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Comment by cmdrfred | Hacker News Reader

The question for me is if our government doesn't provide any of those services why aren't we paying half that number?

Well, you can look at the numbers here: http://www.cbpp.org/sites/default/files/styles/report_371px/...

    Medicare, Medicaid, etc: 25%
    Social Security: 24%
    Military: 16%
    Safety Net Programs: 10%
    Federal / Veteran Benefits: 8%

Looks like some people get services, just not everyone.

At the state level, California: http://www.usgovernmentspending.com/California_state_spendin...

    Health Care 35%
    Pensions 18%
    Education 16%
    Welfare 9%
    Protection (?) 7%

The US does not seem to get a great return on healthcare spending.

Also, US military spending is truly enormous. There is a big return on that (obviously opinions differ as to whether it's worthwhile...)

(Edit for fact-checking: hmm, while the USA's military budget is by far the largest in the world, as a fraction of GDP it's not that extreme. Wikipedia says it's 3.3% of GDP, high compared to the world average of 2.3%, but way behind the likes of Israel, Russia and Saudi Arabia.)

So then the question is are our elected officials corrupt or incompetent?

The biggest problem is that the electorate doesn't trust the elected officials in this matter. To bring down healthcare costs you need to be able to reject treatments that are much more expensive but only provide slight benefits. Organizations like the NHS in Britain are very good at this. But whenever someone gestures in that direction in the US you have people up in arms about "death panels" and the idea is quickly dropped.

I don't know though. Maybe if politicians just came out and said "This proposal will produce 10 extra deaths per year but we'll be saving $50bn so we think it's worth it" then people would be willing to embrace that.

I don't even think you are talking about more net deaths. Every percentage point you raise taxes or healthcare costs pushes a group of people underwater. A certain percent of people who have bankruptcies will commit suicide/beat their wife to death/yell at their children until they develop mental issues etc. Economic policies have consciences that are diffcult to measure.

Because you have the vital job as an American taxpayer of subsidizing oil companies, drug companies, military contractors, investment banks, and land speculators.

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