[2017-12-08] Healthcare

[Guest]

zbbrox, The single-payer health insurance system will not be enough to solve all our problems. There are not enough doctors/ambulances/hospitals to cover those millions of people with actual health care even if they do technically get insured. If lower-middle class are not being discussed here, I would also like to discuss.

"They can't afford insurance that costs more than rent, they'll have to choose between closing up shop or simply going without" - from the "healthcare" smbc comic.

"These aren't borderline shut-in artists like us. They're the guy who runs that used book store or the lady who planned your wedding" - 2nd to last panel

The claim in the comic is that it costs these people now $31,200 a year, which is $2600 a month, compared to the previous 13,000 a year, 1000 a month. For a 60k a year household that is half of their income. For a 90k a year household that would be a little more than a third. Consider that they are running small businesses, and yeah, it becomes a choice between having healthcare, $30,000, cost of living $24,000, and running a small business, which varies, but could be around $30,000 . You can only have 2 of the 3, and losing your small business means losing that income in the first place, losing the cost of living is not gonna happen. Their only choice is to skip out on the health insurance and find other ways.

I am not concerned first and foremost with people like Zach and friends, I am not in the same class, the same race, the same state, or the same part of the political spectrum as them. But even in the comic they speak not out of concern for themselves but out of concern for others, they claim to be able to get by fine either way. The "shame, shame, shame" attitude is not helping anyone and I would like to find a helpful solution with a rational discussion.

[zbbrox]

Guest--

zbbrox, The single-payer health insurance system will not be enough to solve all our problems. There are not enough doctors/ambulances/hospitals to cover those millions of people with actual health care even if they do technically get insured.

This is simply not true. Tens of millions of people have been brought into the health care market by the ACA so far, and we haven't seen healthcare shortages or dramatically increased lines. Canadia, the UK, France, etc. do just fine covering everyone despite the fact that they pay providers substantially less. And if you're really concerned about capacity, it's actually not that hard -- medical school costs are ludicrous and the associated debt scares talented people out of the business. We could reform that easily enough.

The claim in the comic is that it costs these people now $31,200 a year, which is $2600 a month, compared to the previous 13,000 a year, 1000 a month. For a 60k a year household that is half of their income. For a 90k a year household that would be a little more than a third.

You know that the ACA caps people's premiums if they make less than 400% of the poverty line, right? So if you have a family of four, you need to be making at least $98,000 dollars to pay these premium levels. It's less for couples or individuals, but the point is that for these premiums to be this kind of financial hardship you actually have to be doing pretty well -- well enough to be solidly in the middle class.

Again, I'm not saying this isn't hardship -- but yes, it's screwed up that Zach didn't feel the need to talk about healthcare until it affected these people, people like him, rather than when Republicans were posing a dire threat to tens of millions of people worse off.

The "shame, shame, shame" attitude is not helping anyone and I would like to find a helpful solution with a rational discussion.

I disagree. When people thoughtlessly privilege the people like them over the more needy, they need to be called out so they can get a better grip on these issues and hopefully work to actually support the effective solutions. And, again, we know what those are -- single payer is by far the simplest and most effective.

[AussieGuest]

This is simply not true. Tens of millions of people have been brought into the health care market by the ACA so far, and we haven't seen healthcare shortages or dramatically increased lines. Canadia, the UK, France, etc. do just fine covering everyone despite the fact that they pay providers substantially less. And if you're really concerned about capacity, it's actually not that hard -- medical school costs are ludicrous and the associated debt scares talented people out of the business. We could reform that easily enough.

Another thing to note is that the current, low, levels of preventative care (due to expense) leads to greater need for acute care, which is both less effective and more resource intensive.

In other words, having more people getting checkups and stuff will mean more efficient use of those doctors/ambulances/hospitals. Won't speculate on how it'd all settle out, but it's definitely worth mentioning.

[Guest]

If it weren't a small business owner and just a family of four earning a steady income of 60,000-98,000 I'd say they are okay, but when you put hardship upon small business owners I worry that it may have repercussions for people on a lower income level than them. I live in a high population, high immigrant area and there are tons of small business owners. You cut off 50-30% of a small business owner's income and that might be 3-5 or 1-3 workers that they have to let go. Worse yet the business fails as a result and all their workers are without jobs. Apply that on a massive scale and that is tons of people without jobs, plus tons of business lost in general in the area that it affects. People will have to commute further/move away. Not even the mega-corporations can sustain a community.

I wanted to talk about the working class, things are hard for them when they have to work overtime just to get by/ work 2-3 different part time jobs, but if they are let go/have difficulty finding jobs near their area at all, that is even worse. A person who LOSES their small business could find themselves in debt, have no other skills in demand in their area, and be pretty much downgraded to the working class in their older years, filling in even more unskilled labor jobs which we only need so much of. And it becomes a downward spiral where when that next young worker should have saved up enough money/ made a loan/ or otherwise reached a point where they would have started their own business later on in years and hired MORE workers, they don't.

Hospitals serving primarily medicare patients in a high-population area do have long lines. There are better clinics, private ones, family practitioners, specialists, etc. that accept the next level up of discounted health insurance that don't experience the long wait times. What aussieguest said just now was reasonable, but I wasn't arguing against more people being able to have healthcare. I would like to clarify that I would just like it if there ARE simply more hospitals/doctors to help those people, and not with inadequate care, and everyone capable of work should pay something or contribute something to have it, no one should have it for free, unless they are disabled/elderly/a child. Lowering the cost to a fair rate is agreeable, I would prefer that to be achieved with free market competition and growth in the private sector.

Always remember that no matter how you move around the numbers, healthcare never is "free". It costs a person's labor at the very least. To demand free labor is slavery.

Some of the high costs are ludicrous, I agree, but some of them are high in reflection of resources we don't have a lot of but do need a lot of. When we pour more and more of our country's income into the government instead of growing the private sector, that government is going to decide where to purchase those resources from and what quality. I don't know about you but at least half of the government do not represent me at any one time. I am skeptical of trusting the government with too much money and therefore too much power. Those who are powerless will have no choice but to accept what they are given. With the private sector at least some of that purchasing power is in the hands of people.

Those people, experiencing hardship now? I doubt that many of them inherited their wealth like the super wealthy you are so disdainful of. Keep feeling that way about the wealthy, but not necessarily all the rich. The rich person is like the sports player who earns a million dollars a year, the wealthy is the person who signs their check. Separate those in your mind.

Some of those people worked hard, started out with less, but were responsible enough with their money and intelligent enough or talented enough to maintain a small business. That kind of person is a bit uncommon, most people just want to get by. I don't want to punish them, and you shouldn't want to either. To handicap them is to handicap the nation that allows so much potential in upward social mobility. That is part of the reason why we are free, but not all.

I don't have anything against any of you guys. A productive discussion/debate should just have different views. If we all agreed with the same things, and still have problems, we would never find out-of the box thinking or solutions to those problems. zbbrox, you've probably been around for longer than I've been alive and have much more life experience. The reason I argue isn't because of any anger or personal feelings on my part, I just want to discuss things to help us all throw out some ideas, and the knowledge in your heads are valuable.

[Guest2]

--- Guest,

Are you the same person who, in page 1, recommended us to Dinesh D'Souza-

Racism originated not in ignorance and fear but as part of an enlightened enterprise of intellectual discovery.
-Dinesh D'Souza

and Stefan Molyneux?

In other words, a popular Auschwitz guard with a long marriage is the very definition of mental health. Moral considerations do not form the basis of mental health – a compliant Nazi is considered more ‘healthy’ than an outcast one. This form of ‘social ethics’ is largely due to the Jewish influence over psychology.
- Stefan Moyneux

Given that you're "educated" by such wonderful sources, do you really think you're in a position to "enlighten" us about healthcare?

[Kit.]

You cut off 50-30% of a small business owner's income and that might be 3-5 or 1-3 workers that they have to let go. Worse yet the business fails as a result and all their workers are without jobs. Apply that on a massive scale and that is tons of people without jobs, plus tons of business lost in general in the area that it affects. People will have to commute further/move away. Not even the mega-corporations can sustain a community.

Yeah, if you "forget" that every equilibrium in economics is multivariate, any change can be made to look like a catastrophe.

I wanted to talk about the working class, things are hard for them when they have to work overtime just to get by/ work 2-3 different part time jobs, but if they are let go/have difficulty finding jobs near their area at all, that is even worse. A person who LOSES their small business could find themselves in debt, have no other skills in demand in their area, and be pretty much downgraded to the working class in their older years, filling in even more unskilled labor jobs which we only need so much of.

Is "unskilled small business owner" even a thing? Isn't it fair that unskilled people get paid what unskilled people deserve?

And it becomes a downward spiral where when that next young worker should have saved up enough money/ made a loan/ or otherwise reached a point where they would have started their own business later on in years and hired MORE workers, they don't.

Isn't it actually easier to get a business loan when there is obviously unsatisfied demand on your services in the area?

Lowering the cost to a fair rate is agreeable, I would prefer that to be achieved with free market competition and growth in the private sector.

The efficient-market hypothesis tells us that if it were possible to do " with free market competition and growth in the private sector", it would have already been achieved.

Always remember that no matter how you move around the numbers, healthcare never is "free". It costs a person's labor at the very least. To demand free labor is slavery.

Really? And who exactly is not getting paid for labor?

What are you trying to achieve with such cheap demagogy?

I don't have anything against any of you guys. A productive discussion/debate should just have different views.

The view you present is well-known and is actually a part of the problem.

If we all agreed with the same things, and still have problems

https://en.wiktionary.org/wiki/if_my_aunt_had_balls,_she%27d_be_my_uncle

You are describing some hypothetical situation that has no relation to what we have here. Here, if all people agreed on the single-payer approach, the US would not have this problem.

[Guest]

guest2, Yes, same person, and now I have to say that was extremely deceptively misquoted and taken out of context. Neither of them are racist, as you are trying to imply. They both were talking about other subjects at the time:

---
Dinesh D'Souza is Indian-American, that was from his 1995 book "The End of Racism":

"Is racism a Western idea? Yes. Contrary to popular impression, racism is not universal. Indeed there are no clear examples of racism anywhere in the world before the year 1500 AD. Racism arose in the West during the modern era as a rational and eventually scientific ideology to explain large differences in civilization development that could not be explained by environment. Thus, racism originated not in ignorance and fear but as part of an enlightened enterprise of intellectual discovery. The good news is that since racism had a beginning, it is conceivable that it may have an end."

https://books.google.com/books?id=QNV3X ... y.&f=false

Taken out of context it sounds like he is saying racism is a good thing. He is not. He would like to see an end to racism, and that quote was a part of an observation of how soon in human history racism began to appear rather than the praise of racism.

---
As for Stefan Molyneux, he runs a blog, a podcast, and a youtube channel about philosophy. His youtube channel has 700k subscribers, he is canadian, and he claims to have had a close friend and mentor of his die on the waiting list for health care under a single payer system.

"But so what? What’s the problem with shaking things up? Why is it so difficult for people to break out of unhealthy or unproductive relationships?

The answer is, in my view, because mental health has always been defined in social terms – a combination of sustained relationships and productive work. In other words, a popular Auschwitz guard with a long marriage is the very definition of mental health. Moral considerations do not form the basis of mental heath – a compliant Nazi is considered more ‘healthy’ than an outcast one. This form of ‘social ethics’ is largely due to the Jewish influence over psychology. It would be hard for a Jew to say that individual morality is more important than social acceptance, since to be ‘Jewish’ is to automatically place the authority of the group over the conscience of the individual – just as Christians, socialists, Muslims and soldiers do."
- http://freedomain.blogspot.com/2005/04/ ... tupid.html

When you cut out the context of, "Why is it so difficult for people to break out of unhealthy or unproductive relationships?" You might think he is making an antisemitic quote. He is not. He is saying, socially, people define a mentally healthy person as a person who can sustain long relationships and do productive work. Well a nazi guard with a long marriage fulfills those conditions, is he mentally healthy? No, that's ridiculous right? So in the field of psychology, people should consider morality and ethics when it comes to mental health.

Molyneux's mother is jewish. In Molyneux's opinion, jewish psychologists and jewish tradition have had a huge influence over the field of psychology, and that jewish people, on average, score higher on IQ test scores. He is very pro-jew, so it is the opposite of what you may have thought originally.
---

I don't completely blame you for misquoting them though, guest2. You may have gotten the quotes from other people, out of context, as well. If you ever have time, check them out.

[AssueGuest]

I would like to clarify that I would just like it if there ARE simply more hospitals/doctors to help those people, and not with inadequate care, and everyone capable of work should pay something or contribute something to have it, no one should have it for free, unless they are disabled/elderly/a child.

I disagree. If you have someone who's out of work for a little while -be it due to study, issues within their field of work (e.g. business closure and not able to immediately uproot family), or whatever- they could easily cop a serious health problem in that time, and if they don't have reasonable access to healthcare at the time it could spiral until they are disabled. Whenever that happens, you've gone from someone who's able to contribute, and may even be a high-skilled worker, to someone who either has a reduced capacity to work or may even be completely unable to hold down a job (worst case is potential death, even). So there's a significant cost to society in having that sort of gap in care, and I've only presented a logical argument -- I haven't even touched on the more emotional one of the human cost.

The USA has a bit of an obsession with only the 'deserving' getting anything much, and a tendency to shit on anyone who don't fit whatever criteria is being used at the time. But in doing so, you actually ignore the potential of the people who are being dismissed, and reduce your potential high achievers.

Always remember that no matter how you move around the numbers, healthcare never is "free". It costs a person's labor at the very least. To demand free labor is slavery.

It's not magical, no. But there are better and worse ways to pay for it, and what you're doing now is clearly a horrible way to do it, both in terms of outcomes and costs.

When we pour more and more of our country's income into the government instead of growing the private sector, that government is going to decide where to purchase those resources from and what quality. I don't know about you but at least half of the government do not represent me at any one time. I am skeptical of trusting the government with too much money and therefore too much power. Those who are powerless will have no choice but to accept what they are given. With the private sector at least some of that purchasing power is in the hands of people.

This reflects an insidious mindset that I see too often. It is an oppositional attitude towards government, which, frankly, I find a bit stupid.

If you have a democratic (rare in the world; Switzerland is the closest) or representative (e.g. republics, parliamentary monarchies) nation, government is an extension of community. If it isn't, then it's definitely not democratic and is almost certainly not representative. I say this because it's an extension of community will, a way for people to pool their resources to respond to common needs, such as police, defence, infrastructure, education, or healthcare.

Privatisation is not a cure for poor governance; demanding better governance is the way to cure poor governance. The private sector is just as able to run things in a bad way (just look at the shenanigans of Uber), charges a premium for the privileged, and is answerable to a small minority of the population. And yes, there's the whole "But the Market!!" stuff, but time and again you see failures to act in the community interest, requiring the community (by wielding the government) to either force them to do the right thing, whether it profits the business or not, or to outright step into the space. Regional internet access is one example of this.

The private sector tends to be more responsive and is better at finding new niches, but public ownership allows for more efficient use of money (can potentially be run with a profit margin of 0%) and gives the community a direct say in its behaviour and operations. Both are useful, and each has its place, but time has shown public ownership the better model for essential services -- and healthcare is an essential service.

Also worth noting is that when you pour more and more money into the private sector, the more ability it has to corrupt the government, and that corrupted government is going to decide to put public moneys into private hands (look at the USA's military and pharmaceutical industries, among many others) instead of working for the common good.

Some of those people worked hard, started out with less, but were responsible enough with their money and intelligent enough or talented enough to maintain a small business. That kind of person is a bit uncommon, most people just want to get by. I don't want to punish them, and you shouldn't want to either. To handicap them is to handicap the nation that allows so much potential in upward social mobility. That is part of the reason why we are free, but not all.

If you talk to those people, you'll find most of them had at least one point where, had luck not been favourable, they would not be where they are today. Whether it's due to an opportunity arising, serendipity, or simply taking a gamble and winning.

Your current system actually discourages and punishes people who take a punt and try to start a business or take other risks; if you're coughing up tens of thousands of dollars a year (or are reliant on your employer doing so) to make sure your family isn't going to die from health problems, it's much harder to justify dropping to a lower (or, more likely negative) income for however long it takes to get things off the ground, and that's before factoring in any other elements of the decision.

If they do take the leap and they succeed they'll be fine, but if something goes wrong they can easily end up fully fucked. Hell, it's not even absurd to say it could literally kill them -- if you get to a point where you can't afford medical care, it's easy enough for something to sneak up and do you in.

[Guest2]

Guest, please.

His questionable statements on race are just one of many things wrong with D'Souza. Despite the fact that he's a convicted felon, he's also well known for outing gay students while he went to college, and other wonderful quotes like these:

Marriage does not civilize men. Women do. This point is even evident in the gay community: It helps to explain why lesbians are generally much better than male homosexuals in sustaining long-term relationships. The reason that society privileges marriage and gives it a special legal status is because marriage is the only known incubator for the raising of children.

This is what he bases his opposition to gay marriage. Women are babymakers, so gay marriage is useless. This is the genius you want us to listen to?

Not to mention he's a convicted felon:
https://www.fbi.gov/contact-us/field-of ... ance-fraud

And let's look at some more Molyneux quotes shall we?

“If we could just get people to be nice to their babies for five years straight, that would be it for war, drug abuse, addiction, promiscuity, sexually transmitted diseases,” he said. “Almost all would be completely eliminated, because they all arise from dysfunctional early childhood experiences, which are all run by women.”

How do you defend this? He's not giving some general statement about how maintaining "family values" will be better for the country, he's actively saying women are to blame for society's major problems.
If that's not enough to convince you of his misogyny, there's this spiel:

"Women who choose the assholes will fucking end this race. They will fucking end this human race if we don't start holding them a-fucking-countable. Women who choose assholes guarantee child abuse. Women who choose assholes guarantee criminality. Sociopathy. Politicians. All the cold-hearted jerks who run the world came out of the vaginas of women who married assholes, and I don't know how to make the world a better place without holding women accountable for choosing assholes! Your dad was an asshole because your mother chose him, because it works on so many women! If "asshole" wasn't a great reproductive strategy, it would have been gone long ago. Women keep that black bastard flame alive. They cup their hands around it. They protect it with their bodies...Keep fucking monsters, we get catastrophes, we get war, we get nuclear weapons, we get national debts, we get incarcerations and prison guards and all the other florid assholes who rule the world. Women worship at the feet of the devil and wonder why the world is evil."

Where (I don't know why I'd have to clarify, it's all right there^!") he basically (again) blames all women for the problems in society just because "they choose assholes".

Not to mention he's a climate change denier on top of it all:
https://www.youtube.com/watch?v=UNRW5qM ... anMolyneux

Well a nazi guard with a long marriage fulfills those conditions, is he mentally healthy? No, that's ridiculous right?

Actually, no. A Nazi guard with a long marriage probably is more mentally healthy that some outcast loner Nazi. What was probably the case (and what happened a lot during WWII) is that the former was forcefully conscripted by Nazi Germany, and just wants to go home to his family. The latter probably joined the Nazi Party willingly. Just because someone endorses or subscribes to a system of morality that is degenerate doesn't necessarily mean they are mentally unhealthy. Case and point, the entire Religious Right. Molyneux's analogy breaks down when you realize that morality can't predict mental health in any meaningful way.

So in the end, you want us to take economic advice someone who is blatantly misogynistic, doesn't understand psychology, and who denies science, OR you want us to take advice from another misogynist, who his also a homophobe and a felon convicted of campaign finance fraud, of all things.

I think it's time to admit your sources aren't nearly as credible as you think.

[Kit.]

guest2, Yes, same person, and now I have to say that was extremely deceptively misquoted and taken out of context. Neither of them are racist, as you are trying to imply. They both were talking about other subjects at the time:

---
Dinesh D'Souza is Indian-American, that was from his 1995 book "The End of Racism":

"Is racism a Western idea? Yes. Contrary to popular impression, racism is not universal. Indeed there are no clear examples of racism anywhere in the world before the year 1500 AD. Racism arose in the West during the modern era as a rational and eventually scientific ideology to explain large differences in civilization development that could not be explained by environment. Thus, racism originated not in ignorance and fear but as part of an enlightened enterprise of intellectual discovery. The good news is that since racism had a beginning, it is conceivable that it may have an end."

https://books.google.com/books?id=QNV3X ... y.&f=false

Taken out of context it sounds like he is saying racism is a good thing.

Taken in context, it looks like bullshit, swims like bullshit, and quacks like bullshit.

In particular, it looks like he tries to assert (with no proofs at all) that caveman mentality of right-wing politicians has anything in common with rationality or science.

As for Stefan Molyneux, he

...makes some overly general claims about humanity based on a single fact that he believes that his mom has abused him in his childhood. His mom is Jewish, yes.

I think it's time to admit your sources aren't nearly as credible as you think.

Credibility of a source has little to do with adherence to the moral norms of the time -- after all, Galileo was a convicted felon too.

But having no education in Economics (or any other scientific field of applied higher math) and obvious disregard for logic in their arguments definitely do not make them experts in the area of rising healthcare costs.

[AussieGuest]

And let's look at some more Molyneux quotes shall we?
--trimmed--

Now you're just being unfair with your quotemining. You're picking stuff from where he's raving and ranting, which is only, like, 70% of the time his mouth is moving .

Molyneux is an vehement anarcho-capitalist*, which on its own should be enough to raise questions regarding the quality of his thought. I say this because anarcho-communism is a nice idea -essentially that people can get together, cooperate, and share- that requires levels of personal responsibility, intellect, and wide-reaching trust that just aren't prevalent enough the present (I won't assume the future will be the same, but it's not going to be different in the near future, at least).

Anarcho-capitalism tries to solve the same core problems by invoking The Market. In doing so they end up with problems like trying to sue people through competing private courts -- and giving solutions like "Well, if the parties cannot agree on which court to go to**, they just go to a third court which will decide for them!"

'Course, there's also the question of on what basis do these courts make their decisions, and a tendency to answer it with "Case law, obviously," and completely miss the problems.

*Given that it's a left-wing ideology, I do have to admit it means he has at least a basic value in common with me (or is inconsistent in a way that completely undermines any anarchist system... which I wouldn't put past him).
**For example, Alice might want to go to Alice Legit Court Services Co. while Bob wants Bobby Genuine Courts Inc.

[Guest]

Now you're acting like I am arguing against the concept of health insurance itself. I am not. Those people and the gap will be covered once affordable private insurance is available.

Look, as long as the amount of hospitals and doctors increase in the US, I will be satisfied. Right now we need some growth and innovation on that front and I truly believe that the free market can achieve that. We have been handicapped by strict regulations, high taxes, and many other changes put in the recent years.

As for guest2's comments I think they are very misleading and exaggerated. Relying on identity politics to disparage someone's character rather than addressing the persons arguements will only get you so far. His alleged involvement of outing gay students supposedly happened in the 1970s and it comes from one mans claim. He himself denies it and has said that people have equal rights under the bill of rights and constitution. I can accept the felony as a criticism of a persons character but i believe he paid for his crime of giving more money individually than was legally allowed.

I can accept aussieguests criticism of Molyneux as well it is at least based on some listening and discussion of him at the very least. You could say that from your own opinion but note that he also backs up his reasoning with information anyone can check up on online about the importance of a childs development "0-5". I wouldn't say he is blaming all women but rather placing some reasonable responsibility on them.

If the people in virginia could afford it yeah I would love it if they could start a privately owned insurance company or even a medical clinic or hospital by pooling funds together. It would even benefit their community and return their investment over time. They live next to the best hospital in the state but cannot afford it when they are covering their insurance plus many other people's at that cost.

I don't think that overtaxing or overcharge is fair on small business owners. Perhaps if you have to have it your way consider a compromise where small business owners get a break in taxes or healthcare by a certain percentage while someone of the same income level don't.

I am not racist, misogynist, or uncaring as you are trying to imply. Also, I am a woman and not white. I would like my privacy to be respected otherwise.

I care about the US and western civilization in general. What has been done so far is not perfect but its better than many others. Improve it by making more businesses, being charitable, and innovating more. You are all very reasonable and intelligent people, you should understand my reasoning.

[AussieGuest]

Now you're acting like I am arguing against the concept of health insurance itself. I am not. Those people and the gap will be covered once affordable private insurance is available.

Look, as long as the amount of hospitals and doctors increase in the US, I will be satisfied. Right now we need some growth and innovation on that front and I truly believe that the free market can achieve that. We have been handicapped by strict regulations, high taxes, and many other changes put in the recent years.

Okay, lets go on a tangent that leads back to this:

Do you think the free market can satisfactorily provide national defence services? (i.e. Army, airforce, navy, and I suppose nuclear arsenal [since that's apparently a vital thing these days]).

If yes, why? If no, why?

[Astrogirl]

Look, as long as the amount of hospitals and doctors increase in the US, I will be satisfied.

With 2.5 doctors per 1000 inhabitants http://www.who.int/gho/health_workforce ... ensity/en/ the US is slightly better than Canadia and slightly worse than the UK. Quite a bit worse than many other European countries, which partially reach 4. But not totally horrible. If you want more doctors, make medical studies free.

Right now we need some growth and innovation on that front and I truly believe that the free market can achieve that. We have been handicapped by strict regulations, high taxes, and many other changes put in the recent years.

The US has the freeest market, laxest regulations and lowest taxes and still you are in the bottom range of industrialized nations. Your opinion does not seem to be backed by facts.

[Guest]

Aussieguest, no, simply because a completely privatized defense force wouldn't be a national defense force by definition. Theoretically a mercenary/private military force could get to that level but that's not what we want or need, and I'm not arguing anti-government or no government either. Just don't overdo it.

The free market + low taxes will allow a nation to grow. Say you take in 39% in taxes for all corporations, pretty much what we were doing before when you count both federal and state, then your rival nation/state takes in 25% for taxes. Yeah you're taking in a lot for a while but over the years more of those corporations + new corporations open in your rival state than you have. You're missing out in the long run. You lower those taxes just a bit, not even having to equal your rival considering that your nation is "better" and you're on a equal footing and not significantly handicapped on that front. Over the years what you didn't take in taxes gets reinvested into growth, and you're not hurt significantly because you draw in most of your federal revenue from income tax anyway.

Astrogirl, with Canadia one of the only countries the doctors per inhabitants number is better than it's still not good enough. The comparison looks like it's not bad on the front but the reality is the USA has more population than Canadia, more health problems, and Canadia still has issues with its single payer system like long waiting lists for very significant operations. Canadia also has a highly merit-based system for immigration, a immigrant has to prove the ability to work, hold a job/and or pursuit of education.

Instead of seeing it as 2.5 doctors as not that bad I would rather aim for the 4. I agree with making medical studies affordable but I think that free is unwise, unless you make it highly merit-based, which is what we already have with certain scholarships. Free without merit-based could mean you are replacing each potentially good doctor's education with 4-5 student failures and actually losing out on a doctor for the amount of funding that you spent.

We don't have the laxest regulations because small businesses pay about 5k-7k per worker per year to follow federal regulations. I'm not saying no to regulations either, some regulations have to stay, they are common sense and needed, like food, health, and worker safety amongst others. But when we get as far as a small business owner having to spend that much something is going wrong there.

We had the highest corporate tax (35% federal-39% when you count the state) before recent changes when you count the additional state tax on corporate, and we have the 21st highest income tax.

I'm not saying don't have your single payer system, I am saying if you have to have it? Consider all those things (small businesses, corporations, competition with other nations, number of doctors) and make sure we are covered on that front. I'm not totally against you guys there and I don't get a bit of the aggressiveness here, I hope you guys had a merry christmas and a happy new year. I suppose it comes with the argument, but realize it is not needed. We are all having a talk to make things better for everyone, I hope?