Can you provide some supporting evidence? I happened to be plugged into the Canadian sports mafia, and US pro sports teams hire certain Canadian doctors as consultants (an interesting loophole, that). They wouldn’t do that if they didn’t think they were top notch. For instance, the best foot doctor in North America (according to my US sports sources, who have a vested interest in knowing who is really tops) is outside Montreal.

Similarly, I’ve never run across anyone from Canada coming to the US for care, Indeed, I am told by people in the health business that it isn’t safe to go to a New York city hospital without your own private duty nurse. Suburban hospitals are apparently better run, but if you have an emergency, you don’t exactly have the luxury of choice.

Finally, this article ran today in the Canada’s National Post lamenting that Canadian expats game the system, and fly in from abroad to use Canadian care. If it wasn’t reasonably good, cost alone wouldn’t justify going to the trouble of getting on a plane.

In Ozzie & Harriet’s day, keeping up with the Jones meant getting a larger lawn mower. Nowadays it means trading the lease in on the X5 in for a new lease on a Range Rover. To, of course, be parked in the 3-car garage attached to the 3000 sq. ft. home. Thus requiring dual incomes to support.

Contrary to the Robin Hood economic polices of the anointed chattering classes, the middle class isn’t shrinking. Nor is it under attack. It simply has allowed its narcissistic obsessions with instant gratification to overwhelm its financial resources. Instead of looking inward for a solution, “Honey, maybe it’s time to downsize our lifestyle?” they blame storm government, business, and even capitalism itself.

I don’t give the boomers any pass on this however, as it was them who were raised by Ozzie & Harriet — only to become Ozzy & Sharon to their own children.

the only way to buy a pot to piss in, is if you save enough to buy it. It has nothing to do with the lottery of demographics excuse that my generation (30-40 year olds) unfortunately uses to justify living beyond our means. Our parents generation created wealth the only way it gets generated: saving and re-investment. My generation for some reason has forgotten this. Until we re-discover this and stop trying to prop up housing with tax payer money, not only will this country spend the next 10 years as Japan has, people like me who save will have to wait that much longer before housing hits bottom. Ridiculous.

I agree that the will to act is appallingly absent. Everyone is unhappy with health insurance (one of many possible examples of festering problems), yet no one is willing to take the industry out and shoot it (and I don’t necessarily mean a single payer system, it seems anything that might cut their profits is verboten. Hell, that’s precisely what needs to happen here. We’ll throw factory workers on the dust heap, but not companies that are standing in the way of a badly needed restructuring).

I am really perplexed at what has happened to this country. Is everyone anaesthetized by TV, on Prozac, or so burned out by the daily grind as to have no energy left for outrage? When I was a kid (and the very fact of TV was still exciting and fresh), CBS ran a documentary, “Poverty in America” which showed vividly how bad things were in certain parts of America. I am convinced that it helped galvanize the Great Society programs, the same way the lurid footage from Vietnam fueled the war protests. But now that movies and TV programming have far more gory images than the news, maybe the media have lost their impact.

“Our medical system costs substantially more as a % of GDP as that of other advanced countries, and delivers no better health outcomes.”

I agree with the former part of your statement, and that something has to be done, but if we deliver no better health outcome, then why do Canadians come over the border to pay for services in the U.S. all the time? Because we have better services.

This is anon 9:28.

You are correct that the Social Security problem is not unmanageable…….until it is unmanageable. Do you see any politicians calling for raising the age to collect payments based on life expectancy? Because that is how it was originally written. The lawmakers back then were ruthless with the rules. Life expectancy was 62…..the age which you collect payments.

We are spending twice as much per GDP as any other country on health care yet were are not getting extra benefits as you noted. It is indeed a health care problem.

Trouble is, Washington simply can’t solve any of these problems. They have created a monster with entitlements, and they know it. The half measures and compromises that democracies come up with to solve problems will not work. The special interests (AARP, Big Pharma, trial lawyers, doctors) are two entrenched and too powerful. Our out-of-control legal system is a study in interest group politics.

At the end of the day serious cuts are going to have to be made yet nobody talks about this. And you can’t raise taxes much more without capital flight, emigration and eventual currency controls

I suspect the USA will do what all bad governments do when they run into problems like this: print money, monetize the debt and blame others………a de facto default. And hope the overseas bond holders don’t notice they are being robbed.

This brings us to the tax system. Business profit and productivity is not an end in and of itself. Wealth is the reward that society confers on those who do socially rewarding things. We measure social reward partly by profit–taking that which is cheap and turning into that which is expensive. So capitalism isn’t an end. Rather, it’s the means by which society allocates its productive resources most efficiently.

I love capitalism. It’s given me, the child of immigrants, a very good life. But I also don’t mind paying my way. There are public goods that people value, such as infrastructure and social security. There are private goods, such as medical care, that are subject to serious agency problems and therefore must be socialized in order to provide the service at a reasonable cost. Bottom line, society needs taxes.

Taxes, in order to be equitable and efficient, must collect the required revenue with as little drag as possible on the economy, and as broadly as possible. So, if one were to design such a system from scratch, it would probably include consumption taxes, steeply progressive income taxes (marginal utility of money declines as wealth increases), a social security system that offers a minimum income that gets clawed back at some prescribed rate, to motivate work. And probably very low or nonexistent corporate taxes.

Housing interest deductions would have no place in this world, but I guess that flying pigs would.

Dean Baker, and to a lesser degree Paul Krugman have pointed out that the Social Security payment increases aren’t terribly alarming or unmanageable. The problem is Medicare, and that in turn is NOT a demographic problem, but a health care cost problem. The scary growth is due to assumptions on health cost care increases.

Our medical system costs substantially more as a % of GDP as that of other advanced countries, and delivers no better health outcomes. Treating the Medicare problem as an entitlement problem is a mis-diagnosis. We need to do something about health care, pronto.

Nobody disputes the eye-popping numbers. So what is his solution?

Republicans want tax cuts and don’t seem to care about anything else.

The Democrats refuse to even acknowledge the problem. I think that they assume that all we will have to do is “tax the rich”. Trouble is, those deficit projections are based on optimistic economic growth. Higher and higher taxes will inhibit that growth and make the problem worse.