The KGB Oracle Forums General Public Discussion (SPECIAL ACCESS) KGB Political Debate Central The Healthcare Bernie Wants

Good examples, as those systems you describe are all rapidly deteriorating at a noticeable rate.

Healthcare is fundamentally different because it is an order of magnitude more expensive.

Part of the problem, but far from the entire problem, of going with the universal system is that the results wont be as predictable as some like to think. Especially when it comes to both pricing and innovation. As things currently stand, US consumers currently get squeezed for the lions share of profits from new medicines and procedures. Some people favoring a universal system like to say that this wouldn't be the case under a single-payer type system, that is the gov't was negotiating one bulk price, that costs would come down, and innovation would still occur because companies would anticipate selling to the govt.

Of course this ignores political incentive, and the corrosive effects lobbying and public relations would have on the process of assigning and pricing medicine among many other things. Worse yet, you could also state the situation in the obverse: that universal systems elsewhere are basically subsidized by the US consumer, and discounted sales elsewhere are basically just value-added sales. After all, since your profit goals and ROI has been met by the US consumer, what harm could there be in peddling the products elsewhere for whatever those people were willing to pay?

People only seem willing to consider the pros, without giving honest consideration to the possible, even likely, downsides.

Not to mention our political and social fabric of accountability and principled governance has been eroding at an increasing rate for decades. Our body politic is literally rotting around us, as political and financial power centers realize that "democracy" as we practice it doesn't have to foster any sort of honest or responsive gov't. Even the world's most powerful republic can become a banana republic.

Elsewhere you said that even the most cynical vision of gov't would be better than for-profit insurance. But have you really considered that?

Imagine for a second Jeff Sessions running a single-payer program, assisted by Trump Jr and Adjit Pai as his deputies. Because that is exactly what we would get, or worse. Nevermind the inherent contradictions and systemic fragility of such a system, just imagine the people who would inevitably run it and the political and financial forces that would dominate such a system. Hopefully, dumping proven treatments in favor of whatever the best lobbyist is peddling, and instituting such scientifically rigorous health regimens such as "Prayer Faith Healing" for cancer and "tough-love forced labor boot camp" for mentally troubled teens is the type of health care you think everyone deserves. Because that's about what we would end up with.

If the USA were socially advancing, with gov't becoming steadily more sensible and responsive and open, and political advances were being made that actually realized the dreams of the social thinkers who pine for the Star Trek society, then sure, maybe I could be convinced that such a gov't run health system could work in USA, or at least work for the foreseeable future. But, this is not out situation. Our gov't and society is literally rotting out from under us, from the inside. Handing it even more power over our lives and economic well being is tantamount to suicide.

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The details matter. Just saying "pick a system, any system" honestly shows how little someone has read into the actual consequences, because the devil is always in the details. The people who implement and oversee those details are the ones with the real power to make things a success or a failure, and in Washington DC, those people are not people with your interests at heart. Even when and if they are, that doesn't make them able to understand what they need to understand or do what they need to do.

What surprises me the most is that people who play MMOs have such a hard time with this. As we all know, people can't even get virtual worlds, where literally everything outside of player behavior is under their firm control, work properly. Easy to say " I want a fun game, with balanced PvP and conflict, and a good economy, a true virtual world" - implanting it: hard. Very hard. And despite all their shortcomings, the people who create MMOs are vastly more intelligent on the whole than people who work in govt.

If you really want a health system that worked for the poor, then best start thinking about those details. Also best take a close, and an honest, look at other systems and the nitty-gritty of where they succeed and fail, and how it might work in differing circumstances, and how they might or might not continue developing for the better or worse over time, and take principled lessons from it. Trying to treat it as an apples-to-apples situation is no different than the W Bush administration treating Iraq like Japan or Germany post-WW2, and conducting a de-Baathitization program. Hey guess what, Iraqis aren't Japanese, nor is Iraq Germany. The USA is not Briton, and Americans aren't Norwegians.

Fuck, Social Security is only projected to exist in its current state for 17 more years tops. Hand them the whole health system? Seriously?

And for anyone who thinks that other political reforms are needed, and that pressure of maintaining a functioning health system would help make said reforms a political reality - all I can say is please pull your head out of the sand. Under pressure and duress, people become more extreme and impulsive, not more rational and wise, in almost every historical example. If you think threat of impending health and economic collapse will help push through your political reforms, you best also be expecting Jefforson, Madison, Washington and Adams to rise from their cold graves to implement it for you. Because the Trumps, Bushes, Clintons and Obamas of the world sure as shit aren't.