> The US population is aging, which means that 36% slice is going to naturally grow. What do you think should be cut, and how?
Old people [1], veterans [2], high earners and homeowners [3] turn out to vote. The only demographic we can cut benefits to are the poor. That's what's happening. (Given partisan polarisation, my guess is Democrats will take an axe to veteran benefits next cycle.)
> Why shouldn't the health insurance industry be the first item on the chopping block?
Health insurance is orthogonal to federal spending. The correct question is why Medicare shouldn't be allowed to directly negotiate pricing with providers on more items.
> Why shouldn't corporations (that benefit from a healthy and educated workforce, a safe and secure environment, a working transportation system, etc.) be paying their fair share to keep the national debt in check?
The term "fair share" is always loaded in tax discussions. Be honest and say why shouldn't corporations pay more. The answer to that is it's an inefficient way of taxing the wealthy since absent a progressive corporate tax structure, which nobody seems to be proposing, you wind up taxing a lot of small and medium-sized businesses.
Better: add tax brackets at the $1mm, $10mm and $100mm thresholds.
> Health insurance is orthogonal to federal spending.
As an Australian looking at the USA - I'm not sure how you make that claim sincerely.
Perhaps you're constraining it specifically to 'insurance', rather than the only slightly broader question of private health coverage. It still feels like a tenuous claim, given parent's valid point about health costs at the federal level, and intimation around the poor comparison to almost all the other advanced nation states on the planet.
> Be honest and say why shouldn't corporations pay more. The answer to that is it's an inefficient way of taxing the wealthy ...
You seem to be conflating corporations with wealthy people.
Taxing corporations more has been shown - in your country, albeit some decades ago - to be both eminently achievable and effective.
Taxing corporations less has, in recent years, demonstrated clearly how poor a decision that is.
> Perhaps you're constraining it specifically to 'insurance', rather than the only slightly broader question of private health coverage
Correct. Our major uses of our $4.9tn of annual healthcare funds are 31% to hospital care, 20% to physician and clinical services and 9% to retail prescription drugs [1]. Lowering that number begins and ends with better price transparency from and efficiency in hospitals and physicians' practices.
Our sources of funds are private health insurance (30%), Medicare (21%), Medicaid (18%) and out-of-pocket (10%). Within the context of federal spending, Medicare and Medicaid are relevant, as well as the price and utilisation of the aforementioned uses.
> You seem to be conflating corporations with wealthy people
I'm specifically saying these are separate, and that taxing the latter would strike me as fairer than raising taxes on McDonalds franchisees.
> Our major uses of our $4.9tn of annual healthcare funds are 31% to hospital care, 20% to physician and clinical services and 9% to retail prescription drugs.
The adjacent 'National Health Expenditures by type of service and source of funds, CY 1960-2023' paints this picture more clearly, and identifies $1.5T of that $4.9T as going to 'private health insurance'.
It's odd that you overlooked that 30% figure in your summary of major uses (or 'wealthy corporate parasitic recipients', in this case).
I think it's this bit that everyone outside of the USA can't understand the high tolerance for.
> I'm specifically saying these are separate, and that taxing the latter would strike me as fairer than raising taxes on McDonalds franchisees.
Perhaps, but perhaps try both? Anyway, as I said, the USA used to have high corporate tax rates - up until Reagan, I believe - and almost every graph showing something awful happening in the USA at some point in the past 80 years has a suspiciously consistent inflection point of Reagan. [0]
I mention this only as it relates to any proposal to reinstate higher corporate taxes. I don't think anyone's suggesting chasing large numbers of (likely already acceptably taxed) $500k franchisees are the place to focus on. I don't understand why you would assume that's what I meant.
Between 2011 and 2020, Amazon, Facebook, Alphabet (the owner of Google),
Netflix, Apple and Microsoft — known as the "Silicon Six" — paid roughly
$219 billion in income taxes, which amounts to just 3.6% of their $6
trillion-plus in total revenue. [1]
Select the fourth download - as noted above - called "National Health Expenditures by type of service and source of funds, CY 1960-2023 (ZIP)"
I opened the .xlsx, but they ship a csv too. The xlsx file shows on line 6 'Private Health Insurance' - and this is under the sub-heading 'Total National Health Expenditure', itself in the column called 'Expenditure Amount (Millions)'.
I've re-visited your earlier link - https://www.cms.gov/files/document/highlights.pdf - and can't see anything - especially 'top of the second paragraph' that tries to explain that figure differently.
In any case, the full ledger has a lot more clarity.
(Oh, in your highlights document - on page three - there's a 'Health Spending by Major Sources of Funds' - but I note that it's Health Spending they're describing there.)
Democrats do a lot of things deeply wrong, but they seem to exhibit punitive behavior like this a lot less than their Republican counterparts. Republicans pay a lot of lip service to veterans but actual GOP legislation in favor of them is sparse at best
> they seem to exhibit punitive behavior like this a lot less than their Republican counterparts
It's not about being punitive. It's about finding resources to deliver goodies to your voters. Democrats have plenty of spending priorities. They're also, at least now, cognisant of the electoral impact of inflation. That means no more trillion-dollar deficit packages, but finding places to cut. Republicans have the poor. Democrats had deficits; if they can't figure out how to pass tax increses on the wealthy or corporations, that only leaves cuts, and the first place to start is where people who will never vote for you (and are already turning out to the opposition) live.
Hence next cycle. Nobody will say they’re punishing veterans. The pitch will be increasing efficiency at the VA and the reason to fund e.g. the energy transition or some other Democratic priority. Hell, the GOP might wind up going along with it to pay for their tax cuts and border priorities.
Why would they do it next cycle when they haven't done it in the past, especially when there's fair odds that the military will be more Democratic in the future?
R's are much more likely to cut veteran benefits/services and the VA. Some of that is happening now through DOGE, in fact. I don't see this as a likely path for the D's at all.
I think they have plenty of appetite to tax the wealthy and corpos... and we're possibly seeing the first stirrings of a new populist backlash to the billionaire bros. If D's can ride that wave back to power, they'll have a mandate to stick it to the uber rich.
B/c honestly, Musk, Theil, Adreessen, et al, through their recent actions, are making the argument that billionaires shouldn't exist much more effectively than Elizabeth Warren or Bernie Sanders ever could.
> Given partisan polarisation, my guess is Democrats will take an axe to veteran benefits next cycle
I highly doubt it. The Senate “Democrat” in charge of the VA is Bernie Sanders himself, and he’s been a stalwart supporter of improving veteran benefits his entire career. There’s also the whole “it would be political suicide” thing.
Partisan polarization is a good way to predict a lot of things, but if you lean into it too much you will in fact be wrong.
It was political suicide because the 18% of Americans who are veterans turn out to vote, are seen sympathetically by other voters [1] and were often swing voters.
The last part was critical: veterans are already turning out, so offending them was less about turning out votes for your opponent than losing your own votes. But if they aren't voting for you [2], you aren't losing anything by them. Meanwhile, the resources they're getting could help you gain votes (or turnouts) with others.
Or you could just not assume some random unsignaled shift in own goaling might not happen? What's your goal to argue this hypothetical with no evidence or reason so hard?
I feel like you might be contradicting yourself a bit there, though. If veterans mainly don't vote Democrat, then sure, pissing them off isn't a problem. But if veterans "are seen sympathetically by other voters", then you maybe won't want to piss off those other voters, unless we know that they also primarily vote Republican.
Googles net income in 2024 was 100 billion. How much did they pay in taxes? And why %wise my company pays more. This should be DOGEd on top of what is being doged now.
Old people [1], veterans [2], high earners and homeowners [3] turn out to vote. The only demographic we can cut benefits to are the poor. That's what's happening. (Given partisan polarisation, my guess is Democrats will take an axe to veteran benefits next cycle.)
> Why shouldn't the health insurance industry be the first item on the chopping block?
Health insurance is orthogonal to federal spending. The correct question is why Medicare shouldn't be allowed to directly negotiate pricing with providers on more items.
> Why shouldn't corporations (that benefit from a healthy and educated workforce, a safe and secure environment, a working transportation system, etc.) be paying their fair share to keep the national debt in check?
The term "fair share" is always loaded in tax discussions. Be honest and say why shouldn't corporations pay more. The answer to that is it's an inefficient way of taxing the wealthy since absent a progressive corporate tax structure, which nobody seems to be proposing, you wind up taxing a lot of small and medium-sized businesses.
Better: add tax brackets at the $1mm, $10mm and $100mm thresholds.
[1] https://www.pewresearch.org/politics/2023/07/12/voter-turnou...
[2] https://ivmf.syracuse.edu/wp-content/uploads/2024/10/2024_Re...
[3] https://nlihc.org/resource/new-census-data-reveal-voter-turn...