Hacker News Reader

Comment by wyager | Hacker News Reader

Piketty's claim is that, in a capitalist system, wealth disparity increases over time (measured in currency).

I don't think he presented enough evidence to make that statement without a lot of qualifiers, but for now, let's just assume that it's correct.

What Piketty absolutely failed to account for is that capitalism's greatest strength (and even Marx thought this) is that it causes the marginal utility of currency to decrease over time.

That means that even if the dollar gap between rich and poor is bigger today than it was 200 years ago, the actual quality of life gap is just getting smaller and smaller.

A billionaire can afford caviar and ten lamborghinis.

A thousand-aire can afford hamburgers and a used civic.

The billionaire is not a million times better off, and every year, as brutal market forces push the development of better and cheaper technology in every field, the difference between the rich man and the poor man, measured in the quality of food, goods, and services they have access to, gets smaller and smaller. For the most part, billionaires can only buy more of the same thing that almost everyone has access to. The rich guy can buy a harvard education, and the poor guy can buy a cheap but effective online education. The rich guy can buy a gold-plated iPhone, and the poor guy can buy a cheap Android. It's all the same stuff, just with different levels of class.

Compare that to not so long ago when only the rich had cars, refrigeration, electricity, etc.

View on HN

I disagree with you.

"The rich guy can buy a harvard education, and the poor guy can buy a cheap but effective online education"

And what is the outcome of having Harvard education against having cheap online degree? I am sure Harvard graduates come way ahead of graduates of online universities, both in private job market as well as in influential government positions due to "cliques" and "networking".

But the problem is much deeper than whether you can afford high quality commodities or not. Those with excess capital can accumulate assets, and then rent out those assets to those without capital. If this sounds too abstract, consider a concrete example - bay area housing market. Only those with capital can afford houses. Those with excess capital can buy additional houses and rent them out to those who cannot afford housing. Net result? The ones who cannot afford houses now have to keep paying rent to those who could, thus making homeowners richer.

Piketty has elaborated this in detail. But the most salient question he raised was that inequality, per se, is neither bad or good, but whether it is justified? Today, Bill Gates or Mark Zuckerberg have billions more than I do. But I am OK with that because they took risks, invested their efforts (and yes, also got lucky). But I am don't think someone like Alice Walton or Paris Hilton deserve their billions - in their case, all they did was just to be born to rich parents. And they and their heirs are going to have a better life (education, nutrition, accommodation, entertainment, connections...) than almost everyone else. Why? Doesn't seem "justified" to me.

Edit: Why the downvote? And while I respect your freedom of speech (to downvote), I am sincerely interested in knowing your counterarguments.

You're missing his point a little bit. He acknowledges that the rich will keep getting richer, and places like Harvard will continue to act as gatekeepers. But the intrinsic value of education will largely be available both to the rich and the non-rich. The credential and social signal of Harvard won't be, but the actual learning of things will.

Actual learning is only one of the multiple aims of college degree. One aim is also to improve career prospects in terms of better job opportunities and networking. And for that, Harvard has vast advantage over cheap online education.

It seems tautological to say that one of the benefits exclusively allocated to the rich is an ability to be rich. Stipulate that the rich are going to stay rich, or even get richer. How are you rebutting the comment upthread, which argues that regardless of income gaps, the quality of life gap is narrowing? Isn't the quality of life gap the more meaningful of the two gaps?

Rather than income gap or quality of life gap, I personally find "opportunity gap" to be more important. And I believe that gap is proportional to wealth disparity, i.e. rich people have a lot more opportunities than poor people.

Basic safety net in the rich societies may ensure a decent quality of life even for the poor folks. But does that mean they have opportunities to escape poverty, and have means to pursue whatever they are interested in pursuing?

Since you asked for concrete evidence in one of the other comments, here is one example showcasing opportunity gap - a child in Atlanta raised in the bottom fifth of the quintile has only 4% chance to rose to the top fifth.

http://www.nytimes.com/2013/07/22/business/in-climbing-incom...

EDIT: tptacek, seems I cannot reply to you here as well. But you are right - the biggest advantages of being rich today is that you have better life today and you have better chances to be rich tomorrow, which means you (and your heirs) will keep having better life than others.

I responded to your appeal to opportunity downthread. It seems tautological. The benefit you're reduced to allocating exclusively to the rich is "becoming rich".

That's all well and good. Learnings don't matter one bit when it comes to what an HR department or venture capitalist will look for on a resume or pedigree in a slide deck respectively, or the social network of having been present at said institution. Pedigree might be for suckers as PG put it, but it's still a signal of being selected and completing an expensive hazing ritual. So it will continue to function for people that value expense and exclusivity.

Tautology. You can't say that a benefit of being rich is being rich, or having ways to be rich. What are the intrinsic benefits of education? Do the poor in capitalist societies have more access to those intrinsic benefits, or less?

(For what it's worth, I dropped out of college after a single semester).

You're completely wrong and missing the boat.

If someone is a child of a farmer and hangs out in a tiny farm town without internet access, doesn't complete high-school, their odds of creating great wealth are zilch. They may start a hardware store but don't get your hopes up that they'll be the next Sam Walton. Whatever they hope do, it will be much harder. Some of the doors are closed, some doors don't matter.

If someone where a Ruby developer and wanted to work for a startup, a degree probably wouldn't matter as much as say MegaCorp.

But if someone goes to an exclusive university, graduates and then lives in a large city and has lots of friends, their odds of wealth dramatically improve versus the former... if they were ambitious, many more doors would be open to them (vendors, partners, investors, customers, etc.). Being close to the action with the right contacts is a world of difference from being a random person without successful, helpful friends and pedigree.

Furthermore, it is valid to be self-reinforcing because it is. Without wealth, it's impossible to capitalize on opportunities to make smart investments which one would otherwise have to pass on while others with more wealth may have the chance to make more money on them. Also, people with wealth have plenty of pseudo-"friends" pitching them opportunities to make wealth, whereas someone without wealth is unlikely to have a full calendar of people trying to get investment from them. Think of how many deals Mark Cuban can pass on just because he doesn't like the terms, and how good he's gotten good at negotiating favorable equity terms and knowing which deals are good/bad. Someone that's totally new is likely to be totally inept at some part of the business dance and will likely get rooked. Someone with the right friends is far more likely to get good advice from them about what to do or not do in a business setting to make fewer mistakes.

It's harder to get from zero to having VC's for friends that send you sweetheart deals to invest in, but that usually requires proving oneself (rich) first.

In conclusion, rich does not assure itself but it tends to be self-reinforcing.

(I took the ten-year plan and barely finished because I subconsciously resisted due to the conscious futility of it. Box checked, not about to start Dr. ... PhD)

Yes. We all agree about that. The question is: how much does that matter? Maybe it matters a whole lot. I won't be surprised if it does, because that's what I intuitively believe too. But if it's so obviously true, we should be able to marshal evidence to support the idea the idea that distribution of wealth matters to the welfare of the whole population.

So far, arguments against the comment upthread boil down to two things:

* Arguments that appear factually incorrect, like, "the wealth gap means the rich have good nutrition but the poor don't".

* Arguments that wealth inequality means that the poor can't become wealthy, which is like saying "the problem with wealth inequality is wealth inequality".

Those sort of arguments are broad generalizations.

It's impossible to say anything's impossible given determination, but the level of difficulty varies and it's context-dependent.

It's harder to become wealthy if your car is a POS and you miss a crucial client meeting, or live in a rough neighborhood and have your laptop & cell stolen because your apartment was robbed. None of those sort of things individually are fatal, but the likelihood of i) not being taken seriously (lacking friends, intros, pedigree, previous exits, paying customers per my previous comment) or ii) more set-backs as mentioned here make it HARDER to "get ahead." When someone is really broke, doesn't have a car and is living on the street, it's much hard for them to claw their way back to "normal..." it's an uphill battle that only slightly flattens out into more "normal" everyday challenges. (Life's challenges never go away, no matter which end of the spectrum, the challenges just become different.)

Unless someone has been homeless, their ability to appreciate and empathize with the set of challenges they face would be a stretch.

(I've done client-facing AWS technical consulting in the mobile industry while living out of the back of my car, and bested the competition and expanded the "beach-head" as it were. So I've little patience for laziness or people that can't hustle to bring home the bacon.)

How do we make them not broad generalizations? How do we get the "is" right, before debating the "ought"? What's an axis along which the rich have a zero-sum quality of life versus the poor?

Do the correctness of generalizations matter to someone living on the street?

By the way, how apropos: Pandora just played George Thorogood's "Get a haircut."

This reminds me of my father yelling at me when I was 16: "If you don't do good in school, you won't get into a good college, and you won't get a good job and you'll be working at McDonald's." This same dogmatic formula plays out in hundreds of millions of families. It's only partially true, for some kinds of jobs. But if one is absolutely set on startups or some technical jobs, then it's not absolutely essential. In fact, it's best to know what job/field one would be aiming for and work backwards from that... may save a lot of effort, time and cost.

(I did the least amount of work possible in high school and didn't study for the SATs.)

"the problem with wealth inequality is wealth inequality"

Just one nit - the problem with wealth inequality is that it perpetuates wealth inequality (and Piketty has detailed evidence for that).

We have had a lot of back and forth in multiple threads for this post. It is helping me clarify my thoughts, which for now can be summarized as:

1. Today, rich people have much better life than poor people.

2. Rich have higher chance of being rich tomorrow than poor folks. So that means they and their heirs have a higher chance of having a better life perpetually than ordinary folks and their heirs.

3. I don't begrudge better lifestyle for those who earned it (Gates, Zuck, Buffet...), but I do think its grossly unfair to enjoy better lifestyle just because you were born to rich parents (Walton heirs, Koch heirs, Paris Hilton...).

4. If you think capitalism has improved things so much that differences in wealth hardly matter (or such will be the case in future), kindly provide me evidence. I don't see it anywhere in my observations - eg. first class vs economy class experience in air travel, public schools vs private schools in the USA, job prospects for ivy league vs third tier univs, or even longevity[1] - rich people's life is better in almost all aspects (some of those aspects might frivolous but some are very meaningful).

[1] : http://www.nytimes.com/2008/03/23/us/23health.html?_r=0

   > differences in wealth hardly matter

This is obvious from any comparison between the United States and any genuinely poor or developing country.

In the United States, the "poor" own cars and televisions (with cable!), enjoy smartphone service, live in air-conditioned houses, and eat lavish meals. The standard of living they enjoy is fantastically better than the poor or even middle class in any developing nation. Not only that, but their standard of living is far superior to the standard of living of the "poor" in this country 10, 20, or 50 years ago. Economic growth has lifted all boats. What's more, no one in this nation has a valid justification for envy.

If your neighbors are eating well while your children are starving, okay, be envious. It might be justified. That's not the case here. As Maggie Thatcher once responded to an accuser, "you would prefer that the poor be poorer, in order that the rich would be less rich". Greed and envy are not to be confused with justice, and should be rejected.

Perhaps if the wealthiest among us suffered more equally the pain of fighting wars and of medical care insecurity, they would invest more heavily in world peace and healthcare, and less on Angry Birds and luxury taxi services. This is why equality of quality of life matters -- to keep us focused on each others' wellbeing.

Disparity of wealth also erodes our democratic process, when money buys speech.

I'm confused about what people object to, about the parent comment.

We do have virtually equal quality of life in the US. A rich person can have ten cars, but he can't drive ten at the same time. It is a left-wing cliche that the burden of fighting wars falls upon the poor. In the real world we live in, the military is all volunteers and mostly middle-class, not from the poorest demographics. And pretty much everyone in the USA has access to state of the art care. You cannot buy your way to the top of an organ donor list or something. Certainly there is a difference between rich and poor, but you have not shown that it is an unjust difference or that it is harmful to the poor person.

Gates and Zuck were born rich, FYI.

It's hard to get off the streets and back to "normalcy" (or dignity) if people pretend you don't exist.

West is becoming more like semi-urban India as the vice-versa... flattening.

A every increasing wealth inequality destroys incentives to work hard. The song sixteen tons encapsulate the feeling workers get when they just get "another day older and deeper in debt".

With wealth being hereditary entitlement to one group that increasingly get more wealthy, we end up with everyone else being in more debt to them each passing day. The debt bondage model simply moves from being about a mine, and becomes the model of the country.

I feel like this conversation is sidestepping the fact that "cheap online education" is synonymous with "we'll take a bunch of your money under unique loan conditions and operate as a paper mill".

Not to say anything else about the political economy, I'm a believer in capitalism as the 'least bad system', but in the education sector, those 'cheap online schools' are actually a point in favor of the exploitation narrative.

The "paper mill" refers to credentials, which refers to the wealth-enhancing effect of education. But this subthread stipulates that the rich will keep getting richer.

Are the non-rich getting drastically worse access to teaching and learning resources? If you had to plot a line representing this (admittedly abstract) concept starting in 1950 and running to 2020, what would that line look like? It needs to capture the Internet, Wikipedia, the digitization of books, citeseer and scholar.google.com, open source software, Khan Academy, MIT OpenCourseware, and Coursera.

> Are the non-rich getting drastically worse access to teaching and learning resources?

Yeah, that's what I'm arguing if you're going to point to online certificate programs that get advertised on the subway as evidence for equal opportunity. You could make a better case for online self-directed research, probably, but I don't think there's a substitute for 19yos being exposed to great minds with tough expectations -- that only happens at good/decent universities [1]. And that's without even getting into the whole 'learning starts really young' thing with good school districts compared to lousy ones, etc.

[1] If you want to take that point and argue for investment in good state universities, I'm entirely with you, but the current power structures seem to disagree[2] as evidenced by funding decisions.

[2] I realize it's silly to term an emergent outcome as 'disagreement'

I don't know. My 19 year old self went to a decent state research university. The lectures I sat through were much less effective than watching Gilbert Strang on Youtube at 3x speed with arrow keys to get him to repeat himself when I miss something and a pause button so I can work out problems after he writes them on the board but before he explains them. There was 1-on-1 time at "real" school, but it was with TAs and a room full of 19 year olds. I feel like the Internet addresses that use case better as well.

(Fair warning: I've been pretty successful in my career, but I dropped out of school after a single semester).

Well, you're an outlier. Deleted the rest of my post since I'm on my way to bed and didn't want to steal the last word. You can probably guess most of it.

Not necessarily an outlier. I was dumber than him and sat out the whole four years. I spent a year doing something I hated because that's what my degree got me.

I now have a job I love that has literally zero to do with what I studied. If I had focused on the acquisition of knowledge when I realized I wanted to program for a living I could have saved a lot of time, money, and opportunity cost. I know more than a handful like me.

However you also have the luck of having a computer, being interested in computers, and being able to further than interest. Do you think you would've fared nearly as well, if your interest instead was in cars? Clothing design? Social work?

Us tech workers are fairly lucky that in all honesty, the things we tend to like seem to be problems that can be solved with one another.

I'd also argue, that while the billionaire's life is not a million times better than the thousandaire, that this never was the case, and that is thinking of the best of times.

However, look at the worst of times. You get a serious illness- say, a cancer. For one, as a wealthy person you likely could have it detected much earlier from regular doctor visits and various signs. The poor never get this opportunity. When time comes for treatment, the best medicine, procedures, and rehabilitative therapy are available- and for the poor, they might be able to get the procedures, but the medicine will often be second-rate and there likely will be very little, or perhaps even no rehabilitation.

Similar states repeat for smaller life disasters. You get in a car wreck; The rich man likely has a newer car, and can much easier afford to use the insurance to get a worthwhile vehicle again without being out very much. The poor was probably driving a car worth less than $1500, with numerous problems already, but at least it was paid off. The wreck might leave them with only enough money to get another car, but now they must make payments and still only get another 2-3 years out of it, if they're able to at all thanks to an insurance plan with less coverage.

There is a huge quality of life gap here. Being poor today isn't at its worst when everything is going well- overall, things are pretty great there, and are a good reason why even lower middle class people rarely fall into absolute poverty. But the inability to pull oneself out of a hole is a much, much more pervasive problem.

First, most poor people also have access to computers --- as in, have them in their homes.

Second, stipulate an aristocracy of permanently wealthy people and a majority underclass of people living at a technical poverty level. Assume that price competition is going to continue to improve the standard of living of that underclass.

Exactly what will prevent those people from designing and selling clothes, fixing and modifying cars, or doing social work?

> First, most poor people also have access to computers --- as in, have them in their homes.

It depends what you mean by "most". If you mean "more than 50%", that is technically, barely true. 57% of households making less than $25,000 have a computer; the $25,000-$50,000 bracket reaches 76%. For "internet access anywhere", the numbers are 50% and 64%.

http://www.census.gov/prod/2013pubs/p20-569.pdf

And 5-10 years from now, because of price competition, those numbers will approach the numbers for telephones. What percentage of people living at the poverty line in the US have telephones?

Paris Hilton earned her money as an entertainer. You may not like her, but she didn't flop into a career. She took some seed money (just like Bill Gates) and used it to build her bizarre but profitable little industry.

I think you're underestimating exactly what a billion dollars gets you over a thousand by several orders of magnitude. It's not about iPhone vs. Android. It's about having enough money to never need a phone vs. being unable to afford a data plan. It's not about caviar vs. hamburgers. It's about never having to cook vs. malnutrition from not having access to fresh produce. It's not about Lamborghinis vs. Civics. It's about having a ready replacement whenever you get into a wreck vs. losing your job because your car stalled on the freeway and you were late to work.

It's not the physical goods but intangibles that makes a billionaire a million times better off than the thousand-aire. Some particular intangibles:

Time. The billionaire never has to work again for the rest of his or her life and be assured that he or she has sufficient resources to not starve to death. Not so with the thousand-aire, who is likely living paycheck to paycheck.

Freedom. If the billionaire does want to work, he or she can work on whatever he or she wants. Paris Hilton can be a singer / actress / celebrity because she wants to be that. If Paris Hilton was not a wealthy heiress, I think it's safe to say her career choices would be significantly more constrained.

Influence. The political aspects of this are somewhat obvious, but it extends to practically everything else as well. The thousand-aire says, "It sure would be nice if my team won the championship this year." The billionaire can all but guarantee it.

Advanced medical treatments, robotics unavailable to the average person, space flight, the ability to avoid pervasive surveillance, a greatly disproportionate ability influence politics, etc.

There are lots of things you have access to by having a great deal of wealth that are simply unavailable in even a reduced form to the average person.

A homeless person in the US today has access to better health care than the President of the US did in, what? 1960? 1970? Maybe 1980?

Are we really down to "lobbying power" and "spaceflight"? That seems like a weak argument against capitalism.

How about having all of the following, only because you were lucky enough to be born to rich parents and no other reason: - better parenting - better education - better nutrition - better accommodation - better connections and countless other advantages over 99% of other people? Kids of billionaires having all that, and kids of poor people having nothing of that, seems to me the biggest injustice and the strongest argument against capitalism.

Why must an income gap mean that only the rich have good parenting, education, nutrition, and housing? Which of those benefits can you allocate exclusively to the wealthy in an argument backed by evidence? Poor school districts spend enormous amounts of money on students. In the span of half a century, we've moved from a society where the poor lacked electricity to one in which families below the poverty line have air conditioning, a car, and Internet access. His argument is that this is a result of price pressure caused by increasing competition driven by a need to keep capital invested in order to achieve the 'r' that Piketty talks about.

I admire accomplishments of capitalism - like material progress enhancing lifestyles of everyone, or lifting millions out of poverty.

But that was not the main thrust of my comment, which talked mainly about "injustices" caused by unchecked inheritance. If you want an example of the benefits allocated to wealthy, here is one - opportunities. I believe billionaire kids have a lot more opportunities in life compared to middle class kids, let alone poor ones.

Edit: tptacek, since I cannot reply to you, I will reply here - one example of what poor people won't have access to "tomorrow" compared to rich people : ability to be rich. And I already explained the advantages of being rich over being poor are already (food/health/shelter/education/...). And yes, your questions certainly helped clarify my thoughts, so thanks :)

First, you just moved the goalposts. Education, parenting, nutrition, housing: you said the rich have all of that, and the poor none. Did I misread you? Did I effectively rebut you and change your mind, simply by asking questions? That seems unlikely.

Second, in this new argument, you refer to "opportunity". Opportunity for what? Wealth? If capitalism is generating competition which in turn generates innovation which in turn drives down prices which in turn raises everyone's quality of life, how much does the opportunity for wealth matter? What is the thing rich people have "today" that poor people won't eventually have comparable access to "tomorrow" as a side effect of capitalism? I'm sure there's something; what is it?

Incidentally: I sound like I'm an advocate for wealth inequality, but I'm not, nor am I a concern troll. I believe the argument were having here is positive, not normative; we don't even agree on the facts. We should get the "is" down before the "ought".

> Poor school districts spend enormous amounts of money on students.

By what measure? Throughout most of the US public schools are funded through local taxes. The poorer the district, the less resources are available to educate children, which means understaffing, buildings which are falling apart, lack of classroom materials.

And is your comparison on funding per student meant to be against upper class families, who most likely send their children to pricey private schools? I just don't see how your statement is justified.

The norwegian countries(and maybe france) seem to indicate innovation would still happen in more socialistic countries with high taxes.

Sure, but that's a syllogistic non-sequitur. Norway drives innovation, the US drives innovation; either way, poor people get sharply increasing access to medical technology and services, not worse access (as an intuition of income inequality might suggest).

Yes, even in non-equal societies people benefit greatly from innovation.But if innovation is not dependent on extreme capitalism , why attribute it to capitalism in this discussion ?

I believe one argument might go like this:

It's because the engine of all wealth in capitalism is investment. Currency gets less valuable over time. Like sharks, concentrators of wealth need to keep moving. One of the most effective ways to do that is to invest in enterprise, which is competitive, and thus generates innovation.

It's a decent argument, and the arguments about lower taxes and increased innovation sound sensible. But as I said, some high taxes countries are quite innovative.

And in the end, the role of innovation should be to help people and equality, safety net and the like have great value for many. On the whole it's hard to argue social Democratic countries offer a worst deal for people than capitalism.

A homeless person in the US today does not have access to better health care than the president did in 1960. Is a homeless person likely to have up-to-date health insurance information (I'd imagine its pretty tricky to get your health insurance card when you don't have an address). Are they likely to have enough cash on hand for a copay? What about for prescriptions? Are they going to have reliable transportation to a medical office? Are they going to have a reliable phone number where they can get messages from the doctor?

For all of these practical reasons, I would imagine that many homeless people would probably forgo all but the most essential medical care, which they would receive at an ER. They're probably going to be waiting hours to see someone at the ER and when they do it will be an overworked resident. The president in 1960 would be able to see any doctor he wanted at the time of his choice.

Also, a lot of homeless people probably wouldn't be homeless in the first place if they were able to access mental health care.

I can't give a precise date, but you might compare what a homeless person would get for a heart attack in 2014 with what Eisenhower got for his heart attack in 1955.

Maybe for immediate, urgent care, but definitely not for recuperation or follow-up.

Eisenhower's recuperation was "spend six months in bed." It looks pretty sad from here.

I think that a lot of the advances in treating heart disease have to do with preventing a heart attack in the first place by recognizing what risk factors a person has and having them change their lifestyle and take medications such as statins. Improvements in the area of prevention are going to be difficult for a homeless person to access since they require the ability to visit a primary care doctor, get medication and make lifestyle changes. It's pretty hard to eat healthy if you're on a very tight budget for food and don't have access to a kitchen.

The treatment that a homeless person gets when they actually have a heart attack may be better since they would presumably have access to a defibrillator in an ER.

What does it matter if they have insurance, or cash for a copay? Public hospitals are required to treat them, with an extremely high standard of care, regardless of their ability to pay. Not only do they not need to pay to get care, but they don't even wait longer in the ER; ER triage (at least, where I've asked, but I assume this is true everywhere) is need-blind.

I doubt very much that the president would receive the same level of attention and prioritization at an ER as a homeless person, but even if you substitute a wealthy person in 1960 for the president you're still wrong.

Let's say that the homeless person develops a form of cancer that was incurable in 1960 but can now be treated with a very low rate of recurrence with chemotherapy. Your point, I assume, is that because this new treatment exists, this homeless person will receive better healthcare than anyone in 1960. But that presupposes that this homeless person has access to that treatment, which means that they need reliable transportation to a medical office on a regular basis for an extended period of time, they need someone to take care of them when they're really sick, they need some ability to get their medication and to take it regularly.

Those same hospitals are also incentivized to rush an uninsured patient out the door as soon as possible. Serious, painful, but not immediately life-threatening problem: give a random diagnosis and tell them to follow up with their nonexistent primary care doctor as soon as possible, and escort them out.

In many states in the US, Medicaid or other insurance is not available to the homeless or indigent, not unless you have a disability diagnosis from the doctor you can't pay to see, and can get the necessary help to have that diagnosis recognized legally by the government. Otherwise cursory, rushed visits to the free clinic and ER are all that's available.

Hospitals may be as minimally need-blind as required by law (if that, its not like the homeless can sue), but they only offer just that. The number of options and quality of medical treatment is vastly greater for those who can pay than for those who can't.

You are absolutely wrong.

Disregard the homeless for a second. The life expectancy for white Americans without high-school educations has dropped since 1990. -5 years for women, and -3 for men. The life expectancy for white women without high school educations in 2008 was the same as all women in 1960.

Uninsured ER treatment is great when you want to get your gangrened limbs amputated. Not so much when you want insulin to control your diabetes. But yes, I'm sure that a homeless gunshot victim taken to a trauma center today is given better treatment then Reagan in 1981.

[1] http://content.healthaffairs.org/content/31/8/1803 [2] http://prospect.org/article/whats-killing-poor-white-women

Reply on news.ycombinator.com