The US has not one but two of the largest single payer health insurance programs in the world.
Medicare alone has more people enrolled than any European country's single payer programs other than Germany (pop 83,294,633) and the UK (pop 67,736,802).
> The US has not one but two of the largest single payer health insurance programs in the world.
Neither Medicare as a whole nor Medicaid is single-payer. (Individual state Medicaid plans may be single payer plans, but very often they aren't, either.)
Traditional Medicare is single-payer, but the majority (as of this year) of Medicare beneficiaries use partially-subsidized private insurance (Medicare Advantage) plans, not traditional Medicare.
I don't think having discrete programs for subsets of the population is single-payer. Single-payer to my understanding means that the health system itself has a single payer. Having the government pay for some patients and a myriad of insurance plans covering the bulk of other patients is not single payer.
As they said, it is bizarre the lengths the US will go to to maintain its layered system. It seems purpose built to screw people over.
I think it would likely be called a non-universal multiple single-payer system if you want to get pedantic about things, but either way given that Americans spend more on healthcare in relative terms while lagging in most health measures makes it all seem very foolish.
We do not have universal single-payer but we have a few very large government-run single-payer systems.
If you have an example of a country with a single program that has more effective outcomes for a population of similar makeup and size, that would be a useful comparison.
A significant administrative cost benefit to single payer is not having to identify the correct payer, do coordination of benefits, etc.
With multiple “single-payer” systems in the same population (often serving overlapping populations with each other and private health insurance) you've negated that benefit.
You’ve also negated the market power advantage of monopsony purchasing by having multiple of them, and again having them coexist with private health insurance.
(And that's even before considering that while Medicare and some state Medicaid plans have single payer components, Medicare is not a single-payer plan covering the listed number of beneficiaries, but instead just under half are in the single-payer traditional Medicare, and that Medicaid isn't a single payer plan, or even a plan, at all, its a funding mechanism for state-operated plans, each of which may or may not operate entirely as a state-level single-payer plan.)
> With multiple “single-payer” systems in the same population (often serving overlapping populations with each other and private health insurance) you've negated that benefit.
Turkey's system used to have that exact flaw (three single-payers, to be precise) until 2008. All merged thereafter.
> For example, 15-20 years ago we had conservatives yelling video games are the devil and they need to be censored and some topics not even touched.
My memory of the 2003 to 2008 time frame is different.
I recall mainstream complaints about GTA 3, released 2001. Famously, Senator Clinton asked the FTC to investigate GTA 3 over the "hot coffee" mod in 2005.
There was also the 2005 California Law [0] that banned the sale of violent video games to minors.
The fact that you even asked this question speaks volumes.
Vaccines provide herd immunity. It’s not like bullet proof armour that only protects the wearer! We all need to get it for the population to be protected.
You getting more sick because you’re unvaccinated means you spread it to others. Babies. The elderly. The immune compromised. And so on.
What I don't understand is how it's possible to be two years into a pandemic, and people are still ignorant of this.
Especially now that measles is spreading again because the vaccination rate has dropped below the herd immunity level.
Ahh, ok. I was under the impression that the vaccines were to prevent a severe reaction in those at risk due to age or comorbidities, which is why some areas gave priority to the elderly.
Are there places where herd immunity was achieved due to vaccination?
One legal reason is fuel economy regulations (CAFE standards) encourage car makers to make their cars large enough to be classified as "light trucks", leading to less stringent fuel economy standards.
A larger footprint also reduces the fuel economy standard, incentivizing larger vehicles.
I think if you asked DC whether they'd rather continue to be funded by federal income and burdened by the national politics that constantly dictate what they can and can't do - or whether they'd prefer to enjoy the same level of freedom that other US cities enjoy they'd choose the former. In fact I don't think - I know - DC statehood has been a hugely locally popular movement for quite some time.
Just because you bought someone a coffee after punching them in the gut doesn't mean they appreciate your patronage.
A better option would be to transfer the residential neighborhoods of DC to existing states, and keep only the area around the Capitol and White House under federal control.
> A better option would be to transfer the residential neighborhoods of DC to existing states
The Virginia part was already retroceded in 1847, less than 60 years after the creation of the district; retroceding the Maryland part is a pretty common Republican alternative to D.C. statehood since pressure began for it (though it is opposed by both Maryland and D.C. residents who have 232 years of separate history.)
I actually completely agree - I think that it'd be far more fair to residents of the DC metro area if the whole city was just merged into either VA or MD (ideally the entire metro area would end up being moved into one of the states entirely - so maybe MD would be granted Arlington and Alexandria - or VA would get a chunk of MD... but either way I think it'd be far better for DC if it weren't this weird quasi-federal zone.
I also don't think that proximity really confers any undo influence at this point - so if the federal buildings just became federal property within the state of VA/MD similar to thousands of other federal properties that'd probably be fine.
Probably to give your argument as many points in its favor as possible - which is quite difficult considering how absurd your comment was. You originally said "436 states here we come" - even going by the lowest bar we currently have we'd only have two additional states.
Only 28 of our current states have a population above the median population of all US states and territories. I don't think the other 22 states would be wild about that admission standard.
> I don't think the other 22 states would be wild about that admission standard.
We have a well established process for asking states about this sort of thing, the US Congress. They don't seem to be wild about the minimum populous state standard, we should ask about the median populous state standard.
27% of the people in DC work for the federal government. If you're looking to criticize people for living off of tax dollars, there's a lot less honorable ways of doing that than working a 9-5 in an underpaid public service job.
> I now designate daily subway rides for reading New York Times breaking news emails so that clients don’t find me in an anxiety-ridden state when they arrive for tutoring sessions.
"Intellectuals [are] virtually the most vulnerable of all to modern propaganda, for three reasons:
1) they absorb the largest amount of secondhand, unverifiable information;
2) they feel a compelling need to have an opinion on every important question of our time, and thus easily succumb to opinions offered to them by propaganda on all such indigestible pieces of information;
3) they consider themselves capable of 'judging for themselves'.
They literally need propaganda."
Konrad Kellen in the introduction of Propaganda: The Formation of Men's Attitudes by Jacques Ellul
I think there's a lot of social pressure also contributed by other intellectuals to "stay informed", and pressure within political parties to make sure that people are also reading the news with the right interpretations. Just to say, I think the anxiety-ridden mess mentioned previously has some reinforcement behind it.
"In the end, the Party would announce that two and two made five, and you would have to believe it. It was inevitable that they should make that claim sooner or later: the logic of their position demanded it. Not merely the validity of experience, but the very existence of external reality, was tacitly denied by their philosophy. The heresy of heresies was common sense. And what was terrifying was not that they would kill you for thinking otherwise, but that they might be right. For, after all, how do we know that two and two make four? Or that the force of gravity works? Or that the past is unchangeable? If both the past and the external world exist only in the mind, and if the mind itself is controllable—what then?"
George Orwell, 1984
If one grants primacy over their own mental faculties - believing that anybody else's word has more relevance than their very interpretation of the world - then that other group now has the power to make one believe, and ultimately do, anything. At scale, that is a recipe for horrible things.
A society with a freedom of thought will never have a utopia because we just can't stop finding falsehoods appealing. But you will also never have a dystopia because society will always trend towards the truth as the past of least resistance, even if the road there might be quite bumpy. But in the grand scheme of things this is the state mankind has been in that sent us from being glorified apes to to being glorified apes with vast cities, neat toys, and being on the verge of setting out in exploration and settlement of the stars.
There was a lot of discussion [0] of that point when the Model View Culture article was originally posted 7 years ago.
It's complicated, but the author of the piece seems to take issue with how the character set was designed by the language authorities the UTC delegated to.
You can run the SSPL'd code, you can view the SSPL code, if you change the SSPL code then contribute back if you distribute your changes. If you run a service providing the SSPL code, contribute the management layer back as well.
It gets more code into the open, where's the disconnect?
I am not concerned with the code of other users' management layers. I am concerned with being able to use the code of this product in the way I want to use it. Copyleft is not important to me, I see permissive licensing as being a bigger priority for freedom.
> they don't have any intention to develop this software without a profit, then they shouldn't have positioned themselves as a free-and-open-source product in the first place.
If something satisfies the four freedoms [0], it is free software.
Well, the linked page indicated that copyleft is something that applies only to distribution and not use, but I guess the AGPL shows that that's not true.
Nonetheless I don't agree with the GNU's claim that copyleft doesn't reduce freedoms. Of course a permissive license provides more freedoms: it's right there in the name
But this issue isn't really about permissive vs copyleft licensing anyway: Had Apache used a copyleft license with Lucene, Elasticsearch would have never existed.
Schools should start later. But those times don't exist in a vacuum—for obvious logistical reasons, you generally want the kids to be in school before the parents have to be at work.
Medicaid and CHIP: 85,614,581 people enrolled [1]
Military: 9.5 million people covered [2]
The US has not one but two of the largest single payer health insurance programs in the world.
Medicare alone has more people enrolled than any European country's single payer programs other than Germany (pop 83,294,633) and the UK (pop 67,736,802).
[0] https://medicareadvocacy.org/medicare-enrollment-numbers/ [1] https://www.medicaid.gov/medicaid/program-information/medica... [2] https://www.health.mil/Military-Health-Topics/MHS-Toolkits/M...