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Comment by parineum | Hacker News Reader

Those companies weren't disrupted by a democratic government for which all of their employees have a vote.

The government acts at the behest of the governed so they need to get support from at least some of those groups because a lot of families rely on someone working in one of them.

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> The government acts at the behest of the governed

US here. I remember a Princeton Study from 2014 that found no correlation between public opinion and public policy.

https://www.cambridge.org/core/journals/perspectives-on-poli...

That's absolutely true, but the direction in which public policy fails the will of the govern is predictable. Reforma that hurt a few people a lot, and help most people a little, tend to fail in politics. Things like tobacco legislation are minor miracles in a long line of lobbyists winning. So the way in which the US government will keep failing to match the will of the governed here is, if anything, towards the insiders that are ruined by anything resembling health care efficiency.

I suspect that the disruption will come outside of the regulatory realm: As prices go high enough it's cheaper to get the same treatment in Mexico, or have an AI be your primary care provider, the US system will fall. It will not be this year, and probably not this decade, but eventually such level of waste crashes big.

The US government is arranged to ensure that, the Senate and Electoral College both give significant electoral weight to rural areas in the Midwest. Reading the writing from the time that's intentional and by design.

Perhaps, but this is also a great example of tyranny of a (demonstrably corrupt) minority. It’s fundamentally anti-Democratic to say “everyone has to suffer worse health outcomes and pay more money because this small group of people has established a quite profitable scam and pays politicians to keep it that way.” This is why most developed democracies don’t allow this to happen. That being said screwing over the majority people to benefit a corrupt, self-serving minority, is about as close a definition of American “democracy” as I can think of, so I expect little of this to change.

The government has been directly interfering with this industry since the ACA (“Obamacare”) was enacted; forcing everyone to purchase health insurance.

And not before? This industry exists because of government

Before as well, of course. But prior to the ACA there was no requirement for every individual filing taxes to show they had coverage, or most businesses (even relatively small ones) to offer benefits packages.

It also changed small medical practices because suddenly everyone wanted to use this insurance they were paying for. No longer could it just be a doctor and maybe a couple of medical staff; they needed medical coders, specialized software, and so forth. Some decided to join large hospital networks (for worse, from what I have generally heard).

And this cascaded into multiple sub-industries developing around this revenue stream and the medical system. Everyone trying to sell something and grab their piece of the pie.

It was not great before, but you could go see a doctor and literally pay a small amount of cash for an appointment. Many won’t even accept anyone without insurance now.

Edit: as mburns@ pointed out, the IRS no longer asks individuals about their health insurance status since 2019.

The government has been interfering in the industry since at least the imposition of wage controls during World War 2 that drove employers to offer non-cash benefits to attract and retain employees.

Small correction: No one was forced, and the provision you’re thinking of hasn’t even existed for the last 5 years.

It is hard to argue against this comment, because it is not even factually accurate if we accept framing as valid ( it isn't ).

Can defend why Obamacare marked government interference and , for example, not medicare?

At least since sometime around WWII.

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