[colechristensen]

The rest of the world has private healthcare on top of the public ones because the public ones are often inadequate.

Just go look for the local debate in any country with government healthcare and look for the parties who are pushing for change and their complaints.

Then ask yourself if you really would want the current administration in charge of your healthcare... if you'd like every four years to be a coin toss for how your healthcare was going to be for the next four years.

People arguing for public health care, are you ready to say you want Donald Trump to be in charge of your health insurance instead of a private provider? (because we're not in a magical fairy land where government is efficient and agrees with everybody's priorities)

[ryandrake]

The fact that a single person is "in charge" of the government, with the other two branches largely deferring all power to that one person, is a recent aberration from the norm in the USA. I'm for a single-payer health system that is administered by a well-checked regulatory apparatus and institutions that are not subject to wild policy swings at the whim of a single king-like leader.

[colechristensen]

>I'm for a single-payer health system that is administered by a well-checked regulatory apparatus and institutions that are not subject to wild policy swings at the whim of a single king-like leader

And I want to win the lottery, marry a princess, and for my childhood dog to come back to life.

We all want things.

When we're advocating for government changes we need to be realistic and make good choices. Right now throwing an enormous amount of power at a dysfunctional government (public health care) is an insane bid completely disconnected from reality.

We need people to care about the basic functionality of government and for it's various pieces to do their duty. They aren't, so maybe let's shelve the idea of handing over control of our healthcare to them until they can deal with their cowardice in front of an aspirational king.

[ryandrake]

At least elected governments are in theory accountable to the public through voting. Insurance companies and healthcare providers are not in any way accountable to the public, and the public has zero power (outside of regulation) to affect their actions. Just because public [X] is currently a bad choice doesn't make private, corporate [X] always a better choice.

[colechristensen]

Who cares about theory when the reality is a corrupt insane government was elected. We're not dealing with theory. Healthcare is too important to propose major changes based on theory instead of reality.

You DO have healthcare choices now. Consider the healthcare option provided when accepting a job is on the table, provide feedback to your employer about their chosen provider (i.e. say NO to United Healthcare). Even though it involves big life choices with private healthcare there ARE options on the table instead of what the electorate chooses every 2/4/6 years.

And people are pretty misguided. The typical HN crowd person would STILL HAVE private health insurance on top of the public care in almost any country today that has the public option. The public option is bad, slow, and has a habit of denying care. You'd be rich, you'd still want better care than what was available for free.

[toast0]

Public healthcare in the US can work. Most seniors on traditional Medicare like it. Make that available to more people, and bob's your uncle.

I propose allowing buy into medicare at 5 years before regular eligibility. And a long phase in of lowering the eligibility age. Drop it by 6 months every year for 10 years, then 1 year every year for 10 years, then 2 years every year until everyone with work credits is eligible.

At the same time, start covering all kids up to some age with Medicaid (after all, kids tend to have no income, so if eligibility was based on their own income instead of household income, they'd qualify). First year, kids get covered until 6 months, next year until 1 year, etc.

When the Medicare and Medicaid ages meet, we have universal health care. It would take a long time to get there on my schedule, but it would be gradual, so everyone could adapt. And if future legislation could adjust the timeline as needed.

Also, clearly someone needs to add more residency slots.

[colechristensen]

Again, you're disconnected from reality.

Do you want Donald Trump to be in charge of public healthcare? Please stop suggesting we make all of those changes unless you're willing to say you want him to be in charge of it.

[toast0]

Has he broken Medicare or VA health more than it already was?

I'll acknowledge he's playing games with Medicaid eligibility, but is he messing with the administration of care?

[colechristensen]

VA:

"Senate Veterans’ Affairs Committee Ranking Member Richard Blumenthal (D-CT) today released a comprehensive report detailing the harm and impacts of the Trump Administration’s draconian directives and cuts on veterans. The report, Breaking the Pact: Impacts of Trump, DOGE, and Doug Collins’ Ongoing Assault on Veterans, was released ahead of the Committee’s oversight hearing with Department of Veterans Affairs (VA) Secretary Doug Collins next week.

Blumenthal’s report reveals historic staffing losses at the Department resulting in dire workforce shortages, increasing wait times for life-saving mental health care, and veterans’ care and benefits being put at risk as a direct result of the Trump Administration’s harmful policies. The Committee report—compiled from extensive reporting, firsthand accounts, and ongoing conversations with veterans and VA employees across the nation—details the Administration’s systemic assault on VA over the past year and the tangible impacts its cuts are having on veterans."

https://www.veterans.senate.gov/2026/1/cuts-cover-ups-chaos-...

[ssl-3]

I'm thinking much longer-term than Donald Trump. I intend to outlive that orange cretin by a good number of years.

(You are, of course, free to be as myopic as you wish -- just as everyone else is.)

[colechristensen]

I'm also thinking longer term and am not so optimistic that he's just going to go away and the pattern he created won't be taken up by someone else (and the thing to be afraid of is someone else who isn't quite so stupid).

The dam may well be broken, Congress has proven to be full of cowards and the next aspirational autocrat might well win and do better.

[ssl-3]

I intend to live longer than that potential outcome, too.

[collingreen]

There are so many more options than a 4 year administration being hostile to the people it's supposed to represent. Corruption will undermine any collective action amongst honest collaborators regardless of what color their party flag is.

Also, having a baseline of public care and then private as an option on top doesn't sound like the boogeyman this is pitching it as to me. That seems like a great way to reduce the scope of what the state needs to be in charge of.

If the take is that government cannot possibly work for the people no matter what then yeah, all policy is bad.

[rickydroll]

Before we go pushing money into private insurance, we need to define why. We need to understand why the public ones are inadequate and who/what drove those decisions.

A public health care system should be independent of politics. Unfortunately, as the latest administration has shown, even if you designed it to be independent, such as the CFPB, it doesn't matter with an autocrat in charge. On the other hand, private industry does not have all that good a reputation for not effing with your healthcare.

[calvinmorrison]

hard to take you seriously when you think we have an autocratic system.