> What the hell is going on there?

Please tell me if you figure it out. As near as I can tell, there's a profound distrust in any mandatory collective action (aka government) especially the closer to the federal level you get. Voluntary collective action is praiseworthy.

Maybe this is due to unique characteristics of Americans, as documented by de Tocqueville? https://en.wikipedia.org/wiki/Alexis_de_Tocqueville

Yeah, Americans generally prefer doing things voluntarily as opposed to being forced to do them. It’s part of the whole “freedom” thing.

"Freedom" is overblown in American discourse. Americans can't even agree on stuff like "freedom to require people coming into my store to wear a mask during a pandemic" versus "freedom to go about my business without restrictions," so it's often just spin, even without getting into the real fun ones like abortion, birth control, guns...

This is because the word has been redefined in the US. As outsiders we struggle to understand american brand freedom because its a weird concept centred on "my rights" where in most of the rest of the world includes responsibilities.

The US is screwed until they fix their discourse.

Believe me, a decent chunk of Americans don’t even understand the concept of freedom.

We have an expression, “it’s a free country”. But if you go to Mexico, the pharmacy will just sell you anything short of controlled substances—antibiotics, heart medication, whatever. In the US you need a prescription from a doctor. We’re not a free country by a long shot.

One can believe in freedom and also believe that the federal government has grown too big and often infringes on those freedoms.

> Believe me, a decent chunk of Americans don’t even understand the concept of freedom.

The government overreaching doesn't mean people don't understand the concept of freedom, just that the establishment has grown too influential.

I don’t know how you could believe in freedom and not have that opinion about the US federal government. But I’m not sure why you brought that up in this context.

The us has over ten times the population of Australia. The concentration of power is much greater and the distrust of that power isn’t completely irrational.

What I can’t figure out is why one state out of the fifty can’t do healthcare. That’s how it stayed in Canada, in one province.

Many already do to some extent, they're just incremental, narrow changes designed to solve the most pressing issues rather than full "free, universal healthcare". For example, Massachusetts's mandatory health insurance, or Washington State's public option.

I've lived in both countries. While Americans are very strong believers in democracy, Americans trust their government much less than than people in smaller countries. It may be directly related to the problem of empathy at a distance. There are things that I would trust the Australian Government to do that I would not trust the US Government to do, not because I think the Australian politicians are more competent or trustworthy, but because the United States population is 13 times greater, making a human connection between politicians and and constituents, keeping trust and accountability is an order of magnitude easier with a population that's an order of magnitude smaller.

We don't trust the government because power corrupts and absolute power corrupts absolutely, and history repeats itself.

That's what a constitution is for, it's an agreement between the people and government on how they wish to be governed. Ours sets out our God given rights that no government should be able to take away.

The Australian government hasn't been too kind to its people recently during covid, carrying people off for facebook posts, not a great example.

Someone in our prime ministers own government just described him as a man with no moral compass who uses 'his so-called faith as a marketing advantage' But the Australian population is much smaller, which means the public have a much smaller task keeping the government in line. You can't keep brazen narcissist kleptomaniacs entirely in line of course, but you can keep it to the level where they're not buying superyachts. I think this different context leads Australians to have some very different ideas about Government to Americans. We know power corrupts, but we don't see the Australian government as an arena where it is possible to attain absolute power, we don't see it as a vehicle someone can ride to outright despotism. There are people in the government in Australia would love to be despots, would love to rule the nation with an iron fist. The clown who renamed the 'Customs and Border Protection Service' to 'Border Force' and made all the uniforms black (ok really really dark blue) would love to be proclaimed eternal wise father of the nation, but we don't believe he's got a hope of getting that past us. We are more trusting of government not because we are naive, but because a nation of 330 million is a very different beast to a nation of 25 million

Like Australia, the US has a significant portion of its territory dominated by reactionary types who earn a living extracting resources. Their primary mission in life is to maximize return on assets and allow for dynastic inheritance.

Because of the peculiar configuration of the US Senate, these interests hold an outsized sway on the public, and they’ve managed to maintain an extended campaign to create a strange coalition of people against abortion, for guns, against taxes (especially inheritance taxes), and pro subsidy of agriculture, petroleum and real estate and traditional values.

That combo attracts a bunch of unrelated cohorts of voters passionate about a wedge issue, many of whom join together in a cause that is often not in their personal interest or normal mode of thought.

The gofundme is a short term solution to a short term problem. The assumption that the person is going to transition from "I need help right now" to "I'm in a little bit of trouble" to "I can contribute to society"

The stigma with government services is that "these people need help and they will always need help, they will never contribute to society"

I'm not saying the stigma is correct - but that is likely a common rational behind the emotions

Id call that stigma constructed by Conservative Right Wing ideaology! They call them bludgers in my country and parade them around in everyones face and use it to justify tax cuts, subsidies, or grants, for their mates.

its the cicle of life really

Because universal programs are slush funds. If you want to fix healthcare, make pricing transparent and competitive. Don't just let hospital administrators and insurance companies price fix and charge whatever. Same thing as free tuition. Fix tuition costs, don't just make the taxpayers foot the college administrators rolls royce.

What does "make pricing transparent and competitive" mean to you?

I hear this a lot but I don't see people explaining what exactly their desired outcome looks like, and to me, I can see lots of ways it potentially changes things without actually improving them.

Are you picturing a world where before you call an ambulance after injuring yourself you have to get on something like yelp to look at prices for 10 different ambulance services, and ten different local urgent care or ERs? Are you picturing a world where it's obvious that some surgeons and doctors are 10 times better than others, so the rich pay $$$$$$ for 10x better care, and the poor are left with the scraps? Or a world where it's hard to tell, so people compete on price alone, and the doctors who care most about outcomes vs bottom line are at a disadvantage?

When I take my cat to the vet I get upfront estimates.

When I take myself to the doctor no one can tell me how much anything costs.

Regardless of insurance status the vet gets paid the same amount.

My pets get better healthcare then I do and I pay less for it and they don’t have insurance. I’m relatively healthy, my cat has FIV. I have insurance my pets don’t.

> When I take myself to the doctor no one can tell me how much anything costs.

Not an American so asking out of curiosity - don't hospitals have price lists?

In America, you spend a few hours in the hospital, and then for the next year you receive separate snailmail bills for each procedure, medication, machine, instrument, outsourced clinic, and every doctor who happened to pop in to greet you. All in unpredictable, exorbitant amounts. And any of these bills may be sent to you again even if you pay.

If you're well insured, you still get all the fun reading material, but they say "amount you owe: 0.00"

"Amount you owe: $15,000 MOOP (max out of pocket) and $230 premium." There I fixed it for you buddy.

Nope. Here is a personal example that I love to use.

When my wife was first pregnant, we had health insurance amd we picked a hospital whose business was 50% baby delivery.

Not a single person could tell me how much it would cost to deliver the child. The OBG couldn't tell me. My health Insurance couldn't tell me. The hospital couldn't tell me. I know - for a fact - the hospital had delivered babies from other people with my insurance. They couldn't tell me the cost of a delivery.

Also, someone screwed something up and I was improperly charged for a hearing test. SMH.

Technically as of January 2021 hospitals in the US are supposed to have price transparency now. https://www.cms.gov/hospital-price-transparency

While it's a step in the right direction, most people don't know about it, the accuracy is questionable, what insurance will cover isn't clear, and what random additional fees will be added are unknown.

Noone is enforcing it, it was enacted by the Trump administration in 2019, effective Jan 2021, but the Biden administration isn't enforcing it and hospitals are defying it.

https://healthcareexecintelligence.healthitanalytics.com/new...

No. Doctors make a show out of a professional indifference to filthy lucre, except when they cash the checks.

Because the federal government insures the poor and old, the law requires that they get the best pricing. So every other insurer pays a little more, until you get to an uninsured person, who pays some unfathomable rate.

"Are you picturing a world where it's obvious that some surgeons and doctors are 10 times better than others, so the rich pay $$$$$$ for 10x better care, and the poor are left with the scraps?"

Isn't this the case already?

I mean, it could probably be worse, but I doubt Bill Gates will go to the same clinic that I do.

And this is based on evidence from what healthcare systems?

If you can't afford the competitive price do you go bankrupt though?

Healthcare costs are controlled in most markets because of the collective system, not despite it.

Why do Americans freak out on proposed government services? In the USA, we self-select ourselves into two political camps.

The first camp claims our ethnicity/race/class/region/religion/gender/identity has historically been oppressed. The most effective means to redress this injustice is by Federal government action. We want the Federal government, Washington D.C., to resolve our issues. The more government is involved, the better.

The second camp is a reaction to the first. The second camp believes the past is the past. The USA is doing just fine if stop meddling with what the Founding Fathers created. "Government is not the answer to our problems but is the cause of our problems". The less government is involved, the better.

My thoughts as a regular American: Among other factors, floating around in a murky spot in US culture are disdainful notions that money for public services will go to "them" or the undeserving or the degenerate or that it will enable lazy people or devalue hard workers. This intersects with a lot of other longstanding American culture problems, including bigotry over race/ethnicity/religion, distrust of government, culture divides like rural/urban, American (mis)conceptions of meritocracy, etc. These beliefs are often espoused even by people who would benefit greatly (and deservingly) from those programs, but instead they see them as the source of their problems. I can't speak to the details of the hows and whys but those are the connections I see (at least from one angle).

EDIT: I want to add that the above is constantly aggravated by opportunistic politicians and toxic media (both traditional and social media)

To answer your question, not "everyone" but rather a tiny minority of people, will throw money at gofundme under whatever circumstances. By contrast, a majority of people, including about half of Republicans, support Medicare for all (ie, "Single payer" health care).

...

As for the article, Empathy is what separates us from psychopaths, so it's not surprising that a Yale Psychologist would want to damage it to help his political slant. That said, I would say it's unfortunate that people can be fooled and conned easily due to their empathy, but I'm not sure there's fix besides destroying high-trust society altogether. The professor is not concerned with this downside of empathy, I don't think.

I'm curious as to where you gather the insight that Paul Bloom is pushing us politically towards psychopathy. Personally, I've gather the opposite from my interactions with him; he seems to be rather sociable and empathetic. Here is a quote from him (from the article) that nicely summarizes one of his beefs with using empathy rather than rational, compassionate thought:

>> The second problem is the innumeracy. Empathy zooms me in on one but it doesn’t attend to the difference between one and 100 or one and 1,000. It’s because of empathy we often care more about a single person than 100 people or 1,000 people, or we care more about an attractive white girl who went missing than we do a 1,000 starving children who don’t look we do or live where we don’t live.

Having read the article and briefly interacted with Paul Bloom, I can't say that I share your perspective as to his political agenda.

> he seems to be rather sociable and empathetic

It is not the main point here, but psychopats are sociable and can have a very high form of cognitive empathy. They can also be very charizmatic.

Also, I dont think the parent was saying Paul Bloom himself is psychopath. It was saying that he is pushing others to think that way, because that is congruent with his political ideology. That is different claim.