| ▲ | phillipcarter 5 hours ago |
| Unfortunately, much of that gets dispersed into an unfathomably complex web of private and profit-seeking interests, with much less actually going to individual beneficiaries. |
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| ▲ | trollbridge 5 hours ago | parent | next [-] |
| Social Security almost entirely flows to beneficiaries, as do programs like SNAP, where overhead is around 6-7% (admittedly, fraud might be a good bit higher than that); likewise Medicare is one of the most efficient systems at getting money directly to medical providers (although fraud might be a problem there too, estimates range from 10%-25%). |
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| ▲ | munk-a 5 hours ago | parent [-] | | Yup, Medicaid and SNAP are extremely efficient. Social Security is almost completely disbursement charges but those disbursements aren't means tested so even quite wealthy individuals receive them. Additionally you mentioned that Medicare gets money to medical providers but I suspect that was meant to mean medical insurance providers - rather than health care providers (like doctors) since the system is partially direct payments but mostly runs through intermediary privatized companies and, of extreme note here, is that Medicare is famously barred from cost negotiations so while our Canadian healthcare system can talk to a pharma manufacturer and tell them "The price for this drug is unreasonable, we won't cover it unless it's cost competitive to biosimilars" Medicare just needs to roll over and accept whatever made up numbers it's given. The benefits that are intended to go exclusively to the impoverished though, those are extremely means-tested and often have work requirements or other hoops to jump through. | | |
| ▲ | RhysU 4 hours ago | parent [-] | | > Social Security is almost completely disbursement charges but those disbursements aren't means tested so even quite wealthy individuals receive them. Only to those who paid into the system and far less than they personally could have earned on investing the same dollars. | | |
| ▲ | renewiltord 4 hours ago | parent [-] | | Yeah, one of the problems I have with taxes is that if I pay $100 into taxes I don’t get $100 of value back. Everyone should get at least as much as they put in back. Also, some other people should get more back. But we shouldn’t spend more than we make as a government. | | |
| ▲ | munk-a 2 hours ago | parent | next [-] | | Assuming the presence of a sovereign wealth fund which does work somewhat logically for programs like social security - that would make sense. The government should sensibly invest money they're holding onto... however, it's unrealistic to ever expect the government to tolerate a level of risk and thus a rate of return above what you're personally comfortable with so it's unrealistic to assume that the government will be as efficient with money as you'd personally be if they'd never taken that money. Additionally, a lot of these programs will pay out beyond what you've personally put in - programs like Medicaid are nearly entirely social subsidies to ease poverty and financial distress, so I'm not certain where you'd find the money to pay for them if not looking at either other people's taxes or debt. As a taxpayer I expect the money I give to the government to be evident in some social projects but I don't personally expect that for each dollar I pay that I'd see a dollar in benefit to me personally. I have a belief that I indirectly benefit from the expenditure of charitable safety net programs even if I never expect to collect from them directly - the improvement in the lives of those around me is to my personal benefit by making society more just and egalitarian as well as reducing the incentive for crime which is a difficult to measure but observable direct benefit to myself. The fact that so much of our budget goes to debt servicing is probably my personal biggest objection as it is effectively just a wealth extraction from our earn national budget to some select individuals. | |
| ▲ | RhysU an hour ago | parent | prev [-] | | Many people do get more back than they put in. High earners do not: > Most American workers receive significantly more from Social Security over their lifetimes than they contribute through payroll taxes. https://legalclarity.org/is-social-security-worth-it-contrib... |
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| ▲ | ch4s3 5 hours ago | parent | prev | next [-] |
| A lot just gets sucked up by 3rd parties of all stripes. Only ~20% of hospitals are for profit institutions for example. |
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| ▲ | airstrike 5 hours ago | parent | next [-] | | Non-profit doesn't mean money-hating, though | | |
| ▲ | ch4s3 2 hours ago | parent [-] | | No but it directly contradicts OP's claim of "profit-seeking interests". | | |
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| ▲ | tgrowazay 4 hours ago | parent | prev | next [-] | | My daughter’s classmate’s father is a head of a non-profit hospital. They have a 6k sqft house with a basketball court, pool and a pool house in the prime location in West Los Angeles. They had to join two lots to build to their liking. | | |
| ▲ | ch4s3 2 hours ago | parent | next [-] | | Would you expect that job to not pay well in a market where similar skills are directly transferable to running any mid sized corporation? | |
| ▲ | shipman05 4 hours ago | parent | prev [-] | | We call that "pulling an Altman" these days. |
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| ▲ | cucumber3732842 3 hours ago | parent | prev [-] | | >Only ~20% of hospitals are for profit institutions for example. And the other 80% are little to no more efficient in terms of dollars input vs services rendered. | | |
| ▲ | ch4s3 2 hours ago | parent [-] | | I am merely commenting that profit seeking is not a sufficient explanation. |
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| ▲ | jimbokun 5 hours ago | parent | prev | next [-] |
| I don’t think that’s true. US government services generally have very low overhead. |
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| ▲ | phillipcarter 5 hours ago | parent | next [-] | | It's quite true. Take Medicaid grants to states for example, which then goes out to 50 different systems of disbursement to private entities. Enrollees on plans are often done so through private insurers, many hospitals are run as for-profit including being owned by PE groups, etc. | |
| ▲ | airstrike 5 hours ago | parent | prev [-] | | And the intermediaries? And admin? |
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| ▲ | BurningFrog 3 hours ago | parent | prev | next [-] |
| Not sure if this is comforting or distressing, but it's the same in all welfare states. |
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| ▲ | 3 hours ago | parent | prev [-] |
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