I don't understand what you've written at all. Are you in favour of the US healthcare system, or against it?
There's this thing called "nuance."
In very general terms, I'm for personal liberty and autonomy. However, I also recognize that people don't care about that, when they are hungry or fear bankruptcy and illness. [1]
The US healthcare system is broken, in that large numbers of people are left in a state of risking bankruptcy and illness. For me, the path forward would involve a safety net for such people, while minimizing encroachment on personal freedom. Not sure what that would look like.
[1] - A stable society must provide a minimum across society, based on perception of relative status. Otherwise, people are wired up to cause chaos. https://www.youtube.com/watch?v=M3XYHPAwBzE
I've found a lot of "opponents" of universal healthcare actually support a safety net for less fortunate people - they just don't want to pay for it. This is a perfectly valid reason, but I wouldn't call it encroaching on personal freedom, so I'm curious as to how else you see it affecting liberty?
For one thing, why are you so insistent that I'm an opponent of health care reform. (Subjectively speaking, there's this sour stickyness of you assuming things inside my head around that. If you are, please, don't. You would be wasting our time and energy with that.) I voted for Obama the 1st time in large part because of health care reform. That said, I've since changed my mind. The individual mandate in Obamacare is too big an encroachment on individual freedom.
Big government agencies tend to encroach on individual freedom because they tend to accrue de facto then de jure power. Would anyone dispute that the IRS has considerable power, enough to create some potential for abuse? (Not saying we should get rid of them, however.)
As far as individual freedom goes generally, watching the events of the past several years, including those around "activists," and big tech companies, has made me a lot more concerned about individual freedom. A lot of people seem to be paying lip service to concepts like Freedom of Speech and Due Process, but then putting wide ranging things into effect which interfere with or abrogate those rights, though they are not technically illegal. (yet)
I think the assumptions others may have made because you've largely described what you don't want.
Do you have suggestions or thoughts for what an effective system is? What is the system that you do want?
Are you instead talking about being forced to pay for a healthcare system, either directly or indirectly through taxes? Because in that case, then yeah, obviously it would need to be paid for. The alternative is not having it at all. And we already don't have a system where people who can't afford healthcare are denied treatment and forced to die, and such a system is untenable according to our modern society's morals anyway.
I agree with the others; you're using wishy-washy words without clarifying exactly what you're proposing, or even explaining how alternatives to the existing types of systems are possible at all.
I have and continue to spend a lot of time on healthcare. Despite 15 years of grinding, I feel like I barely understand what's going, and am continually surprised. For example, I totally didn't foresee hospital consolidation tipping the balance of power back to them (from insurers), begetting the scourge of surprise billing.
The best, and perhaps only, label for our current system is confusopoly (h/t Scott Adams).
In your travels, all that I ask, given your desire for bipartisan bonhomie, is while you read reform proposals (from policy wonks), please note who is participating in the conversation, and who isn't.
There are tradeoffs, and well spent taxes can open up opportunities otherwise precluded, NHS might be better than a private alternative, but in the cost/benefit analysis, the costs really do exist.
The base case is I think the world needs to change, so I spend 8 hours changing it for the better.
The extended case is other people notice I am making the world better, and want to pitch in. We've got this great indirection system in money to allow that to happen with a highly abstract measure of 'resources' so even if they don't know how to contribute personally they can signal how important my work is to others.
Now, there are respectable schools of thought that believe something like (a) there are people who do not have the capacity to meaningfully contribute resources or (b) initial control of raw resources is more impactful than human endeavor. They employ taxes to change how resources are distributed.
And now, the freedom angle:
Without government tax, if I work for 8 hours I can presumably provide for myself in about 2-3 because modern production is so efficient, and then I get 5 hours to reshape the world into something I want to live in. With government tax, the split is basically 2-3 for me, 2-3 for the government, 3 for changing the world to taste. This is effectively a loss of liberty, because now I have half the control over how the world changes.
That isn't particularly profound, it is just how taxes work. But one of the points of money is abstracting direct work for contributing. In a sense, this is the same as labouring directly on a government project for 2-3 hours, and that would be slavery. Obviously taxes aren't slavery because they aren't mandatory (don't want to pay taxes, don't work) but the parallel is there for reducing liberty.
Far better places to play with a LASER than on a beach.
Instead, we seem to see a lot of people spending those resources on shiny toys to make their own lives a little better, and in some cases, spending those resources to ensure that they get more resources in the future, at the expense of others.
I’m not saying Australia has it right in every way, I’m just saying that universal health care doesn’t need to restrict your choice of care.
I run across this all the time with my brother. He's conservative. He's in his 50s. He says, I don't think health care is in a good place, but we can't do X, Y, or Z. It's never what we can do. It's always what we can't. He offers no solutions.
When you're in a privileged position its easy to say we must wait for the perfect solution. When you aren't it's easy to rush to a solution. However, like I said: this has been debated for over TWO DECADES in the United States. It's been enough time. If you can't think of a solution you like, it's not going to happen in a reasonable timeframe.
I've been in both positions. I suspect what we'll wind up with will be a two tier system (kind of what we have now) that covers almost everyone, but this system won't make anyone happy and the debate will continue.
Not exactly. (Or maybe not necessarily.) I could picture a system I'd like that would look a lot like the system we have right now. I'm not expert enough to know how that would work.
but the rest of it was completely opaque to me
Are you part of the societal cohort comprised of left-leaning upper class people in tech and media? Are you part of the societal cohort comprised of lower middle class people working in tech and media? Are you from a different part of society? That would be useful information for writing a clarification. Exactly what part was opaque to you?