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Re:Iowa insurance market collapse could ground young entrepr... by pc86 on Friday June 23, 2017 @12:15PM (#14620251)
> study the systems of other first-world countries and incorporate the things that work best into ours

The problem with this line of thought is that the US is orders of magnitude larger, more diverse, and more complex than most European nations. For any single European nation I'd wager at least two of those are the case.

But we have a way to do this already without massive Federal overhauls - allow individual states to do what they want. This means the decisions are made closer to the people, so California can do what California wants while Mississippi can do what Mississippi wants. It also has the side benefit of California not paying for services in Mississippi.

Personally if one of the US states offered non-employer-based, single-payer healthcare I would move there in a heartbeat. If it's as successful as proposed, it would not take very long to most states to offer something similar. At that point, depending on individual implementations, it would be much easier to extend it to the Federal level.

Re:Iowa insurance market collapse could ground young entrepr... by mikeash on Friday June 23, 2017 @01:10PM (#14620801)
Why do size and diversity matter? Size is solved by just doing more of the same. If Germany, say, needs X doctors and Y administrators, then the US needs approximately 4X doctors and 4Y administrators. There are problems which get dramatically more difficult with scale, but I see no reason to think that this is one of them, let alone that a factor of 4 is enough to take it from tractable to intractable.

I can't even figure out how diversity would factor into it. Medical treatment depends very little on people's race or culture. I don't get it at all.

Re:Iowa insurance market collapse could ground young entrepr... by kcorbitt on Friday June 23, 2017 @04:16PM (#14622401)
Diversity definitely makes implementing generous social programs more difficult politically. The average working-class voter in any country will be much more supportive of eg. universal healthcare if he feels like the benefits are going to people with backgrounds similar to his own, just perhaps a bit worse off, as opposed to (implied-minority) "welfare queens" living off the fat of the land. The larger and more diverse a population, the less said everyman will feel like his taxes are actually serving people he knows and trusts.

That said, I do think we're moving in an encouraging direction. The percentage of the developed world that's willing to recognize others from different cultures and backgrounds as part of their own society seems to be growing, ever so slowly and fitfully. There will be years and perhaps even decades feel like regressions, but on average it feels like things are getting better.

Re:Iowa insurance market collapse could ground young entrepr... by mikeash on Saturday June 24, 2017 @02:15PM (#14626722)
I can see how that might make it more politically difficult to pass something, but it wouldn't make it harder to come up with a plan that works. A plan that works and can pass is a harder, but unfortunately I was already in the realm of fantasy the moment I started talking about looking at foreign countries to see what worked for them.
Re:Iowa insurance market collapse could ground young entrepr... by glhaynes on Friday June 23, 2017 @12:44PM (#14620537)
If it's as successful as proposed, it would not take very long to most states to offer something similar.

IMO this isn't clearly true. Lots of states (especially those that currently have the worst health care outcomes) seem far more driven by the ideology that has caused their problems than by this kind of pragmatism. Example 1: the ACA's Medicare expansion.

Hell, it might even work the opposite way: proof that something worked in California could end up as an argument against it. "Candidate x wants to implement the same sort of government health care system that's taken over California. This November, send him a message that we don't do things that way here."

Re:Iowa insurance market collapse could ground young entrepr... by pc86 on Friday June 23, 2017 @12:47PM (#14620569)
That sounds like democracy working. Democracy means as many people as possible get the government they want. This get progressively easier as the government gets more local. Overall people are much happier with local, then state government than the federal government.[0] If the people Mississippi don't want single-payer health care, and the people in California do, I'm in favor of a system that gives both of them what they want.

[0] http://www.people-press.org/2012/04/26/growing-gap-in-favora...

Re:Iowa insurance market collapse could ground young entrepr... by glhaynes on Friday June 23, 2017 @01:00PM (#14620702)
Well, that's some type of democracy having some effect, yeah. But I was taking issue with the specific idea you put forward that good healthcare ideas would likely spread (in today's political environment) through the "laboratories of democracy" that are the states. It sounds good in theory; it's not so good if it doesn't happen in practice and you're poor and sick in Mississippi. You and I can move (and likely would have health care regardless). They mostly can't.

EDIT: also, I think this framing can badly mislead us: "If the people Mississippi don't want single-payer health care, and the people in California do, …". We get a picture in our head of Mississippi residents monolithically not wanting it while Californians monolithically do. In actuality it may be that 49% of Mississippi residents want it and 51% of Californians do. This is of course a broader topic (the benefits and failings of democracy and of various electoral systems) but I do think it's worth being aware when certain ways of phrasing might distort.

EDIT2: I don't at all mean to imply that your framing was intended to mislead; I don't think that at all.

Re:Iowa insurance market collapse could ground young entrepr... by sjg007 on Friday June 23, 2017 @01:28PM (#14620951)
Individual states would need need to pool together to make single payer work (except for maybe California). As Congress regulates interstate commerce already you may as well go single payer.

But this is likely what will happen and we will get there eventually. If you are poor in a lower income red state you will be screwed for 20 years unless you move.