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You ought to take a look in the Great Plains states and see what Wal-Mart has done to downtowns-- sucked them dry. You can have a free-market system where a lot of shopowners and manufacturers have a piece of the pie, or you can have a free-market system where only a few get all the dessert.
When a country store owner makes 1800 times what his average employee does, he'd pay the same rate as Wal-Mart would. You have a problem with that?
Well let me ask you something here. There's plenty of walmarts in Mass and yet downtowns are doing fine so what specifically is different in New England vs the midwest?
The fact of the matter is every 10-15 years there's some boogyman that small businesses point to that is destroying them
First it was the interstate highway system
Then it was the malls (many of which are half full today!)
Then it was the box stores
Now it is the internet.
I support small businesses but it has to be reasonable in terms of price and delivery. I recently bought natural local honey made onsite at a small business. There's only ONE store I can buy this from so I went direct. They were only open weekends for the past two months. After the holiday season it is online only.
Walmart is being crushed by Amazon because the delivery system now might be a day or less with a much better rating system and established product lines (kindle for starters).
Retail MUST adopt to use the internet otherwise it will not work in the 21st century. I used to work in a place with a dead downtown. Half closed stores, a closed hospital with grass three feet tall and for some reason eight places to get your hair done in one mile So I asked some small business that sells all of these natural soaps, salaves and so forth how things are going. She said fine. It's next to a building with a massive hole in the roof that's been there for years. How are things fine? She operates the store half time and the other half is fullfilling online orders.
Many downtowns died off frankly because well...people work. When women joined the workforce who honestly had time to shop during the day? So if your 9-5 small business isn't making it try changing the hours and open up on weekends. that's when your customers want to shop in person. Otherwise who honestly would take a day off of work to go...shopping ?!?
I worked at a box store and frankly we never drove anyone out of business. They've been in town for 10.5 years now. There's still hardware stores, plumbing supply, kitchen design, garden centers, craft stores, electric supply, glass supply etc.
Well let me ask you something here. There's plenty of walmarts in Mass and yet downtowns are doing fine so what specifically is different in New England vs the midwest?
Very good question, actually - I think the differences are (i) population density, and (ii) ease of travel.
Population densities are much higher in New England, even northern New England, than much of the Midwest. (I'm always struck how if you drive around at ground level, even in Vermont, but especially places like western Mass or southern NH, you see a lot of trees. But if you fly over, particularly at night, it's house after house after house after house - I think a lot of people don't realize how densely New England is settled.) With more population in a given area, it's easier for local businesses to maintain a sufficient customer base to stay in business.
A related, but separate, factor is ease of travel. In the Midwest you hop on the interstate (or a smooth, wide "blacktop", as they call 2-lane highways) and you're at the MegaStore SuperCentre, 30 miles away, in 15 or 20 minutes. Compare that to much of New England, where between curvy roads, parochial speed limits and dense traffic, you can be lucky to go 10 miles in 20 minutes. So in New England, despite the increased population density, it's often easier to just go to the local store than to schlep to the MegaStore.
Case in point, our property in Sharon, VT. It's technically about 20 miles from the shopping sprawl of West Leb, NH; but more often than not, we'll just shop at the Sharon General Store, or Dan & Whit's in Norwich. Sure part of that is because we want to keep our $$ close; but part of it is simply because of the time it takes to wind our way through the (generally unwarranted) 35 m.p.h. and then 25 m.p.h. sections of Route 132 or Beaver Meadow Road. Once we've dealt with that, we don't want to tack on another 15 minutes of interstate driving just to get to West Leb, unless it's for something big or unusual.
Well in a sense I can believe that. What google maps told me before from work to cambridge was 15 minutes but once traffic came in it was 45!
Certainly population density is a factor but even before the internet there were plenty of mail order businesses. Sears was legendary for ordering nearly everything under the sun. Today I could argue that tractor supply exists for a point the same way.
The internet changed quite a bit in terms of shipping. Back in the day a product could be advertised in the 80's or 90's with a toll free number and it would take a month and half to two months to receive. Very little takes that long today. Days not weeks and now it might even be hours!
If there is one thing that box stores and to a point the media tries to imply as if every store has to be big and have a huge sign. This isn't the case. Businesses these days can be in a house without any sign. The internet enables so much in marketing that the cost saving is put more into the business. I know places to get local eggs, rabbits (pet or meat), honey etc. 3d printers also open up a whole new world as there is zero marginal cost. I know of a women that works at starwood hotels. Starwood does not run call centers as it is all out of peoples homes. Likewise it makes little sense with the inflexibility of the commercial real estate market to make one massive store for a retail front. Warehousing sure if you make it to just be online.
Location: RI, MA, VT, WI, IL, CA, IN (that one sucked), KY
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Originally Posted by Oriz
Do you seriously think ANYONE should be taxed at 50% of their income? I think that's insane. Sure, not all of them deserve to make what they make, but some do, and if you are an honest man working hard and that's how you got to making what you make, no government has the right to take half of that away from you. It's yours. You earned it. And you have no right to tell them, well, you don't really need ALLLLLL that, you're still making plenty.
Depends on what is done with the money.
In most all of the developed world, a single payer system delivers coverage for everyone, with a lower per person cost, and better overall results. It is the fiscally sound decision. I can't think of any place in the world that moved from a single payer system to a system like ours and saved money and/or improved results. It just doesn't happen.
Location: RI, MA, VT, WI, IL, CA, IN (that one sucked), KY
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Originally Posted by Sierrajeff
Very good question, actually - I think the differences are (i) population density, and (ii) ease of travel.
Population densities are much higher in New England, even northern New England, than much of the Midwest. (I'm always struck how if you drive around at ground level, even in Vermont, but especially places like western Mass or southern NH, you see a lot of trees. But if you fly over, particularly at night, it's house after house after house after house - I think a lot of people don't realize how densely New England is settled.) With more population in a given area, it's easier for local businesses to maintain a sufficient customer base to stay in business.
A related, but separate, factor is ease of travel. In the Midwest you hop on the interstate (or a smooth, wide "blacktop", as they call 2-lane highways) and you're at the MegaStore SuperCentre, 30 miles away, in 15 or 20 minutes. Compare that to much of New England, where between curvy roads, parochial speed limits and dense traffic, you can be lucky to go 10 miles in 20 minutes. So in New England, despite the increased population density, it's often easier to just go to the local store than to schlep to the MegaStore.
Case in point, our property in Sharon, VT. It's technically about 20 miles from the shopping sprawl of West Leb, NH; but more often than not, we'll just shop at the Sharon General Store, or Dan & Whit's in Norwich. Sure part of that is because we want to keep our $$ close; but part of it is simply because of the time it takes to wind our way through the (generally unwarranted) 35 m.p.h. and then 25 m.p.h. sections of Route 132 or Beaver Meadow Road. Once we've dealt with that, we don't want to tack on another 15 minutes of interstate driving just to get to West Leb, unless it's for something big or unusual.
You nailed it. Having lived in both the midwest (IN, IL, and mostly WI) and VT and MA, you totally covered it.
In most all of the developed world, a single payer system delivers coverage for everyone, with a lower per person cost, and better overall results. It is the fiscally sound decision. I can't think of any place in the world that moved from a single payer system to a system like ours and saved money and/or improved results. It just doesn't happen.
Well technically given the NHS cuts they are refusing
It's fine as a theory to suggest that everyone is equal or at least should be treated equal but there is some responsibility that has to be extracted at a certain point.
"Smokers and the morbidly obese in Devon will be denied routine surgery unless they quit smoking or lose weight.
Patients with a BMI of 35 or above will have to shed 5% of their weight while smokers will have to quit eight weeks before surgery.
The NHS in Devon has a £14.5m deficit and says the cuts are needed to help it meet waiting list targets."
How can we cover more people with the same number of doctors and nurses and hospitals? How can someone have the right to another person labor without it being rationed? Not all doctors technically work on medical critical health issues but quality of life. Plastic surgery falls under this.
Look at organ donations for a moment. Who specifically should get a patella (knee cap)?
Should a track athlete receive one knowing it would wear faster? Should someone addicted to drugs? Should weight be considered? Some might say you cannot put a price on health but we do that every day. How much should eye glasses cost? What about hearing aids? My contacts might cost me $200 a year. Could I pay more? Sure I guess but the market drove the prices down throughout generations to get to that price. Perhaps it might be $100 in another decade. We have to put prices on things because without them there is less incentives for people to work for them.
The issue from what I see is there is more money in specializations then general practices. In the USA any medical doctor has the incentives to do this. In Europe they have more general practitioners then specialist and as a result if it is specialized care then in some cases you either have to wait or pay for private.
Technically the USA does have single payer to a point called Medicare. It doesn't however cover everything as there's supplemental insurance.
Personally I think health is beyond just medical coverage. It includes diet, exercise and environment.
Location: RI, MA, VT, WI, IL, CA, IN (that one sucked), KY
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Originally Posted by mdovell
How can we cover more people with the same number of doctors and nurses and hospitals?
Cover more with health care coverage. Not provide more health care.
The people are already getting treatment, and we're (those that pay) already paying for them, they're just going to ERs for it so we're paying too much for it.
It is not a matter of who is getting health care treatments, its a matter of how it is paid for and delivered. I would think we would want to deliver it and pay for it in an efficient manner that reduces costs (overall) and improves results.
For some reason we don't want to do that in our society. Oh, actually I know the reason, its the for profit insurance agencies brainwashing of people that his is bad because it is socialized medicine and a bureaucrat is going to get in between you and your doctor! I can't believe there are so many idiots that fall for that.
Cover more with health care coverage. Not provide more health care.
The people are already getting treatment, and we're (those that pay) already paying for them, they're just going to ERs for it so we're paying too much for it.
It is not a matter of who is getting health care treatments, its a matter of how it is paid for and delivered. I would think we would want to deliver it and pay for it in an efficient manner that reduces costs (overall) and improves results.
For some reason we don't want to do that in our society. Oh, actually I know the reason, its the for profit insurance agencies brainwashing of people that his is bad because it is socialized medicine and a bureaucrat is going to get in between you and your doctor! I can't believe there are so many idiots that fall for that.
That's easy to say but many are believing that single payer means instead health care 24/7 to cure everything.
It of course is a matter of who is receiving it because their actions add to costs! it cost more to insure a smoker then a non smoker. Knowing this wouldn't it make sense to require people to quit smoking before costing the system more money? How many anti smoking systems are for the public? What about drinking and drugs?
We can certainly lower the costs of healthcare by subsidizing the supply not the demand. When you subsidize demand prices go up. Student loans will always go up because well it's easy money. Subsidizing supply lowers costs just look at the student lunch program. Heck I personally know people that tried sneaking in after graduating to get a lunch! Another example is solar energy. The subsidy towards energy production has dramatically dropped the price per kw/hr and will continue to do so.
So instead of a blank check to medical providers we simply reverse it and use it to fund more hospitals, more medical schools, more doctors, nurses and dentists.
Just as if we want education to go down we should replace FAFSA with block grants to states to open up new universities. More universities and colleges and more professors means more competition to drive costs down, it's as simple as that.
Sorry, but subsidizing the supply in health care simply shifts the cost; it does not ipso facto lower the price. You might want to start with any of the five studies done on Vermont's single payer system to see how costs get reduced. Dr. William Hsiao's was the seminal one. Even the most critical of the group, the Valere study, agreed single payer would be cheaper than maintaining the present system.
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So I asked some small business that sells all of these natural soaps, salaves and so forth how things are going. She said fine. It's next to a building with a massive hole in the roof that's been there for years. How are things fine? She operates the store half time and the other half is fullfilling online orders.
Another example is solar energy. The subsidy towards energy production has dramatically dropped the price per kw/hr and will continue to do so.
