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Comment by ianmcgowan | Hacker News Reader

I'm from the UK, but live in the SF Bay Area, and this is the single biggest thing I don't get about the US (with education costs being second). I kind of get the libertarian view of not wanting to trust the government but when the alternative is some kind of Mad Max dystopian hellscape (where people are literally dying), surely looking around the world for alternatives that actually work makes sense?

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It's not libertarian. The US system is cronyism, statism at its finest, possibly illegal. Honestly, I think with current US laws and a willing political force, a lot of top players in the current US healthcare system could be punished, even with the death penalty (especially if reinstated at the federal level).

Dreams aside, in order to have a free market healthcare, which is what informed libertarians want, you need to abolish medical license, the FDA, patents and many other State's interventions. There is a reason why the healthcare system in the US is insane, and it's because the laws are made so that cronies have the monopoly on your health. Neocons are pathetic when they defend the current system.

Without the free market (the real one, not the scam you have in the US), healthcare will be a mess more than any other industry and at that point is better to have a single payer, universal system, because in the end they have the same problems of the current US system but at least you don't get ruined.

A functioning market is one where multiple market participants exist (both buyers and sellers) and both are able to make educated choices.

How can a market like this exist when the buyer is incapacitated, not to mention even when not incapacitated, the buyer is not sufficiently educated to understand what they are buying?

You could buy the services of an expert in medical decision-making who will negotiate for you when you're incapacitated.

Also, supposedly people aren't total dicks. At the moment the healthcare industry rewards a lot of psychos due to its incentives. Hopefully with a free market the dicks would be weeded out due to increased choices. Also having a free market means that there would be an incentive to make medicine more accessible, while still correct, because more people could be willing to become healers, maybe specialized healers. Who knows, what's certain is that we have not discovered the full potential of humans healing other humans and the current regulations are a big brake on new systems and innovations.

So, for now I'm ok with the whole single-payer/universal healthcare deal.

Or you can just not do free market on something that should be a human right given the capabilities of modern medicine. It shouldn't be left up to market forces to decide who gets help. That kind of makes sense for some things like TVs and laptops but not life and death when for the most expensive items your only choice is life and death.

Just like the USSR wasn't communist.

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