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U.S. middle class wealth no longer richest in the world

U.S. median (after tax) income is no longer the highest of the large, rich industrialized nations of the world.

There are a lot of ways to measure the prosperity of a nation. Over the past few years, as the United States made a stronger economic recovery than many of the world’s other wealthy nations, especially in Europe, you’ve no doubt read and heard that the benefits of the recovery have been unevenly distributed.

But we’ve reached a new tipping point in which the U.S. middle class is no longer the richest in the world.

The concentration of wealth in the United States in the richest 1 percent of households has reached levels not seen since the 1920s. By several measures, 100 percent of recent economic gains have been to the benefit of the already wealthy with poor and middle-class Americans — as a group — basically treading water. That’s the old news.

But apparently it was still the case, until recently, that the U.S. median income was the highest in the world. If the average American family is still richer than the average family anywhere else, is it pure class envy to worry about how rich the super-rich are getting? Maybe that’s a stupid question (or maybe not) but I raise it to set up a new finding, published Wednesday in The New York Times as part of its analysis of a cache of data comparing wealth and wealth distribution in richest countries of the world.

The big finding of the piece is that the U.S. median (after tax) income is no longer the highest of the large, rich industrialized nations of the world. Canada pulled even with with the United States in 2010 and the Times feels comfortable enough with the trend to announce that median incomes in Canada “now appear to be higher than in the United States.”

By the way, not to obsess overmuch on median incomes, the Times’ summary table indicates that in several countries — including Canada, the Netherlands, Norway, Austria and Denmark — typical households below the median are better off than comparable households in the United States. That finding is summarized in this table.

Comments (66)

  1. Submitted by Neal Rovick on 04/23/2014 - 01:02 pm.

    Those crazy Canucks…Higher

    Those crazy Canucks…

    Higher minimum wages, health care for all, higher immigration rates AND higher incomes for the middle class.

    House of cards–it’ll never work…

    • Submitted by Steve Titterud on 04/23/2014 - 01:59 pm.

      Canadians drive our right-wingers crazy.

      They’re so d*mn satisfied, and they shouldn’t be !!

      The only people I’ve ever heard wail and moan about that awful Canadian health care system are American right-wingers. The Canadians I’ve known (quite a few) are UNIVERSAL in their satisfaction with their health care system. When they’re not looking on Americans with humor, it’s with pity.

      • Submitted by John Appelen on 04/23/2014 - 07:00 pm.

        Pros / Cons

        It looks like there are pros and cons to the Canadian system. Some of the cons would be very hard for Americans to adapt to.

        • Submitted by Steve Titterud on 04/23/2014 - 11:13 pm.

          An interesting series, but takes some thought and digestion.

          Some of the cons are related to high physician salaries in the U.S., which apparently robs Canada of some of its doctors. Also, the author mentions that some private, for-profit clinics have found ways to game the Canadian system, charging for things which are supposed to be without charge in a uniquely Canadian way. We have our problems with people gaming Medicare and the insurance system in general as well here in the U.S.

          When speaking of “hard for Americans to adapt to”, in some respects this is is no doubt true, point taken. But it is also true that the U.S. system had been hard for Americans to adapt to !! Some couldn’t adapt to it at all, & went without health care !! For people who have no health care, being in a wait list for elective procedures is no problem, eh ?

          Isn’t it important to note WHICH Americans we’re talking about here ? Certainly those who have been without insurance and therefore without health care can’t be included in the number of “hard to…adapt to”.

          But for the Americans who nearly always have gotten health care THEIR WAY due to their good fortune, sacrifice for the common good will be extremely hard to swallow.

          The Canadian system, of course, is not perfect and never will be. I have noted that the Canadians I’ve ever known have expressed satisfaction with their system. I realize this is only anecdotal.

    • Submitted by Tom Anderson on 04/23/2014 - 10:40 pm.

      And all that tar sands oil

      To help pay for everything. Imagine if we did the same!

      Did we finally come up with an actual figure (in American dollars) for what income qualifies as middle class? Everyone thinks that they’re in it but only a third should be.

      • Submitted by Neal Rovick on 04/24/2014 - 11:12 am.

        Tar sands economic effect small….


        The IMF is just the latest in a list of credible economic experts that are pointing out that when it comes to the resources the government is pouring into pushing the tar sands, Canada is not getting a great return on its investment, and won’t any time soon.

        The report exposes just how little of Canada’s economic growth is driven by our fastest growing source of greenhouse gas pollution — the tar sands — and what the impact would be if plans to expand the industry are allowed to proceed, or are stopped in their tracks. Currently, the industry has plans to triple tar sands production by 2030.

        The tar sands represent just two per cent of the Canadian economy. According to the IMF report, if the expansion is slower than planned, following a rejection of the Keystone XL pipeline for example, Canada’s GDP would only be 0.5 percentage points lower in a decade than it would have been otherwise. In a scenario where there are zero restrictions on tar sands growth (AKA the International Energy Agency’s pathway to climate catastrophe), Canada’s GDP would be just two per cent higher in 10 years.

        (end quote)

  2. Submitted by Frank Phelan on 04/23/2014 - 05:12 pm.

    Are We Done Yet?

    Do we still have to hear that old saw about how “this is the greatest country in the world”? Because for most of us, it’s not true as far as the economy.

  3. Submitted by John Appelen on 04/23/2014 - 06:43 pm.


    “By several measures, 100 percent of recent economic gains have been to the benefit of the already wealthy with poor and middle-class Americans — as a group — basically treading water.”

    What are these sources? Everyone who owns a stock mutual fund has seen a huge uptick. Thoughts?

    • Submitted by Jon Lord on 04/24/2014 - 10:14 am.

      just a thought

      Not everyone owns mutual funds.

      During the Era around the 1920’s the wealthy would buy up basically worthless stocks which would lead to a boom in those stocks, then the wealthy would pull out with a tidy profit and the stock which was worthless to begin with would crash. That would eventually lead to the Glass-Stegall act.

      • Submitted by John Appelen on 04/24/2014 - 05:21 pm.

        Tough to Retire

        No wonder people do not have enough money to retire if they are relying on asset growth via money funds. I think mine is paying less than inflation right now.

        However, you are correct that if one is scared of the roller coaster they should probably stay off it.

        • Submitted by Jon Lord on 04/25/2014 - 08:58 am.


          I’m surprised you don’t know that not everyone can afford to put money into stock funds, etc? Or that people can lose those savings? Surely you know that.

          Ever hear of the Great Depression? The stock market crash that started it? More people should have been scared of the roller coaster back then. The stock market was manipulated by those with the money to be able to do it with the sole aim of making more money for the very wealthy. That was it! It surely wasn’t benefiting anyone else, or anything else.

          • Submitted by John Appelen on 04/25/2014 - 02:01 pm.

            Lost it

            This post was lost. Start small, save regularly, stay diversified and don’t panic.

            Please note that the 1929 crash was just a small blip in history.

            • Submitted by Jon Lord on 04/26/2014 - 07:32 am.

              oh yea

              You don’t understand today. Nor do you understand the diversity and the multitude of things that can and do go wrong with that meme.

              The ‘panics’ of 1819, 1873, 1879, 1907 were devastating economic times. Blips to some maybe but ruined many people. Hardly noticeable by the ultra wealthy but they were real to those in the middle down not to mention that there’s been dozens of recessions since 1790. This ‘trend’ is considered normal in a capitalistic system.

              • Submitted by John Appelen on 04/26/2014 - 08:45 am.

                How full is your glass

                Each of those down times brought about a buying opportunity. So do you want to focus on the down sides or the recoveries…

                This is why buying small amounts of diversified funds on a regular basis is so important. (dollar cost averaging) You buy fewer shares when prices are high and more when prices are low. I use Vanguard, they allow one to start small and have low costs.

                Food for thought.

                • Submitted by Jon Lord on 04/28/2014 - 02:36 pm.

                  poor food

                  That makes a lot of assumptions. One is about the room at the top, if you understand what I mean. You assume the golden brick road is real. Follow it and everything will be fine…but it’s a toll road now. Every avenue to wealth is a toll road after those who’ve traveled that road to wealth. You know they pick up the bricks behind them don’t you? It’s to keep the ‘riff-raff’ out. How does a person move up from a minimum wage job when there’s only one job ahead of them and dozens hoping for it?

                  So, minimum wage will buy what in terms of stocks, diversified funds, whatever? How much do you think they should pay into those funds per month?? Do you have a figure? How much should they buy on the down sides then how much on the recoveries? I want to know that figure, or those figures. What is ‘start small’ and ‘low costs’ in terms of disposable income? For minimum wage earners. What emergencies are you overlooking? Or discounting? If a light bulb costs $5. If a decent steak costs $15. If a better education costs as much as it does today? How do they swing all of that? Can you realistically parse out all that minimum wage money into covering all the bases necessary?

                  Talk to this too. How much money does a person save taking public transportation versus the cost of gas driving to the same location?

                  During down times, the recessions and the depression, the poor didn’t make money, the wealthy did by buying up foreclosure property and businesses that went out of business. Then when times were better, turned around and sold them for a profit. It’s like ‘flipping houses’ that happened during the housing bubble. Some made money but most got caught in the rubble when it collapsed. It’s still being done by the way, flipping foreclosed property. I heard the ads on the radio just the other day.

  4. Submitted by Ilya Gutman on 04/23/2014 - 07:55 pm.

    Oh, Canada

    Canada spends about 1% of its GDP on defense. So effectively America is paying for their defense. And they also do not have illegal immigration problem.

    As for medical care, 81% of Americans are satisfied with their local health care versus 70% in Canada ( Interesting!

    Canada is a great country but let’s compare apples to apples…

    • Submitted by Steve Titterud on 04/23/2014 - 11:45 pm.

      Those darn Europeans don’t spend enough on their defense…

      …either, which is (in part) because they place a higher value on social welfare, and in part because the U.S. provides a military shield so that higher levels of military spending is not necessary.

      I don’t want to set off another debate here beyond the subject matter at hand, but it is also true that the Canadians and Europeans are simply not as war-like as the U.S. We are the current terror of the world. Our value system and foreign policy dictate that we dominate in every area of the world where our interests dictate and where it is possible. This is very expensive.

      So in a sense, you could say that spending less on their military comes naturally to the Canadians and Europeans at this time, just like spending more comes naturally to the U.S. I don’t think this weighs against the Canadians.

      The Canadians DO have an immigration problem and there is quite a debate going on about this north of the border, but it is a COMPLETELY different kind of immigration problem than ours. You’re right that they don’t have an illegal immigration problem – theirs is a LEGAL immigration problem. It is a very desirable place to be and/or to park money, for the wealthy Chinese.

      Your quote of the Gallup data is incomplete. Let’s have none of that cherry-picking, Ilya !! You are better than that, and perhaps it was mere oversight to not mention the companion data. See below.

      The proposition with which 81% of Americans answered in the affirmative and only 70% of Canadians was: “Are satisfied with the availability of quality healthcare in their city or area”;

      whereas to another proposition, namely,

      “Have confidence in their national health care or medical system”, the same Americans agree at the rate of only 56%, whereas the Canadians agree to the tune of 73% !!

      • Submitted by John Appelen on 04/24/2014 - 08:42 am.

        You did it now…

        “We are the current terror of the world. ”

        I have to wonder if the women and non-Taliban people of Afganistan, the minorities in the Baltics, the South Koreans, the Shia and Kurds of Iraq, the people of Taiwan, the people of Kuwait, the people of Libya and now the people of Ukraine see us that way. Not to mention our role in WWI and WWII.

        With great power and wealth comes great responsibility. I often do wonder what would happen in the world if the USA just pulled back to it’s borders and put up a big electronic security fence…

        How again did our stay at home policy help to allow WWII to escalate?

        • Submitted by Steve Titterud on 04/24/2014 - 09:54 am.

          I too often wonder what would happen if…

          …the U.S. foreign policy were to let other nations govern their own affairs.

          You left out Vietnam, where we fruitlessly destroyed the civil life and much of the infrastructure of that nation, as well as killing huge numbers of humans while making most of the population refugees in their own country – before cutting our losses. They still have a high birth defect rate from all the chemical spraying, and unexploded bombs in the ground still go off now and again while a farmer works his land or a kid plays in a field.

          My own opinion on THAT war is that if we had sat on our hands and done NOTHING AT ALL about Vietnam, that country would be about where it is now, except of course all the destruction and killing we caused wouldn’t have taken place. They’d have been incorporated into North Vietnam. However, we wouldn’t have had the economic buildup the war caused.

          The cases you cite have their downsides, you know, although there certainly is a positive narrative that can be drawn. But we do not invade countries or get into foreign wars and adventures to alleviate human suffering or to right a wrong.

          Remember the great American effort in Rwanda ?? No, you don’t, because there was no money to be made there, or better put: there were no compelling American corporate interests in Rwanda, and merely saving a million or so lives was not on the U.S. agenda. So we did virtually nothing while the mass slaughter took place. So let’s not get carried away talking about the responsibility of wealth and power as manifested in U.S. foreign policy.

          Rwanda gives the lie to the notion that the U.S. is saddled with a great responsibility.

          What IS TRUE, though, is that high-minded altruism is often cited in cases where the economic interests of the U.S. (i.e., its corporations’ interests) leads to foreign adventures. This is what the propaganda machine tells us. You should be careful about how much of this you swallow.

          • Submitted by John Appelen on 04/24/2014 - 02:53 pm.

            Two Factors Required

            “But we do not invade countries or get into foreign wars and adventures to alleviate human suffering or to right a wrong.”

            American interests/allies are involved.
            Human freedom/safety is threatened.

            Do you really want us interfering when only one aspect is present?

            As for Vietnam and the Cold War, well before my time. It sounds like one we lost and the other we won. Can’t win them all. Though it would be interesting to know how the Vietnam war helped/hurt USA/China relations or China’s appetite for expansion.

        • Submitted by Karen Sandness on 04/25/2014 - 11:48 am.

          The Taliban?

          The U.S. should have let the Soviets (who, by the way, were invited in) take over Afghanistan, period. I’m basing this on my knowledge of what happened to the culturally similar Central Asian regions under Soviet rule. I have no love for the Soviet government, but they did two things extremely well in Central Asia: 1) requiring universal education, and 2) giving women equal legal status.

          If the Soviets had taken over, two generations of Afghans would have grown up educated, and things like the burqa and child marriage would have been dim memories.

          Furthermore, the Taliban grew out of the Mujahedin rebels, whom the U.S. not only armed but touted as great freedom fighters. Even in the early days, it was clear that many of them objected not to Communism but to the notion of their daughters going to school. Every time Jeane Kirkpatrick praised them, I thought, “Lady, they’d put a veil on you and hustle you indoors if you ever went to one of the areas they control.”

          If there hadn’t been ten years of constant guerrilla vs. regular army war, Afghanistan would not have had thousands of orphaned boys who were taken in and raised by the Taliban in an all-male, fanatically religious atmosphere.

          After the Soviets left Afghanistan, the CIA actually favored the Taliban, because they were the most organized faction of the Mujahedin. We didn’t even hear about how bad the Taliban were for women until American feminists broke the story in the mid 1990s.

          So don’t justify the American military budget by using the Taliban.

          • Submitted by John Appelen on 04/25/2014 - 01:57 pm.

            Strange Bed Fellows

            I don’t disagree that things get foggy in world relations.

            The enemy of my enemy is my what?

            Saddam Hussein was fine until he broke free of his leash…

            All that considered…
            Should we let Putin take over Ukraine again then?
            Or help the Ukrainian citizens resist?
            There are probably some bad folks in the Ukraine also.

            • Submitted by Karen Sandness on 04/27/2014 - 02:29 pm.

              It’s really foggy in Ukraine

              because there are people (numbers unknown) who want to join Russia and others (numbers unknown) who don’t.

              It’s a confused mess, with partisans of both sides throughout the country. It is not a situation that the U.S. can “fix.” It is certainly not a reason to get into a war with Russia, one of the few countries in the world that could actually send nuclear missiles to the U.S.

              There were far worse provocations during the Cold War era (Hungary, Czechoslovakia, the Korean airliner), but the U.S. did not go to war over them.

              During that era, “Better dead than Red” was a common right-wing slogan, but notice that the people in the Communist countries did not commit mass suicide, even during the most repressive periods.

              The U.S. is not some God-like force that can go in with infinite wisdom and strength and make everything better in any and all situations. If we’re going to start with Ukraine, there are any number of other bad situations around the world, some of them not near any oil fields or oil pipelines or oil ports.

              That has been the common thread in every unilateral U.S. intervention outside of Latin America since Korea: oil fields and oil pipelines. Oh wait, Cuba has a bit of oil (I saw oil wells when I was there), and the disproportionately vilified nation of Venezuela has a lot of oil.

              Wars, preparations for potential wars, and interest on the debts incurred during wars are a major cause of the federal deficit.

              Deficit hawks should be pushing for renewable energy, alternatives to conventional plastics, mass transit, and anything else that weans the U.S off of oil. But most of them would argue for lower taxes and INCREASED military spending, which makes no sense if they’re really hawkish about the deficit instead of just hating the idea of welfare payments to people they don’t like.

    • Submitted by Neal Rovick on 04/24/2014 - 08:16 am.

      Oh, Ilya…

      Perhaps Canada has made the discovery that if they have a big military-industrial complex, every problem will look like it can be solved with a war.

      • Submitted by Steve Titterud on 04/24/2014 - 09:26 am.

        Great point !! I don’t think it has ever occurred to the…

        …Canadians that if they developed an over-bloated military, they could muscle their way into everyone else’s affairs all over the world, and their corporations could make huge profits on such a policy, too !!

        What the heck could they be thinking of ??

        For some mysterious reason, they don’t seek world domination, and are content to stay at home, mind their own business, and take care of Canadians.

    • Submitted by Luke Ferguson on 05/07/2014 - 09:51 am.

      Let’s re-examine that poll…

      Ilya, you’re selectively quoting that poll, and left out an entire survey question. Let’s look at the exact questions asked.

      “Are satisfied with the availability of quality healthcare in their city or area”
      United States: 81%
      Canada: 70%

      “Have confidence in their national healthcare or medical system”
      United States: 56%
      Canada: 73%

      I can be very satisfied with the availability of quality healthcare in my city, even if I have no access to it because I’m uninsured.

      However I have no confidence in my national healthcare system, because it’s the leading cause of bankruptcies, allows poeople to die from lack of access, and spends their profits lobbying against health care reform rather than lowering patient costs. – We’re going bankrupt on medical bills. – it’s hard to track exactly how many, but people are DYING because of lack of acces to healthcare. – This should not be legal.

  5. Submitted by Ilya Gutman on 04/23/2014 - 10:07 pm.


    That link is about 5 years old – it was just one of the first ones that popped up when I typed “Health Care System satisfaction” in Yahoo. But I do not think that it matters in this case – both American and Canadian systems had been in place for long time and my guess is that current results would be similar.

  6. Submitted by Neal Rovick on 04/24/2014 - 08:07 am.

    Canadians do not want US health care…


    “With more than 8 in 10 Canadians supporting public solutions to make public health care stronger, there is compelling evidence that Canadians across all demographics would prefer a public over a for-profit health care system,” said Nik Nanos, president of Nanos Research….

    …Meanwhile, Canada’s government just released a report titled “Healthy Canadians — A Federal Report on Comparable Health Indicators 2008.” Its findings almost identically mirror the CHC polling results. In that report, a leading indicator points to the fact that “Most Canadians (85.2 percent) aged 15 years and older reported being ‘very satisfied’ or ‘somewhat satisfied’ with the way overall health care services were provided, unchanged from 2005.”

    Michael McBane, national coordinator of the CHC, commented: “Throughout our campaign, Canadians have told us they want to keep our health care system public and to improve it with made-in-Canada solutions. They also have told us they flat-out reject Dr. Ouellet’s proposal to provide us with American-style, two-tier medicine. This poll certainly underlines that for us….

    (end quote)

    Canadians may complain about aspects of their health care system but there is damn little support to over-turn it and go to a US style system. The reform efforts are directed along the lines of improving the public system that they have.

    And seriously, why would they go for a system that is twice as expensive, covers fewer and less, and has no better or worse outcomes?

    And have you heard of the trend in the US where the rising cost of healthcare over the years has resulted in slower income growth as benefits are substituted for wages?

    It’s only economic commonsense that if the US pays for much more for heathcare via workplace benefits that reported income will not grow as fast–compared to Canada where healthcare is not tied to jobs and income.!

    • Submitted by John Appelen on 04/24/2014 - 08:56 am.

      New Technologies

      Don’t you think we pay more because the USA healthcare system is funding a great deal of the World’s high tech medical research?

      I wonder what would not have been developed if everyone had state controlled medicine?

      Would the Twin Cities metro have industry giants like Medtronics, St Jude, Boston Scientific, 3M and the other 100+ small device companies that want to become them?

      • Submitted by RB Holbrook on 04/24/2014 - 09:25 am.

        State controlled medicine

        Canada may not have all the cool machines that go “ping” that we do in the US, but they have a longer life expectancy than the US (according to the CIA, 81.67 years vs. 79.56 years), and a lower infant mortality rate (4.71 deaths per 1000 births vs. 6.17/1000). The Canadians also spend significantly less for their health care ($3895/person vs. $7290/person).

        I wonder what would have been developed if we weren’t spending all that on health care.

        • Submitted by John Appelen on 04/24/2014 - 10:33 am.

          Machines that Go Ping

          Almost every country, including Canada has machines that go ping, implantable devices and some really incredible medications. All of these improve or save millions of lives a year.

          I assume in part because American can afford to and do pay more.

          As for health outcomes, have you normalized them for differences in diet, exercise, race, drug use, urbanization and the dozens of other confounding factors.

          • Submitted by RB Holbrook on 04/24/2014 - 01:43 pm.

            Americans can afford to and do pay more

            We do pay more, but whether we can continue to afford to is another matter.

            I don’t think the confounding factors alone can account for the vast disparity in costs and outcomes between the US and Canadian health systems, although I do note that the obesity rate in Canada is lower than in the US (here’s an idea: instead of spending millions of dollars on heroic outcomes, we put even a tithe of that into healthy nutrition education, encouraging exercise, etc.?). One of the biggest factors may actually be that the ready availability of basic medical care eliminates the need for some very expensive treatments.

      • Submitted by Jon Lord on 04/24/2014 - 10:06 am.


        Yes, they are funded by the federal government. If they hadn’t been then they would probably be much smaller companies.

        • Submitted by John Appelen on 04/24/2014 - 03:21 pm.


          Do you think Medicare and Medicaid pay the premium prices required to fund R&D?

          I am guessing not so much so. However you are correct that they are good customers of the proven technolgies.

          • Submitted by Jon Lord on 04/25/2014 - 08:44 am.


            When Reagan came into office I was working for Medtronics. Everyone was exited that they were going to get 10% cut back from their taxes when he was campaigning apparently not realizing that Reagan actually said the 10% reduction was on that year’s ‘increase’ in their taxes. When he became president Medtronics laid off a large part of their work force due to a cut back in government funding.

            Medicare and Medicaid are part of the Federal Government who funds the R&D.

            • Submitted by John Appelen on 04/25/2014 - 12:59 pm.

              Kind of Agree

              Though technically with medicare it is the tax payers paying the premiums, that enable the purchases. (payroll tax) Just like is done with Private insurance.

              With Medicaid /welfare it is a bit more complicated. The government (ie society) is paying for healthcare services. Part of which companies use to fund research. Again just like private insurance or customer direct payments.

              My point is that government (ie society) is mostly buying a product / service and not intentionally paying for research.

              • Submitted by RB Holbrook on 04/25/2014 - 01:48 pm.

                Not intentionally paying for research

                If, that is, you overlook the National Institutes of Health, and the medical research and development done by the Defense and Veterans Affairs Departments.

                • Submitted by John Appelen on 04/25/2014 - 02:04 pm.


                  I was focused on the private vs public insurance discussion.

                  Yes the government does spend some directly on research.

      • Submitted by Neal Rovick on 04/24/2014 - 10:50 am.

        Have you ever thought of the logical and economic impossibility of an ever-growing health care industry that the rest of the world does not want to subsidize and the US itself cannot afford?

        Unlimited spending does not equate to perfect health, immortality, or even morality.

        • Submitted by John Appelen on 04/24/2014 - 03:18 pm.

          No Defibrillators

          I whole heartedly agree with the unlimited spending comment.

          I’ll let you break that to those happy patients who are still living and enjoying life more.

          Now you don’t want wealth deciding who gets which services? Who do you want to decide this?

          Should the government be able to prevent someone with money from getting an expensive treatment just because everyone else can’t? It is a complicated topic.

          • Submitted by Neal Rovick on 04/24/2014 - 03:37 pm.

            It gets tiresome when people play the “Ryan” game.

            The game goes as follows:

            1) Go on and on about the need to cut expenditures.

            2) Be shocked that cuts in expenditures mean cuts in services.

            3) Go on and on about the heartless cuts.

            4) Cycle through that again and again.

            Two options exist–cut services and save money or cut the private insurer out of the process and save money. One choice WILL affect patient services, the other choice probably won’t.

          • Submitted by RB Holbrook on 04/24/2014 - 04:40 pm.

            Complicated topic?

            Why is it good that wealth alone determines who gets medical care?

            Let me ask this another way: Should economics prevent someone in need from getting an expensive treatment because the real money is in cosmetic surgery for the wealthy (about $11 billion per year)? How is that a market efficiency?

            • Submitted by John Appelen on 04/25/2014 - 07:44 am.

              Source Matters

              Is that $11 Billion coming from Public Property or Private funds?

              From my opinion, what private citizens spend their money on is their choice. Be it nip/tucks, cars, travel, houses, etc.

              • Submitted by RB Holbrook on 04/25/2014 - 09:11 am.

                No, it doesn’t matter

                Medical resources are finite. Every physician performing hymenorraphies is a physician who is not performing basic medical services that could save/improve/prolong lives.

                • Submitted by John Appelen on 04/25/2014 - 02:09 pm.


                  Please explain why you believe medical resources are finite?

                  I think we have all agreed that waiting lines in the USA are short. If you have the money or insurance.

                  I have had family members have different surgeries. (ie appendix, gall bladder, back/disc, etc) Usually the wait is less than 1 week from the time it is decided that it is required. Sometimes just a few hours.

                  • Submitted by RB Holbrook on 04/25/2014 - 02:26 pm.


                    I almost didn’t reply to this comment.

                    What would make you think medical resources are not finite? Sure, you don’t have to wait if you have the money or the insurance (or, if you’re Herman Cain, have a good buddy billionaire who can bump you to the head of the line and fly you to a top clinic on a private jet). There are, however, finite numbers of doctors and other personnel, or facilities in which they can practice. It is absurd to suggest otherwise.

                    If you don’t have the money, well, then, hard cheese to another looter, right?

                    • Submitted by John Appelen on 04/25/2014 - 09:49 pm.

                      Medicaid and Charity

                      We already care for those who are in need. However we do ask that they strive hard to care for themselves.

                      Of course we can train more Doctors, Nurses and build more hospitals. Thus the resource is not finite… At least not yet.

                      However if we limit their income potential with arbitrary laws, they will likely become finite quickly.

  7. Submitted by Ilya Gutman on 04/24/2014 - 07:32 pm.


    First about the survey results I quoted. I did not omit the second part to hide something; I did it because it is irrelevant. Many people in the Soviet Union had great trust and confidence in the Socialist system but they lived… badly, to say the least (and they didn’t even realize that). So the fact that people trust the system doesn’t make the system good. Their own experience with the system shows if the system is good or bad and that was the part I used.

    Second, about the military. If America were not as strong as it was and is, Hitler (or Stalin) were the winners in the WWII (any takers for that?) Later on, if America withdrew from the world, the Soviet Union would have grabbed the entire Europe, China would have grabbed Taiwan and the Asian Southwest, and smaller dictators would have grabbed what was available nearby (and what the USSR and China didn’t want). I hope no one would dispute that this is what would have happened.

    Third, America, as any other country, shall act only out of self interests, not out of altruism (and I hope it does even though it is hard to see how acts like bombing Libya may be of any help to us). And if it does, the world benefits (see above).

    Fourth, immigration. Canada “is a very desirable place to be and/or to park money..” Isn’t America as well? So what is the difference? Is it that Canada attracts only wealthy Chinese and America attracts everyone?

    Fifth, Vietnam. It is true, that with the way it ended, Vietnam now is not better off than it would have been without us. However, for alternative one doesn’t need to look any further than Japan…

    Sixth, back to Canada. They did not develop huge military because they knew that America would protect them from the USSR. If they knew that it would not, they would have developed their military to the degree that the USSR would not threaten them (and it would be easier for them than for the Europeans due to the ocean). And I am sure they would have spent as much as necessary even if it meant much lower living standards – I can’t imagine Canadians wanting to become the Soviet dominion, like Cuba.

    Finally, to answer the question why it is good that wealth alone determines who gets healthcare. A simple answer may be that since healthcare is commodity, it is no different from cars so if who gets a BMW is determined by the wealth, so is healthcare. Now, having said this, I want to say that I personally think that healthcare should be different and people should be always able to get it (provided they live a healthy lifestyle); I just don’t think that Obamacare is the right way to achieve it.

    • Submitted by Jon Lord on 04/25/2014 - 09:27 am.

      Just wanted to mention “Ukrainian Russians”. What’s the deal there Ilya?

      Stalin, Churchill and Roosevelt actually won WWII.

      American’s who can tend to park their money in the Cayman Islands, etc. Not in America.

      During WWII America also defended China as it defeated Japan.

      Altruism is a better survival trait than self interest is. Hitler was nothing if not self interested, Roosevelt was far more altruistic towards both America and the world.

      You say, for all intents and purposes, that it’s good that wealth should determine healthcare. Then you say it shouldn’t be.

    • Submitted by Karen Sandness on 04/25/2014 - 11:59 am.

      The U.S. now has the largest military in the world by far,

      so much so that its military budget is larger than those of the next ten countries combined (and that includes Russia and China). The only other country with a military budget out of proportion to the United States is Britain, which has some of the worst inequality in Europe and looks rundown and shabby, despite its North Sea oil. (I suspect that the misuse of the North Sea oil money is one reason why there is a Scottish independence movement after all these centuries.)

      One could argue, given the Iraq War, the invasion of Afghanistan, and earlier, the invasions of Panama and Grenada, along with support for the reactionary governments in Central America, as well as military bases on every continent, that far from being a benefit to our country, the military budget is now a huge form of corporate welfare.

      Not since World War II, and possibly the Korean War, has the American military been used to “defend freedom.”

      The Vietnam War never made sense to me, and during that period, someone mentioned that there was oil in the South China Sea. I never heard anything about it in the intervening years, so I just assumed it was one of those crazy rumors. But now, lo and behold, there IS oil in the South China Sea, although not an easy source to exploit.

      In the early years of Reagan’s first administration, there was an op-ed piece outlining what could have done with just the INCREASE in Reagan’s military budget. It was heartbreaking, because it included projects like upgrading the infrastructure of all of America’s major cities, which was already starting to fail in spots. Imagine, such a project would have created jobs galore and brought us back to full First World status.

      • Submitted by John Appelen on 04/25/2014 - 02:14 pm.

        Military Jobs Program

        Do you think all those military dollars just go into a black hole and are lost?

        As shown, most of it goes to employee people all around the country…
        Almost like welfare, except the people need to work for their checks.

      • Submitted by Steve Titterud on 04/25/2014 - 03:35 pm.

        “such a project” could still create jobs galore

        Your heartbreaking observation is just as true today as then.

        Even though the military budget is supposedly subject to cutbacks in certain areas in a mimicry of economy, it is really more like an obese person eating one less potato chip. Furthermore, cuts in one area of the military budget mask increases elsewhere.

        The defense industry has mastered the manipulation of Congress, right down to every last subcommittee dealing with matters of concern to the industry. They are ALL OVER every Congressperson who could help or hurt them, full time and with a full-court press. Combine this rigorous political expertise with the largesse in influence made possible by that huge river of defense revenue – and then consider further that every Congressperson is from Day 1 after the election continuously campaigning for office, and it is easy to see just how difficult it is to restrain the military budget.

        We have created a monster so vastly in excess of the security problem’s actual scale that it can only be explained in terms like your references above.

        OF COURSE this is all justified with claims of altruism and high-minded purpose !! Propaganda is absoutely necessary, so that the people won’t notice the bloodstains and won’t stop to think about the lost opportunities such as you describe, and won’t pay much attention to what we’ve bought with our money in foreign adventures, such as denoted in Dexter Filkins’ article on Iraq which Eric Black points to in his column today.

  8. Submitted by Ilya Gutman on 04/25/2014 - 08:11 pm.

    History lessons again

    It is interesting that everyone ignored my points about what would have happened had America not been that strong. I do not want to repeat myself, but the entire world would be in big trouble unless there are people among writers here who would prefer to have China or Russia as the world dominant force. So American military budget is not a choice but a necessity – we cover for the entire Western world. If you don’t like it, lobby France and Sweden to spend more on defense.

    I also pointed out (a point also largely ignored) that America should not present itself as a good uncle trying to help everyone. We, as all other countries, should watch for our own interests which we quite often do not do (see Libya example). Altruism works in magic kingdoms only, not in realpolitiks. And FDR was not altruistic but pragmatic. If he were altruistic, he would not have let Stalin grab all Eastern Europe.

    As for an answer to a health care question, I have said that a logical answer “may be” and then said what I actually thought.

    By the way, in Grenada the day of American invasion is a national holiday. And one can argue who was a “reactionary” in Central America: Right wing presidents or left wing guerillas. And defending freedom is not necessarily an act of war; the very fact of strong America already defends freedom from Russia, China, and alike. (Of course, no one thinks that America is strong anymore but that is another matter – determination is as important as the force itself). I can also remember that America freed Kuwait from Saddam (oh, wait, it was all for oil of course).

  9. Submitted by Jon Lord on 04/26/2014 - 08:02 am.

    It’s good

    That you think Health Care should be an altruistic given, where everyone is covered and not just those who can afford it.

    Just because someone doesn’t use strength to make a point doesn’t mean they aren’t strong. It’d be a mistake to push the issue although granted not everyone understands that.

    As a species, altruism is what will save us. We need that ‘magic kingdom’. We’ve got enough power to turn the world into a slag heap, the question is will we use it or not? Altruism is pragmatic and becoming more so every day, although that doesn’t mean self-interest won’t win out. After all, self-interest is where the money is.

    • Submitted by Steve Titterud on 04/26/2014 - 02:24 pm.

      Another kind of altruism you might call selfish,…

      …sees our own well-being as intimately connected to the well-being of others, not only in the personal but in the aggregate as well. You can act for perceived selfish benefit and to the detriment of others, but sooner or later, what goes around comes around. We are not independent.

      Yet in many respects we’re reluctant to see the common welfare in this light.

      Our health care system is a perfect example. The best health care possible for all is also the most beneficial to all, in so many ways – socially, economically; is it too much to say spiritually as well ?

  10. Submitted by Ilya Gutman on 04/26/2014 - 11:58 am.

    Altruism may be good in everyday life – I have nothing against it (even though I am not sure that it saved mankind – after all it is working now when we all have something to eat but that was not the case for most of the history). But in international politics it is a suicide because governments, unlike individuals, cannot be altruistic.

    And if a strong party always yields, eventually it will not be considered strong. A sports team may have great players but if it does not have will to fight, it will be always losing.

    • Submitted by Matt Haas on 04/26/2014 - 02:56 pm.

      You actually have it exactly backward, as usual

      Had altruism not been prevalent, we would have long ago ceased to exist as a species. Take a look at what few existing “pre-civilization” (if anyone has a better descriptor, let me know) peoples’ societies are like. Communal living, shared resources, not even an understanding, in many cases, of the concept of private property. Striking out in one’s own was a recipe for early death for the vast majority of our species history. The Randian ideal is a exceptionally recent development, brought about as a response TO plenty. When survival is taken off the table as a day to day concern, the human mind seems to find it easy to turn towards more self serving concerns, placing the survival of the group at greater risk. I wonder if this serves an evolutionary directive (vaguely) that might serve as maybe a means of balancing population growth, or resource use. Just speculation obviously, but its always made sense to me. It certainly would shed a different light on ideological differences.

  11. Submitted by Ilya Gutman on 04/27/2014 - 10:42 am.

    Altruism and working together are two different things – please do not confuse them. 300 Spartans sacrificed themselves not because of altruism. Volunteering is altruism, going to Africa to help people there is altruism – and those things are new. Volunteering did not exist in the Soviet Union – everyone was trying to survive.

    • Submitted by Jon Lord on 04/29/2014 - 02:21 pm.


      But altruism really does mean working together for the good of all involved.

      Those 300 Spartans…how much do you know of their culture? Beside the movies?

      Altruism is helping people without a specific reward attached to it other than the idea that helping someone may lead to their returning the favor. It’s been around since the days that our ancestors banded together against the dark night and against predators of all types. That by definition means working together.

  12. Submitted by Ilya Gutman on 04/29/2014 - 09:34 pm.


    Jon, in my younger years I was a big fan of history, especially ancient history so I do know some things about that (and I actually haven’t even watched the movie). The 300 Spartans did it because it was their duty not out of altruism. They did not expect anyone to return the favor. That is how most people looked at those deeds throughout history. I maybe use the Russian meaning of altruism but that is how I look at that.

    • Submitted by Matt Haas on 04/30/2014 - 11:13 am.


      Is the word you’re looking for, and its not altruism. Its doing something because you believe it is expected of you, and that there’ll be consequences for not doing so. In your example they would be performing their duty out of fear of being called a coward, or of the repercussions of defeat. Altruism is doing something for someone else with no regards for the outcome, good or bad, toward oneself. A good bumper sticker sloganeering version would be ” Do the right thing, even if no one is looking”.

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