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Comment by walkhour | Hacker News Reader

The US military budget is 12% of the total.

> I want affordable housing. Affordable healthcare. High speed rail. Better zoning laws. New subway lines.

Are you saying we only need 12% of the budget to fix these things? Note that coincidentally medicare is already accounting for ~12% of the total.

Say the military budget goes to zero (which it can't), and we spend half of that on medicare (it would be 18%). Will it fix the problem?

I think the problem is much deeper than wasting this 12%.

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This would be true if the only way to improve healthcare was to throw more money at it. The US could have the best healthcare system if it chose to spend those 12% on something else than pharma's pockets.

There isn't some simple silver bullet here. While the US ends up subsidizing other industrialized countries for prescription drugs (and that should be stopped), it is a small percentage of overall healthcare costs:

>While prescription drug costs only accounted for 8 percent of total U.S. healthcare spending in 2020, the price of such drugs has risen substantially over the last few decades. ... The U.S. spends twice as much on prescription drugs as other comparatively wealthy nations, on average.

https://www.pgpf.org/blog/2022/11/how-much-does-the-united-s...

American healthcare is unusually expensive. We spend more public money as a percentage of GDP than most other developed countries on it. Clearly something else is going on beyond money spent.

I can't say if it's correct or not, but here's an argument [1] that I've heard multiple times:

> Pharmaceutical breakthroughs are financed by the high prices paid by American patients (and backed by abundant venture capital); government-run health systems in Europe then bulk-buy the same drugs for much less. Europe has had some successes—German companies were among those pioneering mrna vaccines—but most of the cutting-edge research in science and technology is done at universities and companies elsewhere.

[1] https://www.economist.com/europe/2022/02/26/europe-is-the-fr...

European drug-makers benefit from those high prices in the US, too. But anyway, I’ve heard that only 11-14% of new drugs are therapeutically important. The rest compete with pre-existing treatments, which I believe is how generic forms bring costs down. I’m ok with universities doing this; bringing costs down does save the lives of poor people.

The government doesn’t need to and shouldn’t spend a dime on housing. It’s up to each state to just make it possible to build more homes. If the government can somehow compel that then great. We can fix the housing crisis and grow GDP at the same time.

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