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by robertlagrant 1136 days ago
Yeah, totally agree. The American system seems to have, despite its amazing innovations and advances, that we all benefit from sooner or later, the worst of both worlds: neither an efficient market-driven approach not a particularly socialised one either. And that's despite the US government spending more per head than I think any other country on healthcare.

The ties between government, big pharma, insurance companies and hospital systems must be so entrenched that it's very difficult to see a way out.
2 comments
Mezzie 1136 days ago
Yes.

Add that to America disintegrating into a low-trust society where one almost has to assume that any stranger one meets is out to scam you/get your money somehow and it results in a country where it's terrible to be vulnerable. Which is one of the ways we grow as people, thus leading to emotional stunting amongst the populace, which in turn makes us less resilient and willing to act (particularly since we can't cooperate anymore) and therefore in my opinion sow the seeds of our own destruction.

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dragonwriter 1136 days ago
> And that's despite the US government spending more per head than I think any other country on healthcare.

Far more per head — part of which is higher cost of labor and that healthcare is extraordinarily labor intensive. But, its also fairly high as a GDP share, for which excuses like that don’t work. The US just genuinely has a healthcare system that is ludicrously inefficient unless your goal is maximizing the wealth-based quality differential, in which case Mission Accomplished.

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robertlagrant 1136 days ago
I really think this cynical take on wealth needs to stop. This is far more likely explained by politics.

Or more precisely: efficiency is distorted by compassion. Which is then recovered by efficiency. Which is again modified by compassion. If your system is a bewildering mish-mash of cost increasing political interventions and cost reducing market innovations then it's never going to work. But lawmakers need something to do to stand out, and so do business people.

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dragonwriter 1136 days ago
> I really think this cynical take on wealth needs to stop. This is far more likely explained by politics.

The only mention of wealth was describing the effect. Yes, politics is a key part of how that effect is acheived. (Of course, advocacy by those with wealth is a key part of how the politics happens, and... well, the politics/wealth interactions here are basically a near-infinite chain. They aren’t competing explanations.)

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