on hard times, and need a bit of help to get back on their feet? Much less likely to get it.

We live in an era of unprecedented abundance. That we are unwilling, that our system is unable, to provide even a basic standard of living for all of our citizens -- that on its own is already a deep, deep, condemnation of how we do things. To go even further, to destroy the bits of aid we do give out, without even trying to replace or rebuild them?

I am more than happy to discuss a re-written Social Security net for American citizens who are truly struggling, but not those looking for lifelong paycheck for nothing. Today we have a grossly abused, wildly expensive, and unbudgetable aid program. And it’s all by design.

We can by all means cut fraud written systems today with plans to add back the necessary functions later. Rewrite and consolidate for the modern era.

There are an enormous number of government services for which the benefit to society is straight multiples of the cost. Throwing out the baby with the bathwater is an exceptionally efficient way to make sure we all suddenly start paying more.

For a blindingly obvious example, see universal healthcare (or more specifically, our country’s lack of it). As the one developed economy without it, we pay multiples of what other people do for worse results. Consider me not particularly enthusiastic about finding out what else we can start paying more for to receive worse results.

> The fact that DOGE is only focused on the items it has access to is not a logical critique of DOGE’s effort.

Of course it fucking is. Just like it is, was, and continues to be a valid critique that California asking residents to cut back on water use when the aggregate of all urban use counts for about 8% of the water is a pointless waste of time, resources, and political energy.

Instead of actually tackling deficits and government spending, they’re putting on a show while cutting to the bone extremely valuable services we rely on. NOAA and FAA are critical for air travel. NASA, the NSF, and scientific research funding in general are critical for our continued technological dominance and for attracting the best and brightest to our country. The CFPB has done incredible work in protecting individual consumers from the worst of banking practices. The parks service, USFS, and everything else under the department of the interior protect our remaining natural spaces which can never be reclaimed once lost.

This is just a microscopic fraction of what’s being dismantled in front of our eyes, and all for the “benefit” of pointlessly saving relative pennies.

For fuck’s sake, as a high-earning, wealthy taxpayer: tax me more. And anyone who’s in the upper echelons of our economy that isn’t saying this while seeing the conditions the rest of our country and world live in is unbelievably narrow-minded, ignorant, selfish, straight up evil, or more likely a combination of all the above.

The switch in your argument to "it's just a drop in the bucket" is odd to me. For one, I hope the same sentiment carries over to other components of government. Massive rein-in of spend. FAA has not been canceled; instead, its unchecked spending is being challenged. Same for the rest of these programs. FAA's 2025 budget is nearly 4x the 1995 budget, despite serving roughly the same number of airports. There may be 30% more flights today than in 1995, with all those occurring at the same airports we had back in 1995. How do you explain a 4x mission scope creep? Inflation address a bit, but ATC should be getting more efficient with technology, not more complicated.

The real answer, theres a lot of misappropriated funding and spending that needs to be reeled in. It is ok to disagree, I nonetheless adjure you to voluntarily pay more taxes.

This is quite an attack, to say if I dont agree with you, then I am a combination of these things: >>anyone who’s in the upper echelons of our economy that isn’t saying this while seeing the conditions the rest of our country and world live in is unbelievably narrow-minded, ignorant, selfish, straight up evil, or more likely a combination of all the above.

2. Your taxes will not be lower. If that's your goal I don't know what to tell you.

> Democrats made up about half of the workforce during the 1997-2019 data period (compared with about 41% of the U.S. population). Meanwhile, registered Republicans dropped from 32% to 26% during the period, with an increase in Independents making up the difference. The most heavily Democratic departments are the EPA, Department of Education, and the State Department, where about 70% of employees are registered to the party, while the most conservative departments are Agriculture and Transportation.

https://newsroom.haas.berkeley.edu/research/study-finds-the-...

Also American First propaganda site lists some individual cases where career staff hinders agenda due to ideological reasons.

Additionally, the republican image typically espouses the idea of private industry and private capital more so than the democrats, where public service takes a bigger role. If people already identified with a given ideology, it’s likely that their career choice would reflect that.

Finally, one’s political leanings aren’t being used to determine if they should be hired.

I'd imagine you wouldn't find an abundance of pacifists working in the military either

You will have a different type of ideologically fueled bureaucrats running the governemnt, just look at what’s happening and who got appointed where. I mean, come on, Kash Patel running the FBI? Kash Patel was selling his own merch.

Could you please elaborate on that decades long terror, but please try not to make it about only you.

What specific examples do you have of being terrorized by bureaucrats?

You mean like Reagan did, bringing in the private sector:

* https://en.wikipedia.org/wiki/Grace_Commission

* https://www.reaganlibrary.gov/archives/topic-guide/president...

* https://www.gao.gov/products/123531

* https://www.pgpf.org/programs-and-projects/convening-experts...

* https://news.ycombinator.com/item?id=42463355

Or Bush (43):

* https://en.wikipedia.org/wiki/Council_of_the_Inspectors_Gene...

Or FDR:

* https://en.wikipedia.org/wiki/Brownlow_Committee

Or Truman:

* https://en.wikipedia.org/wiki/Hoover_Commission

Or Clinton/Gore:

* https://en.wikipedia.org/wiki/National_Partnership_for_Reinv...

There's an entire agency whose job is auditing:

* https://en.wikipedia.org/wiki/Government_Accountability_Offi...

This isn't the question. The question is about the premise of federal spending being "out of control". By what measure is it out of control?

https://www.budget.senate.gov/chairman/newsroom/press/extend...

https://taxpolicycenter.org/briefing-book/how-did-tcja-affec...

So the strategy is to cut taxes and revenue and balloon the deficit, then declare that spending is out of control and constitutes emergency measures to fix.

While certain specific functions of government can and probably do get more efficient as technology progresses, the demand for new functions or more of existing functions goes up. You didn't need an FAA before air travel and you needed less FAA when there was less air travel, for example.