The political polarization of health outcomes in the USA | Hacker News Reader

The political polarization of health outcomes in the USA

nature.com

51 pointsgeox31 comments

Seems like causality might be reversed here. People become more politically conservative the more jaded they become with the healthcare system.

Why would that make you more conservative? Republicans don't have any answers to fix the US healthcare system. It would be far more plausible that someone that experienced the failure of the health care system would vote for a populist position here, and for healthcare the more convincing populist position is certainly the left one.

The current healthcare system was mostly shaped by Democrats with the Affordable Care Act (sometimes called Obamacare) at a time when Democrats held a filibuster proof majority.

The ACA is grounded in a lot of political policy going back to the Nixon era, and draws from quite a bit of conservative ideas. The individual mandate itself, for example, was a Heritage Foundation proposal from the late 80s, and was ironically one of the main targets of Republican objection during and after the implementation of the ACA.

If you review Nixon's CHIP proposal (https://www.nixonfoundation.org/2015/11/the-nixon-comprehens...), you'll find a proposal that maps pretty closely onto the ACA marketplace that we now have available.

"Mostly shaped by Democrats with major proposals cribbed from Republicans" would be a more accurate assessment.

Do you earnestly think the electorate thinks about these things?

I'm just responding to the claim "The current healthcare system was mostly shaped by Democrats."

The ACA is, in fact, warmed over RomneyCare(tm) (a Republican, please note) from Massachusetts.

The fact that Kentuckians loved Kynect and hated Obamacare--which are the exact same thing (aka the ACA)--tells you everything you need to know about the Republican voting public.

Additionally, the fact that Democrats took a pro-corporate conservative policy package and rebranded it speaks volumes about how much daylight actually exists between the parties when you ignore the culture war rag waving.

You call that "the uniparty", while other here at the same time say they want less polarisation and more bipartisan consensus.

Make up your mind.

(I am old enough to remember that Obama convinced the Democrats that it was better than the existing system, and that small progress was better than keeping the status quo or waiting another decade to have maybe, someday the numbers to pass a better bill)

Many people in the US become more liberal as they become more jaded by the (for-profit) healthcare system.

Through what mechanism does dissatisfaction with our for-profit healthcare system lead to support for eg. expansionist foreign wars or aggressive policing policies?

Fear of pronouns.

That's misunderstanding the paper. The correlation here is with outcomes, not support. Republicans may very well be more "jaded" with the healthcare system. But that doesn't explain why they die early.

Isn't it just that they're in the Republican misinformation ecosystem?

This because extreme over COVID. A particular low point was Herman Cain's Twitter account doing COVID denial while, and after, the man died of COVID.

They posthumously named The Herman Cain Award after him. https://www.reddit.com/r/HermanCainAward/

How do you become jaded with something you do not have access to? Has universal healthcare ever been tried in the US?

I suspect this is probably more complicated. My family members who live in small towns and rural areas have been having larger health issues and more trouble getting care even if they want to for years if not decades compared to my relatives who live in major urban areas, and particularly those who live in more affluent areas. Like I'd go so far as to estimate that affluent areas metro adjacent are +7 years vs. non-affluent metro areas, which are also like +7 years vs. rural/small town areas or slum/poor metro areas. But I also think the kind of care and non-care my relatives in smaller/rural areas leads to exhaustion, loss of faith in the system, and interest in alternative options.

But I also don't doubt that adding the modern conservative delusions and paranoia on top of it all only worsens everything.

Of interest to that point:

The Unlucky Country: Life expectancy and health in regional and remote Australia (2023) - https://apo.org.au/sites/default/files/resource-files/2023-0...

  Life expectancy in Far West NSW is almost six years lower than in Sydney, with the divide getting worse.
  Those in the Far West are twice as likely to die prematurely compared to those in Sydney, and ‘potentially avoidable’ deaths are two and a half times more likely.
  Suicide is twice as likely for residents in the Far West, with rates trending up.

Why Australia? -

* Sidesteps the US Dem V Rep preconceptions.

* Highlights Rural V. Urban resource differences.

* Similar Political division in that AU regional tends more conservative (by AU standards) than AU urban.

It's absolutely multi factor, but likely more strongly tied to health assets, funding, and reach of public messaging than to political leanings (although asset distribution, funding, and messaging policy are, of course, tied to politics).

It's well documented that healthcare providers in rural US are diminishing, and yet, they continue to vote for right wing candidates.

It is important to point out though, that the last opportunity to establish single-payer healthcare in the US was prevented by the democratic party.

The famous Hillary quote: "Single payer is off the table"

This is why the RNC has hated on the Clintons so much, and especially Hillary: they were muscling in on republican turf.

> It is important to point out though, that the last opportunity to establish single-payer healthcare in the US was prevented by the democratic party

It is only (possibly) important to point that out if single-payer healthcare is necessary for an affordable, high quality, universal healthcare system.

That is clearly not the case since there are several examples of first world countries with such systems that are not single-payer, such as Germany, France, Switzerland, and the Netherlands.

In all fairness they also have very little in the way of very low population density areas compared to the US. For example, Montana is bigger than Germany and has like 7 people per square mile overall.

> The famous Hillary quote: "Single payer is off the table"

Her point was that getting that passed would be politically unrealistic at the time, and she was almost certainly correct.

Your framing is either ignorant or deliberately deceptive.

The democratic party controlled the house, the senate, and the presidency at that point in time.

My point is that the democratic party blocked public health care for the US.

This is neither ignorant nor deceptive.

> My point is that the democratic party blocked public health care for the US.

That's not what you wrote. You specifically referred to Hillary and "the Clintons", not the Democratic Party as a whole.

Hillary was simply observing the practical reality that they would not have been able to get the necessary votes to pass single payer. Conservative Democratic and "centrist" (codeword for conservative) senators like Joe Lieberman, Ben Nelson, Max Baucus and others would not have supported single payer. They didn't even support a much milder public option.

Are you just trolling?

> It is important to point out though, that the last opportunity to establish single-payer healthcare in the US was prevented by the democratic party.

There is some ambiguity in that sentence: by "last", I don't mean that it was the final opportunity, I mean it was the most recent previous opportunity.

Also, to your last point:

> Hillary was simply observing the practical reality that they would not have been able to get the necessary votes to pass single payer. Conservative Democratic and "centrist" (codeword for conservative) senators like Joe Lieberman, Ben Nelson, Max Baucus and others would not have supported single payer. They didn't even support a much milder public option.

We're totally in agreement on that, and that was my intended point: the DEMs, and specifically the Clinton's were representing the right-wing perspective on the issue.

The DNC has become even more right-wing since then, following the RNC right, as it went off the cliff into MAGA fantasy land...

Over here, far far away from USA, we have a joke story about a certain type of person, who finds a jinni lamp. Jinn tells that person that he can fulfill any single wish of his, but the caveat is that person's neighbor will get twice as much of the same thing. And the person responds with "gouge one of my eyes". And that's basically a tale of healthcare in some countries. "I will suffer some, but at least "those" people will suffer more!".

The Southern Strategy destroyed the GOP as we knew it. It is now the party of dumb. Say that and you get accused of being elitist, but it's the truth. You can win elections as the party of dumb. But, man, it's tough being dumb in the USA today. There's so much misinformation and marketing of harmful products.

Just reading the abstract makes me think of the phrase: Play stupid games, win stupid prizes.

Oh well.

Republicans like to throw around "FAFO" to justify their cruelty.

Well, Republicans, FAFO.

Would need to affect reproduction for Darwinian effects to matter.

Encourage deathly extreme sports for kids/teens/20s/30s? Need more hysteric ball betting.

Build up the belief of rewards in afterlife - vergings towards other religions?

Win by playing a long game.

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