Hacker News new | ask | show | jobs
by hvidgaard 4315 days ago
New Yorkers aren't going to "pay for Idaho". NY may be paying more in tax for the entire state, but their budget would also be much larger. For obvious reasons NY can be more efficient, but that doesn't mean that they'll be paying a significant amount of the budget in Idaho.
2 comments
mcguire 4315 days ago
Well, actually, they would, for the same reasons that the postal service will make money in populated areas and lose money in less populated areas.

Say you need a trauma center within 1 hour of anywhere in the country. A trauma center in Manhattan is going to see a lot of traffic, while one in Clayton, NM, isn't. But the centers have the same basic cost in staff and gizmos.

link
ThomPete 4315 days ago
It's not a once size fits all. You would of course look at the size of the area and the amount of traffic. So areas with higher traffic would get more resources allocated.

The real problem with healthcare is that you can never have enough. Even if everyone paid 100% in taxes it wouldn't be enough.

link
DanBC 4314 days ago
> But the centers have the same basic cost in staff and gizmos.

Hang on: A busier unit is going to have more staff. Staff is not a trivial cost.

link
mcguire 4313 days ago
In my simple model here, staff is per-capita; fixed costs like property, plant, and equipment are per-unit-area. Which wins in this case? I don't actually know, but I don't believe it is a trivial calculation. (Further, the medical events are not necessarily comparable in the two cases---rural means farming and resource extraction, etc., and that shit's dangerous, compared to white-collar work. And then there's transportation costs.)

I do know that in other similar situations, wealthier, more populated areas end up subsidizing poorer, less populated areas.

link
rquantz 4315 days ago
New Yorkers are already paying for Idaho, and every other backwards, poor, uneducated, unpopulated state. And we talk about leaving the Union all the time, but that isn't why. It's because those same backwards, poor, uneducated, unpopulated states whose roads, schools, and healthcare we pay for keep blocking our attempts to turn the United States into a modern developed country.
link