Like half of our budget goes to welfare (Social Security, Medicare, Medicaid, Income Security, etc). https://www.usaspending.gov/explorer/budget_function
Like half of our budget goes to welfare (Social Security, Medicare, Medicaid, Income Security, etc). https://www.usaspending.gov/explorer/budget_function
Yes, the US spends by far the most on healthcare per capita, and still gets the worst outcomes. It's not about throwing money at problems. You have to actually solve them (and want to solve them).
Instead of fixing the leaks in the plumbing we're just increasing flow rate at the top of the system. Right now the medical-industrial complex is a business that happens to provide medical services as a byproduct.
Fee for service encourages more medical intervention. It makes break-fix work more profitable than trying to address root causes. Each layer and sub-sector is for-profit. The supply of physicians is capped. Vertical integration can reduce the double margin problem. Specialists are paid more than general practitioners. Surgeries make more money than non-surgical treatment.
People expect someone else (their employer, the government, the rich) to eat the cost of healthcare. Third party payment makes patients price-insensitive. People unironically expect a cure for death. Drugs and medical devices are expected to be perfectly safe. Americans lead unhealthy lifestyles. Soda is the default drink in cafeterias and at parties. Car culture and car only infrastructure promotes physical inactivity. Kids are not allowed to roam. When there was a push to promote healthier school meals there was immense pushback.
Social Security is a separate tax in a separate fund (invested in T-bonds). If you split that out of the budget, the budget looks even worse. The boomers retiring is just going to be bonds maturing without the holder (social security) reinvesting the money.
Boomers are getting way more than they ever put in.
What annoys me the most about this is I'm like 80% sure none of those programs will exist by the time I retire.
https://www.whitecoatinvestor.com/social-security-is-not-goi...
This article basically says “yeah social security is not solvent and we probably won’t have a solution any time soon, and if we do have a solution it will be bad, but just don’t worry about it bro.”
I came to a different conclusion. That you should expect a 25% haircut through a combination of benefit cuts, tax increases, and not keeping up with inflation. That's bad, but Social Security is not going to entirely implode.
That’s the recommendation in the conclusion, and probably the advice I’ll follow because I don’t really have a better idea. Need to strike a balance between optimism and pessimism.
The programs will exist, the purchasing power (or quantity/quality of the benefits) will not.
And yet that GINI keeps rising and cost of living outpaces inflation over the past 40 years in housing, healthcare, and education. If you are bottom quintile, maybe bottom 2, you are poorer now than 40 years ago on average. Recent policy changes seek to drop the third quintile as well.
America is designed for rich people
The bottom quintile gets everything handed to them and it's still not enough. We all live at the mercy of them and their dysfunction.
Seeing an actual "Lucky Ducky!" in the wild is always a trip.