I usually don't comment but I felt the urge to here.
It's disheartening to see the replies to your comment on this forum that these companies are doing something evil, and that these comments are arguing in favor of higher taxation to "fix" some sense of "fairness".
I personally don't think that governments use collected money generally more wisely than private hands - if they did, it would stand to reason that they should collect even more in order to continue allocating it so effectively, no? The whole private marketplace would be considered inefficient, correct? I hope we can agree (as users of a startup focused forum after all) this is not the case outside of a few tightly defined functions.
They want to make these companies pay a "fair" share, but none can define it. It appears to be "more" until no injustice for others exists along axes such as "healthcare outcomes", "housing outcomes", etc, regardless of people's choices. For example, one commenter gave the juxtaposition of Jeff Bezos throwing a Venetian wedding while people in the world lack health insurance as a case study for unfairness. What volume and kind of healthcare services are these people owed specifically? In the extreme, are experimentally surgeries that can only be provided by one living human counted as necessary? How much would it cost to pay him to provide it constantly, and what happens when he physically can't provide his service to everyone?
Where is the line drawn - because it absolutely matters. Would taxing Jeff more allow you to provide the services you envision? Where is the math showing which services could be provided, for how long, at what taxation rate, and for how many lives saved so we can actually make informed decisions? Until we have this data, it sounds more like this line of thinking comes from a hate for him rather than a desire to help people.
I live in a more remote part of the united states than probably 90% of this forum does: along the axes of "distance to a downtown", "health outcomes", "dental outcomes", "pollution exposure", "likelihood of getting into a car accident", and even "life expectancy" my result will likely be worse than someone in Brooklyn.
While I will be "poorer" on many metrics than someone who made the choice to move to Brooklyn, I would personally consider myself "richer" on the axes that matter to me.
No amount of taxing Meta will plug every gap between individual's outcomes nor bring general prosperity to a given nation, Meta paying even 100% of its income to my particular state will not help convince more truly-competent doctors to live near me nor inspire the ambitious people found in Brooklyn to come here to provide their quality services to me instead in order for me to have the same "quality of life". My outcome will always remain different than others'.
Personally, I think we should minimize taxes as much as possible to reduce the less-efficiently-allocated capital deployed by the government, and have clear goals on missions for equitable outcomes and clear plans for their costs.
To me, a sales tax on free signups really does seem as you say - a shakedown by a sclerotic leadership who want to feed their own operations with no clear plan to use the money well. Somehow they are empowered by supportive people who truly will not see an effective benefit from this extortion.
>But western societies don't seem to have a "We need X people with Y skillset" institution. If someone came to me like, "we need a welder to produce $needed_thing" then i would have put my skill points into that.
We do, it's called the price of labor. We currently need highly educated healthcare professionals like a forest fire needs rain. These wages are literally off the chart:
I recommend reading Robert Putnam's Bowling Alone (2000). American civic and social engagement has been declining in almost every measurable way for 50 years now. There is no way to deny this.
The largest contributor according the book's surveys and studies (and I love saying this) is television outcompeting in-person fun. Car dependency is a factor, but IIRC was factor #2 or #3. While this ranking was true at the time of publication, I would wager that time spent on "screens" is likely factor #1, #2, and #3 now.
I would wager that many people are fleeing their hometowns to socialize in cities not because they're walkable, but because the density of people increases, allowing you to have better odds meeting real humans who haven't been lost to the allure of the indoors.
While residencies have existed since well before Medicare was passed, they were mostly something elites pursued. Overall, residency wasn't an absolutely necessary practice until the mid-late 20th century. By the 70s, with the tailwind of the baby boom, the practice became normalized.
Our demographic makeup means we have more elderly in need of care and fewer to care for them, which means we will need to revert our requirements. The UK is already discussing/planning-for this in their healthcare system: https://www.independent.co.uk/news/health/nurses-doctors-deg...
I understand that it's scary that care quality may be lower, but that argument is similar to demanding that every road worker and civil engineer have a PhD. Our bridges and roads would likely be better if all participants were so educated and qualified, at least for the horrifically expensive and few roads/bridges we would be able to build.
What will probably happen in most US states is that physician education will continue to require residency. But routine primary care will increasingly shift to Physician Assistants and Nurse Practitioners. Real physicians should be reserved for the more complex cases.
I agree with this as a possibility for general doctor visits.
I already mostly see NPs for my checkups. If they aren't sure, then I can jump through the hoops to get a Physician.
It works well and I get plenty of time to discuss things during my appointments.
EDIT: I still think my original point may stand for specialists however, we'll have to see how it shakes out and what healthcare systems under more stress than ours decide to do in the near future.
Exactly. If you create a regulatory system so strict that you cant make doctors, you end up with a shortage, and creating a new class of professionals that do what doctors did before.
I think there are parallels to nursing as well, with increasing credentialism and then creation of new classes. 30 years ago nurses entered the workforce with a 2 year associates from a junior college. Heck, my highschool had a nursing occupational program.
Yes. If the short term rate banks can lend to each other (the fed funds rate set by the central bank) is lower, then all downstream longer term rates / bond yields tend to fall:
Say you have a billion dollars in cash. With rates at 0% and inflation at 2%, you might as well spend that cash by hiring some engineers and chasing a hit product. Or an OK product.
With rates at 5% or so and 2% inflation you can make decent money keeping your cash in a savings account paying 5% YoY. Unless you're sure you have a good idea, you might as well park the cash and skip out on all of that "hiring engineers" business, which may not result in a good product anyway.
and if nobody is willing to lend to these students any longer because their field of study won't yield enough income to pay back a loan... well, mission accomplished
This seems to have proven that growth leads to higher earnings and equity prices.
Of course less taxation and a drop in interest rates will lead to more earnings over time and higher valuations. The crux is that he frames the drop in interest rates as a matter of "luck", as if the government just happened to be dropping them, as opposed to the government reacting to the drop in good/service prices by lowering rates, as a result of innovation, to maintain price stability and the 2% inflation target.
Company A makes more of Good #1 for less money due to Innovation X, and can charge less money. When this occurs across the entire economy, the fed has to drop rates to prevent broad deflation in prices. Lower rates show up as more earnings. The alternative with fixed rates would be that Company A's revenue, after its impressive innovation, would remain roughly the same (or fall) while its competitors' revenues fall (more). The real (adjusted) growth in equity prices, earnings, and revenue would still be going up at the same rate IMO.
It's entirely possible (maybe not likely) that a landmark innovation could deflate prices for most goods in the future and bring us back to low or even negative rates, which would (per his measurements) show up as higher earnings and equity prices.
Maybe I don't know what I'm talking about, but this paper seems circular to me. What would be more compelling is an analysis on the future of goods/services availability, as interest rates and taxation are downstream of those. For example, what does China's potential decline forebode for good availability? What about the hyped up potential panacea of AI?
We also spend around way more per capita on health care than any other country. I bet both health care and defense expenditures could be reduced significantly if they were run with at least a little efficiency and less profit making by middlemen.
Depending on who you categorize as "middlemen", this health analysis is a common misconception: our outsized health care spending comes from providers, not insurers/payers. We just do more procedures (we lead the world in making procedures doable quickly and outpatient-ly) and pay our medical staff more.
Agreed, there's not some organization taking a fat cut, it's a matter of overall demand, namely subsidized demand. We hamstring our healthcare supply in a variety of ways while massively juicing demand, which leads to increased prices.
America spends $4.5t a year on healthcare[0].
~$2t of that comes from the government directing taxed dollars towards healthcare for certain classes, per my previous comment in this thread. If your goal is to reduce our per-capita healthcare spending I see a fairly brutal and swift solution that would halve our spending, and put us below most European countries[1].
This is conjecture on my part, but I would imagine the remaining spending would also fall as the consumers have to bid less money for access to the healthcare resources that are newly freed up.
Further conjecture, I believe we may be able to have our cake and eat it too if we reduce the years of study necessary to start practicing medicine, and reduce our roadblocks to importing foreign-trained doctors. The UK may be trying something similar[2].
If you work the numbers out based on expected utilization levels, extending Medicare to all residents in the United States gets you an administrative overhead fraction that resembles that of private health insurance, so I'm skeptical that insurance has much to do with it.
it would be nice if America could do the minimum that the rest of NATO theoretically agree to and spend just 2% of GDP on defense. Right now that figure is 2.9%.
Consider that most industrialized countries would have nukes by now if the US hadn't guaranteed to come to their aid if they are attacked by a nuclear power in exchange for their not trying to acquire nukes.
It's disheartening to see the replies to your comment on this forum that these companies are doing something evil, and that these comments are arguing in favor of higher taxation to "fix" some sense of "fairness".
I personally don't think that governments use collected money generally more wisely than private hands - if they did, it would stand to reason that they should collect even more in order to continue allocating it so effectively, no? The whole private marketplace would be considered inefficient, correct? I hope we can agree (as users of a startup focused forum after all) this is not the case outside of a few tightly defined functions.
They want to make these companies pay a "fair" share, but none can define it. It appears to be "more" until no injustice for others exists along axes such as "healthcare outcomes", "housing outcomes", etc, regardless of people's choices. For example, one commenter gave the juxtaposition of Jeff Bezos throwing a Venetian wedding while people in the world lack health insurance as a case study for unfairness. What volume and kind of healthcare services are these people owed specifically? In the extreme, are experimentally surgeries that can only be provided by one living human counted as necessary? How much would it cost to pay him to provide it constantly, and what happens when he physically can't provide his service to everyone?
Where is the line drawn - because it absolutely matters. Would taxing Jeff more allow you to provide the services you envision? Where is the math showing which services could be provided, for how long, at what taxation rate, and for how many lives saved so we can actually make informed decisions? Until we have this data, it sounds more like this line of thinking comes from a hate for him rather than a desire to help people.
I live in a more remote part of the united states than probably 90% of this forum does: along the axes of "distance to a downtown", "health outcomes", "dental outcomes", "pollution exposure", "likelihood of getting into a car accident", and even "life expectancy" my result will likely be worse than someone in Brooklyn.
While I will be "poorer" on many metrics than someone who made the choice to move to Brooklyn, I would personally consider myself "richer" on the axes that matter to me.
No amount of taxing Meta will plug every gap between individual's outcomes nor bring general prosperity to a given nation, Meta paying even 100% of its income to my particular state will not help convince more truly-competent doctors to live near me nor inspire the ambitious people found in Brooklyn to come here to provide their quality services to me instead in order for me to have the same "quality of life". My outcome will always remain different than others'.
Personally, I think we should minimize taxes as much as possible to reduce the less-efficiently-allocated capital deployed by the government, and have clear goals on missions for equitable outcomes and clear plans for their costs.
To me, a sales tax on free signups really does seem as you say - a shakedown by a sclerotic leadership who want to feed their own operations with no clear plan to use the money well. Somehow they are empowered by supportive people who truly will not see an effective benefit from this extortion.