Author Topic: My life in a Liberal hell hole.  (Read 33992 times)

habanero

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Re: My life in a Liberal hell hole.
« Reply #150 on: July 05, 2019, 11:05:44 AM »
I am quite amused when people over here refer to health care as "completely free". it ain't nothing like it - it's just that you don't get  bill for anything more than a token amount (the deductible, if you like) and as a patient you never ever see the true cost of any treatment. If I need to get medical services on a regular basis I will just pay the deductible, and after that has reached about 225 dollars for a calendar year  I don't pay anything more that year.

If you took health care out of the services provided by the government the tax rate would, everything else being equal, be significantly lower. At the end of the day healthy (and lucky) persons sponsor those who are unhealthy and/or unlucky, Health issues are by no means evenly distributed in the population and any individual can do quite a bit to significantly reduce the risk for health issues (get regular excersise, eat reasonably healthy food, don't smoke etcetc). But one of the beauties of a single payer system is that the risk pool is more diverse, you don't get a bias towards those most likely to require (expensive) treatment.

And perhaps the biggest advantage is that regardless of how small your 'stash or income is, you know that you don't have to worry to get bankrupt from some enormous health bill should yourself or someone in your family need expensive treatment. Women can give birth without worrying how to pay for it and know that in the unlikely event there are any serious complications, the financial side of it will be taken care of. Health insurance isn't tied to your job so you can switch jobs or start for yourself without having to worry about how to get access to health care.

Davnasty

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Re: My life in a Liberal hell hole.
« Reply #151 on: July 05, 2019, 12:30:53 PM »
If you took health care out of the services provided by the government the tax rate would, everything else being equal, be significantly lower. At the end of the day healthy (and lucky) persons sponsor those who are unhealthy and/or unlucky, Health issues are by no means evenly distributed in the population and any individual can do quite a bit to significantly reduce the risk for health issues (get regular excersise, eat reasonably healthy food, don't smoke etcetc). But one of the beauties of a single payer system is that the risk pool is more diverse, you don't get a bias towards those most likely to require (expensive) treatment.

But if people don't pay their own costs, there's less incentive to take care of yourself...

Country   Rank  % Obesity
US           12      36.2
Canada    26       29.4
Norway    68       23.1

...oh



habanero

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Re: My life in a Liberal hell hole.
« Reply #152 on: July 05, 2019, 01:31:16 PM »
As a healthy male in my early 40s who doesn't smoke, gets lots of excercise, have normal body weight, eat a balanced diet, have a university degree and a white-collar-type job with reasonable hours and a high income I would personally be way better off in a another system. I have consumed close to zero health care for myself for the last 20 years - the most serious being the mentioned bike accident for which I had to fork out a total of about 200 bucks for the 3 visits to the ER (one when it happened, one for a check-up after 1 week and one final check*). For the kids it has been another matter as one of my kids have an allergy which requires us to have Ephinedrie shots at hand (free for us, 400-700 bucks a pair in the US, shelf life max 1 year - if they get exposed to excessive cold or heat they need to be replaced). Been to the hospital once in that regard with ambulance and all the bells and whistles for which I paid exactly nothing as the person in question is under 18. I

The issue isn't me or my family. Its whether you look at access to health care as your right as a citizen of a civilized, advanced country or something which should be dependent on your income, ability to pay or whatever. As much as I do like my 'stash I still vote for the former. As a potential ER it's one of the things you dont have to worry about. it might be easier to understand if you look at utilities. If you read the case studies here, utilities aren't are very big expense in general. If you make it a private product - how much do you think you can charge someone for access to clean, safe tapwater, garbage removal and the possibility to take a dump on your own toilet and flush it into the public sewer system? I sure as hell would be willing to pay more than what my home city charges me for those services. Being connected to the electricity grid is in the same sphere - if someone could charge me for it up and above the highly regulated rate I sure as hell would be willing to pay more for it than I currently do. Its a natural monopoly and should be treated as such - there is no need to pretend a market exists when everything that makes an efficient market is absent.

*) if anyone finds it weird that also the post-event treatment was done at the ER it's because where I live the ER is run by the city's public hospital and is pretty much like a small hospital in itself. The ER is the go-to-place for fractures not requiring any complicated surgery  so it's all handled by them.
« Last Edit: July 05, 2019, 01:34:22 PM by habaneroNorway »

pecunia

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Re: My life in a Liberal hell hole.
« Reply #153 on: July 06, 2019, 12:52:17 PM »
and hospitals nickel and dime with highly inflated costs for basic items/services.

They charge for everything because of all the overhead, to compensate for the people that don't pay anything, and because they are underpaid by Medicare and Medicaid for services rendered.  Despite all that, many health care facilities have gone out of business and closed down or have at least had to cut some of the services they provide, causing people to travel further for their care.

So many health care facilities have shut down and so are unable to provide their necessary service to their clientele.   Well, if private enterprise is unable to do the job, maybe having these places run by Uncle Sam is a better idea.  I think most people would rather have some health care facilities in poor areas to provide those necessary services rather than leave then without.  Certainly, seems more humane.  Then we'd have a really good idea as to what it really takes to break even on costs.  I'll bet there are a lot of cost savings if health care facilities were run frugally.  MMM folks could probably teach them a thing or three about that.

HBFIRE

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Re: My life in a Liberal hell hole.
« Reply #154 on: July 06, 2019, 01:13:27 PM »
Then we'd have a really good idea as to what it really takes to break even on costs.  I'll bet there are a lot of cost savings if health care facilities were run frugally. 

LOL!  You must be kidding right?  The government is anything but cost effective/frugal/efficient.  It's the total opposite.

FIREstache

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Re: My life in a Liberal hell hole.
« Reply #155 on: July 06, 2019, 01:42:26 PM »
Then we'd have a really good idea as to what it really takes to break even on costs.  I'll bet there are a lot of cost savings if health care facilities were run frugally. 

LOL!  You must be kidding right?  The government is anything but cost effective/frugal/efficient.  It's the total opposite.

Indeed!  I was thinking the same thing reading pecunia's reply.

LilyFleur

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Re: My life in a Liberal hell hole.
« Reply #156 on: July 06, 2019, 03:43:45 PM »
Taxation is highly specific to one’s situation and state. From a moderate income, Mustachian perspective, California might not be all that bad of a deal. I would find the crowds and restrictions on personal behavior stifling and have no interest in living there. Even though it’s very beautiful.

If you want to talk about a state where you’ll get screwed 15 ways to Tuesday, then look no further than my home state of Virginia. VIrginia is supposedly a “moderate” to low tax state. At least according to those who write articles about it and don’t live there. But as always the devil is in the details. I pay about 50% of what I pay in Federal income taxes as Virginia state income taxes. There are all sorts of cute little quirks that raise the bill. Such as the top marginal rate kicking in at somewhere around $19,000.  And forcing you to use the piddling Virginia standard deduction when you don’t itemize Federal.

But it gets better. We not only have property taxes on real estate, we have it on cars. Plus registration fees. Plus tacked on parking fees. But wait! There’s more! Do you like to eat out? The restaurant tax is 15% or more depending on the city. Oh and we do have sales taxes of groceries, albeit at a reduced rate.

But let’s look at all the cool stuff we get in exchange: traffic jams, toll roads, and schools that generally suck unless you want to live in the suburbs and commute for 45 minutes. Plus, the entire state is basically a speed trap.

You have to dig deeper when looking at any state; it’s a package deal. Geo-arbitrage isn’t just for Californians.

Sales tax on groceries? Really? As in real food, not junk food? If so, that is hard to swallow and seems to go against the core of our progressive tax system in the USA. At first, I thought, there is no way that VA levies a heavier tax burden than CA on its average citizens, but with your purported grocery tax, you just may have a valid claim here.

Alabama also has sales tax on food. It REALLY hits lower-earners disproportionately. No sales tax on food in California.

LilyFleur

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TomTX

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Re: My life in a Liberal hell hole.
« Reply #158 on: July 06, 2019, 07:40:32 PM »
Then we'd have a really good idea as to what it really takes to break even on costs.  I'll bet there are a lot of cost savings if health care facilities were run frugally. 

LOL!  You must be kidding right?  The government is anything but cost effective/frugal/efficient.  It's the total opposite.
Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.

"Government employees are expensive! Hire a contractor! (Shh! it's at 3x the cost! Plus the employee time to develop and manage the contract.)"


HBFIRE

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Re: My life in a Liberal hell hole.
« Reply #159 on: July 06, 2019, 07:49:19 PM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

pecunia

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Re: My life in a Liberal hell hole.
« Reply #160 on: July 07, 2019, 07:25:37 AM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

Public parks - cheap
Private parks - not
Libraries - cheap
Private libraries are bookstores - not
Public roads - cheap
Privately run toll roads - expensive
municipal utilities usually offer their customers a better rate
Post Office to send a letter - cheap
Fed Ex to send a letter - not so cheap

Example given earlier of private medicine in US vs public in other countries.  Private medicine is more expensive per capita.

Just take a millisecond to think about it.  Private organizations serve multiple masters.  There is the customer and the owners.  The owners want all they can get.  Public organizations serve us, the public.

Now - where competition exists like cell phones there is downward pressure of prices and there private organizations shine.  However, as soon as one company dominates, the shine becomes tarnished.  The downward prices is gone.  The folks that run the company have a captive market and are only accountable to the owners and board of directors.

Now - I have no evidence of this but about 35-40 years ago the folks in conservative think tanks took a look around and thought it was time to employ Propaganda.  The same wrong ideas were repeated over and over again.  You hear it enough and you believe it.  This government inefficiency thing is one of them.  They sold trickle down like that too, but people are finally catching on.

“The most brilliant propagandist technique will yield no success unless one fundamental principle is borne in mind constantly - it must confine itself to a few points and repeat them over and over.”
― Joseph Goebbels

There are conservative hell holes too.


HBFIRE

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Re: My life in a Liberal hell hole.
« Reply #161 on: July 07, 2019, 08:58:45 AM »
All of those things are not really cheap, they are paid for just in a different way through taxation -- it would be interesting to look at private toll road costs vs public ones (real costs).   Post office lost 4 BILLION for 2018, and is on track to double that this year.  Guess who pays for those losses?  Yes, very efficient!  But at least it's "cheap", right?  Let's ignore the real accounting and just pretend its super cheap and other services are "free".  Our gov is so "efficient", that we're 22 trillion in debt. 
« Last Edit: July 07, 2019, 09:30:08 AM by HBFIRE »

FIREstache

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Re: My life in a Liberal hell hole.
« Reply #162 on: July 07, 2019, 09:31:47 AM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

Public parks - cheap
Libraries - cheap
Public roads - cheap
Post Office to send a letter - cheap


None of these things are cheap.  A significant chunk of my property taxes go to these public parks every year, even though I don't use them, just like the local schools.  We've had multiple tax increases in my area in recent years specifically due to required road maintenance.  The post office is hugely expensive.

LilyFleur

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Re: My life in a Liberal hell hole.
« Reply #163 on: July 07, 2019, 10:24:56 AM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

Public parks - cheap
Libraries - cheap
Public roads - cheap
Post Office to send a letter - cheap


None of these things are cheap.  A significant chunk of my property taxes go to these public parks every year, even though I don't use them, just like the local schools.  We've had multiple tax increases in my area in recent years specifically due to required road maintenance.  The post office is hugely expensive.
My city has become much more developed in recent years. Multi-story apartments with sky-high rents, etc. Hotels along the beach, development along the beach. It adds a great deal of traffic to our roads, and it is more difficult to find parking everywhere you go. At least parks give us some open space, and are not developed into more residences. In that sense they prevent future traffic. It's hard to put a price on that.

pbkmaine

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Re: My life in a Liberal hell hole.
« Reply #164 on: July 07, 2019, 11:10:56 AM »
All of those things are not really cheap, they are paid for just in a different way through taxation -- it would be interesting to look at private toll road costs vs public ones (real costs).   Post office lost 4 BILLION for 2018, and is on track to double that this year.  Guess who pays for those losses?  Yes, very efficient!  But at least it's "cheap", right?  Let's ignore the real accounting and just pretend its super cheap and other services are "free".  Our gov is so "efficient", that we're 22 trillion in debt.

The US Postal Service situation is a bit complicated:

https://www.truthorfiction.com/is-usps-losing-money-because-of-a-2006-pension-law/

pecunia

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Re: My life in a Liberal hell hole.
« Reply #165 on: July 07, 2019, 11:23:04 AM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

Public parks - cheap
Libraries - cheap
Public roads - cheap
Post Office to send a letter - cheap


None of these things are cheap.  A significant chunk of my property taxes go to these public parks every year, even though I don't use them, just like the local schools.  We've had multiple tax increases in my area in recent years specifically due to required road maintenance.  The post office is hugely expensive.

They are a lot cheaper then they would be if they were privatized.  I use the parks, the roads and the post office.  I thank you for paying for them.

Here's a link where it states that the post office is paid for those who use it and not by taxpayer dollars.  Now, I suppose you could say that those who use it are still taxpayers, but that may be a bit of a stretch.

https://www.forbes.com/sites/kellyphillipserb/2018/04/04/us-post-office-will-be-busy-on-tax-day-but-wont-use-taxpayer-dollars/#507e693b46b5

First class stamps are $.55 for a letter.  You are right in that the post office is hugely expensive.  Thank Goodness there are millions of people like you willing to spend your $.55 to mail your letters.  All of that postage adds up to pay for that huge organization despite the GOPs effort to thwart it's progress in recent years.

Those letters can be sent out of your liberal hell hole as pleas for help.

iris lily

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Re: My life in a Liberal hell hole.
« Reply #166 on: July 07, 2019, 03:08:59 PM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

Public parks - cheap
Libraries - cheap
Public roads - cheap
Post Office to send a letter - cheap


None of these things are cheap.  A significant chunk of my property taxes go to these public parks every year, even though I don't use them, just like the local schools.  We've had multiple tax increases in my area in recent years specifically due to required road maintenance.  The post office is hugely expensive.

They are a lot cheaper then they would be if they were privatized.  I use the parks, the roads and the post office.  I thank you for paying for them.

Here's a link where it states that the post office is paid for those who use it and not by taxpayer dollars.  Now, I suppose you could say that those who use it are still taxpayers, but that may be a bit of a stretch.

https://www.forbes.com/sites/kellyphillipserb/2018/04/04/us-post-office-will-be-busy-on-tax-day-but-wont-use-taxpayer-dollars/#507e693b46b5

First class stamps are $.55 for a letter.  You are right in that the post office is hugely expensive.  Thank Goodness there are millions of people like you willing to spend your $.55 to mail your letters.  All of that postage adds up to pay for that huge organization despite the GOPs effort to thwart it's progress in recent years.

Those letters can be sent out of your liberal hell hole as pleas for help.

How do you know the government organizations you name would be more expensive if privatized?

GuitarStv

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Re: My life in a Liberal hell hole.
« Reply #167 on: July 07, 2019, 03:30:56 PM »
If you took health care out of the services provided by the government the tax rate would, everything else being equal, be significantly lower. At the end of the day healthy (and lucky) persons sponsor those who are unhealthy and/or unlucky, Health issues are by no means evenly distributed in the population and any individual can do quite a bit to significantly reduce the risk for health issues (get regular excersise, eat reasonably healthy food, don't smoke etcetc). But one of the beauties of a single payer system is that the risk pool is more diverse, you don't get a bias towards those most likely to require (expensive) treatment.

But if people don't pay their own costs, there's less incentive to take care of yourself...

Country   Rank  % Obesity
US           12      36.2
Canada    26       29.4
Norway    68       23.1

...oh

Holy fuck we're getting fat!

LilyFleur

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Re: My life in a Liberal hell hole.
« Reply #168 on: July 07, 2019, 04:19:33 PM »
we ARE getting fat.
https://www.cdc.gov/obesity/data/prevalence-maps.html

Not so much in the liberal hellhole, though.

But the deep South, yes, too many hush puppies and slices of bacon!!!

EngagedToFIRE

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Re: My life in a Liberal hell hole.
« Reply #169 on: July 07, 2019, 05:24:31 PM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

Public parks - cheap
Libraries - cheap
Public roads - cheap
Post Office to send a letter - cheap


None of these things are cheap.  A significant chunk of my property taxes go to these public parks every year, even though I don't use them, just like the local schools.  We've had multiple tax increases in my area in recent years specifically due to required road maintenance.  The post office is hugely expensive.

They are a lot cheaper then they would be if they were privatized.  I use the parks, the roads and the post office.  I thank you for paying for them.

Here's a link where it states that the post office is paid for those who use it and not by taxpayer dollars.  Now, I suppose you could say that those who use it are still taxpayers, but that may be a bit of a stretch.

https://www.forbes.com/sites/kellyphillipserb/2018/04/04/us-post-office-will-be-busy-on-tax-day-but-wont-use-taxpayer-dollars/#507e693b46b5

First class stamps are $.55 for a letter.  You are right in that the post office is hugely expensive.  Thank Goodness there are millions of people like you willing to spend your $.55 to mail your letters.  All of that postage adds up to pay for that huge organization despite the GOPs effort to thwart it's progress in recent years.

Those letters can be sent out of your liberal hell hole as pleas for help.

Wait a second...

https://about.usps.com/news/national-releases/2018/pr18_093.htm

The USPS itself says they run at a $4B loss.  How can you say any of these things would be more expensive if privatized?  I find it hard to believe the government is so excellent at running parks that they do so cheaper than someone who has an actual balance sheet that needs to be net positive.

Personally, I don't mind taxes paying for these things as I consider them essential.  There is a reason FedEx isn't delivering letters for 55 cents.  Because they aren't subsidized by taxpayers.  But that subsidy does make it affordable to keep essential mail flowing for a large number of people.  Same with parks and education.  I'm fine with paying for it.  But the charter schools (private run, public funded) run MUCH more lean than the public schools.  A great example of how much more efficient it is privatized.  In other words, there is a clear balance between taxpayers subsidizing and paying for things that may not necessarily have great "value" from a business perspective, and doing so in an efficient way through private/public partnerships.  The key is "accountability" - and government agencies are notoriously unaccountable.  Once something is privately run with limited funds, it's amazing how much less money you need to accomplish the same thing.

FIREstache

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Re: My life in a Liberal hell hole.
« Reply #170 on: July 07, 2019, 05:54:04 PM »
Personally, I don't mind taxes paying for these things as I consider them essential. 

But Pecunia's original statement is that he/she thinks health care facilities should be run by the government rather than just regulated by the government because the government can run them much more efficiently, as ridiculous as that is.

HBFIRE

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Re: My life in a Liberal hell hole.
« Reply #171 on: July 07, 2019, 07:59:55 PM »

Here's a link where it states that the post office is paid for those who use it and not by taxpayer dollars. 

But that's the problem, the costs are not being covered by those who pay for it.  It's going into massive debt and that debt is increasing exponentially each year.  This year it's on track to lose 7B, last year 4B.  Those losses are covered by tax payers.  This is what I mean by no accountability.

pecunia

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Re: My life in a Liberal hell hole.
« Reply #172 on: July 07, 2019, 08:07:46 PM »
Personally, I don't mind taxes paying for these things as I consider them essential. 

But Pecunia's original statement is that he/she thinks health care facilities should be run by the government rather than just regulated by the government because the government can run them much more efficiently, as ridiculous as that is.

Well - It can't be so ridiculous as other countries have public medical systems that are far less costly than ours.

It's kind of a matter of belief.  It's a mantra that has been repeated over and over to seep into the conservative mind that government is always more expensive.  It may be or it may not be.  However, it doesn't have to be.  It's a wonderful thing when conservatives get together and share these beliefs.  It makes them feel so good.

"Personally, I don't mind taxes paying for these things as I consider them essential" - good attitude.  Lot's less stress. 

 

Abe

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Re: My life in a Liberal hell hole.
« Reply #173 on: July 07, 2019, 09:41:33 PM »
I agree that in general the rest of the developed world has figured out healthcare with some combination of single-payer (UK, Ireland, Italy) or hybrid, heavily regulated system (France, Germany, Japan).

That being said, in the U.S. we have a government-run healthcare system that is a disaster (the VA). It is a train wreck. I have yet to meet a colleague who works at a VA and is happy there. They are continually frustrated with the slowness of everything. Getting patients into clinic. Having clinics run past 3pm. Doing more than two operations a day. Most of them continue working out of a combination of a sense of obligation to veterans and the steady income. Almost all agree that shifting healthcare out of the VA and essentially turning it into an insurance program that pays non-VA hospitals will dramatically improve outcomes. It's a long, complicated story about why its turned into a mess. Interestingly, the active-duty medical system is generally well run and most of my colleagues working in that system are fairly happy.

catprog

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Re: My life in a Liberal hell hole.
« Reply #174 on: July 08, 2019, 02:40:34 AM »

On the flip side very cheap servieces probably lead to overconsumption - the threshold for seing a doctor is very low when the cost you see is about 20 bucks (which is the case in Norway - for under 18s the cost is exactly zero).


The thing with that is the cost of under consumption is very large. You miss the problem when it is easily treated and you end up paying a lot more when it is more complicated.

pecunia

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Re: My life in a Liberal hell hole.
« Reply #175 on: July 08, 2019, 04:58:06 AM »
I agree that in general the rest of the developed world has figured out healthcare with some combination of single-payer (UK, Ireland, Italy) or hybrid, heavily regulated system (France, Germany, Japan).

That being said, in the U.S. we have a government-run healthcare system that is a disaster (the VA). It is a train wreck. I have yet to meet a colleague who works at a VA and is happy there. They are continually frustrated with the slowness of everything. Getting patients into clinic. Having clinics run past 3pm. Doing more than two operations a day. Most of them continue working out of a combination of a sense of obligation to veterans and the steady income. Almost all agree that shifting healthcare out of the VA and essentially turning it into an insurance program that pays non-VA hospitals will dramatically improve outcomes. It's a long, complicated story about why its turned into a mess. Interestingly, the active-duty medical system is generally well run and most of my colleagues working in that system are fairly happy.

Ever hear the phrase, "cannon fodder?" 

https://en.wikipedia.org/wiki/Cannon_fodder

They spend all this money on the most technologically advanced stuff to help the young soldiers fight the war.  When they are done with the soldiers, the incentive to give them the best is no longer there.  I'm thinkin' that may be why you see all these old Vietnam Vets living and dying on the streets and now the Gulf Wars.  Maybe they don't even want to really fix the VA, it's just more of their noise.

RetiredAt63

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Re: My life in a Liberal hell hole.
« Reply #176 on: July 08, 2019, 05:38:50 AM »
Dr. Google makes it easy to find information.

Re costs:
https://www.finweb.com/insurance/average-health-insurance-cost-by-country.html

EngagedToFIRE

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Re: My life in a Liberal hell hole.
« Reply #177 on: July 08, 2019, 06:15:42 AM »
Personally, I don't mind taxes paying for these things as I consider them essential. 

But Pecunia's original statement is that he/she thinks health care facilities should be run by the government rather than just regulated by the government because the government can run them much more efficiently, as ridiculous as that is.

I didn't catch that one, lol.  Someone actually believes that?!  Unless efficiency means "rationing" in this case.  And believe me, they ration.  We have first hand experience with Denmark (my wife being Danish).  If people think these countries have some glorious, efficient system without issue, they are utterly naive.  They close down hospitals and make you drive much further, they ration care, waiting lists, etc.  The US has far better care.  And we pay for it, and generally not that much when you take our overall tax burden in to account.  It's laughable to talk about how much cheaper care is in a country that charges 180% taxes on cars (though that was recently reduced finally) and 60%+ effective taxes on income, 25% sales tax, etc.

The issue is that we are terrible at getting that care to the poor in the US.  And while people can talk about our health spending being so much more, that is rather misleading.  In these countries, you get worse healthcare and pay a fortune in taxes.  To use pecunias phrase, cannon fodder.  These systems have you paying so much in taxes to fund an extraordinarily bloated welfare state for people who don't want to work, that they can't afford to provide you with the same quality care as you would get in the USA. 
« Last Edit: July 08, 2019, 06:27:00 AM by EngagedToFIRE »

RetiredAt63

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Re: My life in a Liberal hell hole.
« Reply #178 on: July 08, 2019, 07:11:24 AM »
Personally, I don't mind taxes paying for these things as I consider them essential. 

But Pecunia's original statement is that he/she thinks health care facilities should be run by the government rather than just regulated by the government because the government can run them much more efficiently, as ridiculous as that is.

I didn't catch that one, lol.  Someone actually believes that?!  Unless efficiency means "rationing" in this case.  And believe me, they ration.  We have first hand experience with Denmark (my wife being Danish).  If people think these countries have some glorious, efficient system without issue, they are utterly naive.  They close down hospitals and make you drive much further, they ration care, waiting lists, etc.  The US has far better care.  And we pay for it, and generally not that much when you take our overall tax burden in to account.  It's laughable to talk about how much cheaper care is in a country that charges 180% taxes on cars (though that was recently reduced finally) and 60%+ effective taxes on income, 25% sales tax, etc.

The issue is that we are terrible at getting that care to the poor in the US.  And while people can talk about our health spending being so much more, that is rather misleading.  In these countries, you get worse healthcare and pay a fortune in taxes.  To use pecunias phrase, cannon fodder.  These systems have you paying so much in taxes to fund an extraordinarily bloated welfare state for people who don't want to work, that they can't afford to provide you with the same quality care as you would get in the USA.

Data please.

Canada has universal health care, run by the provinces (i.e. your individual states).  The buying and negotiating power of a province wide system and province-wide health care (and publicly owned hospitals) means that purchasing costs are lowered.  Paperwork still exists, but the massive amount that insurance requires is much less.  People do not have to pay for routine vaccinations which means a generally healthier overall population.   My local Health Unit has free water quality testing for those of us on wells (rural area).  It also supports low cost rabies clinics for dogs and cats, which really helps lower the risk of rabies in our area (we have lots of raccoons and some bats that are carriers).  Basically there is a lot of general public health support which means a potentially generally healthier population.   People don't realise/remember it, but the major increases in general health have come from improved sanitation and other general health measures - we don't lose our children to cholera and typhoid and diphtheria epidemics any more.  Look at disaster areas - infrastructure breaks down and people start getting sick in large numbers. We take it for granted.


Care is triaged, people who are urgently sick get highest priority.  My friend who broke her leg badly got excellent care and follow-up physiotherapy - as a retired doctor herself I think she can recognize good and bad care.  My friend who had serious gall-bladder issues got excellent care.  One is retired wealthy and one is retired low-income, not quite at GIS but close.  They are both in good health now.  And I don't see a lot of health issues being determined by income - of the 4 women I know who have had their gall bladders out, 3 were professionals and one was blue collar before retirement.  Same with knee replacements - 2 professionals and one blue collar.

People do get supplemental insurance at work, but there are other ways to get insurance.  You can get supplemental insurance if you are a Costco member, for example.  But basically people do not fret over changing or losing jobs because they will lose their health insurance.  They don't worry about health care in retirement - the insurance obsession on the retirement discussions on the forums is all American - it was not an issue when I retired, for example.  And yes, we have a brain drain of doctors to the US, we have a brain drain of all sorts of people to the US, including Mr. Money Mustache.  I remember the old joke that the 5th largest Canadian city is LA, because so many Canadian entertainers ended up there.  I remember hearing the term brain drain when I was a little kid, which means the 50s. 

The system is far from perfect and we let our provincial MPPs know it, but it does work.

Oh, we also are a bloated welfare state by your standards, I am guessing.  Our June unemployment rate was at 5.5% (5.4% in April).


Davnasty

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Re: My life in a Liberal hell hole.
« Reply #179 on: July 08, 2019, 07:17:35 AM »

Here's a link where it states that the post office is paid for those who use it and not by taxpayer dollars. 

But that's the problem, the costs are not being covered by those who pay for it.  It's going into massive debt and that debt is increasing exponentially each year.  This year it's on track to lose 7B, last year 4B.  Those losses are covered by tax payers.  This is what I mean by no accountability.

Did you read the link that was posted in the comment you responded to? The government does not run the post office nor is it funded by tax dollars.

There are however indirect costs to taxpayers which would not exist if the USPS were fully privatized. Things like property tax and vehicle registration exemptions for example, but these would exist regardless of whether the USPS is in debt. On the other hand there are restrictions placed on the USPS that hurt their profitability such as the cap on stamp price and the requirement to deliver to unprofitable parts of the country and operate days/hours that they may prefer to close.

Considering the USPS is not run by the government it was a bad example from the beginning. That it's not 100% free to operate as a private business makes it a bad comparison for anything really. No other business operates with the unique benefits and restraints of the USPS.

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Re: My life in a Liberal hell hole.
« Reply #180 on: July 08, 2019, 08:49:50 AM »


Did you read the link that was posted in the comment you responded to? The government does not run the post office nor is it funded by tax dollars.



Who exactly do you think covers the massive losses to keep it operating?  You think the post office just summons a genie?

Kris

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Re: My life in a Liberal hell hole.
« Reply #181 on: July 08, 2019, 08:54:31 AM »


Did you read the link that was posted in the comment you responded to? The government does not run the post office nor is it funded by tax dollars.



Who exactly do you think covers the massive losses to keep it operating?  You think the post office just summons a genie?

Who do YOU think covers the supposed "massive losses" to keep it operating? You seem to think it's the government and our tax dollars, even though people have repeatedly told you it is not.

HBFIRE

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Re: My life in a Liberal hell hole.
« Reply #182 on: July 08, 2019, 09:16:49 AM »

Who exactly do you think covers the massive losses to keep it operating?  You think the post office just summons a genie?



Turns out.....wait for it.........wait for it........wait for it.........drum roll.......yep, the tax payers.  I know, it's a total shocker.

https://fortune.com/2015/03/27/us-postal-service/

I wasn't going to answer my own question as I thought it was pretty obvious.  There isn't some magic genie paying for these things.






« Last Edit: July 08, 2019, 09:21:22 AM by HBFIRE »

Davnasty

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Re: My life in a Liberal hell hole.
« Reply #183 on: July 08, 2019, 09:21:06 AM »


Did you read the link that was posted in the comment you responded to? The government does not run the post office nor is it funded by tax dollars.



Who exactly do you think covers the massive losses to keep it operating?  You think the post office just summons a genie?

As far as I know the USPS is covering their current debt of ~$13 billion through US government loans. They probably get a good rate which in an indirect way is a subsidy, but they're still on the hook to pay the money back*. Like I said, there are indirect costs to taxpayers but the government is not just handing them money to cover their losses.

*Unless there is a post office bailout in our future

HBFIRE

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Re: My life in a Liberal hell hole.
« Reply #184 on: July 08, 2019, 09:23:51 AM »

As far as I know the USPS is covering their current debt of ~$13 billion through US government loans. T

Government loans add to our debt, which ultimately the tax payer pays.  Anyway you want to do tricky accounting, the burden comes back to us.

Davnasty

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Re: My life in a Liberal hell hole.
« Reply #185 on: July 08, 2019, 09:29:17 AM »

Who exactly do you think covers the massive losses to keep it operating?  You think the post office just summons a genie?



Turns out.....wait for it.........wait for it........wait for it.........drum roll.......yep, the tax payers.  I know, it's a total shocker.

https://fortune.com/2015/03/27/us-postal-service/

I wasn't going to answer my own question as I thought it was pretty obvious.  There isn't some magic genie paying for these things.

The headline certainly backs your position, but once again I'm not sure you've read and understood it. I've already mentioned the tax breaks and cheap loans that the USPS gets but how do you balance that with the restrictions placed on their operation. That article focuses on the benefits they receive and turns them into a $ figure while ignoring the costs of limitations like restricting prices, requiring operation in unprofitable regions, and requiring prepayment of pensions.

I-Ranger

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Re: My life in a Liberal hell hole.
« Reply #186 on: July 08, 2019, 09:36:52 AM »


Did you read the link that was posted in the comment you responded to? The government does not run the post office nor is it funded by tax dollars.




Who exactly do you think covers the massive losses to keep it operating?  You think the post office just summons a genie?

The U.S. military will operate at a massive $686.1B loss this year. Should we privatize it also so taxpayers are off the hook? I don't use the military. I don't want the U.S. starting yet another decades-long occupation of a yet another middle eastern country, so shouldn't I have to option of not paying for it?

The USPS's annual deficit is less than 1% of annual defense spending, so directing tax-rage towards it seems misplaced.

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Re: My life in a Liberal hell hole.
« Reply #187 on: July 08, 2019, 09:40:17 AM »

As far as I know the USPS is covering their current debt of ~$13 billion through US government loans. T

Government loans add to our debt, which ultimately the tax payer pays.  Anyway you want to do tricky accounting, the burden comes back to us.

I don't want to do tricky accounting, the main point I was trying to make was that the USPS is not a good example of an inefficiently run government entity. Your original claim was that taxpayers cover USPS debt and while there is indirect truth in that, it's much more nuanced than you originally implied. If you're going to count the (estimated) $18 billion in subsidies it's only fair to consider the costs of government regulation on how they run their business. For all we know the burdens placed on the USPS as a private business may outweigh the benefits they receive from taxpayers.

Davnasty

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Re: My life in a Liberal hell hole.
« Reply #188 on: July 08, 2019, 09:43:41 AM »


Did you read the link that was posted in the comment you responded to? The government does not run the post office nor is it funded by tax dollars.




Who exactly do you think covers the massive losses to keep it operating?  You think the post office just summons a genie?

The U.S. military will operate at a massive $686.1B loss this year. Should we privatize it also so taxpayers are off the hook? I don't use the military. I don't want the U.S. starting yet another decades-long occupation of a yet another middle eastern country, so shouldn't I have to option of not paying for it?

The USPS's annual deficit is less than 1% of annual defense spending, so directing tax-rage towards it seems misplaced.

To be fair, tax rage wasn't the origin of this debate, it was a question of whether government run entities are more or less efficient than private. The USPS is a particularly bad example because they are not government run but they do have a complicated relationship with the government. We should probably get off the USPS tangent or start a new thread. Not it.

Davnasty

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Re: My life in a Liberal hell hole.
« Reply #189 on: July 08, 2019, 10:03:34 AM »

Uh huh. The Repubs have been pushing that mantra forever. It's crony capitalism bullshit.


Has nothing to do with republicans or democrats or your political views.  There are endless examples of government inefficiencies and waste that continue year after year.  When there is no pressure to be efficient and no accountability, that's what happens.

Public parks - cheap
Private parks - not
Libraries - cheap
Private libraries are bookstores - not
Public roads - cheap
Privately run toll roads - expensive
municipal utilities usually offer their customers a better rate
Post Office to send a letter - cheap
Fed Ex to send a letter - not so cheap


Example given earlier of private medicine in US vs public in other countries.  Private medicine is more expensive per capita.

This is the comment the USPS tangent stemmed from. My take on these examples is that they're very confusing and much too broad. Comparing libraries to bookstores? Private toll roads? Most of the items on this list are "cheap" because they are paid for by tax dollars. We pay for them through taxes because there isn't a good way to monetize them directly and we've decided that providing them to everyone is good for society.

I agree with some of those who scoff at the idea of the government running businesses more efficiently but I also think certain services are better run, or at least closely regulated, by the government.

In my opinion these include things like utilities, military, healthcare, roads, and national parks. I'm actually not sure how I feel about privatizing all postal services. On the one hand I like the idea of flat rate delivery of important documents but I don't like that they've become a junk mail delivery service and I typically prefer everyone pay the true cost of service, meaning rural areas would pay more for delivery.

Davnasty

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Re: My life in a Liberal hell hole.
« Reply #190 on: July 08, 2019, 10:11:18 AM »
Going back a bit further the discussion was about single payer healthcare. Some strong arguments as to why the free market doesn't work the way it does for something like a manufactured good have been made and not yet refuted. We should stick to that debate.

For example, price transparency leading to competition between providers sounds great in theory, but there are significant obstacles. Emergency situations can't be priced out. Geography restricts choice. Patients can't pick and choose each service and switch back and forth between doctors for each service.

There's also the issue of all the paperwork, administration, insurance workers and profits, etc. that all contribute to the overall cost of healthcare but don't do anything to make people healthy.

These are just a couple of issues that make healthcare incomparable to other industries. Can anyone who is against universal healthcare address these points?

Abe

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Re: My life in a Liberal hell hole.
« Reply #191 on: July 08, 2019, 10:55:35 PM »
I agree that in general the rest of the developed world has figured out healthcare with some combination of single-payer (UK, Ireland, Italy) or hybrid, heavily regulated system (France, Germany, Japan).

That being said, in the U.S. we have a government-run healthcare system that is a disaster (the VA). It is a train wreck. I have yet to meet a colleague who works at a VA and is happy there. They are continually frustrated with the slowness of everything. Getting patients into clinic. Having clinics run past 3pm. Doing more than two operations a day. Most of them continue working out of a combination of a sense of obligation to veterans and the steady income. Almost all agree that shifting healthcare out of the VA and essentially turning it into an insurance program that pays non-VA hospitals will dramatically improve outcomes. It's a long, complicated story about why its turned into a mess. Interestingly, the active-duty medical system is generally well run and most of my colleagues working in that system are fairly happy.

Ever hear the phrase, "cannon fodder?" 

https://en.wikipedia.org/wiki/Cannon_fodder

They spend all this money on the most technologically advanced stuff to help the young soldiers fight the war.  When they are done with the soldiers, the incentive to give them the best is no longer there.  I'm thinkin' that may be why you see all these old Vietnam Vets living and dying on the streets and now the Gulf Wars.  Maybe they don't even want to really fix the VA, it's just more of their noise.

Agree on all of that.

Abe

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Re: My life in a Liberal hell hole.
« Reply #192 on: July 08, 2019, 10:58:13 PM »
Going back a bit further the discussion was about single payer healthcare. Some strong arguments as to why the free market doesn't work the way it does for something like a manufactured good have been made and not yet refuted. We should stick to that debate.

For example, price transparency leading to competition between providers sounds great in theory, but there are significant obstacles. Emergency situations can't be priced out. Geography restricts choice. Patients can't pick and choose each service and switch back and forth between doctors for each service.

There's also the issue of all the paperwork, administration, insurance workers and profits, etc. that all contribute to the overall cost of healthcare but don't do anything to make people healthy.

These are just a couple of issues that make healthcare incomparable to other industries. Can anyone who is against universal healthcare address these points?

Those are all good points to raise when comparing healthcare to other successfully privatized service industries. It’s like comparing the markets for USB adaptors on amazon and passenger airliners - one is a commodity with minimal technical expertise needed to manufacture, the other isn’t.

GuitarStv

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Re: My life in a Liberal hell hole.
« Reply #193 on: July 09, 2019, 07:55:42 AM »
Wait a second...

https://about.usps.com/news/national-releases/2018/pr18_093.htm

The USPS itself says they run at a $4B loss.  How can you say any of these things would be more expensive if privatized?  I find it hard to believe the government is so excellent at running parks that they do so cheaper than someone who has an actual balance sheet that needs to be net positive.

Personally, I don't mind taxes paying for these things as I consider them essential.  There is a reason FedEx isn't delivering letters for 55 cents.  Because they aren't subsidized by taxpayers.  But that subsidy does make it affordable to keep essential mail flowing for a large number of people.  Same with parks and education.  I'm fine with paying for it.  But the charter schools (private run, public funded) run MUCH more lean than the public schools.  A great example of how much more efficient it is privatized.  In other words, there is a clear balance between taxpayers subsidizing and paying for things that may not necessarily have great "value" from a business perspective, and doing so in an efficient way through private/public partnerships.  The key is "accountability" - and government agencies are notoriously unaccountable.  Once something is privately run with limited funds, it's amazing how much less money you need to accomplish the same thing.

If the USPS is like Canada's own Canada Post, it has a mandate to deliver to all areas of the country.  Even the remote ones that are very expensive to deliver to.  This raises costs.  A private carrier may well be cheaper to run . . . but it's not going to provide the quality of service expected (ie won't deliver to most remote locations).  This makes service cheaper, but means that some people won't get their mail.

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Re: My life in a Liberal hell hole.
« Reply #194 on: July 09, 2019, 09:18:29 AM »
Ironically on the original link about tax burden per state https://wallethub.com/edu/states-with-highest-lowest-tax-burden/20494/
Iowa is now ranked higher than california. 10 and 11 respectively

bacchi

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Re: My life in a Liberal hell hole.
« Reply #195 on: July 09, 2019, 09:19:15 AM »
If the USPS is like Canada's own Canada Post, it has a mandate to deliver to all areas of the country.  Even the remote ones that are very expensive to deliver to.  This raises costs.  A private carrier may well be cheaper to run . . . but it's not going to provide the quality of service expected (ie won't deliver to most remote locations).  This makes service cheaper, but means that some people won't get their mail.

In the US, it is (was) called rural free delivery. Rural homes and businesses had to pay an extra fee to get mail. Rural mail delivery also encouraged the building of roads.

https://en.wikipedia.org/wiki/Rural_Free_Delivery
https://en.wikipedia.org/wiki/Rural_Post_%22Good%22_Roads_Act_of_1916

There's no question that the USPS would be in better financial shape if it:

- Stopped making rural mail deliveries
- Didn't have to prepay its pension, unlike every other company in America
- Could raise its rates as desired
- Could stop Saturday delivery

Instead, it's in this quasi-state where free marketeers want it to be profitable yet it's constrained by non-market constraints.

Would any other company/entity drive by some rural Alaska homestead to check an empty mailbox? Fedex gives packages to the USPS in Alaska because it's unprofitable to make the drive/flight themselves.

Wrenchturner

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Re: My life in a Liberal hell hole.
« Reply #196 on: July 09, 2019, 09:32:47 AM »
At the least I'd like to see a nominal charge when visiting a medical clinic or emergency room.  Say $50.  I've heard from ems responders that they often get calls from lonely old people who really don't have emergencies.  We don't need to incentivize wasted public resources.   I think that would be a good place to start.  Im not prepared to dismantle the healthcare system in canada, but id like to see some introduction of price discovery.

GuitarStv

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Re: My life in a Liberal hell hole.
« Reply #197 on: July 09, 2019, 09:44:13 AM »
In Ontario there's a 45$ fee every time you call an ambulance.  If your call was deemed medically unnecessary, you pay 240$.  Which seems reasonable . . . and also would seem to cover your ems responders issue.

Not sure you would see a benefit in charging 50$ for emergency room visits.  If it leads to people waiting until symptoms worsen before going in, it's likely to end up costing us more money to treat a worse condition later on.  That said, I rarely use the ER or clinics.  In the past ten years I've made three visits combined.

pecunia

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Re: My life in a Liberal hell hole.
« Reply #198 on: July 09, 2019, 09:45:35 AM »
At the least I'd like to see a nominal charge when visiting a medical clinic or emergency room.  Say $50.  I've heard from ems responders that they often get calls from lonely old people who really don't have emergencies.  We don't need to incentivize wasted public resources.   I think that would be a good place to start.  Im not prepared to dismantle the healthcare system in canada, but id like to see some introduction of price discovery.

Wow!  There isn't even a charge to visit the emergency room!  That was a price discovery to me.

One more thing about the US post office.  I like it.  Where else can I see my picture hanging on the wall and what's more they tell me I'm wanted.  You can't get much better than that.

EngagedToFIRE

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Re: My life in a Liberal hell hole.
« Reply #199 on: July 09, 2019, 04:15:42 PM »
At the least I'd like to see a nominal charge when visiting a medical clinic or emergency room.  Say $50.  I've heard from ems responders that they often get calls from lonely old people who really don't have emergencies.  We don't need to incentivize wasted public resources.   I think that would be a good place to start.  Im not prepared to dismantle the healthcare system in canada, but id like to see some introduction of price discovery.

Wow!  There isn't even a charge to visit the emergency room!  That was a price discovery to me.

One more thing about the US post office.  I like it.  Where else can I see my picture hanging on the wall and what's more they tell me I'm wanted.  You can't get much better than that.

The ER is quite expensive.  They just bill you a different way...