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> I see very little altruism in America's activies and very much realpolitik I wouldn’t call it realpolitik. I think a lot of the decisions are based around a

> I see very little altruism in America's activies and very much realpolitik I wouldn’t call it realpolitik. I think a lot of the decisions are based around a mix of altruism and ideology. It’s hard to seperate the two. For example I would say Europeans and Americans have some fairly similar ideals overall. However, if something is bad for Europeans in the short term then they tend to avoid it. I’d say the only exception is on European integration where they are driven by ideology. > You guys could have vastly more accessible and available healthcare and social welfare if you so chose, but for political and ideological reasons, you choose not to. Could we though? And with what trade-offs? States have a lot of power in the US - so for example a state like California could implement its own single payer system and show the rest of the country how it is done.

EdwardDiego 8y ago
> Could we though? Yep, you already pay the most for healthcare in the world, yet people are routinely bankrupted by medical issues. > And with what trade-offs? Health insurer and pharmaceutical company shareholders might get a lower dividend. In NZ, we have (near) free healthcare available for all, but private health insurance and private hospitals still exist as an alternative for those who want them. We have far fewer economies of scale - our entire population is only slightly larger than the population of LA in a country larger than the UK - yet our healthcare costs impact our economy significantly less than they do yours. I know that some of the world's best medical treatment can be sourced in the US - if you can afford it, or your insurance cover it. But I also know that we spend less on healthcare and live longer, and no-one ever goes bankrupt because of medical bills. But I also know that a former President of the USA once recorded an LP (admittedly before he was President, 10 years after he co-starred in a film with a chimpanzee) explaining that socialised medicine was pretty much Communism and/or the devil, so yeah, I find your country a very strange beast.
- sheepmullet 8y ago
  > Yep, you already pay the most for healthcare in the world Our government already spends as much on healthcare as many governments with socialized medicine. If it was simple then we would already have it. > We have far fewer economies of scale - our entire population is only slightly larger than the population of LA in a country larger than the UK And that’s exactly why the push for socialized healthcare scares so many Americans. Countries like NZ clearly demonstrate it can be done at the state level. So left leaning states can implement it and over the course of 10-15 years they can prove to the other states it is a better system. Instead they want to push it at the federal level exposing the entire country to the risk. > Health insurer and pharmaceutical company shareholders might get a lower dividend. I think it might result in a lot less R&D, less capable doctors, etc.
  - EdwardDiego 8y ago
    > And that’s exactly why the push for socialized healthcare scares so many Americans. I don't understand that - why does it scare Americans that we do it cheaper despite having a more dispersed population?
    - sheepmullet 8y ago
      > I don't understand that - why does it scare Americans that we do it cheaper despite having a more dispersed population? Because if you can do it with a country of a few million then there is no reason for us to handle it at the federal level. Doing it at the federal level is then a political attack on people that want a different system and have different beliefs.
      - EdwardDiego 8y ago
        Ah, with you now.

EdwardDiego 8y ago

> Could we though? Yep, you already pay the most for healthcare in the world, yet people are routinely bankrupted by medical issues. > And with what trade-offs? Health insurer and pharmaceutical company shareholders might get a lower dividend. In NZ, we have (near) free healthcare available for all, but private health insurance and private hospitals still exist as an alternative for those who want them. We have far fewer economies of scale - our entire population is only slightly larger than the population of LA in a country larger than the UK - yet our healthcare costs impact our economy significantly less than they do yours. I know that some of the world's best medical treatment can be sourced in the US - if you can afford it, or your insurance cover it. But I also know that we spend less on healthcare and live longer, and no-one ever goes bankrupt because of medical bills. But I also know that a former President of the USA once recorded an LP (admittedly before he was President, 10 years after he co-starred in a film with a chimpanzee) explaining that socialised medicine was pretty much Communism and/or the devil, so yeah, I find your country a very strange beast.

sheepmullet 8y ago
> Yep, you already pay the most for healthcare in the world Our government already spends as much on healthcare as many governments with socialized medicine. If it was simple then we would already have it. > We have far fewer economies of scale - our entire population is only slightly larger than the population of LA in a country larger than the UK And that’s exactly why the push for socialized healthcare scares so many Americans. Countries like NZ clearly demonstrate it can be done at the state level. So left leaning states can implement it and over the course of 10-15 years they can prove to the other states it is a better system. Instead they want to push it at the federal level exposing the entire country to the risk. > Health insurer and pharmaceutical company shareholders might get a lower dividend. I think it might result in a lot less R&D, less capable doctors, etc.
- EdwardDiego 8y ago
  > And that’s exactly why the push for socialized healthcare scares so many Americans. I don't understand that - why does it scare Americans that we do it cheaper despite having a more dispersed population?
  - sheepmullet 8y ago
    > I don't understand that - why does it scare Americans that we do it cheaper despite having a more dispersed population? Because if you can do it with a country of a few million then there is no reason for us to handle it at the federal level. Doing it at the federal level is then a political attack on people that want a different system and have different beliefs.
    - EdwardDiego 8y ago
      Ah, with you now.