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Comment by bootloop | Hacker News Reader

So this country doesn't make enough money to be able to keep some unlucky people alive without throwing them or their family into poverty? Or is it simply that nobody cares for anybody else as long as you are better off then them?

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A lot of people have a lack of imagination and empathy. It's not a problem until it happens to them.

If everyone really internalized that it could just as easily happen to them, I bet things would change pretty quick.

I think the second explanation works better - if we look at the way people vote. It's a religious thing to abandon people in suffering to banks and creditors. This way the holy right to make money is put in the first position.

I believe it is highly American to believe in self-sufficiency and to minimize the role of luck in success or failure. Whether we go back to the Protestant work ethic, the Puritan sensibility, gold rushes, unfettered capitalism, the Gilded Age, and our current second gilded age, to me it is clear that caring for others is a secondary concern for many Americans. Just look at the "makers/takers" model of our populace put forward by the top current lawmakers. In this framework, sick people are takers and capitalists are makers.

> to believe in self-sufficiency and to minimize the role of luck in success or failure.

I think that, frankly, those two are in opposition to one another. Self-sufficiency at scale is a game of numbers and luck; systems of thinking that try to put more emphasis on mutual support and shared responsibility for success seem to work more towards eliminating luck as a factor.

This is never how it's framed when you actually discuss these problems with people who believe in small government. Every time I've pressed the issue, it's a two pronged response:

A) Healthcare costs are too high, and it's due to malpractice/overregulation/other government influences. B) In the event that an individual can't afford healthcare, the community will pick up the tab -- and have the money to do it, since the government isn't taxing it away from them.

Ya I have never once heard of someone's neighbor or whoever picking up their medical tab for them.

It's meritocracy - https://www.youtube.com/watch?v=bTDGdKaMDhQ - If you're taught you can achieve success by just working hard enough, then the opposite must be true, that poor people are poor because they're lazy.

Paul Krugman has also mentioned, the insane thing is, many of the rich in the USA who inherited their wealth or got lucky with investments also believe that they're successful not because of luck, but because they're hard workers...

> American to believe in self-sufficiency and to minimize the role of luck

Not at all:

https://en.wikipedia.org/wiki/Social_mobility#/media/File:Th...

If you multiply inequality times lack of social mobility, US scores at the bottom across developed countries.

Decades of pop-econ has pushed the narrative that GDP or Purchasing Power Parity is somehow related to how individuals can access capital.

It always finds the form of "America is the richest country in the world, yet they can't [insert problem]."

This assumes that there is some objective resource need recognition system and misses that there is no overarching explicit capital allocation system to direct funds in such a way.

The cash balance of Apple corporation has no connection to whether a blogger can afford brain surgery or not.

So I'm not sure why this keeps coming up.

Except that's not true. Our government could very, very, very easily enact single payer, and we have plenty enough wealth to do it.

>...and we have plenty enough wealth to do it.

Whose wealth?

Yours (if you are a US citizen), mine, the 1%, the other 99%...at least a government mandated reform of the private healthcare system should be able to enforce transparent pricing structures and fight graft.

So everyone's wealth is free for the taking?

Everyone's wealth is already being taken, but spent in fucking weird ways.

The US government pays more for healthcare than some other western countries, but gets worse outcomes across a range of measures.

My wealth is already being used to fight insurgents in parts of the world we have zero business being in.

This is true but this is what follows if you (generic you, not you specifically) believe that the wealth of the US is some collective pot of gold to be spend on X. You don't like X but would rather it be spent on Y is not a fundamental change but a detail.

I merely gave a vague answer to a vague question. Allow me to be specific: The US has a progressive tax structure which could be put to better use taking care of it's own citizens instead of attacking the rest of the world, and letting mega-corporations subvert environmental protections.

It wasn't vague and your reply demonstrates you knew exactly what I was talking about. The wealth of the US is not some collective pot of gold to be spent on X. It is owned by individuals and if you take it, spending on X is a mere detail. You are just arguing for Y instead of X.

That wealth was able to be generated due to everyone coming together to do things like spend on education, roads, fire protection, etc.

Your comment basically restates the same argument only backward:

"America has enough wealth, why can't we just enact single payer?"

It completely ignores the structural challenges to doing that.

What's the counterargument to PPP/

It's still an aggregate number, and doesn't take into account things like wealth inequality, social mobility etc... which we seem to care about more. It also doesn't differentiate between goods broadly - just in relation to currency indexes.

Thanks.

I think the fundamental personal issue in this country is that nobody wants to be told exactly what their government-mandated health regimen should be, or have the government decide which procedures they'll be allowed to have for their condition.

That ultimately means that they're locked into what their insurance company mandated health regimen should be. But at least they can sort of choose their insurer, or no insurer (which is usually 10-100 times cheaper on the total medical bill).

When the government is responsible for your healthcare, and also has a fiduciary duty to it's taxpayers, then the government has a further responsibility to restrict what you can eat, drink and do (not just safe or unsafe, but to penalize snack foods and restrict sports that have a higher risk of injury.)

All of a sudden, my choice to say, engage in martial arts or boxing, goes from a personal decision (Do I want to do this? Do I have the money for the gear? Is this in my risk comfort zone?) to a decision involving the government (is this behavior too risky for the general pool of insured people?)

Healthcare is not free. Healthcare research and technology is in fact, extremely expensive. Somebody is paying - whether that's the individual via an insurance pool or the government through taxpayers. Does the person paying your bill have your same prerogatives in mind?

Please provide an example of a country with socialized/universal healthcare that prevents one from performing martial arts.

You can tell, based on what we are badgered about in the UK at least, what stuff is presumably expensive to treat: drinking-related stuff (health effects, violence, general misadventure), smoking (esp. tobacco), eating shit food and not doing any exercise, driving too fast or carelessly and getting into an accident (see also: drinking).

I've never seen anything about martial arts, or indeed about sports in general. I'm sure it costs more than £0/year to treat the resulting injuries, just not enough more to make it worth worrying about by comparison.

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