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United States43262 Posts
On December 02 2020 04:16 LegalLord wrote:Show nested quote +On December 02 2020 01:38 Neneu wrote:On December 02 2020 01:34 Stratos_speAr wrote:On December 02 2020 01:30 Neneu wrote:On December 02 2020 01:24 Stratos_speAr wrote:On December 02 2020 01:22 Neneu wrote:On December 01 2020 23:51 LegalLord wrote:On December 01 2020 22:56 iamthedave wrote:
Out of curiousity, what level of salary PA would someone need to pay off their student debt in a reasonable time? Obviously it'll vary by degree but I assume there must be an average of sorts. Rule of thumb that students are told is, “student loans not to exceed one year’s salary.” I’d say that’s about the upper bound of what is affordable for the notional 10 year payoff that student loans are means for. As at least one reference point, if you took a loan of $70k at 6 percent interest, that’d be just under $800 a month - marginally serviceable on a $70k salary in most US cities. It’s when you’re out of a job or unable to find one that earns what your degree is notionally supposed to earn that you start having real trouble. Holy shit, you guys pay 6 percent on your student loan?! That is insane! My student loans are capped at 6% interest, and that is only because I serve in the military. 6% is a good interest. Many students pay significantly more. That is crazy. What the risk of your student loan is trying to capture is the possibility of you being able to live an okey life, where you are able to apply the increased benefit of education. Currently I pay 1.37% on my student loan (not a US loan). 6% or more in the current economy, is just predatory behavior from the lenders. I am just blown away. This is the United States. Are you really that blown away? Yes. Because this is batshit crazy, especially considering you are not allowed to claim student loans in personal bankruptcies, so the risk is even lower than other comparable loans. It is 100% predatory behavior on something that benefit the lenders. It is stupidity on a whole exclusive level of stupidity. The strange thing is that the vast majority of student loans are owned by the US government, so the government is the one providing rates that are downright predatory for student loans. I'm surprised that the government doesn't do something even more nefarious like bundling said loans into asset-backed securities or something.
UK did that. The student loans are still managed by the government which can levy payrolls etc to ensure payment but they sold the proceeds up front to investors as ABS. It’s why I don’t feel too bad about defaulting on mine.
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Why is securitizing it nefarious? I don't really see the use since government can already finance cheap so securitization provides little benefits but it doesn't hurt anyone.
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Bill Barr has said there was no evidence of widespread voter fraud that swayed the election.
I think this is the final, final nail in any hopes of Trump getting the election through some crazy trickery.
Via AP:
In an interview with The Associated Press, Barr said U.S. attorneys and FBI agents have been working to follow up specific complaints and information they’ve received, but they’ve uncovered no evidence that would change the outcome of the election.
“To date, we have not seen fraud on a scale that could have affected a different outcome in the election,” Barr told the AP.
The comments are especially direct coming from Barr, who has been one of the president’s most ardent allies. [...]
https://apnews.com/article/election-2020-joe-biden-donald-trump-elections-william-barr-b1f1488796c9a98c4b1a9061a6c7f49d
On December 02 2020 04:37 RvB wrote:
Why is securitizing it nefarious? I don't really see the use since government can already finance cheap so securitization provides little benefits but it doesn't hurt anyone.
It's just hilariously bad financially? Basically the same as the government standing in front of a rich person's house and burning paper bills of tax money.
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United States43262 Posts
On December 02 2020 04:37 RvB wrote:
Why is securitizing it nefarious? I don't really see the use since government can already finance cheap so securitization provides little benefits but it doesn't hurt anyone.
It privatizes the profits from public policy. The government provides the stick with which investors beat us.
I’m not opposed to it in principle when the risk tolerance of the public purse is lower than institutional investors. It makes sense for the gov not to hold risky assets and therefore to sell future unknown cash flows for known amounts. But to me this has always seemed like a sweetheart deal, especially when the gov assumes liability for the underlying loans with the investors. The risk isn’t truly being passed on when defaults hurt the public purse rather than the investor.
I could be misunderstanding the details but that’s basically my complaint. I’ve been biased since the Blair Brown PFI days in the U.K. where private financing cash was brought in to make the gov current account look good but mortgaged future revenues.
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On December 02 2020 05:04 KwarK wrote:Show nested quote +On December 02 2020 04:37 RvB wrote:
Why is securitizing it nefarious? I don't really see the use since government can already finance cheap so securitization provides little benefits but it doesn't hurt anyone. It privatizes the profits from public policy. The government provides the stick with which investors beat us. I’m not opposed to it in principle when the risk tolerance of the public purse is lower than institutional investors. It makes sense for the gov not to hold risky assets and therefore to sell future unknown cash flows for known amounts. But to me this has always seemed like a sweetheart deal, especially when the gov assumes liability for the underlying loans with the investors. The risk isn’t truly being passed on when defaults hurt the public purse rather than the investor. I could be misunderstanding the details but that’s basically my complaint. I’ve been biased since the Blair Brown PFI days in the U.K. where private financing cash was brought in to make the gov current account look good but mortgaged future revenues.
Thanks, it's a good reply to my question. I agree if government assumes liability it makes little sense and it shouldn't be done.
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On December 02 2020 01:01 Yurie wrote:Anybody that knows US history well that can explain what happened around 1980-85? It broke the trend of the US life expectancy keeping up with many other western nations. While increasing spending. ![[image loading]](https://i.imgur.com/gLeHaCb.png)
None of this takes into account lifestyle choices - namely, obesity and all the co-morbidities that come with it. It's why analysis using life expectancy vice health expenditure is misleading at best. Track co-morbid trend lines with that graph. It's not a surpise that Japan is #1. They're very active people who have a good diet. Numerous studies have shown life expectancy increases with caloric deficits. It's always been so odd for me to see people do studies on this issue that completely dismiss lifestyle and diet factors.
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Norway28712 Posts
It's not dismissed at all. It's just that to me, it's pretty intuitive that a profit driven system is absolutely terrible at encouraging prevention rather than treatment. (And this is how you really reduce costs.) American obesity rates are from my perspective also related to both inequality (inexpensive food is less filling and nutritious per calorie than expensive food is) and lack of regulation/ prevalence of advertisement/ encouraging consumption.
From my perspective it's not that a single payer system or universal health care is a panacea or whatever, it's that profit driven systems are really terrible for providing health care.
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On December 02 2020 06:53 Wegandi wrote:Show nested quote +On December 02 2020 01:01 Yurie wrote:Anybody that knows US history well that can explain what happened around 1980-85? It broke the trend of the US life expectancy keeping up with many other western nations. While increasing spending. None of this takes into account lifestyle choices - namely, obesity and all the co-morbidities that come with it. It's why analysis using life expectancy vice health expenditure is misleading at best. Track co-morbid trend lines with that graph. It's not a surpise that Japan is #1. They're very active people who have a good diet. Numerous studies have shown life expectancy increases with caloric deficits. It's always been so odd for me to see people do studies on this issue that completely dismiss lifestyle and diet factors.
What a quick way to blame the individual.
I would be interested in reading a PubMed study on your argument that lots of additional healthcare spending in the US is caused by individual gluttony. Can you link me one or two that was paramount in forming this opinion?
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On December 02 2020 08:26 Artisreal wrote:Show nested quote +On December 02 2020 06:53 Wegandi wrote:On December 02 2020 01:01 Yurie wrote:Anybody that knows US history well that can explain what happened around 1980-85? It broke the trend of the US life expectancy keeping up with many other western nations. While increasing spending. None of this takes into account lifestyle choices - namely, obesity and all the co-morbidities that come with it. It's why analysis using life expectancy vice health expenditure is misleading at best. Track co-morbid trend lines with that graph. It's not a surpise that Japan is #1. They're very active people who have a good diet. Numerous studies have shown life expectancy increases with caloric deficits. It's always been so odd for me to see people do studies on this issue that completely dismiss lifestyle and diet factors. What a quick way to blame the individual. I would be interested in reading a PubMed study on your argument that lots of additional healthcare spending in the US is caused by individual gluttony. Can you link me one or two that was paramount in forming this opinion?
What a quick way to deflect and dismiss the point without engagement. Kudos.
Is this even a question? It's pretty common sense that those who are obese cost more in healthcare terms. Here, I'll do the work for you though.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074251/
Obesity is a growing global health concern, accounting for substantial national healthcare expenditures, with healthcare costs predicted to be higher by around a third in obese people compared to those of normal weight 1. The association between obesity and healthcare costs is well‐documented in international literature. Investigators have largely used attributable fraction methodology 2, 3 and, more recently, instrumental variable approaches.4, 5. These studies have estimated the proportion of healthcare spending on obesity to be around 5%, with results of up to 20% identified in the United States 4, 6. Despite recent efforts to quantify direct costs associated with obesity, the mediators underlying this relationship are poorly understood. Given the continued rise in obesity prevalence and persistence of the condition in individuals 7, the drivers of obesity‐related costs need to be analysed.
https://pubmed.ncbi.nlm.nih.gov/26134917/
ORCs (Obesity-related comorbidities) are associated with substantial economic burden, especially for those requiring continuous treatments.
https://www.tandfonline.com/doi/full/10.1080/03007995.2018.1464435?src=recsys
The cohort included 9651 individuals with BMI V85 codes. After weighting, the BMI distribution was: normal (31.1%), overweight (33.4%), obese class I (22.0%), obese class II (8.1%) and obese class III (5.4%). Increasing BMI was associated with greater prevalence of cardiometabolic conditions, including hypertension, type 2 diabetes and metabolic syndrome. The use of antihypertensives, antihyperlipidemics, antidiabetics, analgesics and antidepressants rose with increasing BMI. Greater BMI level was associated with increased inpatient, emergency department and outpatient utilization, and higher total healthcare, medical and pharmacy costs.
I could go on, but I think you get the point. By the way compare obesity rates. The US dwarfs all other developed countries: https://en.wikipedia.org/wiki/List_of_countries_by_obesity_rate
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Right, but why does the rate of obesity in the US dwarf all other countries? American Exceptionalism isn't a great argument to explain why the US is arbitrarily different, so the next explanation is that the US is deeply entrenched in a Capitalist Consumerist culture that is deeply ingrained and has vested financial interests in making people want to spend more money on worse food, and then spend more money again on inferior healthcare outcomes. Blaming people in the US at large for an endemic obesity issue comes back to American Exceptionalism, but is that something we're proud to be exceptional at?
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kinda easy to dismiss your "but fat people and their choices" when you can easily look at the oecd graph and obesity rates posted.
looks at UK vs US in the oecd data graph ---> 4k vs 10k yearly health expenditures. and the UK has higher life expectancy on top.
looks at UK vs US obesity rates ---> 27% vs 36%
argument basically goes poof. having a lot of obese people is definitely not helpful to curb costs, but in this relation it is anything but sufficient to make this particular point.
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On December 02 2020 09:05 NewSunshine wrote:
Right, but why does the rate of obesity in the US dwarf all other countries? American Exceptionalism isn't a great argument to explain why the US is arbitrarily different, so the next explanation is that the US is deeply entrenched in a Capitalist Consumerist culture that is deeply ingrained and has vested financial interests in making people want to spend more money on worse food, and then spend more money again on inferior healthcare outcomes. Blaming people in the US at large for an endemic obesity issue comes back to American Exceptionalism, but is that something we're proud to be exceptional at?
There are a lot of factors for why the US has such a high obesity rate. I also don't get your fascination with "American exceptionalism" whatever or however you define it (It's obvious you're not using the term in its foreign policy incarnation). All EU states are also capitalist, but they don't have problems with obesity to our extreme. It's not like the US corners the market on ho-ho's. By the way, I didn't attempt to explain why the US is as it is because it's irrelevant when it comes to this issue. It's not like the US Government hasn't spent a lot of time and money on "physical fitness" programs either. That was one of Bush's big things he touted with Arnie. Changing to a UHC isn't going to magically address our problems with obesity. (Oh, yeah, the Governments Food Pyramid....what a disaster! That caused a hell of a lot of problems)
As for healthcare outcomes - if you dig into the #'s we're pretty good on a huge range of healthcare issues. Cancer survival rates especially so. Also, I wouldn't exactly classify our healthcare system as "capitalist" per se. There's nothing capitalist about how the Government built this weird ass employer-insurance system, or SCHIP, Medicare/Medicaid and the whole CMS apparatus, etc. The FDA has rocketed up pharma prices while killing more people than they've supposedly saved (see: Bastiat's Seen and Unseen).
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On December 02 2020 09:05 NewSunshine wrote:
Right, but why does the rate of obesity in the US dwarf all other countries? American Exceptionalism isn't a great argument to explain why the US is arbitrarily different, so the next explanation is that the US is deeply entrenched in a Capitalist Consumerist culture that is deeply ingrained and has vested financial interests in making people want to spend more money on worse food, and then spend more money again on inferior healthcare outcomes. Blaming people in the US at large for an endemic obesity issue comes back to American Exceptionalism, but is that something we're proud to be exceptional at?
The low fat/Big Corn craze fucked everything.
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On December 02 2020 09:17 Wegandi wrote:Show nested quote +On December 02 2020 09:05 NewSunshine wrote:
Right, but why does the rate of obesity in the US dwarf all other countries? American Exceptionalism isn't a great argument to explain why the US is arbitrarily different, so the next explanation is that the US is deeply entrenched in a Capitalist Consumerist culture that is deeply ingrained and has vested financial interests in making people want to spend more money on worse food, and then spend more money again on inferior healthcare outcomes. Blaming people in the US at large for an endemic obesity issue comes back to American Exceptionalism, but is that something we're proud to be exceptional at? There are a lot of factors for why the US has such a high obesity rate. I also don't get your fascination with "American exceptionalism" whatever or however you define it (It's obvious you're not using the term in its foreign policy incarnation). All EU states are also capitalist, but they don't have problems with obesity to our extreme. It's not like the US corners the market on ho-ho's. By the way, I didn't attempt to explain why the US is as it is because it's irrelevant when it comes to this issue. It's not like the US Government hasn't spent a lot of time and money on "physical fitness" programs either. That was one of Bush's big things he touted with Arnie. Changing to a UHC isn't going to magically address our problems with obesity. (Oh, yeah, the Governments Food Pyramid....what a disaster! That caused a hell of a lot of problems) As for healthcare outcomes - if you dig into the #'s we're pretty good on a huge range of healthcare issues. Cancer survival rates especially so. Also, I wouldn't exactly classify our healthcare system as "capitalist" per se. There's nothing capitalist about how the Government built this weird ass employer-insurance system, or SCHIP, Medicare/Medicaid and the whole CMS apparatus, etc. The FDA has rocketed up pharma prices while killing more people than they've supposedly saved (see: Bastiat's Seen and Unseen). Gee I wonder if it has anything to do with government regulations and limits on what crap companies can put into their products (food/drink/snacks/candy). And the utter lack thereof in the US.
If I were describe the issues plague American obesity I would probably start with 4 words. High Fructose Corn Syrup.
Telling kids to do some fitness doesn't help when you pump their bodies full of suger 24/7.
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On December 02 2020 09:54 Gorsameth wrote:Show nested quote +On December 02 2020 09:17 Wegandi wrote:On December 02 2020 09:05 NewSunshine wrote:
Right, but why does the rate of obesity in the US dwarf all other countries? American Exceptionalism isn't a great argument to explain why the US is arbitrarily different, so the next explanation is that the US is deeply entrenched in a Capitalist Consumerist culture that is deeply ingrained and has vested financial interests in making people want to spend more money on worse food, and then spend more money again on inferior healthcare outcomes. Blaming people in the US at large for an endemic obesity issue comes back to American Exceptionalism, but is that something we're proud to be exceptional at? There are a lot of factors for why the US has such a high obesity rate. I also don't get your fascination with "American exceptionalism" whatever or however you define it (It's obvious you're not using the term in its foreign policy incarnation). All EU states are also capitalist, but they don't have problems with obesity to our extreme. It's not like the US corners the market on ho-ho's. By the way, I didn't attempt to explain why the US is as it is because it's irrelevant when it comes to this issue. It's not like the US Government hasn't spent a lot of time and money on "physical fitness" programs either. That was one of Bush's big things he touted with Arnie. Changing to a UHC isn't going to magically address our problems with obesity. (Oh, yeah, the Governments Food Pyramid....what a disaster! That caused a hell of a lot of problems) As for healthcare outcomes - if you dig into the #'s we're pretty good on a huge range of healthcare issues. Cancer survival rates especially so. Also, I wouldn't exactly classify our healthcare system as "capitalist" per se. There's nothing capitalist about how the Government built this weird ass employer-insurance system, or SCHIP, Medicare/Medicaid and the whole CMS apparatus, etc. The FDA has rocketed up pharma prices while killing more people than they've supposedly saved (see: Bastiat's Seen and Unseen). Gee I wonder if it has anything to do with government regulations and limits on what crap companies can put into their products (food/drink/snacks/candy). And the utter lack thereof in the US. If I were describe the issues plague American obesity I would probably start with 4 words. High Fructose Corn Syrup. Telling kids to do some fitness doesn't help when you pump their bodies full of suger 24/7.
You do realize the EU imposes no regulation on HFCS? It did have a production quota for a while, but that didn't have anything to do with health, but to try and equalize agriculture production across EU states (which has since been abolished). I am curious where you get your "facts" from? I would be curious to see these EU health regulations on HFCS consumption and ingredient levels in food and drink.
People tell me I over-simplify things, but comments like this are routine in this thread but are ignored because it reinforces particular viewpoints. Obesity in America and its causes is a very complex issue. Intertwine food culture, Government recommendations that were heavily pushed for decades, food subsidies, prioritization of convenience and decrease in % of home-cooked meals, sedentary life-styles with increasing technology, etc. Besides, we've gotten away from the point. You can't use ridiculously non-causal and simplistic Healthcare Spending = Avg. Life Expectancy. It doesn't work like that. You're better off looking at specific surgeries, comorbid factors and death rates, CA survival %, etc. to gauge healthcare.
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I don't think you read what you linked. They basically define health outcome as life expectancy. Never mind the analysis there is extremely limited looking at very few variables (only Breast and Cervical CA, Flu vaccination > 65, Mammograms > 45, etc.). Is this the type of analysis that informs your world view?
Also what does this mean?
Second, our findings call for addressing risk factors for, and better management of, chronic conditions.
This basically sums up the whole article - vagaries, unspecified gobbledlygook, etc.
For why the above is poo about "managing healthcare costs" see: Can Disease Management Reduce Health Care Costs By Improving Quality?
Long-story short: No.
Disease management (DM) promises to achieve cost savings by improving the quality of care for chronic diseases. During the past decade the Permanente Medical Group in Northern California has implemented extensive DM programs. Examining quality indicators, utilization, and costs for 1996–2002 for adults with four conditions, we find evidence of substantial quality improvement but not cost savings. The causal pathway—from improved care to reduced morbidity to cost savings—has not produced sufficient savings to offset the rising costs of improved care. We conclude that the rationale for DM programs, like the rationale for any medical treatments, should rest on their effectiveness and value.
PS: Health and obesity varies tremendously by state in the US. https://www.cdc.gov/obesity/data/prevalence-maps.html
People forget that when they compare the average EU state to the US that's apples and oranges. The average EU state is smaller than most US states and are definitely more homogenous.
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So basically anything that doesn't support your opinion is 'unspecified gobbledlygook' and poo, meanwhile you still haven't provided a single source to back up your own claims but continue to repeat the same points over and over again as if saying the same thing ten times is bound to somehow make it more true.
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He isn't the guy breaking down life expectancy as some function of healthcare spending to be compared across different countries.
You may recall articles from earlier this year (Andrew Yang brought it up) talking about how recent changes in life expectancy were related to suicides and drug overdoses. I also doubt other nations are totally homogenous with respect to the US in both of those. And diet and exercise. It's a classic correlation ≠ causation and not including enough explanatory variables (which hitherto I thought our forum was well versed in).
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EPT
