So What Should We Do About Drug Addicts?

[dismalist]

I don't want to say that any particular level of government spending is the correct. I have a more rhetorical aim than a substantive one.

Yes, of course the US is at the low end of government expenditure share, but it's a lot bigger than Switzerland's, and close to the UK's. The point here is that the share is not absurdly low. [I don't want to get into it, but what the hell are France and Italy spending their governments' money on?] Thus, one can't use "Americans are against government spending" or "against public goods" as an explanation of anything.

If one identified new services that are useful -- such as provision of needles -- one must argue the benefits and costs and not automatically claim "it's a public good" or "it's insurance", or even it's "social spending" as justification for more spending. It all too easily bogs down to "I want more."   

The US spends nearly twice as much (~17% of GDP when I last looked) on healthcare as other OECD nations, with equal or worse outcomes. Channeling dismalist, I'd say that what one wants is effective or efficient spending. There's no point spending more on any given public measure if a significant portion of that spending is going to be wasted.

In that vein, it's worth asking whether that military spending is efficient. From where I stand, it looks like it diverts an awful lot of funds to (1) private profit, and (2) a large-scale but morally suspect work program with dubious returns.

It's absolutely about efficiency!

Healthcare in the US is muchly about prices. Those prices are high because of an historical anomaly, the successful political entrepreneurship of the American Medical Association. And they stay that way because most voters are content. Outcomes are actually good, given the patient population. It just costs too much.

Defense spending is the best example for the problematic invocation of "public good" to justify spending or more spending. Defense is in fact the perfect example of a pure public good -- all of us have to consume all that defense. Once produced, we have no choice. But some of us don't like all that defense spending, perhaps to the point that at least some of it is a public bad!

So, we must argue on the merits, not with labels.

[spork]

Anyone who is interested in the subject of health care costs should read:

• Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer by Shannon Brownlee.
• The Price We Pay: What Broke American Health Care by Marty Makary.

I'll go back to what I first posted when this thread began: remove the firewall between treatment for mental illness and treatment for drug addiction. Since it would really only require a bureaucratic swipe of the pen, it's much easier to accomplish than ensuring that everyone has housing.

[Kron3007]

I don't want to say that any particular level of government spending is the correct. I have a more rhetorical aim than a substantive one.

Yes, of course the US is at the low end of government expenditure share, but it's a lot bigger than Switzerland's, and close to the UK's. The point here is that the share is not absurdly low. Thus, one can't use "Americans are against government spending" or "against public goods" as an explanation of anything.

If one identified new services that are useful -- such as provision of needles -- one must argue the benefits and costs and not automatically claim "it's a public good" or "it's insurance", or even it's "social spending" as justification for more spending. It all too easily bogs down to "I want more." 

The US spends nearly twice as much (~17% of GDP when I last looked) on healthcare as other OECD nations, with equal or worse outcomes. Channeling dismalist, I'd say that what one wants is effective or efficient spending. There's no point spending more on any given public measure if a significant portion of that spending is going to be wasted.

In that vein, it's worth asking whether that military spending is efficient. From where I stand, it looks like it diverts an awful lot of funds to (1) private profit, and (2) a large-scale but morally suspect work program with dubious returns.

It's absolutely about efficiency!

Healthcare in the US is muchly about prices. Those prices are high because of an historical anomaly, the successful political entrepreneurship of the American Medical Association. And they stay that way because most voters are content. Outcomes are actually good, given the patient population. It just costs too much.

Defense spending is the best example for the problematic invocation of "public good" to justify spending or more spending. Defense is in fact the perfect example of a pure public good -- all of us have to consume all that defense. Once produced, we have no choice. But some of us don't like all that defense spending, perhaps to the point that at least some of it is a public bad!

So, we must argue on the merits, not with labels.

Outcomes in the US are good for some, probably the best...but as a population not so much. I know there is more to it, but life expectancy in Canada is about three years longer, largely attributed to access to health care.

I don't think it is so much that most Americans are content with the medical system, just that someone has done an excellent job convincing them that socialized medicine is the devil and/or it would never work in the US. 

As a Canadian, when I lived in the US south this would come up often (not by my choosing).  Most people down there had a pretty twisted view on single payer healthcare (well done, propagandists).  Even in principle many were against it simply because "people take advantage of social programs".  I get this view for welfare programs and such, but healthcare?
 I don't think people are going to break their arm to score a free cast, but there you have it

[spork]

[. . . ]

 someone

[. . .]

The AMA, the executives and shareholders of private insurers and hospitals, and the craven politicians beholden to them.

[ciao_yall]

Per our discussions about legalization...

Alcohol Poisonings Rise in Iran, Where Bootleggers Defy a Ban
Iran's prohibition of the drinking and selling of alcohol has led to a flourishing underground market. But even officials have acknowledged a wave of hospitalizations and deaths in recent months.

[Kron3007]

Per our discussions about legalization...

Alcohol Poisonings Rise in Iran, Where Bootleggers Defy a Ban
Iran's prohibition of the drinking and selling of alcohol has led to a flourishing underground market. But even officials have acknowledged a wave of hospitalizations and deaths in recent months.

I have an Iranian tech, who has told me about their home distilling activities back home.  I assume they were knowledgable enough to do it safely, but doesn't mean everyone is.  Prohibition dosn't stop it, just makes it riskier for all involved.

[marshwiggle]

It should also be kept in mind that 92% of US residents have health insurance, and most are quite happy with it.

Outcomes in the US are good for some, probably the best...but as a population not so much. I know there is more to it, but life expectancy in Canada is about three years longer, largely attributed to access to health care.

Putting these two stats together is interesting.
Canada life expectancy is about 83; U.S. is about 80. If all of the difference is due to the uninsured in the U.S., (so that insured people have a life expectancy of 83, like Canada), then it means the uninsured have a life expectancy of about 46 to shift the average.  That's praticaly medieval.

If it's not all due to the uninsured, then it means that insured people in the U.S. have a lower life expectancy that average Canadians. No-one argues that the U.S. doesn't have world-class medical facilities; the problem is that even insured people clearly don't have as ready access to them as people in other countries do to their facilities.

[Kron3007]

It should also be kept in mind that 92% of US residents have health insurance, and most are quite happy with it.

Outcomes in the US are good for some, probably the best...but as a population not so much. I know there is more to it, but life expectancy in Canada is about three years longer, largely attributed to access to health care.

Putting these two stats together is interesting.
Canada life expectancy is about 83; U.S. is about 80. If all of the difference is due to the uninsured in the U.S., (so that insured people have a life expectancy of 83, like Canada), then it means the uninsured have a life expectancy of about 46 to shift the average.  That's praticaly medieval.

If it's not all due to the uninsured, then it means that insured people in the U.S. have a lower life expectancy that average Canadians. No-one argues that the U.S. doesn't have world-class medical facilities; the problem is that even insured people clearly don't have as ready access to them as people in other countries do to their facilities.

Yes, but there are obviously other differences than health care.  Ever seen the size of a small order of fries at Hardees?

When I was in the US south, they had converted the university cafeteria to an all you can eat model.  A lot more going on down there impacting life expectancy....