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forumposter123@protonmail.com's avatar

I'd propose an alternative read of Smith's data based on my own experience.

I think that with a lot of healthcare services people decide what spending target they want and then back solve to it. That's what I actually see happening when people running health plans make decisions.

So if I decide that I want my premium to be $X, I make whatever changes to the health plan are needed to hit that target (raise/lower copays, cover/not cover services, alter reimbursement rates for providers, require/not require referrals or step therapy, etc).

For decades people were willing let premium tick up faster than wages. Either because of the tax treatment or because health spending is more popular or whatever.

But as healthcare approached 17.X% of GDP, it just got to be too much. You can't run a business or a country with that kind of overhead. So the system started pushing back. Maybe that takes the form of say not being able to find a Medicare provider in NYC because the reimbursement rates are too low. Or maybe deductibles go up. Or the plan increases the paperwork burden to the point where people just give up and forego treatments.

I can buy that 17% is just the max our economy will tolerate (which BTW is still too high), but I don't necessarily buy that this has something to do with "productivity".

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Doctor Hammer's avatar

I can’t help but think that the problem with arguments against crypto is that “not letting the government freeze your assets” is also illegal, but probably desirable. After seeing the Canadian government’s actions around protests and the UK basically jailing people for saying bad things, criminal activity is increasingly not immoral activity.

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