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Comment by throwaway123x2 | Hacker News Reader

Healthcare, education, infrastructure... all of which badly need funding.

So colleges and hospitals will finally have more administrators than students/patients? ([0], but you can google more). I think, the problem is not the lack of funding, but terrible inefficiency and lack of transparency.

[0] https://www.aei.org/carpe-diem/chart-of-the-day-administrati...

> So colleges and hospitals will finally have more administrators than students/patients? ([0], but you can google more). I think, the problem is not the lack of funding, but terrible inefficiency and lack of transparency.

This is one of the proposed ways to pay for things like universal health care.

Additionally, your citation (https://www.aei.org/carpe-diem/chart-of-the-day-administrati...) is about public schools, not colleges and hospitals as you suggest.

Medicare for all will drastically reduce the amount of administration for health care.

That's a very good question. IIRC, the current mess with inflated medical bills started when Medicare placed caps on some fees that were below the actual cost. So the hospitals had to recover the difference from those who are not covered. This killed transparency, promoting even more cost inflation through bullshit admin positions.

So now it's a tough spot. On once hand, if you apply the Medicare caps universally, many hospitals will go belly up. If you remove the caps and let them bill whatever they want, you will end up with a rapidly growing hole in the budget.

I would say, instead we need a solid system of rules on what you can and cannot bill, some auditing body and a way for the patients to dispute inflated bills at an affordable cost. Whether it goes out-of-pocket or from a tax-filled fund is IMHO not as important as the cost audit/dispute mechanisms.

> Whether it goes out-of-pocket or from a tax-filled fund is IMHO not as important as the cost audit/dispute mechanisms.

IOW, more administration. Didn't this thread start with a complaint about administrative cost?

There are many examples of successful universal medical systems with different trade-offs that have been refined over the last 50 years. Canada, Britain, Germany, Switzerland, etc. Choose the set of trade-offs you prefer and copy it; reinventing the wheel is likely not going to end well.

> Healthcare, education, infrastructure... all of which badly need funding.

Education is poorly funded? We spend more per student than any country except Norway as of 2015: https://nces.ed.gov/programs/coe/indicator_cmd.asp

The education system is not poorly funded. The money is poorly and inequitably allocated, and the system is poorly run.

> The education system is not poorly funded.

Every SpecialEd teacher and student would politely disagree with you. Not every aspect of education is funded differently, even when factoring i’m better budget management.

That might just be an example of poorly allocated and more money should go towards special ed.

That's an example of exactly what the comment you're replying to said.

infrastructure I agree, but we should just move funds to do that. healthcare and education are both already spending way too much on. healthcare is pretty obvious, but education as well we spend more than most other countries

https://www.theguardian.com/us-news/2018/sep/07/us-education...

> healthcare and education are both already spending way too much on.

Huh? Currently on mobile so I don’t have the CBO file to link but I will when I get to my PC.

Anyway, Healthcare spending is not actually “too much” and instead is too low. When we expanded Medicaid and implemented the ACA, estimated costs were below actual cost by hundreds of billions to one trillion dollars due to the unknown number of people accessing healthcare. Healthcare is the one area in which there is not enough money being spent on lower income brackets and Medicaid/Medicare users.

When people say infrastructure they usually mean roads. Roads are perhaps overextended already and making more or bigger roads ends up subsidizing urban sprawl. Anyways, outside of interstates, roads could just be handled entirely at the state or local level and paid for via use taxes. If we are trying to combat global warming, not building more or bigger roads is an easy place to start.

> When people say infrastructure they usually mean roads.

[citation needed]

Granted, I can only speak for myself, but when I hear the word "infrastructure" I'm picturing a smörgåsbord of different things:

- Roads

- Bridges

- Tunnels

- Rail lines

- Canals

- Levees

- Electrical delivery (power lines, distribution boxes, etc.)

- Telecommunications delivery (data lines, radio towers, etc.)

- Fuel delivery (pipelines, refineries, storage, etc.)

- Water delivery (pipelines, aqueducts, reservoirs, wells, desalination plants, etc.)

- etc.

This is consistent with Wikipedia's definition of "hard infrastructure" (as opposed to "soft infrastructure", which focuses on institutional structures/organizations).

How does that help people that can’t afford to pay for everyday things?

By providing them a job with a decent living wage.

Just off the top of my head...

By not bankrupting them as soon as they get sick.

By giving them an opportunity to go to college and improve their economic standing without taking on six figures of debt.

By giving them access to affordable reliable public transportation so they don't have to deal with the huge expense of owning a car.

Why not to the military?

Two of these three things provably don't need even more money poured into them - money just needs to be spent more efficiently. In fact, they'd probably benefit from cutting some of the spending: many bloodsucking intermediaries will fall off and move to something else. Infrastructure could use a funding bump, I agree.

Healthcare, at least in the US, needs about 80 percent less "funding". The whole problem is that costs are out of control. Not that taxpayers are being insufficiently raped.

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