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Do we expect more applications (more people willing to go into medicine) and increased competition?

Do we expect lower salaries for future doctors as physicians and surgeons will no longer fight lower pay as they have no big loans to pay?

In other words, do we expect complete turmoil for future pre-medical students?
 
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Big difference in undergrad and professional/terminal degrees.
This is something that I definitely thought of at first, but she didn't specify whether free tuition would be given to undergraduate vs. graduate schools, which leads me to think she plans on free tuition in all public universities regardless of the degree. Or perhaps, she avoids saying that she "will give free tuition to only undergraduates" so as to foster up more votes.

But this is besides the point, if it so happens that medical school becomes free, what are the potential consequences and the future challenges for medicine?
 

Commer_Knocker

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There's def a bent towards undergrad when these types of statements are made. But that's because comparatively few ppl go to prof/grad school. I could see reduced prof/grad tution being part of this plan, should she be elected. I could also see free tution. I could also see nothing getting done, because of partisan government infighting or a lack of resolve.

Better keep doing your FAFSA.
 

LizzyM

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Between rising federal and local taxes to pay for "free" school and "free" and subsidized health insurance (keep in mind that the ACA is covering health care costs for a growing proportion of the US population) your income will be taxed in the extreme and on top of that your income will be shrinking due to a clamp-down on payments to providers with no crying allowed about the need for generous compensation to make up for the high cost of student loan debt.

I would only hope that with declining income from medicine, the profession will lose some of its prestige and desirability; as a result, we may find that only those truly interested for the good of the patients will pursue the profession. Just like the old days (pre WWII).
 

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while getting eaten by a shark and getting hit by lightning!

The chances of this happening are lower that me winning both the Powerball and Mega Millions simultaneously (those odds aren't great either).
 

aldol16

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Interesting proposition. I don't think financial issues are keeping too many medical applicants out now. There will certainly be some who will work for several years to save up money for school, but most medical students take out loans anyway. So I don't think applicant volume will change much even if it were free. Though it is possible that medical school being free may attract more people to the profession because of the free schooling but I doubt the most qualified applicants now are being turned off because of tuition. So even if applicant volume swells due to more unqualified people applying, matriculant volume shouldn't change much unless medical schools want to lower their standards.

But unless Bernie has changed his name to Hilary recently, this is not happening anytime soon.
 
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Do we expect more applications (more people willing to go into medicine) and increased competition?

Do we expect lower salaries for future doctors as physicians and surgeons will no longer fight lower pay as they have no big loans to pay?

In other words, do we expect complete turmoil for future pre-medical students?
First, Hillary Clinton wouldn't make medical school tuition-free. There's already a surplus of medical students, and unlike a college degree, a medical degree is not necessary to be competitive in the modern workforce unless you want to be a doctor. As LizzyM stated, taxes would increase dramatically. Tuition would only be free at state medical schools, so there'd be fierce competition at schools that used to be people's best option. Meanwhile, applications would decrease at private schools. They'd be forced to cut services and tuition to woo applicants. Also, I don't expect lower salaries for quite some time. I don't think anyone would choose not to fight a pay cut!
 
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Lucca

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First, Hillary Clinton wouldn't make medical school tuition-free. There's already a surplus of medical students, and unlike a college degree, a medical degree is not necessary to be competitive in the modern workforce unless you want to be a doctor. As LizzyM stated, taxes would increase dramatically. Tuition would only be free at state medical schools, so there'd be fierce competition at schools that used to be people's best option. Meanwhile, applications would decrease at private schools. They'd be forced to cut services and tuition to woo applicants. Also, I don't expect lower salaries for quite some time. I don't think anyone would choose not to fight a pay cut!
Would the increase be dramatic? It's worth taking a deeper look even though I agree Clinton would not make medical school tuition free. Given our current healthcare model there is no incentive or real reason to do so and given her politics it is even less likely since she doesnt support the changes that would get our system to the place where it would make sense for medical school to be free.

There are 87,000 medical students in the US. The average cost to attend one year of medical school is about 45,000 a year. Thats about 15.7 billion dollars to fund four years of medical school expenses for every medical student in the country attending a private or public school. Or, 3.9 billion dollars a year. Such a program would have to fund both private and public medical school students to an equal extent, though students at private school would either have to take loans above a fixed amount or pay out of pocket for the difference if private schools themselves dont cut costs to meet a normalized tuition line.

Ok so we have a public cost of 3.9 billion dollars a year. Seems like a lot, but not really.

Ok, let's assume the likeliest case where US military spending isn't cut. In fact, it'll likely rise in the same way it does almost every year. So the federal govt. needs to find 3.9 billion dollars and we aren't going to cut any existing programs so let's tax the people. There are a million and one ways to do this (you can tax businessess, maybe even health insurers, instead of individuals to give one example.) but let's pick the simplest tax to raise: federal income tax. There are 122 million american taxpayers. Let's follow the simple assumption that every single one of them would pay for this equally (which is, of course, not representative of reality). This means that each american taxpayer would pay about 32 more dollars in federal income tax every year to fund this "Med-School for everyone!" program. A more realistic scenario is that the bottom bracket taxpayers pay something like 16 more $ / year for the program and the top brackets pay like 64$ / yr just to give some estimates.

This is not a dramatic increase in taxes. It's hardly an increase at all. It's a pittance. It also doesn't count the reduction in administrative costs from eliminating federal loans for medical school altogether on the med school and government lender side.

That being said, there are other ways to fund this kind of initiative. None of which, however, make sense when our system isn't really geared to meeting the healthcare needs of the whole public. This kind of thing would have to come after serious healthcare reform.

One fantastic way to pay for everything would be to pass legislation to let the U.S. government, the largest purchaser in the healthcare market, to actually bargain for drug prices lowering costs and freeing up money to, say, build a *truly* public healthcare option in the US.

edit: removed the bit about F-35's, the planes actually cost about 100 million / plane 8.5 billion worth were purchased by the US government in FY-2015. So to ammend my previous statement, one way to fund these costs would be to not purchase F-35s for two years (~120 fewer F-35s)

edit 2: removed a math error. Previous estimate calculated the tax increase necessary to fund four years of medical school but had taxes being collected in one year. Now taxes collected in one year pay for one year of medical school for 87,000 medical students.
 
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Wow, people really do believe everything that comes across their TV.
 

Kpw101

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Ok so we have a public cost of 15.7 billion dollars. Seems like a lot, but not really. It's less than the cost of 2 F-35 fighter jets. If we build 2 fewer F-35s every year than we do now we can fund free medical school for every student in the country indefinitely without any increases in taxes. In fact, we would have 2.3 billion dollars in surplus to ...idk, give a small stipend to medical students?
The average F-35 Jet cost a little under 200 million, not 7.5 billion: That would be absurd. Cutting the production of 15.7 billion dollars worth of Military tech a year would lead to a decline in U.S military power that we all take for granted. Taxing people an extra 100-200 a year equally to pay for our medical school is wishful thinking; Given that it is actually possible to do this the money would be better spent on a better endeavor (subsidized housing, covering healthcare costs for the less fortunate). After medical school and residency, doctors are considered to be one of the highest paid people in the country. I think I'm okay with the tuition costs.
 

LizzyM

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edit: removed the bit about F-35's, the planes actually cost about 100 million / plane 8.5 billion worth were purchased by the US government in FY-2015. So to ammend my previous statement, one way to fund these costs would be to not purchase F-35s for two years (~120 fewer F-35s)
Easy for you to say if F-35s or their parts are not made in your district. The unemployment that comes with a cutback in defense spending is not pretty and it hurts both working class (fabricators) and middle class (engineers) alike. The pain is then felt across entire communities as the buying power of unemployed workers declines and they take lower paying jobs or move elsewhere. I've lived it through family members and I get a pain in my stomach thinking about it.
 

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The average F-35 Jet cost a little under 200 million, not 7.5 billion: That would be absurd. Cutting the production of 15.7 billion dollars worth of Military tech a year would lead to a decline in U.S military power that we all take for granted. Taxing people an extra 100-200 a year equally to pay for our medical school is wishful thinking; Given that it is actually possible to do this the money would be better spent on a better endeavor (subsidized housing, covering healthcare costs for the less fortunate). After medical school and residency, doctors are considered to be one of the highest paid people in the country. I think I'm okay with the tuition costs.
Yah I fixed the bit about F-35s they actually cost about 100 million dollars / jet now apparently. I agree, it doesnt make any sense for medical school to be free right now, that money is better off elsewhere. Like I said in my post, this only makes sense in a specific type of system, particularly one designed to actually serve the whole public.
 
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Lucca

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Easy for you to say if F-35s or their parts are not made in your district. The unemployment that comes with a cutback in defense spending is not pretty and it hurts both working class (fabricators) and middle class (engineers) alike. The pain is then felt across entire communities as the buying power of unemployed workers declines and they take lower paying jobs or move elsewhere. I've lived it through family members and I get a pain in my stomach thinking about it.
I dont think this argument holds any water at all. These are separate issues. The claim I targeted was that such a program would mean a *dramatic* increase in taxes which is just demonstrably false, and assumes the cost has to be footed by the public which is not necessarily the case. It would hurt the economy in the sense that high-tech industry relies very heavily on public subsidy via the federal government, especially military spending. However, there are a million things the government does that hurt the economy, and the working and middle classes. Ordering fewer jets from Lockheed isn't going to deliver a heavier blow to US manufacturing than 100 other things the government already actually does. It is a separate discussion. I used the military spending example to highlight that "this isn't a lot of money, we spend way more on other stuff regularly."
 

LizzyM

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I dont think this argument holds any water at all. These are separate issues. The claim I targeted was that such a program would mean a *dramatic* increase in taxes which is just demonstrably false, and assumes the cost has to be footed by the public which is not necessarily the case. It would hurt the economy in the sense that high-tech industry relies very heavily on public subsidy via the federal government, especially military spending. However, there are a million things the government does that hurt the economy, and the working and middle classes. Ordering fewer jets from Lockheed isn't going to deliver a heavier blow to US manufacturing than 100 other things the government already actually does. It is a separate discussion. I used the military spending example to highlight that "this isn't a lot of money, we spend way more on other stuff regularly."

And the increase in taxes would be not just from free med school but free undergrad and, no doubt, free graduate programs in nursing, various types of therapy, etc. We'd soon be headed to a income tax similar to those in most of Europe. http://www.bbc.com/news/magazine-26327114

I'm just saying that cutting spending in one place (military jets) to spend it in another has consequences. We'd better knock it off before this party gets moved to the lounge.
 

Lucca

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I'm just saying that cutting spending in one place (military jets) to spend it in another has consequences. We'd better knock it off before this party gets moved to the lounge.
Sure it does, obviously, I'll stop it here but I think if you look you will find that not all spending is created equal in terms of job creation or how much of the money actually goes to public services and public employment.
 

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As LizzyM stated, taxes would increase dramatically.
It's not often that I find reason to amend @LizzyM but here it is. You can read a rather dry analysis of Clinton's tax policy proposal here. Excerpt:

Clinton has proposed several changes that would increase taxes on high-income households. She would enact a 4 percent surcharge on AGI in excess of$5 million($2.5 million for married couples filing separately).

Clinton would also impose a minimum tax of 30 percent of AGI on filers with AGI greater than $1 million (i.e., the Buffett Rule). Taxes counted toward the new minimum tax requirement include:regular income taxes(after certain credits and including the Affordable Care Act surtax on net investment income), the alternative minimum tax (AMT),the 4 percent surcharge on AGI,and the employee portion of the payroll tax.4Taxpayers with AGI over $2 million would owe an additional tax on the difference between30 percent of AGI and the sum of those taxes.The tax payment phases in ratably between$1and $ 2million of AGI.

In addition, Clinton would limit the tax benefit from specified deductions and exclusions to 28 percent. This cap reduces the value of deductions and exclusions for taxpayers in the 33 percent and higher tax brackets. The cap applies to all itemized deductions (except for charitable contributions), tax-exempt interest, excluded employer- provided health insurance, deductible contributions to tax-referred retirement accounts, and certain other deductions.


Tl;dr: this proposal would only noticeably affect those making over $1 million a year. If you are going to medical school hoping/expecting to make over $1 million a year, I have some bad news for you.
 

Weirdy

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Easy for you to say if F-35s or their parts are not made in your district. The unemployment that comes with a cutback in defense spending is not pretty and it hurts both working class (fabricators) and middle class (engineers) alike. The pain is then felt across entire communities as the buying power of unemployed workers declines and they take lower paying jobs or move elsewhere. I've lived it through family members and I get a pain in my stomach thinking about it.
Gov't contracts are a hoe to live through.
One day you're employed the next day you and 7 other guys who have been working in that field for 20 years are cut.
Completely agree when you say families and real middle-class folks suffer.
 

LizzyM

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It's not often that I find reason to amend @LizzyM but here it is. You can read a rather dry analysis of Clinton's tax policy proposal here. Excerpt:
Thanks. I really wasn't speaking to Clinton's campaign but as a thought experiment ... what if medical school was a government benefit ? What would happen? I think 100% taxpayer funded medical school (outside of the military and MSTP) has a snowball's chance of happening.
 
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Lucca

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Thanks. I really wasn't speaking to Clinton's campaign but as a thought experiment ... what if medical school was a government benefit ? What would happen? I think 100% taxpayer funded medical school (outside of the military and MSTP) has a snowball's chance of happening.
Even in Texas we get snow. I put it lower than that.
 
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To be MD

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That's what people about Obamacare, and look where we are now!
A sentence fragment insulting the Obama administration... Trump? Is that you?
 
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https://www.hillaryclinton.com/issues/college/

She didn't specifically say "free tuition at medical schools", however, she said "free tuition at state/public colleges" which I think would include many medical schools.
If what Obama did with student loans for grad students (getting rid of subsidized loans and higher interest rates) is any indication she will probably encourage these schools to jack up tuition on grad students to make up for free tuition for undergrads.


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Med Ed

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If what Obama did with student loans for grad students (getting rid of subsidized loans and higher interest rates)
The conversion from floating to fixed (6.8%) interest rates on graduate occurred in 2005, and took effect on July 1, 2006, two and a half years before Obama took office. In 2013 Obama did sign the 2013 Student Loan Certainty Act, which reconnected loan interest rates to the 10 year T-bill. For graduate and professional student loans this reduced the rate to 5.31% (as of 2016).

Subsidized loans for graduate and professional students were cut as part of the Budget Control Act of 2011, which you may remember was the resolution to the 2011 debt ceiling crisis, something that was manufactured by certain members of Congress.
 
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gonnif

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while getting eaten by a shark and getting hit by lightning!
Dont worry though, Donald Trump is gonna make med school admissions great again!
 

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Do we expect more applications (more people willing to go into medicine) and increased competition?

Do we expect lower salaries for future doctors as physicians and surgeons will no longer fight lower pay as they have no big loans to pay?

In other words, do we expect complete turmoil for future pre-medical students?
I like this thread because it's a great example of "begging the question". People use that term wrong all the time.
 
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Law2Doc

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Clinton was only talking about undergrad, not professional schools. And this was mostly a concession to Bernie voters, not even her own platform. When she was First Lady, pioneering the Clinton healthcare plan she enlisted insurers and nurses onto her advisory panel, and essentially cut doctors out of the process, made them the enemy, so we slready know she has no real love for the medical profession. So no, there won't be free med school tuition. But there may be more opportunities for midlevels to get a slice of the pie.

That's the unfortunate thing this election -- if doctors and future doctors actually want to vote their interests they are stuck with a candidate who is troubling in a whole host of other areas. The guy who will let doctors keep their incomes, will likely have a neurosurgeon in his cabinet, and will make it harder for offshore interests, including Caribbean med schools to compete, is also the guy who is a loose canon, thinks vaccines cause autism, and has troubling world views.
 

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When she was First Lady, pioneering the Clinton healthcare plan she enlisted insurers and nurses onto her advisory panel, and essentially cut doctors out of the process,
Do you have a source for this? I have taken some interest in Hillarycare as a historical study in policy failure, but it is difficult to find quality records that are intelligible.

For anyone who shares the same curiosity, Paul Starr's 2007 piece The Hillarycare Mythology is a very intriguing read.
 

Law2Doc

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Do you have a source for this? I have taken some interest in Hillarycare as a historical study in policy failure, but it is difficult to find quality records that are intelligible.

For anyone who shares the same curiosity, Paul Starr's 2007 piece The Hillarycare Mythology is a very intriguing read.
The major newspapers were all over it at the time -- there was a full page ad in the NY Times thanking the members of her blue ribbon panel with many insurance reps and nurses and HMO administrators listed but with doctors conspicuously absent. You should be able to dig articles up through Google pretty easily if you don't know any doctors who lived through it. It wasn't exactly a secret.

Anyhow, it seems what's good for the country and what's best for doctors in the upcoming election likely aren't well aligned. I wouldn't bank on lower med school debt or other doctor benefits with the Democrats. At best things will stay the same. At worst we are looking at more reimbursement cuts and more of a role for cheaper midlevels in the system.
 
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Med Ed

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The major newspapers were all over it at the time -- there was a full page ad in the NY Times thanking the members of her blue ribbon panel with many insurance reps and nurses and HMO administrators listed but with doctors conspicuously absent. You should be able to dig articles up through Google pretty easily if you don't know any doctors who lived through it. It wasn't exactly a secret.

Anyhow, it seems what's good for the country and what's best for doctors in the upcoming election likely aren't well aligned. I wouldn't bank on lower med school debt or other doctor benefits with the Democrats. At best things will stay the same. At worst we are looking at more reimbursement cuts and more of a role for cheaper midlevels in the system.
Thanks, but giving out vague guidance isn't exactly providing a source.
 
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TheBiologist

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I'm not saying I'm for making college free, but are you saying medicine should only be for people who feel financially safe? That someone who doesn't have any money should have a harder time becoming a doctor?

Remember that the supposed goal of "free" education would be to extend opportunity to those who would likely succeed at college but may feel like they can't afford it. They still have to make the grades, take the SAT or MCAT etc.

You sound like you are suggesting "Damn! if we let the poor people in it will be harder for ME to compete."

Very capitalistic of you....

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**** that. All politicians are liars anyway. Say what they need and then they lick it and stick it when you ain't looking. It's a cold game.

Newsflash people.

You can't do jack **** with a college degree anywayyyyy lol

Your diploma is essentially a 6-figure receipt saying "thanks for sitting at home, reading off powerpoints, and now you are ready for the 'real world'. Oh... btw.. you can't really do much with this but thanks for paying!"
 
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It's not often that I find reason to amend @LizzyM but here it is. You can read a rather dry analysis of Clinton's tax policy proposal here. Excerpt:

Clinton has proposed several changes that would increase taxes on high-income households. She would enact a 4 percent surcharge on AGI in excess of$5 million($2.5 million for married couples filing separately).

Clinton would also impose a minimum tax of 30 percent of AGI on filers with AGI greater than $1 million (i.e., the Buffett Rule). Taxes counted toward the new minimum tax requirement include:regular income taxes(after certain credits and including the Affordable Care Act surtax on net investment income), the alternative minimum tax (AMT),the 4 percent surcharge on AGI,and the employee portion of the payroll tax.4Taxpayers with AGI over $2 million would owe an additional tax on the difference between30 percent of AGI and the sum of those taxes.The tax payment phases in ratably between$1and $ 2million of AGI.

In addition, Clinton would limit the tax benefit from specified deductions and exclusions to 28 percent. This cap reduces the value of deductions and exclusions for taxpayers in the 33 percent and higher tax brackets. The cap applies to all itemized deductions (except for charitable contributions), tax-exempt interest, excluded employer- provided health insurance, deductible contributions to tax-referred retirement accounts, and certain other deductions.


Tl;dr: this proposal would only noticeably affect those making over $1 million a year. If you are going to medical school hoping/expecting to make over $1 million a year, I have some bad news for you.
I don't need $1,000,000 to make me happy.

$500,000 will do though.

:)
 

mehc012

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And the increase in taxes would be not just from free med school but free undergrad and, no doubt, free graduate programs in nursing, various types of therapy, etc. We'd soon be headed to a income tax similar to those in most of Europe. http://www.bbc.com/news/magazine-26327114
You say that like it's a bad thing, but if we could get our **** together enough to pay what Europe does in order to get the benefits that Europe does, that'd be a wonderful improvement over what we've got now.
 
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Is that $500,000 before or after alimony and child support?
Neither. Been in long term relationships in the past and they weren't all that great. I mean, the sex and stuff is cool but once that part is over is when the crazyness shows up. Don't have the time or mental fortitude for all of that.

Plus, the way I have it mapped out, I will probably be moving back into my parent's paid off home. No mortgage.

Will pay my own car payment and auto insurance.

$250-300 AFTER taxes is more than enough to live the life I envision myself living. :)
 

LizzyM

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You say that like it's a bad thing, but if we could get our **** together enough to pay what Europe does in order to get the benefits that Europe does, that'd be a wonderful improvement over what we've got now.
Americans prefer autonomy and independence to the idea that all pay in according to their means to provide for the common good including higher education and health care. Americans want to keep what they earn and believe that anyone who works can earn. It might be the American Dream or a pipe dream but it explains why we will never be like Europe.
 
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mehc012

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Americans prefer autonomy and independence to the idea that all pay in according to their means to provide for the common good including higher education and health care. Americans want to keep what they earn and believe that anyone who works can earn. It might be the American Dream or a pipe dream but it explains why we will never be like Europe.
Americans think that they're paying extra for autonomy and independence. That's not what they get.
The belief that 'anyone who works can earn', while it sounds nice, is not true in our society explicitly because we don't make basic education and the ability to live equal access things for everyone. Instead, we just repeat it to allow us to pat ourselves on the back while we piss on poor people here, because our society has always functioned on picking out a group of people to hold out as an example of "their lives suck the most because you are better than them" so that everyone else can ignore that their lives aren't much better.

That's what I meant by 'get our **** together'. We won't do it, even though we should, because we've deluded ourselves into thinking that we're speshul snowfwakes even though our democracy is less democratic than most other countries, and our 'freedom to do what we want' is true only for a much, much smaller proportion of our population than in other countries. We're so caught up in thinking that we're better than everyone else that we will never actually learn from those who have outstripped us in the areas that we supposedly value most. A twisted caricature of the American Dream, combined with American exceptionalism, is what's holding us back as a nation, and in order to accomplish any of what many European countries have, we would have to 'get our **** together', get over ourselves, and actually work towards the reality of the American Dream instead of the cartoon version the way everyone else has figured out how to do.