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> It's not that they can't attempt to do it, it's that they can't do it efficiently. The US has some of the highest healthcare costs in the world. You’re right

> It's not that they can't attempt to do it, it's that they can't do it efficiently. The US has some of the highest healthcare costs in the world. You’re right, the fact that America’s government-run single-payer healthcare system is so expensive is proof that the US government can’t do things efficiently. If only we let efficient private companies handle health insurance instead. Oh wait… > The real problem here is the attempt to treat it like a single country, as if masses of people are going to want to take a train from Miami to San Francisco. It's too much distance, people who want to go there are going to fly. No serious person things Miami-SF is a viable high speed rail route. But the thing is, cities in the US are not evenly distributed—they are regionally clustered. Thus there are substantial regional HSR networks that do pencil out, even if the fantasy coast-to-coast ones do not.[0] The math behind this is pretty straightforward and has a lot to do with network effects which many here should be familiar with.[1][2] [0] https://pedestrianobservations.com/2021/03/22/high-speed-rail-followup/ https://pedestrianobservations.com/2021/03/22/high-speed-rai... [1] https://pedestrianobservations.com/2020/02/13/metcalfes-law-for-high-speed-rail/ https://pedestrianobservations.com/2020/02/13/metcalfes-law-... [2] https://pedestrianobservations.com/2020/12/20/metcalfes-law-for-high-speed-rail-redux/ https://pedestrianobservations.com/2020/12/20/metcalfes-law-...

AnthonyMouse 3y ago
> You’re right, the fact that America’s government-run single-payer healthcare system is so expensive is proof that the US government can’t do things efficiently. If only we let efficient private companies handle health insurance instead. The claim was that the federal government does a competent job of regulating US healthcare. But US healthcare costs more than both public and private systems in any other country, so clearly they've messed it up pretty bad. And the high costs have quite a lot to do with the FDA, the tax code, the patent system, medical licensing boards and malpractice lawsuits, none of which is a private company. > But the thing is, cities in the US are not evenly distributed—they are regionally clustered. Thus there are substantial regional HSR networks that do pencil out, even if the fantasy coast-to-coast ones do not. Rail networks make sense in the North East Corridor or the coastal areas generally. But meanwhile Amtrak is operating passenger rail through deserts and farmland, and overcharging passengers in other areas to do it.

AnthonyMouse 3y ago

> You’re right, the fact that America’s government-run single-payer healthcare system is so expensive is proof that the US government can’t do things efficiently. If only we let efficient private companies handle health insurance instead. The claim was that the federal government does a competent job of regulating US healthcare. But US healthcare costs more than both public and private systems in any other country, so clearly they've messed it up pretty bad. And the high costs have quite a lot to do with the FDA, the tax code, the patent system, medical licensing boards and malpractice lawsuits, none of which is a private company. > But the thing is, cities in the US are not evenly distributed—they are regionally clustered. Thus there are substantial regional HSR networks that do pencil out, even if the fantasy coast-to-coast ones do not. Rail networks make sense in the North East Corridor or the coastal areas generally. But meanwhile Amtrak is operating passenger rail through deserts and farmland, and overcharging passengers in other areas to do it.