3 ms·
Because while that vibe may be an accurate representation of how things are portrayed on social media, it's not an accurate representation of reality. Without
by tristor 6y ago
Because while that vibe may be an accurate representation of how things are portrayed on social media, it's not an accurate representation of reality. Without writing an expository essay:
1. Healthcare is actually hard at scale.
2. The incentive structure in the US (read, follow the money) is one which is against the public good.
3. There are many many many landmines of technical debt within the current US system which cannot be papered over or solved easily even if you waved a magic wand and got full buy-in for single payer universal healthcare tomorrow.
It's true in some respect that Republicans have taken a general stance against universal healthcare in American politics, but the idea that Democrats have any meaningful and decent strategy for fixing it is a misnomer. At best, we have some politicians who have said the correct words to convey the right sentiments, but no meaningful plans.
As to why this issue is so much worse in the US than elsewhere, that's its own separate essay, but largely comes down to the structure of healthcare mandated by the government since the 1920s, especially after the formation of Medicare and the passage of Part D combined with first mover disadvantages as much of the rest of the world had the opportunity to radically structure their healthcare infrastructure differently post WW2 while rebuilding inclusive of the cost of rebuilding, while the US did not. In a fit of irony, the US footed the bill and drove economic levers to help cement universal healthcare into much of Europe while failing to implement it at home. Even now, part of the complication is that the outsized pricing of healthcare in the US acts as a partly disconnected subsidy on the cost of healthcare elsewhere in the OECD.
After having worked in this space and seeing how completely and utterly fucked the US healthcare system is internally from a technology/records keeping perspective, to the entire payment processing flow, to the way we track and report healthcare incidences, the entire system is broken badly and needs a total overhaul, but that's a much bigger ask than incremental improvements which don't really move the needle much. The US healthcare system is (literally) a legacy codebase written in an esoteric language held together with fears and sorrows because the hopes and dreams already died. The only feasible way to fix its myriad bugs is a complete rewrite, but doing so will form it's own set of technical debt and bugs.