jazzdude

A lot of the actual effort isn't pushing one group over another, but rather removing barriers/drag placed on particular groups that may have been put there unintentionally or have unintended effects. Whether it's outdated policies or standards, or reassessing requirements-things change, and the system we all live and work with has to change to stay current. How about an analogy that contains what some would consider some heresy on this board? Maybe advanced degrees should be unmasked from all promotion boards, at it helps paint a picture of how well rounded a person is. The AF wants an educated force, and continued education is one way to encourage diversity in thought as well as develop skills. It's one of the 4 items on the promotion board instructions, especially for technical skills. The downside is this came with several unintended consequences. People saw the correlation that having a master's improved your promotion chances, and started getting a check the box masters using TA, that didn't actually improve them in any appreciable manner. This meant the AF didn't really get someone who really learned anything in the addition education, and had to several thousands of dollars for pretty much every officer to check a box that became diluted. Lots of pilots in this board complained that while they were hacking the mish on 12+ hour days, our FSS counterparts were getting plenty of time to do there master's coursework. We (pilots) complained that this de facto requirement was unfair, and that our skills and job specific training brought value to the AF when considering promotions. Even though the AF values advanced education, it recognized that the negative effects of having it be considered in promotions, and that those negative effects outweighed any gains from considering education in promotion. So the masking the advanced degrees on promotion boards through O-5 was removed, and with it the perception that a master's degree was required for those grades. It removed a burden from many officers that didn't have any particular interest or need in continued education. It removed a barrier for officers that did not have the time (due to their primary jobs) or money (many worthwhile degrees come with a significant out of pocket expenses, even with TA) to complete a master's degree. Masking the degrees did come with a price though. Now positions where an advanced degrees is relevant or needed (AF engineers, for example) gets masked from the promotions board. You can't refer to degrees on OPRs, either, so that gets lost completely. But the bad outweighed the good, and it was masked. That kind of examination on requirements/standards is what a lot of the recent diversity push have been about: re-examining what we do, how we do it, and went we do it, and the effects of the rules we put in place, to try and create a fair environment for everyone in the service (fair as in race/gender do not influence outcomes, just your abilities). Your line of argument, applied to this situation, would've doubled down on the keeping degrees unmasked for promotions. Unmasked degrees were the standard and advanced education is valued, and this is fair since everyone knew it was considered in promotions, has access to TA to pay for it, and since the big AF values it, your supervisor should give you time to work on it on duty; you just need to manage your time better and suck less, and quit complaining about how the system is unfair.

Generally, yes. Part of the American culture is that if I work hard, I can get rewarded for that work and create more opportunities for myself. Here's a 2016 look at the Air Force demographics as a whole, broken out by rank and component. First page shows breakdown of majority/minorites vs rank, second page shows men/women vs rank, followed by a more in depth breakdown of numbers. https://diversity.defense.gov/LinkClick.aspx?fileticket=gxMVqhkaHh8%3D&portalid=51 The percentage of women tends to stay more or less constant across the ranks, so you'd infer that generally, women compete on an equal footing compared to men for promotion and retention, as the relative proportion stays pretty much the same. I'd posit based on that data that gender isn't as big of an issue for diversity, though maybe improvements could be made in the recruiting end. However, looking at racial majority vs minority, as you increase in rank, the percentage of minorities goes down. Why? Is it that minorities just can't hack the mission and thus are promoted at lower percentages than their peers? Or is there something tipping the scale against them as they promote? Maybe there something that causes then to leave the service before the next promotion? It's all correlation, and the AF and DoD are after why it's happening. Here's a long read, and I'll admit I only skimmed quickly through it, but looks like my guesses at how to attack the problem aren't too far off what DoD is planning to do: https://diversity.defense.gov/Portals/51/Documents/Special%20Feature/MLDC_Final_Report.pdf Again, I only did a quick skim, but I didn't see quotas mentioned as a solution One thing the report does call out is that higher ranks tend to come from combat specialties, which tend to have more white men compared to other specialties, and discusses trying to remove those barriers (real or perceived) to entry in the combat specialties. For the AF, this means pilots. The discussion tend to focus on the line flyer and hacking the mission, but the AF also needs to develop people to fill the staffs and to lead. And we need good people on both paths. This need creates conflict, as some just want to fly their whole careers, and some want to fly, then move onto other things while flying if they can (or not). That conflict gets more complex when you throw race/gender on top of it. Unless you want the staffs filled by support AFSCs that may not understand how we fight and how the decisions they make affect the warfighter (line pilot). But again, the answer is not quotas, as it's heavy handed and creates conflict between groups that no one wants. But if we end up with quotas, it's because of a failure of leadership and management at all levels in the service.

I will give you that there's probably not a lot of overt racism/sexism anymore. I don't support quotas for the long run, and I'm not sure that quotas in the near term are necessarily the right answer either (if anything it should be a tool of absolute last resort except maybe in recruiting efforts/goals, and I don't think we're anywhere near needing to be that heavy handed for promotions or retention). Hate to quote my earlier post, but going to do it anyways... Those are the kind of fixes we should be after, not necessarily mandating quotas, which would likely lead to resentment on both sides of that quota. But the military does like to promote a certain appearance, whether we like to admit it openly or not. Why else would every package to be an exec, or aide de camp, etc, or any job that generally can fast track your career, all require a photo in the application package? Naysayers will say it's because we don't want any fatties, but if they meet height/weight standards, why do you need a picture? Especially when requiring a picture introduces biases into a decision based solely on what a person looks like and not what their abilities are? Fix the weight standard if you're worried about overweight airmen in uniform. As an analogy, musical orchestras used to be dominated by white men. Everyone would audition, and the "best" would get selected, which happened to be white men. When they started moving to blind auditions (person auditioning is not seen by the reviewers, isn't identified by anything but a number, and doesn't talk during the audition) to prove they were being fair, the number of women and minorities making the cut significantly increased. Now it's a pretty standard practice to do blind auditions in order to hire the best musicians, and remove any racial/gender biases based on what the musician looks like. Then there are some easy kills, like fixing our dress and appearance AFI to allow hairstyles that accommodate people of different ethnicities. It also spelled out what was considered faddish, narrowing the definition since airmen provided feedback on getting counseled based on the whims of a someone who outranked them thinking their appearance was "faddish." Or extended shaving waivers, etc. But all that took way longer to fix than codifying pilots pushing up their flight suit sleeves (which arguably, who cares? We were going to push our sleeves up regardless). There's also been a trend to accommodate where we can. Uniforms/equipment sized for women so they can be comfortable. Researching solutions for a female piddle pack so they aren't tactically dehydrating themselves for flight. Stuff that makes their lives easier so they can focus on hacking the mission without having to compensate for things that don't fit, improving their performance. Hell, we just recently updated what anthro standards are going to be used for future aircraft to accommodate a wider set of the American population, and now accounts for typical female ranges for anthro measurements. How long have women been flying jets to when that standard was updated? That opens the door for a bigger pool to draw from to find and train the best aircrew, and no longer eliminates a large portion of women from pilot duties based on being an average sized woman. If I were king for a day: - Fix mentorship across the board. Knowing the game is half the battle, and it can be difficult to either reach out to someone for career guidance, or to get honest feedback, especially if there's a perceived (or real) cultural barrier. Can't just be pencil whipped like OPR midterm feedbacks (only had 3 in my 14 years so far). At the very minimum, you should have access to direct feedback from not only your rater, but your additional rater as well, who should serve as a check/balance against what your rater's assessment of your performance is. - Reassess how we hire into certain jobs, and be on guard for biases (based on race/gender) creeping into the decision making process, especially any time interviews are conducted. Get rid of photos in hiring packages full stop. - Consider masking names, gender, race, ethnicity on PRFs. - Continue with community outreach, and encourage recruiting in communities that are less represented in the military. This has to be supported by other government functions to provide education which paves the way for other opportunities. The other piece is public messaging -the military isn't a career of last resort, but can a meaningful and fulfilling experience and/or career. The goal is to remove barriers for people across the board, not to give any particular group an extra advantage in the name of diversity. Though some barriers may only exist for particular groups. And I think the AF has been on a good path on that end in recent months.

Completely agree. But if someone in a position of authority IS considering those factors when they shouldn't be, whether consciously or unconsciously, wouldn't it be appropriate for leadership to recognize it is happening, step in, and put a stop to it? Otherwise you disenfranchise a segment of the population, reduce the pool of people willing to volunteer for service, and limit the pool of talent and experiences our nation has to draw from. Let's remove race and sex from the issue for a moment. How many gripes about the promotion system, school selection, strats, etc are there on these message boards? I'm pretty sure 69% of this board is just complaining about injustices "the man" levied on the line pilot hacking the mission. How many commanders still track masters degrees on their strat matrix? Or the perception (or reality) of favorite golden childs being selected as mid level Captains and being groomed as a future GO, and given opportunities to accelerate their career and check all the boxes? Most guys I've known flying the line build up a resentment towards the system that says it rewards hard work and excellence in primary duty, only to see someone who may not have been hacking the mission get rewarded for organizing the Sq holiday party and the AFAF/CFC drive. We've all probably had a bad commander or supervisor that played favorites, or emphasized the extracurriculars outside of the mission, or at the very least had the perception of doing so by some out on the line. Maybe you could decide to play the game and do the extracurricular stuff to get recognition and opportunities. Or not, the ball is in your court to decide; you own that choice and the consequences of that choice. It sucks, people get mad and punch out of the Air Force, and if their experience was bad enough, probably would warn others away (like their kids, friends, kids of friends, etc). This hurts the Air Force twice- first for the loss of an experienced aviator, and then again in the future with it's ability to recruit. Military service is becoming much more of a family tradition, with people joining because of the positive experiences of family or close friends, especially in the officer corps. Now throw in an immutable fact about yourself that you can't change (race or sex, though I guess you could change the latter but that opens a whole other can of worms...), and that POS commander could derail your career, especially at critical points in your career, just because they "don't like your face." That individual doesn't have the choice to play the game to do what is valued by their (crappy) leader; that choice to be in the game or not was taken from them based on something they can't change. It hurts the individual, who then may go back into their community and discourages service, reducing the pool of talent our nation has to pull from. I think most of us want the best that the country has to offer fighting to defend our freedom, regardless of race/sex/whatever. The problem isn't just a military problem, but a societal one that also impacts the military. Quotas aren't the answer, but doing nothing just ignores the issue and may exacerbate it as time goes on.

I'll preface my post with this: having traveled around the world and enjoying most of my travels and cultures I've visited, there's no where else I'd rather call home besides the USA. But just because we're the best doesn't mean we don't have flaws, or shouldn't strive to become better. And we need to do that as Americans, not as Republicans or Democrats throwing spears at each other, otherwise, our enemies will use that divide to weaken us or tear us apart. The great power struggle doesn't just exist militarily, but also politically and economically between nations. One is a private organization, and one is a public institution. That's the difference. And no, I don't think matching percentages in different populations should be the end goal for either organization. The NBA went through its transition long ago dealing with race, to the point where the race of the player doesn't matter now, just their performance, because that's what sells tickets (an exciting game), and makes money. But they got past the hurdle of integration and quotas/caps long ago The military strives to be a meritocracy, but there are still biases that exist that favor some groups and hinder others. For example, the army ran an e where they removed the official photo from the promotion package, and got a surprising result. https://www.military.com/daily-news/2020/06/25/inside-armys-decision-eliminate-photos-officer-promotion-boards.html/amp I think it's right we get after any unfairness in the system based on things that shouldn't matter (race/ethnicity/gender) to allow the best to rise through the ranks and so everyone is treated fairly, especially if we want to be a meritocracy. It's also easy to point at the recruiting pool and say there aren't enough qualified from X group, but issues could go earlier than that. Educational/academic opportunities, athletics, clubs, etc in K-12 schooling, that lead up to being eligible in the recruiting pool, especially on the officer side. That's not DoD's problem, but a societal issue that merits looking at from other parts of government (or our society, which should be reflected in government). In a sense, the military (especially the officer corps) may already be reflective of the country based on opportunities available, whether that's just educational/volunteer opportunities that combine into an attractive package (sts), or just familiarity with the military growing up and it being a realistic/attainable goal. It'll likely take a generation or two to fix, but that requires groundwork to be laid now to create a better future for our kids, and we likely won't see any benefit in our careers. It's less about making percentages match up (though there are people that believe that), but ensuring that if people want to compete, they aren't having to overcome additional barriers based on the race/gender, because they shouldn't have to.

I agree with most of what you said, though when you're talking capabilities, it quickly becomes a discussion about MWS's, and turns into the A-10 debacle. No matter what Generals may say in public about priorities, priorities are truly set by budget. If something is an important, it'll get fully funded. If it's important but less of a priority, it'll get at least partial funding. Things that don't get funded? Well, it's not really a priority, despite whatever rhetoric surrounds it. And it's not just the AF that sets the priorities, but Congress gets to weigh in with the defense authorisation and appropriations bills, and can adjust funding (aka priority) as well. And the AF can only spend money on what Congress both authorizes and appropriates, with little ability to move money around without asking Congress for permission first.

Interesting article, but ignores how to pay for it. Buying more B-21s or extending legacy bombers has a cost- so what gets cut? The article also points out the Navy will be retiring SSGNs in the 2030s, so I'm guessing they'll need to recapitalize the submarine force, so it'll be harder to try and take money from the Navy to pay for bombers if we're unwilling to cut anything. But I agree with the article's premise. We're probably starting to move away from an emphasis on fighters (although kicking and screaming and trying to use the ACE concept as a solution to keep fighters relevant) with the pendulum swinging back towards favoring the long range bomber. Something about SAC will be back...

I would assume, barring a direct and existential threat to the US, that our budget at best will be flat, if not likely reduced. So I agree that the challenge will be to find what gets cut to find any new capabilities. Is the answer longer range strike assets? Maybe. But could also be longer range weapons on existing platforms. But that's based on the assumption of direct action, and we continue the current policy. However, keep in mind that policy is just policy, it's not written in stone and can be changed relatively easily, and not having a treaty means we have no formal obligations. I don't fully buy your business argument with being concerned about american businesses operating in China. If we need to go to war, well, those businesses will likely be a casualty of war, and it's a business risk they took by going to a foreign country. We shouldn't ignore the business concern, but those concerns (for corporate interests) should be secondary to national interest aims/goals. If we as a nation are concerned though, we should be providing incentives to work with our partners and allies, and disincentives for working with China. What's scary about China is their apparent ability to have a unified national policy, that encompasses their military, economic, and diplomatic goals. Maybe they can't project military power like we can, but they sure have been on a full court press to invest in other countries economically, building relationships and industries, and raising their influence while undercutting ours in the world through non military means.

What if we write off that we probably can't realistically push back a Chinese invasion of Taiwan and not try to meet them force on force there because we'd be at a significant disadvantage? Threaten retaliatory strikes on military/industrial/economic capability using TLAMs, conventional TBMs/ICMBs, cyber. Have a large coalition willing to boycott Chinese trade in the event they invade Taiwan. The name of the game is deterrence, caging China so it believes an invasion wouldn't be with the pain we'd inflict. All this assumes Taiwan truly is vital to our interests, and not just posturing. But my gut feeling is that if the only deterrence option on the table is direct force on force to defend Taiwan and just push Chinese forces back into China, that the equation heavily favors China with the home field advantage. Worst case is if it's to get our aircraft carriers involved in conflict, labeled as legitimate military targets, and directly attack strategic US capability, reducing our influence in the region/world

I think they already closed that experiment. Not sure what happened with the handful of people that went down that path

Younger me typically voted straight R ticket. Now I'm probably closer to center, but still probably would be considered on the right (though I've been increasingly frustrated with the Rs, especially in the last 4-6 years). Still a registered R based on how my state does primaries and the effect that has on the later voting for offices. I do see your desire to be self reliant as a good thing, it's something I strive for as well. Never been hunting, but I did field dress a rabbit once upon a time. But can cobble together a shelter, build a fire to stay warm, procure water, fish (sorta), make basic repairs, improvise solutions, sew, etc. SERE was "great," but a lot of my survival skills were built/learned in scouts when I was younger. Labels are weird though. Politics has devolved into a highly polarized debate, with no room to meet in the middle out find common ground. It's appears to be more of a power struggle between the R and D parties, using taking points to get in and stay in office, with politicians changing their beliefs to appease their voting base, and dividing everyone into either for them or against them. Then you've got the whole realist vs liberal vs constructivist philosophies, which frame your world view. (Hey, I learned something in ACSC)(crap, I drank the kool aid, don't burn the witch). The liberal (not US liberal) in me wants to believe in the best intentions on people and that we can collectively work together to improve things for everyone. Rising tide raises all boats and what not. The realist in me bought guns for home defense, locks the doors at night, maintains emergency supplies, and believes in a strong military to defend our values and interests when disagreements between nations inevitably occur. But I guess to answer your question- TL;DR-I've got a mix of opinions that doesn't put me squarely as conservative or liberal, but probably skew towards "conservative" //RANT ON// -First off, we need to fund what we believe in. Doesn't matter how good an idea sounds, if we're not willing to pay for it (ie raise a tax or bond, or cut another program), then it's not a good idea. This includes overseas contingency operations/war- if it's vital to national interests, raise a tax or sell bonds to pay for it. -Guns are fine, need to limit access to criminals. Limited access to people with mental health issues as well, but that's really murky because it's hard to define and can be subject, so currently a 'no' for me right now for limiting access. Own a few firearms, and my wife shoots to almost as well as me. -Don't own an AR, but see why people would want to, just not in my budget or a priority right now. Magazine limits are dumb -Shootings are a form of violence, and even if you remove all guns, people intent on violence will cause harm to others. So we need to attack the real causes of shootings-whether it's poverty, selfishness, mental health, a perceived need for revenge for an injustices, etc. -Came from a "normal/typical" Christian, nuclear family. Married a wonderful lady. Don't really think LGBT is right personally, but I won't treat them as less than a person. Doesn't mean I won't be friends with them, or get along with them. My wife has several gay friends, and we've gotten along fine. What they do in the bedroom doesn't really have any bearing on my life, so they can do what makes them happy. Just don't shove it in my face and tell me I'm a bad person for not embracing/celebrating their choices in life. But I've got the same opinion on dudes oversharing about their latest tinder hookup. Don't care, please don't over share, glad it makes you happy. -Gay marriage is a weird problem. On one hand, as a Christian I believe in the 1 man 1 woman definition. Civil union is probably the better term across the board, and helps remove religious or traditional connotations of the word to help facilitate debate. Not like paying a law defining marriage in the traditional sense is going to stop a gay couple from being together. So why does it matter? Because our society, as someone else pointed out earlier, is such in a 1950 ideal of a family. Healthcare is generally tied to our jobs, with dependents under the plan being defined in 1950s terms. The legal system doesn't recognize rights of a "special friend" in matters. But it doesn't really infringe on my ability to pursue of life/liberty/happiness, so they should have the same opportunities I do as a married heterosexual dude. -Healthcare is tough, and I'm still trying to figure out what right looks like in my mind. I'm not convinced that gov single payer is the right answer, and a touch weary of what that means regarding other liberties (can't do X because of risk). But our system as is leaves people without access to preventative medical care, driving up emergency costs and lowering quality of life. Business have gone cheap on healthcare, and for lower level jobs, they may not offer healthcare at all. And having floated my wife's insurance on the open market when she was in between jobs before we were married, open market insurance is stupid expensive. About $450/mo for my wife for a middle of the road plan, with a lot of out of pocket expenses should emergency or specialty care be needed. And healthcare institutions have no incentive to lower costs, and have a high bar to entry that is funded by (and therefore limited by) the government (residencies), so competition isn't a strong driver in reducing costs. -Social security is another interesting issue. We are an individualistic society. The norm is to break out on your own as an adult and make your own path. Great for the individual, but bears risk compared to other societies that are more family oriented and love in multigenerational homes, as costs go up for things such as child care, elderly/end of life care, housing, etc. If someone plans poorly, or falls on bad circumstances, they could be left old, destitute, and with no one to turn to. Probably the hardest question we have right now as a country is answering what it means to be an American. I like to think it's a place where we can pursue what fulfills us in life if we're willing to work for it. That system needs defending, and there are tradeoffs internally that need to happen to ensure people are not being left behind due to systemic issues/biases. No one's going to make it this far so I can throw out some heresy- one good thing about ACSC-DL was the unit discussing realism/liberalism/constructivism. Got me really thinking about why I believe what I do, what I find important, and what I don't. Philosophy, ethics, morals-interesting topics that I wish I had more time to read about and think on. Maybe I'm just getting old.

Government should be limited, and act within the scope the people have given the government (at any level, federal, state, county, city). In theory, our government is representative of us, so helping out other citizens is like helping out your neighbor, though they might not be right next door. What role do/should the different levels of government play in execution/policy? People pay taxes, and want to see a return on what they've given up, which is fair. But a lot of functions may not directly impact them as individuals in the here and now, but may help others in need now, or lay out a system that creates a fair environment for everyone to pursue their life/liberty/happiness in the long run. It's good that we debate the role of government, and increase/decrease scope as what our society wants. I'm wary of mob rule though, so popularity polls (and calls for popular direct vote on national issues) concern me, as it allows large urban areas to dominate the discussion and disregard rural voices that may have different concerns/realities. I'd argue the government can run a convenience store, class 6/AAFES seems to do okay. Maybe not the greatest, but not run into the ground. Maybe we are asking too much of our government based on how much we're willing to pay. Implementing programs because they sound good, but not funding them, leads to frustrations as a disconnect forms between what we want and what we get. Taxes are what pays for government and it's programs, but we have been cutting taxes but not programs. Since we're talking about smaller government, should DoD get more funding, as we're part of that government? If funding stays the same, or gets reduced, what gets cut? It's how we in DoD ended up with "do more with less" in the past, and there are many people that believe our investments (in taxes) in defense are still too big. And don't forget, there's a support tail needed to support the direct warfighter, so cuts in support could affect the warfighter in the long run, whether it's support, quality of life, retention, etc. Also, remember paying a contractor for support functions still comes out of that same budget.

You've got the benefit of space, and that's great. You've got enough land where you don't have to interact with people if you don't want to; "leave me alone and I'll leave you alone." The challenge with cities is population density. More people living much closer together, which creates friction, and with that comes rules to reduce friction/conflict. Industrialization concentrates populations, and encourages people to specialize in tasks. This also drives technological advances. It's easy to call out others for lacking skills you have and thinking of them as lesser people for it. But maybe they aren't interested in your hobbies. Not saying that the skills you mentioned (changing a tire, fishing, hunting, etc) are bad; they're great. Are they essential? Depends on your outlook on society. The heart of the matter is what the role of society should be. How individualistic should we be, and how much should we cooperate towards collective goals? Ref. BLM/LGBT/etc, I think people just want to be treated as people. Sure there are some associated with those interest that want outlandish things, but I'd wager most just want to have an even footing in life so they can pursue their life/liberty/happiness. Some of the issues may be injustices/biases in our system/society-let's do some real root cause analysis as a society/state/country and fix it. We tend to ignore and kick societal issues down the road until it boils over into violence, so here we are...

It's decent training. What makes it challenging is that the TOT can shift, especially if you're trying to cross show center right at the end of the national anthem with a live performer that may go faster/slower than planned or rehearsed... Flyovers typically come out of the unit's flying hour program/local training fence, and are supposed to be "non-interference" with the unit's training objectives. So there's no additional cost to the taxpayer for the flyover, and it's usually good publicity for the military. A lot of flyover requests do go unfilled, as flying units are "paying" for them with a training sortie, or may have other operational commitments.

Part of the issue is that it's really hard to cost out care. It's easy to say "a bandage plus some motrin is only a couple dollars at the store, why am I being charged $200+?! That's price gouging!" But there's a lot of overhead and indirect costs that have to be covered that are necessary to keep the hospital running. This isn't to say price gouging doesn't happen. You need to pay the doctors and nursing staff, not just for contact time, but for their time on shift without patients, vacation time, sick leave time, and admin time (a simple 15 min contact can be 30-45 min of work for the doctor to review charts/record, and then update charts/record afterward). But you also need to pay for janitors, mx, appointment clerks, billing/finance, and managers. You also need money to pay for continuing education and training for the professional staff. And the building/electricity/water. Don't forget computers, and licenses for electronic health records software. Then there's equipment and supplies that's rarely used but needed on hand for emergencies. Then on top of all that, since we're a capitalist society, the hospital needs to be profitable (though investing for the long term would make this easier, most hedge funds and investment groups seem to value quarterly growth and short term profits). But when you get the bill, there's no "overhead" charge. They build it into the prices for each billable line item. It's essentially like buying a car-only suckers pay the full sticker price. But in addition to insurance being a means to pool resources to cover large expenses should they arise, it also puts insurance companies in a good negotiating position for the price of services compared to an individual (like collective bargaining), which drives down costs but only in-network where they've negotiated prices. Some hospitals may elect to lower prices for people that can't afford to pay, heavily subsidizing the individuals costs. But that subsidy comes from somewhere, whether it's a wealthy donor, staff working pro bono, or by adjusting prices elsewhere for others. I do agree on generic drugs, but how do you put that into practice? A generic still has to go through the approval process, which takes time and can be costly, and the g producing the generic also needs to turn a profit. Along those lines though, if the government invested in/funded a treatment's research (which again, the federal government already does invest a good chunk of change in medical research), then it's reasonable for the government to have a say in pricing the drug.

This is also how medical insurance works in our country. Except that it's not the government making the decision, but a private company out to make money for it's shareholders making that decision. And even with insurance, you can still run up some significant bills that wipe out savings pretty quickly. Especially if you end up at an out of network emergency room for a catastrophic event. I think many countries that have socialized medicine also have a second layer of medical care, where you can buy treatments above/beyond the basic coverage, or accelerate timeline. Even if you got rid of insurance and socialized medicine, so long as medical care is a limited resources, there will be some level of triage and prioritization of care Either way/system, money buys options. Unfortunately, I'd wager that most of us don't have that kind of money laying around

This line of reasoning gets really weird really fast, where the activities I enjoy are fine and of acceptable risk, but those other activities I don't enjoy are dangerous and shouldn't be covered. Maybe I don't want to pay higher taxes for people injured participating in MMA (or insert any moderate to high risk activity). Maybe I don't want to pay higher taxes for treatments for alcohol related issues, both acute or long term effects. I'm sure no one here has ever lied to their PCM about how much they drink at their annual physical. I do understand your sentiment here though regarding personal responsibility and taking an interest in one's own health. This is the biggest thing that worries me about universal healthcare (especially when the line of discussion is to get rid of all insurance companies and go to solely government provide healthcare): access provided by the government may come with conditions that limit my choices elsewhere in life. My other concern is that we essentially already have a nationalized healthcare system for a select group of people: the VA healthcare system. I can't imagine implementing something, which would probably look similar to the VA, for everyone in the US. Lots of people would be very disappointed, and we would've wasted a lot of money.

4. Assess what is actually needed in the residency programs. They have been increasing in length over the years. You could argue it's to increase knowledge. You can also argue that hospitals are using residents as cheap labor (80 hour work weeks for $30-60k/year) to pad their budgets, and since new doctors must complete a residency, they have no real negotiating power for salary or work schedules, and can't just go to another program (since it is controlled by a central match board). 5. Increase the number of nurse practitioners and the scope of what they can do. This one has been on the rise in the last decade or so, and is a pretty contentious issue within the medical community, as they don't complete a residency before they can practice, and the scope of their training is more narrow. On the other hand, it makes for a cheaper, more accessible alternative to seeing a doctor, though the quality of diagnostics may not be as good. This is essentially how your bullet #2 has been put into practice. But on bullet 1-that's federally funded... And you can't receive medical treatment from a doctor in the US unless they completed a US residency program. Who pays for that? (Taxation is theft!/s) Should Congress control the limits on residency program seats? Why hasn't the free market increased the number of residency seats due to a demand for doctors? Also, one private organization runs the match process, so there's no other way to attend a residency than to go through that organization. It's not a free market for doctors looking to work in the US. And if a doctor wants change specialties (say they are burned out working in an ER and want to switch to family medicine), they have to go back through a new residency program, which takes a seat away from a new doctor. Why can't a doctor just apprentice to an experienced doctor with X number years experience outside of a match process to satisfy their residency requirement? On bullet 3, how do you encourage preventative care, especially for people without insurance, or have insurance with high deductibles/coinsurance costs? I like your approach to this discussion-too often the issue gets distilled into a soundbyte about universal healthcare and polarized by both political parties, when the truth and heart of the debate really is in the middle. But that doesn't make for good news entertainment, not does it rile up the voting base, so...

Well put.

Best can mean a lot of things to different people, and that's something that needs to be understood going into this discussion. If you can't see that there may be other definitions of what best means regarding healthcare, then any debate is meaningless. And you can't separate insurance from this discussion, so long as healthcare costs more than people can pay out of pocket for. That ignores 2 of the points you made: accessiblility and cost (cheap). Have you been following the discussions on changes in military healthcare? Dependents are starting to get pushed off base as MTFs downsize. However, even though they have decent insurance, people have found it challenging to find off base PCMs willing to take on new patients. Premiums for retiree Tricare are creeping up (though still way below open market prices), and the new-ish Tricare for Life adds additional cost on top of that (due to having to sign up/pay for Medicare). Defense isn't cheap. Was what we spent in Afghanistan worth it? Did that campaign make us stronger as a nation, or further essential national goals worth the price we paid? There are many on the left that say the defense budget is theft as well. Like you said, that money has to come from somewhere. Healthcare would be an investment in our society. Access to routine and preventative care should help more people be productive members of society. The question is how much to invest and what level of care to provide.

Why should the government provide healthcare coverage for military families/dependants at extremely low cost to the member? Should service members pay insurance premiums comparable to the national average for premiums? At least for the service member, you could argue they should have healthcare coverage to protect the investment made in the service member if they have a critical skill. Should service members be covered for a pre-existing condition, or for medical accidents that happen not in the direct line of duty (say, breaking your arm while skiing on leave)? Or pay for coverage to cover non-line of duty accidents? The government subsidizes lots of things. Food stamps, social security, medical research, basic science research, education, arts, conservation of wilderness areas, roads, housing, etc. It also (heavily) subsidizes defense. Basically, it's all an investment in our society to hopefully make us all better, even if it's not a "right." What about combat zone tax exemption? Why not eliminate that? What purpose does it serve, besides essentially being a pay raise for doing the job we signed up to do? (Especially since HFP/IDP also exists)

Access to Tricare was probably the single most important factor is me deciding to take the pilot bonus (and stay to 20). Pilot bonus put money in the bank/investment portfolio for my family if something were to happen to me (above and beyond SGLI), and check of the month would mean that even if I can't work after I reach military retirement, my family's basic needs could be met. But Tricare removes what I feel is the biggest risk to finances in retirement-healthcare costs. Healthcare costs are probably the one big risk (in my opinion) that can ruin financial security, especially as you get closer to retirement (real retirement, and no longer working), and could potentially wipe out decades, or a lifetime, of careful financial planning. Hell, it was hard enough to decide how much I was willing to pay when my pet cat went to the emergency vet; I can't imagine having a loved one going to the ER and having to set a price on their life because health insurance didn't cover the care (or cover enough with high deductables or co-insurance). Especially when I (eventually) am no longer working and living on a fixed income. What's the catastrophic cap for Tricare? $600 in a given year? It's low enough that as a major, it's a drop in the bucket in my emergency fund.

Need more information... What defines "best" regarding healthcare? This is probably the fundamental question regarding healthcare policy. So what is best? Cutting edge technologies and research in treatments? Access to basic care at adorable prices? Access to basic care covered by taxes? Access to emergency/preventative/diagnostic care? You also make a strong assumption that you can separate insurance from the healthcare system. So long as people may need to pay for medical treatments that they can't afford to pay out of pocket for, insurance will be a factor in the discussion. It's like saying car insurance should be made optional (especially if you believe healthcare is not a right, since most people don't consider driving a car a right). As military members, it's easy to have a skewed opinion, as Tricare has pretty good coverage and is significantly cheaper than anything comparable on the open market.

Remember when they did (tried) the same thing for the CENTCOM AOR? Pick your best and brightest and give them experience giving Afghanistan and Pakistan a hand... At least indopacom should have nicer locations...