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Comment by bruce511 | Hacker News Reader

In the USA its all about the money. Those "political forces" are not a grassroots movement, people in the street demanding insurance-based healthcare.

No, it's well organizes, very well paid, lobbying on behalf of a profit-based health system. A system that generates lots of profits for nice big companies.

And make no mistake, they're not going to roll over.

And sure, doctors are depressed because they're finally coming to realise that medical care (in the US) is not about "helping sick people" (despite their good intentions.)

Doctors and nurses set out with the noblest goals, then find themselves inside a system where the one true goal is to separate people from their money. They rile against "adminustrators" while at the same time failing to note that those administrators are the _reason_ for yhd business, and actual doctoring is just medical janitoring.

Yay free markets!

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> are not a grassroots movement, people in the street demanding insurance-based healthcare.

> No, it's well organizes, very well paid, lobbying on behalf of a profit-based health system. A system that generates lots of profits for nice big companies.

I am not a lobbyist or an owner of an insurance company. I am a "person on the street". I do not want single payer.

Can I ask why? Even right wing think tanks agree that medicare for all would save 2 billion a year in healthcare costs at least

https://thehill.com/blogs/congress-blog/healthcare/484301-22...

It is simple, calculating, and heartless.

When there is a fixed amount of X available, a fair division of X across Y people gives everyone X / Y.

When you need more than X / Y, you are screwed (ask anyone in england who's needed cataract surgery on their second eye and was told that QoL improvement was not there, like it was for the first, so GTFO)

Since I can afford to buy a lot more than X / Y of healthcare for me and my family, should it be needed, the outcome for that limited and, to be honest, complete set of people whose well-being i care about is better in the current system.

I appreciate your honesty.

I completely agree that the current system is excellent for those who can afford it, and queuing-based-on-worth certainly appeals to those with worth.

In the US this worth translates into money, which translates into lobbying. You are not marching in the streets because you don't need to. Your money speaks for you.

I say this not to patronise you, since you clearly understand this is the case. I say it merely to point out that this system works for the few, not the many. And yes it works well for the few.

Regarding your cateract example, if the queue is need based, and you have two patients, then one with 2 cateracts is ahead of someone with 1. That's another system, a system I agree which would be most distressing to someone with 1 careact and lots of spare cash.

I get that any system other than the current one will make you worse off. Equally I hope you see that any system at all will be a massive step forward for huge numbers of people.

Sure, I get it. I prefer systems that favor me. The seething masses aren't "real" to me. I don't know them like I know me and the people I care about. I care about my medical needs now, not some hypothetical "other person". Like you, I can pay for my medical, and I appreciate that I can.

But I also wonder if this is the best way. It works for me, but maybe there's something better for us all.

I will also add that many problems in the US and other countries stem from the perversion of incentives and benefits of the few over the many. What I mean is that keeping this broken system in place as it greatly benefits the insurance companies, of which there are a few. It’s so valuable that they have the money and resources to buy the politicians, pay for the media campaigns and lobby the propaganda outlets to mitigate any power the populace has to address the issue. This allows industries to control pretty much all policy in the US. It’s a sad state of affairs.

> a system I agree which would be most distressing to someone with 1 careact and lots of spare cash.

It wouldn’t be distressing to someone with lots of spare cash in the UK because they would just get the surgery done privately. There seems to be a common misconception that private healthcare is not available in the UK.

> ask anyone in england who's needed cataract surgery on their second eye and was told that QoL improvement was not there, like it was for the first, so GTFO

A bad example, given that private cataract surgery is quite affordable in the UK. You could quite easily pay that much in the US even if you had insurance.

https://lp.opticalexpress.co.uk/cataract-v1-0/?cam_id=20230&...

private care exists in the UK.

X isn't fixed though.

New technology, new knowledge and training all increase X. It's relatively fixed at a given moment in time (where your point is very true), but society shouldn't be making a major structural decision one moment at a time.

The article says $2 trillion over 10 years, that's $200 billion a year.

Lobbyists have been successful convincing you of something in their paymasters interest and not at all in yours.

I despise the current system, but arguments like this do a lot of damage to the reform cause.

Aside from the incredible arrogance of assuming that GP is just so much stupider and more manipulable than you, it's also factually wrong in enough cases that it instantly discredits you. For example, many people who are upper-middle-class and above are better off in the current system.

The US could have medicare for all and additional private insurance simultaneously.

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