What would it take for the U.S. to enter a recession?

[Ecky]

Originally Posted by Xist

Iceland has a population of 341,243. That is bigger than Rhode Island, Delaware, South Dakota, North Dakota, Alaska, D.C., Vermont, or Wyoming, but Phoenix, Tucson, and Mesa have more people, so yes, it is small.

Not quite!

Vermont: 626,000
Wyoming: 577,000
Rhode Island: 1.05 million
Delaware: 967,000
DC: 633,000


Iceland's population is actually smaller than all of those listed. To my knowledge the population density is also much higher - most people live right around Reykjavik. Never visited though, so take that for what it is.

[Ecky]

Originally Posted by redpoint5

I don't know which way you're arguing on socialized medicine.

For sure it's simpler and can be less expensive. The only thing you lose is liberty. In my view, probably worth it considering our current situation (and I lean slightly libertarian). Our current system has the worst aspects of both capitalism and socialism. At least in socialized medicine you'll still have the option to pay out of pocket for private medicine. The only thing I don't like is that when the public is responsible for your healthcare, they are also responsible for your personal life decisions. Maybe the socialists make donuts illegal even though I don't abuse them.

Unfortunately (?) hospitals still treat people even when they can't pay. It just gets written off as a donation, and tax payers still foot the bill. But you probably already knew that.

I guess the question is, if we're going to treat someone who is ill regardless of whether they can afford it, and the burden ultimately falls on tax payers anyway, why not socialize it a little more. Doesn't seem like people take medical expenses into account in their behaviors regardless of what kind of system they live in, and our medical system is strictly sick care anyway - virtually none of it is prevention or lifestyle modification. I don't like it either, and I'm not keen on paying for other people's poor choices, but it just seems to be the reality of things.

Originally Posted by redpoint5

Yep, been saying the single easiest and best move would be to decouple health insurance from the employer. The group policy has a few options, but I'm not a group, and I may not work at the same place the rest of my life.

If employers wanted to contribute to health insurance, it should go into a special account that can only be utilized for paying a health insurance premium. Still don't like that it would essentially tie health insurance to a particular place of employment.

Agree 100%.

My wife would really like to go fully contract work and 100% small business, but we can't justify it due to the loss of employer-provided health insurance.

She works for a non-profit, and I'm eligible for pretty steeply discounted coverage through her employer. A few weeks back I was talking with my boss about potentially dropping health care coverage through him, what he might be able to offer me as a compromise. Looks like it might be a $5 an hour raise - we'd both win at that price point.

[redpoint5]

Originally Posted by Ecky

I guess the question is, if we're going to treat someone who is ill regardless of whether they can afford it, and the burden ultimately falls on tax payers anyway, why not socialize it a little more. Doesn't seem like people take medical expenses into account in their behaviors regardless of what kind of system they live in, and our medical system is strictly sick care anyway...

Oregon did an experiment where some randomly selected individuals were given 100% free healthcare with the expectation that they would utilize the emergency room much less since they could visit their primary care physician for free. Instead ER utilization drastically increased. It turns out people who have no intention of paying a medical bill still "feel bad" about it and limit their visits. People who are entitled to free healthcare don't feel bad and have no restraint in considering the cost of their care.

She works for a non-profit, and I'm eligible for pretty steeply discounted coverage through her employer. A few weeks back I was talking with my boss about potentially dropping health care coverage through him, what he might be able to offer me as a compromise. Looks like it might be a $5 an hour raise - we'd both win at that price point.

I highly recommend an HSA and high deductible plan if you're healthy. I've got my 1 year old daughter on an HSA and my employer contributes $1000 to our HSA in addition to paying half of the premium.

[Fat Charlie]

It looks more like they've been in the rut so long that in their minds the ER is "the doctor's office." Only someone completely ignorant would willingly go to the ER for something that a walk-in could handle, no matter who pays for it.

Then you can look at factors like ERs being open at night and easier to get to, another part of the rut these people have been in: they know where the hospital is and they've never been to any of the many urgent care clinics in the area. Simply offering to cover medical bills doesn't change enough of what's wrong in someone's life to make it a good experiment.

[JSH]

Originally Posted by redpoint5

I highly recommend an HSA and high deductible plan if you're healthy. I've got my 1 year old daughter on an HSA and my employer contributes $1000 to our HSA in addition to paying half of the premium.

Completely agree with that. My first opportunity to get an HSA was 3 years ago and we have taken full advantage of the $7,000 a year that can be saved COMPLETELY tax free. My employer pays 100% of the premium (Which is $15,936 last year for 2 people)

High Deductible plans with HSA's are great for healthy people - as long as you stay healthy. On the other hand they encourage people to delay routine care and not get treatment until things are really bad. That is the opposite of what you want to do if the goal is to bring down health care costs.

Contrary to popular talking points most people have no choice in their health insurance. You get what your employer provides. One of my former employers changed providers 3 times in 5 years so I was constantly changing doctors.

The US system of tying health insurance to employment stifles a lot of innovation and small business creation. I know plenty of people (including myself) that didn't pursue opportunities because they couldn't afford to buy health insurance and would not risk their family's health and financial security to go without.

[JSH]

Originally Posted by Fat Charlie

Then you can look at factors like ERs being open at night and easier to get to, another part of the rut these people have been in: they know where the hospital is and they've never been to any of the many urgent care clinics in the area. Simply offering to cover medical bills doesn't change enough of what's wrong in someone's life to make it a good experiment.

This is key. If you are a low wage worker with no sick time and no job security you can't go to the doctor because most doctors and specialists are only open when people are at work.

[redpoint5]

Originally Posted by JSH

This is key. If you are a low wage worker with no sick time and no job security you can't go to the doctor because most doctors and specialists are only open when people are at work.

That's been my gripe. I'm more productive in the evening, and surprised there aren't clinics that either run extended hours or shift to later hours in the day. Same with banks. Why are they only open when I'm stuck at work? Fortunately I can go years without stepping foot into a bank now.

If I had a practice of any sort, I'd boost revenue and offset the fixed costs of the infrastructure by seeing patients over a longer hours. Rather than building a bigger facility, I'd just spread out appointments over a longer time-frame and offer hours more compatible with people's needs.

[JSH]

Originally Posted by redpoint5

That's been my gripe. I'm more productive in the evening, and surprised there aren't clinics that either run extended hours or shift to later hours in the day. Same with banks. Why are they only open when I'm stuck at work? Fortunately I can go years without stepping foot into a bank now.

If I had a practice of any sort, I'd boost revenue and offset the fixed costs of the infrastructure by seeing patients over a longer hours. Rather than building a bigger facility, I'd just spread out appointments over a longer time-frame and offer hours more compatible with people's needs.

I've thought the same thing but I also understand how difficult it is to get people willing to work an odd shift. For banks something like 11am to 8pm would be ideal but who would work that shift? You would never see your family.

2nd shift is the hardest to staff in a factory.

3rd isn't too bad and a lot of people prefer it to 1st. You work 10pm to 6am, come home and sleep, and then get up when the family comes home from work and school. You can also get a bunch of things done because everything is open when you are home.

[redpoint5]

Single people and older people would be ideal for the extended hours shift.

At my previous factory job, I worked 6am-6pm, 6pm-6am, noon-midnight, midnight-noon, and 8-5 shifts.

I never did adjust to the midnight-noon shift. It would surely take years off my life if I worked it for 30 years. The difficult thing was it got busy starting around 7am, right as my energy levels had bottomed out. I'd make "zombie" coffee as my coworkers called it just to give the impression of a functioning human.

[JSH]

Originally Posted by redpoint5

Single people and older people would be ideal for the extended hours shift.

Only if they don't have friends or social lives.