[baddox]

I agree with all those criticisms to some extent, but without some alternative I don't find the argument very useful, and I certainly don't find the original commenter's approach useful.

It's like listing the many many examples of plane crashes due to pilot error. That's not controversial. I don't think many people claim that individual pilots act without flaw, or that the entire system of pilot training and qualification is without flaw. But surely the proposal should not be to take comfort as more and more people "doubt the entire notion of an airplane piloting establishment that the population should 'trust' to make decisions without oversight."

[keenmaster]

Criticism moderates duplicity and complacency. The mere presence of widespread criticism would help. It would also serve as a foundation for a system to mitigate these problems going forward. You can't solve the problem until you:

1. First identify it as a problem (which I don't think we've done enough but you think the problem is apparent to everyone)

2. Direct the criticism to the right people (not just politicians, but medical leaders and the medical establishment as a whole - believe it or not, they have a halo effect and are not sufficiently criticized. The industry systematically weaponizes our high regard for the medical profession in order to prevent what it sees as adverse reforms)

3. and acknowledge that there is a way to mitigate the problem ex ante, instead of saying "sure it's a problem but it's unsolvable because of all the emergent complexity." Say what you want about Elon Musk, but the man thought "I'm going to shoot multiple giant rockets through the atmosphere and land them back on a moving boat simultaneously" then proceeded to actually do it. He didn't throw his hands up to emergent complexity. SpaceX took complexity by the horns. Synthesizing and amplifying non-duplicitous, high quality advice from medical leaders/orgs is not that complicated! Only they can lead you to believe that it's complicated, and then somehow deny that they did that. If they contradict themselves, it's because "we used the best available facts at the time." Laughable, and completely non-falsifiable.

As an aside, perhaps Americans would be less anti-scientific if a majority of them weren't scammed by the medical industry and charged $150-$200 for a tiny consultation with someone who is bribed by pharmaceutical representatives to shill for harmful drugs. Maybe Americans would be less anti-scientific if their government wasn't captured by medical lobbyists for over a century so that there isn't a faint hope for reforms like universal healthcare. The industry doesn't care, because they know that if America wakes up, and politicians aren't captured, total compensation for doctors and surgeons would eventually drop 40% with negligible or no impact on innovation and medical outcomes. To them, something is wrong if a huge chunk of your disposable income isn't siphoned to their wallets every year (part of which you never even see - that is, insurance premiums paid by your employer that you would otherwise receive as income).

[baddox]

The trouble with your example of healthcare is that Americans for whatever reason overwhelmingly approve of the American system of private health insurance plans, and even if they didn’t, I don’t think many would make an association between expensive health care and fundamental problems with the scientific community.

[keenmaster]

I'm highly skeptical of the "overwhelmingly approve" part.

Do Americans overwhelmingly approve of the deprivation of their disposable income and health due to the broken status quo? Of course not. It's just that many don't connect the dots because the debate isn't even happening. Democrats and Republicans are captured. The media doesn't seem interested. The system is too complex for people to even understand and know what to criticize. Most Americans don't even grok the fact that they would receive employer-paid premiums as salary under universal healthcare. They don't have a clue how well universal healthcare works in other countries and how widely approved it is (relative to a privatized system). Saying that Americans overwhelmingly approve of their private insurance plan is like saying Russians overwhelmingly approve of Putin...ya, ok, but I don't think the people who repeat that statement know how meaningless it is.

Do you know what American political scientists call foreign democracies with captured politicians, distorted media, and widespread corporate cronyism but...ostensible elections? Pseudo-democracies. There's a spectrum from democracy to pseudo-democracy, and we all know where we're headed.

As for the connection to trust in science, I already spoke about that from one angle (the exploitative interface between the average American and their medical care). Another angle is the following: the very same medical paternalism that broke our healthcare system also broke the institutional guidance regarding COVID-19.

[baddox]

I don’t really want to get into arguments of the form “they think they want X but they actually want Y,” because if you’re willing to use that mode of argument then it’s completely irrelevant to you what people think or say they want, and you might as well just argue for what they “actually” want without any regard for their input.

But the fact of the matter is that common proposals to overhaul the American health insurance system are extremely unpopular, and people overwhelmingly report being very happy with their private insurance plans.

[keenmaster]

How about this: 58% of Americans favored Medicare for All according to a Kaiser Family Foundation poll. This was back in 2015, when people were in a less medically and economically precarious position, and despite all the aforementioned misunderstandings regarding universal healthcare. I'm sure the medical industry will play up the "but mah haylth insurance" trope as the prospect of universal healthcare becomes more real. https://www.kff.org/uninsured/poll-finding/kaiser-health-tra...