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[Leafsnail]

Is an weighting the value of people living on really the main problem with the US healthcare system?  Surely the main problems are more to do with a huge number of people being unable to afford coverage, coverage often not actually covering you even if you have it (although I guess that's being fixed), the wasteful nature of only giving people expensive interventions at taxpayer expense etc.

[Frumple]

There is nothing "wrong" with the system the US has in place, [snip]

Sanity check me, you mean regarding the underlying conceptual systems, right? Not the actual implementation? Because the on-the-ground of the US system has some tremendous fuck ups right now, and there's not really a kinder word to use for it. Class size, teacher training and salary, school funding and oftimes even focus... there's other stuff, too, and that's just off the top of my head.

It's arguable whether the underlying assumptions are flawed and to what extent if they are, but I'd have trouble agreeing that the US system's implementation has nothing "wrong" with it right now

[MonkeyHead]

Well, the principles are sound - its just that (as you point out) how they are implemented is not ideal. The US does little different to most EU nations in terms of teacher training, class size, standards, funding (twice that of schools local to me that I have used in my work, but with no real evidence that funding works) and so on "in principle".

The issues you highlight are identical to those in nearly all "western" education systems, and only represtent a minority of schools. In the US, as elsewhere, there are excellent schools and poor schools, all affected by the issues raised by a lesser or greater degree. Concerningly, the differences between what a good school does and what a poor school does are incedibly tricky to quantify.

[Aklyon]

Get rid of the SOLs, for one thing in the educationals. They aren't teaching anything new ever, because anything that wouldn't be on the test is 'wasting time'

[GlyphGryph]

Is an weighting the value of people living on really the main problem with the US healthcare system?  Surely the main problems are more to do with a huge number of people being unable to afford coverage, coverage often not actually covering you even if you have it (although I guess that's being fixed), the wasteful nature of only giving people expensive interventions at taxpayer expense etc.

No, it's not the main problem, but its a symptom of our larger "whatever it costs, even if the cure is significantly worse than the disease" mentality. It drives up costs significantly, and of course doctors are going to support it because it protects them from malpractice suits for stuff they didn't catch. Countries with socialized medicine (that have successful systems) often go out of their way to avoid this, and set up systems that don't encourage pointless or even detrimental hospital procedures. Back to the obsession with survival thing, it would be cheaper to spend 50k to let a terminally ill patient go wild for four weeks than have him survive for six weeks in a hospital bed attached to tubes for four times the price, yet the first is rarely an option (getting more common thankfully).

Another related example is a good portion of cancer screenings. In many population groups, you are significantly more likely to die early from getting regular cancer screenings than you are if you avoided them completely, for a whole host of reasons. But people are so afraid of dying that they are willing to take a higher chance of dying to prevent it. :/

It IS a problem, and a significant one, for the US healthcare system. It is by no means the only one. The things you mentioned are also problems, significant ones, but none of them explain why we have costs that are so much more than other countries, only why fewer people benefit from them.

[Sheb]

That can be explained by the fact that you only have for-profit insurers. Free market doesn't always work.

[GlyphGryph]

It's more the for profit hospitals - insurers absolutely hate the practice, but can't do a whole bunch about it aside from raising everyone's premiums to cover it.

There are "wellness" systems in some places, where instead of purchasing insurance you pay a flat yearly fee for medical care, and those seem to both keep the costs down while resulting in better care with fewer wasteful (and dangerous) procedures. Which is part of why I hate the insurance mandate - the best free-market healthcare systems we have in the US are all insurance-free. Insurance for regular procedures is a terrible way to break any free market system.

[Duuvian]

0. Above all else, attempt to honestly inform the public about where we are and where we are going; both as a society and technologically. Bring about real discussion about the future, what will happen, and what can be done about it, in order to figure out how best to avoid terrible mistakes.
1. Copyright reform
2. Prioritize digital infrastructure and regulate the way companies with monopolies or near-monopolies over regions of internet users are gouging them
3. Lower defense budget, particularly our oversized doomsday arsenal (blowing up the world once over is plenty, no need to pay the maintenance to keep the ability to do it 3 times over), and cutting our collection of outdated big-budget toys. Moving the military from its current status of industrial behemoth towards a 'more with less' philosophy emphasizing technological solutions over brute force. Essentially turn it into an agile R&D centric organization.
4. Increase the budget of NASA. Very good investment historically; provides large numbers of high-skill, high-paying jobs, good R&D which benefits everyone, and most importantly, encourages children to go into STEM fields. Which brings me to:
5. Increase funding for primary & secondary education. The current cuts are entirely unproductive in an era when, in some states, jobs requiring technical expertise are expected to outnumber qualified job seekers 2:1 in coming decades.
6. Allocate funding for expansion of post-secondary education. People talk about how college costs are rising at silly rates, the need for post-secondary degrees is rising at similarly high rates; these factors are probably not unrelated. Demand is growing at a rate at which current increases in post-secondary capacity can simply not supply. Fix that issue of supply, and I suspect costs won't be doing what they are now.
7. Universal health care in some form or another. As it currently stands our system is the worst of both worlds; no one has the leverage to lower costs.
8. Ensure laws are based on humanism, not dictated by any particular religious creed.
9. Rein in the current rapidly expanding corporate power. Democracies can not coexist alongside behemoth, rigidly hierarchical entities whose sole aim is profit and which have total or near total control over entire industries, including the distribution of information.

Well, there's probably more, but that's the gist of it.

In addition, as a citizen, I'd like to see a US Government manufacturing plant that does primarily industrial/manufacturing process research regarding mass production of solar panels; and produces solar panels secondarily as a sort of factory-testbed to prototype the mass production process. Product lifespan and Reliability should be of the utmost priority, as they should be built to last and be fairly modifiable; if possible keep the stems and replace the leaves. I'd also want the production details and data to be released freely. I think it would be a good investment by the government for the citizenry, especially as it might lead to more efficient (possibly time consuming yet available) charge for handheld solar powered recharge devices as they would function off-planet in theory and be multipurpose should a visit to a Mars Colony ever be possible. Streamline and automate government solar panel production methods according to academic standards rather than corporate and set a reasonable price ceiling through competing via the government run process, to exist until the industry has proven itself capable of standing on it's own in cost and the increase of demand that the initial supply would bring once the buildings and their effect on infrastructure are visible to people. Who wouldn't want to coat or shingle their building with energy harvesting material if it was available and profitable in the long term?

[Leafsnail]

It IS a problem, and a significant one, for the US healthcare system. It is by no means the only one. The things you mentioned are also problems, significant ones, but none of them explain why we have costs that are so much more than other countries, only why fewer people benefit from them.

The third one explains it quite nicely - the system is effectively destroying wealth by allowing easily treatable problems to become life threatening ones (IE the US is spending more on healthcare because it's allowing there to be more problems for it to have to treat).  Add in "rampant profiteering off monopoly infrastruture" and it's probably fully explained.

[Mr. Palau]

Mr. Palau, while a 0% corporate tax is a nice idea (for corporations), you have to remember that we have a fuckton of debt, which unlike the discretionary spending, we can't just stop paying for. Letting away organizations that could owe much more than any individual could in taxes isn't the brightest idea in the world there, you'd just have richer people staying outside the US to avoid your very high tax on them.

True, although they do that now anyway, they would probably do it more. You could impose a tax on all foreign payouts by corporations, in the form of salaries over 1/4 of a million, and dividends. Then they would end up paying the exact same tax rate on their corporate derived income. Keep corporate taxes in place for foreign corporations. 

Re: Number 4. An area directly linked to part of what I do for a living....

No-one, not even the Finns themselves, has any idea why thier educational methods turned an adequate system into one that is rated so very highly by PISA in a relativley short timespan (there are other measurement systems in place that do not rate quite so highly but is is consistanty towards the top 20% or so in any metric). Many other nations have taken aspects of the Finnish system and found that when applied they make little to no difference. It sems to me to be very much a case of right collection of ideas at the right time with the right people both providing and receiving the service. The Finnish model goes very much against entrenched ideas within the US system and would probably not be done justie by a generation of educators used to a very different set of guidelines. There is nothing "wrong" with the system the US has in place, but similar to other rich western nations, education has ceased to be the "all powerful gateway out of poverty" that it is in nations such as India and China, whos systems are also top performers in a range of educational grading systems.

Then simplying do general things like decrease class size etc. (Thats the one I think would make the biggest diffrence.)

[MonkeyHead]

Then simplying do general things like decrease class size etc. (Thats the one I think would make the biggest diffrence.)

Not so - thats simply not cost effective in terms of how much money it would cost levied against modest gains - where are the rooms and staff for your extra classes going to come from? In addition, the extra teachers needed will have to be at least as good as the ones already working or you harm pupil progress. The number 1 most cost effective influence is teacher quality, and even then that makes little difference - A good teacher with experience (which is the biggest influence in if a teacher is actually any good or not) is worth less than one grade over the course of an acdemic year. It also takes a long time to generate a workforce of sufficient quality capable of making a measurable positive improvement on pupil progress. To make an improvement in the short term you need to free teachers up so they can spend time on the nuts and bolts of teaching, and not bog them down with needless red tape and paper chasing.

Source: This Guy, who I have cited lots of times in my own work...

[Mr. Palau]

Then simplying do general things like decrease class size etc. (Thats the one I think would make the biggest diffrence.)

Not so - thats simply not cost effective in terms of how much money it would cost levied against modest gains - where are the rooms and staff for your extra classes going to come from? In addition, the extra teachers needed will have to be at least as good as the ones already working or you harm pupil progress. The number 1 most cost effective influence is teacher quality, and even then that makes little difference - A good teacher with experience (which is the biggest influence in if a teacher is actually any good or not) is worth less than one grade over the course of an acdemic year. It also takes a long time to generate a workforce of sufficient quality capable of making a measurable positive improvement on pupil progress. To make an improvement in the short term you need to free teachers up so they can spend time on the nuts and bolts of teaching, and not bog them down with needless red tape and paper chasing.

Source: This Guy, who I have cited lots of times in my own work...

Expand classrooms and hire more janitors/IT people/other support people. Institute teaching training program, insure best preforming students have the worst teachers ('cus they would do good anyway) and the worst get the best. Wait until a sufficently qualified work force is generated. Increase teacher pay to draw smarter people into the profession, and encourage teachers to go back to work (that may include pension cuts, so they stay in longer). Raise retirment age (something that I should have put in the list o' demands) so that good teachers can stay in the profession for longer.

[kaijyuu]

I've always supported boosting teacher paychecks to artificially boost demand; if it's a job you actually get a decent wage for, more people will want to go into it as a career, meaning more competition for the positions, meaning schools can be picky and only take the best teachers.

People getting paid a good wage for a necessary service is a nice bonus in addition to that.

[GlyphGryph]

Unfortunately, teaching standards are nearly nonexistant and social respect nil.

It's estimated that somewhere between 35-50% of those who graduate with a teaching degree cheated their way to it - mostly because no one gives a damn. I've been to teaching classes - its the career I plan on going into - and they are a total joke. A few even actively discouraged good teaching methodology, amazingly enough.

It's like all Truean's complaints about the law school system except even MORE stupid, and without any of the after-the-fact pressures to succeed that make at least a good chunk of lawyers work impossible hours to make up for what they didn't get.

The single biggest difference seems to be that the Finnish culture values teachers and the Finnish education system actually trains them to teach well.

America seems to follow the model of "Those who can't do, teach, and those who can't teach teach other teachers to teach."

[darkrider2]

I remember one of my teachers telling me that they're primary job is to educate us to a level where we can pass the big tests that come around every year. (ACT/OGT/etc.)

I'm pretty sure by this point almost every other country with a reputable education system does education better than us (USA) by now.