It's not clear to me that @bluedino was arguing that people who can't pay for health care should go without. Instead, to me, the comments merely stated that such people can get access to health care. They can do this either by subsidized treatment, or by not paying the bill. We probably all agree that the US system has many flaws, but it is worthwhile to recognize the various routes to getting treatment.

First, if you're making miniumum wage, don't have kids.

If you do, you (or at least your kids) likely qualify for Medicaid, so you do get treatment. Often preferentially. I have been to providers who have a 6-8 week lead time on appointments for new private insurance patients, but Medicaid patients get in almost immediately.

Making minimum wage can happen years after having kids. I know a guy with two young kids who lost his job and is now making ~35% less. That’s not the kind of thing you can know ahead of time.

So part of your solution to healthcare is poor people not having kids? How do intend we accomplish that?

Not GP, but I read that more as "if you can't afford something, don't do that thing" coupled with "kids are not an exception to the previous recommendation".

It's not a matter of forcing that decision on people, but rather having the same expectation of personal choice and responsibility for that choice that we have for other health matters (exercise, diet, smoking, alcohol use).

Yes, well stated.

Yes. I think we need stronger education in middle school and high school as to what kids cost, and what they deserve in terms of a stable home and parenting, education, etc. And to not have kids until you are in a position to provide those things.

It's a biological drive so it's tough. But I think we could do better. We're too sensitve that we might be "poor shaming" or such nonsense to even discuss it these days.

> I think we need stronger education in middle school and high school as to what kids cost, and what they deserve in terms of a stable home and parenting, education, etc. And to not have kids until you are in a position to provide those things.

That's mostly value indoctrination (both the what they deserve part and the “do not do X if you cannot do Y” part fairly directly,and also the “what they cost” if it focuses on what a preferred approach costs rather than the costs of a spectrum of choices), not education.

> It's a biological drive so it's tough

It's also an economic choice, which is why birthrate declines with strength of social safety nets.

(Which is also why strengthening the social safety net is probably a better approach than trying to shame people into not reproducing.)