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Oh, another interesting side note, home ownership in 1975 in the US was 64%, recent data in the US shows it at 68%. So, the idea that homes are less attainable at the very basic level is untrue.
All that means is people are living in smaller homes/condos/townhouses and/or that they are deeper in debt than they were before.
 

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You are talking about a very different risk profiles. I have employed people with Downs, and both were great employees, fwiw. I can't say I have employed people with autism, or at least obvious, but again my point about hiring isn't that I care about whether or not you can do a job which is effectively your question here, but rather whether or not you are bringing a potential legal or greater strategic problem to a business. For instance, I can't very well have an employee who is autistic that cannot communicate or is subject to having outbursts, not to any degree. That's not discriminatory against autistic people, it is a basic requirement of the job. If someone can do the job and is the best qualified person, then great, but the other caveats apply. This is different from someone who shows up with a potential legal issue. When you get the transgender, non-binary, political activist sort of issues showing up with employees it becomes a larger problem, because it ends up with employee conflict at best. When you have someone show up with facial tattoos in a customer facing business, it alienates customers. That's the risk, not the risk of the wage of the person. If the Down's employee doesn't work out because they can't do the job, I am not worried about being dragged into a legal/HR nightmare.
It's really that not different at all. I've worked in this space. Many companies fears with hiring those with disabilities are very much rooted in the social and legal areas (interaction, sensitivity, perception, etc).

Companies will likely always hire the lowest risk employee, understandable, but then we're left with potentially yuuuge disparities in marginalized groups. The free market ain't so free if you're not what it wants you to be.


I always love when I hear people say "I would start a business if only I had universal healthcare". The easiest response in the world, entrepreneurs being blocked by their own personal healthcare expense is probably exceptionally limited. For one simple reason, if you don't make much money (ie: starting a business) you are likely to be getting free/heavily subsidized healthcare in the first place. However, I do think it is interesting that the claim that you can only start a business by being subsidized by the state in the first place is a real shining star example of an entrepreneur, right?
I see you're at least attempting to stretch my words. I never said anything close to "only", rather that having your healthcare tied to your job reduces your incentives to leave said job.

Let's look at two facts:
1. Percentage wise, the most successful times to start a company are in your mid 30's - 40s. That's also prime age for having a spouse + kids (read higher insurance costs)
2. Healthcare costs are a major expenditure for US families and included in over 60% of bankruptcy filings.

So lets pose a simple question, how in the hell is that not a factor when someone risks their savings and employer contributed insurance when trying to start a venture? The burden on proof is on you if you don't think having cheaper insurance, (whether that be fully market based or M4A) would nudge people to take on additional risk.

Your tone seems to have shifted towards chiding anyone who doesn't become an entrepreneur regardless of their circumstances. Maybe we should shut down startup accelerators/incubators too? Real entrepreneurs don't need the mentorship, networking, and seed money, they'll figure it out regardless.

Neat for you, I'm happy you are able to make living self employed, but if your services are so superior and desirable, while also being morally superior, why not expand? Why not do more good for more people and make yourself more money? Why are your miracles so sparingly spread?

Like I said above, if your skillset is so amazing and ethically superior you should have zero problem expanding it to save the world, right? Give up that one man "business" that is your basement office and expand and rival Pulte or KB!
First the retort is "why don't you start a business of your own?". Then, once you find out someone is in fact a business owner, you question why they aren't Fortune 500 status? This honestly could be material for an SNL skit. Dow 30 or GTFO!

As to your argument about healthcare costs exploding, do you think healthcare in 1980 resembles healthcare in 2020? It is akin to comparing the POS 1954 Chevy to the 2020 Honda Accord.
Nope. Not even in the slightest, in fact it's actually the opposite.

It’s perhaps not surprising that health care expenses have risen over the past three decades. But the main driver of the increase is not drug costs or medical services. In fact, the costs related to medical services have decreased by about a third since the 1980s.

The biggest reason for the increase is insurance costs, which have grown by 740% since 1984, Clever calculates. The average American paid about $3,400 for insurance alone in 2018.
[0]

I'd love to know how the 2020 ibuprofen $60 edition the ER charges you is different than the $0.60 pill from 1980. Does the new one send me a notification when it's been absorbed into my blood?

And finally, to keep this thread on track.

What would it mean for sports cars if wages kept up with productivity? Or if income shares stayed constant? More people would be able to buy sports cars.

In 1980, the top 1% of earners took home 10% of US national income, and the bottom 50% of earners took home 20%. By 2016 however, these positions had reversed: the income share of the top 1% had increased to 20%, and the income share of the bottom 50% had decreased to 13%.

52727




[0] - BLS statistics analyzed by a startup
 

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You what else is killing sports cars, internet bench racers. Armed Google and YouTube clips, anyone can be an expert. Sports cars expert, Real Estate expert, Financial expert, Pandemic expert, etc....
 

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All that means is people are living in smaller homes/condos/townhouses and/or that they are deeper in debt than they were before.
I haven't seen any data to support that. Most older homes are materially smaller than newer homes, and also with less amenities, with a lower overall build quality often.

Companies will likely always hire the lowest risk employee, understandable, but then we're left with potentially yuuuge disparities in marginalized groups. The free market ain't so free if you're not what it wants you to be.
I get what you are saying, and I sympathize when someone can't help that, ie: race or disability. My previous comments were largely directed at choices people make that impact their employability. This is where we talk facial tattoos, purple hair, alienating outspoken opinions etc.

I see you're at least attempting to stretch my words. I never said anything close to "only", rather that having your healthcare tied to your job reduces your incentives to leave said job.
In fairness, you could extend that same line of thinking to "income". The more the state provides for anyone it frees them up to do things they would prefer to do. So sure, state sponsored healthcare, or any other subsistence benefit is going to make it easier to start a business.

Let's look at two facts:
1. Percentage wise, the most successful times to start a company are in your mid 30's - 40s. That's also prime age for having a spouse + kids (read higher insurance costs)
2. Healthcare costs are a major expenditure for US families and included in over 60% of bankruptcy filings.
If you want to dig into that healthcare=bankruptcy statistic, it gets interesting. Generally that statistic is portrayed as healthcare being the factor for the bankruptcy, when in reality it simply means they had healthcare liabilities, without differentiating the severity etc. I would wager cell phone bills are included in over 99%! of bankruptcy filings! Doesn't tell us much, we don't know if that means a 10$ prescription on their credit card, or a $100,000 chemo event.



Nope. Not even in the slightest, in fact it's actually the opposite.

It’s perhaps not surprising that health care expenses have risen over the past three decades. But the main driver of the increase is not drug costs or medical services. In fact, the costs related to medical services have decreased by about a third since the 1980s.

The biggest reason for the increase is insurance costs, which have grown by 740% since 1984, Clever calculates. The average American paid about $3,400 for insurance alone in 2018.
[0]

I'd love to know how the $60 ibuprofen the ER charged me is different than the $0.60 on from 1980.
Citation?

This is my wheelhouse, a lot of the businesses I have been involved in throughout my career are healthcare. We can talk about how reimbursement for certain ICD codes and procedural codes have changed, however the overall cost and consumption of services is way up. The best example is the simple fact that people in bygone decades just didn't survive as long with intensive interventions. If you had breast cancer, you had a mastectomy and some rudimentary chemo and you got better or you got dead. Now, we have all sorts of intervention ranging from more specialized surgical intervention, reconstruction, gene typing, customizing chemo intervention, proton therapy etc. Or hell, we can just talk about the number of hip/knee replacements we now do courtesy of fatties wrecking their wheels.

What would it mean for sports cars if wages kept up with productivity? Or if income shares stayed constant? More people would be able to buy sports cars.

In 1980, the top 1% of earners took home 10% of US national income, and the bottom 50% of earners took home 20%. By 2016 however, these positions had reversed: the income share of the top 1% had increased to 20%, and the income share of the bottom 50% had decreased to 13%.
It's a weak argument when someone argues that wages should be correlated to productivity. Should a CNC machine operator get paid based on what the machine producers? If so, why would the business owner invest the $1MM in a state of the art CNC machine? Why invest in computerization and automation? Productivity has increased because of technological innovation and capital investment, or are you going to suggest that somehow the average worker is putting in bolts twice as fast today as they were 30 years ago?
 

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You what else is killing sports cars, internet bench racers. Armed Google and YouTube clips, anyone can be an expert. Sports cars expert, Real Estate expert, Financial expert, Pandemic expert, etc....
Agreed. The horsepower wars have taken their toll on the sports car. It's a miracle that we still get the Miata and 86 Twins.
 

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By your standards, I'm the model adversity-overcoming posterchild. You must really love someone like me, because as covered elsewhere in this thread:

1) Grew up dirt poor (alcoholic walkout father), paying mortgage and all utilities at 17 on $8/hr. Nobody knew, either.
2) Didn't ruin my life with alcohol, drugs, criminal record, or teen pregnancy.
3) Started working at 14, worked 39 hours per week in high school to pay the mortgage.
4) Put myself through school to get the vaunted chemical engineering degree that people keep talking about in this thread, and from a top 3 pressure cooker program at that; threw in a chem degree too, and still worked 39 hours per week while getting said degrees. Couldn't live on campus either because I needed the insurance provided by my grocery store job near my house. So add 2 hours a day in the car because why not. Lucky me the top chemE program was in my backyard.
5) Bought my own house with zero help.
6) Elected not to spend another $140k on Ivy League education. Even turned down spending ("only") $70k on another top 5 program in the UC system (only two schools I applied to).

Bonus:

7) Wife is a successful first world immigrant, whom I met while living abroad myself.
8) #humblebrag like everyone else because internetz.

Some would say I have earned every right to sit up here in my glass house and throw stones at others, condemning their choices, and telling them to pull up their bootstraps, because I did it. But I don't, because here's where you and I differ. I don't act like I have it all figured out, and I sure don't act like everyone else can just do the same as me. The simple fact that you reduce everything down to "choices" and literally nothing else, and yet indigence persists in society shows that it's simply ignorant, and more importantly, just flat-out incorrect. I acknowledge that not everyone is technically competent enough to "just go get a chemical engineering degree and get a J-O-B like me", and I also acknowledge that not everyone can do it at all while working full-time or even part-time. I also enjoy white privilege, which is very, very real.

Honestly, while I don't know your background (have glossed over much of the thread) it sounds like you either:

1) Have overcome adversity and hold an elitist attitude towards others about it because you assume everyone else should be able to do the same, and if they don't it's due exclusively to "poor choices".
2) Have never actually faced any real adversity.

If 1), you should make room for your positions to evolve. If 2), well, then it speaks for itself, seen that before. Your positions might evolve when you realize life isn't as simple and black and white as you suggest. I don't know your politics, but what I do know is I've seen more than one "bootstrap" touting Republican stop casting this exact same type of holier-than-thou shade unto others when they find themselves in a pretty sh!t situation through no fault of their own. Nothing changes positions and empathic ability more than finding yourself absolutely f*cked through no fault of your own. And yes, there really is such a thing as being absolutely f*cked through no fault of your own.

You are entitled to your opinions, but you most certainly do NOT have it all figured out. You need to understand that there exists a disconnect between your positions and reality, and you need to do some soul searching to understand just why that may be. Hint: it's not that everyone is a lazy slob who made "poor decisions", so there must be other factors.

I'm sure this is a futile post, but it needed to be said. Been poor, beat being poor, and erudite enough to understand it isn't black and white.
The lack of empathy from him is stunning. I too grew up poor. My parents got married at a time when interracial marriages were frowned upon, especially in the Chinese refugee community. They were teenagers when my sister was born. I spent my formative years bouncing between government assisted housing (Regent Park for the Canadians here) and Sick Kids hospital. I know the feeling of gnawing hunger and roaches crawling over you while you try to sleep. Do you know what got us out of that? I would love to say it was purely my parents' grit, but it wasn't. It was socialized medicine. It was public education. It was government funded childcare and after school programs. It was affordable post-secondary education and housing. It was public transit where fares were not increasing 5 - 10% per year. It was scholarships and bursaries. We are robbing our future generations by allowing wealth inequality to grow.
 

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In fairness, you could extend that same line of thinking to "income". The more the state provides for anyone it frees them up to do things they would prefer to do. So sure, state sponsored healthcare, or any other subsistence benefit is going to make it easier to start a business.
If you want to miss the point entirely, feel free to extend it.

The US is one of the only nations of our stature that directly ties your health insurance to your employer. It's a perverse incentive. And it honestly wouldn't be a big deal if US healthcare was affordable, but it's not. So it's fair to assume when something as essential as health insurance is provided by your job, you're less likely to leave said job to take on any sort of risk.

If you want to dig into that healthcare=bankruptcy statistic, it gets interesting. Generally that statistic is portrayed as healthcare being the factor for the bankruptcy, when in reality it simply means they had healthcare liabilities, without differentiating the severity etc. I would wager cell phone bills are included in over 99%! of bankruptcy filings! Doesn't tell us much, we don't know if that means a 10$ prescription on their credit card, or a $100,000 chemo event.
C'mon, at least put some effort in if I am. The statistic is for the primary reason, not some ancillary charge like your Hulu bill that you also couldn't pay and tacked on. It's why you are filing for bankruptcy in the first place. Credit card debt for unpaid bills is 3rd or 4th reason for filing IIRC.

The American Journal of Public Health (AJPH) from the American Public Health Association (APHA) publications

Citation?

This is my wheelhouse, a lot of the businesses I have been involved in throughout my career are healthcare. We can talk about how reimbursement for certain ICD codes and procedural codes have changed, however the overall cost and consumption of services is way up. The best example is the simple fact that people in bygone decades just didn't survive as long with intensive interventions. If you had breast cancer, you had a mastectomy and some rudimentary chemo and you got better or you got dead. Now, we have all sorts of intervention ranging from more specialized surgical intervention, reconstruction, gene typing, customizing chemo intervention, proton therapy etc. Or hell, we can just talk about the number of hip/knee replacements we now do courtesy of fatties wrecking their wheels.
Homie, those services are already included in the stat linked above, which was for all medical procedures. And those (now) outdated treatments were more expensive and state of the art back then, yet still cost less relatively.

BTW those exact same knee surgeries are 40%-75% cheaper in fellow developed countries such as New Zealand and Holland. I'm sure that ibuprofen pill is 40-75% cheaper too. [1]

You want to get crazier? In India a pulmonary thromboendarterectomy costs $10,000. Here? $200,000

And it's no less safe: About 1.4 percent of Narayana patients die within 30 days following a heart bypass, according to the Commonwealth Fund, which studies public health, compared with 1.9 percent in the U.S. Narayana also outperforms Western systems in results for valve replacements and heart-attack treatment, the group found. [2]

So it's apparent that our healthcare quality isn't better for the vast majority of services, yet we're 2-20x more expensive. The US is a cluster**** of price obscurity, price inflation, rent seeking, and lack of competition. It's not quite a free market, and not quite socialized, the worst of two worlds. And we have a looooot of people getting rich from it, many here in Nashville. Problem is, It's gotten to the point where it's side effects are chewing up a significant % of American's finances.

It's a weak argument when someone argues that wages should be correlated to productivity. Should a CNC machine operator get paid based on what the machine producers? If so, why would the business owner invest the $1MM in a state of the art CNC machine? Why invest in computerization and automation? Productivity has increased because of technological innovation and capital investment, or are you going to suggest that somehow the average worker is putting in bolts twice as fast today as they were 30 years ago?
Why was it okay to correlate the two up until the 1970s then? Machines have been assisting worker productivity for over 200 years! Who cares if the machine has gotten better, the worker is still doing the same job.

Will you suggest the factory owner is twice as intelligent as he was 30yrs ago? Or is he working twice as many hours? Nope. He's just alive during a time of increased automation, just like the worker. Hell, maybe the excess profits should be paid to the CNC machine inventor who is far more responsible for his increased share of income?

[1] International comparisons of health care prices from the 2017 iFHP survey

[2] Bloomberg - Are you a robot?
 

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It's a weak argument when someone argues that wages should be correlated to productivity. Should a CNC machine operator get paid based on what the machine producers? If so, why would the business owner invest the $1MM in a state of the art CNC machine? Why invest in computerization and automation? Productivity has increased because of technological innovation and capital investment, or are you going to suggest that somehow the average worker is putting in bolts twice as fast today as they were 30 years ago?
Have you ever run a CNC machine? Unless it's plastic or brass the operator makes a difference. Not to mention machines need to be programmed, they can walk on tolerance, workpieces need to be set up. Try setting up a 5 axis job with .050" clearance, even with a probe it gets a little scary. I posted earlier that at the most entry level it's easy, but it gets a lot more complex as you climb the ladder. The shop I used to work at had one guy who could efficiently run 4 screw machines, he left in the summer and they haven't found a comparable replacement yet. Same goes for carpentry, working on cars, anything technical. Sure, technology makes the job more efficient, but productivity will lie in the worker.
 

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x50,000. I say this despite our company being, without a doubt, more productive when people were in the office. I know many people feel they are more productive (and I don't doubt that), but it's much harder for ideas to be generated and shared, for work to be distributed, and just generally for collaboration to happen. Teamwork is a force multiplier, any increase in individual productivity is more than offset by the amount that has diminished.

Still, we passed on an office expansion pre-COVID and I genuinely feel bad for our neighbor that took it. Work at home may have diminished overall productivity, but disgruntling staff that are convinced work at home works by forcing them to come back full time isn't a viable solution. We don't know how we're going to handle the post-COVID world, but new office space is out of the question entirely, and if it weren't for 10-yr leases we'd probably drop our 1st annex. Fortunately the leases are generally long, otherwise I think we'd see a pretty big vacuum.
We had some acquisitions and my company just took on a new lease in a brand new class A office last year. We’ve probably been no more than 30% occupancy for most of this year. I know it’s got to be burning them up. We were fortunate to avoid the revenue issues many have had, so it’d be more of an aggravation than a need.

Overall, I’ve seen fewer lease amendments/modifications than I’d expect so far. Unfortunately, theres the rare BK. It’s definitely going to trend down over the next several years.
 

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In an attempt to reconcile here and then discuss sports cars, might I offer :

1) we have significant income inequality in this country. That is a fact.
2) we have always had income inequality. It is more stark now in part due to the massive gains at the top, not because the bottom has crashed. The issue is relative gains.
3) the same goes for wealth inequality, a fact that has been made worse by policies to fight recessions in multiple decades since the 70s.

Now, even with the finger pointing herein, I have learned a great deal from both sides of this argument/ discussion, and I greatly respect you all for what you do, have done, and how you think and care. I’m more inspired than ever to make the world a better in any way I can, starting with treating you all with the dignity you deserve. But arguing who is at fault, on a personal level, does very little. We each take personal offense when generalized to be part of the problem or failing to properly take advantage of this or that opportunity. People take action based on many factors. The realty is that GDP has always grown faster than median incomes in times of recession, as shown by the graph below. Those of us in our 20s felt it in that period 1986-1995. Those in their 20-30s now felt it from 2008-2012. It is hard to have empathy when you’re being talked down to. But we get it. And we’re all more alike that we are different.




So, GIVEN that we have income and wealth inequality (and putting aside the blame game), and noting that median income in the US has risen significantly since 2012 (graph), it seems there certainly is SOMEONE that might buy sports cars (recall that median is not average, so it isn’t just highest earners pulling that graph up).

So, have sports car sales declined because

A) they are too expensive or

B) other cars have gotten so much better that they provide all the sportiness most need.

I contend “B”, in that 40 years ago a sedan or truck was a miserable drive compared to a sports car. Today, a nice sporty crossover provides great handling, acceleration, and braking. It also lets you take vacations, haul stuff, move family, and get all that extra “utility” you get from the “U” in CUV or SUV.

And I’m sure many of you prefer (C) “all of the above”, but that’s the easy answer ;-)

Discuss.
 

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In an attempt to reconcile here and then discuss sports cars, might I offer :

1) we have significant income inequality in this country. That is a fact.
2) we have always had income inequality. It is more stark now in part due to the massive gains at the top, not because the bottom has crashed. The issue is relative gains.
3) the same goes for wealth inequality, a fact that has been made worse by policies to fight recessions in multiple decades since the 70s.

Now, even with the finger pointing herein, I have learned a great deal from both sides of this argument/ discussion, and I greatly respect you all for what you do, have done, and how you think and care. I’m more inspired than ever to make the world a better in any way I can, starting with treating you all with the dignity you deserve. But arguing who is at fault, on a personal level, does very little. We each take personal offense when generalized to be part of the problem or failing to properly take advantage of this or that opportunity. People take action based on many factors. The realty is that GDP has always grown faster than median incomes in times of recession, as shown by the graph below. Those of us in our 20s felt it in that period 1986-1995. Those in their 20-30s now felt it from 2008-2012. It is hard to have empathy when you’re being talked down to. But we get it. And we’re all more alike that we are different.




So, GIVEN that we have income and wealth inequality (and putting aside the blame game), and noting that median income in the US has risen significantly since 2012 (graph), it seems there certainly is SOMEONE that might buy sports cars (recall that median is not average, so it isn’t just highest earners pulling that graph up).

So, have sports car sales declined because

A) they are too expensive or

B) other cars have gotten so much better that they provide all the sportiness most need.

I contend “B”, in that 40 years ago a sedan or truck was a miserable drive compared to a sports car. Today, a nice sporty crossover provides great handling, acceleration, and braking. It also lets you take vacations, haul stuff, move family, and get all that extra “utility” you get from the “U” in CUV or SUV.

And I’m sure many of you prefer (C) “all of the above”, but that’s the easy answer ;-)

Discuss.
Solid post....

As for cars...I think both...cars are so expensive nowadays...my 2002 f350 was 42.k brand new...the new one I just built was 82k... technology and creature comforts have made huge strides....and with that comes the hefty price tag of all that tech....also I think cars are more sporty...I mean look at some some of the "sporty" SUV's out there...if you can have a family car that is a blast to drive and only have 1 car payment....kind of a no brainier for non enthusiasts...
 

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The whole thread can largely be summed up by:

Most rich people say that it's "easier than ever" to get rich because there are more rich people than ever, therefore the only problem for the 90% of "have-nots" is that they're stupid/lazy. It's possible to get rich from nothing, hence the world is perfect.

The rest of us see that humanity has collectively created a ton of wealth and great things and don't understand why ~10% of folks get the vast majority of the benefits from those efforts - far far far beyond how much better they are than everyone else, regardless of what their inflated egos might think. There's plenty of wealth in the world, why do we still have poor people?

Answer: The rich make the rules.

There's enough wealth in this country for every household to have a sports car, but the Daves have to have 5+ of them because they're 5+ times better than us. He worked SEVENTY HOURS! Never mind that my mom does too, and still does at 58 years old... doing actual physical labor... For $12.xx/hr. There's no reason for that to be happening in 2020.
 

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If you want to miss the point entirely, feel free to extend it.
Not looking to go down the rabbit hole of single payer healthcare and its implications to wider economic activity, we can do that if you want, just PM me but we are already far enough off topic. Suffice to say that the more government assistance, of any kind, that is provided will enable more people to be "flexible" with their career choices.

C'mon, at least put some effort in if I am. The statistic is for the primary reason, not some ancillary charge like your Hulu bill that you also couldn't pay and tacked on. It's why you are filing for bankruptcy in the first place. Credit card debt for unpaid bills is 3rd or 4th reason for filing IIRC.
I didn't get passed the paywall, what I will tell you though is that you are citing a source that is largely based on anecdotal and incomplete evidence from an extremely biased source (Public Health Association). It's like asking the Koch Foundation what their opinion of environmental change should be, we both know the answer before they even do any research.


Homie, those services are already included in the stat linked above, which was for all medical procedures. And those (now) outdated treatments were more expensive and state of the art back then, yet still cost less relatively.
I honestly don't follow what you are trying to say here honestly. Take aneurysm coiling, medicare reimbursement for that in the early 80's was ~$22,000 for the professional service, today it is ~$550 around these parts. The problem is that in the 1980's we didn't have the treatment and options that exist today. How many people in the 80's did you hear about getting multiple joint replacements? How many people did you know getting common place cardiac stenting? Or we can talk about cancer treatment. Moreover, look at the overall health of society in 1980 compared to 2020. Our healthcare is more expensive because we are consuming vastly larger amounts of healthcare more than anything else.

BTW those exact same knee surgeries are 40%-75% cheaper in fellow developed countries such as New Zealand and Holland. I'm sure that ibuprofen pill is 40-75% cheaper too. [1]
Total knee replacement in Germany is ~$18000E, which is ~$21,000. Roughly similar in all of western Europe. In the US it can range higher than that, to lower than that. Go look at Surgery Center of OK, cash price of $16k all in. Think about that in the context of your argument. The private surgical center, which accepts no insurance, is cheaper than medicare which is collapsing financially and is getting harder and harder to find qualified physicians to accept it.

You want to get crazier? In India a pulmonary thromboendarterectomy costs $10,000. Here? $200,000

So it's apparent that our healthcare quality isn't better for the vast majority of services, yet we're 2-20x more expensive. The US is a cluster**** of price obscurity, price inflation, rent seeking, and lack of competition. It's not quite a free market, and not quite socialized, the worst of two worlds. And we have a looooot of people getting rich from it, many here in Nashville. Problem is, It's gotten to the point where it's side effects are chewing up a significant % of American's finances.
You realize when you quote a PTE you are way out in the weeds, right? That's a highly specialized procedure that is usually only done in Tier1 facilities, at not commonly. So it is going to be all over the place in terms of pricing. Again, don't want to get too deep into the healthcare weeds here, but look at Tenncare here in Nashville. Go find a good physician willing to take it, please, I will wait. They aren't there. Go find a Mohs surgeon willing to touch Medicare, good luck. The socialized models are failing in both cost containment and patient access. I own medical facilities, I sit on the board of major healthcare operators, the reality is that Medicare is a money loser for providers. We don't want them. Same with medicaid, for slightly different reasons. So the idea that socialized medicine and pricing dictating is working just isn't. Moreover, you can't compare even Medicaid to foreign national health plans. Do you have any idea how the Tenncare formulary compares with the NHS formulary? It is night and day.

Why was it okay to correlate the two up until the 1970s then? Machines have been assisting worker productivity for over 200 years! Who cares if the machine has gotten better, the worker is still doing the same job.

Will you suggest the factory owner is twice as intelligent as he was 30yrs ago? Or is he working twice as many hours? Nope. He's just alive during a time of increased automation, just like the worker. Hell, maybe the excess profits should be paid to the CNC machine inventor who is far more responsible for his increased share of income?
What changed in the 70's? Anything jump out at you? Oh yea, European and Asian competition emerged on the global scene. Prior to that labor in the US had all the leverage in negotiation. Look at the steel industry as a classic example. The USW fought the automation and retooling of the steel industry tooth and nail, why? It would have reduced employment through automation. As a result, the Japanese and Korean mini-mills ate their lunch and ended up effectively bankrupting the domestic steel industry. Additionally the cost of technological improvements began to climb as well as their benefits.

It doesn't matter if the factory owner is more or less intelligent, the enterprise is investing and performing and the owner of anything is the one entitled to the profits. You don't get to be employed labor who is guaranteed compensation and get a share of the profits without the capital risk. If you want to be a shareholder, be a shareholder, if you want to be an employee, be an employee. You don't get the best of both worlds.

The CNC machine inventory, or at least first innovator in the field, John Parsons made quite a bit of money through his invention. Patents don't last forever though. You don't think the companies and individuals who come up with these efficiency and productivity improvements make enormous sums of money? Ask Bill Gates.

Have you ever run a CNC machine? Unless it's plastic or brass the operator makes a difference. Not to mention machines need to be programmed, they can walk on tolerance, workpieces need to be set up. Try setting up a 5 axis job with .050" clearance, even with a probe it gets a little scary. I posted earlier that at the most entry level it's easy, but it gets a lot more complex as you climb the ladder. The shop I used to work at had one guy who could efficiently run 4 screw machines, he left in the summer and they haven't found a comparable replacement yet. Same goes for carpentry, working on cars, anything technical. Sure, technology makes the job more efficient, but productivity will lie in the worker.
I am no machinist. What I can however tell you is that the best machinist in the world isn't going to be anywhere near as productive without a CNC machine as they are with one. That's why the business owner spends a few million bucks on a state of the art CNC setup rather than hiring another dozen machinist.
 

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Thanks Dave for trying to get it back on track.

I’m gonna go with B. You can press a CX5 into some corners and have fun. The same isnt true for a 70’s Suburban. You’d need to have a family hauler, and a fun car. Now with the right SUV, you can have both.

But what would I know. I only have one refrigerator
 

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So, have sports car sales declined because

A) they are too expensive or

B) other cars have gotten so much better that they provide all the sportiness most need.
Not mutually exclusive. With sport sedans and coupes, the 2-seater market has diminished to those with such an emotional connection they're willing to ignore the reasonable part of their brain to have one. Manufacturers don't want unsold units, so they shrink production. With fewer units to distribute cost over, we all know what happens to the price.

Not to mention it was always a low volume industry, and increasing regulation favors higher volume. Sports cars dodge some regulations for being low volume (like crash testing), but not a lot of them. I actually really like what the NHTSA and EPA have done for the industry as a whole, but I do think sports cars had to sacrifice a bit for that progress to be made.
 

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Nope. Not even in the slightest, in fact it's actually the opposite.

It’s perhaps not surprising that health care expenses have risen over the past three decades. But the main driver of the increase is not drug costs or medical services. In fact, the costs related to medical services have decreased by about a third since the 1980s.

The biggest reason for the increase is insurance costs, which have grown by 740% since 1984, Clever calculates. The average American paid about $3,400 for insurance alone in 2018.
[0]

I'd love to know how the 2020 ibuprofen $60 edition the ER charges you is different than the $0.60 pill from 1980. Does the new one send me a notification when it's been absorbed into my blood?

And finally, to keep this thread on track.

What would it mean for sports cars if wages kept up with productivity? Or if income shares stayed constant? More people would be able to buy sports cars.

In 1980, the top 1% of earners took home 10% of US national income, and the bottom 50% of earners took home 20%. By 2016 however, these positions had reversed: the income share of the top 1% had increased to 20%, and the income share of the bottom 50% had decreased to 13%.

View attachment 52727



[0] - BLS statistics analyzed by a startup

52853


Its here. The administrators/insurance are the issue. Cant live with em, cant live without. Administrators received more money than the physicians administering the care last year. Let that sink in. Yes PharmD's, Nurses etc are vital but the hospital cannot exist, function or get paid without MD's driving the care. All that being said, a CABG paid between 4-5k in actual 1990 dollars. Its about 3k now. Reimbursment for cardiac services has not even kept up with inflation. Its all the suits and the powers that be.

As an aside, I've been a patient now. When I got the bill there were four columns. Like WTF. So complex.


If you want to miss the point entirely, feel free to extend it.

The US is one of the only nations of our stature that directly ties your health insurance to your employer. It's a perverse incentive. And it honestly wouldn't be a big deal if US healthcare was affordable, but it's not. So it's fair to assume when something as essential as health insurance is provided by your job, you're less likely to leave said job to take on any sort of risk.



C'mon, at least put some effort in if I am. The statistic is for the primary reason, not some ancillary charge like your Hulu bill that you also couldn't pay and tacked on. It's why you are filing for bankruptcy in the first place. Credit card debt for unpaid bills is 3rd or 4th reason for filing IIRC.

The American Journal of Public Health (AJPH) from the American Public Health Association (APHA) publications



Homie, those services are already included in the stat linked above, which was for all medical procedures. And those (now) outdated treatments were more expensive and state of the art back then, yet still cost less relatively.

BTW those exact same knee surgeries are 40%-75% cheaper in fellow developed countries such as New Zealand and Holland. I'm sure that ibuprofen pill is 40-75% cheaper too. [1]

You want to get crazier? In India a pulmonary thromboendarterectomy costs $10,000. Here? $200,000

And it's no less safe: About 1.4 percent of Narayana patients die within 30 days following a heart bypass, according to the Commonwealth Fund, which studies public health, compared with 1.9 percent in the U.S. Narayana also outperforms Western systems in results for valve replacements and heart-attack treatment, the group found. [2]

So it's apparent that our healthcare quality isn't better for the vast majority of services, yet we're 2-20x more expensive. The US is a cluster**** of price obscurity, price inflation, rent seeking, and lack of competition. It's not quite a free market, and not quite socialized, the worst of two worlds. And we have a looooot of people getting rich from it, many here in Nashville. Problem is, It's gotten to the point where it's side effects are chewing up a significant % of American's finances.



Why was it okay to correlate the two up until the 1970s then? Machines have been assisting worker productivity for over 200 years! Who cares if the machine has gotten better, the worker is still doing the same job.

Will you suggest the factory owner is twice as intelligent as he was 30yrs ago? Or is he working twice as many hours? Nope. He's just alive during a time of increased automation, just like the worker. Hell, maybe the excess profits should be paid to the CNC machine inventor who is far more responsible for his increased share of income?

[1] International comparisons of health care prices from the 2017 iFHP survey

[2] Bloomberg - Are you a robot?
Quoting Indian cardiac outcome studies to here is laughable. Why did you pick a CTPE? If you come in with a quick PE and I do a emergent pulmonary embolectomy, its in the 20-40k range. If you have CTPE, you need plenty of preop testing and a circulatory arrest case. I can absolutely guarantee that outside of UCSD and CCF theres not 50 done in the US a year, so its weird you chose that. And Narayna is the top hospital in india, so the top hosptial outperforms all of america averaged by half percent (and who knows if thats a propensity matched study, probably not) - in India you dont have 87 year olds on death doorstep that eveyone says 'do what you can for grandma' because no one is allowed to die in the US.


Not looking to go down the rabbit hole of single payer healthcare and its implications to wider economic activity, we can do that if you want, just PM me but we are already far enough off topic. Suffice to say that the more government assistance, of any kind, that is provided will enable more people to be "flexible" with their career choices.



I didn't get passed the paywall, what I will tell you though is that you are citing a source that is largely based on anecdotal and incomplete evidence from an extremely biased source (Public Health Association). It's like asking the Koch Foundation what their opinion of environmental change should be, we both know the answer before they even do any research.




I honestly don't follow what you are trying to say here honestly. Take aneurysm coiling, medicare reimbursement for that in the early 80's was ~$22,000 for the professional service, today it is ~$550 around these parts. The problem is that in the 1980's we didn't have the treatment and options that exist today. How many people in the 80's did you hear about getting multiple joint replacements? How many people did you know getting common place cardiac stenting? Or we can talk about cancer treatment. Moreover, look at the overall health of society in 1980 compared to 2020. Our healthcare is more expensive because we are consuming vastly larger amounts of healthcare more than anything else.



Total knee replacement in Germany is ~$18000E, which is ~$21,000. Roughly similar in all of western Europe. In the US it can range higher than that, to lower than that. Go look at Surgery Center of OK, cash price of $16k all in. Think about that in the context of your argument. The private surgical center, which accepts no insurance, is cheaper than medicare which is collapsing financially and is getting harder and harder to find qualified physicians to accept it.



You realize when you quote a PTE you are way out in the weeds, right? That's a highly specialized procedure that is usually only done in Tier1 facilities, at not commonly. So it is going to be all over the place in terms of pricing. Again, don't want to get too deep into the healthcare weeds here, but look at Tenncare here in Nashville. Go find a good physician willing to take it, please, I will wait. They aren't there. Go find a Mohs surgeon willing to touch Medicare, good luck. The socialized models are failing in both cost containment and patient access. I own medical facilities, I sit on the board of major healthcare operators, the reality is that Medicare is a money loser for providers. We don't want them. Same with medicaid, for slightly different reasons. So the idea that socialized medicine and pricing dictating is working just isn't. Moreover, you can't compare even Medicaid to foreign national health plans. Do you have any idea how the Tenncare formulary compares with the NHS formulary? It is night and day.



What changed in the 70's? Anything jump out at you? Oh yea, European and Asian competition emerged on the global scene. Prior to that labor in the US had all the leverage in negotiation. Look at the steel industry as a classic example. The USW fought the automation and retooling of the steel industry tooth and nail, why? It would have reduced employment through automation. As a result, the Japanese and Korean mini-mills ate their lunch and ended up effectively bankrupting the domestic steel industry. Additionally the cost of technological improvements began to climb as well as their benefits.

It doesn't matter if the factory owner is more or less intelligent, the enterprise is investing and performing and the owner of anything is the one entitled to the profits. You don't get to be employed labor who is guaranteed compensation and get a share of the profits without the capital risk. If you want to be a shareholder, be a shareholder, if you want to be an employee, be an employee. You don't get the best of both worlds.

The CNC machine inventory, or at least first innovator in the field, John Parsons made quite a bit of money through his invention. Patents don't last forever though. You don't think the companies and individuals who come up with these efficiency and productivity improvements make enormous sums of money? Ask Bill Gates.



I am no machinist. What I can however tell you is that the best machinist in the world isn't going to be anywhere near as productive without a CNC machine as they are with one. That's why the business owner spends a few million bucks on a state of the art CNC setup rather than hiring another dozen machinist.

I like you. You have a good sense of things.
 

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Thread confirms the following:

Dave_Car_Guy is a wealthy dude with empathy and from his posts that mention his upbringing and life path, that empathy comes from growing up in poverty and overcoming those barriers on his path towards wealth accumulation. Dave_Car_Guy gives a **** and I like Dave_Car_Guy

Bave is a wealthy dude who lacks empathy and from his posts that mention his upbringing and life path, that lack of empathy comes from growing up with privilege and security and having no structural barriers in the way of his path towards wealth accumulation. Bave doesn’t give a **** and I do not like Bave.

People like Bave use their positions, vote, and ideology in ways that directly prevent more people like Dave_Car_Guy from gaining wealth, let alone financial stability. This is a zero-sum game.

Anyway. Sports cars are dying because of market forces, which are largely dictated by boardroom maths and industry-intertwined policy, and much less so by personal car buying public opinion and choice. I’m gonna drive my supercharged Audi to the storage garage and get my E30 out with the roof off. It’s sunny out in ****sburgh, finally.. probably one of the last good days of the year for this!
 
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