If you want better healthcare you don't need to invent anything new or "disrupt systems of oppression". Just pick another country where it's working and do what they do.

Largely, they have a lot more doctors, hospitals and MRI machines per capita than we do, and they pay their doctors less and require less education from them.

This is particularly safer in America because the #1 thing voters hate is anyone doing anything new. If you ever try doing anything new you'll immediately get voted out. That's what happened after the ACA passed.

Unfortunately we have the AMA which won’t let us import or bulk train doctors to the point of depressing their salaries

> If you want better healthcare you don't need to invent anything new or "disrupt systems of oppression". Just pick another country where it's working and do what they do.

Sure. That's like telling me that if I want to win an Olympic gold medal, I should just do what Phelps does. It'll work, right?

Even those countries may only have metastable healthcare economics, and while it looks as if it works now it could fail in the future. In the short term.

> Largely, they have a lot more doctors, hospitals and MRI machines per capita than we do,

So you're saying that all we need to do is have more resources that we don't have more of?

The AMA artificially caps the number of doctors and hospitals we have to increase salaries and costs. So no it doesn't necessarily take more resources to do these things

They've backed off on that and I think support more residency slots for training doctors now, but it actually is a funding issue because Medicare pays for a lot of that.

We also have very high to impossible standards for training doctors, and our residency rotation program requires you to not sleep because it was designed by a literal coke addict.

Which is dumb because there’s plenty of money to pay the residents otherwise.

The AMA has reversed position from their 1990s lobby to limit residency slots (which got enacted under the Republican "Contract with America"). At this point, increasing funding for residency slots would be seen as increasing government spending and is politically unpalatable.

medical school admissions is such a zero sum pissing contest of schmoozing profs for research positions, building houses for free in africa, grinding academics far past the point where the knowledge is beneficial, sheer perseverence, and sometimes being the right skin colour. the US could 10x the number of residency spots (and therefore med school spots) without significantly diminishing the capability of the incoming class to be good doctors.

You can simply buy more MRI machines and open more hospitals, yes.

The US has "certificate of need" laws saying you can't open a hospital unless all the nearby competitors allow it first. We could just not do that.

> Sure. That's like telling me that if I want to win an Olympic gold medal, I should just do what Phelps does. It'll work, right?

America is the #1 country at a lot of things. Surely you're not going to let Australia, Japan, the Netherlands etc beat you on this.

>If you want better healthcare you don't need to invent anything new or "disrupt systems of oppression". Just pick another country where it's working and do what they do.

This is completely impossible. We're talking about America here: it's utterly impossible for America to look at other countries and just copy them. It doesn't matter how much sense it would make; if America has a choice between sticking with some brain-dead system (perhaps, a measurement system for instance), or adopting a very logical and sensible alternative that America didn't invent, America will stick with its own brain-dead system, and claim that the alternative somehow can't possibly work in America because America is "different" and "exceptional". The only way America will adopt something new and better is if it's invented in America.

I've seen enough of American politics to consider that copying a better system and lying your ass off that it's American made would work (tbh this would work for most modern democracies).

The United States is #2 in the OECD for MRI machines per capita [1], with double that of France and nearly four times as many as Canada. Of the 38 nations of the OECD, only Japan has more MRI machines per person.

[1]: https://www.statista.com/statistics/282401/density-of-magnet...

I was indeed thinking of Japan but didn't go look up any other countries.

There is additional nuance here. Not all of the MRI machines are the same.

The USA typically uses machines with higher magnetic field strength, which are more expensive but produce higher spatial resolution. These machines are based on large superconducting solenoid magnets.

In Japan, there are many MRI machines with lower magnetic field, which makes them much more affordable while still quite useful. Some of such machines even use ordinary permanent magnets, which have much lower upkeep costs compared to the large superconducting devices.

Just expand Medicaid.. simple.

I think someone could sneak in Medicare for children if they tried.

This is the main reason I built https://chitchatter.im/. I hope to see it be used as a tool to safely organize around building a better world.

Thanks for this! Gonna ask around for help in evaluating it for security.

Awesome! Let me know if I can help or answer any questions. :)

https://chitchatter.im/public/a15225a7-cf8c-4f6c-955a-e5fe15... to join a hackernews public chat!

I have some ideas. randyselimi on Discord

I'm peculiarlyrevokingconsent on Discord. Sent FR.

You’re on the right path my friend, hang on to the feeling that drove you to write this. Not everyone has it, and you may even find yourself having woken up with it missing one day. So use it while you have it

Thanks for the encouragement! I care for a 6-year old I've nurtured through anarchic principles. This feeling, if it can go missing, is reignited by things they say and normalized forms of childhood oppression they experience/witness.

civic tech! https://civictech.guide/

> I'm looking for different paths than murder to accomplish this.

It seems like our entire system has been intentionally designed and refined over centuries specifically to ensure that nothing short of radical, even violent, acts will have any meaningful impact on those in power.

Corporations in particular have insulated themselves from any accountability whatsoever and there are literal serial killers who knowingly sold products and took actions that they knew would kill people who have never and will never see a single day behind bars.

I sure hope that programmers, hackers, computer scientists, or systems designers/engineers find some means to improve the situation, and I'd certainly support the effort but I'm far from optimistic.

>Corporations in particular have insulated themselves from any accountability whatsoever and there are literal serial killers who knowingly sold products and took actions that they knew would kill people who have never and will never see a single day behind bars.

Exactly: look at the people behind the Ford Pinto (with the exploding gas tank), and more recently the people behind the Boeing 737MAX.

Philip Morris, DuPont, Philips Respironics, Purdue Pharma, Johnson & Johnson, Nestlé, the list just goes on and on.

I hate to defend them, but at least with Philip Morris, they warn you outright that their products cause cancer, right on the package, yet people keep buying them anyway. (Yes, I know they had to be forced into this years ago by the government, but still that's better than Boeing where the government said their product was safe.)

Philip Morris and RJ Reynolds didn't put such labels on the foods they developed after buying major food companies in the 80s and applying their addiction tech to our diets.

I haven't fully fact checked this, but I have read that some of the same scientists the tobacco industry hired to fake research and lie to the public about the harms of smoking have been working as GRAS panelists tasked with convincing the FDA that food additives are totally safe. Seems like nothing could go wrong there.

The speed with which we are poisoning ourselves has long outpaced our ability to detect it at the collective level.

It is reasonable that corporations and individuals "protect themselves". No one wants to work for a company that's been damaged by bad judgement or bad luck. So companies have boards of directors and stockholders to oversee operations, hold officers liable to varying degrees, and purchase insurance against risks.

But corporations are guided by human beings so, in the end, we have ourselves to blame. If making any accusation you'd best put a name or names to it and forgo accusing a corporation purely.

But that doesn't make corporations a bad thing. They have, quite the contrary, proven to be a wonderful economic construct, along with such tools as capitalism and insurance.

Not as a direct response to the call to action, but this comment reminded me of the entire plot of the 2014 videogame Watch Dogs[0]

[0]https://en.wikipedia.org/wiki/Watch_Dogs_(video_game)

Oddly a talk from emacsconf a few days ago comes to mind:

https://emacsconf.org/2024/talks/blee/