7 ms·

So what? Both of the countries I've lived in have carried out health-related reforms (one a really big reform — almost half of hospital beds were closed, the o

by Arnt 4y ago

So what? Both of the countries I've lived in have carried out health-related reforms (one a really big reform — almost half of hospital beds were closed, the other a much smaller reform). The people who lost income didn't matter for the success or failure of either reform.

emodendroket 4y ago
So they can spend a lot of money to convince people that reforms are bad, they can buy influence among powerful politicians, and all the rest of the moves that make it so elite preferences do a lot to dictate policy the world over. Are we being naive here?
- Arnt 4y ago
  I think so, yes. You're basically saying that there are lobbyists and that's an insurmountable obstacle, and throwing your hands up in the air. You're not, for example, trying to learn how the countries that executed reforms successfully did so. EDIT: You could easily find a list online of the top ten health systems. Learning about the reforms carried out by each of those in the past 30 years requires effort, but it's really not impossible.
  - junofan 4y ago
    US health spend is bigger than the GDP of every country on that list. The biggest employer in nearly every congressional district is a healthcare system. It’s politically difficult.
    - Arnt 4y ago
      You make it sound as if closing nearly half of a country's hospital beds is politically simple. Was done. Or as if nationalising most of a state's hospitals is politically simple. Was done. (In some people's opinion, not mine, but lots of people described it in those words, so it's a fair way to describe the political controversy of the reform.) It's possible to learn how these things were done, or it's possible to just give up and say it's politically difficult.
      - emodendroket 4y ago
        Since Medicare has served as a model for some countries that provided universal care, I don’t think lessons are what we need. The problem is overcoming strong, bipartisan opposition.
  - emodendroket 4y ago
    Maybe I missed a rhetorical question but would-be reformers of the American health system were defeated by the efforts of moneyed interests (AMA, insurers, etc) in the past. It’s not that nobody thought of it. Argue about the wisdom of it if you want, but Obamacare was structured as it was with the idea of turning the industry into allies rather than implacable opponents.
    - Arnt 4y ago
      No, I think the part you miss is that some people succeeded at difficult reforms. Consider a reform where control of parts of each hospital's budget is removed from the owners/management of most hospitals. Might meet with some resistance, wouldn't you say so? You Americans seem to have this idea that your entrenched interests are somehow uniquely skilled at defending the status quo. Something like: "American hospital systems are so much better at defending their budget than that hospital system, so therefore that learning how that reform was executed would be pointless."

by Arnt 4y ago

emodendroket 4y ago

So they can spend a lot of money to convince people that reforms are bad, they can buy influence among powerful politicians, and all the rest of the moves that make it so elite preferences do a lot to dictate policy the world over. Are we being naive here?

Arnt 4y ago
I think so, yes. You're basically saying that there are lobbyists and that's an insurmountable obstacle, and throwing your hands up in the air. You're not, for example, trying to learn how the countries that executed reforms successfully did so. EDIT: You could easily find a list online of the top ten health systems. Learning about the reforms carried out by each of those in the past 30 years requires effort, but it's really not impossible.
- junofan 4y ago
  US health spend is bigger than the GDP of every country on that list. The biggest employer in nearly every congressional district is a healthcare system. It’s politically difficult.
  - Arnt 4y ago
    You make it sound as if closing nearly half of a country's hospital beds is politically simple. Was done. Or as if nationalising most of a state's hospitals is politically simple. Was done. (In some people's opinion, not mine, but lots of people described it in those words, so it's a fair way to describe the political controversy of the reform.) It's possible to learn how these things were done, or it's possible to just give up and say it's politically difficult.
    - emodendroket 4y ago
      Since Medicare has served as a model for some countries that provided universal care, I don’t think lessons are what we need. The problem is overcoming strong, bipartisan opposition.
- emodendroket 4y ago
  Maybe I missed a rhetorical question but would-be reformers of the American health system were defeated by the efforts of moneyed interests (AMA, insurers, etc) in the past. It’s not that nobody thought of it. Argue about the wisdom of it if you want, but Obamacare was structured as it was with the idea of turning the industry into allies rather than implacable opponents.
  - Arnt 4y ago
    No, I think the part you miss is that some people succeeded at difficult reforms. Consider a reform where control of parts of each hospital's budget is removed from the owners/management of most hospitals. Might meet with some resistance, wouldn't you say so? You Americans seem to have this idea that your entrenched interests are somehow uniquely skilled at defending the status quo. Something like: "American hospital systems are so much better at defending their budget than that hospital system, so therefore that learning how that reform was executed would be pointless."