Khmalye Memo

I've heard a lot about this supposed dichotomy between takers and payers in the United States, usually with an implicit or explicit assumption about how the "two halves" vote. But I haven't seen any reference to data that suggests in detail whether it's in fact true that the recipients of federal tax largess principally vote for Democrats. I suspect it isn't, especially if you include all federal spending and not just entitlements. Reliably Republican enclaves such as Wyoming, South Carolina, Alaska, Texas etc. are among the largest per capita recipients of federal money; if people were truly voting in favor of the spigot faced their way, you might expect to see them turn away from those making the most noise about radically slashing the budget. Here's a great graphic about voting and spending patterns, with federal spending aggregated:  If you exclude all non-entitlement spending, I'm still not convinced (due to the complete lack of compelling...

Health care in the United States has several defining characteristics: it's extremely effective and high quality for the wealthy, difficult to receive for the poor, and extraordinarily cost inefficient and expensive as a system. Everyone wants to stop the skyrocketing cost of the health care system, many want to establish universal coverage. The first step has to be to control costs, and the best way to do that is with a single payer health care system. The current system is patchwork and somewhat ad hoc, a mixture of public and private facilities providing care with a mixture of public and private funds. This fragmented system is different in every state and every community, built based on local priorities and resources yet straining almost everywhere to keep from falling apart. Politicians in the last two years have debated many strategies for reform, focusing on extending access to health care to more of the people who need it. That is a noble and just goal, but it has a fatal...