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Yes, I almost expanded further on the healthcare point for that reason, but then realized the author seems as if they are possibly writing from the UK.
by divbit 10y ago
Yes, I almost expanded further on the healthcare point for that reason, but then realized the author seems as if they are possibly writing from the UK.
- XorNot 10y agoAustralia (mentioned because Americans love to talk about the size of their country somehow making single-payer impractical).
- shaftoe 10y agoHonestly, when we say size, we mean diversity. Countries used as success examples are far more homogeneous in their population and culture.
- knz 10y agoCan you clarify what impact that has in regards to population? I don't believe the US has significantly different medical needs compared to any other OECD nation?
- extra88 10y agoI don't know if America's "size" is really used as an argument against single-payer working here but if it is, I'm sure what is meant is population size. What's an example of referencing a country's large size meaning more diverse or heterogeneous rather than greater population? But I agree that "size" in this case definitely does not mean geographic size. Geographic size might be a factor for why America doesn't have better telecommunications or rail system, not health care.
- extra88 10y agoI'll walk that last part back a bit, geographic size, and having sparsely populated areas, can make providing health care for all more difficult and therefore more costly. But I think it would be a very minor factor and Australia serves as a good example of that, it has a much smaller population but some of it is comparably far-flung.
- bmelton 10y agoI agreed with, and upvoted your answer, but upon reflection, so long as insurance policies in America are still constrained by state borders, there might well be a (fairly arbitrary) hurdle on risk pools. States with more and a higher concentration of population centers may benefit from a more diverse risk pool than states that look more like Alaska.
- extra88 10y agoTrump and some Republicans have argued for allowing selling policies across state lines but I think more knowledgable people have said it would not make a significant difference in health care costs and poses some race-to-the-bottom risks. I think most insurance providers are multi-state entities so higher costs in one state can be balanced by lower costs in others. But there may be some limits; if the ACA requirement that insurers use 80% of revenue on health care costs is applied per-state, they may not be able balance out a really unhealthy state. But this isn't an issue due to America's geographic or population size or even the quantity of states, it's that America has much more political power at the state level.
- vidarh 10y agoMakes no sense. The EU has a larger and far more diverse population than the US, and yet has universal healthcare and demonstrated exactly how to handle it if you're so diverse: Just set up multiple systems. The US even has very convenient boundaries to split up the systems along: States, just like the EU. Even most countries with universal healthcare further subdivides their systems. E.g. Norway (5 million people) operates regional health trusts that are largely independent. The UK (60 million) does the same on a larger scale (more trusts) and leverages the number of trusts to improve management of individual trusts by occasionally having successful trust take over the running of trusts where management is failing. The "size" argument is almost always a total red herring.
- jdietrich 10y agoI really don't understand this argument. I can only assume it's some sort of euphemism I don't have the cultural context to understand. Belgium is split right down the middle by language and culture, with many people supporting a split into two independent countries. Spain has Catalonia and the Basque country, two culturally and linguistically distinct regions that have long fought for independence. Ireland has spent most of the last century in a slow-burning civil war. Half of Germany was part of the Soviet Union until 1989. When people say that universal healthcare can't work in the US because of "diversity", what exactly do they mean by that word?
- Trill-I-Am 10y agoHe means racial diversity because in America a lot of white people don't like black people
- TheCoelacanth 10y ago"Diversity" is frequently a euphemism for "black people".
- mrmrcoleman 10y agoI believe he is writing from the U.K. but they have the NHS, or did I misunderstand your point?
- divbit 10y agoThe point was that, given the NHS, the health benefits issue is probably, for good reason, not something I would expect the author to consider in their summary of dad jobs.
- mrmrcoleman 10y agoOk, understood, and agreed.