The solution to this problem is single payer. Where the insurer (government) now has negotiating power on prices because they’re the only game in town.

I am all for single payer (Medicare for all for example) but there are plenty of ways the US system could improve. First would be to mandate pricing transparency so we actually have some data on the table for a rational discussion.

The US government is essentially the only game in town for military hardware and contracting, but I don't think anyone would hold up that procurement system as a model of efficiency.

In the world of health care, many developed countries have single-payer healthcare and the US pays twice as much for everything as all of them. If goverment-run health care is inefficient, why is our "free-er" system half as efficient?

My point is that it's probably something other than monopsony effects.

That is one solution to one problem. It has the side effect of overly simplifying American systems of governing and labor, and would cause new side effects or amplify existing ones.

In the long run its the same funding model as police and public schools, so health care will mostly be funded by property tax (or crazy local alternatives for those without prop tax), and the same local people who balance the tradeoffs of protecting from criminals vs protecting from fire will now be balancing education vs health care.

Virtually all health care is local and monopoly and time sensitive, just like policing or kindergarten.

I live six blocks from supposedly the best neonatal intensive care unit in the region; Only people who live nearby can benefit and I should pay more for it. Much like I pay a lot of prop tax for the local police to keep crime rates to low range of the suburban experience. Much like education I'm sure the feds and state will kick in some bucks but most of the money will come from property tax (much as most of the benefits to me come from living nearby)

I believe that funding based on local property tax is a uniquely American proposition.

In other countries, it is considered distasteful that people in poor neighborhoods get less funding for their schools and police force. And especially for schools, the country at large reaps the benefit from people going to a good school, much moreso than it is a benefit to parents that their children go to a good school.

Yes foreigners think majority funding means 100% funded, but my local K12 gets $80M from prop tax, $50M from the state acting as middleman (its a proxy for income tax funding the schools), and $3M from the feds.

With the rise of identity politics in the USA, there's little motivation to help the kids of people who hate you and your kids, its a natural outcome of a multicultural nation.

Dog-whistle racism has no place on HN.

Poor communities of all races have been underserved since long before whenever you imagine "identity politics" started to "rise" in the USA. Was "identity politics" not enshrined in the US Constitution, which protected racial slavery while giving more-slaveowning states extra voting power over less-slaveowning states

https://blackpast.org/aah/three-fifths-clause-united-states-...

https://en.wikipedia.org/wiki/Brown_v._Board_of_Education