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Comment by padobson | Hacker News Reader

So the US spends a ridiculous percentage of it's GDP (15-20%) on health care. Many treatments for serious diseases are far too expensive for a family living on a median income to afford, so health insurance is a requirement in order to avoid bankruptcy in the face of a serious health problem.

My question is, are we getting something for this money? Does healthcare research and innovation in the United States justify what it's costing us, or does the whole system need a reboot?

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It's the latter. Privatization of sectors that are responsible for meeting human rights such as right to life (enforced by the police - as of now a public entity), liberty (right to vote - in some cases needs to be afforded by paying for IDs), education (we had a strong public education system until late 1980s), health care (private insurance companies are run as profit-making corporations, treating patients as cash-cows that are disposed of when valueless), and others is not sound policy for a democratic nation. We fell victim to the siren songs of lobbyists and paid media analysts, and have supported massive privatization and agglomeration efforts by corporates over the past 30+ years. This is hurting us.

I was more asking whether or not the quality and advancement of the healthcare in the United States justifies what it costs. Are we getting what we pay for?

Another way to phrase it: if we trade market forces for universal access, will the rate of healthcare innovation slow down?

no, because policies governing access to health care should not share a lot of commonalities with R&D efforts in medical science and technology. The former should be public, while the latter should be commercially driven as much as possible. In our country, the former is predominantly privatized, while the latter is public funded. As a result, we have shown relatively slow progress in R&D while doling out sub-standard health care.

p.s. I really like this statement - "You start to understand how an economy works when you realize Karl Marx and Adam Smith were hitting on the same idea". It is accurate in that both men seeked a more efficient economic system - a far cry from what we have today. What we should have is a combination of both ideas - merging public guarantee of basic rights with the concept of private property.

The former should be public, while the latter should be commercially driven as much as possible.

I think there's a recipe for consensus building here. Granted that you'll never be able to pay for universal health care by eliminating public research grants, but there's got to be some lobby money coming from medical R&D for policies like this.

As for Marx and Smith, the statement is not just about efficiency, but also oppression. Forceful intervention into an economy is oppressive and inefficient. Impoverished workers operating in unsafe conditions are both oppressed and unproductive. These are obviously blanket statements that require nuance for specific situations, but that's basically what I was getting at.

I'd personally like to see an environment where initial risk is taken on by the capitalist, and as a venture matures, ownership gradually passes to labor. When you think about it, it's not too far off from what we have now with the Seed -> VC -> IPO cycle.

Hmm that is also an interesting and truthful way of looking at that statement. I echo your sentiment for businesses to be more employee centered. We have to buck the trend for making profit margin the absolute bottom line.

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