Inequality: the 8 richest people have as much wealth as the 3.6 billion poorest people

RightHoJeeves said:

It does seem like Americans have to pay a lot of tax for not much in return (good free healthcare or free/heavily supported tertiary education). Probably part of the reason so many areas are so distrustful of the Government.

Click to expand...

Eh. The number of people I've heard say they're glad they don't have to pay high taxes like Canadians, or that Canadian healthcare, the NHS, etc., are all so terrible compared to the U.S. Reality is not always an issue.

Not sure I agree 100% about Canadian health care. It has its own perks but there are downsides there too. I have family in Sarnia, and others in Buffalo. I forget which goes where but one half goes to the other side for scripts while it flip flops for elective surgeries...

To Canada for prescriptions (markedly cheaper as Canada bargains hard with drug co.s), to the U.S. for elective things, as, depending on what it is and where you are, there can be a decent wait in Canada.

tiggs said:

Perhaps this would help: https://www.bloomberg.com/news/arti...re-system-ranks-as-one-of-the-least-efficient

Click to expand...

Thank you, that's a starting point - although it does say

The index reflects the first full year of Obamacare. While the U.S. Affordable Care Act expanded access to health insurance and provided payment subsidies starting on Jan. 1, 2014, its impact on life expectancy will take a while to gauge.

Click to expand...

It would be interesting to see how it would have developed over time, given more support.

I'll wait to see how the equivalent Trump system works out over its first year.

cornflake said:

Eh. The number of people I've heard say they're glad they don't have to pay high taxes like Canadians, or that Canadian healthcare, the NHS, etc., are all so terrible compared to the U.S. Reality is not always an issue.

Click to expand...

Forgive me if this is a stupid question. I always thought that most Americans got their healthcare through their employers or private insurance which they have to pay for. The shortfall is for the poor who can either not afford insurance or don't have jobs that give them insurance as a benefit.

It's that section of society that the universal healthcare most benefits, right? It doesn't make a lot of sense to compare private US healthcare to public healthcare in Canada or the UK. In Australia everyone knows private care is better, but not everyone can afford that.

It has reduced costs even more than it was projected to.

The idea there is or will be an equivalent Trump system is... hopeful? The Republicans have started the legislative moves to repeal the ACA. There is no actual plan that's been proposed, to take its place, at all, despite some of them (like Rand Paul and Trump) saying it'd be replaced the same day it was repealed.

Trump was recently talking nonsense about insuring everyone at very low cost, which... yeah, good idea. Except how that'd happen is magical fairies with giant trucks of money, so no. Paul Ryan wants nothing, and he wants to privatize or remove medicare (government insurance provided to citizens over 65), because Paul Ryan loves Ayn Rand and he's not one to put up with poor people. He also lies incessantly, a lot! <--- true, but irrelevant, and just for fun to demonstrate the kind of person we're talking about.

RightHoJeeves said:

Forgive me if this is a stupid question. I always thought that most Americans got their healthcare through their employers or private insurance which they have to pay for. The shortfall is for the poor who can either not afford insurance or don't have jobs that give them insurance as a benefit.

It's that section of society that the universal healthcare most benefits, right? It doesn't make a lot of sense to compare private US healthcare to public healthcare in Canada or the UK. In Australia everyone knows private care is better, but not everyone can afford that.

Click to expand...

Most do -- first, the scope of what we're talking about is different than in countries with much lower populations. Before the ACA, there were something like 40 million Americans without insurance. Second, it's not as simple, I don't think, as how you're thinking of the insurance people had.

Stuff like employer-provided healthcare always varied widely. Plenty of people didn't get coverage from employers, or couldn't afford it (a large percentage of employer-provided insurance was not completely gratis, but shared cost, either with an actual cost, taken out of every paycheck [which could often be in the hundreds a month], or in stuff like health savings accounts, which employees paid into), and the cost of private insurance is like a joke, it's so astronomical. People could pay more than $1,500 a month, easy, for a small family, for shitty coverage.

Add to that that insurers, before Obamacare, were not required to insure anyone. Even if your employer provided insurance, for instance, but you had diabetes when you were hired, the insurance company would cover exactly nothing connected with it, as it was a preexisting condition. Also, there were lifetime caps on coverage. Christopher Reeve (Superman from the movies in the '80s, among other acting work), hit his cap after he was paralyzed in a riding accident. His friend, Robin Williams, took over the cost; otherwise, it'd have bankrupted Reeve's family in short order.

So, yes, it's the uninsured (who aren't just poor people -- note the costs we're talking about), but it was also a ton of people who weren't covered, or coverable, or just had marginal stuff, or... that Obamacare was attempting to patch together. So universal healthcare would save not just the uninsured, but -- especially if key provisions in the ACA are overturned -- tens of millions of others, or hundreds, if people with employer-provided didn't have to pay, etc.

Medical bills are the biggest cause of bankruptcy in the U.S., and many of them had insurance.

Well I don't know if anyone has ever thought of this idea before, but someone should sort out universal health care for Americans.

*ducks, narrowly avoiding thrown shoe*

RightHoJeeves said:

Forgive me if this is a stupid question. I always thought that most Americans got their healthcare through their employers or private insurance which they have to pay for. The shortfall is for the poor who can either not afford insurance or don't have jobs that give them insurance as a benefit.

It's that section of society that the universal healthcare most benefits, right? It doesn't make a lot of sense to compare private US healthcare to public healthcare in Canada or the UK. In Australia everyone knows private care is better, but not everyone can afford that.

Click to expand...

Most of what I'll say echoes cornflake's post. This is my experience with health insurance, both from my employer, and from when I elected to go on the ACA (aka Obamacare).

The two most common means for Americans to get health insurance was through their employer or buying direct from the insurance companies. When buying direct from the insurance companies there is no negotiation, little to no customized plans. You may have a few options to purchase and that's that. In my experience, these same plans were consistently cheaper when purchasing through the state-marketplace (aka Obamacare). Why? Because the state functions as a mass-purchaser, promising to bring so many thousands or millions of customers to the insurance company, who then cuts the prices to reflect the increase in sales.

I lived for part of 2016 in three different states and shopped buying direct versus buying through the state-marketplace in each while my family was moving around. Consistently, the state-marketplace offered the same plan for cheaper than buying direct. Additionally, the insurance companies did not offer any additional plans that were not already in the state-marketplace. Going through the marketplace was hands down the best option between the two.

The other means most Americans get insurance, via employer, ranges drastically. Small businesses (less than 50 employees) are exempt from many of the healthcare laws, and don't need to provide insurance to their employees. Otherwise the employer can offer a single plan or a plethora to their employees. The costs will vary depending on the quality of the plan. The employer may pay for the plans in full, or merely act as a broker and get you a discount on a plan for which you're liable for the entire bill.

My former employer offered two options to us:

1) Select one of three plans, they would pay for the employee's coverage but not their spouse or children's. (E.g. a $500 plan would cost $0 for just the employee, $500/month for a spouse, $1000/month for a spouse and child). The cheapest plan started I believe at $500.
2) Waive coverage, get an additional $1.60/hour pay and purchase your own insurance.

I took the second option. My employer's insurance plans were not that great for the cost, and were more than what I needed. I was/am young and healthy. I had no plans for elective procedures and really just needed something to take care of me in case I got in a car wreck. I found insurance plans through my state and paid $140/month and got to pocket the difference of the $1.60/hour. Additionally, I found those same plans my employer was offering on the state-marketplace: the state had negotiated a better deal.


As for the people deemed too poor to purchase insurance: that's what Obamacare is for. You can get a subsidy that'll pay for some or all of the insurance cost. Which once again varies drastically depending on the quality of the plan. No one is being forced into spending thousands of dollars a month for coverage.


TL;DR:
Employer health insurance may be expensive or not offer plans suitable for your family. Purchasing through state-marketplace almost always better than buying direct from the insurance company. If you're too poor to purchase healthcare then you'll likely qualify for a subsidy of part or all of the cost.

chompers said:

It bothers me when people go on about inequality. Those people worked hard for their money. Yes, a lot of poor people were given a bad card in life, but so did a lot of rich people. Where's the fairness when the hardworking people are told they are bad people because they have money?

Next time people go on about money inequality, go give your hard-earned income to a homeless drug addict on the street. Not a dollar here and there, but at least 50 percent on a regular basis. Let's see how many people think that's fair.

Click to expand...

blacbird said:

Well, let's do some math. Eight people have as much wealth as 3.6 billion other people. Which means they worked . . . 36,000,000,000/8 harder, which computes to about . . . they worked 4.5 billion times harder than those others.

Click to expand...

Also, let's not forget that, apparently, all 3.6 Billion of the poorest people in the world are homeless drug addicts on the street. Don't forget that.

Hoplite said:

As for the people deemed too poor to purchase insurance: that's what Obamacare is for. You can get a subsidy that'll pay for some or all of the insurance cost. Which once again varies drastically depending on the quality of the plan. No one is being forced into spending thousands of dollars a month for coverage.

Click to expand...

Thanks for that info. I did read a few years ago (pre-Obamacare) that Medicaid varied from state to state, and if you had the misfortune to be in a non-funding state, you were pretty much on your own. Was that fixed under ACA? (It's good to have someone to ask about this stuff, because so much of what comes up in a google search is so slanted Rep or Dem. If there's a trustworthy unbiased site that's basic enough for outsiders, could you point it out?)

cornflake said:

Eh. The number of people I've heard say they're glad they don't have to pay high taxes like Canadians, or that Canadian healthcare, the NHS, etc., are all so terrible compared to the U.S. Reality is not always an issue.

Click to expand...

Any scarce commodity is going to be rationed.

Healthcare is a scarce resource in the economic sense. Not meaning that we have a drought of healthcare, but basically meaning that, given no controls, humanity would consume more healthcare than is available.

Therefore, society has to have a mechanism to regulate how much healthcare is used.

So, yes in Canada and the UK and almost ever other G20 nation, healthcare is rationed based on a mandated measure of "need." There are waiting lists, and some treatments are difficult to obtain.

In the US, the rationing is completely arbitrary depending on a mish-mash of employer plans, government reimbursement schemes, private payments, private insurance and charities. There is no rhyme or reason to the way our care is rationed. People who need urgent care are left out. People who happen to have great insurance have minor care taken care of instantly.

For instance, a year ago, I had a high deductible plan. My son's meds cost me over $400/month and his quarterly doctor visits were $150-with insurance. We rationed our family's use of healthcare by only taking our kids to the doctor, and then only for what was required. My older son developed a terrible cough, and we treated it with OTC meds the best we could. In June, I got insurance with my new job-better insurance that only charges $15 for a doctors visit and the maximum price for any prescription is $40. Everyone in my family has been to the doctor since June. My husband is on cholesterol meds for the first time. My son's cough turned out to be incipient asthma, and he now has an additional daily medication for that along with a rescue inhaler. I've had several pre-cancerous moles removed that I had previously not even thought about. And we've still paid less than we did in the same period the previous year.

Is that sensible rationing? Does it make any sort of sense for us to go from never seeing a doctor to seeing one for every little thing? Is that good for the economy? I know it wasn't good for us.

Plus, all of the profit-mongering in our healthcare system has made it the most expensive in the world without making our care any better. Everyone in this country pays too much for healthcare. Go to the UK and see how much a hospital stay costs even if you aren't covered under the NHS. It's crazy how much more you pay for a simple procedure in the US.

mccardey said:

Thanks for that info. I did read a few years ago (pre-Obamacare) that Medicaid varied from state to state, and if you had the misfortune to be in a non-funding state, you were pretty much on your own. Was that fixed under ACA? (It's good to have someone to ask about this stuff, because so much of what comes up in a google search is so slanted Rep or Dem. If there's a trustworthy unbiased site that's basic enough for outsiders, could you point it out?)

Click to expand...

Again, yes and no, depends. Part of what the ACA did, and how many of the previously-uninsured got coverage, was to expand Medicaid coverage. As Medicaid is, as you note, administered by the states, the way they did it was to offer to cover the cost of the expansion of Medicaid for states,dialing back to 90% of the cost to be borne by the federal gov't (presumably because costs should have declined -- as see my above link, they have -- so the states wouldn't be paying as much even when they were covering more of the cost).

However - this is actually what happened, I swear, though it seems unbelievable -- a number of states, run by Republican governours, with very heavily Republican populations, mostly in the south, refused the money and the expansion, because they didn't 'believe in' Obamacare. Millions of people in their states who were living without health care and could have gotten it, courtesy of the federal government, did not, because their states' governours were Republicans. Really.

The 22 states that didn't expand Medicaid eligibility as part of Obamacare last year saw their costs to provide health care to the poor rise twice as fast as states that extended benefits to more low-income residents.

It's a counterintuitive twist for those states whose governors, most Republicans who opposed the Affordable Care Act, chose not to accept federal funds to extend Medicaid to more people.

A Kaiser Family Foundation survey of Medicaid directors in all 50 states and Washington, D.C., showed that those that didn't broaden coverage saw their Medicaid costs rise 6.9 percent in the fiscal year that ended Sept. 30. The 29 states that took President Obama up on his offer to foot the bill for expanding Medicaid saw their costs rise only 3.4 percent.

That modest increase in Medicaid spending in the expansion states came even as the rate of Medicaid participation rose 18 percent, three times as much as the states sitting out...

There have been stark differences between states that take up the expansion and those that don't.

Texas, for example, hasn't expanded eligibility and its rolls have increased by about 192,000 people in the last two years, or just 4.3 percent. Federal reimbursements to the state fell last year from 58.05 percent to 57.13, according to the Kaiser study.

California, by contrast, was among the first states to sign on to the expansion. Enrollment in Medi-Cal, the state's name for Medicaid, grew by 30 percent in the first year. All told, 3.4 million Californians were added to the Medi-Cal rolls between Sept. 2013 and July 2015.

In many states, legislators have been battling over whether to accept the federal money to pay for health care for more of their poor residents or continue to refuse on principle because they opposed the Affordable Care Act.

Click to expand...

As to sources, it's hard both because some things do have agendas, even those that are pretty much news-based (not FOX, but like, The National Review is a real endeavour, but it's very right wing). I'd recommend national news orgs, like NBC, ABC, and stuff like NPR, BBC, the Economist, the New Yorker, the Atlantic, the NYT, places with a long history of fact-checking and devotion to actual journalism (including long-form, which allows for much more comprehensive and nuanced assessments, especially The New Yorker and the Atlantic, both mags).

cornflake said:

However - this is actually what happened, I swear, though it seems unbelievable -- a number of states, run by Republican governours, with very heavily Republican populations, mostly in the south, refused the money and the expansion, because they didn't 'believe in' Obamacare. Millions of people in their states who were living without health care and could have gotten it, courtesy of the federal government, did not, because their states' governours were Republicans.

Click to expand...

Oh, that's what I read and yes, I thought it was - unlikely, at best. I knew there hadn't been bipartisan enthusiasm - but I didn't think States would make their people miss out entirely. Unforgiveable, if that's the case.


Thanks for those sources - I read most of them, but I've always assumed they were slanted left. (I agree with them, and I tend to slant left in most things so it seemed a reasonable assumption.) If you wanted to read an honest, intelligent, longer-form right-slanted thinkpiece, who would you read?

Also, yes to the kitties with the hats up there.

I have a bunch of Canadian friends. Yes, depending on where you are and what it is (more populous areas the wait can be longer), you can wait months for something elective. If you have something not elective, you're covered. This seems entirely logical to me.

A friend of mine had an issue with his hip -- his dr was concerned so sent him for an MRI, which he got within days. He saw a specialist a day later. It was found to be a chronic thing that could have a surgical fix, but wasn't causing huge problems. If he wanted it done? Four month wait. If it'd been something that needed to be done immediately? It'd have been done, pretty immediately.

mccardey said:

Oh, that's what I read and yes, I thought it was - unlikely, at best. I knew there hadn't been bipartisan enthusiasm - but I didn't think States would make their people miss out entirely. Unforgiveable, if that's the case.


Thanks for those sources - I read most of them, but I've always assumed they were slanted left. (I agree with them, and I tend to slant left in most things so it seemed a reasonable assumption.) If you wanted to read an honest, intelligent, longer-form right-slanted thinkpiece, who would you read?

Click to expand...

They get blasted for being slanted left, by the right. They generally work hard to maintain their integrity. I've read stuff that I disagreed with in the Atlantic, heard stuff I disagreed with on NPR plenty of times, etc. They also fact-check themselves like crazy (The New Yorker is renowned for their fact-checking obsessiveness). Honest is hard, with right-slanted things, and I am certainly left-slanted personally, but while I've read stuff and thought 'that's fair, huh' on some outlets, like maybe Forbes, occasionally National Review, you have to be pretty careful with checking their sources, as some of them are absolute bullshit. Not 'I disagree' bullshit, but real, actual bullshit, like Paul Ryan up there claiming Obamacare is failing economically. There are thinkpieces that reiterate that, but they tend to use very questionable, old, missing source material, which, as an outsider, it may be harder to pinpoint. Like, citing the cost increases in Obamacare last year -- yes, costs went up. Less, by a good amount, than they'd gone up in any of the whatever years before it was enacted. There was also an argument that the rise was a correction due to specific factors, which would be debatable, but if something just says costs went up without the full picture... in my experience, the full picture tends to be most likely to be presented by the NYT, the Atlantic, etc.

cornflake said:

They get blasted for being slanted left, by the right. <<snip>> in my experience, the full picture tends to be most likely to be presented by the NYT, the Atlantic, etc.

Click to expand...

Oh good, thank you. I'll bear that in mind. I'm trying very hard this year (in keeping with the new P&CE principles as well) to listen to intelligent voices on both sides of the debate. I suspect this is going to be harder than ever for a while.

ETA: Shoutout to J.D.Vance's Hillbilly Elegy which gave me a clearer understanding of some of the pro-Trump people and why they supported him. (Which is not to say that all Trumps supporters are the same or have the same reasons. Obvs.)

There have been a number of pieces in the NYT since the election with Trump supporters, in their own words. Including stuff like this -

This week Republicans in Congress began their effort to repeal and potentially replace the Affordable Care Act. But after listening to working-class supporters of Donald J. Trump — people who are enrolled in the very health care marketplaces created by the law — one comes away feeling that the Washington debate is sadly disconnected from the concerns of working people.

Click to expand...

This -

MONTICELLO, Iowa — The Table of Knowledge was delving into President-elect Donald J. Trump’s plans to upend government, and marveling at how he had forced his fellow Republicans in the House to reverse themselves on gutting the Office of Congressional Ethics.

“He’s getting responses; things are happening,” Jerry Retzlaff, a retiree, said. “He got Congress to turn themselves around with one tweet.”

“There’s no secret the press doesn’t like him, and neither does a lot of the leadership,” he added. “And that’s because he’s planning on making a lot of changes.”

The eight men around a rectangular table, sipping coffee from a hodgepodge of mugs donated by customers, meet daily for breakfasts of French toast, eggs and bacon at Darrell’s diner, all while solving the world’s problems, hence their gathering’s nickname.

Click to expand...

This -

To be sure, there are some very real shortcomings that Mr. Trump identified in his campaign. They include minimal pay growth for less-skilled workers, near-record numbers of Americans not in the labor force, and disappearing factory jobs. Still, many mainstream economists say that the Trump agenda — aimed at lowering taxes, peeling back regulations and reopening trade deals — will not alter those trend lines.

“Tax cuts are unlikely to boost labor participation rates, nor will they reverse the aging of the population,” said Michael Gapen, chief United States economist at Barclays. “Less regulation could have a positive impact on long-term growth, but it is unlikely to move the needle over the next two years.”

Click to expand...

This -

millions of women went to the polls for Mr. Trump on Election Day, including, according to surveys, 53 percent of white women.

Why did they?

Conventional wisdom that his behavior and remarks would disqualify him in the eyes of many women proved wrong. Interviews with more than a dozen women around the country showed a range of reasons for their support:

Click to expand...

Alessandra Kelley said:

That said:
The Economist. The National Review. The Wall Street Journal (but not its editorials).

Click to expand...

Excellent, thanks

Donald Trump has announced that his new health care plan will provide coverage for everyone, with lower cost and with lower deductibles. How this will actually be accomplished, as usual, is unknown. All anyone needs to know is that he's going to make healthcare great again.

https://www.google.com/amp/s/www.wa...2b1e18-db5d-11e6-ad42-f3375f271c9c_story.html

As to how Trump got elected, and to why so many people ignored his outrageous statements and crude behavior, here is an interesting interview from salon.com (about a very long article) that explains things in a different way. It views the election in terms of marketing, especially as it relates to his own field, cognitive science.

I think the writer really has a hold on something here.

http://www.salon.com/2017/01/15/don...xplains-how-the-democrats-helped-elect-trump/

RightHoJeeves said:

Forgive me if this is a stupid question. I always thought that most Americans got their healthcare through their employers or private insurance which they have to pay for. The shortfall is for the poor who can either not afford insurance or don't have jobs that give them insurance as a benefit.

Click to expand...

My family hasn't had employer offered insurance in a few years now (the ACA kicking in was what allowed my spouse to leave his toxic job with mostly excellent insurance for a job with similar pay, healthy store culture, and better hours but no insurance).

We've lived in two different states during that time and in both we qualified for free healthcare thanks to low income (perks of not being paid a living wage? HAH!), until recently (now the kid policies are still free but we pay $10/mo for adults; I assume this is a heavily subsidized plan), but both of these states are ones that expanded medicaid when the ACA was passed. If the Republicans forced these states to reduce medicaid again by withdrawing their funding, then we probably won't qualify for cheap healthcare anymore since our income has finally gotten high enough to approach the ACA cut-off amount as it is, let alone whatever it will be under whatever corruptcare plan congress comes up with.

So, the ACA has been very good for us, though I do know people who it hasn't been good for. I have an acquaintance who is currently shopping around because she's going to have to pay $500/mo just for her children's health insurance, and then there's also a hefty deductible to meet before any of the benefits actually kick in. But her family is very well off, and they could afford it if they had to.

I would really wince at having to pay those kind of prices even if I could afford it, so I have sympathy for her family and hope they can find a more affordable option that works for them, but I have even more sympathy for the people who are actually poor and may not be able to afford any healthcare at all once the ACA is repealed; especially those with chronic conditions. Type one diabetes runs in my spouse's family, so some of them are going to suffer from the shenanigans being pulled by the R's and it's possible my children may have to deal with it in the future, too--one of my children already has a chronic condition that doesn't require medication, fortunately, but having it means the likelihood of him developing other chronic conditions that do require medication, specifically type one diabetes, is higher.

Silva said:

So, the ACA has been very good for us, though I do know people who it hasn't been good for. I have an acquaintance who is currently shopping around because she's going to have to pay $500/mo just for her children's health insurance, and then there's also a hefty deductible to meet before any of the benefits actually kick in. But her family is very well off, and they could afford it if they had to.

Click to expand...

This is what seems to underly the issue, to me. It's whether one feels the unfairness of having poor health and expensive health needs, or the unfairness of having to support a system that supports those with poor health and expensive health needs.

If you've lived with one system (subsidised health care), it's hard to understand the thinking behind the other. And vice versa, I suppose - although that seems fairly brutal.

Hoplite said:

TL;DR:
Employer health insurance may be expensive or not offer plans suitable for your family. Purchasing through state-marketplace almost always better than buying direct from the insurance company. If you're too poor to purchase healthcare then you'll likely qualify for a subsidy of part or all of the cost.

Click to expand...

If I'm honest I don't think I've heard a reason the ACA is bad. I'm sure its not perfect and could be altered, sure. But it seems the benefits hugely outweigh the drawbacks?

RightHoJeeves said:

If I'm honest I don't think I've heard a reason the ACA is bad. I'm sure its not perfect and could be altered, sure. But it seems the benefits hugely outweigh the drawbacks?

Click to expand...

Wait till Paul Ryan Healthcare, Inc. jettisons ACA. Predictions are that many private health insurance premiums will skyrocket. Let's get into reality here: Trump boasts that he will produce affordable health insurance for EVERYBODY, in the same way he boasts he will wall off our southern border with Mexico. Rhetoric with the substance of morning fog on a hot summer day. Aside from that, the GOP legislators have proposed . . . NOTHING. Which is what they want: NOTHING. Back to the pre-2008 status quo. Which was really great. Right.

caw