Their Baby Died in the Hospital. Then Came the $257,000 Bill

Doing this all at once might not be palatable to a lot of people. In reality, boiling the frog slowly may be the better way to go here. Reduce their earnings a fraction each year, over say a 20 year timespan. Decreasing the eligibility age for Medicare each year by a year or so might partly accomplish this.

The whole argument that it will be better with everyone is absurd. You cannot point to other countries examples when we know what the US does. If advocates of changes in the current system cannot fix IHS or the VA then they are incapable of fixing the rest of it.

First, we have a strange relationship with taxes. The highest amounts are paid to the Federal Government (at the nation-level) and as you travel down the chain to state and then local (city/county), less tax money is owed to these places typically. Regardless of where someone sits on the political spectrum, it is widely accepted that the federal government does not efficiently spend the money, with citizens receiving no tangible value. For example, during the pandemic, many people got $1200 stimulus checks and a "good luck" even though taxpayers fork over thousands over the course of their lives. Stuff that actually affects our lives directly is often done at the local level, with roads, for example, funded by a tax on gas in California (and some federal dollars, too).

Given the perception of how grossly incompetent, understaffed, or ill-prepared government offices are to deal with anything, people are not exactly lining up to have such an inefficient system provide them with insurance.

We also have an accessibility problem in that every process that one must initiate to receive most government benefits, is rife with bureaucratic, over-reaching, and easy to mess-up paperwork designed by people who's goal it is to dish out as few benefits as possible.

Having spent a bit of time in Germany myself, it's clear the attitude is different. Germans (and EU citizens) actually receive benefits from the taxes they pay that are both accessible and tangible. Having medical expenses paid by the state via taxation is ultimately what creates a more healthy society.

Second is the fact that we allow large lobbies and organizations (like insurance companies) to influence what legislation gets passed. This is also so far removed from people's every day life that this sort of non-corruption, special-interest sway happens all the time. Insurance companies have a great thing going on for them, imagine being able to charge whatever you want and be wildly inept and unwilling to actually provide services (pay out) when your customer requires it as per the policy you sold them. They fund (behind the scenes) mass-marketing campaigns (yes, instead of paying actual claims) that spread propaganda about how bad healthcare is if left up to the government.

There are other problems, but maybe this helps see why it's such a big social issue here. This is just my take on what I find to be two major ones.

Particularly for the last point, socialized medicine is often weirdly spun as bureaucrats taking away your freedom of choice and preventing you from getting health care ("death panels" and all that). So people visualize the current fucked-up system, imagine what it would be like if they had even more obstructive bureaucracy dictating whether you're allowed to get surgery and how long you need to wait in line, and often course they think that sounds even worse -- although the reality is that would be better for most people than the status quo of only being able to get surgery if you can afford it, and still risking getting bankrupted in the process.

The American system generates a tremendous amount of administrative work, and reduces the quality of care. If you've ever been in a doctors office, or a hospital in the US, they are constantly looking at the paperwork, not at you. Totally different in Germany. (Which was weird because in virtually every other respect Germans seem to love paperwork!)

Like a fish that doesn't know what water feels like, it dawned on me how stressful all that paperwork is, and how much worse it makes you feel, when you are already feeling bad. And of course in the US any contact at all with the healthcare system is not just painful now, it could be painful for years.

The reason we don't change is because people don't know or believe it could be better. And that, in turn, is because some of that huge money flowing through the healthcare system pays the salaries of professional sophists and lawyers who are very good at playing on the intellectual weaknesses of an American audience. They have lots of tools, but the two most effective seem to be an appeal to "American exceptionalism" - if we didn't invent it then its not good - and the classic strawman attack that anything that isn't the current system is communism. A foolish claim that has no merit, not least of which because none of those same people would assert that Germany is communist.

It's a very sad state of affairs. The US is like a mean old grannie being robbed by a handsome and clever son-in-law who plays on her prejudices and ignorance. Even when other family members try to warn her, NO, she snaps, he tells me you are the monsters, and he is handsome and clever and better than you! There is a villain here, but it's hard to have much sympathy for the victim, either.

We need fewer "systems."

1. U.S. health-care system ranks last among 11 high-income countries, researchers say https://www.washingtonpost.com/world/2021/08/05/global-healt...

Not that I needed it so far, but I get that they can be massive, especially for anything dental. This tends to be funny every few years on routine checkups at the dentist when they try to sell this and that which isn't covered by anything, and I'm like: 'No, just the basics, dammit!'