291–300 of 569 posts
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You paid much more than that. A substantial part of your rent is property taxes. I also doubt you included sales taxes in that number. Then there's more esoteric stuff like tariffs, etc
NY has low property taxes compared to most no-income-tax states
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> "your salary will now be half and we're maxing our your workload" should be fine if they pay their student loans no? isnt that the main reason the salaries are so high? cost of living + debt
cost of living isnt the reason for high salaries in Medicines. Unlike tech, salaries in medicine increase as you go to rural and/or underserved areas. It is driven by supply/demand and quality of life in urban vs rural areas.
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Long tail costs are things like freak car accidents, hail, etc. Reckless drivers should and are charged more because their costs are higher as a result of their own choices. Obese smokers should be charged more than healthy people but they're not because ACA says you can't discriminate based on pre-existing conditions. That means healthy people end up subsidizing lung cancer treatment, heart disease treatment, insuli…
Older people do pay more for healthcare insurance…
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Very broad strokes, doctors in the US are overpaid and conservatives legislated Medicare can't negotiate drug prices. Lots of room to drive down costs. Spending is high because of a dysfunctional system driven by profit instead of care. https://www.npr.org/sections/money/2019/03/12/702500408/are-... https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010.... https://www.bostonglobe.com/2021/10/25/opinion/let-medi…
We already have a shortage of doctors and it is very expensive to become a doctor. How will paying doctors less help this? We need to reduce requirements for becoming a doctor and have "tiers" so people who just do family doctor things only need to know family doctor things. Prescription drug spending is less than 20% of medicare. Negotiating prices might help but taking that 20% to 10% still leaves healthcare as a v…
The fact that you think family medicine is about "just knowing family doctor things" tells me all I need to know about your level of medical knowledge.
Family medicine is arguably the field with the highest knowledge ceiling, because they have the first encounter with literally anything the patient can present with.
Lowering standard and having NPs write adderall(have you heard the news about those ridiculous ADHD online clinics? btw people don't seem to appreciate that adderall is functionally meth) and antibiotics for everyone they set their gaze upon is not the right way to improve healthcare.
Coming from a country that has this, there should be caution: it gets more affordable, but you get what you pay for. In my country of origin, you get a partially-paid-for ride to the emergency room, where you pay for things like casts, non-ward rooms, dental care out of pocket. There is no prescription coverage. There is no optometry coverage. I would wait significant chunks of a year for procedures and diagnostics.…
Switzerland has private insurance just like the US and people I know that live in Zurich love it.
Profits are regulated (sometimes down to zero) in CH. Profits are unregulated in the US.
That is an important paragraph. If you want good public health care, you need to make sure the rich use it too. Canada does it by not allowing doctors to work in both the public and private systems. This law takes a different approach, instead barring the insurance companies from competing. Wonder if it will hold up in court.
Without this paragraph I don't think it could be a good system. With it, there's at least some hope.
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> The young should not pay for the healthcare of the elderly. The same way responsible drivers should not pay for reckless ones? Or responsible homeowners shouldn't pay for reckless ones? The whole idea of insurance is to distribute the costs so that no one has to bear long tail costs alone...
Long tail costs are things like freak car accidents, hail, etc. Reckless drivers should and are charged more because their costs are higher as a result of their own choices. Obese smokers should be charged more than healthy people but they're not because ACA says you can't discriminate based on pre-existing conditions. That means healthy people end up subsidizing lung cancer treatment, heart disease treatment, insuli…
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No, it wouldn't. The European single-payer systems pay half what we do per-capita, factoring in private and public spending in both systems. The US system is wildly cost inefficient. See the chart at https://data.oecd.org/healthres/health-spending.htm
The amount paid per capita and whether you would pay more taxes are not exclusive things. I’m not sure why people keep bringing up Europe - the USA is not Europe. For one doctors are paid more in the USA compared to Europe, medicine is more expensive here, more of the R and D originates here, etc
"Critics of drug price regulation argue that free market pricing strategies and higher prices in the United States are instrumental to innovation. One might therefore expect the United States to be the most innovative given that it is the only country with a predominantly unregulated pharmaceutical market. However, US pharmaceutical innovation appeared to be roughly proportional to its national wealth and prescription drug spending. Our data suggest that the United States is important but not disproportionate in its contribution to pharmaceutical innovation. Interestingly, some countries with direct price control, profit control, or reference drug pricing appeared to innovate proportionally more than their contribution to the global GDP or prescription drug spending."
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> Coming from a country that has this, there should be caution It's big world - without knowing which country, this is of little help. I'd like to see a comparison of people forced into debt, bankruptcy or death due to the respective medical systems This hits home because I have a friend that got cancer with "good" U.S. insurance and if he did not fight the insurance company he'd be in debt for 1mm+
I'm from the UK, which is basically fully free-at-point-of-use healthcare (you pay a nominal fee for prescriptions, dentistry, optician) and is often championed as a great option. Reality is it's pretty grim. Don't know if I'd recommend it to other countries to be honest. Be careful what you wish for!
As someone who's never experienced the UK health care system, and only know one person who has (as a foreigner, so they paid out of pocket and said the experience was positive, but otherwise not a good data point) ... I'd like to hear a bit more detail about how it's pretty grim, if you're willing to elaborate.
it will be interesting to watch NY (and/or CA) put something like this in place and observe from afar. i strongly feel that states should be much more aggressive running policy experiments if their constituents desire them, and at the national level we all get some benefit of seeing how things turn out in real time. all that said, assuming there is some tangible tax increase, NYC high earners are going to be knocking…
This came up in the VOX in the weeds on healthcare policy some time ago. Their conclusion from the people that had looked into it is that it is sort of impossible for states to do this. Can't really remember the reasons. There was another state that was trying something like this, I believe it was Vermont.