Comment by trome | Hacker News Reader

Comment by trome | Hacker News Reader

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58% of Americans would prefer a federally funded healthcare system[0], akin to healthcare in Canada.

We only feel alone because both parties are bought and owned by multi-nationals, and don't give a shit about what most people want. First Past the Post ensures a 3rd party will cause carnage if it ever did rise, splitting the vote and not electing the candidate most voters would prefer.

Look at Wolf PAC in Connecticut closing 26 points of a 36 point gap by beating the streets with 500 volunteers[1], or Bernie in West Virginia going to town hall after town hall and talking to people about the very real issues that affect their lives.

We can convert the "unwinnable" "red" states if we only dare put in the effort to beat the streets and call people, have one on one interaction and talk about issues that matter. Jobs, healthcare, workers rights, when you connect to people, even if you disagree with a person about "divisive" issues, they can often feel you are out there fighting for a better future for them and their family.

So get out there, go join Wolf PAC, Our Revolution/Woke, go to a Womens Day protest, a BLM protest and fight for a better future. If we take action, we can create change!

0 - http://www.gallup.com/poll/191504/majority-support-idea-fed-...

1 - http://www.mediaite.com/online/the-message-we-want-to-send-i...

You badly need a multi party system. Your current system is too polarized. There's no way to represent nuances. What if I like guns but I want universal healthcare? What if I want a smaller government but I also want great environmental policies?

The US system was ok in the 18th century but now it's a relic. Some things don't age well.

First, I have some good American friends. My grudge is not with the people of America but the American system, which the people of American has no say in.

George Carlin puts it best, "America was founded by a group of Salve owners on the premise that all man are created equal."

My observation is that America is the land of law & order as every illegal & unethical practice becomes law. Its owned by 1% and wages war for the 1% in the pretext of spreading the seeds of democracy.

The thing that worried me the most as a non-American is that people around the world think that America is a democracy and all the "bad dudes"(corrupt self-interested 1%), gain power in America and try to impose their will on rest of the world by using Hollywood, CIA & US defence force.

Do you retain first past the post, switch to AV, move to proportional representation?

What are the consequences of each of these choices and who is the right person to make them? There is no perfect voting/political system - all of them have side effects.

The fact that there's no perfect __anything__ shouldn't stop us from trying to improve the status quo.

Agreed, so my question is why the OP is declaring 2 party system as "worse" when all current systems have drawbacks.

Worse is subjective in this arena. So what are your metrics? What do you define as better? I'm not terribly keen on prop rep, for example - I think it actually gives too much power to extreme parties. Maybe you disagree. Maybe you think it would be better? If so, why?

I'm OP. I just said why the 2 party system is worse. Re-read my previous comment.

This is a common argument. For example, many people in the UK's Labour party said this would be the case if the UK moved away from FPTP to AV. The conservatives wouldn't even allow the choice of real PR, limiting the vote to either what they wanted or a crap choice that no-one wanted in an attempt to get their policy choices rubber stamped with a false sense of public approval. This "worked" for that vote, and for Scottish Independence (not allowing further devolution as an option which would have won handily) and failed catastrophically with Brexit.

Notably, Brexit was caused by the small party UKIP stealing votes from the Conservatives, and then by Lib-Dem voters fleeing to Labour because they previously teamed up with the Conservatives. So a leftward shift of voters, sent the result rightward, giving the Conservatives a clear victory which meant they had to deliver a referendum that they never thought they'd have to.

Too late now to change it, but it seems likely the UK wouldn't be tearing itself apart at the moment with a better system.

> You badly need a multi party system. Your current system is too polarized.

Definitely we need to get rid of First Past the Post, but while our parties are polarized, they are both far to the right of the vast majority of voters.

> What if I like guns but I want universal healthcare?

That is actually fairly common. Gun control can be done in a nuanced way, and we can have more guns with few instances of gun violence esque Switzerland if we train our populace to properly secure and disarm their guns when not being actively used.

Comparatively, people like my great grandfather thought it was fine to leave a dozen or more loaded guns of varying types all throughout the house. Not great when a shotgun falls out from behind the stove and nearly gets ya.

> What if I want a smaller government but I also want great environmental policies?

Hard to do, small gov't = small town corruption if you look at areas that take this approach.

> The US system was ok in the 18th century but now it's a relic. Some things don't age well.

Definitely, we need to update our antiquated political system.

> we can have more guns with few instances of gun violence esque Switzerland if we train our populace to properly secure and disarm their guns when not being actively used.

Would a law requiring guns to be safely stored (i.e. in a safe) be acceptable? I assume the gun lobby would scream at the thought, but what would the majority think?

Likewise, would a national register and limits (i.e. every serial number is bound to a person in a national registry, the number of registered weapons to an individual is limited, and carrying a weapon not in the registry is a felony) - would that be acceptable?

I think all these countries with tons of guns e.g. Switzerland, Nordics, Canada, the key is they are to a large part hunting weapons. Hunters are usually completely fine with keeping their guns, or in some cases just vital parts of each gun, in a safe. This however means you can't keep a handgun in your bedside drawer, for example. But that's no problem - no one is using guns for "protection" anyway. I think the difference to the US is that in the US people still believe in using weapons for personal protection. Not being able to carry guns outside or have them lying around the house then sort of removes the ability to use them for protection.

The U.S. is particularly sensitive to government encroachment... registries are a hard no-go, never will be accepted, I'm frankly somewhat surprised the sex offender registry exists (think of the children), despite its' flaws. Also, they don't tend to work well for home defense when locked in a safe (as you mention). I don't own a gun, but am very pro the right to do so.

I consider myself a pragmatic Libertarian, so my personal political views don't really align with either of the major parties, but are definitely more conservative in terms of limited federal government than most of the rest of the world view, exceptions to essential infrastructure, which to me includes water, power, communications/internet, transportation, preserving public lands, and education (though in need of some revision). As to corrupt local governments... those are easier for local citizens, and even states to address. Of course historically that hasn't always worked out so well.

In the end, what keeps Germany from being corrupted vs. Belgium... the States in the U.S. are slightly more coupled than the EU nations, but it's not too dissimilar, discounting the same language for the most part here.

Right now, provided a serial number, American police can trace a gun used in a crime to its last legal owner. It takes a number of phone calls -- first to the manufacturer, then to the gun store, then to the first owner, and down the chain -- but it generally works.

And, although it's not mandated by law, gun owners do tend to keep records on private party sales. Nobody wants to be in the situation of "we found this Glock at a crime scene, and it appears to be yours?" and not be able to provide evidence to the contrary.

So a registry doesn't really offer any real utility... except to confiscate those weapons down the road.

If you want to promote safe storage, the best solution would be a tax benefit for buying safe-storage equipment. Gun safes are expensive, at least if you want something that can't be crowbarred open in a few minutes.

Something else that I would love to see, and stealing a page from the Swiss, is universal gun education.

There are more guns than cars in the United States, and I find it negligent that not every American learn not just gun safety, but also how to safely store, handle, and yes, fire a gun -- even if they never plan on owning one.

> If you want to promote safe storage, the best solution would be a tax benefit for buying safe-storage equipment

Yes, a tax benefit seems like something you would probably need to add to a bill requiring safe storage, just to get it past lawmakers and special interest groups.

> Something else that I would love to see, and stealing a page from the Swiss, is universal gun education

That sounds like a good idea. Not sure if having it mandatory even for never-to-be gun owners is the best use of resources, but at least having it as a requirement for a license sounds reasonable - just like driving.

Being a Swede we have (and had) mandatory gun education. For men at least. Same thing in Switzerland. Conscription! (now everyone is again elgible for conscription but far from everyone will be required). So that problem is at least solved in countries with conscription armies. Obviously, neither Sweden nor Switzerland ever trained everyone in gun safety but there is mandatory training before ever using a gun at least, because the licenses require it. So owning a gun for hunting requires passing an exam, Military obviously includes a lot of training, and owning a gun for sports of personal protection is simply not a concept.

I'd actually be fine with a mandatory year of military service, but not sure how well that would sell politically to other Americans.

Personally, I think it would do a lot to connect Americans from different walks of life. I know a lot of people in SF that have no idea what rural California looks like, and that works the same way in the other direction.

As far as licensing goes, that's off the table for historical reasons, and also why I say that we should make gun education universal.

Pretty much every gun control law in the United States, starting after the Civil War, and up to and including California's Assault Weapons Ban and Open Carry Ban, have been primarily to limit gun rights for the poor, and for minorities. It's why the laws are so patchwork, and make so little sense.

So, given that history, public education is the most sensible way to promote responsible gun culture and firearms safety, without imposing the licensing burden that is still used today as a means of discrimination.

Doesn't federally funded healthcare system have problems like lower quality of healthcare, increased government spending, increased chances of corruption and creating a moral hazard of not working to earn what is consumed ?

No, it doesn't.

I'm gonna address these point by point with opinions.

lower quality of healthcare

Not overall, but arguably yes for people with perfect healthcare plans at the moment. I think that everyone having 90% "rated" healthcare is better than a split of 0%/50%/100% by wealth bracket.

Increased government spending

Yes. Absolutely - you have to tax people the money that would otherwise go to insurers and spend it as an insurer. Since the US currently spends the highest proportion of GDP on healthcare for incredibly unequal healthcare you can decide for yourself whether even big government could manage to be less efficient.

Increased chances of corruption

No.

Creating a moral hazard of not working to earn what is consumed

Sure. It's a problem when there's zero cost involved in healthcare - something many systems struggle with. Often in european countries you'll see some kind of excess/copay so people have a little "skin in the game" before using the system. The UK uses waiting lists and gateway doctors (GPs) to assess need.

Rationing of healthcare on a basis of need, rather than wealth seems smarter to me from a population basis.

There are many healthcare systems, all have trade offs. Most of the first world is unconvinced that the current American system is optimal

>lower quality of healthcare

On the very top end of healthcare? Maybe, but countries with public healthcare aren't doing too bad on that side either. On average? The quality is insanely higher. Until budget gets cut because some dimwit thought it would be a good idea to stretch their resources thin.

>increased government spending

Covering everyone costs money, yes. But considering the amount of money that is already being invested by the US govt. into health care and the abysmally poor results it gives, it can't really be worse.

>increased chances of corruption

Very little. And it solves lobbying, doctors being paid by companies, etc. It's usually a net positive.

>creating a moral hazard of not working to earn what is consumed

Screw that. People have a right to live decently, even without earning it. That's why we made societies. That's why we keep elders alive, and not immediately send them off to the glue factory as soon as they retire, that's why we keep children and feed them and teach them until they're able to be a useful member of that society. In most sensible systems, their education is largely free too.

The NHS in the UK seems to cost about $3,000/year/person. Admittedly, that probably needs to go up by $500-$1000 to provide a better service, but that seems to be comparable to federal spending in the US already?

the level of service that the NHS provides is pretty poor for people with ongoing conditions. They're great for providing emergency treatment but if you require ongoing treatment you will likely get much, much better service from BUPA or another health insurer. One thing the NHS does really well is providing downwards pressure on health insurers' rates though.

Frankly, what I wish would have happened here would have been to gather up all the federally funded healthcare initiatives and create a government owned, non-profit healthcare corp to cover the same people (va, medicare, medicaid, federal employees, etc). To provide for downward pressure and a baseline for private insurers to compete against... allowing anyone to get a private policy from said corp.

Would likely have cost less, reduced redundant agencies and staff, and had a chance at making things better.

I totally agree. I think the conversation around healthcare in the US seems incredibly polarised, to the point where no reasonable middle-ground can be achieved that works for both Democrats and Republicans. The system you've described seems to cover both bases, with coverage for all in times of need but the ability to leverage the market to drive innovation and improved quality. It seems to work well in the UK, for those that can afford BUPA cover.

The UK still allows private healthcare so those who really want to pay extra can do so. In several areas, for instance emergency medicine, there isn't a private offering and others the NHS has the centres of excellence available to all based on need.

While our emergency system is often at the point of creaking it at least isn't anywhere close to American levels of having to deal with what should be primary care problems. There's also the massively real hazard of what happens when you have a large proportion of the population who can't access basic healthcare, for instance a greatly increased communicable disease risk. Then there is the economic cost of people unable to work, or work as well, due to potentially treatable medical conditions or bankrupted by medical bills. On a purely economic basis there is a case for universal healthcare.

"While our emergency system is often at the point of creaking it at least isn't anywhere close to American levels of having to deal with what should be primary care problems."

How much of this "creaking" is intentional underfunding or political meddling by politicians looking for a payday from American medical insurance companies when they ruin another nations healthcare is debatable.

It's very similar to recent Trump moves of putting people who hate what a government department does in charge of that same government department. Jeremy Hunt the former Health Secretary previously called for the NHS to be replaced with an insurance system. So how can you trust that he's not trying to achieve that goal by crippling the existing system?

I can't speak for Trump's motivations, but I've noticed something similar in the corporate world. If a capable executive is particularly critical of an aspect of the business, he may (inadvertently) find himself put in charge of it. It's a method for breaking status quo. And just because this new leader starts as an outsider doesn't mean he stays an outsider after becoming intimate with all the invisible challenges facing that business unit.

I think this kinda describes Trump himself pretty well. An outsider who's initially critical without understanding the nuances of how something works, but after finding themselves on the inside develops an appreciation for why things are like that.

> lower quality of healthcare

No. US does not have better health care indicators than other countries with similar development levels.

https://en.wikipedia.org/wiki/List_of_countries_by_quality_o...

> increased government spending

Maybe... But you will spend much less overall on healthcare, so it'll be a net positive for normal working Americans.

http://data.worldbank.org/indicator/SH.XPD.PCAP?year_high_de...

> increased chances of corruption

Countries with better healthcare than the US also have less corruption perception. I'm not suggesting public healthcare causes that, but it certainly does not cause the opposite.

https://en.wikipedia.org/wiki/Corruption_Perceptions_Index

> creating a moral hazard of not working to earn what is consumed

Moral hazard "occurs when one person takes more risks because someone else bears the cost of those risks". How does this affect healthcare?

We know that a lot of diseases have a strong genetic factor, so moral hazard isn't an issue there.

Of course, behavior is also an important factor. But working insured Americans are already subject to moral hazard (since they're on a group policy, their disproportionate costs are already supported by others). Medicare and Medicaid recipients are also already subject to moral hazard.

So moral hazard will be created for uninsured people and people on an individual policy, for behavior induced health problems. If that's a deal-breaker for you, you should be against federally funded healthcare.

Doesn't have to.

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