5 ms·

It should cover everyone. No body goes to the doctor because they want to. I'll dare say it would be a net positive to even expand this to the undocumented.

It should cover everyone. No body goes to the doctor because they want to. I'll dare say it would be a net positive to even expand this to the undocumented. Many of them have dependents, it's not going to be great if your dad can't afford his insulin and is thus unable to work to provide for you. This includes a large percentage of our farm workers who are literally getting sprayed with pesticides all day. That's another issue, but when they get sick they more than deserve treatment. And finally, the vast majority of illnesses can be treated cheaply if irregularly do your checkups. It can cost society $200 today for a doctor visit , or 30k for an ER stay in 3 years. That said, I think this should be handled on a state by state basis. If the people of Alabama don't believe in single-payer healthcare, or they want to forbid using single pair healthcare for contraceptive or something, that shouldn't stop a progressive state from implementing it.

diogenescynic 11mo ago
I wholeheartedly agree, but I don't think the national politics would support that at the moment. I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... but they might against 18 or 19 year olds. It's a foot in the door persuasion tactic rather than try to get everything all at once.
- ryandrake 11mo ago
  > I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... Not sure what gives you this idea. The major political party in power in the US today campaigned in large part on cruelty and removing subsidies and social benefits from people. There are a huge number of people who would bitterly fight against providing health care to children. It's the same mentality that bitterly fights against free school lunch for children.
  - LadyCailin 11mo ago
    [flagged]
    - frumplestlatz 11mo ago
      No, we just have a very different idea of how best to help people.
      - venturecruelty 11mo ago
        "Taking away every social safety net" is a curious way of doing it.
  - frumplestlatz 11mo ago
    I’m not cruel because I think society operates best — in terms of human outcomes — if incentives and disincentives are tied to decisions in ways that maximize the likelihood and benefit of personal responsibility. Parents need to be responsible for their children. The state should only step in if they fail in their responsibility. How is it folks like yourself can understand these concepts across a myriad of domains, including things like wildlife and their rehabilitation, and the importance of fostering self-sufficiency, but not this? It’s not kindness to create people dependent on the state, or to advantage businesses that do not pay a living wage by subsidizing their employees. Hell, look at what we’ve done to the cost of education by creating government-backed loan programs that simply allow universities to charge as much as students can afford to mortgage from their future.
    - venturecruelty 11mo ago
      >I’m not cruel because I think society operates best — in terms of human outcomes — if incentives and disincentives are tied to decisions in ways that maximize the likelihood and benefit of personal responsibility. And how did personal responsibility make housing unaffordable? >Parents need to be responsible for their children. The state should only step in if they fail in their responsibility. How neat and tidy. >How is it folks like yourself can understand these concepts across a myriad of domains, including things like wildlife and their rehabilitation, and the importance of fostering self-sufficiency, but not this? What are you talking about? Everyone who's poor and powerless should be helped. More importantly, though, they shouldn't be taken advantage of by wealthy interests. That includes animals, that includes expectant mothers who don't make enough money to survive because the "money to survive" dial was cranked up to 100 in the last five years. But please, lecture us some more about how that's HER fault. >It’s not kindness to create people dependent on the state, or to advantage businesses that do not pay a living wage by subsidizing their employees. It's also not kindness to raise their rent for no other reason than you can. >Hell, look at what we’ve done to the cost of education by creating government-backed loan programs that simply allow universities to charge as much as students can afford to mortgage from their future. And we could end it all tomorrow by saying "the US government must fund university education". You know, like they do in Europe, or like we did a few decades ago in the United States. You're pointing to a radically predatory policy decision, designed to benefit rich people, and saying: "See? Government doesn't work!" But that's "conservatism" for you: say government doesn't work and then get elected and prove it. I don't know if you truly believe that education costs would come down if we stopped shunting students into indentured servitude (guess which loans are the only ones that can't be discharged in bankruptcy? What a curious law of the universe that must be!), but if that's the case, then I have a fabulous bridge I'd be willing to part with for a modest price. I will never stop fighting against people who wield the power of the state to punch down and then point the finger at those same people and blame them. It's disgusting, it's abhorrent, and it must stop.
BobbyTables2 11mo ago
Expanding to undocumented providers is probably ripe for abuse. Although perhaps abusable either way. What stops someone from saying “I’m an undocumented provider with 500 kids. Pay me 500 x AMOUNT”. Public schools have residence and identity requirements. What’s an undocumented childcare provider going to have?
roywiggins 11mo ago
> No body goes to the doctor because they want to. This isn't entirely true, there are entire industries catering to the worried well, eg expensive precautionary full-body MRIs with unclear scientific backing, whatever it is Bryan Johnson is doing and selling these days, etc. And exactly what counts as need flexes and changes depending on circumstance and who is asking. "Do I need a doctor for this" is not a question that everyone answers the same way.
- 999900000999 11mo ago
  The type of doctors who accept Medicare or a possible single payer system are not giving out precautionary excessive mris. Such a tiny percentage of people actually want to do stuff like that. Even without factoring in cost, most people shrug it off until it’s bad. Practically every other country has figured this out, it’s not impossible
nradov 11mo ago
This is a common misconception. For asymptomatic adults there is no proven benefit to regular "checkups". https://doi.org/10.1001/jama.2012.36756 https://doi.org/10.1001/jama.2012.36756 There are certain preventive care procedures that are proven to be effective based on reliable evidence. Everyone should get those, and for anyone with health insurance they're covered at zero out of pocket cost. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits... The majority of healthcare spending goes to chronic conditions caused primarily by lifestyle factors such as substance abuse, over eating, poor sleep, and lack of exercise. The healthcare system can't deal effectively with lifestyle problems. Those are more in the domain of public health, social work, and economic policy.
polski-g 11mo ago
> No body goes to the doctor because they want to. I routinely go to specialists for things I don't need to, because I make enough money that it's better than waiting for the issue to go away on its own. Now imagine expanding that to the entire country, when they don't have skin in the game.
- HarryHirsch 11mo ago
  Their health would improve?
- 999900000999 11mo ago
  Imagine it doesn’t go away on its own, it’s something serious and you caught it early. For working class people , the skin in the game is having to miss a day of work, etc. Theirs still an opportunity cost

diogenescynic 11mo ago

I wholeheartedly agree, but I don't think the national politics would support that at the moment. I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... but they might against 18 or 19 year olds. It's a foot in the door persuasion tactic rather than try to get everything all at once.

ryandrake 11mo ago
> I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... Not sure what gives you this idea. The major political party in power in the US today campaigned in large part on cruelty and removing subsidies and social benefits from people. There are a huge number of people who would bitterly fight against providing health care to children. It's the same mentality that bitterly fights against free school lunch for children.
- LadyCailin 11mo ago
  [flagged]
  - frumplestlatz 11mo ago
    No, we just have a very different idea of how best to help people.
    - venturecruelty 11mo ago
      "Taking away every social safety net" is a curious way of doing it.
- frumplestlatz 11mo ago
  I’m not cruel because I think society operates best — in terms of human outcomes — if incentives and disincentives are tied to decisions in ways that maximize the likelihood and benefit of personal responsibility. Parents need to be responsible for their children. The state should only step in if they fail in their responsibility. How is it folks like yourself can understand these concepts across a myriad of domains, including things like wildlife and their rehabilitation, and the importance of fostering self-sufficiency, but not this? It’s not kindness to create people dependent on the state, or to advantage businesses that do not pay a living wage by subsidizing their employees. Hell, look at what we’ve done to the cost of education by creating government-backed loan programs that simply allow universities to charge as much as students can afford to mortgage from their future.
  - venturecruelty 11mo ago
    >I’m not cruel because I think society operates best — in terms of human outcomes — if incentives and disincentives are tied to decisions in ways that maximize the likelihood and benefit of personal responsibility. And how did personal responsibility make housing unaffordable? >Parents need to be responsible for their children. The state should only step in if they fail in their responsibility. How neat and tidy. >How is it folks like yourself can understand these concepts across a myriad of domains, including things like wildlife and their rehabilitation, and the importance of fostering self-sufficiency, but not this? What are you talking about? Everyone who's poor and powerless should be helped. More importantly, though, they shouldn't be taken advantage of by wealthy interests. That includes animals, that includes expectant mothers who don't make enough money to survive because the "money to survive" dial was cranked up to 100 in the last five years. But please, lecture us some more about how that's HER fault. >It’s not kindness to create people dependent on the state, or to advantage businesses that do not pay a living wage by subsidizing their employees. It's also not kindness to raise their rent for no other reason than you can. >Hell, look at what we’ve done to the cost of education by creating government-backed loan programs that simply allow universities to charge as much as students can afford to mortgage from their future. And we could end it all tomorrow by saying "the US government must fund university education". You know, like they do in Europe, or like we did a few decades ago in the United States. You're pointing to a radically predatory policy decision, designed to benefit rich people, and saying: "See? Government doesn't work!" But that's "conservatism" for you: say government doesn't work and then get elected and prove it. I don't know if you truly believe that education costs would come down if we stopped shunting students into indentured servitude (guess which loans are the only ones that can't be discharged in bankruptcy? What a curious law of the universe that must be!), but if that's the case, then I have a fabulous bridge I'd be willing to part with for a modest price. I will never stop fighting against people who wield the power of the state to punch down and then point the finger at those same people and blame them. It's disgusting, it's abhorrent, and it must stop.

BobbyTables2 11mo ago

Expanding to undocumented providers is probably ripe for abuse. Although perhaps abusable either way. What stops someone from saying “I’m an undocumented provider with 500 kids. Pay me 500 x AMOUNT”. Public schools have residence and identity requirements. What’s an undocumented childcare provider going to have?

roywiggins 11mo ago

> No body goes to the doctor because they want to. This isn't entirely true, there are entire industries catering to the worried well, eg expensive precautionary full-body MRIs with unclear scientific backing, whatever it is Bryan Johnson is doing and selling these days, etc. And exactly what counts as need flexes and changes depending on circumstance and who is asking. "Do I need a doctor for this" is not a question that everyone answers the same way.

999900000999 11mo ago
The type of doctors who accept Medicare or a possible single payer system are not giving out precautionary excessive mris. Such a tiny percentage of people actually want to do stuff like that. Even without factoring in cost, most people shrug it off until it’s bad. Practically every other country has figured this out, it’s not impossible

nradov 11mo ago

This is a common misconception. For asymptomatic adults there is no proven benefit to regular "checkups". https://doi.org/10.1001/jama.2012.36756 https://doi.org/10.1001/jama.2012.36756 There are certain preventive care procedures that are proven to be effective based on reliable evidence. Everyone should get those, and for anyone with health insurance they're covered at zero out of pocket cost. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits... The majority of healthcare spending goes to chronic conditions caused primarily by lifestyle factors such as substance abuse, over eating, poor sleep, and lack of exercise. The healthcare system can't deal effectively with lifestyle problems. Those are more in the domain of public health, social work, and economic policy.

polski-g 11mo ago

> No body goes to the doctor because they want to. I routinely go to specialists for things I don't need to, because I make enough money that it's better than waiting for the issue to go away on its own. Now imagine expanding that to the entire country, when they don't have skin in the game.

HarryHirsch 11mo ago
Their health would improve?
999900000999 11mo ago
Imagine it doesn’t go away on its own, it’s something serious and you caught it early. For working class people , the skin in the game is having to miss a day of work, etc. Theirs still an opportunity cost