Earlier quoted context omitted.
The way to attack the problem economically would have involved giving everyone in the USA an HSA that was funded to allow them to directly consume healthcare services with price exposure. It would naturally force competition on price. The ACA that we got instead cemented the separation of people from the price of their service and costs have ballooned even more than that were previously. The economic approach is the…
This wouldn't work when you can't get an accurate, up-front price for anything, and all unexpected costs fall on the patient with no real recourse.
DOGE's only public ledger is riddled with mistakes
831–840 of 1001 posts
Re: DOGE's only public ledger is riddled with mistakes
#832For those who want to have a substantive discussion on the federal budget and believe these cuts are justified, I have a few questions (putting aside questions of constitutionality for this thread): 1. There are claims that federal spending is out of control. How do you square that with the fact that spending as a percentage of GDP is only slightly elevated compared to the historical average going back to at least th…
2. This is all true, but much of the fraud takes please "in name" of something good. You will easily find things like funding some NGO to host a party in the "taking care of the elderly" code. Many things get misclassified to hide them better.
3. You don't really want to be fast and loose with health because it can produce some very bad headlines like people left with no care. Truth is, you can cut some spending and some pharma company who is on the receiving end of it can just stop supplying drugs or services leaving people to die and blaming you. And because it's a private company with it's own accounting, that may be true or not, but in any case it's better business for them to sabotage you and teach you a lesson.
4. This has more to do with accounting quirks than anything else. Companies have ways to spend money on intangibles with less and less scrutiny and it makes no sense to book any kind of cash profit, especially with higher inflation among other factors.
Re: DOGE's only public ledger is riddled with mistakes
#833Earlier quoted context omitted.
The way to attack the problem economically would have involved giving everyone in the USA an HSA that was funded to allow them to directly consume healthcare services with price exposure. It would naturally force competition on price. The ACA that we got instead cemented the separation of people from the price of their service and costs have ballooned even more than that were previously. The economic approach is the…
Why do Americans think competition on price is practical for health services? The most expensive services people receive tend to trauma care or for long term debilitating conditions. In both cases the ability to "shop around" is either literally impossible, or geographically limited (and the ability to travel is just another regressive tax).
Re: DOGE's only public ledger is riddled with mistakes
#834Earlier quoted context omitted.
The proposed Senate budget includes $150 billion increase in the defense budget, which already was 50% of all discretionary spending (that means after SS and Medicare as that is covered by a separate tax). This is much more than any DOGE savings, and shows that this isn't about reducing the federal budget, but about cutting services in order to fund two things: military, and corporate tax cuts (which largely benefit…
> I'd much rather my money being spent on education, foreign assistance, scientific research, etc., even if there is some inefficiencies and waste, than being spent on the military (which, by the way means that the big defense contractors in the US are _subsidized by tax payers_). I would rather not spend taxpayers money on any of these and especially on military.
Re: DOGE's only public ledger is riddled with mistakes
#835I think impartial observers have not spent time in actual government bureaucracy. Basically everything will seem like “they’re cutting something important!” Or “they’re stopping critical research!” because every government contract needs justification; so naturally they will all sound good. The data and accounting itself is such bad quality in all cases that it is impossible to be perfect at this; there are entire in…
Just to back up this point: This is 100% my experience when I was an employee for them (disclaimer: 3-4 year tenure, some number of years ago). Everything we built was marketed as this brilliant, cutting edge, leading AI ML tech, and what we were actually building was React CRUD apps with 0 users, with a heavy focus on "making the UI feel like Minority Report / feel futuristic", etc.
It's not Skynet, it's a contracting company with a great design and marketing team.
Re: DOGE's only public ledger is riddled with mistakes
#836I think impartial observers have not spent time in actual government bureaucracy. Basically everything will seem like “they’re cutting something important!” Or “they’re stopping critical research!” because every government contract needs justification; so naturally they will all sound good. The data and accounting itself is such bad quality in all cases that it is impossible to be perfect at this; there are entire in…
1. Streamlining and simplification is good. Trimming can come with harsh cuts. But what we witness is arbitrary destruction. Otherwise Musk wouldn't try to reinstate nuclear inspectors they just fired.
2. Efficiency is not the goal. Neutralization of governmental power is. And with less governmental power, corporate power will fill the gaps.
3. Ideology is the driving engine. Talking points of "Anti Woke/DEI" or "no work from home" sounds appealing one half of the people, but carries no substance beyond it. In fact, these terms are misused and retooled as weapons (such as getting rid of "woke" generals).
4. If you want more efficiency, you must make investments. No company or state entity has ever become more efficient just by cutting cost. Slashing budgets only cost you more money in the medium/long run.
5. Transparency is good. It holds people accountable and allows for better decisions. But one of the few purposes of these acts seem to bring are to bring chaos. In chaos, the stronger will win. It is the opposite of transparency.
Re: DOGE's only public ledger is riddled with mistakes
#837Earlier quoted context omitted.
The proposed Senate budget includes $150 billion increase in the defense budget, which already was 50% of all discretionary spending (that means after SS and Medicare as that is covered by a separate tax). This is much more than any DOGE savings, and shows that this isn't about reducing the federal budget, but about cutting services in order to fund two things: military, and corporate tax cuts (which largely benefit…
> I'd much rather my money being spent on education, foreign assistance, scientific research, etc., even if there is some inefficiencies and waste, than being spent on the military (which, by the way means that the big defense contractors in the US are _subsidized by tax payers_). We all would, but given that Russia, Iran, China, and NK are aggressive states and all actively claim that the US is the enemy, and that t…
Re: DOGE's only public ledger is riddled with mistakes
#838I think impartial observers have not spent time in actual government bureaucracy. Basically everything will seem like “they’re cutting something important!” Or “they’re stopping critical research!” because every government contract needs justification; so naturally they will all sound good. The data and accounting itself is such bad quality in all cases that it is impossible to be perfect at this; there are entire in…
> However bad your experience with corporate politics, know that government is 100x worse. Reading your comment I saw so many similarities to any large organisation which I worked for that I can't help but think it's simply on the same level. Hell, my first internship was 100% budget filler and, in line with my role, I was useless. Regarding inefficiency: I'm a contractor for a large organisation and have been for ov…
Everybody cries when the government raises taxes. Yet, when corporations increase prices despite not having higher cost, we just accept it as "business as usual".
As corporations rival the power of nations more and more, some people should rethink their attitude to public and private enterprise.
Re: DOGE's only public ledger is riddled with mistakes
#839Earlier quoted context omitted.
People are not just cheering for that. They're cheering because of the stated causes that money was going to were "woke" and "not America first" The general public's understanding of soft power, a global economy, and maintaining an economic hegemony is just not there. We have a democratic Republic because our founding fathers were smart enough to realize the general public is not smart enough (or, doesn't have the ti…
> We have a democratic Republic because our founding fathers were smart enough to realize the general public is not smart enough (or, doesn't have the time to) rule on every issue. Maybe - maybe - a merry band of lily-white slave-owners born hundreds of years before solar power and social media don't know how best to run a modern government. And maybe we'd be smarter if our government didn't treat schools as a pipeli…
Re: DOGE's only public ledger is riddled with mistakes
#840Earlier quoted context omitted.
I think we all agree that making the Gov more efficient is a good thing but this is about terrorizing federal employees for ideological reasons. There is no crisis to justify this. We do have a crisis in healthcare which is being ignored.
Ha. I have the complete opposite take. That the terrorism being done here is by unelected bureaucrats weaponizing tax payers money against the tax payers like myself. And it’s gone unchecked for decades. That’s the crisis.