Social Security. The senior voting bloc. 2024 general elections.
Serendipity?
Watching the news while having some knowledge of the foreseen Government shutdown it hit me like a brick falling out of the sky. On No! If that happens no Social Security check for me on the 3rd of Oct. Serendipity? Quickly doing a search it turns out they will go out. There is a FAQ on Congressman Dan Kildee’s website that dispelled myths I held.
What a 2023 Government Shutdown Means for You
https://dankildee.house.gov/governmentshutdown
Soon after, checking my emails, I saw a notification from AARP. AARP membership is in the 38 million area or nearly half of seniors. It was an opportunity to watch/listen to a broadcast. It is; Conversations with Congress on the topic of Social Security. Serendipity? The opening paragraph is:
“Timothy, last week AARP members got an exclusive look at two leading members of Congress’ plans for Social Security’s future challenges. If Congress doesn't act, Social Security could be cut by 20% in the next 10 years. This bipartisan conversation with Senator Bill Cassidy (R-LA) and Congressman John Larson (D-CT) was essential for our community and an opportunity to hear directly from lawmakers about the future of our hard-earned Social Security.”
How many seniors do you speculate watched/listened to it?
I listened to it while playing around on my PC learning this and that about Social Security’s future and other stuff.
If interested in watching/listening to a little more than an hour video on the topic go to this link.
https://www.aarp.org/retirement/social- … nbKWhrU%3d
One interesting article I found is; As Republican contenders start to line up for the White House in 2024, Social Security may be key issue by CNBC (June 7, 2023) [About a 13 minute read. One could skim stopping here there too.]
https://www.cnbc.com/2023/06/07/where-2 … urity.html
Some of what I learned:
** An average of 66 million Americans receive Social Security benefits each month
** This amounts to $1 trillion in benefits spent throughout the year.
** Social Security will face a funding shortfall around 2035
** That means benefits will be cut by about 20 percent if Congress does not act.
** The seniors voting block is the largest historically
** In the 2016 general election, 71% of Americans aged 65 and older turned out to vote.
** According to Pew Research, a third of the electorate was over 65 in 2022
** Republicans are against Social Security in the form that it currently exists. Warranted while considering today’s budget battle?
** Democrats support expanding Social Security. Same question as above.
Any thoughts on how Social Security's current state and future will affect voting as a singular issue? Do voters vote on singular issues? Is it an emotional issue?
Does it affect other demographics besides seniors? Do you think they are concerned?
Thoughts?In reading your intro I get the impression that in the USA the State Pension is part of Social Security benefits; and thus your concerns?
In the UK State Pension is separate from Social Security (Welfare Benefits); and as such pensioners don’t have the same fears in the UK that pensioners in the USA may have e.g. in the UK we have the ‘Triple Lock’ on State Pensions.
The Triple Lock was introduced by the Conservative Government in 2010 as a means of buying votes e.g. over 60% of pensioners vote Conservative, whereas less than 30% under the age of 25 vote Conservative. So to the Conservatives, keeping pensioners happy is important in winning General Elections.
The Triple Lock is whereby each year the State Pension is increased by whichever is the greater of the three criteria listed below:-
• 2.5%
• The Rate of Inflation if higher than 2.5%
• The percentage rise in average wages, if higher than the rate of inflation.
The current situation is that because last year’s inflation was 10%, and this year’s inflation is 7.5%, the UK Conservative Government are faced with a gigantic rise in public expenditure at time when Government borrowing is far too high, and the Government is looking at ways to reduce public expenditure.
Therefore, in recent weeks the Conservative Government briefly contemplated in abolishing the ‘triple lock’; but both Labour and the Liberal Democrats quickly responded that they would keep the triple lock in their Election Manifesto for next year’s General Election; so the Conservatives have been backed into a corner, and have been forced to also keep the triple lock in their Election Manifesto."In reading your intro I get the impression that in the USA the State Pension is part of Social Security benefits; and thus your concerns?"
Yes and no as to concern. There is no pension per se as many think of it from our government. Social Security is a benefit. A Q&A for it is at the next link.
https://www.ssa.gov/history/hfaq.html
The purpose of the OP was to raise awareness that the future of Social Security benefits is threatened. Said, it will be insolvent by 2035 (13 more years). And, to 'some' facts surrounding the issue. My emphasis is that seniors are a very large voting bloc. Party positions and candidate positions are paramount in my eyes to know. In other words, it will impact the coming 2024 elections.
The political parties are somewhat diametrically opposed to each other not only on funding it but on the principles themselves. In other words, socialism vs. free market. Many today prefer it to be funded by privatization.
The surrounding elements are (From above):
** An average of 66 million Americans receive Social Security benefits each month
** This amounts to $1 trillion in benefits spent throughout the year.
** Social Security will face a funding shortfall around 2035
** That means benefits will be cut by about 20 percent if Congress does not act.
** The seniors voting block is the largest historically
** In the 2016 general election, 71% of Americans aged 65 and older turned out to vote.
** According to Pew Research, a third of the electorate was over 65 in 2022
** Republicans are against Social Security in the form that it currently exists. Warranted while considering today’s budget battle?
** Democrats support expanding Social Security. Same question as above.
I got somewhat wordy writing it ha-ha
I just felt like going on a writing adventure.Thanks for your feedback, and link; I am amazed that there is “no state pension per se” in the USA, and that it’s only a Social Security benefit.
State Pensions were introduced by the Liberal (Democrat) Government in the UK in 1908, and is separate from Social Security - currently in the UK State Pension accounts for 11.5% of all Government Expenditure; 5.3% of GDP.
In the UK to qualify for the full State Pension you need to have been in full time employment (paying your taxes) for at least 35 years; if you only worked for between 10 & 35 years then you get a reduced State Pension on a pro-rata sliding scale.
In the UK State Pensions, along with your works’ pension, is something workers can look forward to in retirement e.g. the combination of your work’s pension and State Pension helps to give you a good standard of living, and for some an income (in real terms) that is as high, if not higher, than the income they earned when they were working full time – making them even financial better off and more secure in their twilight years.
While contemplating your comments about social security in the USA, and on reading your link (which was very educational); it struck me on how so recent Social Security was first introduce in America compared to the UK e.g. The Social Security Act 1935 in the USA, compared to the ‘Poor Laws’ introduced in Britain in the 16th century.
In the UK the foundation of the Welfare State (Social Security) can be traced back to a series of Poor Laws introduced by Queen Elizabeth I, dating back to 1531 and accumulating in the Poor Act of 1552.
Under the Elizabethan Poor Laws, local governments (Parishes) had a legal responsibility to provide relief to the poor residing in their Parish (area), provided the person was born in that Parish (location); and to pay for the cost of this social welfare the local government taxed the wealthy landowners.
In doing my family research I came across an article that draws upon Parish (local government) records from 1686 to 1719 that shows the Poor Laws in action e.g. where the Parish of Pitminster, Somerset, England was saddled with having to support a single mother because she was born in that Parish, and because she repeatedly refused to say in court who the father(s) of her children was/were. The reason her local government took her to court each time she had a child, being that if they knew who the father was then he would be made responsible for the cost of her welfare and the welfare of her children (assuming he wasn’t poor himself).
I was given permission by the author of the article to post it on my website (link below), the events tells a story, giving a glimpse of life for the poor in Elizabethan Britain in the 16th century, which can make it an interesting read:-
For example, a couple of extracts from the 1694 Parish Records:
• Paid out for a waistcoat and mittimas (summons) 2/- Paid to Richard HERRING's wife for keeping Sarah Brodbeare's two children and make one charge? 6/2d
• For her child. 1/6d. For beding. 5/6d. For linen and woolen. 3/6d
And an entry in the Parish Records for 1699 reads “Layd out for a guard uppon Sarah Bradbeare and for carrying her to her justice to name a father to her child. 2/-”
To add some relevance, 2/- (two shillings) quoted above, in today’s currency value would be the equivalent to about $34; and for the bedding 5/6d (5 shillings and 6 pence) in today’s money would be around $94.
The Infamous Sarah Bradbeare (1664-1719) of Pitminster: https://www.nathanville.uk/bradbeer/project-one-8t49z
In 1832 the Whig Government (forerunner to the Liberals (Democrats)) abolished the ‘Poor Laws’ and created the Poor Houses (work houses for the poor), which were little more than effectively open prisons (in all but name) whereby the poor were work hard, under harsh conditions, for a mere pittance of food and shelter.
By 1906 the Liberals had abolished the Poor House system and started to introduce Welfare reform (Social Welfare (Social Security)); the welfare system we enjoy today was introduced by Labour in 1948.Interesting read, thanks!! I marvel how back in history the laws of England/Britain goes such as what your shared above. Of course ours only goes back 246 years the 18th century. Seems with the social welfare system we both have today began about the same time or era. I will have to look into what the modern thought was at that time. Probably liberal as President Roosevelt (FDR) was a Democrat. Social Security has been controversial since.
Do you still keep up with your website? I had a blog, yet I only lasted a year and gave up; no time, no earnings, and lack of relevant information for topics in the sense of Search Engine Optimization and ranking high enough in the SERPs to be seen.
I thought I should mention with our Social Security it is a tax sort of thing. It is called the Federal Insurance Contributions Act (FICA). Today, the employee pays 6.2% and the employer pays 6.2% for social security. For Medicare (The medical plan) it is 1.45% by both employee and employer. So, the total is 7.65% for both. That is why I said it is a benefit.
As shared in my OP it is threatened today. Supposedly when 2035 arrives it will be insolvent. Supposedly there will be a 20% cut to benefits. Sixty-six million receive social security benefits. (Seniors = 84%, Social Security Disability Insurance recipients = 13% & young survivors = 3%) 1 in 6 are over 65 or over. It is said 40% rely solely on Social Security. The average benefit paid is $1,782.
I imagine it will be an issue with a lot of seniors this coming election. The senior voting bloc is said to be the largest.
Policy Basics: Top Ten Facts about Social Security by Center on Budget and Policy Priorities (Apr 17, 2023)
https://www.cbpp.org/research/social-se … l-securityThanks for such a comprehensive reply; it’s kept me busy trying to work out comparability between the USA & UK.
Your Federal Insurance Contributions sounds very much like our National Insurance, which was introduced by the Labour Government in 1948 to pay for their comprehensive Welfare System that we enjoy to this day.
In theory the National Insurance contributions is intended to cover the cost of the NHS, State Pensions and all other Welfare Benefits; but in practice all Government Revenue is put into one pot so National Insurance contributions and government money spent on Welfare don’t have to match.
National Insurance is a tax on earnings, very much like the ‘income tax’, it’s even collected in the same way e.g. deducted from your wages by your employer before you get paid.
The only real difference between the National Insurance tax and Income tax is that ‘income tax rate’ is higher in the higher tax brackets, whereas the National Insurance is the reverse e.g. people in the top tax bracket only pay 2% National Insurance on income in that tax bracket, whereas everyone else (earning less) pay 12% National Insurance on their earnings above the tax threshold.
12% may sound a lot, compared to your 7.65% that you quoted; but that does also include the NHS e.g. healthcare in the UK is free to all at the point of use, and so in the UK we don’t have the cost and worry of paying for healthcare insurance, and we don’t have co-pays either (it’s all free, including prescriptions for most people).
Another thing I noticed in reading your link is that in the USA “Social Security benefits are based on the earnings on which people pay Social Security payroll taxes. The higher their earnings (up to a maximum taxable amount, $160,200 in 2023) the higher their benefit.” That isn’t the case in the UK:
In the UK the State Pension is a flat rate e.g. everyone gets the same amount, and everyone gets the same level of healthcare regardless etc.
Looking at some specifics, the link quoted that “the average Social Security retirement benefit in (in the USA) is about $21,384 per year.”, but that you have to pay Medicare’s Supplementary Medical Insurance premiums which are deducted from your Social Security cheque.
The full State Pension in the UK is a lot less, it’s only $14,000 per year; but as the healthcare is free, and coupled with all the other benefits that low income people would be entitled to, in the UK, for a pensioner $14,000 (tax free) is a liveable wage – then if you have a works pension on top of that you can have quite a high living standard.
As stated above, the National Insurance tax in the UK is 12% (on earnings above the tax threshold), which for a worker on the average wage in the UK works out to around £194 ($235) per month; but that cost also includes the cost of the NHS, so there is no Healthcare Insurance to pay: Out of interest, how much does Health Insurance cost in the USA?
Thanks for the stats on number of Americans receiving Social Security, and percentage breakdown; I’m a little surprised that it’s only 66 million. Looking on the UK Government website, in 2022 (excluding the NHS, but including State Pensions) 22.4 million people in Britain claimed Welfare benefits of some sort (about a third of the British population); of which 12.7 million were State Pension, and 9.1 million of working age claiming some form of benefit that year.
Gathering info from different government sources, and doing a few maths calculations; I compiled the following list showing Government Expenditure on various Social and Welfare benefits, and including the NHS, as follows:-
• NHS = 40.9%
• State Pensions = 25%
• Income support benefits (for low wage earners) = 10.3%
• Disability benefits = 9.9%
• Housing benefits (for people who can’t afford to pay their own rent) = 5.6%
• Unemployment benefits = 0.4%
• Other benefits = 7.9%First, for social security w/medicare the full retirement age is 66 if you were born from 1943 to 1954. The full retirement age increases gradually if you were born from 1955 to 1960 until it reaches 67. For anyone born in 1960 or later, full retirement benefits are payable at age 67. There is a segment of politicians (Conservatives) that want it increased to 69 because it supposedly will be insolvent in 2035.
Next, Medicare is offered at the time you qualify for social security benefits. Medicare is deducted from the Social Security benefit. Currently it is $164.90. It can change from year to year. On that note, Social Security does have Cost of Living Adjustments (COLA) reviewed annually.
Then, there are what is known as Parts for Medicare. There are four. You mentioned an additional option with Medicare’s Supplementary Medical Insurance also known as Medigap. That is used with Part B Medicare insurance. It is completely optional.
People who obtain Part C - Medicare Advantage Plan, have no need for Medigap while it is not an option. Also, Medigap is not available to people who are not on Medicare or Social Security. In other words, the younger ones need to obtain a private insurance carrier. The Affordable Care Act (ACA) mandates obtaining health insurance.
A simple-to-read table of the costs surrounding medicare options (Parts) is at the next link:
Costs by Medicare.gov
https://www.medicare.gov/basics/costs/medicare-costs
For what is covered by each part is a short read, Parts of Medicare at the link next. It is also from Medicare.gov.
https://www.medicare.gov/basics/get-sta … f-medicare
Approximately 16% of the population are seniors receiving Social Security benefits. 4% are disabled under 65 receive Social Security Disability Insurance (SSDI). Once a disabled person turns the age to receive benefits in the retirement sense they are converted. 2% are others receiving Social Security benefits.Wow, healthcare in retirement in America (by British standards) look expensive.
Thanks for the two links; I found the first link confusing because in Britain we just don’t have any of that e.g. all healthcare in the UK is 100% free, including prescriptions (drugs) and there is no co-payments; so we’ve got none of the bureaucracy e.g. if you feel ill you see your doctor, your doctor treats you, and that’s it – no paperwork, no forms, no money to pay.
I noticed in the first link there are lots of expensive deductibles, which must surely eat into your pension if you need medical care?
The second link made a lot more sense, and seems simple enough e.g. Part A covers Hospital, Part B covers all other medical care, and Part D covers prescriptions. Since my three weeks stint in hospital in 2020, when I was rushed to hospital in an NHS ambulance I’ve used a lot of what’s covered by Part B, and initially had a lot of prescriptions, while I was making a full recovery – and it didn’t cost me a penny. I’d dread to think how much it would have cost me if I had to pay for it; it certainly would have eaten into my pension.
Like your Social Security, which has a cost of living adjustment and reviewed annually, in the UK welfare benefits are automatically increased annually in line with inflation; except State Pensions, which have the triple lock (as previously explained) so that State Pension increases is usually higher than inflation.
Your figures for the USA in your last paragraph are remarkably similar to the UK:-
• In USA 16% of population are seniors receiving Social Security – In the UK its 18.6% of the population who are over the age of 65.
• 4% of population in USA are on disablement benefits; which is the identical percentage for the UK.
Also, the gradually rise in retirement age in the USA mirrors the UK; although the political reasons for increasing the state retirement age may differ.
State Pension age in the UK rose from 65 to 66 in 2018. Currently in the UK the State Retirement age for those born 1960 is 66; for people born after 1960 there will be a phased increase in State Pension age to 67 from 2026, and eventually 68 - precise timing of the increase to 68 will be determined by longevity (increase in life expectancy). The only reason the State Retirement age is gradually being increased in the UK is because of an ageing population e.g. people are living longer, and there are fewer births.Howdy! Yes, most definitely the UK with HMS is much simpler. Thus far, I have only been sharing about Medicare for seniors. Not, anything about the private insurance companies for the working folk. However, the working folk use a private insurance company and do not deal with all the different Parts used by Medicare. Only us old folk are thrown curve balls.
Maybe?
You mentioned Medicare Part A, Part B, and Part D. There is another, Part C. I have a Part C policy. (See last link for info on Part C while comparing to Part A & Part B - long read) That is through a private insurance company. It costs the same as Part B does in most cases and is deducted from your Social Security payment the same as Part B.
Most if not all are a Health Maintenance Organization (HMO) policy. (See the second link for that) It uses medical groups for the services. Currently, my medical group is Scripps Heath (See first link following). They are a rather large medical corporation covering all of San Diego county. They have their own hospitals for instance.
However, some people elect a PPO plan. That is a Preferred Provider Organization. You can use out-of-network doctors on this policy. For some, they have no choice if a medical group is not available. There is an additional cost. See the third link for that.
Scripps Medical Groups (you can explore the different medical groups covering different areas of the county, yet basic services are the same)
https://www.scripps.org/medical-groups
Health Maintenance Organizations (HMOs) by Medicare.gov - a short read
https://www.medicare.gov/health-drug-pl … ptions/HMO
Preferred Provider Organizations by Medicare.gov - a short read
https://www.medicare.gov/health-drug-pl … ptions/PPO
Understanding Medicare Advantage Plans by Medicare.gov - It is a PDF document and a very lengthy read. But, the table of contents is linked to their section.
https://www.medicare.gov/Pubs/pdf/12026 … -Plans.pdfWow, all so complicated: I browsed through your links and it just looks like a minefield to me; if hypothetically, I moved to America I wouldn’t know where to start.
One impression I got from browsing through all the links is that you can’t choose just any doctor in America, but choose one that’s in the insurance scheme that you opt for?
In the UK a doctor is called a GP (General Practitioner); and GP’s work together in a practice, called a Surgery. Which Surgery you register with is entirely your choice e.g. we have three Surgeries near us to choose from; and if you don’t like one Surgery (for whatever reason) you can at any time opt to change to another Surgery. Is it a similar arrangement in the USA?
One question that rose in my mind, is what happens in America if while you are on holiday in a different State you feel unwell e.g. an upset stomach or a sore throat, and you don’t want to wait until you get back home to see your doctor?
In the UK, if while on holiday you don’t feel well e.g. an upset stomach or a sore throat, rather than waiting until you get back home, you can always pop into a local hospital A&E (Accident & Emergency). A&E were originally set up specifically as Accident and Emergency Departments; but it’s the Policy of the NHS A&E never to turn anyone away, no matter how minor the medical complaint – So use of A&E in the UK does notoriously get abused by the public. Therefore A&E operates a two tier system e.g. when you report to reception in A&E if it’s a genuine life threatening Accident or an Emergency then you are treated straight away, but if it’s just a trivial complaint you have to wait your turn.
Another question that spring to mind, is that with the medical service being fragmented in America e.g. different doctors and hospitals covered by different insurance plans, I guess there is no national centralised database for you medical records?
A couple of years ago, with the advancements in new technology, all our medical records in the UK are now on a central database – which gives both the NHS and patients the advantage of easy access to your personal medical records.
For example, if while on holiday you do pop into an A&E for minor medical treatment, which may involve the hospital prescribing you penicillin, they can double check your medical records to make sure that you are not allergic to penicillin; and then update the database so that your doctor can see what treatment the hospital A&E gave you while you were on holiday.
The other advantage of a centralised database is that I can access my own personal medical records at any time from an app on my smart phone.
Get more control of your health and care. Get the NHS App. https://youtu.be/421wy0ND9Ls
NHS App - How to view your GP health record https://youtu.be/YzqCDQzv9PkFirst, I live in San Diego County, California. It is larger than two states - Delaware & Rhode Island. It is 4,526 sq miles (11,722 sq km). To the west is the Pacific Ocean. To the East are mountains, but beyond them is desert. South is Mexico. North is another county on the west - Orange County and on the east is Riverside County.
Basically, it is semi-arid with Mediterranean tossed in in some areas. The population is 3.3 million. It has 18 cities. There are towns, villages, and rural areas too.
There are 15 major medical groups. Some have groups within the main group like Scripps has for servicing different areas of San Diego County. There are 16 major hospitals.
I don't know how many clinics (Usually a small group of private practice doctors), urgent care facilities, and what they call Express Care. Plus, private practice doctors of all sorts. Too, there a specialty places like imagining, blood labs, etc. There is one teaching university - the University of California San Diego. It is pretty prestigious.
" San Diego County Medical Society (SDCMS), the professional association for physicians in San Diego. Founded in 1870, SDCMS currently counts over 4,500 physicians and medical students as members."
Yes, navigating Medicare is a task. Then navigating medical groups too. For instance, my primary care is in one location. I have seven specialists located in four different cities. However, mainly in my area known as North County. The farthest I have to drive is forty minutes. Most are within twenty.
One must consider if one has bucks who cares, right? The poor on welfare is something different altogether. They are on Medicaid administered by the state. In California, it is called MediCal. Medicaid is a definite task to navigate. Usually, they are clinics. At least in my neck of the woods.
Medicaid.gov-Keeping America Healthy
https://www.medicaid.gov/
The middle-class working folk are pretty much using private insurance. BTW . . . as declared by the Affordable Care Act it is mandated nationally to have insurance. It is contentious and the conservatives want to repeal it.
Most of those people have the same choice between an HMO or PPO as shared in the other post. So, the game with medical groups continues.
The bottom line, again, your NHS is far easier!!Yeah, the NHS does seem far easier; and in contract to America where “The middle-class working folk are pretty much using private insurance.” And “The poor on welfare in America is something different altogether.” In the UK the NHS serves all alike (rich & poor), and is even used by the Royal Family, as this British newspaper article shows: - https://www.theguardian.com/uk-news/202 … s-hospital
St Bartholomew’s hospital (now an NHS hospital), where the Duke of Edenborough (The Queens husband) was treated in 2021, is Britain’s oldest hospital, over 900 years old; and is a centre of excellence in cardiac care.
Thanks for all the data for where you live in California; it’s difficult to make any direct comparisons, but suffice to say the medical healthcare facilities and services in USA and UK, like any wealthy country, are certainly comprehensive. But out of interest, using NHS websites to gather some of the information, I’ve compiled data for Bristol (where I live) and for England in general, along the same lines as the data you provided for where you live, as follows:-
N.B: Clinics (as you describe) e.g. usually a small group of private practice doctors, is essentially what we call GP Surgeries in the UK (except the doctors are NHS employees and not private).
BRISTOL
• 42.5 square miles
• Population 0.47 million
• 56 GP Surgeries in Bristol - 3 of which are within walking distance from where I live e.g. less than 1 mile.
• 9 NHS Hospitals in Bristol (4 of which have A&E)
ENGLAND
• 50,301 square miles
• Population 56 million
• 55 cities and around 40,000 towns and villages
• 6,495 GP Surgeries (doctor practices) in England
• 704 NHS hospitals in England
From the data you provided for California:-
• 4,526 square miles
• Population 3.3 million
• 18 cities
• 16 major hospitals
Picking up on your point about ‘teaching hospitals’ in California (the University of California San Diego); I can’t get exact numbers without a lot of research and a lot of maths, but suffice to say, most NHS hospitals are university hospitals e.g. a partnership between the hospital and their local universities for training and research – it’s a natural partnership that benefits both sides.
The hospital where I spent three weeks in 2020 (very state-of-the-art): https://youtu.be/741SRxcCozUAnother interesting aspect about the NHS is that with 1.7 million employees, the NHS is the 5th largest employer in the world (with Walmart in the USA, with 2.3 million workers, being the largest): https://en.wikipedia.org/wiki/List_of_largest_employers
I find the NHS website very useful, especially their "Health A to Z" section, which is a complete guide to conditions, symptoms and treatments, including what to do and when to get help: https://www.nhs.uk/Yup, the NHS system is different. The contrast is NHS is nationalized medicine funded by taxes whereas here it is big business, though the medical segment maintains its nobility.
See the following link for the national perspective of how big it is. At the beginning is Key Healthcare Statistics. After that, it is a very lengthy read. However, on the right will be a table of contents. Maybe worth a peek and skim?
39 U.S. Healthcare Industry Statistics, Facts & Size by Cross River Therapy (01/11/23)
https://www.crossrivertherapy.com/healt … statistics
I live in the city of Escondido population of 151,000+ (2021). We have only one hospital - Palomar Medical Center. It also services neighboring small cities. The video next is from 2012, when the hospital opened, shares how high-tech it was for the day.
Bloomberg TV Visits Palomar Medical Center
http://www.vgocom.com/bloomberg-tv-visi … cal-center
The next link is about the University of California San Diego (UCSD) medical world as far as teaching goes and servicing the county. It is known as UC San Diego Health.
Facts at a Glance
https://health.ucsd.edu/about-us/facts-glance/
To give a compare/contrast between the difference between NHS and the big business of the medical world, Medicare, and insurance world is a challenge I am undergoing today. It demonstrates the puzzle presented to people to obtain medical care. Today . . .
I am on a Medicare Advantage Plan (HMO), which is the Part C option of Medicare for seniors over 65. It is an insurance company, but is a non-profit corporation. I have been using the same medical group, Scripps Health, for decades. So, when I had private insurance while working I was a patient of them.
Well, they decided to discontinue contracting with 'any' Medicare Advantage Plans that are Health Management Organization (HMO) ending Dec 31 of this year. Oh No!!! What to do, what to do, now? From news articles that decision will affect over 32,000 patients in San Diego County.
Currently, I only pay the deducted amount from my Social Security for my policy, which is an HMO. That is the same amount deducted for Part B of Medicare.
Options open to me:
** I can change my policy to a PPO and have an additional premium and continue with Scripps. I can't afford an additional premium for a PPO.
** I can find another medical group that accepts my current plan hoping they do have the specialists I need that are 'in network'. For a specialist out of network means finding one that accepts my HMO carrier and the plan I have.
Well, after a few days of researching I have a solution. (Thank the cosmos we have the internet today otherwise in the old days it would be a disaster to figure out what to do)
What do I have to do? As it turns out:
** I discovered a medical group that does accept my insurance carrier for Part C, Medicare Advantage plan (HMO), but not the same plan. Coincidentally it will be UC San Diego Health a part of the UCSD system.
** I will have to change plans, which thankfully is an HMO, so no additional premium.
** Between Oct 15 and Dec 7 Social Security/Medicare has open registration to join, drop, or switch plans. Yup, you can only do those in a designated time period.
** I will have to get a new primary care doctor. I don't know how soon it will be to meet up. Probably a week or two after I switch my policy. Then I start over. Fortunately the office is a fifteen minute drive, though I will have to drive on a highway for part of it.
** The primary care doctor will have to make referrals for the specialists in their network that I need. With research some will be in a different city a twenty-five minute drive from me. And, some will be a forty minute drive. I faced the same thing with Scripps, so no difference.
** Hopefully, I will be able to meet up with them within at least 30 days. Sometimes with a medical group, it can take longer.
** I have to start over with the new specialists and bring them up to date on my treatment plans. Notably for me is my Prostate Cancer.
Some of the challenges will be:
** Scripps will have to transfer my medical records to UC San Diego Health. Will the two computer systems integrate smoothly?
** I downloaded all my medical records and they are PDF documents over a thousand of them.
** Fortunately, like you, I have online access to my records with Scripps in an organized fashion. It shares categories like visit summaries, test results, procedure results, current physicians, appointment dates, diagnoses and more. They even share with us what the imaging images look like. Cool!
So, I made notes and printed a few things out like the summary of diagnoses, blood test histories, and more. I think I am prepared for the upcoming battle. ha-ha
I shudder to think about seniors not savvy with a computer and/or the internet.
I presume many are more healthier than I am, so not really affected much only having to deal with the primary care doctor. Yet, they have the same dilemma and are 32,000 patients.
However, in the working world, an employer usually only offers one insurance carrier and usually two choices for a policy - HMO or PPO. Then comes choosing what medical group to belong to and selecting a primary care doctor. I don't know much about that world. I left employment when the Affordable Care Act went into effect. I don't know the ins and outs of what a person is faced with.Sorry to hear that Scripps Health is ending its contract with the HMO Medicare Advantage Plan, and that you have to scrabble around to find a suitable and affordable alternative; it must be a very worrying and stressful time – but glad to hear that you have been savvy enough to find a suitable alternative.
I watched the video on your hospital, and certainly a very impressive high-tech hospital; it’s good to have that on your doorstep.
I browsed through your other links over the past couple of days, especially the first link; and yes, it shows how vast the business is in American healthcare e.g. “14% of adults in the USA work in the healthcare industry” compared to just 5% in the UK. Although on the downside, it must be concerning to see that they say “20% of adult Americans don’t have the means to access healthcare.”
Your link also gives the average wage for healthcare employee in the USA as $60,976; I haven’t been able to find any reliable comparisons for the NHS – although I suspect medical staff in American gets paid a lot more than NHS staff. But what I did find is the latest pay scales for the NHS which starts at pay Band 2, £22,383 ($27,397) and the top rate at Band 9 is £114,949 ($140,697).
The other thing that always amazes me is how much healthcare costs per capita in the USA compared to the rest of the world e.g. the link states $10,224 per capita; a comparison is given by the OECD data given on Wikipedia (the figure for the USA is slightly different to the one in your link) but the differential between the different countries is in line with similar data from other sources that I’ve seen in the past: https://en.wikipedia.org/wiki/List_of_c … per_capita
Of course the cost on health isn’t just a measure how much money is spent on healthcare, it’s also a measure on efficiency, cost effectiveness and how much profit is being creamed off by profit making insurance companies, hospitals and doctors etc.
Plus another contribution to health cost is the high cost of drugs. My understanding is that individual American hospitals and doctors don’t have a great deal of bargaining power when buying from big American pharmaceutical companies, so if they want the drug they have to pay top price for it.
In the UK, it’s not the NHS who negotiates with the pharmaceutical companies, it’s an Independent Government Department called NICE (National Institute for Health and Care Excellence). The NHS, are prohibited from using drugs not approved by NICE. And NICE, when negotiating with pharmaceutical companies represents a single market of over 67 million people, giving it a lot of bargaining power – and often NICE gets generous discounts for expensive American drugs; which save the NHS a lot of money.
NICE’s ambitions for the future of health technology evaluation: https://youtu.be/4Tphd-_WHfk
In 2021 NICE negotiated with a Swiss pharmaceutical company to buy the most expensive drug in the world for the NHS; cost £2.2 million per dose – although as explained in the 8th paragraph from the bottom in the link below, NICE negotiated a substantial discount price.
https://www.theguardian.com/society/202 … -zolgensmaWow!! £2.2 million a dose!! Yet, it does sound like the drug is a miracle drug. I certainly hope so! However, here, I bet it would be a challenge for caring parents of their child to get access.
I poked around for here seeing a similar cost. Also, there seem to be quite a few health insurance companies covering it. The out-of-pocket expense would vary by corporation and policy. That may put a brick wall in front of everyday parents.
I read the article you shared. One thing we both know is the NHS does the bargaining for the people, whereas here it is the game between pharmaceutical companies and the insurance companies.
For instance, my insurance for pharmaceuticals is three tiers. Tier 1 is fairly inexpensive. For, instance my diabetes and high cholesterol meds have no cost, but they are generic drugs. No problem as I see it. The retail cost of them is is dirt cheap too.
But, Tier 1 is based on retail cost for a cap of $4430 (£3619). Once one goes over that they move into Tier 2 where the out-of-pocket is 25% of retail. I do have brand drugs that are not generic. In other words in my case they are expensive. The catch is it, too, has a cap, but it is based on out-of-pocket spending. Not retail. Its cap is $7400 (£6046).
If you go over that then you go to the next tier called Catastrophic Coverage. It has a cap at $3400 (£2778) out-of-pocket. Once that is exceeded the drug is at no cost.
The following is for the two brand drugs I get. The flow is retail cost → my Tier 1 out-of-pocket → my Tier 2 out-of-pocket at 25% of retail. One thing to note is that for me with just one prescription fill of my brand drugs, I almost exceed the cap of $4430 (£3619).
Drug A = v – 90-day supply - $2713 (£2216) - $106 (£87) - $678 (£562)
Drug B = a – 90-day supply - $1263 (£1032) - $ 126 (£126) - $315 (£257)
Note: To convert $ to £ I used 0.817
As I am sure we both recognize here the medical world is flat outright big business. Checking out the per capita I immediately sorted it. Wow!! Yes, we are #1 and by a fairly large margin too with the OECD table. It would have been nice if another column was added with whether nationalized medicine or not.
We have something similar to NICE. It is the Federal Drug Administration (FDA). The FDA is responsible for protecting public health by regulating human drugs and biological products, animal drugs, medical devices, tobacco products, food (including animal food), cosmetics, and electronic products that emit radiation. So, they are busy I would think. They have 22,000 employees (2022) with a 7.2 billion dollar budget. That is what? £5.9 billion.
I have a Friend in Sweden who also has nationalized medicine. We have had email discussions of costs. That brings up a question for you. What about optical and dental? Those are not covered in Sweden from what she has shared with me.The simple answer to your question is yes & no!
When Labour created the NHS in 1948 it included both optical and dental.
However in the 1980’s Margaret Thatcher, largely (but not completely) scrapped free NHS optical; Margaret Thatcher hated the NHS on principle e.g. she saw it as pure socialism.
So the current situation is that you can still get free eye tests on the NHS if any of the following applies:-
• You are under 16, or under 18 if in full-time education.
• Over the age of 60
• Registered partially sighted or blind.
• Have diabetes or glaucoma, at risk of glaucoma or over 40 and have any close family member with glaucoma.
• In prison.
• On a low income e.g. receiving Welfare Benefits (Social Security).
And if any of the following apply, you can get a free voucher from the NHS to pay for the cost of glasses or contact lenses:-
• You are under 16, or under 18 if in full-time education.
• In prison.
• If you or your partner (including civil partner) are on a low income e.g. receiving Welfare Benefits (Social Security), or you’re under 20 and dependent on someone on Welfare Benefit (such as living at home and your father who is unemployed).
As regards Dentists
The NHS Dentists had a barmy dispute with the Conservative Government in the mid-1990s, because the Government refused to negotiate better payments for NHS dentists; so the vast bulk of NHS dentist went largely private (only accepting a small number of NHS patients on their register); so these days, especially if you don’t live in a big city) you have to do a lot of phoning around to find a dentist who is currently accepting new NHS patients on their books.
Although c2006 an NHS dental practice, calling themselves MyDentist, started with 3 dental practices in North West England; they now have over 600 NHS dental practices across the UK, and about 3 in Bristol – So living in Bristol it’s not too difficult to find an NHS dentist.
In 1951 the Conservative Government introduced dental charges, and today, unless you are exempt from the charges the NHS dental charges are as follows:-
Band 1: £25.80 ($31.58)
Recommended six monthly check-ups; and covers an examination, diagnosis and advice, includes X-rays, and scale and polish if needed.
Band 2: £70.70 ($86.54)
Covers all treatment included in Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth (extractions).
Band 3: £306.80 ($375)
Covers all treatment included in Bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges. Although denture repairs are free on the NHS.
However, all NHS Dentist work is 100% free if any of the following applies:-
• You are under 18.
• Pregnant, or have had a baby in the last 12 months.
• On low income e.g. on Welfare Benefits (Social Security Benefits).
However, anyone can get ‘free’ emergency dental treatment if they make a visit to an NHS Dental Hospital rather than visiting an NHS dental practice. The reason the Dental Hospitals are free ‘to all’ is because if you go there you will be treated by a dental student (and not a fully qualified dentist), as it’s the Dental Hospitals where potential Dentist of the future study part of their university degree to become fully qualified.
Discover what we do at Bristol Dental School: https://youtu.be/L7-vXV2kJ38
A day in the life of a Bristol dental student https://youtu.be/d_M4CCx4J3U
I’ve just limited this post to answering your question, as it’s turned out to be quite a lengthy reply; and I’ll get back to your other points in a separate reply (if not later today, then hopefully tomorrow).
How does the NHS dental charges (listed above) compare to dental charges in the USA?As we have discovered between us in the UK, Sweden, and here in the US those services – dental and vision, in an odd sense, to me at least at this time, are not considered medical in general. I don’t know about the UK, but here hearing joins them. They all are off in their own worlds.
Well, let me correct myself. Ophthalmology is covered by typical health insurance policies whereas optometry is not. My diabetes eye exams and my cataract surgeries fall/fell into that realm. I paid nothing for the surgeries and my annual eye exams I paid a specialist co-pay of $35 (£29). However, the new HMO plan I will switch to a specialist is $0.00.
I have a separate policy for optometry. In my case, though a separate policy, it is given to us by my Medicare Advantage insurance company as a bonus kind of thing. It provides for free eye exams and an allowance for lenses and frames.
Hearing is also a bonus separate insurance policy given to us by my health/medical insurance carrier. It covers exams and hearing aids at 50%. Of course, you have to go to contracted services.
First, dentistry is big business. Typical Dental costs will vary based on the market related to location, competitiveness, and the dentist themselves business plan. I say typical Dental because there are periodontal surgeons too. Yet, some periodontal services are done by a dentist trained in it. For instance, my dentist does implant services and other services as well.
Dental checkups range from about $100 (£82) to over $300 (£245) per appointment. And the average cost of X-rays/imaging is about $80 (£65) to over $200 (£163). I keep saying imaging because many today use computed tomography (CT) scans to capture 3D dental X-rays of your teeth, jaws, joints, nerves, and sinuses in place of X-rays. My dentist uses both.
The CT scan was done on my initial visit whereas X-rays were done for my teeth extractions. The CT scan was pretty cool. A machine apparatus goes around the head doing the imagining. It happened in seconds.
A note: I don’t have dental insurance. I can get it through my present medical/health insurance carrier at a premium. Or, go onto the open market.
As far as dental or periodontal costs go to the next link where there is a list of services. Remember it will show a range.
Average Dental Costs and Pricing by CareCredit (hint, hint the name of the company)
https://www.carecredit.com/dentistry/costs/
Just for information, the next link is to my dentist's website to explore. It is a group organization with different locations in San Diego County. A note is the main owner is big into trains.
Somewhere at the site is a spiel on trains. There is a model train track at my office that goes around the area where the services are performed. So, the choo-choo passes several times while I am there sitting in the chair.
Dental Express
https://www.thedentalexpress.com/
As you have gathered the medical world here, especially regarding insurance coverage is varied as well as within the welfare system and social security/medicare for seniors. So, again, socialized/nationalized medicine is a whole different ball game. Shooting from the hip it would be a monumental task for the US to become socialized/nationalized medicine.
A good laugh is I did a little research for dental costs on the web. I just now visited FaceBook and my feed is inundated with posts for dentists and dental work.
Thanks for a comprehensive response, and the links, which is enlightening. I learnt from the links how expensive dental care can be if you don’t have any insurance coverage – It makes me all the more appreciative of the NHS costs, which seems modest in comparison.
I didn’t find the spiel about trains on the Dental Express website, but I certainly liked the logo and hyperlinked icons at the top of the home page – cool.
Yes, where you say “it would be a monumental task for the US to become socialized/nationalized medicine.” for that to happen in America would require seismic shift in politics (to the left) and an equally seismic shift in public opinion. It was only possible in Britain because Labour won a ‘landslide’ victory in the 1945 General Election.
You raised the question of hearing; it is covered by the NHS – do you know if it’s covered by the Swedish healthcare service?
In the UK you can get a free hearing test from the NHS, pharmacies and opticians.
And if you do need a hearing aid or implant then they are available on the NHS. A close friend of ours had a civil partner who was from the Netherlands, who had hearing implants, and while living in Britain they needed replacing (a fault) and he got them replaced for free on the NHS.
I note from your reply that in American a separate insurance covers 50% of the costs of hearing exams and hearing aids. I have no idea on costs as it’s free on the NHS, so I don’t know how much our friend from the Netherlands would have had to pay if it wasn’t free on the NHS for him. Are hearing aids and implants expensive?
The team at an NHS Hearing Implant Centre: https://youtu.be/j9xTlygjQp4
You might ask ‘how can pharmacies and opticians offer free NHS hearing tests’. The answer is that although opticians and many (but not all) pharmacies are private, opticians do some work for the NHS (including free hearing tests), and under British law (since 1948) a Pharmacy shop cannot operate without there being at least one NHS pharmacist on the premises. The advantage for the public is that for minor complaints they don’t have to always make an appointment to see their doctor, they can optionally just pop into their nearest private Pharmacy shop to get free medical advice from the NHS pharmacist on duty – as shown in this short NHS TV Advert: https://youtu.be/9RhQVasBFs8
The Pharmacy shop I usually use is next door to our GP Practice, and is part of the NHS; just a 10 minute walk from where I live.I always appreciate the videos on a topic that you share, Arthur. They are not long usually and to the point regarding info, especially the NHS ones. So, thank you. I may look for some on this side of the pond in the future.
Well, I did seek out some videos. I aimed at Social Security/Medicare. They may clarify some things I have shared.
Medicare Parts Explained (FAST!) by Boomers Benefits (5:22 min.)
https://www.youtube.com/watch?v=J1B57hXIjb0
Do You Need A Medicare Supplement Plan? That is also known as a MediGap plan by Boomers Benefits (5:29 min.)
https://www.youtube.com/watch?v=eSIOcPXSpak
What Does Medicare Part C Cover? | Medicare Advantage 2023 by Boomer Benefits (3:55 min.)
https://www.youtube.com/watch?v=Ba0groz1eYM
I have a Medicare Part C plan. It includes the Part D plan following next.
Understanding Medicare Part D in 2023 by Boomer Benefits (8:28 min.)
https://www.youtube.com/watch?v=JpA5nisotRg
Health care in Sweden is different than both of us. They have a national segment of the national government that oversees the medical world, but the care is overseen by the regional governments. So, some of the specifics will vary by region.
Overall I like what is done in Britain regarding hearing. I don't know if hearing is covered in Sweden. Let me interject here for us implants may or may not be covered by an insurance company. I don't really have any personal experience with hearing at all. I may in the short future being an old guy. After I get through my adventure with the switch of my medical group I'll look into it.
One thing to bear in mind the medical world is big business here. An example, today, the fiasco of the Scripps medical group dropping patients (32,000) with a Medicare Advantage HMO plan coming this Dec 31. I have already seen businesses that will help you navigate the challenge and, maybe sell you a new and different medical insurance policy at a cost of course. In other words, an insurance brokerage firm.Yes, the medical world in the USA is ‘big business’; we have a saying in Britain “People before Profit”.
Most defiantly, yes; videos do help e.g. the old say “a picture paints a thousand words”; although, even after watching all four of your videos, it’s still confusing – but it does now make a little more sense to me: Although one thought that crossed my mind while watching the videos, is that if had all the medical expenses in Britain that you have in America e.g. the deductibles and co-pays etc., our State Pension would need to be more than double what it is, otherwise many baby boomers would be living in poverty, and ill health!How many seniors live at or below the poverty level is debatable at times. One metric that is used more than the actual poverty level itself is 200% of it for assistance programs.
From a CNBC article Aug 5, 2023 the key points share:
** About 23% of Americans over age 65 live in poverty, according to the Organization for Economic Co-operation and Development. That’s one of the highest shares among developed nations.
** U.S. Census data suggests a smaller share of the elderly are poor, and that old-age poverty nationwide has been falling.
**Experts say tweaks to Social Security benefits would be the best way to address senior poverty. But it would be costly at a time when the program’s finances are already shaky.
I bring that up because Medicare out-of-pocket will have to come from Social Security benefits in many cases. That is where the Medigap policy will be a financial lifesaver for those on traditional Part A and Part B. Yet, that is a monthly cost/premium too.
The article is:
Are U.S. seniors among the developed world’s poorest? It depends on your point of view by CNBC (Aug 5, 2023) A short to medium read.
https://www.cnbc.com/2023/08/05/whether … -used.html
Another somewhat short read is next.
Social Security and the Poverty Line by the American Enterprise Institute (Sept 26, 2022)
https://www.aei.org/economics/social-se … erty-line/It took a bit of research to find and verify the data I wanted, but I got there in the end:
The short answer to your question is that according to the OECD (Organization for Economic Co-operation and Development) in 2018 23.1% of Americans over 65 lived in poverty and 15.5% of UK citizens over the age of 65 lived in poverty.
https://www.oecd-ilibrary.org/sites/d76 … 76e4fad-en
But one word of caution is that the term ‘poverty’ as used, is a relative term e.g. relative to median average income:
• The UK Government defines poverty in the UK as “Relative low income: This refers to people living in households with income below 60% of the median in that year.”
• The OECD defines poverty globally as “Percentage with income lower than 50% of median equivalised household disposable income”
The timeline for poverty over the last three decades for pensioners in the UK, according to UK Government sources, is as follows (my added comments given in brackets):
• Mid 1990s – Pensioner poverty rate was over 28% (after 18 years of Conservative rule)
• By 2012 – Pensioner poverty rate had declined to 13%; poverty driven down by increasing income from private pensions (work pensions) and increases in benefits (Social Security): (Following 13 years of Labour rule).
• In 2019, Pensioner poverty peaked at 18% (following 9 years of Conservative rule).
• By 2021, Pensioner poverty had reduced to 15% and is still falling (Under Conservative rule -e.g. the triple lock kicking in during periods of high inflation, and additional social security handouts during the pandemic and cost of living crises caused by the Ukrainian war).
Two positive actions the Conservative have made, which helps to keep ‘Pensioner poverty’ lower in the UK, since coming to power in 2010 are:-
• 2010 – Introduction of the triple lock on State Pensions, and
• 2012 – Making workplace pensions compulsory.
A more pertinent question would be “how many pensioners live in abject poverty rather than just ‘relative’ poverty”? I can’t put my figures on any meaningful data, but I would expect, and hope, that in wealthy counties like the USA & UK that people living in abject poverty would be an extremely low percentage of the population!
I was mulling over in mind when I went up front to watch TV about the owner of Dental Express and his interest in trains. So to share with you about it I found three short videos.
This is the one I saw already that I mentioned. It is about them shipping a train to one of their offices to display in the front. The video is on the top right and is about 2 min.
https://www.thedentalexpress.com/shipping-wars/
This one is a little girl playing choo-choo at one of the offices where they have a train mock-up for kids to play on. Less than a minute.
https://www.thedentalexpress.com/videos/21613/
Finally, this one is a tour of one of their offices. It shows the train that goes around the service area along the top of the wall. Plus, it shows the CT machine doing a scan. About a minute. (Quality a little blurry)
https://www.thedentalexpress.com/videos/21616/Very impressive: From your previous description I was imagining a model train; but wow, the train in front of the shop and the play train are full size, and even the model train that runs around the dental office is big – so the videos were helpful, and goes to show that “a picture paints a thousand words”.
I too love trains, especially the old stream trains; whenever on holiday in Britain, if there’s a steam train station in the area we try to make a point of visiting it, and perhaps taking a ride on the train if there’s time.
My favourite steam train railway that we’ve visited so far is the Ffestiniog and Welsh Highland Railways; the video I took of our time on this railway is rather long I’m afraid but it does start off with a Welsh school choir singing on the train station in welsh – Although, by pressing the ‘More’ button in the description box under the video there’s a linked menu that allows you to skip to any part of the video of interest: https://youtu.be/1_6KTpd0bko
Also, decades ago I and my son (Nathan) built a model railway village in our loft (short video clip): https://youtu.be/IG6BWJL6VDsWow!! That is a pretty extensive model train village and rail system in place. Is it still there now? How long did it take you two to complete it? I am sure as a father-son project it was amazing!!
I enjoyed the steam train trip. The scenery caught my interest. Beautiful! How long did the actual trip take? Yes, the menu came in handy. Brilliant idea to put one there!
Have you heard of or is the comedy sitcom 'Young Sheldon' broadcast in the UK? Young Sheldon is when Sheldon of the infamous comedy sitcom The Big Bang Theory was a kid. Young Sheldon is a spinoff from the Big Bang Theory. It is still running today going into its seventh season. Young Sheldon was nine years old when the series began. It is in the Top Five shows for me to watch every week.
Sheldon in the The Big Bang Theory is a Theoretical Physicist. In Young Sheldon, he is a genius and is in High School. That is grades 9 - 12 ages or ages 14 - 18. Jim Parsons plays Sheldon in The Big Bang Theory and is the narrator for Young Sheldon. So, they are connected for fans of both.
Here is an interesting video of different clips of both shows strung together about his interest/life with trains. (4 min.). Most of it is from The Big Bang Theory.
Sheldon loves playing Model Train sets Clips
https://www.youtube.com/watch?v=w0IBoAKY_Zw
Anyways, he is big into trains on both sitcoms. That came to mind while learning of your interest in trains and seeing your village.
Following are Wikipedia links for both shows. These are in order of when they were broadcast.
The Big Bang Theory
https://en.wikipedia.org/wiki/The_Big_Bang_Theory
Young Sheldon
https://en.wikipedia.org/wiki/Young_SheldonYes it was a great father-son project; it took months to build the model railway. Unfortunately, when my son graduated from university to become a freelance professional photographer he wanted to convert our loft to a photographic film studio, so we had to carefully dismantle the model railway village.
All the bits and pieces to the model railway were carefully packed away, so that perhaps one day either I or my son can build a new railway model; and I salvaged the wood used in its construction, and subsequently recycled the wood in various DIY projects.
Yeah, the scenery in North Wales is breath-taking (beautiful). The whole journey time for the steam train trip we took was a total of 3 hours and 20 minutes (including lunch), as below:-
Blaenau Ffestiniog to Porthmadog train journey times:
• Blaenau Ffestiniog to Tan-y-Bwlch Station = 30 minutes
• Lunch at Tan-y-Bwlch Station = 1 hour
• Tan-y-Bwlch Station to Porthmadog = 40 minutes
• Return journey Porthmadog to Blaenau Ffestiniog = 1 hour and 10 minutes
Total travel time on train, including lunch break at Tan-y-Bwlch = 3 hours and 20 minutes
While on holiday, we only had time to explore that part of the steam train network in North Wales, there’s a good handful of other excursions we could have chosen, the longest being 7 hour roundtrips, including time out to explore the historic towns. Further details are given here: https://www.festrail.co.uk/trains/
Yes we do get The Big Bang Theory and Young Sheldon on British TV; although I’ve seen snippets, I’ve never actually had time to watch a whole episode e.g. we already have tons of stuff pre-recorded on the TV cable box to watch in the evenings (family quality time). Currently, after watching a family film we watch a couple of episodes of various series we’re following; at the moment it’s the American TV series ‘Willow’, staring Warwick Davis and filmed in Wales, and the latest ‘Ghost’ BBC Comedy Series (The British version), MASH, and a British adult BBC Comedy Series called ‘Not Going Out’.
Not Going Out is now the 2nd longest British TV Comedies Series; 99 episodes over 13 years, to date. Link below is an Episode covering the topic of where men should health check their private parts for amoralities (adult humour): https://youtu.be/O4TShxUWQeM
Early next year hopefully a new season of Murdock (Canadian production) and the latest Dr Who will be just two of our top choices for evening family TV.
Therefore, not having watched the series myself, I wasn’t aware of Sheldon’s interest in trains; and watching your video clip was a delight. Although we do have a close friend who’s a fan of Young Sheldon, and he has filled me in on other aspects of Young Sheldon when I’ve visited him – so next time I see him I’ll have to mention the trains in the Series.
Wow, that sounds so complicated for medical drug supply; and quite expensive: Especially as the cost for all your medical drugs added to all the other out-of-pocket expenses and co-pays; which all adds up. It must be difficult, and potentially stressful, when trying to budget for your healthcare, especially for Americans on a low income.
Interesting to read about the responsibilities and coverage of the FDA; they certainly have a wide remit, which as you say, keeps them busy.
In the UK NICE is only responsible for medical drugs used in the NHS specifically.
The other responsibilities that you list, that are covered by FDA in the USA, in the UK are covered by various Government Departments; for example:-
• The FSA (Food Standards Agency) which is a subdivision of the UK Government Department for Environment, Food & Rural Affairs, is responsible for food safety and food hygiene, and animal welfare in England, Wales and Northern Ireland. (Scotland has its own similar Government Department).
• The OPSS (Office for Product Safety and Standards) which is a subdivision of the DBT (Department for Business and Trade), responsibilities includes the legislation for cosmetic products.
• And standards for any goods and services sold in the UK is also covered by the Trading Standards Office (responsibility of local governments) e.g. Trading Standards will seize illegal imports of cheap China products that don’t meet British Standards, and in partnership with the police will prosecute any retail business for importing cheap illegal goods etc.
The Trading Standards Profession in the UK: https://youtu.be/Vrped818y4EYeah, prescriptions and the tier system has not been good to me. Sad!! It will drive me into the poor house. Alas, it is because of my diagnosis. They are related to diabetes.
The cost of pharmaceuticals is a constant complaint here in the US. It is an issue that politicians mainly Democrats (Left) run on with their campaigns. Recently a bill/act passed Congress allowing Medicare to negotiate with the drug companies.
Biden-Harris Administration Moves Forward with Medicare Drug Price Negotiations to Lower Prescription Drug Costs for People with Medicare
https://www.hhs.gov/about/news/2023/10/ … icare.html
For products, there is also a different agency that responsibility falls into. It is the Consumer Product Safety Commission (CPSC). I don't know if they coordinate on medical products or not with the FDA.
Consumer Product Safety Commission
https://www.cpsc.gov/Thanks for the feedback and links; it's good to see that Medicare can now negotiate with drug companies; a bit of a long wait e.g. the reduced drug prices don't come into effect for a couple of years (2026), and initially will be for just 10 drugs - but its a step in the right direction.
And thanks for the CPSC link; yes, the CPSC is similar to the 'Trading Standards' Office in the UK - and their desire (on their 'About Us' page, to become a world leader in the field of consumer protection is good.
In reply to your question “Do you still keep up with your website?”
I haven’t much with it for a few years because I’ve been busy/preoccupied on other tasks; but it is my genealogy/family history website, and I do still have a lot of family documents to transcribe to the website, and there is still more family research I want to do when I get the time:
So I am planning to get back to working on my website in the near future; perhaps over the winter months when there is little to do in the garden.
Obviously I don’t make any money from it, because it’s not that sort of website (no advertising on it); but it does provide contacts with others doing similar research, and even the BBC contacted me through my website a few years ago because I had family documentation that they were interested in borrowing for part of a documentary series they were making called (A House Through Time). In exchange for me lending them the documentation for the episode they gave me and my family a private tour of the house in Bristol that they were featuring: 10 Guinea Street (it made for a nice family day trip out).
The current state and future outlook of Social Security undeniably hold significant implications for voting behavior as a singular issue, in my view. SS, as a cornerstone of the U.S. social safety net, is a vital concern for millions of Americans, particularly seniors and individuals with disabilities.
As the population ages and the program's financial challenges loom, I do feel voters increasingly scrutinize candidates' stances on SS, more so than ever. The program's solvency and sustainability become central campaign themes, and most likely does influence voters' decisions.
Moreover, Social Security's future impacts younger generations, making it a cross-generational concern. The perception of whether candidates prioritize bolstering SS or propose reforms, like raising the retirement age or adjusting benefit calculations, can certainly sway voters. Therefore, the trajectory of Social Security's funding and policy decisions is likely to remain a pivotal factor in shaping voter preferences and could drive policy debates and political platforms for years to come.
Just my view, voters do not always vote solely on singular issues, as their decision-making process can be influenced by a variety of factors. While some individuals may prioritize a specific issue that aligns with their values or interests, many voters consider a combination of factors when casting their ballots. These factors can include a candidate's overall platform, party affiliation, leadership qualities, and perception of how a candidate will address a range of issues.
I feel emotions can also play a significant role in the voting process. Voters may be emotionally attached to certain issues that deeply affect them or their communities, and this emotional connection can totally influence their decision-making. Additionally, candidates often aim to evoke emotional responses from voters through their campaign messaging and speeches, hoping to connect on a personal level and garner support.
While singular issues can be important to some voters, I feel the decision to vote is typically influenced by a complex interplay of factors, including emotional considerations and a candidate's overall platform.Thank you Sharlee for the contribution to the OP, which for me is important. By that, I mean both the size and importance of the senior voting bloc and what is happening with Social Security today. Next, I addressed what to me stood out paragraph by paragraph with what you shared.
Okay, the statement that 66 million receive social security benefits is somewhat misleading. It is verifiable that seniors are 84% of that. So, that means the seniors are 55.4 million. That is the senior voting bloc, though we don’t know how many participate in the voting process.
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“ . . . I do feel voters increasingly scrutinize candidates' stances on SS . . .”. Most likely, yet is it up in the air kind of thing? We know the Democrats seek to protect it as it is today if not expand it.
At the next link is the article by Yahoo Finance; These GOP candidates want to trim Social Security for younger Americans. They disagree how. There is a graphic near the beginning of the article for the stance of all the Republican candidates for Social Security.
https://finance.yahoo.com/news/these-go … 46915.html
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“Moreover, Social Security's future impacts younger generations”. That point is well taken! However, is it a concern? How many, today, care?
From Pew Research, we learn “Among those who are not retired, about four-in-ten (42%) doubt they will receive any Social Security benefits when they leave the workforce, while an additional 42% say benefits will be provided but at a reduced level.”
We already have been told or hinted that there will be a 20% cut to social security benefits in 2035 due to predicted insolvency. The year 2035 arrives in 12 years. That means a potential cut will affect 50 million baby boomers and Gen X who are not eligible for Social Security today but will be eligible or collecting it in 2035.
Will that affect how they vote?
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“Just my view, voters do not always vote solely on singular issues . . .”. Agreed! But, the reality is there is a large enough percentage that it impacts elections Five examples are inflation/economy, abortion, climate change, race relations, and gun rights.
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Yup, emotions are a biggie when it comes to singular issues, isn’t it? Article after article has been written about the impact of emotions on voting behavior. There has been study after study on the topic.
Some were compare/contrasted with emotion vs. rationality. However, one study supports your view, which BTW I agree with. It states, “However, this study suggests that rationality plays a more important and consistent role in individual turnout decision than emotion because the effect of emotion on turnout might be built on the appearance of charismatic candidates.”
We know the two leading candidates are definitely seniors. They also are voters. Is there a relationship between the senior voting bloc and senior candidates?
How older voters feel about voting for older presidents by NPR/KPBS on Sept 24, 2023. Caution: A quite lengthy read. However, it is interviews with senior voters. Maybe worth a skim here and there to get a pulse on their feelings.
https://www.npr.org/2023/09/24/12014229 … presidents
And, for more, at the next link is an article about voting for a senior. There is a 1:45 min video with Christian Fong, assistant professor of political science at the University of Michigan speaking about if voters care about candidates' age. Plus, the article itself adds to that.
Do voters care about politicians’ ages? by Michigan News of the University of Michigan (Sept. 29, 2023)
https://news.umich.edu/do-voters-care-a … ians-ages/My three 30-something children are not making their retirement plans even considering social security. They assume it will be gone by the time they would have needed it.
I think they will be OK. Besides what they inherit from their parents, they are all making more than $100K/per year plus 401K matches, are buying $400K houses, and have fewer children than we did.
If we could send three kids to college on incomes of no more than $70K/per year and borrowing against a $150K house, then they should be able to send two fairly easily. By retirement, without SS, they should be - as we say in the South - "standing in tall cotton"!
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