If you add "on average" that's exactly what the original paper says. The averaging is over "someone who doesn't get cancer but died of screening complications", "someone who got false positive and decreased their lifespan with unnecessary treatments", and of course "someone who got true positive and increased his lifespan due to treatment". Are you sure you will be in the last group?
X-ray is not just adding anxiety, it's harmful, and it's affecting all women who get screening, not only those who actually get cancer. Magic of numbers.
You may be decreasing premature deaths from cancer but increasing premature deaths from other causes related to screening, thus you don't increase life expectancy. Read the original article in JAMA.
You are also presented with a choice: you take a test and you die in X% because of the test itself (there are no non-invasive tests, even IV is potentially dangerous), or you may be diagnosed with cancer with Y% chance of right diagnosis and Z% of lethality. Math is getting much more complicated. Now consider that only 2.5% women will die from breast cancer, but 97.5% others will get X-ray exposure once a year (with 100% test coverage of course). X-rays are know to cause mutations and thus cancer. Add to this money spent on tests that can be used to find a cure (we don't have unlimited resources).
1. You have an aggressive (i.e. non-treatable) cancer, maybe you feel slightly off, but you go on with your life, until you finally got worse and die. Or you performed screening, focus on treatment, bankrupt your family and ... die anyway,
2. You have a slow growing cancer (e.g. prostate), live your life and die of some other causes. Or you performed screening, got surgery, got tons of problems and die of myocardial infarction (yes, that's one of complications after prostate surgery).
If you read the original JAMA publication you would notice that there is a research on quality of life metric. That metric for breast cancer is higher among non-screened women.
Have you read the original article, not the CNN interpretation? They are talking about harm vs benefits of screening. In simple words: you performed colonoscopy, got colon perforation and died of complications. Was colon cancer prevented? Absolutely! You didn't die of colon cancer! Is it any easier? No, it's not. The chance of dying of breast cancer is around 2.5%, so 1 women in 39 will die from that. OTOH annual X-rays affect the other 38 too, how many of them will die from X-ray exposure (which can cause e.g. another type of cancer, not necessary breast)? For the sake of discussion let's say 1 in 380. Congratulations, you've just increased breast cancer related death by 10%! Only it won't be in statistic as deaths from breast cancer.
MA is not a "high-tax state", it's in the middle by an overall tax burden (depending how you count), so it's another myth. Check this for example: https://wallethub.com/edu/states-with-highest-lowest-tax-bur.... Also I'm not in the top 10% percentile, more like in the top 20% in MA. Give me your definition of the "middle class". Also I explained that for the "lower class" medical payments are even higher.
No, I'm not getting "welfare state" benefits, I'm getting a pretty crappy medical service for a price which is waaay higher than in Germany. And if I lose my job I will be paying 2K/month + copays and co-insurances, not mentioning deductibles, unlike in Germany. And God forbids you get into a hospital without insurance, your jaw will drop to the floor when you see the bill.
Have you ever been in the Boston subway? Compare it with almost any city in Europe, hell, even with Montreal. Tell me which welfare state has subways like Boston or NYC? Commuter rail like in Boston? NYC commuter rail is a bit better, but still is not even close to German railways.
And all of the above we get for taxes which are very similar to Germany. No, they are not much lower, it's something with your math. And in absolute value we pay waaay more than in Germany given higher salaries.
Agree on VAT, but MA also has 6.25% sales tax which I didn't consider, that is if you want to start from revenue. So the difference will be less than 19%. Also VAT in Germany is not 19% on everything, there are exemptions and low rate of 7%.
33% is not a marginal rate, it's an effective tax rate (filing jointly) including payroll taxes which are deducted from my wages, I mentioned it. Also we have a state tax in MA which is also included in 33%.
In any case there are other taxes too (e.g. gas excise, vehicle excise, property tax etc.), so I'm not trying to compare the whole tax burden, that would be too much for HN. But regarding payroll taxes -- they are pretty close even if you consider VAT, certainly not a "lot less", it's a myth propagated by politicians. So the question is: we pay (almost) "welfare state" taxes, where is my part of a welfare state?
Yep, but you need to count employer paid taxes too to get the whole picture. Tax base will be different (+ 7.3% healthcare + 9.3% pension + 1.5% unemployment), so if your base is ~1.17 of your "official" base, the effective tax becomes (0.35 + 0.17) / 1.17 = 45% (leaving you with 55%). Which is in line with the chart I posted.
Now here's how it works in the US. Let's take my $170K household income (it's 2x of state median in Massachusetts, but 1x in my town). My effective tax rate (without medical insurance and without employer part of payroll taxes) is 33%, but with employer taxes and after tax base adjustment it's going to be (0.33 + 0.08) / 1.08 = 38% (I'm ignoring social security cap here, but it won't make a big difference). But we left out a very important part, and it's medical insurance. Let's add 24K/year (14%) to the mix, then it becomes (0.33 + 0.08 + 0.14) / 1.22 = 45%. Oops! Sounds like I'm paying the same percentage as in Germany. Sure, I have 2x of median, but for 1x things are getting even more ugly, because 24K will stay the same, and while the income tax is lower, medical will take its part and more.
Of course I still bring home more than an average German family, yet expenses are different too so it's hard to compare. Sure, I can buy more junk, and I have a bigger home so I still have some place to live after I placed all that junk :) But to the original comment:
> The American lower and middle classes pay a lot less of their incomes - that would be the group that would have to pay for an American welfare state. That won't go over well...
No, American lower and middle class doesn't pay "a lot less of their incomes", it's simply not true.
Here's some comparison, but it is misleading when it comes to the US. Technically medical insurance (de facto mandatory) can be from ~15% to >25%, depending on the income. It's not reflected on the picture, so in reality tax burden in the US might even be more than in Belgium (VAT aside).
https://upload.wikimedia.org/wikipedia/commons/4/49/Payroll_...
You are conveniently leaving out payroll taxes which constitute another ~35%. So 42% becomes ~77%. 19% doesn't technically apply to the payroll, but it does apply when you buy something.
> People do things alone without ever entering into a community around those activities or showing the results to anyone else.
Of course! I'm not saying that "everything is for sale" or we always need to contribute to a society. But if you don't do it you may quickly find that your life is boring and you need to share with somebody. Obviously all people are different, some need (or can bear) more solitude, some hate it, but on average we are social animals and it's inside us. Even when you cook for yourself, aren't you ever discussing it with somebody? Hell, why am I typing all this? It has no transactional value for me, none whatsoever, in fact I wasted half of my Saturday :) I could have just created my theories in secret and enjoyed them, but for some reason I need to post here. Maybe because I want to know what other people think, what if I'm dead wrong with my theories? So there is a transactional value even in these posts as I learn something new which may help me later :) No, "later" is not a conscious reason why I'm doing it, it's a subconscious thing, our internal program.
It's not necessary about amount, but about distribution. Let's say a medical tax in Germany is 14.6% (correct me if I'm wrong), my medical insurance here in the US for a family of 2 is around 14% (yes, it's paid by my employer, but there is no free lunch and I consider it _my_ tax). The only problem here is that payment is fixed, so if I had 50% of what I have now (and that would be a median salary in my state) it would be 28%. Also if I lose my job I will have to pay it in full myself, from after-tax money. Unlike Germany. Oops. So I'm already paying on par with Germany (when I'm employed), and I would pay twice, of even triple of that if I was an average worker.
I would include VAT. No matter B2B or not, it's how much your end customer pays is what matters. Yes, business will pass on this tax further, but end consumer won't be able to claim it. It's the same as a sales tax in the US. To include it in price or not is more a psychological thing (in the US it's not included in price). When I pay $106.25 for something it makes a little difference for me that $6.25 goes to my state or passed to the previous business, and if I only have $100 you lost me. That's the reality.
Basically it's very similar to debates about US taxes. Sure, it's not 70%, but things add up quickly. Income tax, social security, medicare, medical insurance, sales tax. The usual argument is "but, but ... it's not me who is paying my medical insurance or half of social taxes, it's my employer, so it's not my tax". Well, it is. That's the money your employer would have paid _you_ if those taxes hadn't existed.
> And then neither them or corporation gets taxes nowhere close to what the normal employee is
How did you figure that? Corporate tax rate in the US is 21% which is roughly equivalent to an effective tax for a single filer with about $180K in income. Can't say we are talking about "normal employee" here. Besides if you are talking about dividends (which are distributed _after_ 21%), there is a dividend tax on top of that, which, depending on your share class, can be the same as a normal tax rate. So yeah, nowhere close, usually +21% for the preferred stock.
Also don't fall to that communist idea. I grew up in the USSR where we had a "fair" distribution (no, it wasn't fair) -- trust me, you don't want to live in that world. There were some upsides, but still, and it didn't end up well.
AI won't take over traditional employment either, humans tend to congregate and choose leader(s) as many tasks are not possible to accomplish alone, with AI or not. If there are leaders, there will be an employment of some kind, it's a fundamental thing. Money is only an equivalent of a value in exchange, so "monetizable" in the wide sense of this word is "exchangeable", and it almost always applies to social activities even like running a marathon, otherwise people would run those 26 miles alone in the forest.
Machines don't produce a value, humans do. Simply because the "value" (added or not) has a meaning only when you exchange goods or services. Nail gun makes things much faster but it's a carpenter who produces the value.
Money is simply a universal equivalent of that value, nothing more. So if you give me a breakfast for help with unloading your truck, it's still an exchange, and my work's value is equal to "one breakfast" even no money was involved.
AI is just a nail gun, there still needs to be somebody who trains/operates it (like with ChatGPT) and who will ask for something in exchange. It may eliminate some jobs (happened before), but it will create others because human society is not only about food (not sure ChatGPT can help here though), but about interactions which are not going to be automated by ChatGPT (think of sex, power).
This world is not fair, do you know how to fix it? I don't. There are different models with different degrees of fairness, but all have their downsides.
I specifically mentioned that you don't have to work "for a company". Jeff Bezos is not a traditional employee last time I checked. Neither are mom and pop shops or self-employed contractors. Just not everybody wants to deal with a hassle of being the one. But aside from that a lot of "no money" activities bring you friends (AKA connections), position in a society (think about OSS, can it help you to find a good paying and interesting job if you are Linus Torvalds?). Sometimes you get benefits where you don't expect. It's still "monetizable" in my books as opposed to "I'm doing something nobody needs and enjoying it while living on a basic income".
Let's start from basics. People need to eat, so somebody needs to make food. Those people need tools. Somebody needs to make tools. Now for this to work they need to make extra food and exchange it for tools. This exchange has been in development since before human existed (look at wolves pack) -- never perfect, but kind of worked. So you want to make something you like and nobody needs? No problem, go for it. Where are you supposed to get food? Do you want a government to pay you the basic income? That means those who make food will give it to you for free, which means they won't get tools, which in turn means they won't be able to make that food. Oops. In a balanced system you are never "taking more than giving" or vice versa, because, as you know, price is a result of supply/demand. How do you know you Java library is worth a breakfast?
I didn't say "economic value". Let's take "modifying a vehicle" as an example. Will you keep it in your garage guarding it from anybody's sight? Why are you doing it? What's coming to your mind? It's not always as straightforward as "economic value". You want somebody to look at your vehicle, you want to show it to somebody. What for? Keep it in your garage, you are doing it for your "mental side", aren't you? Money and economic value is not the only way of keeping society together, there are others. If you are showing your vehicle to somebody, you _are_ expecting something in return. Acquaintance? Friendship? Help when you need it? Continue yourself.
You think so? Have you been in that position? I was. It's not what you think it is. Also unless you want to spend your wealth pretty fast (money has a half-life time like radioactive elements, doesn't depend on quantity) you have to work to keep your wealth, and it's not less nerve-racking than spending your 8 hours at work and forgetting it until next morning.
How about moving to Amish county? You always have a choice. Just don't expect to find there a social utopia where "everybody is free and everybody has at least 6 slaves", people are the same everywhere, with iPhones or not.
We need that many cars because having own home and living in a suburb is an American dream, isn't it? How many people want to live in a high rise building with noisy neighbors? Yes, it is expensive, but living in a cave is pretty cheap, somehow nobody wants it.
I know that comparing averages is not always correct, but. Median home price around 1975 was $100K (give of take), median family income: $14K. Today the median family income in MA is $75K. The median home price in MA is around $550K. You were saying prices went up and you can't afford a home anymore? Then you couldn't afford it in 1975. Should we go back a couple of centuries? And yet we have TVs, Internet, smartphones etc.