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I'm not an American and I don't really understand why you say this. Only a small percentage that the machine produces comes out in a form usable by non-rich peo

I'm not an American and I don't really understand why you say this. Only a small percentage that the machine produces comes out in a form usable by non-rich people? Then what's, for example, Obamacare, which seems to be a system that finally resembles how health insurance works in many European countries? And isn't that same Obamacare under fire by lots of people who think that the machine shouldn't support the people and that everybody needs to support themselves instead of taking a piece of tax money? I'm more confused than before.

belovedeagle 10y ago
Except that's not how Obamacare works at all! It involves an expansion to Medicaid and Medicare, which are huge failures, and the forcing of healthy Americans into the health insurance market. In fact it has nothing to do with healthcare at all; it only has to do with health "insurance" as if by forcing more money into the system we'll somehow fix it. Because what the American health insurance industry - of which a very small part is healthcare, since even hospitals are putting most of their effort into getting as much money out of the public and private "insurance" schemes as possible - really needs to be "fixed" is more money! I use scare wires around "fixed" because, from the point of view of those running it, the health insurance industry is better than it's ever been.
mirimir 10y ago
No, Obamacare only pretends to resemble European-style healthcare. In fact, it merely forces everyone to sign up with private health insurance companies. Which still take their huge profits.
- fennecfoxen 10y ago
  Yes, and private health insurance companies have profits so huge that they're pulling out of the insurance markets left and right and saying "sorry, we're just not interested in this business anymore!" Arizona's had it worst – many places there are on their last insurer – but that's just a taste of the phenomenon. The premium hikes are paying for the treatment of the "uninsurable" and chronically ill. Even the profitable for-profit insurers are only running margins of 3%, maybe 4% in a good year. You could turn them all nonprofit and it wouldn't really help premiums. (And people tried! Look at the health-care co-op collapses in Colorado, Iowa, Kentucky, Louisiana, New York, Nevada and Tennessee, and Oregon, as well!)
  - mirimir 10y ago
    OK, maybe Obamacare is melting down in some states. But national healthcare works in Europe, Canada, etc. So what's so special about the US?
    - fennecfoxen 10y ago
      If we want to compare apples to apples, national healthcare doesn't work in Europe. It works in a variety of individual countries within Europe, some of which are imperiled. (And Canada has a population a tenth the size of the US.) Some of those countries have culturally homogenous well-educated populations smaller than the United States illegal immigrant population, so there's a demographic difference. That said... Euro health care, writ large, works in the sense that "this is a substantial tax on our national incomes and possibly contributes to an economy which continues to suffer low growth rates and youth unemployment rates regularly in excess of 25% – and given the Euro crisis on top of that there may be some ugly cuts in the future, especially in places that aren't Germany." (Canada's health care at least has less of that problem.) These national health care systems generally deal with cost control for the chronically ill and the elderly by rationing care through waiting lists for various operations... or, in the case of the Netherlands, by building a culture which pushes the elderly into assisted suicide. (This is as opposed to the US who has historically dealt with them by making them pay for their own care, but has recently switched to dealing with them by hiking everyone's health care premiums to the point of unaffordability.) Don't think I'm pitching solutions here!! I've just got buckets of cynicism for everyone!
      - UncleSlacky 10y ago
        > Some of those countries have culturally homogenous well-educated populations smaller than the United States illegal immigrant population, so there's a demographic difference. Dogwhistle for "can't have nice things because blacks". Notwithstanding the relative homogeneity of their populations (the US is well down the list BTW), what difference should it make?
        10y ago
- oergiR 10y ago
  This is how healthcare is set up in Switzerland and the Netherlands. It is just an implementation issue how payments (through tax or otherwise) are routed. In a system that involves market forces, the key thing is that if everybody is insured, including the healthy, the cost per person comes down.
- afterburner 10y ago
  Nothing odd about private industry being involved in public health care, many successful universal health care systems involve private corporations.
thatcat 10y ago
Obama care removed some barriers for those with pre existing conditions and forced young healthy people to sign up to pay for it under threat of tax penalty, it didn't collectively negotiate drug prices with insurance companies or provide universal coverage, the way UK, Canada, etc do.
peterwwillis 10y ago
In very general terms, the majority of the American populace does not think about politics in terms of rhetoric. They think in terms of jobs, moral values, and pride. You can see this in every corner of American life, in the highly educated upper classes and the poor, in the suburbs and the inner cities and rural farms. Things like "Obamacare" don't mean anything to them. It's just some crap the people on the TV talk about. If it can be explained to them in a way that it's anti-job, anti-moral-values and anti-pride, they will vote against it. And vice versa. But the major problem with the system here is most people find Congress and politics in America in general to be corrupt. That's why they elected Trump. He's not a politician. He's so far not a politician that half of the people who voted for him don't agree with what he says. But he said he would get them jobs. And support their moral values. And re-instill their pride in America. That is all they want, and he says he will give it to them, so they vote for him. In this way, they understand perfectly how the American political system works. Obamacare was a pet project of a particular group's vote (again, people voted and they got what they wanted, essentially). But Obamacare can be dismantled over the same amount of time it was put into place. It has nothing to do with the American political machine's output; it was more of an accident. In general, the political landscape here is very opposed to socialist programs like this. Medicare and Medicaid were extremely controversial in their time in the 60's - people went much crazier over the idea of those than Obamacare. But Republicans (who are the primary opposition to these programs) have actually expanded them over time. It's best not to think about how the machine works. Social programs are a red herring. Logically, a large group of people paying into a system that would lower your health care costs and save you money would be a boon, but it isn't seen this way here. It won't grow your wallet as quickly and simply as a tax cut. Honestly, the details of each party's arguments are immaterial. Each party makes promises and people vote primarily with their wallets in mind. The idea that they would receive less money or pay more tax is inconcievable, partly because of how low wages and savings are and how high student loans are and how the economy has tanked etc etc. Every year, the rich (and corporations) get richer while the people do not. That's the big pink elephant everyone is aware of, and they know voting won't change anything, but they have no other choices. The machine produces money in different forms, and the form made for the consumption of the general public is regulated to be very small. Most of it goes to corporations and the rich. I don't think people have really grasped this concept, and so they can't really attempt to change it. So their votes continue to not count for much, which they recognize, so they don't vote. In the past, the machine worked differently. Instead of votes and labor, it was "empire" and labor that produced money, and because "empire" involved looting other lands that the people didn't live in, they kind of reaped the benefits. There was more money to go around, so people didn't notice how small a part of the pie they really got, or they were just socially conditioned to it with things like class rule. In an American Democracy, we removed the old class rule and replaced it with a system of voting for a group of individuals who would maintain the illusion of a lack of class rule, as a sort of proxy for the upper class. It works really well because nobody seriously talks about reform or rebellion here. Theoretically, it is completely possible for the people to self-determine huge shifts in how the country works. That somehow frees us up to not care that we don't actually control how the country works. (We technically do, but in practice the rich and corporations who use the political puppet proxies to administrate the nation are actually in control) I apologize for rambling. I don't get to talk politics much.

belovedeagle 10y ago

Except that's not how Obamacare works at all! It involves an expansion to Medicaid and Medicare, which are huge failures, and the forcing of healthy Americans into the health insurance market. In fact it has nothing to do with healthcare at all; it only has to do with health "insurance" as if by forcing more money into the system we'll somehow fix it. Because what the American health insurance industry - of which a very small part is healthcare, since even hospitals are putting most of their effort into getting as much money out of the public and private "insurance" schemes as possible - really needs to be "fixed" is more money! I use scare wires around "fixed" because, from the point of view of those running it, the health insurance industry is better than it's ever been.

mirimir 10y ago

No, Obamacare only pretends to resemble European-style healthcare. In fact, it merely forces everyone to sign up with private health insurance companies. Which still take their huge profits.

fennecfoxen 10y ago
Yes, and private health insurance companies have profits so huge that they're pulling out of the insurance markets left and right and saying "sorry, we're just not interested in this business anymore!" Arizona's had it worst – many places there are on their last insurer – but that's just a taste of the phenomenon. The premium hikes are paying for the treatment of the "uninsurable" and chronically ill. Even the profitable for-profit insurers are only running margins of 3%, maybe 4% in a good year. You could turn them all nonprofit and it wouldn't really help premiums. (And people tried! Look at the health-care co-op collapses in Colorado, Iowa, Kentucky, Louisiana, New York, Nevada and Tennessee, and Oregon, as well!)
- mirimir 10y ago
  OK, maybe Obamacare is melting down in some states. But national healthcare works in Europe, Canada, etc. So what's so special about the US?
  - fennecfoxen 10y ago
    If we want to compare apples to apples, national healthcare doesn't work in Europe. It works in a variety of individual countries within Europe, some of which are imperiled. (And Canada has a population a tenth the size of the US.) Some of those countries have culturally homogenous well-educated populations smaller than the United States illegal immigrant population, so there's a demographic difference. That said... Euro health care, writ large, works in the sense that "this is a substantial tax on our national incomes and possibly contributes to an economy which continues to suffer low growth rates and youth unemployment rates regularly in excess of 25% – and given the Euro crisis on top of that there may be some ugly cuts in the future, especially in places that aren't Germany." (Canada's health care at least has less of that problem.) These national health care systems generally deal with cost control for the chronically ill and the elderly by rationing care through waiting lists for various operations... or, in the case of the Netherlands, by building a culture which pushes the elderly into assisted suicide. (This is as opposed to the US who has historically dealt with them by making them pay for their own care, but has recently switched to dealing with them by hiking everyone's health care premiums to the point of unaffordability.) Don't think I'm pitching solutions here!! I've just got buckets of cynicism for everyone!
    - UncleSlacky 10y ago
      > Some of those countries have culturally homogenous well-educated populations smaller than the United States illegal immigrant population, so there's a demographic difference. Dogwhistle for "can't have nice things because blacks". Notwithstanding the relative homogeneity of their populations (the US is well down the list BTW), what difference should it make?
      - 10y ago
oergiR 10y ago
This is how healthcare is set up in Switzerland and the Netherlands. It is just an implementation issue how payments (through tax or otherwise) are routed. In a system that involves market forces, the key thing is that if everybody is insured, including the healthy, the cost per person comes down.
afterburner 10y ago
Nothing odd about private industry being involved in public health care, many successful universal health care systems involve private corporations.

thatcat 10y ago

Obama care removed some barriers for those with pre existing conditions and forced young healthy people to sign up to pay for it under threat of tax penalty, it didn't collectively negotiate drug prices with insurance companies or provide universal coverage, the way UK, Canada, etc do.

peterwwillis 10y ago

In very general terms, the majority of the American populace does not think about politics in terms of rhetoric. They think in terms of jobs, moral values, and pride. You can see this in every corner of American life, in the highly educated upper classes and the poor, in the suburbs and the inner cities and rural farms. Things like "Obamacare" don't mean anything to them. It's just some crap the people on the TV talk about. If it can be explained to them in a way that it's anti-job, anti-moral-values and anti-pride, they will vote against it. And vice versa. But the major problem with the system here is most people find Congress and politics in America in general to be corrupt. That's why they elected Trump. He's not a politician. He's so far not a politician that half of the people who voted for him don't agree with what he says. But he said he would get them jobs. And support their moral values. And re-instill their pride in America. That is all they want, and he says he will give it to them, so they vote for him. In this way, they understand perfectly how the American political system works. Obamacare was a pet project of a particular group's vote (again, people voted and they got what they wanted, essentially). But Obamacare can be dismantled over the same amount of time it was put into place. It has nothing to do with the American political machine's output; it was more of an accident. In general, the political landscape here is very opposed to socialist programs like this. Medicare and Medicaid were extremely controversial in their time in the 60's - people went much crazier over the idea of those than Obamacare. But Republicans (who are the primary opposition to these programs) have actually expanded them over time. It's best not to think about how the machine works. Social programs are a red herring. Logically, a large group of people paying into a system that would lower your health care costs and save you money would be a boon, but it isn't seen this way here. It won't grow your wallet as quickly and simply as a tax cut. Honestly, the details of each party's arguments are immaterial. Each party makes promises and people vote primarily with their wallets in mind. The idea that they would receive less money or pay more tax is inconcievable, partly because of how low wages and savings are and how high student loans are and how the economy has tanked etc etc. Every year, the rich (and corporations) get richer while the people do not. That's the big pink elephant everyone is aware of, and they know voting won't change anything, but they have no other choices. The machine produces money in different forms, and the form made for the consumption of the general public is regulated to be very small. Most of it goes to corporations and the rich. I don't think people have really grasped this concept, and so they can't really attempt to change it. So their votes continue to not count for much, which they recognize, so they don't vote. In the past, the machine worked differently. Instead of votes and labor, it was "empire" and labor that produced money, and because "empire" involved looting other lands that the people didn't live in, they kind of reaped the benefits. There was more money to go around, so people didn't notice how small a part of the pie they really got, or they were just socially conditioned to it with things like class rule. In an American Democracy, we removed the old class rule and replaced it with a system of voting for a group of individuals who would maintain the illusion of a lack of class rule, as a sort of proxy for the upper class. It works really well because nobody seriously talks about reform or rebellion here. Theoretically, it is completely possible for the people to self-determine huge shifts in how the country works. That somehow frees us up to not care that we don't actually control how the country works. (We technically do, but in practice the rich and corporations who use the political puppet proxies to administrate the nation are actually in control) I apologize for rambling. I don't get to talk politics much.