I find the farmers to be the funniest. Like without their stimmy cheques and subsidies they'll all be homeless. For some reason not many farmers call this socialism.
There's a quote attributed to Upton Sinclair: "It is difficult to get a man to understand something when his salary depends upon his not understanding it"
I do see a rebound in 2027 though. Several signals tell me things will not work out for many AI companies/startups and targets will not be met. People will have to be rehired.
>A single-payer universal health care system could cover every American, save more than 100,000 lives a year, and still cost $1 trillion less than the system it would replace, according to a new preprint study led by researchers at the Yale School of Public Health.
FWIW, the methodology that produced this particular result is known to have significant issues. The claimed effect disappears after correcting for them. It also isn't the first time that these authors have published similar studies with these issues. They are not a credible source.
Universal health coverage may save lives and money but this study doesn't provide actual evidence for it.
"known" by whom, and documented where? if you're going to just parachute in and say this paper by domain experts is dead wrong, at least link to what you believe shows this to be the case.
Per the study we are discussing -- as well as the results from every single other developed country I believe? -- more efficient when it comes to healthcare, yes.
Because both studies and real-world results from every other developed country show gov is more efficient at healthcare, is your argument that means gov is more efficient in every field?
The perverse incentive of the politician / general / bureaucrat to favor their personal interest over the public interest is identical to the perverse incentive of the CEO to favor his personal interest over the same.
I would argue the government case is actually much worse because at least the CEO has the feedback mechanism of revenue because the company <> customer relationship is entirely voluntary on both sides. The public vote is supposed to restrain the government in the same way, but in practice it seems to be much less effective in restraining politicians than the customer is at restraining companies.
I can if I want to switch jobs too. Probably not a good idea given the current economic conditions. I'd be all for forcing a decoupling of these things, but I don't see that anywhere on the table, and it would probably run afoul of politics anyways.
Total profits for US health insurance companies in 2025 were $50 billion. The other $950 billion has got to come from cutting:
1. money to providers
2. overall healthcare consumption
3. bureaucratic redundancy and waste
1 is going to piss off medical providers. 2 is going to piss of the general public. 3 is going to piss off the 20 million healthcare industry workers who are not direct care providers. So pick your poison. This is why it will never pass.
The average Georgian plumber has higher purchasing power than the average German doctor. In order for the United States to balance its medical books, doctors will have to be paid dramatically less than they are at present. Perhaps there’s a deal to be made where doctors take the hit, but all of their debt is paid off by the state. Going forward medical school is free, but like in Germany you have to qualify, I mean really qualify to even get your foot in the college door. That’s an expectation change for the United States population on all fronts. We don’t do well with expectation changes.
You can afford to go to law school if you're willing to prioritize it and make some sacrifices. There are plenty of law schools that have part time night or online options. Take one class at a time and you'll eventually get through.
And most of that income is salaries to existing healthcare administrators. Quickly ending the employment of the people working those jobs would be a significant shock.
Not really. Private health insurance would still exist alongside for the more wealthy (including nearly everyone on HN) that doesn’t want to wait a year for their public system MRI. Same thing that plays out in other countries. The U.S. already has a form of this in so-called concierge / premium providers too. Lots of profit to be made.
This isn’t true of the Medicare for All Act, for what it’s worth. That would ban private insurance altogether. Personally I think that’s a bug, not a feature, but if you’re very concerned with fairness then you probably think the opposite.
Having the machine capacity to get non-urgent MRIs in hours is part of why US healthcare is so expensive. Anyway, the average (again for non-urgent MRIs) where I live in canada is 9 weeks, which is i am sure skewed due to the rural population. In the city it’s like half that.
If private health insurance was allowed, UHC would be stillborn. It only works if providers don't have better options than medicare reimbursement rates.
> It only works if providers don't have better options than medicare reimbursement rates.
1. A number of other developed countries have UHC while also allowing a private system as well - what is unique about the US that other countries' existing approach couldn't work here?
2. Less importantly, in this world where everyone has medicare, but a smaller fraction have private coverage, your argument is that the existing healthcare providers would choose to give up most of their (medicare) patients? If so, why wouldn't providers choose to stop serving medicare patients under the pre-2026 system, where giving up medicare patients would be a far smaller loss than in a world where everyone has medicare?
> 1. A number of other developed countries have UHC while also allowing a private system as well - what is unique about the US that other countries' existing approach couldn't work here?
Mainly, expectations. I understand that UHC in European countries doesn’t cover all the things Americans assume it does.
Japan apparently keeps costs down by not using cutting-edge drugs. That’s not going to happen in the US.
The US Congress just isn’t good at keeping costs down.
> 2. ... why wouldn't providers choose to stop serving medicare patients under the pre-2026 system, where giving up medicare patients would be a far smaller loss than in a world where everyone has medicare?
They absolutely do. Many providers don’t accept Medicare. Very few providers accept Medicaid. The payments just aren’t high enough.
The US is dead last in terms of health outcomes among every developed country (despite spending far more), but you believe expectations will cause every other developed country's system to fail here? I guess your argument is that the propaganda machine pushing the idea that America's healthcare is not the worst in terms of outcomes (while also being about the most expensive), would prevent Americans from accepting no longer having the worst results and the highest costs?
> Many providers don’t accept Medicare. Very few providers accept Medicaid.
1. About the same percent accept Medicare as private insurance (85-90%, while ~70% accept Medicaid - is that "very few"?).
2. "Medicare for all" is one of the primary proposals being discussed.
3. Previous smaller expansions of government healthcare resulted in expanded provider capacity to handle them, not less, but your argument is that we'd see the opposite results from further expansion?
4. And in this new world where everyone had Medicare or similar, your argument is that providers would choose to ignore most patients, where they don't under the existing system where government-sponsored healthcare makes up a significantly smaller portion of the customer base?
5. And your argument is that if the government finds that healthcare providers contract to the point that outcomes remain the worst among every developed country, as they are today, that the government would be unwilling to make any changes (such as reimbursement rates) to address this?
> The US is dead last in terms of health outcomes among every developed country (despite spending far more), but you believe expectations will cause every other developed country's system to fail here? I guess your argument is that the propaganda machine pushing the idea that America's healthcare is not the worst in terms of outcomes (while also being about the most expensive), would prevent Americans from accepting no longer having the worst results and the highest costs?
The argument is that the US system has a much lower floor, which leads to the bad health outcomes, but also generates a lot of people who expect and demand more than most universal healthcare systems would give them. An Uber driver with the cheapest marketplace plan he could find would benefit greatly from any universal healthcare system; a guy with really bad ulcerative colitis (https://www.propublica.org/article/unitedhealth-healthcare-i...) would likely not be able to get a prescription for a cocktail of drugs at non-FDA-approved doses costing $2M/year.
I’m saying the US won’t implement anything like what other countries implement. I honestly think Philip Greenspun’s proposal ( https://philip.greenspun.com/politics/health-care-reform ) makes sense but has no chance of being implemented. Americans asking for some kind of single payer system are expecting something better than basic health care.
I remember when President Obama suggested “maybe you’re better off not getting the surgery but taking the painkiller” ( https://youtu.be/rin4h4cRs6Y ). That seemed to surprise many of the people who wanted a single payer option. He stopped suggesting that kind of cost-cutting that very quickly.
I also remember when a few people received anthrax in the mail. Every news story said that people who had any contact with the letter had received Cipro to avoid developing an infection. After a couple of weeks, the government actually announced that other (cheaper) antibiotics were effective against anthrax, but it was obvious that no company was going to hand their employees something other than Cipro.
Incidentally, my autistic adult son has Medicaid. I don’t think I’ve yet found a doctor who will accept it. Luckily he’s also on my health insurance.
In all seriousness, this would be a massive stimulus to the economy. Americans are consumers at heart. All the money saved on insurance and/or other healthcare related costs would then be spent elsewhere.
Cars, clothes, TVs, Labubu dolls. People will use the savings to buy things. In massive quantities.
There is also some indirect bonus: if people's healthcare is not tied to their employer then it's easier to look for a new one. Also if the system is done well, then many companies would lose the incentives they currently have for not giving full-time employment.
Presumably not; the same national income would just be redistributed from shareholders to insurees (or shareholders of companies that pay for employee health insurance).
Are you implying you would decide to sacrifice citizens health for a few GDP points, a somewhat useful but oversimplified metric that doesn’t reflect anything tangible?
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