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USA does not have an oil fund that amounts do $150k per capita to pay for "free everything" (university education, universal health care, childcare) and good pensions for everybody. Norway generates more revenue with oil than the entires US of A, for 5 million people, and is third worldwide exporter for Natural Gas just behind Qatar and Russia, again with only 5 million people to serve (less than the population of New York)

The policies you enjoy are paid for by those revenue, and are not applicable to "regular" countries.

I admit tho that your politician did a good job at ensuring that those revenue are used for the good of the general population and are managed with the future in mind.



I'm from Sweden, and we have the same policies but basically no natural resources that are worth anything anymore. Unlike the US of A.

It's not about oil, it's about realizing that a healthy, well educated and happy population is an investment that pays itself over time.


You've also got a top marginal personal income tax rate approaching 60% which is nearly twice that of the US and political suicide.

I'm not making a judgment for or against high marginal taxes, I'm just saying "the US could do it too" ignores, well... the very core of economic and tax policy in the US.


So now you leave the realm of economical possibilities and start pointing at political problems.

Isn't that a little too simple?

"No, we can't do that because we don't want to."


Well, it's important to engage the political realities. Doesn't make it impossible, but a hybrid proposal or smaller first step might be more practical, given the politics.


Hybrid proposal is the real solution.

Yes, in the US, the taxation of the Nordic countries won't work and the socialist approach to services is also not accepted by half of the country.

Two key ideas, however, could be implemented:

--- IDEA 1 - REALLY EDUCATE people on WHY they need to get new vocational training.

Currently too many people are being given false promises of the return of working class jobs that are not coming back. It's not just globalization that has caused the loss of these jobs, but also technology advances that have made many of these jobs obsolete.

Your blue collar worker today isn't going to get a job moving metal equipment from one place to another because a machine can do it much more efficiently 24/7. Our capitalistic society means that a corporation will seek to create maximum efficiency to generate maximum profit. Corporations aren't in the business of maximizing the number of employees, but rather maximizing the return per resources invested in the organization. And that means, excuse my somewhat callous statement, that people are viewed as resources to the organizations, a means to generating profit. If a machine is able to perform a function faster, longer, for less overall money than an employee, a corporation will seek for that alternative.

So when many politicians make promises of bringing back good jobs. They AREN'T telling people WHAT JOBS are coming back. In fact, when you look at manufacturing jobs in the US, we currently CAN'T FILL THEM.

The problem is that your blue collar worker still expects a manual, low skill manufacturing job. But the job the US corporation wants is a manufacturing person who has a math or CS degree who can program or operate a high-end automation machine. Who can manage the CNC process or who can input the specifications for highly detailed technical operations. This requires specific training, math, engineering, or certifications.

This is the truth that more politicians need to hammer home to the people, then government follows up making sure that there is an incentive for educational institutions to allocate resources to teach these people.

But today, we're still stuck in: politicians claim that it's federal government's fault that they don't have a job, and that electing them instead will magically bring these low skill jobs back.

--- IDEA 2 - DECENTRALIZE FEDERAL GOVERNMENT AGENCIES (Move them out of Washington D.C.

A CNN op-ed suggested this as a way to bring the Federal government closer to the people in the country. (http://www.cnn.com/2016/09/06/opinions/government-department...)

The capital, Whitehouse, and some executive services would remain in D.C., but many of the key departments would be moved to different regions of the country.

For example:

-The Veterans Administration in Phoenix -The IRS in Dallas -Treasury Department in NYC -FBI in SLC -The EPA in Portland or Seattle -Department of Agriculture in Iowa

and so forth. Federal government jobs move to other places around the country bringing it closer to the people so they get a more personal connection with the government since it actually supplies jobs to the people they know. It also moves these departments into locations that cost less than the high prices of the D.C. beltway.

Is there some loss of more interpersonal meetings between departments and cabinets? Sure, but high speed Internet access is readily available in ALL metropolitan areas around the country. We have video conferencing technology which eliminates the need for us to have the requirement of so many in-person meetings. It's a trade-off, but one that is greatly benefiting the people of the country.

And as the Federal government this is a big win because today, much of the sentiment is that the Federal government DOESN'T DO anything for me. It's a bunch of "elites" who waste time and money and the people don't see anything direct benefit.

Decentralizing the location of government agencies begins to eliminate this. Just like the US National Guard has a training camp just north of the city where I live, I can't say that the national guard doesn't do anything and isn't needed. They offer a great service and employ a lot of the people in my community, the surrounding communities. The national guard members, employees, and their families all buy homes in our communities raising home values (since these are stable jobs, homes aren't sold left and right, people stay, pay taxes, leading to general growth for our communities). These people also buy goods in our stores, contributing to the local economy. All because the Army put one of their national guard training camps here instead of concentrating them at West Point in New York.


Idea Number 2 is actually what Germany does (other countries as well). Here's a list of German Federal agencies (in German, location is in the last column): https://de.m.wikipedia.org/wiki/Liste_der_deutschen_Bundesbe...

I can't say those agencies are specifically "in touch" with citizens. I'd rather say, they might be more hellish if they were all centralized in Berlin.


The second idea is also a great idea from a strategic perspective. At the risk of sounding doomsdayish, by spreading the federal government's agency headquarters around the country, it minimizes the risk of a single city-wide or even state-wide catastrophe (sea level rise, nuclear carbomb, Giant Meteor delivering on its one campaign promise, etc.) eradicating the leadership of most/all federal agencies.


I've never heard that second idea before. That's a really good idea.


We (Norway) did just that a few years ago; mostly, it was a success once the dust settled.

For instance, the coastal administration moved from the capital Oslo to Ålesund which is smack in the middle of a world-renowned maritime cluster; fisheries agency. moved to our #2 city (or #1 if you ask the locals) Bergen, historically the major export hub for the coastal fisheries, etc.

The key benefit is that it ensures there is a need for highly skilled labour also outside the capital; also, as you mention, it provides for more closeness to government - the sectors affected by the whims of a government agency has said agency within spitting distance, which helps.


I like your ideas...a lot actually.

The only thing I would point out (see my comment a little further down about US budget) is that our current level of taxation supports comparable levels of spending to Nordic countries. I would guess, not doing an in depth analysis, that this is partly or even mostly due to the much larger relative size of the US GDP.

And in the case of healthcare, we are flat out spending more, both in real dollars and per capita measurements, and getting less. So I view tax arguments as more or less red herrings: We already spend as much or more, instead we should ask what is wrong with our system? Changes to our systems should not require increases in our taxation (necessarily).

But it's also why I really like your ideas since they are systemic in nature.


What's simple about making 300 million people want the same thing?


In New Zealand we have free public healthcare, education subsidies (though tertiary education is not free), and a top tax rate of 33%, while we still make most of our money from primary industries like beef, dairy and wood[1].

Public healthcare allows us to have a huge single buyer for our pharmaceuticals - Pharmac[2] - which brings a lot of power to negotiate good deals.

It might not be reasonable for the US to become like the Nordic countries, but things could certainly be better.

[1] https://upload.wikimedia.org/wikipedia/commons/e/eb/2014_New...

[2] https://en.wikipedia.org/wiki/Pharmac


Things can be made better in a way that's consistent with American principles of merit and competition. That's what Trump represents -- a return to the pre-Bush style of government that put reasonable economic restrictions in place and tried to provide an even playing field for everyone without introducing artificial government dependence.

GHWB and Bill Clinton sold this country into servitude for the elite by allowing them to freely export their labor overseas where it costs less than a dollar per hour. GWB and Obama continued that. That's 28 years of policy that have seriously exacerbated the economic condition of the average American while the fat cats at the top have gotten ever-richer.

Trump wants to make sure American money is used to help and employ Americans. That's good! There's no reason that all the money has to go overseas.


"You've also got a top marginal personal income tax rate approaching 60% which is nearly twice that of the US and political suicide."

That's only true if you count Federal Income Taxes alone. By the time you're done with Social Security, Medicare, state and city taxes (esp in NY, CA), the top marginal tax rate here approaches 50%.


Everyone ignores this when talking about taxes. I had an accountant do the math for me out of curiosity if I were to move to the Netherlands - and my marginal tax rate would have increased a whopping 7%.

I would have saved more than that in health care related expenses, so it was more or less a wash with that included.

People that say the US is low taxed are simply not paying attention. I pay comparable "all in" taxes as my Canadian co-workers.


The top US marginal tax rate is 40% and the burden quickly exceeds 50% depending on the state you live in and factoring payroll taxes.


Marginal tax rates mean literally nothing.

Nordic countries pay significantly more in taxes any way you look at it. You'd get laughed out of the room if you talked to someone like Donald Trump about paying a 40% marginal tax rate.


and most folks in that tax bracket are doing things, other than paying short-term gains or regular income tax, to reduce their burden significantly.


And then add on Healthcare, child-rearing, and education costs and guess what...

USA Citizens pay more overall. Just not through "taxes." per -say.


> I'm just saying "the US could do it too" ignores, well... the very core of economic and tax policy in the US.

Hardly. It was the core of the tax policy for a very long time.[1]

1: https://commons.wikimedia.org/wiki/File:Historical_Marginal_...


This talking point of once-sky-high marginal tax rates gets a lot of airplay, but it's very misleading. Almost no one paid those rates. Tax receipts as percentage of GDP have been remarkably stable over time:

https://en.wikipedia.org/wiki/Hauser%27s_law#/media/File:U.S...

Total tax revenue in the US is 27% of GDP. In Sweden, it's 46%:

https://en.wikipedia.org/wiki/List_of_countries_by_tax_reven...


> Tax receipts as percentage of GDP have been remarkably stable over time

That may be true, but since the sources you listed contradict each other, I'm left confused. I can find supporting evidence of the graph[1], but not of the wikipedia entry. The world bank apparently thinks they are all wrong[2]. Then there's a report that Norway is actually doing it with much less taxes than Denmark and Sweden[3], but that might be likely due to oil revenue. I'm left to conlcude that without a lot of research to look into the specifics, there's quite a few ways to measure this, and I'm not sure which are most relevant to the discussion at hand.

1: http://www.taxpolicycenter.org/statistics/source-revenue-sha...

2: http://data.worldbank.org/indicator/GC.TAX.TOTL.GD.ZS

3: http://www.thelocal.no/20151204/norway-leading-the-field-for...


And isn't anymore. If you want to argue that it should be, I'll listen to that, but you can't just throw out a link to graph about tax rates 50+ years ago and think that settles it and the US can be just like Norway.


> And isn't anymore.

But it was, not not too long ago. 35 years ago it was 50%. 40 years ago it was 70%. Just saying it ignores the core of economic and tax policy in the US ignores, well... the the recent history of the economic and tax policy of the US. Rather than a rank dismissal of the idea, why not explain what's so different than now from then that makes it impossible?

> you can't just throw out a link to graph about tax rates 50+ years ago and think that settles it and the US can be just like Norway.

I didn't. I just meant to show that your reason for dismissing it seems poorly founded, or at least poorly explained.


70 decades ago, if I were a billionaire, I'd have no choice but to stay in the US and pay that tax rate. Europe is rebuilding from a war, Asia is an agrarian back-water and South America is about to start experimenting with Communism. Yeah, where am I going to run to, Mars?

Now it's different. I'll be laughing with my other billionaire buddies about your tax rate plans while snorting coke of a hooker's tits on my private yacht and watching the Monaco F1 GP from the harbor. I've got all the luxuries I need over there, and in fact, everywhere, that I previously could only enjoy in the US. I can talk with who I need to talk to over Skype, I can do my business, banking, everything, remotely.

It's not like other countries don't have equal or better infrastructure. It's not like I can get clean water and food only in the US that would somehow make this a magical place I'd never leave.

So why would I just sit quietly and let you tax me at 90%, exactly?


Except, jokes on you, you may still owe the US taxes even if you don't live there but you get income from there, and they expect you to fill out your worldwide income and file taxes if you're a US citizen.

> So why would I just sit quietly and let you tax me at 90%, exactly?

Extradition treaties and/or freezing of your bank accounts, businesses and resources within the US.

Nobody expects the Spa.. I mean IRS.


> if you're a US citizen

That's something you can opt out of. In fact, some do: http://fortune.com/2016/08/11/us-citizens-renounce/


That's a red herring, just take a look at some budget breakdowns:

https://www.nationalpriorities.org/budget-basics/federal-bud...

The largest portion of our budget is mandatory spending (~65%). Of our mandatory spending, the largest portion of that is spent on Social Services (Social security, medicare and health, etc) and yet we still have worse services than almost any other western country (IMO).

You start looking at percentages and an even more sinister picture starts to take shape:

https://visualeconomics.creditloan.com/how-countries-spend-t...

> "Canada spends 6.3 percent of its total yearly budget on military spending. The United States spends 19.3 percent of its budget on military expenses. Mexico uses 3.3 percent of its budget for military spending."

> "Canada spends 17.9 percent of its total yearly budget on health care. The United States spends 19.3 percent of its budget on health care expenses. Mexico uses 11.8 percent of its budget for health care."

> "Norway spends 17.9 percent of its budget on health care spending, while its neighbor Sweden spends 13.8 percent of its budget on health care."

> "In France, health care spending is 16.7 percent of France’s yearly budget."

This article needs citation, but see this report that seems to at least tangentially support some of the trends voiced:

http://www.oecd.org/els/health-systems/Briefing-Note-NORWAY-...

> "The United States is, by far, the country that spends the most on health as a share of its economy (with 16.9% of its GDP allocated to health in 2012)"

So at this point we can conclude that the US spends roughly the same share, or more, of it's GDP on Health care as other countries...even those "socialist" ones...yet we have a much worse standard/level/cost of care.

Even at our "lower" tax rates our GDP is by far and away the largest:

https://www.google.com/search?q=list+of+countries+by+GDP&oq=...

But moreover, our PER CAPITA GDP is one of the highest in the world (higher than Norway and Sweden).

So at the end of the day, America:

* Spends more on healthcare in flat dollar terms than almost any other nation

* Spends more on healthcare PER CAPITA than almost any other nation

and yet we still have far worse levels of care.

So this problem has nothing to do with economic or tax policy in the US. The question is: Where is the enormous sums of money we are ALREADY pouring into the system going?


Most Western health systems are universal and more or less exclusively government-funded. This means that the entire population is in the same risk pool, reducing costs for the more vulnerable users and increasing the incentives to implement more preventative medical practices. As de facto monopolies, these systems can do a much better job of controlling the costs of salaries, equipment, and drugs. And, because the systems don't need to turn a profit, they can operate at cost.

Our private health care system, however, has a cycle of perverse incentives -- employers, insurers, patients, and doctors -- that leads to spiraling costs with no increased benefits. The populations with the highest health risks (i.e. costs) are shoved onto the public rolls, in the form of Medicare, Medicaid, and the VA. Meanwhile, the lowest-risk populations are forced to pay into private, for-profit insurance schemes. Specialists have outsized bargaining power, which leads to grossly outsized salaries. Equipment and drug manufacturers can play hospitals and systems off of each other to bid up prices. And, of course, shareholders want a return on their investment.

This problem has everything to do with economic and tax policy in the US.


I think the point I was trying to address was the implied claim that we "can't afford" health care systems akin to other western examples. Arguments like:

> "Your tax rate is so high America would never vote for a similar tax."

> "Percentage wise those countries spend a lot more on health care than the US."

I would agree that our private health care system has perverse incentives. Combined with the degree of separation between cost and consumer due to our insurance system, this has resulted in general market failure.

Neither of these are directly economic or tax policy related (IMO). We already are being taxed and paying for health care...the issue is where is our health system failing to deliver value-per-dollar spent. Which generally might involve some economic policy overlap as far as market regulation, but I don't think it is the whole (or even the majority) of the story.


Corruption, lack of a single payer system that dramatically increases efficiency in the "socialist" countries. Insane health insurance system (ties into corruption).

It's doubtful they can/will fix any of this. America is a country controlled by lobbyists.

The politicians don't matter at the end of the day, look at Obama, had the right idea, could only implement a relatively mediocre system because anything good was politically untenable. The fact that politics can trump (lol) the health of the nation is enough for me to never want to live there.


American healthcare is run by the private sector with pretty much zero accountability compared to say, the UK, where the NHS is for the most part, a public organisation with open books.


You're fronting the overhead of medical R&D, which the US is doing the bulk of.

Still kind of ridiculous that the amount we spend still amounts to most of the population getting shafted.


Are we?

> ...industry supplies the bulk of the funds devoted to research and development, the public sector—primarily the National Institutes of Health (NIH)—supports most of the nation’s basic biomedical research.

http://content.healthaffairs.org/content/30/2/332.full

This quote seems to indicate the majority of R&D is coming out of the private sector.

Moreover, this overhead of medical R&D from the public sector doesn't explain price differences in drugs between US and other developed nations:

http://usuncut.com/news/us-drug-prices-in-the-us-are-literal...

http://www.wsj.com/articles/why-the-u-s-pays-more-than-other...

There are deeper, systemic issues IMO.


I wonder what would happen if the U.S. passed a law requiring that drug prices in the U.S. be no higher than anywhere else in the world. That is the drug company is free to set any price, but they cannot sell at a lower price outside the U.S.


Wouldn't it be dramatically easier to just allow Americans to buy their drugs from other first world countries at the prices they pay? If American drug companies have to compete with extra-national pricing, I'm guessing they'll figure out a way to.

On top of that, you're not forcing anybody to do anything.


No I mean specifically from the private sector. You have to front that cost somehow. Whether you're seeing the cost as more expensive drugs or whatever, you're still paying it. R&D is factored into the cost.

The negotiation process is just different than when other countries are negotiating with US pharmaceutical companies.


>So this problem has nothing to do with economic or tax policy in the US. The question is: Where is the enormous sums of money we are ALREADY pouring into the system going?

The pockets of the oligarchy represented by Clinton and Trump.


We could anyway imo. Our "very core" of economic and tax policy is actually pretty flexible. Just look at how the markets have developed over the last several decades. Yes there will be pain, but I'd trade a little short-term pain with long-term benefit over short-term relief with long-term decline anyday.

Not to say Scandinavia has the best of everything, but regardless... Jag skulle vilja bo i skandinavien istället USA


Marrying a Swede is unquestionably the best thing I ever did.


Yes, that's the price you pay for civilization.


That's the price you pay maybe for civilisation.

Take the other example of Belgium whose tax level is more or less equivalent but is scaling down on basically everything. People there complain that they pay a lot now, but are almost certain that when their turn come, they will not get anything.

We are in a context where you can't predict the outcome of the next election a single day before, who will trust to current generation of politician with policies in 30 years ?

Also, that's not just a question of egoism. I don't mind paying today so that people get unemployment benefit and a good pension. The problem is that if it goes the other way when I reach retirement age, I will neither receive the pension nor the year of tax cut to make up for it.


It will be interesting to see how the US solves this problem without raising taxes. If it solves the problem (which i hope).


And responses like this are why he US has these problems.

Dismissing solutions as too hard or those won't for us.


It helps when someone else is picking up the bigger ticket items like a national defense.


and healthcare r&d.


Whenever someone tells me about the "nordic blessings" I tell them to "junte" the "law" up.

Smaller, more homogenic countries compare badly to more populated heterogenic ones.

Also: norway's oil example holds up since the once poorer than Swedes Norse outperformed the Swedes because of this. 1-2 generations earlier, "nordicly blessed" Norse were the house maids and guest workers for the Swedes. Nowadays it's Swedish students doing Norway's dishes.

Also Sweden maybe high rated in terms of social mobility, but only until the highest income percentiles are reached. Above that it's way way harder to reach compared to other first world countries. So while you can climb up more easily than normal the social latter, it's steps mean less than normal and you'll almost never make it into Sweden's 1%. A category that is the most open in the US of A.


Because in the US of A it is so very easy.


Of course not easy. But doable compared to Sweden. You have to look at the statistics. The top Swedish percentile is made up more than normal of inherited wealth (48% in Sweden, 12% in the US). The US doesn't have a Wallenberg family that owns 42% of the country's stocks.


Of course you're right, but it doesn't mean anything.

It's like saying that you should buy people lottery tickets instead of healthcare.

I once heard that the US citizens most vehemently against raising taxes for the rich were the homeless, because they didn't want THEIR taxes raised once THEY became rich.


Yes, BUT these small countries do not pay the heavy Global Police tax to keep the world safe for example from Terrorism..we DO! Thus its not the same thing fits both small and big countries..


Yeah, this is a chicken and egg problem.

The US causes terrorism by steam rolling third world countries, but more or less has to do it now since these third world countries already hate the US enough to require this kind of policing.


Once the population is "well educated" they will start to ask intelligent questions which will then prevent them for voting for someone like Trump (or most republicans in general).

So it's in his/their best interest to keep them uneducated.


If people are so generous over there, why the need to put that burden to government and instead make funds so people can use what they need, and if a fund goes into corrupt hands you can always create a new one and vote with your wallet.


> Norway generates more revenue with oil than the entires US of A, for 5 million people

I find this hard to believe. The US generates what looks to be close to 5x the barrels of oil per year as Norway, and since oil is globally prices, that should lead to approximately 5x the revenue. It will obviously be less per-capita, but that's not what you said.

> and is third worldwide exporter for Natural Gas just behind Qatar and Russia

Your facts are also slanted here. The US is the worlds largest natural gas producer[2], at over 6x the production of Norway, and 25% more than the second place, which is Russia.

That said, it's not like the US is a poor country, or doesn't have credit available to finance anything it wants. Training jobless workers would be a net benefit to the economy after a few years, and would pay itself off. We could easily finance that if we decided to. It's a matter of will, not capability.

1: https://en.wikipedia.org/wiki/List_of_countries_by_oil_produ...

2: https://en.wikipedia.org/wiki/List_of_countries_by_natural_g...


You are mixing up production and export. US produces more Oil and natural gas, but is low on exports. Norway on the other hand has a low domestic consumption (because of a low population) and is able to generate more revenue on exports.

> Oil : http://www.indexmundi.com/g/r.aspx?t=10&v=95&l=en

> Natural Gas : http://www.indexmundi.com/g/r.aspx?t=10&v=138&l=en


> You are mixing up production and export.

Because for this argument they are irrelevant. Domestic consumption is money you aren't spending to buy gas on the market, at market prices. If Norway had a use for 100% of it's oil, it would be saving the equivalent amount from the global market as it would be gaining in revenue.

The bigger difference is that one is state owned, and the other is mostly privatized. Then again, for the larger picture, this is only relevant if the countries in question are constrained to the income available from this system. Neither are. If the US wanted to issue a few hundred billion in bonds, they could do so with little trouble if it was politically feasible. Or they could literally just make the money out of thin air, if they weren't concerned with or were willing to accept the possible inflation.

It's hard to overstate just how much economic and monetary power the US can bring to bear.


> US produces more Oil and natural gas, but is low on exports.

For now, the US are exporting more natural gas than Norway. However, with the completion of Cheniere's project at Sabine pass, this will be the opposite [1]. Actually, this November, the US are going to export more than twice the volume of Norway.

[1]: http://imgur.com/a/uyBiZ

Disclosure: I work in an intelligence company, but I'm not a market expert.

Edit:

> USA does not have an oil fund that amounts do $150k per capita to pay for "free everything"

No, but they certainly have other ways of funding a "free everything" that don't rely on fossil fuel. Let's call that "taxes".


US domestic oil production isn't nationalized while in Norway it is.


> USA does not have an oil fund that amounts do $150k per capita to pay for "free everything" (university education, universal health care, childcare)

The US federal government pays more per capita for health care than Norway, for one! The fact the US manages to pay so much per capita for healthcare and not have universal health care is actually quite an achievement.


They are paying much more for healthcare, while everything else is cheaper than Norway, one of the most expensive countries in the world.


If everything else is most expensive in Norway, it seems more remarkable that Norway's single payer system spends less per capita.


So Nordic patients are paying less for the same treatments, and/or getting less aggressive care. (I don't know which or how much of both)

To the extent Norway pays less for the same drugs/treatments, they are funding a smaller share of the profits of biotech & pharmaceutical companies.

The US pays a significantly higher share of pharma/biotech profits than any other country (citation needed). We therefore contribute the most to the new research, new drugs and treatments developed by those same firms. I actually think this is one of the greatest things we do as a country.

Some people call this "overpaying" but I think of it differently.


Even if this is true, it's a horrible way to fund the companies. If we want the US to fund drug companies, we sould do it through some sort of progressive tax, not through a raised cost in base level care, which affects everyone, and when it gets high enough effectively means poor people can't pay, and the middle class feels it as a large burden.

$3000 or more a year in healthcare costs is not felt the same by someone that makes $50k a year as someone who makes $150k a year. And that's for an individual. Many people are trying to cover a whole family at these rates.


But that's not how people actually pay for care... Insurance cost, copays, and deductibles are all set based on household income. In Medicaid Expansion states, if you make less than FPL and you pay literally nothing - it's the best insurance money can't buy. As you make more the subsidies taper off and you pay more in premiums and more in OOP costs. The cost is absolutely socialized through progressive taxation.

On the supply side, the price of care is set roughly in the market's ability to compete, but the price is absolutely back stopped by government policies like patents and Medicare reimbursement rates.

Take an inside look at how these firms bring new treatments to market and you know it's intensely competitive. The level of investment is commensurate to the potential payoff.


> Insurance cost, copays, and deductibles are all set based on household income.

Isn't it more accurate to say discounts to these are all set based on household income? At a certain point, you're paying regular plan costs. All this amounts to is a separate way to tax people for the costs, which means it can use a different schedule than the regular tax code. If the US is funding these companies, there should be a better way to do so that the craziness that is this.

> Take an inside look at how these firms bring new treatments to market and you know it's intensely competitive. The level of investment is commensurate to the potential payoff.

I've yet to be convinced that the massive cost of R&D due to trials and marketing which needs to be recouped by massive prices isn't at least in part the result of a runaway feedback loop. We require lots of testing to protect the populace which necessitates a lot of money to develop the drugs which means that if it's a dud or has negative effects it's in the interest of the company to occasionally cover that up because it cost so much which leads to drugs on the market that cause problems which leads to more stringent testing which leads to increased cost which leads to increased need for success which leads to....

We need to drastically decrease the cost of trials while making the cost of taking a bad drug to the general market more. That's a tall order, but it's what's needed.


Medicine is really fucking expensive. If you can solve this problem without increasing patient risk you make a dent in the universe.

Or a corollary, the amount of money the market would pay for cheaper methods of safe drug development is immense. Market, meet unsolved problem.


This is one of those situations where we want the market to solve it, but we probably aren't prepared for what a totally unencumbered market response would be. We've likely over (or at least poorly) regulated drug development, and since most things are cyclical, it will probably swing the other way at some point. That's probably good, as long as it doesn't swing too far. I want a more efficient system, but not necessarily at the expense of a few million casualties from cascading mistakes.

Unfortunately, since it has to do with people being hurt, or the possibility of people being hurt, I think it's unlikely we'll get legislation or a majority of politicians that are willing to look at it rationally. It's too easy to drum up emotional support for some aspect or another for personal gain.


It's the price of having to wait months in order to see a doctor I guess. That is if government thinks you are worth treating and you don't have to resort to medical tourism.


heres an article i like about this:

www.thepublicinterest.com/archives/2001winter/article1.html

socialized health care may not be required.


Höpö-höpö. The rest of the Nordic block - Finland, Sweden, Denmark, Iceland - doesn't have oil, and we all have very similar policies that Norway has.

It doesn't fully protect us from effects of globalization and we have similar situation with the population in rural areas and small old industrial towns not doing that well and turning against immigrants because of that.

But it seems that the situation is much worse in the US.


When an immigrant or anyone your tribe doesn't particularly care for comes along and is willing to do the same work for less, it breeds resentment. Unfortunately, that's human nature.

The U.S. has had to deal with this problem on a greater scale compared to countries that grew over millennia because of a liberal immigration policy and economic freedoms afforded to immigrants, and the aftermath of slavery. It's remarkable that this experiment has worked as well as it has (thank you, geography). But the ruling class dropped the ball over the last 20 years and ignored the rapid increase of those marginalized by immigration & trade side-effects, even though there still is a widely-held regard for the "melting pot", so now we got Trump.


It's worth noting that the current wave of immigrants is by no means the first to be marginalized, either. Irish immigrants in the 1800's, for example, faced very overt persecution for many of the same reasons (notably: "stealing" the jobs of non-immigrants), especially at the height of emigration from Ireland due to the Great Famine.

In the long run, we'll likely look back at all this fuss as another chapter in our history books, but I'm sure there'll be some other ethnic group immigrating in droves. The melting pot is a continual process. Slow and frustrating sometimes, but it works for the better in the long-term.


Out of curiosity, what's the proportion of rural or small-town population v. urban population in those countries? I find that tends to be the big dividing line here in the US, and am curious as to whether or not the same can be said elsewhere (i.e. if a lower rural:urban population ratio correlates with a higher probability for Nordic-style policy).

It's probably not the only variable at play here (economic development and education levels could be additional factors), but it might be influencing those variables in subtle (and not-so-subtle) ways.


your whole nordic block has a population of 26.6 million. That's similar to Texas, not the us. in other words, what is applicable to those places may not translate to such a big country. if you start expanding it to be similar in size to the US, you'd need to take very problematic areas in, like Russia. similarly it can be noted that northern places in the us tend to have lower income inequalities in general (northernmost state, alaska ranks second within us, northernmost country, iceland ranks first within europe). nearly all states that border canada do well on poverty measures (the exception being new york).


I'm from Denmark, and we have the same policies but basically no natural resources that are worth anything anymore. Unlike the US of A.

It's not about oil, it's about realizing that a healthy, well educated and happy population is an investment that pays itself over time.


Weird, this is a copy of a comment made by another user with the country's name changed.

Please stop astro-turfing.


Perhaps he is, I've no idea. I, however, do live in Denmark and am able to point out that we get all that. Hell, if I spend money on health in Europe I get it returned by the state when I come back.

Does my being physically present at some point on this planet make the original argument any more or less valid?

Sure, we have many problems but actually getting good benefits and seeing our taxes put to use at our isn't one of them.


Denmark is one of the NATO countries who don't contribute the required 2% of their GDP to their defense budget.

So, we're effectively pulling your weight in that.


That's probably the one thing I actually agree with Trump on: when he said the whole "NATO, we have to talk" comments. We're all living under the US umbrella when it comes to defense and it's pathetic that we don't fulfil the terms of the agreement we made.


And yet the statement is true and the irony just whooshed over your head.


that's the joke.


That entire fund was grown long after these policies. In fact Norway was one of the poorest countries in Europe as they were being implemented.


Hell, most of these kinds of policies were enacted on the outset of WWII, not exactly a time of greatness and plenty. For an other example, the UK enacted the NHS just a few years after the war ended.


Funnily enough it was an Iraqi immigrant that was involved in that effort.


You're being glib with the term 'immigrant'. He was an upper middle class professional who moved to the west in order to obtain health treatment for his kid that was unavailable in iraq.

https://www.google.com/amp/s/amp.ft.com/content/99680a04-92a...

That's very different from the people that (some in) the west are afraid of having come over.


> Norway was one of the poorest countries in Europe

Norwegian GNP per capita was among the top in Europe from the early 20th century and on.

The wealth was unevenly distributed, wages were low and there was poverty, but the country wasn't poor.


That's utter nonsense. I live in Canada, and there is no way someone like Trump could be elected here. The message simply wouldn't resonate. Harper was considered extreme and he was left of Hilary.

You know what goes a long way to eliminating blue collar angst? Healthcare. There's a policy that the US would have no issue implementing if the will existed. Hell it would be cheaper than what you currently spend.

You know another policy that would help? Subsidized maternity leaves.

Do you want a third? A government run pension program.

A forth? Controlled college tuition.

All of these are well within the US's power to implement, provided the will is there. But the will not being there has nothing to do with the ability of a nation to implement these things.


Yeah buddy, I don't know where you live, but I grew up in northern Manitoba, lived in Winnipeg, and in other parts of rural southern Manitoba. I have family throughout Alberta and Saskatchewan, and on the east coast. They have been following, promoting and loving Trumps message. If you don't think Trumps message resonated with blue collar folks in Canada, you better break out your filter bubble and take a look around, and think about what you want the political landscape of the country to look like after the next election.


The difference is that the U.S. is a heavily rural country, whereas Canada is the second most urbanized country in the world. Our hinterland is not sufficiently populous to elect a Trump-like figure.


All three Prairie provinces have a combined total of 49 seats in our Parliament.

ON and QC can each double that amount.

I hate to say it, but what people in Manitoba and Sask. think is entirely irrelevant to the country.

(Also, let's just put aside for a second that SK is a traditional NDP stronghold)


A lot of QC is made of run down blue collar workers who are on hard economic times, and somewhat xenophobic. I'm wouldn't be so quick to say Trumps policy would fail here.


The problem for them though is that they are also French, so things like the ADQ are tied to the inevitable "we'd be better on our own" and don't ever leave the province.


> I live in Canada, and there is no way someone like Trump could be elected here.

Early 20th century European history is looking at you in disbelief.

I agree with the rest.


Well, Europe isn't Canada, and 1933 isn't 2016. One of the major differences between Canada and any other country on the planet is the level of multiculturalism that is not only supported, but encouraged. It keeps all sorts of extremism at bay. I'm personally think it goes too far, but I have to concede that this is a benefit.

That comment however wasn't that someone like Trump could never be elected here, it's that the current environment, along with that of the foreseeable future, would have to change dramatically for it to be the case.


> Well, Europe isn't Canada, and 1933 isn't 2016.

You're right, but not for the reasons you think. What's keeping xenophobia at bay is not multiculturalism but a reasonably strong economy and social safety net. If these start to fail you will see the xenophobia ramp up as people look for someone to blame for their misery.

I recently visited my family in Alberta where many are struggling due to the crash in oil prices and xenophobia is definitely on the rise. Pretending that "it can't happen" is exactly what allows it to happen.

Do you think that most Germans are, at their core, antisemitic? I don't think they are, but the economic conditions of a 1933 Germany made it easy for many people to blame a specific "other" for their situation with devastating results.


Exactly.

The rise of the demagogues is a known core bug of the system called democracy, and what triggers it is fear and anger without a clear, objective, immediately identifiable cause.

If the cause is clear and straightforward (invasion by a foreign army), then fear strengthens society, and the whole system responds effectively with unity and determination.

If fear and anger exist, but the cause is complex and remote (globalization, automation, progress), and seems beyond the grasp of the everyman, then the masses turn to demagogues for "help", and are invariably wrong. That's what happened in the '30s. This is what is happening now - hopefully not with the same end result.


but a reasonably strong economy and social safety net.

Which was exactly what I said in my first comment.

You're correct, but then again we have some built in safeguards that mitigate these events. One of them being FPTP, which is why I'm personally in no great rush to get rid of it.

It's harder to find groups to rally against when many of those groups are part of the general populace. The more diverse the culture, the less likely it is to be xenophobic when times get tough. That's why major population centres in Toronto, Vancouver and Montreal voted Trudeau last time around - the Conservative message that leaned towards "dealing with" Muslims was utterly rejected.


Look, we in the U.S. just went from a multi-racial, forward thinking, cosmopolitan, thoughtful President...to Donald Trump...in one election.

I mean, I'm not saying we are as multicultural as Canada, just that political environment can change breathtakingly fast.


"It can't happen _here_. It can't happen _here_. I'm telling you my dear, that it can't happen _here_...

Who could imagine that they would freak out somewhere in Wisconsin? Who could imagine that they would freak out in Michigan? Who could imagine that they would freak out in Washington DC? Who could imagine?..."

- Frank Zappa (mutatis mutandis)


Um, the US has been completely divided right down the middle since Bill Clinton was in office.

Not only is all of that possible to imagine, it should be almost expected. Canada is a completely different beast, with a completely different governmental structure.


Heh, but the propaganda machine is working as intended and those who pay for it have made sure at least half of the American population think government run healthcare, pensions and anything else is close to pure fucking evil. You do it on your own or you're not a proper American. Amazing, really.


>there is no way someone like Trump could be elected here

That's what we thought...


Let me introduce you to a man named Rob Ford.


What about him? He's not only dead, he never went beyond Mayor. Mayors are notoriously loony because only special interest groups vote in municipal elections.


If the suburbs are a "special interest group", sure, but otherwise Ford had widespread support.


you sound like someone who has never talked to a blue collar worker in the rust belt.


I seriously doubt that /everyone/ would be on the 'free everything' plans. Just like right now not /everyone/ is in jail (but those that are still cost us QUITE a bit both in jail fees and in public court fees of various kinds).

Wouldn't a social safety net to prevent destroyed families, to prevent crimes driven by desperation and/or drug abuse, and to fund the enrichment of workers in to higher skill cogs in the machine that is society be a wiser investment than in more police, prosecutors and jails?


USA has plenty of money for its military its bases abroad and its wars. Maybe that money could be put at good use and USA should stop thinking it's so exceptional. Let USA concentrate on domestic policies instead of the middle east.


It's a question of priorities. It's easy to get into a war thinking it'll be short and easy then once you're in it's poisonous politically to not fund the war because it gets spun as not supporting the troops. Then it's hard to pull out of place like Iraq even if you don't want to keep funding the war because now it'll just become an broiling pot of lawless extremism because it's hard to rebuild a state and impose outside political systems at the same time.

Also a lot of the larger bases like those in Japan and South Korea are partially paid for by the countries there as part of getting US troops for defense.


Do you know how rich the USA is in natural resources?


Yet we do have the funds to pay for perpetual war in the Middle East and the military industrial complex? The money we spent on the Iraq war alone would have paid for years of free college.


Right. We have the money. We just have to pick one thing from the choice of: Global military conquest, or happy, healthy populace and infrastructure.


Stop spending on military and weapons and there's suddenly a lot more money for everything else. Every year.




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