[mjevans]

Single payer healthcare, absolutely. Negotiating a market rate between professionals and the entire public is the most optimal approach for the consumers whom; in a moment of need, won't really be able to shop around and choose.

While I do believe there needs to be a first world floor to living conditions, I've come to more understand UBI as one more way of killing the middle class. It's the Supply side, a lack of competition, that is out of whack for many of the most expensive things in the US, and probably most other industrialized nations.

UBI increases how much the poorest can pay, it does nothing to limit how much can be demanded by the rent-seeking rich. In effect UBI is a subsidy to the rich and an attack on the middle class.

[bertjk]

But the same supply side problem is also an argument against single payer healthcare. Maybe you've negotiated an awesome rate for the public, but then this comes back to bite you in the form of shortages and/or reduced R&D of new treatments. I mean, essentially it is one big monopsonistic price control regime, right? On the other hand if we can somehow bolster competition, increase doctors trained, etc., then maybe prices can come down on their own to a level accessible to the public again.

[mjevans]

If a thing is desired by society but the market is unable to fulfill that need that sounds like an area the government (the people's organization of foundation, first / last resort) should apply work. Though sometimes government can be the cause if regulations aren't well thought out and there's a failure to minimize unintended consequences.

If there aren't enough doctors as a whole, that's a sign that either the incentives and detriments offered by society are incorrect or that barriers to entry are too high for the market to function. (In the case of medical professionals in the US I've heard that a combination of artificial scarcity and malpractice worries are the issue. For the latter I'd like to see criminal (reckless endangerment, etc), rather than economic, outcomes for egregious cases; which should also apply to institutions training and certifying doctors. With that layer of protection the 'insurance' against being harmed should instead be covered by normal disability programs at the society level.

In the case of insufficient doctors in an area, that sounds like a great place for the military to have a base and provide civilization; though the doctors (and possibly other professionals) not existing there might also be a sign of larger issues.

If a place isn't economically viable anymore it is important to identify the root cause and fix it, or offer assistance to relocate to places that are useful for their residents and society.