441–450 of 569 posts
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I do, the talent exists elsewhere cheaper
No it doesn't. If it did, they would already hire those people and get rid of their more expensive talent.
One thing I don't understand is how you can make healthcare "equal" in the sense that it will stand up to court challenges in the U.S. Free speech is a self-service right, so the government can just step out of the way and everything is fine. But healthcare requires the government to do a lot. Not doing something equally (like stepping out of the way of free speech) is easier than doing something (like healthcare) eq…
The SC is trying its best to devolve all powers to the states. They can't have it one way for a contentious issue and then be hypocrites for anything else.
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Citation needed. Every population graph I can find show a small decline over the last few years but it's still above 2000 and they've had population dips before (1970-1980) that then recovered. This comment reads like my in-laws who always talk about how "people can't get out of CA fast enough", um the population numbers say otherwise.
"A smaller Empire State: New York continues to lead nation in population decline" https://www.democratandchronicle.com/story/news/politics/alb... The population flight is primarily for US-born residents, which is what happened in CA as well.
Covid CRUSHED NYC tax revenues - and many people have still not returned.
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…
> NYC high earners are going to be knocking on the door of 60% combined rates (city, state, federal). tax avoidance and/or relocation services are going to be booming if so. It turns out that people don't often move over taxes, despite the claims of the anti-tax crowd, or NY and CA would have been emptied out long ago. Taxes are investment; we need to start calling them 'low-investment' and 'high-investment' states (…
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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.
I'm guessing the economy of scale for such a buy in isn't enough, and that states would have to take out as much debt as their yearly budgets or even more. Even a Elizabeth Warren's proposed solution was something like 17x the federal budget.
I’m an MD who trained in NYC. I have also had emergency surgery in the NHS at one of their most prestigious hospitals in London and so I feel like I’ve seen the system a little bit from the inside. It was far cheaper for me than it would have been as a Brit in the USA, but the standard of care was lower. They didn’t have some technical and staffing resources late in the afternoon that would be a baseline in any of th…
This is a good take. Single payer might work in the USA using HMO plans funded by taxes, income/asset linked tiers of coinsurance, tax increases, major efficiency corrections, reduced barriers to entry, and mix of deregulation and regulation to increase competition. Also, the US healthcare system is the excellent and one of the world's best if : A) you have good insurance or medicaid/medicare in the right place. B) y…
There are some niche fields where the USA is demonstrably the best - pediatric oncology surgery, some difficult transplants, and novel cancer therapies come to mind. But I think it is hard to argue that it is anywhere near the best on the metrics usually used to judge a healthcare system, which other people have posted about.
In my experience, it also suffers from thinking it is the best and patients expecting it to be best. I have seen some patients get quite excessive and even unusual treatment in hallowed healthcare institutions in the USA.
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Citation needed. Every population graph I can find show a small decline over the last few years but it's still above 2000 and they've had population dips before (1970-1980) that then recovered. This comment reads like my in-laws who always talk about how "people can't get out of CA fast enough", um the population numbers say otherwise.
"A smaller Empire State: New York continues to lead nation in population decline" https://www.democratandchronicle.com/story/news/politics/alb... The population flight is primarily for US-born residents, which is what happened in CA as well.
"Most of New York's population decline has been upstate."
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I don't want to be rude, but if you paid 17%, that's basically the minimum income tax rate (10+4+3) for NYC. That's pretty far form the OP's "NYC high earners". Of course, if you got credits, that's orthogonal as normally those credits cost more than they are worth. For instance, the child credit is far from the cast of raising a child.
If you own your home and are married the rate comes down until you make >500. I live in NY, not NYC and pay ~18%, or ~22% with property tax.
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Actually, the median American has access to exceptional care. What is actually the case is that care available to the bottom quartile of Americans is below the care received on average in a top-tier universal care nation, and the US spends an absolute fortune delivering this quartile with substandard care. We also spend a bit more than average providing exceptional care to everyone else, except that we also spend a t…
60% of the US has access to "good" healthcare. Why is it ok to throw the under 40% under the bus?
We already pay to cover our own family members on our plans. Why are we being forced to now cover everyone else's family?
I'm more likely to move to the adjacent state than pay 15% higher tax rate and literally get LOWER quality care.
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I have made no statements about how things should be. I have lots of opinions about how things should be, which I don't share on HN. I was making statements about how things actually are , since no discussion about how to make the world we want is likely to be meaningful or useful if there is not a shared view of what is first.
And what you focus on brings about thoughts of a zero sum game which I called out. You can safely assume I don’t agree with what you find most pertinent. I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system.
lol