It also has to make financial sense, everyone's insurance would be much higher, cancer treatments are $$$, in countries with a public healthcare system it's a no go
It cheaper to treat cancer if it's caught early. Reduced screening isn't reducing the need for cancer treatments - everyone who has cancer still has cancer. You might get an increase in follow up tests due to false positives, but these are cheap.
Because everything is mostly following on local purchasing power. You can build a beautiful modern house in buttfuck nowhere Belarus for 20% of what you'd pay for the same exact house in Germany.
The screening isn't even the problem, finding you have _a_ cancer is one thing, pinpointing where it is, how to treat it, treating it and recovering from it cost orders of magnitude more than the initial diagnosis.
The point I was trying to make was that cancer screening is expensive only because we have a highly inefficient healthcare system. (India was an example and their healthcare system has its own flaws) Sure we can point to PPP, but the reason why screening is that cheaper elsewhere is not ONLY because of PPP. Since you mentioned Germany, public health insurance covers early detection cancer screen every 3 years (2 for skin cancer) once you’re 35. The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here. It shouldn’t be that expensive to screen and it shouldn’t be that expensive to treat.
> The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here.
100% definitely not lol, you need 2-3 months to see any kind of specialist in germany, 5-10 hours before someone sees you in the emergency room. The healthcare system of every western EU country is getting worse year after year because of the aging population, and on top of that we're taxed more, for shittier services.
I pay 800+ a month and it doesn't even include a yearly blood work unless I beg for it. Just look at your own link, in germany we screen for two cancers for each gender and it's already so fucking expensive, there are dozens of cancers you could theoretically screen for.
> More than 80,000 Americans are told each year they have melanoma skin cancer. If that sounds like a lot, it’s because the numbers are six times higher than they were 40 years ago.
> Overdiagnosis is one of the most harmful and costly problems in medicine
> you need 2-3 months to see any kind of specialist in germany, 5-10 hours before someone sees you in the emergency room
That’s like pretty much the standard in the US as well? The unless you’re dying, you’re pretty much in an extremely long wait before you get seen in an emergency room, and then later get sent a $10k+ bill at the minimum. And there’s very few specialists that you can see immediately. In fact, for the majority of people, the step before “how fast can I see my specialist” is the “what specialists are in network”.
And as far as costs are concerned, I pay $2000/month for two people and it will only go up once we have a family of 4. This isn’t even the top tier plan, just a good enough one. Not to mention the thousands of dollars in deductible that you have to pay before the plan kicks in.
And we have an aging population as well. And that’s not going to change regardless of who’s paying for the care.
You’re being taxed for it, we’re paying out of pocket. The only difference is that you get shittier services when taxed, and here you don’t get the care if you can’t afford it. And if you end up in the ER and they have to treat you despite you not having the coverage, the taxpayers cover it anyway.
In the US, depending on your health plan, the fastest way to see a doctor is Urgent Care. They will typically see you nearly immediately, and send you to the emergency room (with paperwork already handled). You will still be charged, although at least in my case, it's just a copay.
> In the US, depending on your health plan, the fastest way to see a doctor is Urgent Care
Correct. It’s faster than getting your PCP to see you and it’s faster than Emergency Room (which GP was comparing the wait times for in other countries). But how much you wait really depends on a lot of factors: how many other patients are sick that day, what time of day are you calling, does the urgent care take appointments, how many urgent care centers are in your area etc. In my area if you call at 8 in the morning and the urgent care you are calling gives out appointments, you’ll probably be seen the same day. You’ll have to wait for your appointment, but once you show up for the appointment, you’ll be seen immediately.
If you’re calling in later (after 10 in the morning) or walking in to a facility, you’ll probably be waiting at least 2-3 hours if you’re lucky. All of this of course comes with higher costs (not as much as ER though).
The problem with urgent care though is that it’s more expensive if you’re running tests and is only designed to fill in for conditions that you’d ideally want your PCP to take care of, but can’t get an appointment for. True emergencies still go to ER. In fact some urgent cares don’t even have equipment like xray or sonography machines, so if you need one, you’d end up in ER anyway. (and get charged for both)
I don’t know the details… does the suspension make the current state in Germany similar to the Selective Service requirement in the US? Or is it “easy” for the German government to establish a draft?
> does the suspension make the current state in Germany similar to the Selective Service requirement in the US?
I don't know how the Selective Service requirement in the US works, so I can't answer this question.
> Or is it “easy” for the German government to establish a draft?
Such a (temporary) suspension can hypothetically terminated at any time by the government. The question is basically how the population will react. I guess if the suspension of the general conscription would be terminated by the government, there would be really furious public rallies (and I am rather certain that my boss would immediately attempt to approve a vacation request if I wanted to attend such a rally in Berlin if it happened during the work week - just as an "innocent" kind of support for this cause from behind the lines :-) ) because multiple generations got really radicalized against compulsory military service (I wrote about this topic at https://news.ycombinator.com/edit?id=46177817 ).
This is why the German government currently attempts to approach the whole topic of quitting the suspension of compulsory military service so indirectly.
In the US, men have to register for potential draft within a few months of turning 18. Women still exempt. But instituting an active draft wound take an act of congress and be signed by president - very unlikely to pass for the same reason you mention in German - the population likely wouldn’t stand for it.
This current US administration, who didn't win a majority in the first place, is under water on every issue, and is currently on a mission gerrymander everywhere they can in order to not lose congress in a year. What the people are willing to stand for doesn't matter.
Yeah, I can easily see something like 2 separate at $20/month vs 1 super at $35/month (make-believe figures).
Assuming all WB and Netflix customers move to the super platform, that's a loss for Netflix (assuming the super platform doesn't significantly reduce their costs).
And the $35 might be more than some set of current Netflix subscribers want to pay, so they drop the service, so an even bigger potential loss.
Certainly, I have no desire to subsidize sports fans via a higher Netflix super package.
The irony is that a lot of people complained loudly about the cable bundle then complained loudly about streaming service fragmentation even when it at least offered a choice to cut their monthly bill.
There was a brief happy period where you could ditch cable ($100/month or whatever), subscribe to ~2-3 streaming services (~2-3x $20/month), save a decent amount and still have a good selection of content. And bonus, you didn't have any ads.
Then the fragmentation got worse, as all the legacy media companies rolled out their own platforms, and it suddenly became ~5x$20/month to get the same content. And ads got added back into the mix, even after subscription fees.
These days, I actively switch platforms every few months. It's a bit annoying, but beats the old cable days.
My biggest complaint today is the fragmentation across some sports. Take pro cycling (TDf, etc) - it's split across 3-4 platforms in the US. So, I need to get FloSports, Peacock, and a few others. I wish I could either get individual events OR a bundle that included everything. Oh well, I'll pay for a few and pirate the Sky or continental feeds for the rest.
We briefly had a reasonably priced, all pro cycling coverage streaming service called GCN plus.
Swallowed by Discovery and then (in the UK) bundled into a 30 GBP a month sports package called TNT that comes with a little bit of premier league football.
Prohibitive and has led many to piracy this year. I only hope whoever eventually wins the race to buy Warner Bros eventually undoes this madness, it could not be worse as a cycling fan.
When Netflix started losing shows did they lower their price to allow users to sign up for competing services? The price just went up for everyone in reality.
No but there's very little I deeply care about watching, including live TV. I definitely pay less for video content than I was paying 5 years or so ago. Netflix has been on my bubble for a while. We'll see what happens with this news.
And I already have Amazon Prime and Apple TV+ through other bundles I have for other reasons. We'll see.
I don’t see how this is ironic at all. Doesn’t this just make sense that people are complaining about the same business model? Or are you saying people should be more grateful we don’t have to watch ads anymore?
Still, the real issue is one that both cable and streaming services don't solve.
People don't want to pay for what they don't watch. Both streaming and cable have the price of everything they own and produce built into the price. When you subscribe to either, you're subsidizing a bunch of stuff you don't care about.
People don't want to pay $20 a month to watch stranger things in oreer to subsidize a bunch of stuff they don't watch. It was the same with cable. Netflix is just one giant cable bundle, it always has been.
I'm regularly a bit surprised at how many people don't even consider purchasing a la carte content or Blu Rays. For films it's often a pretty reasonable option for occasional viewing.
I was never taught that servant leadership should be some weird "manager as parent" relationship.
Instead, servant leadership implies the manager serves the team (as the name implies). That includes removing impediments, but also includes empowering the team, ensuring their careers are growing, etc.
It’s the concept of a management chart as an inverted pyramid with each layer holding up and supporting the layer above them. If you imagine a promotion as working your way down the corporate pyramid, then it’s easier to see how the managers at the bottom are carrying more weight and deserving of higher pay.
As opposed to a pyramid where it’s visually represented as the broader management layers supporting the layers above them.
In a pyramid, it looks like the CEO has a cushy, overpaid job. In an inverted pyramid it looks like they have the weight and responsibility of the company on their shoulders.
I honestly have never heard anyone—even those executing it poorly—try to frame Servant Leadership the way the original author did here (the "curling parent" analogy).
I have certainly seen people fail badly at practicing this style, but that failure was invariably due to a lack of character, poor communication skills, or other individual execution matters, not an issue with the core concept of servant leadership itself.
Good news, the average career in the House is already 8 years, so no new law needed! The Senate average is 11 years, so it's already less than 2 terms, no change needed there either!
I'm only half kidding - yes, there are outliers, many of whom probably should have retired years ago (but not because they've been around too long, but because they're simply too old to do the job - Pelosi and McConnell come to mind). But, the range of term limits that are usually discussed are already within the existing range, so it doesn't change all that much.
Less than 6 years, since there’s a GOP majority and the GOP imposes a 6 year limit of chairs. And since they introduced that (late 90s, Gingrich era?) they’ve fallen into complete uselessness. So I’m not convinced that’s an answer.
Those with longer tenure though tend to end up in the powerful senate positions like becoming a majority/minority leader. Thus you end up with absolute fossils like Pelosi or McConnell who most recently basically snuck in banning hemp into the budget bill, which was something absolutely almost no one in the USA was calling for and incredibly unpopular.
I doubt a minority/majority leader with only 2 terms would be as good at snaking in this kind of stuff in, or snaking their way through the politics of various committees to kill off proposed legislation before it's voted upon, that takes practice to really get good at all the underhanded techniques.
I'd absolutely support a maximum age limit, maybe e.g. if you will reach 70 years of age in your term of office you cannot run. So a senator could be elected up to age 64. A Representative up to age 68. And I'd apply that to all elected offices. My biggest criticism of Biden vs. Trump was that they were both too old.
No, no. We want the wisdom of the older generations.
We want the stability of someone who has seen life’s ups and downs and understands there is more to life than the petty day to days of a presidency. There is a legacy beyond them and they imbue that in their policy.
Age can be a symptom of your inability to do this, but it is not the problem.
The problem is with specific mental ailments and behavior coming into the presidency. We should scrutinize those ailments heavily, and build a culture around stepping down when life inevitably gets to you too — and having it taken from you if you do not take the opportunity for mutual dignity.
The problems that afflicted Biden could happen to anyone at any age. It is a problem if any candidate experiences it.
And I do not really think age has effectively changed Trump’s view of the world.
Think through the downstream impact of term limits... where does the power accumulated by long-term congressmen go? My guess... it flows to either/all of career bureaucrats, lobbyists, or career congressional aides. Do we really want to cede more power to groups that are not elected (bureaucrats, lobbyists) or elected-by-proxy (aides)?
I take the exact opposite view. A revolving door of congresspeople would decrease the influence of lobbying (and, for that matter, the influence of political parties in general), because once a member of congress reaches their term limit they would no longer be influenced by campaign donations.
Also, let's take a step back:
> where does the power accumulated by long-term congressmen go
We need to take a very hard look at any supposedly democratic system in which power is "accumulated" by individuals. Deeply entrenched politicians who never face term limits nor reelection resistance have no reason whatsoever to care about the will of the people.
Ding ding! I think that's the real problem. If I were king for a day, I'd end gerrymandering and replace it with non-partisan (probably algorithmic) districting. And I'd shit-can partisan primaries and introduce approval voting or instant-runoff (or something similar).
> A revolving door of congresspeople would decrease the influence of lobbying
Make an argument that actually supports this rather than asserting it.
Most people who study this kind of thing outright disagree.
Lobbying in the US doesn't happen because we let people work in government for a long time, plenty of other countries do that, it happens because we are one of the only places that legally empower rich people to pay for the campaigns of elected officials and have one of the most expensive political campaigning systems in the world and we openly claim lobbying to be a right of rich people.
Political parties in the US yet again come back to just how absurdly expensive running a campaign is in the US, largely because we refuse to regulate it. Other countries don't allow candidates to run advertisements a full year in advance because that's wasteful and stupid. Candidates are beholden to the political parties for campaign funding. Even Bernie suckles the political party teat to maintain his seat.
If you don't fix that but you limit the ability of a politician to gain mindshare simply by doing a good job in congress (because you only give them two terms) all you have done is make it easier for rich people to control who can get elected.
Indeed, even the US system used to be better! The Civil Rights Act was bipartisan, with meaningful republican support, because there used to be socially progressive republicans! There used to be racist asshole democrats! When the Clinton government was cutting programs, prominent republican representatives from Texas were actively working with prominent Democrat representatives to maintain funding to the particle collider project there. But as America continued to enshrine the right of the rich to fund politicians, and continued to let campaign costs balloon to the point that only a rich person's super PAC or the literal party establishments could afford to run one, what did you expect to happen?
Trumps power over the republican party is fascinating because it largely isn't money based. He's just so populist among republican voters that he can unilaterally control who gets elected regardless of funding. This is generally a fucking bad thing, because trump sucks, but it's just a more direct version of what the Democrat and Republican parties have done for a few decades now.
Are you aware that both democrat and republican lawmakers spend most of their time on the phone calling and begging rich people to fund their next election campaign, even right after an election?
None of this goes away with term limits. All you are doing is giving the people who hold the purse more power over elections.
How good would you be at your job if you had to spend a few million dollars every four years to keep it? How good would you be if your company's competitors were loudly offering to pay that burden?
Depends on what power we cede. We should give them clear rules so they can make decisions based on their expertise. They should not be making the rules though (except as suggestions to congress - as experts this is an important part of their job)
If we don't pay them well (and we arguably already fail to do that[1]), then it becomes really hard for anybody but the independently wealthy to be in Congress.
1 - $174,000 is the current salary. With that, they have to maintain two households (one in DC, one in home district/state). That salary is far from unusual for white collar workers in major metro areas.
Yes, like every other profession in the US seemingly, Congress is also underpaid. But letting them individually fight for getting as money as they possible can before they retire via means the typical person doesn't have access to, isn't right either. I agree they should be paid appropriately, so they also can survive on their salary, but still think they shouldn't be able to do certain things others can, because of their position.
Singapore pays its public officials high salaries primarily to ensure the integrity and quality of its government. The official justification centers on attracting top talent who could otherwise command high incomes in the private sector, thereby establishing a "clean wage" that reduces the financial incentive for corruption. Salaries are explicitly benchmarked to the median income of the nation's highest earners.
e.g.,
Singapore PM annual salary: ~$1.63 million USD
Singapore President salary: ~$1.14 million USD
(These are the highest public salaries in the world for politicians)
You’d have a massive influx of incompetent grifters who only get themselves elected for the salary. At the end of the day public service still has to a “sacrifice” (doesn’t mean that it shouldn’t be compensated at e.g. top 5 percentile income).
Give them spending rights. You need a second home in DC? Ok, if you pass a means test we reimburse your rent and travel costs. There's no sense in giving them additional excuses for not doing their job. 174k is plenty of money to live off.
> If we don't pay them well (and we arguably already fail to do that[1]), then it becomes really hard for anybody but the independently wealthy to be in Congress
Congress should be paid minimum wage. They are the ones who determined that this is enough to live on so everything above that is wasteful spending of public funds. If they don't think it's enough, they can change the minimum wage to a liveable amount.
That’s the best way of ensuring that bribes (legal or not) become the primary source of income for every representative who is not independently wealthy.
But, as the article notes, we don't know if any particular cancer will kill an individual.
It's a conundrum. But, "Meh, let's not test since it might not kill you." doesn't feel like the right answer.
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