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If you want to compare Indonesia with the US, you also have to take quality of care into account. If you want to argue if something is possible to implement for Indonesia, that's fine and all. But you also have to accept what that would mean in terms of outcomes. Because the logic that you can build a system for 250 mln people with certain outcomes, would imply you could build something for 300 mln but with completely different outcomes is not a strong one. (not saying it can't, but it all depends)

I'm not familiar with the situation in Indonesia, but my guess is that the standards and expectations of the Indonesian healthcare system are completely different to the US situation. So I don't expect a copy-paste approach to be a success.

 

In the end though, the most important message should be: it's complicated. I personally think it's rather ironical to get into discussions with people who generally think Trump is an idiot (for mistakenly thinking solving the healthcare issue is easy, for instance), and then argue it's a moral/ethical dilemma and single payer is the only option (with the proverbial mic dropping, end of). Don't need to explain that's an obvious case of pots calling kettles, I'd hope. It's the exact same logic Trump uses when he says it's simple. Come on, people. You have a brain. Use it wisely.

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7 hours ago, Zeffolia said:

when is now in particular, and why is it the special time where all of the simple fixes have been made?

"If it were truly as simple as just no longer enslaving people, don't you think it would have been done by now?"

 Nice pithy quote that has nothing to do with the situation. 

Since all you have to do is raise taxes on corporations, let’s hear your plan. 

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As far as I can tell, in central parts of Indonesia (so not on the outer islands) *basic* care is quite ok.

Which, given that afflictions that are not in any meaningful way complicated to treat cause immense financial hardship in the US, the healthcare situation in Indonesia is actually better than it is in the US.

For basic care, anyway.

But, of course, once you get into the details for more, it can get complicated.

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41 minutes ago, rhmilo said:

Which, given that afflictions that are not in any meaningful way complicated to treat cause immense financial hardship in the US, the healthcare situation in Indonesia is actually better than it is in the US.

Infant mortality rate in Indonesia is way higher than in the US, and life expectancy in the US is substantially higher, so probably not. Although there are mitigating factors such as the high prevalence of tobacco usage in Indonesia.

Still, the attempt to implement universal health care in Indonesia could be instructive, as like the US, there is a large population with widespread socioeconomic disparities. Doing some more reading on it now (not that reading about it will solve anything but still, good to have a more informed view - learning more about the situation in Canada as a result too, so that's a nice bonus).

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11 hours ago, Zeffolia said:

it's not hard to figure out the solution, increase taxes on corporations and use them to pay for everything that health insurance companies and individual citizens used to pay for. 

I'm no expert here, but wouldn't increasing taxes on corporations just mean they will turn around and pass that increase down to the consumer, therefore we would end up paying for it in the long run?

I think the easiest solution is to raise taxes across the board - to corporations and individuals. This is IMO why we are in such a quagmire, because nobody wants to pay more in taxes. Everyone would rather have someone else pay for it! State level sales tax increases, increased federal withholdings from your paycheck, and a higher corporate tax rates are what are going to be needed to get this thing rolling. Then once that is done can the pressure be put on the bloated pharma-bro companies to change their business model, and eventually phase out the ridiculously high premiums we all pay in the country for healthcare (my premium just got raised again recently, so now I pay around $600/month for a family plan). 

But hey, I know this is a very simple way to view it and there's a lot more pieces to move around than just this, but IMO this is the biggest elephant in the room. Americans will have to be sold on paying more in taxes now with the guarantee that eventually it will work out to be lower than what they pay per month for health coverage AND will result in better care AND the chances of this not getting completely fucked up by power hungry CEO's/politicians are 0%.

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3 minutes ago, chenGOD said:

Infant mortality rate in Indonesia is way higher than in the US, and life expectancy in the US is substantially higher, so probably not. Although there are mitigating factors such as the high prevalence of tobacco usage in Indonesia.

True, but you have to take into account they've only had universal healthcare for less than ten years. Also, they only expect to have it be truly universal - meaning for 100% of the population - sometime this year (says Wikipedia). So, you know, early days.

 

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2 hours ago, zero said:

I'm no expert here, but wouldn't increasing taxes on corporations just mean they will turn around and pass that increase down to the consumer, therefore we would end up paying for it in the long run?

I think the easiest solution is to raise taxes across the board - to corporations and individuals. This is IMO why we are in such a quagmire, because nobody wants to pay more in taxes. Everyone would rather have someone else pay for it! State level sales tax increases, increased federal withholdings from your paycheck, and a higher corporate tax rates are what are going to be needed to get this thing rolling. Then once that is done can the pressure be put on the bloated pharma-bro companies to change their business model, and eventually phase out the ridiculously high premiums we all pay in the country for healthcare (my premium just got raised again recently, so now I pay around $600/month for a family plan). 

But hey, I know this is a very simple way to view it and there's a lot more pieces to move around than just this, but IMO this is the biggest elephant in the room. Americans will have to be sold on paying more in taxes now with the guarantee that eventually it will work out to be lower than what they pay per month for health coverage AND will result in better care AND the chances of this not getting completely fucked up by power hungry CEO's/politicians are 0%.

corporations are undertaxed in comparison to individuals especially with loopholes which are essentially only exploitable by the rich and by corporations.  yeah they'll pass on costs, but it doesn't matter.  we need everyone to start paying appropriate taxes and move on from there

3 hours ago, chenGOD said:

 Nice pithy quote that has nothing to do with the situation. 

Since all you have to do is raise taxes on corporations, let’s hear your plan. 

halve war spending, use it for free college for all, number of doctors increases, number of medical equipment and pharmaceutical researchers increases, cost of healthcare goes down, pay for it for everyone with extra taxes.  it's straightforward, you're saying it won't work but not providing any actual evidence

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6 minutes ago, Zeffolia said:

halve war spending, use it for free college for all, number of doctors increases, number of medical equipment and pharmaceutical researchers increases, cost of healthcare goes down, pay for it for everyone with extra taxes.  it's straightforward, you're saying it won't work but not providing any actual evidence

 

Halve war spending - I agree, the US should reduce its military budget, and should disentangle itself from many of the international "policing actions"/wars that it is currently in. So now you have a large number of people that no longer have a job, and will have difficulty finding anything that paid nearly as well as the military, when you include the benefits. What do you propose to do with them? Send them to college, which is free, for four years?

Free college for all - where's the causation to the rest of that chain of events? What numbers are you predicting for an increase in doctors, researchers etc etc. Will the number of doctors in rural america increase (which is where they are most needed). As the number of doctors increases, under universal healthcare, the government pays for doctors, so the cost of healthcare will actually go up, as the number of doctors billing the government will increase.

Those medical device/pharmaceutical researchers need to be employed - are corporations that are now paying more in taxes (I'm assuming you're including payroll tax in there) likely to hire new employees?

Which corporations are you taxing? All of them, or do they have to employ a certain number of people, have a certain amount of revenue, etc. etc.? Will higher corporate taxes induce corporations to set up shop elsewhere in the world?

I'm not saying it won't work. I'm saying it's not so simple as saying "increase corporate taxes and things will magically work out."

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22 hours ago, goDel said:

- a national budget for hospital care, for instance. not sure how that could work for the entire US

this is called medicare

https://en.wikipedia.org/wiki/Medicare_(United_States)#Part_A:_Hospital/hospice_insurance

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4 hours ago, dr lopez said:

Medicare covers 60M people at about half of their healthcare expenses. America has about 320M people, so an already underfunded program is going to need to dig up some serious scratch. 

Unless you’re talking about the administration piece, in which case yeah that part is totally feasible. In fact this is where universal health care would start to show cost savings, as administrative costs would go down due to more regulatory alignment with fewer insurance providers (they would be mostly state providers under a system like in Canada). 

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8 hours ago, chenGOD said:

 

Halve war spending - I agree, the US should reduce its military budget, and should disentangle itself from many of the international "policing actions"/wars that it is currently in. So now you have a large number of people that no longer have a job, and will have difficulty finding anything that paid nearly as well as the military, when you include the benefits. What do you propose to do with them? Send them to college, which is free, for four years?

Free college for all - where's the causation to the rest of that chain of events? What numbers are you predicting for an increase in doctors, researchers etc etc. Will the number of doctors in rural america increase (which is where they are most needed). As the number of doctors increases, under universal healthcare, the government pays for doctors, so the cost of healthcare will actually go up, as the number of doctors billing the government will increase.

Those medical device/pharmaceutical researchers need to be employed - are corporations that are now paying more in taxes (I'm assuming you're including payroll tax in there) likely to hire new employees?

Which corporations are you taxing? All of them, or do they have to employ a certain number of people, have a certain amount of revenue, etc. etc.? Will higher corporate taxes induce corporations to set up shop elsewhere in the world?

I'm not saying it won't work. I'm saying it's not so simple as saying "increase corporate taxes and things will magically work out."

I'm not pretending to have all the answers to how to implement it in the short-term, but the end goal should be clear.

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When you try to tax corporations more, they will just find ways to get around it, like having an office in Ireland with 1 person and having all the money go through there.  Big companies have entire departments dedicated to decreasing their tax liability.  At the site where I work (for a very large company), they keep a certain percentage of the site as grassland and they pay local farmers to harvest the hay so that the site can be classified as a farm and pay much less property tax.  Point is, it would be extremely difficult to close all of the loopholes that are out there right now.

I heard someone say something interesting, forget where I heard it, that it would be nice if we were able to have different tax schemes for corporations depending on what they produced.  For example, lower taxes on businesses that actually manufacture goods for people, and highest taxes on companies that only make money off of money, like banks and investing firms.  I have no idea if that could even make a difference, I'm not an economist, but it seems that we should reward beneficial goods and services over just increasing wealth which is I guess the result of our capitalist system.

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anyone watch the debate that last? 

the part where castro asks biden "have you forgotten what you said just 2 minutes ago?" was really telling when he contradicted himself on whether or not there is automatic enrollment in his medicare-for-all plan. to make matters worse, biden doesn't even seem to get what castro is referring to and needs clarification from sanders; which leads me to think one of two things:

1). he's just repeating talking points and doesn't actually understand his own game plan or

2). he actually did forget what he said

also- biden's strongest hand in all this seems to be "hey, remember i was vice president under obama? well, i'm going to continue doing what he started. so vote for me"

i don't know if it's just me, but i can't stand biden

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^pundits directly afterwards were all going real hard against Castro for “being mean” in that, but what Castro said when Pete/whoever criticized him onstage was of course correct: ‘this is a primary for an election’ or whatever. shit can get serious, especially when everyone is turning a blind eye to what you mentioned re: Biden’s being wrong/misinformed/forgetful about it. In general he is a joke and everyone knows it. hoping a big gaffe or health scare will get him to drop out or kill all his support because it’s obv the elites/uninformed voters going for Biden 

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50 minutes ago, auxien said:

^pundits directly afterwards were all going real hard against Castro for “being mean” in that, but what Castro said when Pete/whoever criticized him onstage was of course correct: ‘this is a primary for an election’ or whatever. shit can get serious, especially when everyone is turning a blind eye to what you mentioned re: Biden’s being wrong/misinformed/forgetful about it. In general he is a joke and everyone knows it. hoping a big gaffe or health scare will get him to drop out or kill all his support because it’s obv the elites/uninformed voters going for Biden 

another thing i hate about pundits accusing castro of being mean is that, if he can't handle castro's attack, how will he handle trump? and even worse- how will he handle trump's base? 

the problem with biden is he's always out of his element when things don't go his way. he doesn't have to have all the answers then- but he should at least be able to defuse the situation either through wit, humor, facts etc. he has to shake the 'creepy joe biden' without the goofy "c'mon guys- we're better than this" desperation plea. and worst of all, he has to stop appearing like riding the coat-tails of obama's legacy. 

it's very clear to me that biden is the classic establishment politician that acts the part, looks the part, occasionally remembers to say his lines- but doesn't absolutely nothing. and this new requirement in leadership that forces him to do something and say anything that has been discussed and rehearsed is beyond his abilities.

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2 hours ago, Nebraska said:

also- biden's strongest hand in all this seems to be "hey, remember i was vice president under obama? well, i'm going to continue doing what he started. so vote for me"

should have just gone with obama's voice-over as well

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On 9/13/2019 at 1:16 PM, Nebraska said:

another thing i hate about pundits accusing castro of being mean is that, if he can't handle castro's attack, how will he handle trump? and even worse- how will he handle trump's base? 

 

Castro literally was the only non-frontrunner who performed well. The pundits are literally manufacturing narratives and "conflicts" at this point. Same with their dismissive tone about Sanders being too serious or "grumpy." They'll talk about Castro and Sanders being too mean/negative on cable shows then literally cut to some panel discussing Trump and his cronies outrageous vitriol of the week. The amount of enabling the mainstream media in the US does for Trump is incredible. 

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On 9/13/2019 at 2:04 PM, Nebraska said:

should have just gone with obama's voice-over as well

The only thing Biden has beyond the Obama association is his cool uncle who kick Trump's ass after a few beers vibe that's not totally eroding as he makes the rounds. That vibe is totally eroding as he reveals just how old and out of his element he is now. He and Trump are likely both in different stages of dementia, the former is more benign and not mean-spirited, the latter is revealing how much of a clueless sociopath he is. Biden can't remember Obama's name but he can recall off-tangent anecdotes from his youth with clarity. He's being apologized for and defended while Sanders is literally more articulate and fired up than most of his peers who are half his age.

Biden is the Bush of the Democratic party. He's corrupt, he's complicit to a lot of bad policies but I don't doubt IRL he's a friendly person with genuine friendships and a career in which he thought he did what was best. That's going to completely be shut down by Trump literally mocking him IRL and spouting his faux positive populist shit. We need to call Trump out for the liar he is, propose substantive policy ideas, and not flinch when attacks from the right come flooding in. HRC 2.0 in the form of an equally old centrist white dude is not going to work.

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22 minutes ago, joshuatxuk said:

The amount of enabling the mainstream media in the US does for Trump is incredible. 

Of course they do.  I'll bet this divisiveness has greatly increased viewership, and the media doesn't want to lose out on that.  Everyone is tuning in either to see what boneheaded thing Trump said this time or to get upset about the latest things the "libtards" want to take from them.

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