“the notion that you are going to cut a trillion dollars and not accidentally hit some “bone” is a standard of perfection that cannot be met in the real world.”
Medical costs are about half that of that in the USA in Western Europe.
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One of thing to do is change taxes from fixed rates to program cost-related rates.
If Congress votes for $6 billion/year to spread perversion globally, it thinks that is without a cost.
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If Americans want European-level handouts, they need to expect to pay European level taxation.
The problem is that everybody wants to maximize their “benefits” and minimize their taxes.
It is a classic game theory problem that used to be given a lot of study in academia by serious people (before DEI got rid of most of them).
What we want are “win win” solutions.
That requires very clever people getting very creative.
No government on the planet has done it yet.