7 ms·

One of my main arguments for a universal health care scheme in the united states is how horrendously expensive, for employers, health care is. Lets totally igno

by ecshafer 10mo ago

One of my main arguments for a universal health care scheme in the united states is how horrendously expensive, for employers, health care is. Lets totally ignore efficacy, moral arguments, expense for the patient, etc. If you are a company in the US a large percentage of the effective compensation of employees is healthcare. A moderately good PPO is like ~$10k+ a year per employee. You can pay workers in some other countries less than just the cost of paying for health insurance for a US employee.

jonhohle 10mo ago
As someone paying for a family on a marketplace bronze plan, that’s a bargain! I think our premiums will exceed $20K this year. With all of the medical group consolidation, all of the wait time woes our Canadian friends always complained about are the reality here now as well. So I’m paying more than anywhere else on the world and have to wait 6 months for a PCP appointment. We have the worst of both worlds.
- ecshafer 10mo ago
  So the ~$10k a year is just what the employer is paying in my example, taking some numbers from chatgpt for a medium sized company in new york. Not even counting the employee side of the premiums, which can be crazy high as well.
- tharkun__ 10mo ago
  I'm curious to compare this to other countries that have state owned/mandated insurance and are so far still mostly covering everything and which are always touted as "superior" to the US, who "have the most expensive health care system". Can't use Canada as OHIP et. al. don't cover much and the same employer tied insurance scheme as in the US exists and is necessary. An example of a country with "good healthcare" and such a system would be Germany. Extra insurance does exist there as well nowadays from what I understand but health insurance isn't tied entirely to employment and the extras are things like a 20 EUR per month to cover the co-pay on large and expensive procedures. While private insurance exists there too, I want to compare to the often touted "free healthcare" i.e. public system. There are still different providers even under the one public system. So from a quick search, Germany has insurance rates from ~14-16% of gross salary, half of which the employee pays from their gross salary. But most insurances have an extra percentage they charge on top. I found one as an example that charges 17.29% total, which if you're self-employed, you have to cover yourself (to be comparable to your marketplace bronze plan being entirely self-paid). Now the question becomes: Are you paying more or less as a percentage of your salary and by how much? (and side question for your parent I guess: how does that compare to the $10k the employer pays, which would be 8.645% in this example)
  - jaarse 10mo ago
    Canadian (OHIP recipient) here. As a long time employer, and former employee, I can tell you that no one takes a job here for the heath care. Some things like dental and vision are not covered (unless you are under 18, over 65, or low income), but everything else is. Over the course of a decade my father in law had 3 heart attacks, a stroke, and ultimately lost a year long battle with lung cancer. The total health care bill to him (or his employer) was $0. Now the downside … because health care is free, everyone uses it and the wait times are longer. My grandfather recently required an MRI (non life threatening). The wait time in Ontario was 3 months. He drove to the USA, paid out of pocket, and had it done within in week …
    - theLiminator 10mo ago
      > Now the downside … because health care is free, everyone uses it and the wait times are longer. My grandfather recently required an MRI (non life threatening). The wait time in Ontario was 3 months. He drove to the USA, paid out of pocket, and had it done within in week … Imo, singapore solves this well, by ensuring that some cost is borne by the patient at point of use, but it's never anything excessive. No one goes bankrupt from emergency hospital visits.
  - larkost 10mo ago
    It is actually more complicated than this implies. For example hospitals are often held afloat by Medicare/Medicaid spending (25%/19%). Private health insurance is about 37%, so larger than either, but smaller than both. But then you have to remember that some of the private health insurance is being subsidized by taxpayer dollars (e.g.: the ACA subsidies), and that private health insurance is largely coming from tax exempt dollars (a form of subsidies). So where the costs are actually being paid is more difficult. https://www.kff.org/health-costs/key-facts-about-hospitals/?entry=national-hospital-spending-spending-by-payer https://www.kff.org/health-costs/key-facts-about-hospitals/?... I am not sure where your question about a percentage of your salary is valid on the face of it. Do you count the employer portion of your medical coverage as part of your salary? Do you count the tax exemption? How do you figure the taxes taken out to support Medicare/Medicaid/Veterans Health (all of which are required to support the system as it exists)? And how do you figure that for single payer systems? So a much more direct way of comparing is to look at total costs per person, and then figure out how outcomes compare. When you do that the U.S. comes to about double the cost, and generally worse outcomes. Conservative politicians will scream about how long it takes to get procedures, but the research shows that elective procedures take about the same time (and no-one waits for emergency procedures in comparable systems). https://www.pgpf.org/article/how-does-the-us-healthcare-system-compare-to-other-countries/ https://www.pgpf.org/article/how-does-the-us-healthcare-syst...
- volkadav 10mo ago
  I'm pretty sure the original 10+k/yr/employee for good ppo coverage is a radical underestimate, for what it's worth, though I guess "way more than ten" is technically part of the "ten+" range, haha. The last time I had reason to look at full market-rate price for a family of four for a good PPO (Seattle market, circa five years ago, large tech company), it was around 3300 USD per month, or over $39k/yr. That was for cobra coverage, so a combination of what I would have normally paid and what the employer would've (about one third us and two thirds them when I was employed by that corp). I can only imagine it's gotten more expensive since then; we left the country three years ago.
  - ecshafer 10mo ago
    I got the $10k a year employee from chatgpt with "Assume I have a company with 100 employees in New York, how much on average does it cost to provide health insurance" and it gave me poor, moderate and good ppo plan prices. I figure this seemed reasonable for ballpark figures from employer friends, so the numbers may be very well off.
  - bpt3 10mo ago
    Just as an FYI, that is a massive outlier based on available data. My employees are about $500 per month in a major metropolitan area, and a family of 4 can run up to $2000 a month for the most expensive plans (I cover individuals and their spouses in full for standard plans, and could cover one dependent for basic plans). I looked at marketplace plans in WA because I was curious, and it looks like it's about the same as where I am but nowhere near what you were quoted 5 years ago.
- bpt3 10mo ago
  The key part of your statement is that you're paying for a family. Individuals do not cost $10k per year under any normal circumstances, and if you're paying almost $2k a month for a family bronze plan, you either have a lot of kids, you have some unusual needs, or you are getting ripped off. Even more so if you're waiting for a PCP appointment, because that is unusual as well.
baal80spam 10mo ago
Asking as not an American - $10k per year, how much % of a yearly salary is it? In Europe (here: Germany example), which is frequently seen here as the ideal example of healthcare spending: Employees and employers typically split around 14.6% of gross salary for public health insurance. [1] [1] https://feather-insurance.com/blog/germany-healthcare-statistics#:~:text=Is%20healthcare%20free%20in%20Germany,contributions%20rather%20than%20being%20free. https://feather-insurance.com/blog/germany-healthcare-statis...
- bluedino 10mo ago
  > Asking as not an American - $10k per year, how much % of a yearly salary is it? Depends on if you make 35k or 200k/year
- vjvjvjvjghv 10mo ago
  The problem is that in the US it's a fixed amount vs in Germany a proportion of your income. This works OK for higher incomes but for lower incomes it's a big problem. And as always, the people in the middle get screwed. Not enough money to afford the premiums easily but too much money to get subsidies.
- ecshafer 10mo ago
  SO this is just what the employer pays. The employee then pays premiums monthly as well for access. Employers pay somewhere between $5k and $25k (or more) per employee a year for health care depending on quality and portion of premiums they pay for the employee. Usually its split, so someone makes $80k a year, they pay $10k a year in premiums, employer pays $10k a year in premiums.
Imustaskforhelp 10mo ago
The irony of the situation when you realize that you can probably get healthcare yourself in India (not sure about other countries) but for even a very good healthcare program to be around 25$ per month And that 10k$/year can be considered middle class / heck I can even argue just slightly above middle class in India And you can actually enjoy food and a lot of things really cheap as well Usually the only problem becomes if something is inherently expensive (think college or land) which is where PPP does hurt but in everyday life, I think India's decent to live in. Now I want to ask you but even if someone spends around ~$10k+ a year, even then I have heard people describe american healthcare subpar. Like why? Is it just corruption at healthcare level and lobbying efforts? Is there truly nothing that the average american can't do about to make things better for the healthcare situation. To me its feeling like america's moving even backwards right now from cutting medicaid putting even more strain on the amount and still even on the average person themselves as well.
- stocksinsmocks 10mo ago
  There is no simple explanation, but an important issue is that there is no price discovery mechanism or system pressure for efficiency. You also may not know that the US healthcare system is also an elaborate jobs program. Walk into any hospital and you will see 5-10 mostly young women doing basically nothing. I don’t know why the powers that be decided that the US should divest itself from any useful work, but here we are. Now we’re a couple generations into this social experiment by “smart” billionaires and their courtiers, and the military industrial complex is begging the Taiwanese to hold our soft hands and teach a blossoming generation hipsters and resentful immigrants how to build the computers we invented. We had a good run, but we’re Rome circa. 400-500 AD. Don’t let the marketing in Venezuela fool you. I’m just hoping the robots give us a few more decades of working plumbing.
bluedino 10mo ago
> One of my main arguments for a universal health care scheme in the united states is how horrendously expensive The costs need to be fixed, first. Moving to the government/taxes paying for it doesn't fix that.
- naasking 10mo ago
  > Moving to the government/taxes paying for it doesn't fix that. It kinda does, bigger players have more bargaining power. There is no bigger player than the government in a universal healthcare system. Furthermore, a significant cost in healthcare is all of the bureaucracy around billing. Much of that goes away with single payer.
  - bluedino 10mo ago
    It would be very tough to reduce pay for doctors and other staff. The United States medical industry is one of the highest paying in the world.
    - naasking 10mo ago
      Doctor and nurses are not bureaucrats. Single payer would significantly reduce the bureaucracy in healthcare, and simplify everything for citizens and businesses.
      - nickff 10mo ago
        The main cost driver in medical care is provider (nurse, doctor, etc.) wages, not bureaucracy or drug prices (though they're frequently cited). I have tired of posting sources for the statistics, but they are very easy to find.
        cduzz 10mo ago
        So, let's look at UnitedHealth Group; do they deliver health care? If there were single payer, what would their role be in the healthcare delivery process? Apparently they made 2.3 billion in profits on 113 billion in revenue in Q3 of 2025. How much of that friction would evaporate if they weren't in the healthcare delivery infrastructure. Someone once said "the best part is no part" ?
potato3732842 10mo ago
It's like every other compliance cost. It hurts the little guys more than the big guys. Too much of the US economy is big players so the status quo persists.
vjvjvjvjghv 10mo ago
"how horrendously expensive, for employers, health care is." So why aren't they pushing for abolishing employer-based health insurance? They had no problems getting rid of pensions but for some reason nobody really lobbies for employers to get out of the health care business. The same for 401k. Why do companies have to manage those instead of just contributing some money and let the employees find the right package on the open market? It's really weird.
- coredog64 10mo ago
  Union employees have negotiated healthcare into long-term contracts, making it hard for those employers to switch. (Feel free to read up on so-called "Cadillac plans" during the original ACA negotiations for more details). The size of this market makes employers exiting a non-starter IMO. Any org that wants to exit will see a huge resistance to this change even if they can showcase all the common benefits.
- terminalshort 10mo ago
  Because if they let employees manage their own retirement accounts some of them would gamble all of it on crypto or options and lose it all. Then, because our society has become fundamentally incapable of saying "You are an adult. You have nobody to blame but yourself, and now you will face the consequences," this will become someone else's problem to pay for it.
  - NickC25 10mo ago
    >Because if they let employees manage their own retirement accounts some of them would gamble all of it on crypto or options and lose it all. This part is true. >Then, because our society has become fundamentally incapable of saying "You are an adult. You have nobody to blame but yourself, and now you will face the consequences," this will become someone else's problem to pay for it. Except that's an incredibly stupid short-term way of thinking. Because regardless, we end up paying for people's mistakes. As we should, because that's the whole point of society - we need to take care of the failures, the degenerates, the pieces of shit, etc because they play an important role in society - they too are humans and some of them weren't gambling away their savings out of a sense of fun, they did so to be able to continue to live in a day and age where costs continue to skyrocket, job growth is negative, and the economy is being hollowed out. We have many tools and mechanisms to help the winners in society. We need that for the opposite party, too. In winner-take-all capitalistm, the losers will always outnumber the winners. And you need to make life palatable for the losers, in hopes that their luck may one day change. Because if you don't take care of people who continue to lose and have nothing going for them, they will grow in numbers and eventually eat you. And besides, we've bailed out enough bad actors in important sectors of the economy that main street deserves to be taken care of too.
stocksinsmocks 10mo ago
We almost do. Employers must provide insurance. If you’re unemployed you can probably get Medicaid. We have private entities handle the details instead of something that looks like the Post Office. There is nothing anyone in Congress can do which results in all 8 billion people on Earth having instant access to all conceivable treatment in any location the the US. Like socialized medicine, there is no meaningful price discovery mechanism in the US. Unlike socialized medicine, it’s a lot harder for political parties to conduct pogroms by rationing resources and euthanizing demographics that don’t vote the way they like.
dfxm12 10mo ago
It's a price to, in a way, handcuff workers. Systemically combined with policies that make sure unemployment doesn't get too low, weaken labor power, tie other benefits to employment, etc. Workers know they need your job to have affordable healthcare, so they have no choice but to stick with it even if it is somewhat crappy.
mrguyorama 10mo ago
And yet they never lobby for nationalized health care. Because "Deal with our illegal, immoral, or stupid work requests or literally lose your healthcare" is such a massive bargaining chip for them. They would rather spend more money and have more docile and controllable workers, but not spend that money on paying workers more to be docile and controllable. It's not about the money.

jonhohle 10mo ago

As someone paying for a family on a marketplace bronze plan, that’s a bargain! I think our premiums will exceed $20K this year. With all of the medical group consolidation, all of the wait time woes our Canadian friends always complained about are the reality here now as well. So I’m paying more than anywhere else on the world and have to wait 6 months for a PCP appointment. We have the worst of both worlds.

ecshafer 10mo ago
So the ~$10k a year is just what the employer is paying in my example, taking some numbers from chatgpt for a medium sized company in new york. Not even counting the employee side of the premiums, which can be crazy high as well.
tharkun__ 10mo ago
I'm curious to compare this to other countries that have state owned/mandated insurance and are so far still mostly covering everything and which are always touted as "superior" to the US, who "have the most expensive health care system". Can't use Canada as OHIP et. al. don't cover much and the same employer tied insurance scheme as in the US exists and is necessary. An example of a country with "good healthcare" and such a system would be Germany. Extra insurance does exist there as well nowadays from what I understand but health insurance isn't tied entirely to employment and the extras are things like a 20 EUR per month to cover the co-pay on large and expensive procedures. While private insurance exists there too, I want to compare to the often touted "free healthcare" i.e. public system. There are still different providers even under the one public system. So from a quick search, Germany has insurance rates from ~14-16% of gross salary, half of which the employee pays from their gross salary. But most insurances have an extra percentage they charge on top. I found one as an example that charges 17.29% total, which if you're self-employed, you have to cover yourself (to be comparable to your marketplace bronze plan being entirely self-paid). Now the question becomes: Are you paying more or less as a percentage of your salary and by how much? (and side question for your parent I guess: how does that compare to the $10k the employer pays, which would be 8.645% in this example)
- jaarse 10mo ago
  Canadian (OHIP recipient) here. As a long time employer, and former employee, I can tell you that no one takes a job here for the heath care. Some things like dental and vision are not covered (unless you are under 18, over 65, or low income), but everything else is. Over the course of a decade my father in law had 3 heart attacks, a stroke, and ultimately lost a year long battle with lung cancer. The total health care bill to him (or his employer) was $0. Now the downside … because health care is free, everyone uses it and the wait times are longer. My grandfather recently required an MRI (non life threatening). The wait time in Ontario was 3 months. He drove to the USA, paid out of pocket, and had it done within in week …
  - theLiminator 10mo ago
    > Now the downside … because health care is free, everyone uses it and the wait times are longer. My grandfather recently required an MRI (non life threatening). The wait time in Ontario was 3 months. He drove to the USA, paid out of pocket, and had it done within in week … Imo, singapore solves this well, by ensuring that some cost is borne by the patient at point of use, but it's never anything excessive. No one goes bankrupt from emergency hospital visits.
- larkost 10mo ago
  It is actually more complicated than this implies. For example hospitals are often held afloat by Medicare/Medicaid spending (25%/19%). Private health insurance is about 37%, so larger than either, but smaller than both. But then you have to remember that some of the private health insurance is being subsidized by taxpayer dollars (e.g.: the ACA subsidies), and that private health insurance is largely coming from tax exempt dollars (a form of subsidies). So where the costs are actually being paid is more difficult. https://www.kff.org/health-costs/key-facts-about-hospitals/?entry=national-hospital-spending-spending-by-payer https://www.kff.org/health-costs/key-facts-about-hospitals/?... I am not sure where your question about a percentage of your salary is valid on the face of it. Do you count the employer portion of your medical coverage as part of your salary? Do you count the tax exemption? How do you figure the taxes taken out to support Medicare/Medicaid/Veterans Health (all of which are required to support the system as it exists)? And how do you figure that for single payer systems? So a much more direct way of comparing is to look at total costs per person, and then figure out how outcomes compare. When you do that the U.S. comes to about double the cost, and generally worse outcomes. Conservative politicians will scream about how long it takes to get procedures, but the research shows that elective procedures take about the same time (and no-one waits for emergency procedures in comparable systems). https://www.pgpf.org/article/how-does-the-us-healthcare-system-compare-to-other-countries/ https://www.pgpf.org/article/how-does-the-us-healthcare-syst...
volkadav 10mo ago
I'm pretty sure the original 10+k/yr/employee for good ppo coverage is a radical underestimate, for what it's worth, though I guess "way more than ten" is technically part of the "ten+" range, haha. The last time I had reason to look at full market-rate price for a family of four for a good PPO (Seattle market, circa five years ago, large tech company), it was around 3300 USD per month, or over $39k/yr. That was for cobra coverage, so a combination of what I would have normally paid and what the employer would've (about one third us and two thirds them when I was employed by that corp). I can only imagine it's gotten more expensive since then; we left the country three years ago.
- ecshafer 10mo ago
  I got the $10k a year employee from chatgpt with "Assume I have a company with 100 employees in New York, how much on average does it cost to provide health insurance" and it gave me poor, moderate and good ppo plan prices. I figure this seemed reasonable for ballpark figures from employer friends, so the numbers may be very well off.
- bpt3 10mo ago
  Just as an FYI, that is a massive outlier based on available data. My employees are about $500 per month in a major metropolitan area, and a family of 4 can run up to $2000 a month for the most expensive plans (I cover individuals and their spouses in full for standard plans, and could cover one dependent for basic plans). I looked at marketplace plans in WA because I was curious, and it looks like it's about the same as where I am but nowhere near what you were quoted 5 years ago.
bpt3 10mo ago
The key part of your statement is that you're paying for a family. Individuals do not cost $10k per year under any normal circumstances, and if you're paying almost $2k a month for a family bronze plan, you either have a lot of kids, you have some unusual needs, or you are getting ripped off. Even more so if you're waiting for a PCP appointment, because that is unusual as well.

baal80spam 10mo ago

Asking as not an American - $10k per year, how much % of a yearly salary is it? In Europe (here: Germany example), which is frequently seen here as the ideal example of healthcare spending: Employees and employers typically split around 14.6% of gross salary for public health insurance. [1] [1] https://feather-insurance.com/blog/germany-healthcare-statistics#:~:text=Is%20healthcare%20free%20in%20Germany,contributions%20rather%20than%20being%20free. https://feather-insurance.com/blog/germany-healthcare-statis...

bluedino 10mo ago
> Asking as not an American - $10k per year, how much % of a yearly salary is it? Depends on if you make 35k or 200k/year
vjvjvjvjghv 10mo ago
The problem is that in the US it's a fixed amount vs in Germany a proportion of your income. This works OK for higher incomes but for lower incomes it's a big problem. And as always, the people in the middle get screwed. Not enough money to afford the premiums easily but too much money to get subsidies.
ecshafer 10mo ago
SO this is just what the employer pays. The employee then pays premiums monthly as well for access. Employers pay somewhere between $5k and $25k (or more) per employee a year for health care depending on quality and portion of premiums they pay for the employee. Usually its split, so someone makes $80k a year, they pay $10k a year in premiums, employer pays $10k a year in premiums.

Imustaskforhelp 10mo ago

The irony of the situation when you realize that you can probably get healthcare yourself in India (not sure about other countries) but for even a very good healthcare program to be around 25$ per month And that 10k$/year can be considered middle class / heck I can even argue just slightly above middle class in India And you can actually enjoy food and a lot of things really cheap as well Usually the only problem becomes if something is inherently expensive (think college or land) which is where PPP does hurt but in everyday life, I think India's decent to live in. Now I want to ask you but even if someone spends around ~$10k+ a year, even then I have heard people describe american healthcare subpar. Like why? Is it just corruption at healthcare level and lobbying efforts? Is there truly nothing that the average american can't do about to make things better for the healthcare situation. To me its feeling like america's moving even backwards right now from cutting medicaid putting even more strain on the amount and still even on the average person themselves as well.

stocksinsmocks 10mo ago
There is no simple explanation, but an important issue is that there is no price discovery mechanism or system pressure for efficiency. You also may not know that the US healthcare system is also an elaborate jobs program. Walk into any hospital and you will see 5-10 mostly young women doing basically nothing. I don’t know why the powers that be decided that the US should divest itself from any useful work, but here we are. Now we’re a couple generations into this social experiment by “smart” billionaires and their courtiers, and the military industrial complex is begging the Taiwanese to hold our soft hands and teach a blossoming generation hipsters and resentful immigrants how to build the computers we invented. We had a good run, but we’re Rome circa. 400-500 AD. Don’t let the marketing in Venezuela fool you. I’m just hoping the robots give us a few more decades of working plumbing.

bluedino 10mo ago

> One of my main arguments for a universal health care scheme in the united states is how horrendously expensive The costs need to be fixed, first. Moving to the government/taxes paying for it doesn't fix that.

naasking 10mo ago
> Moving to the government/taxes paying for it doesn't fix that. It kinda does, bigger players have more bargaining power. There is no bigger player than the government in a universal healthcare system. Furthermore, a significant cost in healthcare is all of the bureaucracy around billing. Much of that goes away with single payer.
- bluedino 10mo ago
  It would be very tough to reduce pay for doctors and other staff. The United States medical industry is one of the highest paying in the world.
  - naasking 10mo ago
    Doctor and nurses are not bureaucrats. Single payer would significantly reduce the bureaucracy in healthcare, and simplify everything for citizens and businesses.
    - nickff 10mo ago
      The main cost driver in medical care is provider (nurse, doctor, etc.) wages, not bureaucracy or drug prices (though they're frequently cited). I have tired of posting sources for the statistics, but they are very easy to find.
      - cduzz 10mo ago
        So, let's look at UnitedHealth Group; do they deliver health care? If there were single payer, what would their role be in the healthcare delivery process? Apparently they made 2.3 billion in profits on 113 billion in revenue in Q3 of 2025. How much of that friction would evaporate if they weren't in the healthcare delivery infrastructure. Someone once said "the best part is no part" ?

potato3732842 10mo ago

It's like every other compliance cost. It hurts the little guys more than the big guys. Too much of the US economy is big players so the status quo persists.

vjvjvjvjghv 10mo ago

"how horrendously expensive, for employers, health care is." So why aren't they pushing for abolishing employer-based health insurance? They had no problems getting rid of pensions but for some reason nobody really lobbies for employers to get out of the health care business. The same for 401k. Why do companies have to manage those instead of just contributing some money and let the employees find the right package on the open market? It's really weird.

coredog64 10mo ago
Union employees have negotiated healthcare into long-term contracts, making it hard for those employers to switch. (Feel free to read up on so-called "Cadillac plans" during the original ACA negotiations for more details). The size of this market makes employers exiting a non-starter IMO. Any org that wants to exit will see a huge resistance to this change even if they can showcase all the common benefits.
terminalshort 10mo ago
Because if they let employees manage their own retirement accounts some of them would gamble all of it on crypto or options and lose it all. Then, because our society has become fundamentally incapable of saying "You are an adult. You have nobody to blame but yourself, and now you will face the consequences," this will become someone else's problem to pay for it.
- NickC25 10mo ago
  >Because if they let employees manage their own retirement accounts some of them would gamble all of it on crypto or options and lose it all. This part is true. >Then, because our society has become fundamentally incapable of saying "You are an adult. You have nobody to blame but yourself, and now you will face the consequences," this will become someone else's problem to pay for it. Except that's an incredibly stupid short-term way of thinking. Because regardless, we end up paying for people's mistakes. As we should, because that's the whole point of society - we need to take care of the failures, the degenerates, the pieces of shit, etc because they play an important role in society - they too are humans and some of them weren't gambling away their savings out of a sense of fun, they did so to be able to continue to live in a day and age where costs continue to skyrocket, job growth is negative, and the economy is being hollowed out. We have many tools and mechanisms to help the winners in society. We need that for the opposite party, too. In winner-take-all capitalistm, the losers will always outnumber the winners. And you need to make life palatable for the losers, in hopes that their luck may one day change. Because if you don't take care of people who continue to lose and have nothing going for them, they will grow in numbers and eventually eat you. And besides, we've bailed out enough bad actors in important sectors of the economy that main street deserves to be taken care of too.

stocksinsmocks 10mo ago

We almost do. Employers must provide insurance. If you’re unemployed you can probably get Medicaid. We have private entities handle the details instead of something that looks like the Post Office. There is nothing anyone in Congress can do which results in all 8 billion people on Earth having instant access to all conceivable treatment in any location the the US. Like socialized medicine, there is no meaningful price discovery mechanism in the US. Unlike socialized medicine, it’s a lot harder for political parties to conduct pogroms by rationing resources and euthanizing demographics that don’t vote the way they like.

dfxm12 10mo ago

It's a price to, in a way, handcuff workers. Systemically combined with policies that make sure unemployment doesn't get too low, weaken labor power, tie other benefits to employment, etc. Workers know they need your job to have affordable healthcare, so they have no choice but to stick with it even if it is somewhat crappy.

mrguyorama 10mo ago

And yet they never lobby for nationalized health care. Because "Deal with our illegal, immoral, or stupid work requests or literally lose your healthcare" is such a massive bargaining chip for them. They would rather spend more money and have more docile and controllable workers, but not spend that money on paying workers more to be docile and controllable. It's not about the money.