Generation Y and Z Debt

[cowgirl836]

That is interesting, I have had the exact opposite experience.

and I'm not saying it's necessarily a bad thing to have parental assistance past a certain age. It's sort of an American thing to expect the complete independence compared to other cultures that have more inter-generational living. Can be pretty nice - parents help with childcare/running household and have care as they age. But the attitude that I see with it in my experience is almost a sort of obliviousness.

I had a relative ***** because my mom bought me granola bars and cereal over a college break that I took back with me. "You're out of the house now, you shouldn't be getting anything. You're on your own". Literally over $40 in groceries that I was very grateful to receive.

Same person today? Living in their parents' rental, rent-free and got pissed when parents wouldn't agree to provide free daycare for their child. On parent's healthcare until 26. Probably still on parent's cell phone plan. But extremely conservative politically (so definitely no college tuition help, Medicare for All type stuff) and would have no problem ******** about the idea of urban millennials living with their parents/still getting help from them. And I know a pile of others back home who would be just like that.

 

[Sigmapolis]

The Economist did a very basic study of why medical costs are so much higher in the USA, and looked at returns (can't recall exactly which metric) for several different sectors - hospitals, insurance companies, drug companies, etc. Most of them had normal returns, which would not be considered excessive or gouging.
The one area that did was "specialty processing" which are companies who navigated the rules and bureacracy that the hospitals, insurance companies, etc could not figure out. So these companies were charging a lot for that service, and if you think about it, that is total wasted effort and expense (muda for you Lean people).

I tried to google the article but could not find. Sorry if I don't have it quite right, going from memory.

Yeah, there are a lot of reasons for it. To summarize a few...

-- Baumol's cost disease is a huge reason for it.

-- Doctors/nurses/etc. are paid more in the U.S. -- incomes and standards of living are generally higher in the U.S. than in other OECD countries, which draws wages up generally, and it is reflected in the cost of healthcare that we receive.

-- Doctors pay for their own education in this country, which means higher wages/costs, while that expense is buried as "education" spending in other countries.

-- U.S. medical culture is just more aggressive about pushing cutting-edge and last-ditch measures, while the old and dying or those born with little chance of survival are more often left to expire in peace with only palliative care in other countries... this is about both societal expectations for care and the training professionals receive about what to do.

-- Americans are fat and lazy and in bad health.

-- There is more medical litigation in the United States... which means doctors carry malpractice insurance... which further drives up the cost of care.

-- We actually have low deductibles and co-pays compared to many other OECD systems, which discourages shopping around and looking for value for routine preventative and outpatient care, the way you might shop for a vet or cosmetic surgery.

-- We do not try to exploit monopsony like single-payer systems do, but the restrictions on the quantity and quality of care that would imply are hard to square with American expectations of "everything, the best, and I want it right now" for care.

-- U.S. medical infrastructure is just built to be expense... e.g., buildings have individual rooms for most patients, not wards, meaning we have duplicate equipment and staff not being used to capacity like crazy... we are just not efficient as a system.

-- And yes, some profit in the system there (though not like the Canadian system has zero profit within it), but that is minor compared to the above.

Just spit-balling a few of the major reasons.

 

[SEIOWA CLONE]

https://www.businessinsider.com/us-ranks-27th-for-healthcare-and-education-2018-9

What a moronic post.

-- Comparing me to a tobacco executive dying the dangers of smoking, which were called "coffin nails" as early as the 1930s, is offensive and patently absurd.

-- When and where did I say I did not want change?

-- When did I ever say our system was doing anything other than producing poor outcomes for high costs? I just said that isn't because of private insurance.

-- I thought I was the one that said most of the money was flowing into the healthcare industry itself... doctors, nurses, techs, facilities, equipment manufacturers, etc., rather than into the insurance companies, which is factually true.

The money ain't with Aetna and UnitedHealth. It's with providers.

Every one of your posts and responses takes the form:

@SEIOWA CLONE -- *blatant misunderstanding or factual errors*

@Sigmapolis -- *gentle correction with factual information

@SEIOWA CLONE -- *changes the subject to something completely unrelated and pretends that somehow refutes the facts you cannot deal with*

@Sigmapolis -- *points this out, further facts*

@SEIOWA CLONE -- *aggressively mischaracterizing of my points, accuses me of being shill for whatever bogeyman you think is the bad guy*

Do you have brain damage?

If I were a shill or a lobbyist for an industry, I could be having a lot more bang for my buck for my time involved than posting on here about your various myths and legends.

Private insurance is not what is making my wife her salary. Most of her patients are on Medicaid and CHIP, anyways, so the reimbursement rates are pretty sub-par. You fit in here, though, turning vicious and personal when confronted with difficult facts.

I see a lot of this attitude any more, I got mine, so screw everyone else. No helping hand, no excuses. Why is it for many, the wealthier they get, the less willing they are to have the government help those in need?

 

[AuH2O]

Yeah, there are a lot of reasons for it. To summarize a few...

-- Baumol's cost disease is a huge reason for it.

-- Doctors/nurses/etc. are paid more in the U.S. -- incomes and standards of living are generally higher in the U.S. than in other OECD countries, which draws wages up generally, and it is reflected in the cost of healthcare that we receive.

-- Doctors pay for their own education in this country, which means higher wages/costs, while that expense is buried as "education" spending in other countries.

-- U.S. medical culture is just more aggressive about pushing cutting-edge and last-ditch measures, while the old and dying or those born with little chance of survival are more often left to expire in peace with only palliative care in other countries... this is about both societal expectations for care and the training professionals receive about what to do.

-- Americans are fat and lazy and in bad health.

-- There is more medical litigation in the United States... which means doctors carry malpractice insurance... which further drives up the cost of care.

-- We actually have low deductibles and co-pays compared to many other OECD systems, which discourages shopping around and looking for value for routine preventative and outpatient care, the way you might shop for a vet or cosmetic surgery.

-- We do not try to exploit monopsony like single-payer systems do, but the restrictions on the quantity and quality of care that would imply are hard to square with American expectations of "everything, the best, and I want it right now" for care.

-- U.S. medical infrastructure is just built to be expense... e.g., buildings have individual rooms for most patients, not wards, meaning we have duplicate equipment and staff not being used to capacity like crazy... we are just not efficient as a system.

-- And yes, some profit in the system there (though not like the Canadian system has zero profit within it), but that is minor compared to the above.

Just spit-balling a few of the major reasons.

So if I can paraphrase, your wife is profiteering by colluding with the insurance companies to get rich while denying people as much care as possible. To top it off she probably goes and gambles her millions away in the Wall Street Casino, am I right?

 

[Sigmapolis]

https://www.businessinsider.com/us-ranks-27th-for-healthcare-and-education-2018-9


I see a lot of this attitude any more, I got mine, so screw everyone else. No helping hand, no excuses. Why is it for many, the wealthier they get, the less willing they are to have the government help those in need?

Yep, education and healthcare are the two most sclerotic sectors of the American economy, where we pay more and receive less... and also, besides defense spending, the two sectors most dominated by the government, either public ownership of the means of production (with K-12 education), heavy subsidies (college), or heavy regulation.

I think advocating that people richer than you should give money to people poorer than you is not nearly as righteous or morally courageous as you like to think, though.

I have already paid a lot of taxes in my life and expect to pay a lot more.

 

[Sigmapolis]

So if I can paraphrase, your wife is profiteering by colluding with the insurance companies to get rich while denying people as much care as possible. To top it off she probably goes and gambles her millions away in the Wall Street Casino, am I right?

Yep -- he sounds like a smoothie of the usual clichés from /r/politics or /r/communism.

Neither of my parents and none of my grandparents went to college, and if somebody could see the absolute hell young doctors go through during their education and training while throwing their 20s away, going deeply into debt, and doing an incredibly difficult and stressful job while doing it, I do not think any reasonable person would begrudge us the upper middle-class living we earn from it. This is especially true with the time, effort, and discipline it took for the two of us (with her helping people along the way and me helping to grow a startup business).

Heck, my wife came home for dinner off her shift last night... and told me about a teenage girl with knife lacerations on her neck and a gunshot wound in her leg that she received while being gang-raped. That was her main patient for the evening, which she had to treat the critical issues and stabilize her before a nurse specializing in sexual assault cases, a social worker, and a police detective could talk to her to try to help her and help bring some justice.

I do not think many people can handle that.

And that girl was on CHIP. How was that "shilling" or "exploiting" again?

I think Poe's Law is active.

"It is impossible to create a parody of extreme views so obviously exaggerated that it cannot be mistaken by some readers for a sincere expression of the parodied views."

 

[mdk2isu]

https://www.businessinsider.com/us-ranks-27th-for-healthcare-and-education-2018-9


I see a lot of this attitude any more, I got mine, so screw everyone else. No helping hand, no excuses. Why is it for many, the wealthier they get, the less willing they are to have the government help those in need?

1 - thats not the governments job
2 - the government is bad at doing that anyways
3 - there are multitudes of charities that do a better job of helping people in need without jumping through umpteen million hoops like the government makes people go through
4 - people who are wealthy generally dont get wealthy by wasting money, the government is the king of wasting money
5 - wealthy people are, on average, more philanthropic than poor people

 

[Halincandenza]

1 - thats not the governments job
2 - the government is bad at doing that anyways
3 - there are multitudes of charities that do a better job of helping people in need without jumping through umpteen million hoops like the government makes people go through
4 - people who are wealthy generally dont get wealthy by wasting money, the government is the king of wasting money
5 - wealthy people are, on average, more philanthropic than poor people

No.

 

[Trice]

I did grow up in a rural area. Funny, the only ones in my friend/relative cohort I know still taking lots of assistance from parents in their 20's..............are the ones who would hold the same attitude as you on the topic. Bootstraps and such. While living with parents until mid-20s or in a rental paid by parents. It's interesting the cognitive dissonance that goes on with that and how they seem to have convinced themselves it's something they are owed instead of something they should be grateful for.

My friends living in urban areas all pretty much stopped taking help after graduation and the only ones who have had parents living with them - the parent moved in with THEM to recover from surgery for a couple months.

Cognitive dissonance is a great way to describe it. If it were somehow possible to solve that, plus figuring out how to improve people's compassion for the plight of others, we'd really be getting somewhere.

 

[cowgirl836]

Cognitive dissonance is a great way to describe it. If it were somehow possible to solve that, plus figuring out how to improve people's compassion for the plight of others, we'd really be getting somewhere.

The interesting thing I've read is that people on the left and right have the same amount of empathy - but it's who its reserved for that differs. The right extends it to family and friends - their circle only. The left extends it to everyone. The former is beneficial for times of crisis and such. You have to care for you and yours first. "Others" become the enemy who may take resources from you. It's less good in times of relative stability and when trying to structure a stable society.

 

[madguy30]

and I'm not saying it's necessarily a bad thing to have parental assistance past a certain age. It's sort of an American thing to expect the complete independence compared to other cultures that have more inter-generational living. Can be pretty nice - parents help with childcare/running household and have care as they age. But the attitude that I see with it in my experience is almost a sort of obliviousness.

I had a relative ***** because my mom bought me granola bars and cereal over a college break that I took back with me. "You're out of the house now, you shouldn't be getting anything. You're on your own". Literally over $40 in groceries that I was very grateful to receive.

Same person today? Living in their parents' rental, rent-free and got pissed when parents wouldn't agree to provide free daycare for their child. On parent's healthcare until 26. Probably still on parent's cell phone plan. But extremely conservative politically (so definitely no college tuition help, Medicare for All type stuff) and would have no problem ******** about the idea of urban millennials living with their parents/still getting help from them. And I know a pile of others back home who would be just like that.

Yeah I have a friend who several years ago ******** about paying for other people's healthcare etc. but opened up a business by getting a huge loan from parents and the banks. The selfish 'me and mine' mindset but relies on external sources. Standard.

 

[madguy30]

Cognitive dissonance is a great way to describe it. If it were somehow possible to solve that, plus figuring out how to improve people's compassion for the plight of others, we'd really be getting somewhere.

Generally it takes a bad situation for people to buy in to the concept of caring for others.

 

[ArgentCy]

My wife's parents paid for her school. The four years that she was in school the S&P 500 went up about 51%, for about 12.75% per year. Subsidized loans were about 4% and private loans were about 7%. Her family would have been better off maxing out her loans and keeping their money invested in the market.

You can't look backwards like that for returns. That is not how risk adjusted returns work. I mean if I could just go back to my 20 year old self and hand myself a chart of the DOW through 2019 I'd be richer than Warren Buffet.

 

[Halincandenza]

I do not exactly advocate giving an 18 year old high school graduate a scalpel and wishing them the best of luck with that appendectomy. But you do not learn how to do an appendectomy as an undergraduate or medical student, either -- you learn on the job as a resident or a fellow with years of on-the-job apprenticeship/training to actually practice as a doctor.

Even professional degrees have significant degrees of this. Doctors are not licensed to practice when they earn an MD; they are licensed to practice when they finish a residency, and much of their late undergraduate years are about getting into medical school and much of their late medical school years are about finding a residency. Attorneys have to clerk and work under other attorneys before practicing more independently. Engineers have to go years before they will be seriously in charge of projects and/or handling things that they might break or might hurt somebody if things go wrong. I can go on, but humans learn by such absorption.

Plus, these kinds of degrees are relatively rare. Engineering majors are <10% of degrees awarded nationally, and most people graduating college have relatively generic academic degrees in liberal arts, sciences, or business. I have yet to figure out what the hundreds of thousands of arts majors are prepared to do besides be grad students in their field.

Not calling them dumb -- far from it. I was one of them. But then the real learning starts.



Average GDP per capita for a few familiar places...

U.S. = $59,532
Iowa = $59,075
Canada = $45,032
United Kingdom = $39,720

View attachment 65183

Man, how do those Canadians and British people survive on so little money.

The median value you describe above is about as rich as people get on this planet.

Big list of OECD comparisons here...

https://en.wikipedia.org/wiki/List_of_OECD_regions_by_GDP_(PPP)_per_capita

American states tend to rank highly. Even lowly Mississippi...

View attachment 65185

...gives you a standard of living near that to Seoul, South Korea.

Attorney's don't have to clerk or work under other attorney's before practicing independently. You can have a solo practice straight out of law school after you pass the bar exam. I am guessing it fit your position so you just made it up.

 

[ArgentCy]

https://www.businessinsider.com/us-ranks-27th-for-healthcare-and-education-2018-9


I see a lot of this attitude any more, I got mine, so screw everyone else. No helping hand, no excuses. Why is it for many, the wealthier they get, the less willing they are to have the government help those in need?

Because they realize how freaking terrible the government is at helping people. They can do it themselves much more efficiently and without the need for force.

The nine most terrifying words in the English language are, 'I'm from the government and I'm here to help.'
Ronald Reagan

 

[Sigmapolis]

Attorney's don't have to clerk or work under other attorney's before practicing independently. You can have a solo practice straight out of law school after you pass the bar exam. I am guessing it fit your position so you just made it up.

All true -- but the general path is to learn under others while progressively garnering more authority and/or independence before maybe breaking out on your own.

Much like other professionals, actually... doctors, accountants, etc., all that.

Some other fields have more structured versions of this, especially doctors, but the basic process in the same. But throwing some numbers into this...

https://data.lawschooltransparency.com/enrollment/all/

According to that, there are roughly 40,000 law school enrollments each year. You probably know graduation rates better than me, but I will keep the larger number.

https://nces.ed.gov/programs/digest/d17/tables/dt17_322.10.asp?current=yes

There are 1.9 million undergraduate degrees awarded each year.

So roughly 2% of those graduates go on to law school.

-- So even if law is the perfect example where schooling prepares you to be an attorney, you are talking about a really slim subset of the undergraduate population.

-- I think you want to talk about law school because it is a better example, and it is, than undergraduate training. But how much do you really need a politics or history or whatever it might be degree before going to law school? Why do they need a BA? Why not take bright high school seniors, AAs, or those who worked a few years, perhaps even a law office?

 

[ArgentCy]

Yep, education and healthcare are the two most sclerotic sectors of the American economy, where we pay more and receive less... and also, besides defense spending, the two sectors most dominated by the government, either public ownership of the means of production (with K-12 education), heavy subsidies (college), or heavy regulation.

I think advocating that people richer than you should give money to people poorer than you is not nearly as righteous or morally courageous as you like to think, though.

I have already paid a lot of taxes in my life and expect to pay a lot more.

We don't necessarily receive "less" healthcare. I would agree that we do see worse outcomes. However, I lay most of that blame at the corruption of the government like the FDA and medical profession like the AMA. Then look to lawyers and frivolous lawsuits.

 

[Sigmapolis]

We don't necessarily receive "less" healthcare. I would agree that we do see worse outcomes. However, I lay most of that blame at the corruption of the government like the FDA and medical profession like the AMA. Then look to lawyers and frivolous lawsuits.

I forgot to add to my list...

Defensive medicine is rampant in our system. It costs the hospitals and doctors nothing to over-prescribe and over-test (insurance is just going to pay for it) and, heck, might even make them more, and it is a backstop against malpractice lawsuits.

That "more is more, don't get sued" mentality drives up healthcare usage greatly.

 

[ArgentCy]

I forgot to add to my list...

Defensive medicine is rampant in our system. It costs the hospitals and doctors nothing to over-prescribe and over-test (insurance is just going to pay for it) and, heck, might even make them more, and it is a backstop against malpractice lawsuits.

That "more is more, don't get sued" mentality drives up healthcare usage greatly.

The FDA also made it Illegal or impossible to patent anything that is natural. So nobody can say that something like marijuana can have medical benefits. Or opium for that matter. A company has to refine it into say heroine and then they can patent the "drug".

 

[AuH2O]

Yeah, there are a lot of reasons for it. To summarize a few...

-- Baumol's cost disease is a huge reason for it.

-- Doctors/nurses/etc. are paid more in the U.S. -- incomes and standards of living are generally higher in the U.S. than in other OECD countries, which draws wages up generally, and it is reflected in the cost of healthcare that we receive.

-- Doctors pay for their own education in this country, which means higher wages/costs, while that expense is buried as "education" spending in other countries.

-- U.S. medical culture is just more aggressive about pushing cutting-edge and last-ditch measures, while the old and dying or those born with little chance of survival are more often left to expire in peace with only palliative care in other countries... this is about both societal expectations for care and the training professionals receive about what to do.

-- Americans are fat and lazy and in bad health.

-- There is more medical litigation in the United States... which means doctors carry malpractice insurance... which further drives up the cost of care.

-- We actually have low deductibles and co-pays compared to many other OECD systems, which discourages shopping around and looking for value for routine preventative and outpatient care, the way you might shop for a vet or cosmetic surgery.

-- We do not try to exploit monopsony like single-payer systems do, but the restrictions on the quantity and quality of care that would imply are hard to square with American expectations of "everything, the best, and I want it right now" for care.

-- U.S. medical infrastructure is just built to be expense... e.g., buildings have individual rooms for most patients, not wards, meaning we have duplicate equipment and staff not being used to capacity like crazy... we are just not efficient as a system.

-- And yes, some profit in the system there (though not like the Canadian system has zero profit within it), but that is minor compared to the above.

Just spit-balling a few of the major reasons.

That's one aspect that I think is deceiving about health care performance studies. Many include obesity rates as an outcome of the health system rather than a condition that the health care system has to deal with. As most can imagine, the US is far and away the most obese OECD country. If you believe our health care system causes people to be fat, then yes, our performance is very poor and our health care system should be changed to about anything else. If you believe that causes outside of our health care system make people in the US obese, then that is not necessarily the case. Obesity and the lifestyles that lead to it destroy the US's performance in most metrics.

I think there are some aspects of health care systems that may help reduce obesity rates, but if you look at how different countries around the world rank, it seems there is no correlation between style of health care system and obesity. It appears to be driven by cultural and economic factors. In other words, obesity is something that each health care system around the world have to deal with at different levels.

How would Sweden or Denmark's health care system perform in terms of medical outcomes if they nearly doubled their obesity rate to match US levels?