[tptacek]

But literally every state in the country disagrees with you and so it's not going to happen.

[rrrrrrrrrrrryan]

Most Americans support a public option, which is the transition step toward a healthcare system that more closely aligns with other first world nations.

[tptacek]

Only in the abstract. When you work out a concrete proposal that involves people paying for programs, support evaporates.

[antisthenes]

People are already paying for the healthcare one way or another, whether they understand it or not.

[tptacek]

Oh, you can get a lot of stuff done if you just assume you know better than voters do and make the decisions for them.

[antisthenes]

You think the ruling classes in the US don't assume that they know better than the voters?

And they still get nothing done when it comes to entrenched interests. Let's not glorify the average voter either.

[locopati]

The voters are for the most part uninformed, bordering on flat out ignorant. I feel safe in saying the experts who solve problems like this do know better than voters.

[mostlysimilar]

(decades of propaganda and state capture by the insurance companies later...) oh I guess the people just don't want it! Too bad.

[bdangubic]

true but that doesn’t make it right when people are running these states are paid by the same people who benefit from the current system…

[tptacek]

The people in those states do not want it, which is why state single payer referenda fail.

[paulryanrogers]

Romneycare and the ACA were a pretty big step in the single payer direction. Popular enough to overcome vetos and attempts to roll them back.

[tptacek]

I like the ACA. I think the Swiss system makes a lot of sense. Community rating, guaranteed issue, mandate, subsidy, then universal single payer at retirement, where costs are concentrated. It's a sane system. The problem isn't the system structure.

[rawgabbit]

What one thing would you change in the American system?

[tptacek]

I would drastically increase the number of residency slots Medicare funds.