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Comment by igorkraw | Hacker News Reader

Ah, okay, the probably yes. But it's still natural, since one influenced the other heavily.

Also, Social insurance, but also affirmative action and regulation of common goods, although none of these need to be state driven.

One of the neat details that I think is underappreciated and underexplored about Germanies (my native country) public health care system is that it is public and democratic but not state, it functions more like a specially regulated cooperative system, which tends to work quite efficiently. So there is design space for a minimal "state" (which in anarchist circles would be expected to be much more decentralised and democratically run anyway) while still fulfilling a lot of services by "the public"

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Yup, the German healthcare system is definitely a very interesting example of how large-scale social problems can be solved without the state running everything.

(It also confuses the hell out of American liberals, largely because many in those circles genuinely believe that every developed country outside of US has some form of single-payer healthcare, and that a decent non-government-run healthcare system is impossible in principle.)

> It also confuses the hell out of American liberals

Only the ones who don't travel enough to understand how weird US culture is.

> is impossible in principle

Not in principle. I suspect it is impossible in the US without a significant cultural shift, somehow. A disturbing fraction of the country seems to consider the commonweal to be an old-fashioned concept or the domain of suckers.

I suspect nothing is possible in US on the federal level because of the lack of consensus.

But e.g. the Canadian (single-payer!) system is bottom-up - it originated with the provinces and is still run mostly by them, with the feds getting into the game relatively late and focusing mostly on funding and interoperability of the provincial systems. In theory, any Canadian province can withdraw from that system and run its healthcare however it sees fit, including a fully private system - it's just that it's a political non-starter even in the most conservative ones.

It's not clear to me why the same approach hasn't been tried more broadly in US, not even in deep blue states. All the focus is on the federal level, where it gets the most pushback, and where the party deadlock is the worst.

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