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I've experienced government health care via the military. Still have a variation of it. If we needed anything other than basic care or a 25 year old treatment, they sent us off-base. An anesthesiologist friend of mine left the military because he felt he was falling too far behind modern medicine. He said the equipment he had to use was like driving a 50 year old car.

Now....the military does have a FEW very good hospitals. Some of the best there are. But day-to-day, we got a lot of "Take some aspirin and tough it out". And I still have to be seen by a nurse (until COVID) every 6 months to get authorization to be seen by the same Doctor who has been treating me every 6 months for the last 10 years...

Don't know the answer though.
 

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I don’t know the answer either. Although I am against an overall socialist society, I personally believe I would appreciate socialized medicine like Australia and Canada @SueC. I see what bsms is saying too though.

It seems we can’t figure it out here just yet. Obamacare didn’t solve the problem. I pay for it, which isn’t bad. I’ve not been unhappy with it, although it does require we stay in state. That is fine and dandy, but my state is excessively expensive on the medical and dental side. I sent husband and little girl to the dentist. He had a toothache. The visit to see what was the matter was $500. He is requiring an individual visit per tooth, which irritates me, and the visit on Thursday, the first of 4, was $1,700 for just regular cavity filling. There went half of the money I have saved. I don’t have dental insurance, and this is actually the cheapest of the dentists in our area.

I was reading my insurance paperwork since big girl got her concussion. They won’t pay anything for emergency care until we meet a bit over $13,000. I imagine the bill will be hard to take.
 

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I would be interested in R&D investment in countries that have one payer systems.
Well that's pretty easy to find:

Source: ONS (2019) gross domestic expenditure on research and development, 2017. OECD Main Science and Technology Indicators 2017. Data for comparator countries shown. Note - figures are rounded. Please note, ONS data has been used for the UK for greater accuracy. The latest available data has been used for each country. Some countries have not published data for more recent years, in which case the latest available data has been used.

Depending on what you mean by "one payer systems," you could categorize the nations above into single-payer, national health service, universal multi-payer, etc. and see that the US is about average but trails many systems that provide universal coverage to all.

What's pretty clear is that the US is the only industrialized nation in the world that tolerates people going without healthcare, draining their savings to pay, or going bankrupt to access life saving care. I grew up in a military family and never wanted for anything when it came to my "government provided health care"- whether it was preventative medicine, acute incidents (oops, ER visit after busting a knee as a teenager playing soccer), dental, vision, the whole nine yards was accessible and affordable. I don't recall it really taking an exceptionally long time to access services or have things approved, but I was lucky to always be healthy and not need much; same with the rest of my family.

Now, even with my "cadillac" private insurance, I wait for months to get an appointment and fight tooth and nail with this company when they consistently attempt to tell my doctor what is or is not allowed, or require multiple appeals before paying for things like telemedicine appointments. I really have never understood the argument that going to a public, universal coverage system is going to lead to unacceptable wait times or cause a bureaucrat to interfere with my doctor's preferred treatments. That's here now. Just in the form of private (or nominally "nonprofit") companies paying CEOs and their boards massive salaries, while for-profit hospitals nickle and diming nurses and other techs a salary well below what they're worth while engaging in constant one-upsmanship with the insurers. And I'm one of the lucky ones to actually have low-deductible, comprehensive employer coverage. I don't understand why the collective we tolerate this situation.
 

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I trust free enterprise to be more innovative and to find new solutions due to the profit motive. OTOH, it is outrageously expensive. As I said, I don't know the answer. There is a reason I'll never run for office, and it ain't just because I'm not telegenic!
 

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I don’t know the answer either. Although I am against an overall socialist society, I personally believe I would appreciate socialized medicine like Australia and Canada @SueC. I see what bsms is saying too though.

It seems we can’t figure it out here just yet. Obamacare didn’t solve the problem. I pay for it, which isn’t bad. I’ve not been unhappy with it, although it does require we stay in state. That is fine and dandy, but my state is excessively expensive on the medical and dental side. I sent husband and little girl to the dentist. He had a toothache. The visit to see what was the matter was $500. He is requiring an individual visit per tooth, which irritates me, and the visit on Thursday, the first of 4, was $1,700 for just regular cavity filling. There went half of the money I have saved. I don’t have dental insurance, and this is actually the cheapest of the dentists in our area.

I was reading my insurance paperwork since big girl got her concussion. They won’t pay anything for emergency care until we meet a bit over $13,000. I imagine the bill will be hard to take.

I am on Obama care, too. I mean,, I get my insurance through that market place. Obamacare is only a market place for private carriers. But, anyway those costs are outrageously high. I live near Seattle, and I thought OUR costs were high!
 

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Interesting graph, although I don't see the part that said this was R&D in medical advances.
Well, you didn't ask me for that ;)

Here's one summary, though admittedly quite dated at this point (1998), of the percent of GDP invested in health related R&D.
1614019321034.png

Source. Young, A. (2001). Compiling performer-reported health GERD. Chapter 2 in Measuring Health-Related R&D. Paris: OECD Publications Service.

In this more contemporary New England Journal of Medicine article (Chakma et al., 2014), it seems that while the US health-related R&D investment is still leading in terms of actual dollars and by %GDP invested, that is declining comparatively over time. (You can create a NEJM account to access two free articles/month.)
Table S2: Change in biomedical research and development expenditure as a percentage of nominal gross domestic product (GDP) of regions, in current US dollars (USD) as of 6/25/2013
1109823


I trust free enterprise to be more innovative and to find new solutions due to the profit motive. OTOH, it is outrageously expensive.
But that's the very definition of a public good- the thing that there is no profit motive for free enterprise to address. For whatever reason, private companies have decided in the US that it is not enough of a problem that millions of our friends and neighbors go without health care. "We" (the global we) have decided that it's ok for @Knave to have to pay $13K- literally half of what I made as my annual salary my first year as a teacher- out of pocket before her insurance kicks in, or go without. When the market offers so little that is affordable to the average person, that's when public goods become relevant. Right now around 10-11% of Americans have no health care at all, and I don't have time to look up the statistics about the % on top of that who have functionally no health care (meaning, outrageous deductibles or bare minimum coverage that really does nothing if you are seriously ill or injured). How is this a market figuring out an innovative solution to figuring out how to ensure Americans aren't bankrupted or outright killed by lack of access to sustained, preventative medical care?

Here's another less consequential example that is playing out in an ugly way in my tiny town right now: We have no access to cable or fiber broadband interet in my part of town (the very rural, southern part outside of the village, which has cable AND access to fiber). There is NO for-profit company coming out here with wired connection, ever. There is a local community broadband district (public nonprofit) that has wired most of our surrounding towns, and part of our own town, with access to fiber which is supposed to be really good. We signed up when we moved in 3 years ago and are STILL waiting. The older residents in town keep telling those of us who are still working and schooling virtually to shut up already about the broadband. But it's pretty hard to understand how we are supposed to work in a fully virtual world when there is no market solution. There is literally no amount of money I could pay Comcast to come here (other streets were quoted $30K to bring cable down the road to 4 houses, and they paid. Comcast won't even take $30K to come down our street). There is no amount of money I could pay Verizon to give me a bigger data plan, since I run internet off my phone as a hotspot. It just doesn't exist. I don't understand how we can get away with saying that internet connection is not a public utility, but I guess we have deregulation of the 1990s to thank for that. We may end up with access to Elon Musk's Starlink, finally. We have paid our deposit and are hoping. So maybe a market solution will save us after all ;)

There is a reason I'll never run for office, and it ain't just because I'm not telegenic!
Haha, you and me both!! ;)
 

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Lol bsms and @egrogan. I was on the school board. I didn’t like it. It was harder than you would think, and doing things the honest way led me to zero results and a lot of negativity and stress.

A part of our county, a small town a ways out, has what we call a “box.” Inside the box, which is 1 square mile, has power and water. Outside of that box has none. Lots of people live outside the box in these odd made houses, some nice with solar power, and some rather ‘off the grid’ in a bad way, are s.o.l.. It would cost $65K to take the power out of the box, and the county refuses to because they look negatively at the town.

It’s a struggle.

@tinyliny I think Obamacare is much better in Seattle. Our county only is covered by one insurance. It’s take it or leave it, and it has to be purchased through Obamacare or a job site. I think certain jobs have been grandfathered in to other insurances, but any self insured or smaller business was dropped.
 

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My sister is on Obamacare. She's trying to get switched to Medicare but the Social Security people have been dragging their feet. She also gets a good discount on a new medicine for migraines which cut her from 12-15/month down to around 3/month. It is expensive but the private company has a program to provide it at a discount for folks below a certain income level. I had 13 potential cancer spots frozen off my face today. The retired military insurance (Tricare) is a pain to deal with but CHEAP compared to most private insurance. I was staggered when I started doing taxes and seeing how much some folks paid for health insurance and child care.

Really wish I knew the answers and was telegenic.... ;>)
 

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I’m sure you’re telegenic enough for politics bsms! I think you would put a lot of thought and care into it too. You would be the perfect kind of politician!
 

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Thanks. I'm impressed you've been in politics @Knave . I spent some time just on the Board of Directors for a small HOA. HATED it! But someone who has served on a school board has my admiration. THAT is tough AND important!

Talking about training holes on @gottatrot 's journal...started this but it belongs on this thread instead of cluttering up hers.

We've made an offer on a house and it has been accepted. We're now working once again on the inspections prior to purchase. COE is planned for mid-April. It is undoubtedly horse property. The current owner has raised Arabians there for the last 15 years. It includes this:


None of my horses have ever SEEN a 6-stall horse barn. I'm pretty sure none has even been in an enclosed stall. Nor do I plan to keep them in individual, enclosed stalls there. I'll probably build a 12x24 flat roof shelter for them to use most of the time and try to teach them to accept being in a stall in inclement weather. I don't think it will take a long time to teach them. But I doubt they'll rush in the first day. Is that a training hole? Most horses in Arizona will go their entire life without finding out.

The rodeo fairgrounds are about a mile from the house. I won't be able to ride Bandit there during a rodeo. Certainly not at first and I may not ever get him ready. It would involve work and I don't see much reason to do that work. It might turn into this and I don't bounce so good:


PS: The house is small and has an awkward floor plan. But The Wife and I are looking forward to it. Nice Living Room, Dining Room and Kitchen. The rest is....well, I think over time we can move some walls and make it more bearable. We made the offer mostly because of the location. Not much good, nearby riding off property - all paved roads with so-so shoulders that I can see. But there is a lot of great riding within 15 miles. So they need to learn to load and unload in a trailer. That hasn't been a "hole" for them for 10 years (and all have done it before). But I now need to get a truck that can haul more than 3500 lbs and a trailer and get them good at it.

Lots of holes are just things one hasn't had a need to do before. Or the opportunity to do, perhaps. I have plenty of holes as a rider. I couldn't imagine being able to do what a lot of you do daily. Without even thinking about it. Maybe the change in scenery and land and roads and other stuff will create "opportunities to learn" - which is another name for "training hole".

The view to the west. 9,456' MSL, nicknamed "Old Baldy". This is a big part of why we're willing to put up with very awkward bedrooms and the smallness (about 1450 sq ft plus a bonus room):


Of course, we were really excited about moving last month until we hit a show stopper. If anyone wants to offer prayers or good wishes, I'll accept both gladly. I have a good feeling about this. At this point, I can't imagine something popping up that would halt things....but there are still things like appraisals and home inspections ahead. Like the previous house, if it falls through, it won't be because we didn't sincerely want things to work. This one, though, I know has no interstate gas lines (or several of them) crossing the property. I will never again look for a house without checking for that before my first visit!

BTW - it is only 25 miles from our current house. But 5,000 MSL makes for a huge change in environment. This link has more on the local area, emphasizing the wineries....

 

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Oh yay!! I’m super excited for you and will say a prayer that direction.

I am fully with you and @gottatrot on the “holes” concept. I think that people who miss seeing that are people who are educated, sometimes highly and sometimes barely, but in a very specific setting. They lack the outside viewpoints and begin to think they know more than they do.

Even some of the “great” trainers get so caught up in a specific plan that they lose the general knowledge of a youngster making things work. Suddenly they forget that there are other ways.

I worked for a cutting horse trainer once. I don’t respect him much as a human, but as a trainer I saw a lot of good in him. He was kinder than most, and he let horses think things through themselves. He was very successful at the time too.

Anyways, he told me once that if a kid wanted to make a cutting horse, and knew what he wanted the end result to be, if he could be consistent, he would be successful. He thought, even if the kid did everything “wrong,” he would end up getting to the correct result. Sometimes I have to remind myself of that. I know that it is a generalization and not specifically always a rule which will be true, but the idea is right in my opinion.

I hate the pressure that these holes and rules put on people. It annoys me that as a culture in America, and probably many other countries, we spend our time proving we are better than others and tearing them down.
 

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Looks like great scenery and the weather seems pretty nice too. I was looking at the fairgrounds website...I wonder if they would let you use the track when the facility is not in use. To me that would be fun, to have nice footing where you could let a horse run sometimes. Or at least do some good cantering for fitness. Or if there is a big arena to ride in for something different. Of course the fairgrounds themselves might be scary and need some getting used to, even when nothing is going on.
 

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Sending you all the good thoughts that this house will be the one!

Our house also has a very odd floor plan. It’s hard to explain, but there are a lot of ways you could walk in circles between rooms and halls. There’s a secret passage. A lot of it is from adding on over the years in ways that didn’t make sense. But as we make changes, including taking out some walls and repurposing rooms, it’s starting to be more comfortable.
 

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My house is small, so I can never relate when people talk about odd floor plans or anything like that. My yard is beautiful and big at least. Lol

I don’t mind having a small house. I don’t think I’ll ever change it, excepting to maybe add a mud room at some point. We need something like that. I want to find ways to improve what’s already here, and when my girls graduate there will be no reason for it to be any bigger.

Maybe you will find ways to improve on your odd built house in that same feeling.
 

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You have lots of good thoughts, wishes, and prayers from me too. Our house has a crazy terrible floor plan also, but I don't worry about it too much. Our master bedroom is ridiculously huge and ends up storing everybody's junk because they say, "You have room in here." I hope everything goes smoothly for you!!!
 
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