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Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US? Comparing

by jjeaff 7y ago

Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US? Comparing us to countries that are hardly as populous as one US state is not a fair comparison. As anyone in the tech industry should know, there are a lot of unforeseen issues that popup when scaling something. It's rarely as easy as adding more CPUs or more people for that matter.

jariel 7y ago
"Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US?" Healthcare in the US is run at the state level, moreover, in Canada it's also run at the Provincial level. Germany's healthcare 'system' is bigger than NY and California combined. In Switzerland, insurance is at the cantonal level. Scale is not the issue - in fact, scale should mean lower prices. There actually is not a lot of competition for Medical services in the US, you have very powerful guilds with power handed to them by the gov. It's almost Mercantilist in a way.
computer 7y ago
If that were true, then solve the problem state by state.
- jjeaff 7y ago
  That is what should likely happen and is already the case to a point. Much of the existing programs are funded at the state level. But the federal government is already meddling so you can't exactly do what works best for you. You have to follow the federal ACA rules no matter what you implement at this point.
anongraddebt 7y ago
I've always considered that a fair objection. If there is a bottleneck at scale, though, it'd be nice to know what exactly it is. This also doesn't detract from my broader point that U.S. healthcare seems to intentionally exist in a no mans land.
- jjeaff 7y ago
  And scale I think is only part of the issue. The problem of scale is compounded with 50 different states, all with their own laws, unique geography, and demographics. Then add to that the very high levels of diversity in the U.S. population. There is a diversity of races, religions, and income that doesn't exist in most of these other countries that have been able to implement universal healthcare. (For example, the U.K. is something like 86% white.)
mFixman 7y ago
Brazil.

by jjeaff 7y ago

jariel 7y ago

"Seems obviously a problem of size. Can you point to a working healthcare system in any other country that has a population anywhere close to the US?" Healthcare in the US is run at the state level, moreover, in Canada it's also run at the Provincial level. Germany's healthcare 'system' is bigger than NY and California combined. In Switzerland, insurance is at the cantonal level. Scale is not the issue - in fact, scale should mean lower prices. There actually is not a lot of competition for Medical services in the US, you have very powerful guilds with power handed to them by the gov. It's almost Mercantilist in a way.

computer 7y ago

If that were true, then solve the problem state by state.

jjeaff 7y ago
That is what should likely happen and is already the case to a point. Much of the existing programs are funded at the state level. But the federal government is already meddling so you can't exactly do what works best for you. You have to follow the federal ACA rules no matter what you implement at this point.

anongraddebt 7y ago

I've always considered that a fair objection. If there is a bottleneck at scale, though, it'd be nice to know what exactly it is. This also doesn't detract from my broader point that U.S. healthcare seems to intentionally exist in a no mans land.

jjeaff 7y ago
And scale I think is only part of the issue. The problem of scale is compounded with 50 different states, all with their own laws, unique geography, and demographics. Then add to that the very high levels of diversity in the U.S. population. There is a diversity of races, religions, and income that doesn't exist in most of these other countries that have been able to implement universal healthcare. (For example, the U.K. is something like 86% white.)

mFixman 7y ago

Brazil.