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tptacek a day ago

We spend more on pension and benefits than we do on wars. The United States government is a benefits manager with a standing army.

toomuchtodo a day ago | parent [-]

The evidence shows we could spend less and deliver more within the scope of healthcare delivery (this piece). We actively choose not to. The Pentagon hasn't passed an audit eight years in a row, I hear little that "we cannot afford to keep funding the military at these levels and with such inefficiency."

https://usafacts.org/government-spending/

https://usafacts.org/articles/how-much-of-the-federal-budget...

https://www.militarytimes.com/news/pentagon-congress/2025/12...

tptacek a day ago | parent [-]

I don't want to sound like I'm fundamentally arguing with you, because if I could swap our system with Germany's I'd do so in a heartbeat. But (a) the "money that should be going into health care and education is going to military" argument is highly rebuttable, so I'd be careful hanging my hat on it, and (b) everybody, literally everybody (except the AMA) agrees we're spending too much on health care --- the problem is that money goes to practitioners, so it's very tricky to talk about clawing it back.

bonsai_spool 23 minutes ago | parent | next [-]

> except the AMA

What an idle comment - where is the AMA on record saying that we should spend more on healthcare? Here's all the work they do to describe our increasing costs:

https://www.ama-assn.org/about/ama-research/policy-research-...

Also, when people invoke the bogeyman of 'AMA' they treat it like the lobbies that tech companies belong to. The AMA is not enriching physicians or hospitals (which have their own lobby!) but generally espouses consensus perspectives among doctors while making money from administering things like a residency program application system.

It's frustrating for someone like you to make this statement which feels quite divorced from any fact when you would not do the same about a security topic.

tptacek 14 minutes ago | parent [-]

The AMA orchestrated the capping of residency slots through CMS/Medicare, which is the primary structural impediment to increased supply. Doctors in the US make integer multiples of what they do in Europe in part as a result of this.

I have to say: you can go either way on the AMA, I guess, but it's a weird hill to die on, isn't it? They're a trade group, not a public health organization. They exist for the benefit of their members.

toomuchtodo a day ago | parent | prev [-]

I appreciate you keeping me honest on this topic.

tptacek a day ago | parent [-]

Back atcha!