What causes high healthcare costs in the US?

I do generally know the factors, but I was wondering if let's say an efficient number hypothetically is 9% of gdp, while it is 18%, how would you breakdown that 9 extra percent into 100: ie supernormal cost? For example the distortion from tax advantaged employer healthcare: would it be closer to 10% or 40%, or for example administrative costs solely as a result of it not being centralized, green fielding, local quasi monopolies held by hospital systems, just to name a few. A quantitative estimation by specific cause would be nice.

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u/ImTechnoThePig — 5 days ago
▲ 2 r/arch

Nvme corrupted

Installed arch with sway window manager just a few days ago with a minimal rice, so excited using linux for the first time. Then it happened: ran a git pull just as my battery died, and somehow the whole storage got corrupted, so the drive could not be detected at all. Lesson to all laptop archers out there: download something that hibernates when you reach a critical battery eg 5%!! If anyone has any other theories for why it broke, would be much appreciated but I'm pretty sure it's this.

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u/ImTechnoThePig — 7 days ago

CMV: College accreditation should not be mandated by law

This is an awfully specific topic, but I'll start off with the premise that any economic problem either is caused by too little government intervention to protect property rights, or too much, restricting innovation. Ballooning healthcare costs are caused by a huge list of factors, but one is the chronic shortage of doctors. Doctors are known to be paid fantastically well, but not when you consider years of school (possibly 15+), crippling student loan debt and of course an intellectual reckoning. Absolutely, specialized cardiologists or neurosurgeons should have extensive, and probably training that long or even longer. But because this is mandated by law in order to be a licensed physician, many doctors that do not require such a prolonged education are forced to be overeducated. Such explains the rise of nurse practitioners, but much more can be done. Consider also lawyers and the bar, which mandated 4 years of undergraduate study. Lawyers can absolutely benefit from breadth of knowledge and specific subject matter expertise, but this sort of broad stroke policy mandated by law is deeply harmful.

I should clarify what I mean by 'mandated by law'. In almost every specialized profession in the US, there is an accrediting agency, usually just one, that is technically a non-governmental non-profit that regulates it. However, because only they are recognized, and you need their backing to be certified, they effectively have a monopoly, that result in broad policies that stifle innovation. Furthermore, these firms are usually run by incumbents, who have an incentive to demand high standards, in order to create shortages, in order to ultimately boost their own wages. This results in degree inflation.

The model for colleges is slightly different, which need accreditation to get student loans and access to Pell grants. In this case, because accreditation is at the institutional level, it hides good programs at poor schools, poor programs at good schools. In general, it also replaces more specific measures of achievement, which can better identify student strengths rather than just a 'bachelors' at a good school. Apprenticeships and trade schools have also been regulated into oblivion, with high compliance costs and unnecessarily strict standards. This explains degree inflation also, as everyone is directed to college instead of other viable alternatives, increasing costs and ultimately leading to less efficient education.

The main argument for accreditation is risk management. I anticipate comments that state the obvious: architects, lawyers, doctors' quality must be assured. But that's precisely why government sponsored accreditation is less important than you think. Everyone, in a world without it, would still demand a reputable license before they hire a lawyer, or choose a doctor, or hire any college graduate. A true competitive non profit ecosystem of licensing firms would emerge, eventually with a few that are known to be prestigious and reputable. They would innovate to find standards that most accurately describe your ability or skills: because of the market forces of you trying to find one that describes you best, and employers or customers' insistence on reputable accreditation. This is not a catastrophic problem, but it's one that wastes our time and raises costs.

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u/ImTechnoThePig — 9 days ago

CMV: Inheritance taxes are fair

The best argument against an inheritance tax is that as a one time surcharge, it forces a liquidation event: you have to sell your family farm in order to pay the tax. This is merely an administrative issue however, as governments can simply allow payment schemes, where you pay the tax over time.

In order to close loopholes, gift taxes should also be extended where appropriate. In both cases, exemption amounts can be set high: at 1m for example, affecting a negligible portion of the population.

Inheritance taxes are incredibly unpopular because most feel they are being targeted for trying to help their children, but an inheritance tax can be highly progressive. An inheritance tax is only bad the same way all taxes are bad on the surface: that it removes capital or reduces investment are not valid arguments. It is a tax superior to most others, and at the very least severely underutilized.

The fairness argument is the most obvious one, but also the primary motivation. Yes, a lot of "inheriting privilege" is in greater educational and life opportunity. That is no argument against a tax that any liberal republic, where "all men are created equal" (but not just the US) should use to counter a hereditary elite.

I might be convinced if there is disproprtionate economic harm, but inheritance taxes are starkly different from wealth taxes which are highly harmful.

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u/ImTechnoThePig — 14 days ago

Georgism does NOT (just) make better cities!

In its purest form, a LVT would not reduce sprawl or encourage building taller. A building's current land value is purely based on the total future rent you can expect to charge from it, minus the natural rate of inflation-adjusted interest (it's lower because you have to bring all the money upfront) Consider a piece of land you can charge 10k a year of rent on; you can only do this for 10 years effectively. This is because the value of future rent is lower than the value of current rent, even with inflation, as long as inflation adjusted interest is greater than zero. If you can get 10% inflation adjusted from the stock market, 10k next year would only be worth 9k and it decreases ever year, even if rents increase because of inflation (because you look at inflation adjusted gains) We know this because land value is not infinite, even though land can keep generating value.

So if we make that simplifying assumption over ten years, the land value would be 100k. If a land value tax of 20% was implemented, you can still charge 10k a year (important: rents are determined by what the market is willing to pay), but you can only get 8k, so land value actually drops to 80k. This is crucial: the economics encourages building taller and less sprawl when land value increases, not decreases. But it does not encourage sprawl either: before, your activity was justified if it produced 10k a year of economic activity. Now, it also has to produce 10k a year of economic activity to justify itself: 8k to justify the purchase price, 2k to pay the tax. A LVT is perfectly neutral, at least theoretically: this is why conservative economists love it.

The mainstream theory is that the 100k plot of land, when taxed at 20%, will go from needing to justify 10k of economic activity a year, to 12k of economic activity a year, hence justifying building taller. This is not the case because land values decrease exactly proportionately. Let me make it clear: I wholeheartedly support a LVT because it will make our cities better! The main problem a LVT solves is when a chic corner store, new infrastructure, a new bus line opens in a city, lucky property owners get the gain, even though it's paid for by the public (not just infrastructure, but stores and other private businesses can raise land values too). A LVT makes not just cities better, but rural areas and suburban areas. It is not a panacea for urban decay problems either. That's why it matters how messaging is done: for too long a LVT has been associated with a left wing urban dream, but it's a policy that can help everyone, much more than they know.

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u/ImTechnoThePig — 30 days ago

How to take AP exam externally?

My high school doesn't offer the course (Physics C) and they've asked me to look through the AP course ledger, a list of schools offering the course that the College Board endorses. However, I've called ~10 schools on the list so far and been rejected by all. Generally, there's no reason for them to offer this service. Fortunately I am early, as this is for next year, but any suggestions would be helpful!

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u/ImTechnoThePig — 1 month ago