> These are life-changing possibilities, especially for entrepreneurs.
I would quit my day job and completely focus on my side business if I didn't have to worry about healthcare.
I would quit my day job and completely focus on my side business if I didn't have to worry about healthcare.
Personally, I would retire early. I have enough to cover bills and reasonable HC costs, but the way it is now, I'll just keep plugging away for a few more years.
The "well of course" moment took me a day longer than it should have.
https://news.ycombinator.com/item?id=47161587 (expat resources for those potentially interested)
https://relocateme.substack.com (a product of andrewstetsenko here, no affiliation, I just like resources that can help humans achieve their success criteria)
https://healthcareinfusion.org/ (for healthcare workers interested in Canada, likely does not apply to many here, but please share with others who might be seeking a path)
(i see this problem as a vulnerability management and exposure exercise to attempt to solve for, ymmv, no affiliation with any resources recommended)
This is one major reason why most of the world's universal systems make private insurance work, and it doesn't blow up the way ours does. But I don't think employers are any happier about it than you are!
Can we afford it? Doesn't stop trillions of dollars for DoD spending for middle east wars or tax cuts for the wealthy, so that isn't an argument, that's subjective cover for not fixing it, we do lots of things we cannot afford (current sovereign debt outstanding is ~$40T, as of this comment). Can't be done? Almost every other OECD country has solved this in some way. Therefore, as a scholar of systems, the root cause I am left with via Occam's razor is "This is an active choice to not fix this suboptimal system, where the fix would be both more economically efficient and humane, For Reasons while the electorate is lied to or paid lip service."
Employers, who supposedly are unhappy with their healthcare costs, could form a coalition and lobby for legislation and fund PACs to fund candidates who would fix this state by state with universal healthcare systems (Canda's universal healthcare system started in a single province as an experiment, for example). Why don't they? Are the costs not high enough yet? They can't argue they don't have enough power, they already, in many ways, bend the US government to their will. They have the power, they actively choose to not use it to fix this system failure.
https://en.wikipedia.org/wiki/The_purpose_of_a_system_is_wha...
https://usafacts.org/government-spending/
https://usafacts.org/articles/how-much-of-the-federal-budget...
https://www.militarytimes.com/news/pentagon-congress/2025/12...
What an idle comment - where is the AMA on record saying that we should spend more on healthcare? Here's all the work they do to describe our increasing costs:
https://www.ama-assn.org/about/ama-research/policy-research-...
Also, when people invoke the bogeyman of 'AMA' they treat it like the lobbies that tech companies belong to. The AMA is not enriching physicians or hospitals (which have their own lobby!) but generally espouses consensus perspectives among doctors while making money from administering things like a residency program application system.
It's frustrating for someone like you to make this statement which feels quite divorced from any fact when you would not do the same about a security topic.
I have to say: you can go either way on the AMA, I guess, but it's a weird hill to die on, isn't it? They're a trade group, not a public health organization. They exist for the benefit of their members.
> The AMA orchestrated the capping of residency slots through CMS/Medicare,
This has very little to do with the AMA, though it is true that in 1997 the AMA was predicting an oversupply of physicians. CMS funding is the role of Congress and the AMA has supported increases in residency seats since the prediction of oversupply was found incorrect.
If there's a problem with an advisory group suggesting that the US not overspend, then I think we'll not agree on much.
I take their 1997 position as one in good faith; the graduate training component of medicine is very resource-intensive (and honestly dangerous!) so it should not be expanded without good reason.
> Doctors in the US make integer multiples of what they do in Europe in part as a result of this.
Doctors in the US make mulitples of what they do in Europe because we do not have a single-payer. You even say this earlier in the thread!
> They're a trade group, not a public health organization. They exist for the benefit of their members.
I assure you, no physician feels their needs are reflected by the AMA. It's an odd duck that probably made sense in the era of PCPs owning their own firms. The AMA has several structural roles in medical training (they administer application programs, primarily) so they're not going away any time soon, no matter what I may wish.
https://www.hrsa.gov/sites/default/files/hrsa/advisory-commi...
It's weird to hear someone in medicine say this, because it was a big deal at the time and it comes up in many health care economics discussions (it's a commonly stated reason we can't just make more medical schools to create more doctors, and in that way bring the cost of medical education down). And: if you feel that physicians are alienated from the AMA, OK, why are you defending the AMA?
"Single payer" can't be the reason doctors make more here, because they make far less in systems like Germany which aren't single payer. There's a really widespread misconception on the left in the US that "universal care" elsewhere in the world automatically connotes "single payer", but most universal systems aren't single payer.
A quick caution: if you write to me as if I'm a defender of the US system, you're going to miss me consistently, because I am not that. I just think the reflexive position that the answer to our problems is to universalize medicare is bad policy. We could do guaranteed issue, community rating, price transparency, and means-tested subsidy and land essentially where Germany is without essentially ratifying permanently the perverse protectionist premium paid to providers.