“The 2022 Inflation Reduction Act stands as the single largest piece of legislation to address climate change in United States history.
The IRA contains nearly $370 billion for programs like tax credits for more efficient appliances, building new battery plants, and subsidies for renewable energy. And it triggered a boom in new construction and manufacturing for things like solar panels. It also created hundreds of thousands of new jobs.
But two years later, much of that money remains unspent.
The largest investment — ever — for the clean energy transition has yet to materialize into actual hardware like heat pumps or wind turbines. Despite more than $7.5 billion allocated to building electric vehicle chargers, for example, only a handful have been built. About 40 percent of big IRA projects hit delays, according to the Financial Times.”
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“Now President-elect Donald Trump has said he wants to claw back the unspent money and congressional Democrats are getting antsy. In a recent letter, dozens of senators and representatives wrote to the White House asking Biden to get more money out the door, from the IRA as well as other legislation like the Bipartisan Infrastructure Law.”
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“One of the big challenges with spending most federal funds in programs like the IRA is that the money doesn’t go straight to suppliers for construction materials, EV chargers, batteries, or home insulation. Rather, the funds are sent to state and local authorities who then distribute the money.
That added step creates a lot of complications. First, a lot of local officials simply are not set up to receive a lot of cash all at once. It requires rigorous accounting and record-keeping, so before they can use the money, recipients have to invest in the personnel and tools to track it. Then when money hits bank accounts, local officials have to decide where to spend it. That means seeking out proposals, soliciting competitive bids, and giving enough time for communities to weigh in. Even for “shovel-ready” projects, they often have to contend with last-minute hurdles like rising financing costs from inflation, supply chain snarls, and litigation that can halt ground-breaking.
Local governments also have their own incentives. While Biden’s White House wanted to juice the clean energy economy as fast as possible, often state and local governments want to stretch out the funds. “There’s always a sense that if money is spent too quickly, people might get used to the money, maybe even addicted to it, and then officials would have to raise taxes to make up the difference” when it runs out, said Donald Kettl, professor emeritus at the University of Maryland School of Public Policy who studies government spending.
Delays also result from how the funding is leveraged, whether it’s a grant, a loan, a loan guarantee, or a tax credit. Tax credits add an inherent lag because you don’t receive the cash benefit until you file your taxes.”
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“There are also factors beyond Biden’s direct control at play. Changes in global demand and uncertainty about the outcome of the presidential election led some companies to hold off on executing IRA-funded projects. And those that do want to get rolling often have to go through a tedious, sometimes years-long permitting process before they can break ground.”
“Physicians elsewhere do not bear the same financial burden. I traveled in 2019 to the Netherlands, Australia, and Taiwan, which have three distinct health care systems that still manage to cover all of their citizens: universal private insurance, a public-private hybrid, and single payer, respectively.
In the Netherlands, physicians take three years of undergraduate studies, three years of master’s studies, and complete a one- to two-year internship before being licensed; certain specialties then require further training. Dutch university students typically graduate with much less debt (less than 25,000 euros on average, or about $26,200) than their American counterparts. In Australia, the training requirements would look familiar to US doctors — a decade or so of education and then on-the-job training — but the tuition would not, with annual medical school costs capped at less than $10,000 per year. Taiwanese doctors likewise spend significantly less money on their education, even relative to differences in cost of living, than US doctors.
What all of those countries have in common is more robust public support for higher education and generous loan repayment programs. The high cost of college is a longstanding issue in the US, and that contributes to the prohibitive cost of a medical education for reasons that have little to do with health care itself.”
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“There is another way in which the US health system places an unusual burden on doctors: the headaches of health insurance paperwork. As left-leaning policy analyst Matt Bruenig wrote on the recent brouhaha over insurers and doctors after the killing of Brian Thompson, at least some of the excess pricing of US medical services can be attributed to the administrative costs that providers incur while dealing with private insurers.
The demands of insurance claims on doctors’ time and attention not only make for a less pleasant working experience, they also take them away from patients, which can contribute to worse health outcomes.
Here is perhaps the most telling statistic, from the Commonwealth Fund’s 2024 international survey of doctors: 20 percent of US doctors said they spend “a lot” of time on paperwork or disputes over medical bills. That was nearly double the rate in the country with the next highest share; 12 percent of Swiss doctors said the same working in their country’s system, which also relies on private insurers to oversee benefits.
Only 5 percent of Dutch doctors and 9 percent of Australian doctors said paperwork and billing took up a large chunk of their time.
This wasteful activity affects both the cost and quality of our health system. Among wealthy countries, US patients have the fewest number of consultations with a doctor in a given year, with the exception of Sweden, and spend the least time with their physicians. Time and money spent on administrative work, for both insurers and providers, account for about 30 percent of the excess medical spending in the United States.”
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“The average physician salary in the US ranges from about $260,000 (for endocrinologists and pediatricians) to $550,000 (for certain surgeons). The most elite providers earn more than $1 million annually.
Dutch general practitioners, by contrast, make about 120,000 euros ($126,000). Even senior hospital surgeons typically earn about 250,000 euros. Australia, with a more robust private market, can be more generous: While primary care doctors earn between AUD$100,000 and $150,000 ($60,000 to $93,000) on average, senior practitioners make more and specialized surgeons can rake in as much as AUD$750,000 ($460,000) — much closer to the American norms.
Doctors in Taiwan — where, it should be noted, nationwide average incomes are about half of what you find in the United States — can make between $60,000 and $100,000 per year. The policy experts I spoke to there agreed that doctors are underpaid relative to the high number of patients they see, substantially more than a typical American physician will see in a day.
Whatever complaints American physicians may have, doctors in those countries feel undercompensated.”
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“The blame game between insurers and doctors is ultimately a distraction. Other countries have private health plans and private providers and yet don’t experience nearly the same waste and out-of-control price increases as the US has. The whole system — the prices and how they’re paid — will need to be addressed in the long run. As one landmark health economics paper put it 20 years ago: “It’s the prices, stupid.””
“Few things do more to increase humanity’s aggregate prosperity than allowing people to migrate from less wealthy nations to the United States. And the immense benefits that immigrants derive from moving to the US do not come at the expense of native-born Americans. To the contrary, in the long term, immigration makes Americans more prosperous, while rendering the country’s retirement programs more secure.
Precisely because immigration is so beneficial, however, it’s imperative for Democrats to forge a politically tenable approach to the issue. The party should neither embrace full-bore restrictionism nor project complacency about chaos at the border.
Instead, Democrats must make American politics safe for mass immigration. Maintaining the party’s recent pivot toward more aggressive border enforcement and less lenient asylum policies is likely necessary for achieving that goal.”
“contrary to what Musk claimed, tackling “waste, fraud, and abuse” cannot possibly generate enough savings to eliminate the annual budget deficit, which was nearly $2 trillion in fiscal year 2024, let alone reduce the ever-climbing national debt, which currently exceeds $36 trillion, including $29 trillion in debt held by the public.”
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“Even if Musk succeeds in curtailing “waste, fraud, and abuse,” there is only so much he can accomplish by focusing on “driving change through executive action based on existing legislation,” which is how he described his agenda last November. Any serious attempt to reduce federal borrowing will require new legislation that addresses the main drivers of federal spending, including Social Security, Medicare, and the military budget. But the platform on which Trump ran takes all those things off the table while promising pricey policies that will only exacerbate the problem that Musk decries.”
“DOGE deserves some credit for simply trying to map the federal government—a gargantuan endeavor that involves over 100 agencies, each a matryoshka doll of sub-agencies and offices. As former federal technology officer Marina Nitze wrote in Reason today, the amount of nonsensical rules, regulations, and turf battles means it’s a Sisyphean struggle to make even the most basic improvements to federal websites and tech systems.”
“If the White House’s preliminary assessment is accurate, it would be the largest tax increase on Americans since World War II—and one that Trump would apparently seek to implement without congressional approval.
The specifics of Trump’s reciprocal tariffs plan remain sparse. The executive order Trump signed Thursday instructed the Department of Commerce and the U.S. Trade Representative to develop new proposed tariff levels that take into account the tariffs charged by other countries to import American goods, as well as industrial subsidies, value-added taxes, and other economic policies that Trump views as unfair. It will take weeks (and perhaps longer) for the new tariffs to be calculated and rolled out, and the changes may be implemented on a country-by-country basis, according to Megan Cassella, a reporter for CNBC.”
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“The direct costs of taxes on so many imports would be only part of the problem. Trump’s idea of charging different tariffs on every country’s exports means the same product could be charged wildly different tax rates depending on where it was sourced. Those tariff rates would also be subject to constant fluctuation, as other countries shift their policies—as many will likely do in response to Trump’s new tariffs. That’s a recipe for not only higher taxes on American businesses that rely upon imports but also a constant state of uncertainty.”
“Mass layoffs have begun, with most of the some 200,000 probationary employees expected to be terminated in the coming days, mostly from the departments of Energy and Veteran Affairs, but also some from the Small Business Administration, the Consumer Financial Protection Bureau, the Department of Education, the Department of Agriculture (specifically the Forest Service), and—ironically—the Office of Personnel Management (OPM), which has been overseeing the layoffs.
Probationary employees tend to be workers who have only been in their jobs for a year or under (or two years in some cases). They have the fewest job protections so they tend to be the easiest to fire.
“These firings are not about poor performance—there is no evidence these employees were anything but dedicated public servants,” said government employee union president Everett Kelley in a statement. “They are about gutting the federal government, silencing workers, and forcing agencies into submission to a radical agenda that prioritizes cronyism over competence.””
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“The OPM has apparently dispensed shifting guidance, reportedly telling agencies earlier this week that they should focus on terminating underperforming employees before later in the week shifting to a policy that all or most probationary employees should be dismissed.”
“Whether you’re hot or cold on DOGE’s government-slashing potential, everyone agrees it needs data to survive. Record access lawsuits might starve it of them.”