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251 USAF7138th Nov 2011 04:50:18 PM from the United States
I changed accounts.
Because they don't spend very much on other things.

Social Security and the United States Military (who are first and second, respectively, in terms of largest shares of the US Government budget, at ~$600+ USD billion each) say hi.

edited 8th Nov '11 4:51:20 PM by USAF713

I am now known as Flyboy.
252 pagad8th Nov 2011 04:58:37 PM from perfidious Albion , Relationship Status: Having tea with Cthulhu
Sneering Imperialist
Colour me honestly surprised that a larger amount of the budget is allocated to Social Security than the US military.
Typhoid and swans - it all comes from the same place.
253 Jeysie8th Nov 2011 05:00:07 PM from Western Massachusetts
Diva of Virtual Death
Well... AFAIK, Social Security is only technically a part of the overall budget, as it's supposed to be funded by payroll taxes, not general taxes.
Apparently I am adorable, but my GF is my #1 Groupie. (Avatar by Dreki-K)
254 USAF7138th Nov 2011 05:05:58 PM from the United States
I changed accounts.
It's a margin of only some $20-30 billion...

Well... I guess that's probably close to the entire budget of some Third World nations, but it's comparatively small.

Medicare and Medicaid combined were about $602 USD billion in 2004, though, so they're not exactly small pickings either (it was $207 USD billion for Medicare and $305 USD billion for Medicaid, while it served a combined total of 87 million people [and the "dually eligible" have been accounted for in that total]).

Edit: More recent statistics (as per Wikipedia).

(Note: this isn't actually what was passed, but rather what President Obama requested to be passed. The actual values may very well have changed in between those two ideas).

Mandatory spending: $2.173 trillion (+14.9%)

  • $695 billion (+4.9%) Social Security
  • $571 billion (+58.6%) Unemployment/Welfare/Other mandatory spending
  • $453 billion (+6.6%) Medicare
  • $290 billion (+12.0%) Medicaid
  • $164 billion (+18.0%) Interest on National Debt

So... we spend the most on Social Security, followed by the US Military (first item on the list below), then unemployment and welfare (and other, unlisted stuff), and then finally Medicare and Medicaid.

Discretionary spending: $1.378 trillion (+13.8%)

  • $663.7 billion (+12.7%) Department of Defense (including Overseas Contingency Operations foreign wars)
  • $78.7 billion (−1.7%) Department of Health and Human Services
  • $72.5 billion (+2.8%) Department of Transportation
  • $52.5 billion (+10.3%) Department of Veterans Affairs
  • $51.7 billion (+40.9%) Department of State and Other International Programs
  • $47.5 billion (+18.5%) Department of Housing and Urban Development
  • $46.7 billion (+12.8%) Department of Education
  • $42.7 billion (+1.2%) Department of Homeland Security
  • $26.3 billion (−0.4%) Department of Energy
  • $26.0 billion (+8.8%) Department of Agriculture
  • $23.9 billion (−6.3%) Department of Justice
  • $18.7 billion (+5.1%) National Aeronautics and Space Administration
  • $13.8 billion (+48.4%) Department of Commerce
  • $13.3 billion (+4.7%) Department of Labor
  • $13.3 billion (+4.7%) Department of the Treasury
  • $12.0 billion (+6.2%) Department of the Interior
  • $10.5 billion (+34.6%) Environmental Protection Agency
  • $9.7 billion (+10.2%) Social Security Administration
  • $7.0 billion (+1.4%) National Science Foundation
  • $5.1 billion (−3.8%) Corps of Engineers
  • $5.0 billion (+100%-NA) National Infrastructure Bank
  • $1.1 billion (+22.2%) Corporation for National and Community Service
  • $0.7 billion (0.0%) Small Business Administration
  • $0.6 billion (−14.3%) General Services Administration
  • $0 billion (−100%-NA) Troubled Asset Relief Program (TARP)
  • $0 billion (−100%-NA) Financial stabilization efforts
  • $11 billion (+275%-NA) Potential disaster costs
  • $19.8 billion (+3.7%) Other Agencies
  • $105 billion Other

edited 8th Nov '11 5:21:15 PM by USAF713

I am now known as Flyboy.
255 Jeysie9th Nov 2011 03:29:53 AM from Western Massachusetts
Diva of Virtual Death
Ironically we could cut Medicare/aid like mad with proper single-payer healthcare and cost controls, and cut welfare systems with more jobs and a living wage minimum wage. Yet the Pubs who want to cut spending won't do a single thing to implement either of those changes.

edited 9th Nov '11 3:30:28 AM by Jeysie

Apparently I am adorable, but my GF is my #1 Groupie. (Avatar by Dreki-K)
256 USAF7219th Nov 2011 04:07:21 AM from the United States
257 pagad9th Nov 2011 04:13:58 AM from perfidious Albion , Relationship Status: Having tea with Cthulhu
Sneering Imperialist
Could someone explain to this ignorant Brit what exactly the terms "Medicare" and "Medicaid" denote?
Typhoid and swans - it all comes from the same place.
One is "you get health bills paid if you're poor enough" and the other is "you get health bills paid if you're old enough".
Don't just tell us the facts; tell us the memes, tell us the archetypes, tell us the catchy ideas and symbolic roles that get planted in pe
259 Jeysie9th Nov 2011 04:17:51 AM from Western Massachusetts
Diva of Virtual Death
Basically, they're both the closest thing the US has to a publically-funded healthcare system. Medicare is for all senior citizens and people of all ages too disabled to work, while Medicaid is for low-income individuals of all ages.
Apparently I am adorable, but my GF is my #1 Groupie. (Avatar by Dreki-K)
260 USAF7219th Nov 2011 04:38:52 AM from the United States
F-22 1986 Concept
Programs created during the Great Society legislation process under President Lyndon B. Johnson, they slowly expand every once in awhile, and eventually might have become actual UHC systems.

Given that Big Pharma is number two on the list of domestic controllers of politics, that's probably why the Republicans are after both programs. The US is the last bastion of pharmaceutical profits, and if we go down the path of the rest of the First World that's billions in lost dollars to medical corporations...
USAF713 on his phone or iPod.
261 Enkufka20th Dec 2011 11:51:29 PM from Bay of White fish
Wandering Student ಠ_ಠ
Ok, necroing thread because this is awful.

this is a study about bankruptcies here in the US in 2007. The sample size was 2314 bankruptcies. The results:

RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001

Emphasis mine.

This means that even with private health insurance, you are still likely to get completely shafted when you get a debilitating sickness.
Very big Daydream Believer.

"That's not knowledge, that's a crapshoot!" -Al Murray

"Welcome to QI" -Stephen Fry
262 feotakahari21st Dec 2011 12:50:11 AM from Looking out at the city
Fuzzy Orange Doomsayer
If you get cancer, statistically, you will go bankrupt within two years.

In a way, this is actually relevant to me, since I have a rare immune disease. My insurance is billed $20,000 every eight weeks for my treatment, though due to the way the system works, it only pays a small fraction of that amount. If I were not insured, I'd be required to pay that whole sum, and since I have a preexisting condition, I have no idea whether I would be allowed to buy private insurance—which means I need a job that has health coverage, and can't afford to dream of being a writer or an entrepreneur.

Edit: Decided to do some more research, and this looks promising.

edited 21st Dec '11 1:17:46 AM by feotakahari

That's Feo . . . He's a disgusting, mysoginistic, paedophilic asshat who moonlights as a shitty writer—Something Awful
263 USAF71321st Dec 2011 03:59:14 AM from the United States
I changed accounts.
I know universal healthcare sure would help small businesses...
I am now known as Flyboy.
The fact that universal healthcare delivers superior healthcare for a lower cost should be enough to convince people, if the fact that privatised insurance has shown itself to be a thoroughly corrupt and unsustainable system isn't enough to convince you.
265 MajorTom21st Dec 2011 02:46:44 PM , Relationship Status: Barbecuing
Eye'm the cutest!
Basically, they're both the closest thing the US has to a publically-funded healthcare system.

And it's been complete crap since 1972. (It wasn't much better before then.)

Why anyone thinks we'll do better doing the same to the rest of the healthcare industry is really an exercise in insanity. The US government is not a shining beacon of competence when it comes to most things healthcare included.
"Allah may guide their bullets, but Jesus helps those who aim down the sights."
266 USAF71321st Dec 2011 02:53:21 PM from the United States
I changed accounts.
So the VA isn't good at what it does and cheaper than private healthcare. Gotcha.
I am now known as Flyboy.
Well the issue is that you have to prove that VA care is worse than private care. You state how it is "insanity to spread this to all healthcare" but then I can reverse your statement. Private healthcare is total garbage in the US, it is insanity to keep going with it.
268 ch00beh19th Mar 2012 04:10:43 PM from Who Knows Where
To continue on from the 2012 American Elections thread, my friend got back to me about why he thinks it's not entirely feasible for healthcare to be socialized in the US. Just copying this straight out of an e-mail.

We can talk more about it, but very quickly, and based only on public sources (not NDA covered), that's not at all true about R&D. It's actually a very complicated issue with companies trying to balance sourcing new products from R&D and from M&A, but most companies still spend a lot on R&D - to the tune of billions. Sales and marketing is a very high expenditure as well though. I can't comment on what the ratio between the two might be, but rest assured that R&D is responsible for billions and billions of expenditures.

You can google a few major companies (ie Roche, GSK, Allergan), look at their bottom line profit and also their R&D expenditures. The R&D Expense to Profit ratio is really high for most companies (a few exceptions of course). It varies, but for example, Roche spends 8+ billion n R&D and makes a net profit of about 8 billion. That's on the high-side, but its not cheap, and the government certainly can't subsidize that level of R&D. Also, pharma development is international! Who pays for it then?

If the argument is to save money from sales and marketing, in my opinion, that's not very practical or beneficial. And I'm not sure how subsidized drug development helps save on sales and marketing, besides that it creates intense competition for limited public funds (and hence fewer products to compete with each other). Ultimately don't see the good for society. Bear in mind that sales and marketing in healthcare often serves as education for doctors and patients. Doctors and patients (worldwide) rely on pharma companies to learn about new therapies; that's even the case in Europe where medicine is highly-socialized.

Its overly idealistic for Americans to envy Europe's socialized medicine; as long as Europe is so heavily socialized, America cannot become that way, because pharma companies need to make money somewhere, and its more profitable here. And who can argue that it's beneficial for them to make money (and then, presumably, use that money to innovate)?

I know that was a bit scattered - when I have more time I can put together a more coherent argument for your internet buddies. Let's talk another time about this.
"Never let the truth get in the way of a good story."

The Game Developer Thread
And who says that socialised healthcare has anything to do with the control or subsidization of pharmaceutics or that that even has anything to do with the savings of socialised healthcare?
Don't just tell us the facts; tell us the memes, tell us the archetypes, tell us the catchy ideas and symbolic roles that get planted in pe
270 AceofSpades19th Mar 2012 04:22:31 PM from The Wild Blue Yonder , Relationship Status: Yes, I'm alone, but I'm alone and free
Given that the big pharma companies often have incentive to lie or manipulate doctors into selling their drugs, I'm not exactly going to cry over a few of them going down in the event of socialized medicine. None of us are discounting the cost of the R&D, in fact that's what a lot of the proposed tax hikes would go to pay for. The primary idea behind socializing medicine so that the insurance companies and hospital billing can't drive you into a debtor's prison for the rest of your possibly short life, or burden your family with crippling debt if you die.
271 TheyCallMeTomu19th Mar 2012 04:33:37 PM , Relationship Status: Wishfully thinking
Totes Moe
If you assume that it's impossible to research anything unless there's market forces at work, then yes, America has to be the non-socialist martyr by having a craptastic healthcare system while everyone else gets to live in a decent state of affairs. However, this assumption is ridiculous.
272 Fighteer19th Mar 2012 05:22:37 PM from the Time Vortex , Relationship Status: Dancing with Captain Jack Harkness
I'll be honest, if the question comes to (a) provide quality healthcare with the tools and medicines we have now to the vast majority of U.S. citizens, versus (b) guarantee Big Pharma astronomical sums of money to invest in funding new medical products, I choose A.

However, there is no evidence that this is at all a realistic dichotomy. In the other thread I proposed a two-pronged solution to the crisis: first, divorce R&D from sales; second, fund R&D out of the national healthcare budget and make the primary incentive to deliver safe, effective treatments.

edited 19th Mar '12 5:24:15 PM by Fighteer

273 Enkufka19th Mar 2012 06:54:09 PM from Bay of White fish
Wandering Student ಠ_ಠ
If the mandate is repealed, the health insurance companies have 2 options: Jack up premiums (by 25%) or kick people with pre-existing conditions off and jack prices up based on your age.
Very big Daydream Believer.

"That's not knowledge, that's a crapshoot!" -Al Murray

"Welcome to QI" -Stephen Fry
I'm pretty sure that the NHS is still generating medical firsts so I don't buy into the argument that socialised medicine hurts R&D
Dutch Lesbian
275 Fighteer20th Mar 2012 07:22:22 AM from the Time Vortex , Relationship Status: Dancing with Captain Jack Harkness
It seems to me that many of the arguments being deployed are less along the lines of saying there's a fundamental incompatibility between national healthcare and healthcare research and more like a threat that if we do these things, Big Pharma will pack up its toys and go home. To which I answer, "Suck it."

Less colloquially, they won't just fold up and go home; they have businesses to run and protect and investors to be responsible to. They will adapt to the changing market situation because they have to. The whole point of a free market system is that it's more readily able to innovate than government systems. If they are so completely locked into the current way of doing things that they are incapable of surviving when it changes, then capitalism is a failure.

edited 20th Mar '12 7:25:40 AM by Fighteer

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