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Number one expense for SMB is healthcare, providing a nationalized healthcare service would likely unlock trillions in value (imagine what Americans would do if

• irishcoffee 3mo ago
  How would nationalized healthcare get funded other than shifting that 200-500/check towards… nationalized healthcare?
  • Avicebron 3mo ago
    When you cut out the insurance middlemen and pharmaceutical companies driving up record profits at the expense of care you can get pretty far with less in taxes
    • daedrdev 3mo ago
      Insurance companies make like 2-4% hardly breaking the bank here. Pharmaceutical companies make a lot of money, but the US also funds most drug development which other countries freeload off of. US healthcare workers get a state enforced shortage to drive up their wages thanks to residency limits, but nobody ever wants to look at that. If you can't tell I am extremely pessimistic about the changes of universal healthcare improving on our current system. And to be clear it's universal, not unlimited.
      • Apocryphon 3mo ago
        Insurance companies basically are banks, in that while they make low profit margins they wield such vast amounts of capital, some of which they invest in, they might as well be financial service institutions. There's also other categories of entities (pharmacy benefit managers, wholesalers and distributors) that also get a cut. https://medium.com/@brian-curry-research/the-healthcare-maze-tracing-a-dollar-through-six-layers-of-middlemen-2abb718003a1 https://medium.com/@brian-curry-research/the-healthcare-maze...
    • richwater 3mo ago
      You cut out the insurance middlemen but you introduce government bureaucracy. There's absolutely no way the government operates more efficiency in this space.
      • Apocryphon 3mo ago
        Better one bureaucracy than many. The U.S. health system requires constant patient management of multiple moving parties, it's maddening.
        • rayiner 3mo ago
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          • Apocryphon 3mo ago
            Do those school bureaucracies require parents of students to attend customer service calls that require multiple transfers over the better part of an hour?
      • shimman 3mo ago
        We know how efficient government operates tho, the admin expenses of say social security and medicare is less than 3%. Pray tell, what corporation operates with 3% admin expenses? Once again, what a crock of shit.
    • rayiner 3mo ago
      The big 7 U.S. health insurers made $55 billion in profits in 2025. Pharma industry profits on U.S. revenue was about $100 billion. Total U.S. healthcare spending in 2025 was $5.7 trillion. Cutting insurer and pharma profits out of the equation entirely would reduce spending by 2.7%. I support universal health care. But most of its proponents are suffer from innumeracy and magical thinking. It’s very scary to me that we’d put these people in charge of health care reform.
      • deleted 3mo ago
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• rayiner 3mo ago
  The U.S. spends more money on education per student than any OECD country other than Norway and Luxembourg. Yet it gets quite mediocre results. Why do you think the U.S. will be able to do public health care in a more cost efficient way than it does public education? I favor universal health insurance, but you’re going to pay more, not less. European countries didn’t flip some magic switch where they saved a bunch of money by just “cutting out the profit.” They do it through measures like the UK NHS setting the standards of care, so in a malpractice lawsuit the entity that says what the doctor ought to have done is the same entity that bears the cost of unnecessary tests and procedures. Efficiency is also achieved by aggressively rationing providers such as MRIs, keeping health worker salaries low, etc. There is no stomach to do any of that in the U.S.
  • Apocryphon 3mo ago
    The U.S. system is neither fish nor fowl, there is more spending per capita than other countries' public systems and endless amounts of red tape because instead of one government bureaucracy you're also dealing with the insurance networks, the providers, etc. I certainly don't think it'll be automatically cheaper, but one can't help but think that the current system encourages hop-ons that exploit the inconsistencies and convolutions. It's like one big nightmarish parody of public–private partnerships.
    • rayiner 3mo ago
      But our publicly run systems are full of inefficient bureaucracy and red tape, too. Why shouldn’t we assume our public healthcare system would be operated the same way as the public school systems in Chicago, New York, or Los Angeles? Moreover, there is a massive amount of overcare that americans aren’t willing to confront. My wife’s grandmother had a stroke at 87 and was airlifted from rural oregon to a hospital in portland. She had only 3/4 of her lungs after having cancer in her 60s. The doctors wanted to do an intensive intervention, which didn’t happen only because she refused and died peacefully the next day. My parents are on medicare and they just wander into the ER every time their blood pressure goes too high. I took my 7 y/o son in for a black eye after he ran into a table. The doctor looked at him, concluded there was almost no chance of internal bleeding, but ordered an MRI (or CAT scan, I forget which) “just in case.” We got one and the results within 90 minutes because we just have million dollar machines lying around “just in case.” My daughter went to get her retainer at a small dental office in exurban Maryland, and the office had four people working at the checkin desk. I think this practice has only three dentists total. America’s “customer is always right” culture means it will be politically impossible to roll back any of this.
• Georgelemental 3mo ago
  Our healthcare system has its flaws (to put it mildly), but nationalized systems have their own. I know people who don't have primary care because they live in a country with a nationalized healthcare service and their government, in its infinite wisdom, chose not to allocate enough doctors to their town.