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Comment by hedora | Hacker News Reader

Look at national opinion polls. The US is incredibly united right now. 70% want medicare for all (53% want single payer health care). Strong majorities object to overturning Roe v Wade and rolling back gun control laws.

The issue is that the senate can be filibustered with 5% of the US population's backing. A majority vote requires 8%. A fillibuster-proof majority requires 12%.

This implies that it would not take many geographically mobile liberals to end the Republican party forever.

Ironically, the Republican party invented this technique back when they were what we would currently call a liberal party. It worked great. Read up on carpetbaggers.

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Not to overly pick a nit, but if you dig into that Medicare for all poll, only a single digit percentage of Americans support it when you get into the actual details of the plan as presented at the time of the poll.

Well, yeah. The root of the problem isn't single-payer vs. out-of-pocket. The real problem is too many people competing for too little doctors and hospital beds.

Making it centrally-funded won't magically warp new doctors from hyperspace. It will simply shift the pressure from prices to waiting times.

The working solution would be to reduce the bureaucracy and make it easier to open new practices, ban anticompetitive behavior by hospitals and address the residency spot bottleneck. But nope, nobody is suggesting that. We keep fighting about the most fair way to split 3 beds between 10 people.

> The real problem is too many people competing for too little doctors and hospital beds.

Well, that one of the problems and the AMA is very effective as a labor organization.

Sure but I think the thrust of OP is correct.

single payer alone is close to 70% now.

medicare itself is very very popular in that age group.

People are easily scared and those that already have good care are afraid of losing it. Look at death panels.

but the general idea of healthcare as a fundamental right and a national system of health are very popular.

> single payer alone is close to 70% now.

Thats only when you don't get into the details of the implementation, and things like the need to pay for it with something like a European style VAT tax. When you dig in to the details in the polls, support plummets.

This isn't a critique of the idea, just noting the on the details almost no Americans actually support doing what it would take to implement.

> Look at death panels.

All healthcare systems have some kind of rationing, in America generally people who don't have employer provided healthcare and are neither especially poor or old get care rationed. This isn't ideal, I agree.

"when we fearmonger, support plummets"

yeah I'm not surprised.

This is IMHO akin to the false consciousness argument and probably wrong. I think when people say they want A but not if they personally have to pay a lot for A, then it seems like we should take them at their word. This isn’t a value judgment or to say that single payer wouldn’t on the whole be for example for a 20% VAT, but Americans by very large margins say they don’t want that. I think it’s really important to be honest about these things when have discussions about public policy. Trying to mislead with survey data, telling white lies, and hiding costs ultimately undermines your position. People will find out, and it negatively influences their opinion of your position.

American's just don't like taxes. When explained that the system is cheaper, their net costs would be the same or lower, it still has solid support.

the problem again is the 'haves' (who also tend to vote a lot more) are the ones who see themselves as losing and gaining a tax.

if it's employer paid for and you don't even know the true value it's hard to see it as comp

> When explained that the system is cheaper, their net costs would be the same or lower, it still has solid support.

I haven’t seen polling that shows that.

Well older people tend to vote more, but there are a lot of lower income folks who vote reliably.

I think part of the issue is that proponents of single payer in the US present it as something that can be paid for by further taxing “the rich” alone, and that’s clearly not true. No other country pays for social welfare that way, and it’s trivial to find that out. Being dishonest about how it might be funded undermines the project politically. No one is trying to sell the idea that VAT + healthcare is a better overall deal. Which it may or may not be, depending on the implementation. Nevertheless proponents are lying about how it can be paid for.

Which polls are you looking at? Do they have the sampling data or provide limiting factors for their assessment?

Yeah, I’ve seen a lot of poll numbers today without citation. To be fair, every existing poll can be safely defenestrated anyway since the SCOTUS ruling will have changed a high fraction of minds.

Even if it was taken in the last two weeks? This ruling was the worst-kept secret in SCOTUS history.

I linked to a comment for the medicare for all and single payer polls. They were from 2018 and 2020. The other polls have been all over the news in the last month.

https://news.ycombinator.com/item?id=31768611

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