[jeromegv]

They have actively worked at crippling it. Now that it’s crippled they tell you.. oh but surely the government can’t fix it, we need private enterprises to fix it!

You walked right into it.

What makes you think private business are capable of delivering something cheaper than what the government can do? The most expensive health care in the world is private.

[Folcon]

To be honest I'd be ok with private healthcare if they had to also obey the same constraints as public healthcare.

IE they had to provide care to everyone at a reasonable price.

I'm deeply suspicious of healthcare that gets to exclude people for cost reasons.

I too can provide great healthcare if everyone is mandated to pay me for my services and I get to exclude those I treat, that's a great business, the healthy pay and I exclude the sick, what wonderful pure profit business!

The insurance model bothers me for that reason, they really shouldn't be allowed to exclude anyone, if they're taking on the business of healthcare, then that's that, they are providing a utility service, which means they supply to everyone and they make money by spreading the cost between everyone.

There are nuances to that, but practically that's the goal they should aspire to, but unfortunately that model isn't the most profitable.

I mean take a look at the original US health insurance that existed:

> The first plan guaranteed teachers 21 days of hospital care for $6 a year, and was later extended to other employee groups in Dallas, and then nationally [0]

That insurance model worked, it just happened to get outcompeted by entities who were willing to undercut them by aiming to capture only the most healthy people, which is in effect a tragedy of the commons.

Which is a real problem in my book, I'd be fascinated to see what innovations a private company could come up with under that model. We might have missed out on a whole slew of interesting ideas if we kept going down that route, which would still have been a pretty profitable business and would have been a great success for those who do believe that the private space can do healthcare better.

As it stands I don't believe the current private model meets that criteria as it fails at the first hurdle of being a health care service, it doesn't care about health.

So it seems like the choices are bad private care, good public care and bad public care. So yea, I'm leaning to the good public care.

- [0]: https://en.wikipedia.org/wiki/Blue_Cross_Blue_Shield_Associa...

[raffraffraff]

Exactly. Why would it be cheaper or better to run healthcare as a for-profit business? If you have to take a profit, then by definition there's less funds available for the actual service.

[robertlagrant]

The point of private enterprise is it has to cost less or be a better product to survive, which is why things like cars are unbelievably better than they were 50 years ago, or even 10 years ago.

E.g. saying a state-run car company would've done better because all that profit money would've been perfectly allocated is not right. Otherwise the government's perfect decision-makers would be starting car companies left and right and making a fortune, instead of working for the government.

[MattPalmer1086]

Only if there is both competition and consumers can make informed judgements on the service.

In things that affect your health, I don't want to be the guinea pig that discovers the service I paid for wasn't up to standard. That provider may go bust in the long run, but in the meantime will do a lot of damage.

[ZeroGravitas]

If fossil fueled cars burning leaded fuel on state funded roads and then getting bailed out not that long ago is your idea of free enterprise triumphing over the state, you might not be as capitalist as you think you are.

"Bob Lutz compares Tesla to socialism after GM took $11B from taxpayers under his reign"

https://electrek.co/2016/08/18/bob-lutz-compares-tesla-socia...

I agree that cars are much better than they were 10 years ago. Thanks mostly to government regulations that the incumbent industry fought strongly, while Chinese state owned firms were taking advantage of the opportunity.

[robertlagrant]

> on state funded roads

Roads aren't cars? I'm not saying that central planning is never a good idea, just that it's mostly not a good idea. "Where to put roads that a private company will build" is a reasonable role of government in a capitalist society.

> and then getting bailed out

I don't think they should've been bailed out. That was politicians buying car worker votes by doing politician things, like inflating the currency to make everyone's wages worth less.

Cars are better not mostly because of regulations, but because of manufacturing improvements, electronic/chip hardware and software improvements, and, most of all, competition.

[pharmakom]

This makes me wonder… if Conservative strategy is to run it into the ground and then privatise, which is an unpopular plan with the public, then how are they able to consistently win elections?

[solar-ice]

Largely because the Tories are also willing to be fairly openly xenophobic, which is very popular with a large portion of the public. "Making sure the poors don't take more than they deserve" is another one of their popular policies.

The more-well-off also think Tory policies will get them a house and security. In practice, the UK housing market is completely fucked and gets more so every year, but... it doesn't stop people believing it.

Basically the health of the NHS is about the tenth thing on some people's minds when voting, until they get cancer or break an arm, at which point they start complaining about it.

[etc-hosts]

Probably because the opposition party has poor leadership and most UK newspapers are aligned with the Tories.

[ayngg]

It is more nuanced than that. The issue is that a lot of western societies are falling into debt traps because of a lot of social and economic factors which are already straining these systems to the point that they cant keep up, and the conservative strategy (in my good faith interpretation) regarding this is reducing the cost of programs that they consider to be bloated. This can be interpreted as running it into the ground as the bloat is often in bureaucracy which can easily pass the buck to actual service providers which then suffer from lack of funding. In contrast a more liberal solution would likely involve increasing spending then trying to recover that through additional taxes, which conservatives would say doesn't solve the cost problem but rather exacerbates it since bloat remains and is paid for by more debt or taxes. Of course this is just a general simplification of the conflict.

Clearly the solution is probably somewhere in between, but political polarization has simply pushed people to their party lines and entrenched their positions such that no real progress can happen while things continue to fall apart.

[starkd]

It is the organizing structure that is more efficient. It's not perfect, but just more resonspive to changes over time.