Same with education. I am more than happy to pay taxes for an education system, even if I do not personally have children.

Public health systems vary with country. Private advocates say public sucks, until it is their turn to be scammed.

Public education is largely a scam to put 'original sin' of debt of children to society so when they grow up there is some plausible explanation that "we're a society" and they must feed into the pyramid scheme.

I'm not sure what nation you're from, but here, in the US, we pay a fairly significant part of our wages towards something called "Social Security."

If we pay a lot, during our working time, we can draw more, after retirement (and it is nowhere near a living wage -it was never meant to be).

In my country, we pay for education with property taxes.

Kids are not only getting classroom time. They inherit a whole baseline that previous taxpayers built: safer streets, clean water, courts that mostly function, vaccines, roads, libraries, stable money, and the accumulated tech and culture that makes modern jobs even possible. That bundle is huge, and it starts paying out long before anyone is old enough to “owe” anything.

Also, adults are not literally trapped. People can move, downshift, opt out of a lot, or choose different communities. Most don’t, even when they complain loudly, and to me that’s a pretty strong signal the deal is at least somewhat reasonable. Not perfect. Not fair for everyone. But not a cartoon pyramid scheme either.

If there’s a real fight worth having, it’s making the burdens and benefits less lopsided across generations, not pretending the whole social investment in kids is fake.

Let’s say I have a bag of bread, and I pass them down one by one expecting people to only keep one. You decide to keep two.

The human’s reasoning is often bulletproof:

I don’t have enough. You do. I’d didn’t steal from the person next to me, I took it from someone with plenty

^ No where in that reasoning is the possibility that in the aggregate, if enough people do that, you steal from each other.

—-

Insecurity needs to be rehabilitated before any form of support can be provided. Otherwise you get toxic results. How could charity possible go wrong? Easy - bad hearts are left untreated.

Today a hope of many years' standing is in large part fulfilled. The civilization of the past hundred years, with its startling industrial changes, has tended more and more to make life insecure. Young people have come to wonder what would be their lot when they came to old age. The man with a job has wondered how long the job would last.

This social security measure gives at least some protection to thirty millions of our citizens who will reap direct benefits through unemployment compensation, through old-age pensions and through increased services for the protection of children and the prevention of ill health.

We can never insure one hundred percent of the population against one hundred percent of the hazards and vicissitudes of life, but we have tried to frame a law which will give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age.

This law, too, represents a cornerstone in a structure which is being built but is by no means complete. It is a structure intended to lessen the force of possible future depressions. It will act as a protection to future Administrations against the necessity of going deeply into debt to furnish relief to the needy. The law will flatten out the peaks and valleys of deflation and of inflation. It is, in short, a law that will take care of human needs and at the same time provide for the United States an economic structure of vastly greater soundness.

I congratulate all of you ladies and gentlemen, all of you in the Congress, in the executive departments and all of you who come from private life, and I thank you for your splendid efforts in behalf of this sound, needed and patriotic legislation.

If the Senate and the House of Representatives in this long and arduous session had done nothing more than pass this Bill, the session would be regarded as historic for all time. ”

--Franklin D. Roosevelt

We’re not billiard balls. We have agency. Nothing causes a human being to choose to commit immoral acts vs. immoral acts. A human being may be put in a situation that may entice that person’s corrupt desires (we used to call this temptation), and responsibility while mitigating culpability is possible when someone’s rational faculties are overwhelmed, but the choice remains.

Blaming systems for theft is scapegoating and an evasion of responsibility. (To make this clearer by distinction: a starving man taking bread from an overstocked warehouse during a famine is not choosing to commit an immoral act; he isn’t stealing in the first place, as some share of that bread is his).

This is neither here nor there. As I said, temptations can arise that make things more attractive to certain people given their conditioning and the habituation of their desires. But ultimately, at the end of the day, we can refuse to indulge even strong desires. To the degree that we are in possession of our wits, we are culpable.

> If what you said was true then rule of law would have been the standard throughout history

I have no idea how this is supposed to follow, or even what this means.

There are plenty of capitalist nations that provide public healthcare on a large spectrum of coverage and quality.

Ahead of Canada, sure (they come worst here in both scenarios) but behind countries like the UK, Germany & the Netherlands that do have universal health care.

"Aljin says treatment at their local hospital in the city of Cebu was slow, and she had messaged everyone she could think of for help."

The Philippines' constitution says access to healthcare is a human right. They have universal healthcare insurance, and public hospitals and medical centers.

The next one is the girl from Colombia. Colombia has a mostly public (with regulated private) healthcare system with universal health insurance.

The next one is from Ukraine. Ukraine has a government run universal healthcare system. Wikipedia tells me "Ukrainian healthcare should be free to citizens according to law," fantastic, but then it goes on, "but in practice patients contribute to the cost of most aspects of healthcare."

In first world countries with social healthcare systems like Canada and Germany and Australia, people with complex illnesses do not get coverage for unlimited treatments either, or general costs of being sick (travel, family carers, etc). There are many cases of fundraisers for, and charities which try to help, sick people in need in these countries.

Capitalism is not the reason not everyone with cancer is being cured and not chasing expensive treatments. Healthcare is something that you can throw unlimited money into. You'll get diminishing returns, but there will always be more machines and scans and tests and drugs and surgical teams and devices you can pay for. It doesn't matter the economic system, at some point more people will get more good from spending money on other things, and those unfortunate and desperate ones who fall through the cracks might have to resort to raising money themselves.

In capitalism it is easy and transparent: price, with the side effect of aligning society interests with those of the selfish individual.

Of course the strange and heavily regulated US health-care system is obviously far far away from a free market.

In socialism it's much more random: black markets, lists, lotteries, friends and network of connections. The side effect is that the most productive individuals are discouraged and punished, with the whole society lagging in effect.

Case in point: the EU that started lagging the USA so much in growth that ended up having to beg for basic defense when a blood-thirsty neighbor came hungry for land.

And no, no lists, no lotteries or any of that other lies the conservative US media is spewing out to keep the masses pacified.

I strongly believe, that if US citizens were to experience German healthcare for a year and having to go back to the US system, that there would be riots. Because I don’t think anyone with first hand experience of both systems would ever want to return to the US system.

Even once I do hit the income threshold to switch back to private (switching back to fulltime work), I'm pretty sure I won't.

As far as doctor choice goes, I feel like I have more on the public insurance here (like 90% of the population) than I did with UHC in the early 2000's back in the US. I certainly have fewer financial surprises.

There definitely are lists. You don't just get the surgery or therapy you need the next day. You get the next free slot in the list of people queuing at the hospital/practice that still has free slots.

For example the first appointment you can get at my state funded therapist if you call today, will be in june. How is that "not a list"?

Or like, if you call most public GPs in my neighbourhood, they'll all tell you they're full and don't have slots to take on any new patients and you should "try somewhere else". How is that "not a list"?

Anyway, do you not realize the fault with the system in your logic? Because if everything becomes urgent in order to bypass queues, then nothing is urgent anymore.

It doesn't fix the problem, you're just scamming the system to get ahead of the problem.

If it's not lying then it's another word that ultimately still does the same outcome of putting you ahead of the rest.

For some other things, you can travel further away to where there is less demand for what you need, and if you're willing, you don't have to wait as long. These are all different "lines" and they're the ones doing the schedule.

Let's focus on the other part you said, "waiting 1 year" if it's not urgent. 1 year sucks no matter how you spin it around.

Except it doesn't. At least not in the United States. I have Peripheral Artery Disease.

I had two completely occluded arteries in my left leg and a third that was mostly occluded and had an aneurysm to boot.

One day, that third artery collapsed and I was left with zero blood flow to my left foot.

The doctor had me go to the Emergency Room to get testing and imaging to have surgery the following week.

He did not simply schedule surgery, as that would have required pre-approval from my insurance company and, in fact, the insurance company denied the claim and did not approve the procedure (which saved my foot) until six weeks later -- at which time I'd have had to have my foot amputated without the angioplasty and arterial bypass.

In fact, after surgery the insurance company continued to deny my claims and refused to authorize pain meds (they sliced my left leg open from my hip to my ankle and rooted around to use an existing vein to bypass the blockage on one of my arteries) for those same six weeks.

Oh yeah, US healthcare is so much better. /rolls eyes. My insurer would have forced me to wait until I required amputation if I hadn't just gone ahead on an emergency basis as suggested (because it's not unusual for that to happen) by the surgeon.

And in case you were wondering, yes I have private insurance and pay nearly $1200/month just for me. In fact, my deductible for next year just went up 20% and my annual out of pocket doubled, yet I'm still paying essentially the same premium.

No. The US healthcare system is completely fucked and I hope you don't die or lose important body parts learning that.

Yes, this system has issues. But I'd still take it any day over the US.

But you have lists, queues, lotteries, whatever you call it. That's not a lie. The fact you think lists are a vast right wing conspiracy demonstrates your government is not really forthcoming about your healthcare system. There are lists everywhere. There are ambulance wait times, hospital emergency wait times, various levels of urgent and elective treatment wait times. There are procedures and medicines and tests that are simply not covered at all.

Now, obviously USA has queues and lists too. And I could be wrong but I'm sure I've heard that US private insurance companies are notorious for not covering certain treatments and drugs as well. I don't know what it is exactly these right wing people are saying about healthcare, I thought they did not like the American "Obamacare" though.

the market / capitalism won’t correct itself, much people want to call it God/ perfect

Regulation, anti-trust laws try to correct somethings but many politicians are against those things because they limit the profit that can be made, profit first, that’s the corruption

> In socialism it's much more random: black markets, lists, lotteries, friends and network of connections. The side effect is that the most productive individuals are discouraged and punished, with the whole society lagging in effect.

Evidence: the vast majority of European countries who have socialized medicine and seem to be doing fine.

>Evidence: the vast majority of European countries who have socialized medicine and seem to be doing fine.

That evidence of socialism working well, only works as long as there are enough resources to cover the needs of most people, basically some of the wealthier European countries.

But when those resources become scarce due to poor economic conditions and/or mismanagement, then you'll see the endless queues, black margets and nepotism running the system.

Evidence: former European communist countries who experienced both systems and where in some, nepotism to bypass lists still work to this day.

Socialized systems don't work without abundance. How you generate that abundance is orthogonal to socialism since even countries that are wealthy on paper suffer from shortages and long waiting times in public healthcare leading to a gray-market of using connections to get ahead or more private use.

You do realize that the "vast majority" of European countries doesn't mean highly developed Western Europe, right?

Here in Central and Eastern Europe (where I live) socialized medicine is not "fine". You should visit some hospitals in Bulgaria or Romanian to get a more complete picture. We pay the state outrageous insurance costs every month then go and pay out-of-pocket in private hospitals when we actually need them.

This quality of service costs me and my wife ~$23,000/year.

Sure, we can walk into urgent care and get seen. I've also never had a problem walking into a walk-in clinic in Canada, either. The clinic's lobby and the doctor's car in the parking lot isn't as nice over there, though.

I needed a sleep study. An inpatient sleep study is booked 3 years out here. Good insurance.

Seeing that sleep study doctor in the first place just to get sent a $150 gadget that listens to me sleep? I waited two months. The follow up appointment? 3 months.

Do you know why non-emergency care waits that long? Efficiency. Turns out, hospitals want to not spend extra money on doctors they don't need whether they get paid by the government or this weird industry called "insurance" we have developed.

Go head, tell me about how you can get any treatment or any scan in a week without fail in our wonderful overpriced system.

Both actual capitalism, i.e. the bad thing, and this which can plausible be argued to be well-functioning market economies, are is often stabilized by adding elements of communism to the system-- publicly funded education, healthcare etc. This is one of the reasons why I as a vaguely socialism-influenced whatever I can reasonably be said to be see communism, i.e. a system characterized by the distribution principle "to each according to his need" as less revolutionary than the socialism distribution principle "to each according to his contribution". Communist distribution principles can coexist with ill-functioning market systems such as things which have degenerated into actual capitalism, whereas the socialist distribution principle can't.

The market is just reacting to the regulatory environment and all the political patches and shortcuts of same done to appease voters over the last 100 years. Fix that and the market will sort itself out.

“Bad news, detective. We got a situation.”

“What? Is the mayor trying to ban trans fats again?”

“Worse. Somebody just stole four hundred and forty-seven million dollars’ worth of bitcoins.”

The heroin needle practically fell out of my arm.

I don't think your statement is true absolutely, I think it's very possible to have pure market economies that are quite well-functioning, i.e. not monopolies etc., where many people are very rich but with some people being really poor, even to the point of not being able to afford healthcare or healthcare insurance, so I don't think it's guaranteed to be true, though I think it's mostly true.

You won't have to worry about distributing advanced cancer medications when they don't exist in the Communist version, because they weren't discovered. You can't fulfil a need with a drug you never risked a giant amount of funding and effort to discover.

Let’s also imagine the other side of the equation. Can you not imagine any penalty or cost other than bankruptcy? Let’s say you are forced to allocate $1 million per year to research. is the only cost function you can imagine based on the risk of default?

So I don't understand how your comment really relates to mine. My comment is basically me quibbling about terminology with the terms capitalism and market economy.

This allows decentralised decision making for large grained resource allocation - for example should we build a factory for shoes, or for toothbrushes? - and is a good thing, as central planning has been demonstrated to not work if applied to the whole economy. (the converse, no central planning to any of the economy, has also been demonstrated to not work!)

However that accumulation can be (and nowadays usually is) orchestrated by a corporate entity, which in an ideal world would be almost entirely beneficially owned by retirees on an equitable basis.

What has gone wrong, is that the benefits of productivity enhancements (since 1970?) have flowed to capital more so than to workers - which not least prevents them from forming capital themselves (savings/pensions), hence rising wealth inequality.

But this kind of thing, i.e. capital accumulation by some to the exclusion of others, is, I think, objectively problematic in that it's not really compatible with free markets since capital ownership will be barrier to entry once capital has in fact been accumulated by some to the exclusion of others.

I agree that it is decentralized though, but sort of like how feudalism is decentralized.

But don't worry your free market friends are killing it right now, for tax reductions

https://www.wired.com/story/how-trump-killed-cancer-research...

The benefits were already delivered by that strong and prosperous economy in form of products and services.

Taxation is of course necessary to fund government spending but we need to keep in mind its drawbacks: from discouraging productive activity and slowing economic growth to giving politicians funds to buy votes with populist social policies.

Like, yes, we are discussing an "imperfection" here! You are the one that asserting the greater perfection, not the lesser.

And it makes sense, considering human nature and motivation: how much would you work considering the taxation? Me:

0-20%: I work as hard, want to excel and advance; I will take risks and invest in entrepreneurial endeavors

20-40%: I will do my duty, 9-5 then hit the door to spend time with the family; actively seek low-responsibility low risk high stability and lots of benefits government jobs

>40%: f that s, I will take my welfare payments and do various cash jobs without declaring that income; stay in my parents basement playing Xbox, smoking weed and jerking off

In the US, unless you or your family own a holding with a lot of companies, the country taxes you between 50 and 40% (well, 30 and 50%, but food stamps are a bit weird so i will exclude them here). If you manage to get rich enough to be able to optimize your taxation, you are only taxed on company profits (so 21% to federal, 27-29% depending on your state) and sometime use taxe (sales taxe doesn't really apply anymore).

I have benefited from VAT-free school furniture most of my life because my uncle owned a company that bought office furniture regularly, and VAT-free sport clothing/tools because of a similar scheme by his wife and her companies.

I assure you you pay more taxes overall than people holding a few companies, and the more you own, the easier it get to avoid VAT and taxes in general (the owner of the Yacht my sister used to cook for was hired by the Yachting company as the captain or something for his vacations: avoided VAT on buying the Yacht, avoid VAT on a personal cook, avoid VAT on food. And if this specific company loose a small amount of money every year, tax write-off baby!).

Zucman wrote The Triumph of Injustice: How the Rich Dodge Taxes and How to Make Them Pay. It's an interesting read, and

Actually I've been lucky to practice what I preach all my life. Early in my career I realized that salaried employment is a rip-off: you pay through your nose for an illusion of safety and stability you don't want nor need. So I embraced risk and switched to contracting.

Having leftover income this way, I looked into investing. That's when I realized that being financially prudent, saving and investing was actually punished in the USA, taxwise, while borrowing and spending was encouraged. So I left the USA and returned to Eastern Europe.

Understanding that selling your time is much worse than selling a product drove me to entrepreneurship. Luck threw a little success my way and turned me financially independent.

Now I am semi-retired living from investments and small gigs and spending time with my family. My tax rate (income only, not consumption or VAT) is well under 20% on most of my income. I didn't do any effort to optimize it further, but I could if I must. I actually do not mind paying taxes, but I do respond to incentives and I am not afraid to relocate.

> If you manage to get rich enough to be able to optimize your taxation

Actually I did a little research and you don't need to be rich, you can do that with very little money. But then the gains for a few percent reduction aren't that great anyway so...

> you pay more taxes overall than people holding a few companies

I probably do, but I don't mind it. I think the rich are a net positive to our society because capitalism ensures they contribute to the society orders of magnitude more than they manage to keep. Also I lived under communism pre-1990 in a world without rich and I've seen how bad it is.

https://www.forbes.com/sites/danalexander/article/the-defini...

Most of his added wealth comes from "crypto" and name licensing.

Yes, there is quite a bit to improve in the German system. No doubt there. But if I compare it to the abysmal situation in the richest country on this planet, I am left standing awestruck asking myself why. I really, genuinely cannot wrap my head around.

[1]https://d3nkl3psvxxpe9.cloudfront.net/documents/econTabRepor... via https://truthout.org/articles/6-in-10-americans-back-medicar...

Your vote has consequences, and republicans have been voting for people who objectively and loudly tell their voters that they have no intention of doing those things.

It's time for people who vote republican to own that they suck at picking who to vote for.

Tons of them also say they want recreational weed, but it's only republicans working to prevent that in most states, often literally ignoring citizen's initiatives and court cases to accomplish that.

Now maybe when I stop working that may be a different comparison. And its not like there is a choice, voting for a D doesn't magically get German healthcare.

You need to show that it has a chance of working (literature etc...) and it will be reviewed by a doctor from the "Medical Service" which is independent from the Health Insurers.

If they decide it should be paid, it will be paid (which is most of the time the case).

Otherwise you can go through the social courts. (No court costs for the insured person. You can get a lawyer reimbursed if you're poor)

Especially within the University Hospitals who administer these treatments they already have the experience how to write these applications and know their counterparts

If the US were to shift to that model today, a country already heavily in debt would have to either take on more debt PR increase revenues in a manner that they wouldn't have been willing to in order to fund our already growing debts.

The debate over whether public or private healthcare is better is all well and good, but first we should be debating how the US would pay for it in the first place.

Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

The healthcare industry in the US is massive and already full of corruption and inefficiency. Even if we are to assume giving politicians and bureaucracy more control over the system will reduce both issues, we can't predict how successful that will be.

Similar claims were made regarding the hopes for ACA reducing costs and here we are.

No, this is not Medicare Advantage, in which Medicare just directly pays private health insurance premiums for enrollees.

Other public systems vary between 1-4%

Also we don't need "pre-auth" and other Bullshit before we start standard treatments.

The real death panels are sitting in your Insurance Companies Offices as seen by the news coverage around United Healthcare et al lately

For comparison, the New York City public transport system (MTA) runs a deficit of about $3 billion. Six billion for universal healthcare in a country of 83.5 million people seems like a total bargain.

Yes.

To help you think a bit more clearly: the health insurance system is not a for-profit system, even though some people mistakenly hold on to the idea that it should be. It is a risk spreading mechanism.

I live under a system where even very expensive treatments are covered by the state using taxpayer money, and I'm not starving. Sometimes you need to optimize for human dignity.

The German Healthcare System also has some historically developed peculiarities that don't make much sense in today's age, but they are difficult to address without pissing people off (The duality of Private and Public Health Insurance, allowing the first one to get rich and very healthy people out of the risk pool, and then loopholes to switch back into the public system when they grow older and don't want to pay the then high prices in private insurance)

The Hospital Reform is already working to reduce costs by reducing the number of small hospitals, and concentrate them into bigger ones. (As a side effect, quality of care will increase too, since outcomes are correlated with experience)

Also more care will be shifted to outpatient setting.

Otherwise we are fighting with the demographic change. But these problems are also hurting all other developed nations including the US, where funding problems in Medicaid are also expected in the next decades

tl:dr We have problems due to the demographic change, but these are in line with other developed nations. There are some efforts to address them, but politicians are hesitant to do real reforms, because old people have the most voting power

Governments-paid treatments are god-sent but many times the funds are limited so they only cover older, cheaper treatments. Approval and funds for newer ones come so late, sometimes too late.

Germany has one of the most developed economies on the planet so naturally has more spend on healthcare. But that can change and when the money is tight, tough choices have to be made. I'd make those choices for myself rather than trust the State to do it for me.

Slovakia?

I have three second-hand cancer experiences from family here in Australia (Dad, Mum and my half-sister - under 35/yo). All three were detected early thanks to regular checkups and screening (covered under Medicare), treated in major hospitals (Dad was in a rural hospital, Mum and half-sister in Metro major city hospitals) and are all alive and certainly not in debt. The biggest cost was parking at the hospital, drinks from the vending machine and the PBS medication (all PBS medicine costs $31.60 for adults, and $7.70 for concessions).

Any PBS medication has the full-cost price printed on the label for reference, more often than not the printed prices go from $300 - $2,000, but I remember that these aren't the full price anyway since our government collectively bargains for cheaper prices on OS medication).

I can't imagine having to pay for treatment AND the insane full price of medications, it must be so much more stressful for families going through cancer treatment.

Americans, don't let the media and your government tell you otherwise. Universal healthcare is cheaper [0] and more effective than whatever archaic system you have now.

I am so god damn proud of our system in Australia, it's not perfect, but damn it's so efficient for critical care, thank heavens for Medicare and the PBS.

Oh and for those that say "well doctors aren't paid very well"... they are. My brother-in-law is a surgeon and he's doing pretty well for himself, bought a new Audi last month for his wife, heading to Europe for a month-long holiday with his family and just moved into a new house.

[0] https://data.worldbank.org/indicator/SH.XPD.CHEX.PC.CD?most_...

Boy are you in for a ride. France will be first and Germany is on a good track for it within the next two decades.

The end of ACA subsidies is probably gonna collapse that approach.

So then you would expect life expectancy in the US to be higher than in Germany, France, UK?

It is not.

Pretty soon, actually. EU countries are falling further and further behind economically. Health care costs are increasing, taking up an ever increasing slice of the government budget. Labor force participation rate is decreasing due to generous welfare and high taxes. Natality is plummeting. Attempts to increase retirement age are met with riots.

We're a technological backwater. AI research is done in USA and China - the benefits will mainly go there too. We can't even cool our cities: we're losing more people every year to heatwaves than the USA to gun violence. We're closing down nuclear power plants after years of shamelessly funding the Russian war machine for cheap energy.

Years of redirecting defense spending into social programs are coming back to bite us. Russia is hungry and aggressive, while the US is not protecting us anymore. What do you think will be the life expectancy under drone and rocket attacks?

American life expectancy compares extremely unfavourably with the UK. The English seaside town of Blackpool has been synonymous with deep-rooted social decline for much of the past decade. It has England’s lowest life expectancy, highest rates of relationship breakdown and some of the highest rates of antidepressant prescribing. But as of 2019, that health-adjusted life expectancy of 65 (the number of years someone can be expected to live without a disability) was the same as the average for the entire US.

https://www.ft.com/content/653bbb26-8a22-4db3-b43d-c34a0b774...

Also what you conveniently forget to mention, all European countries still spend less on Healthcare than the US, as a percentage of their GDP. In absolute numbers this comparison would look even worse

So this isn't Defense Spending redirected to Healthcare

Is it so hard to believe in today's day and age that somebody tries to learn and understand how the world around works using observation, published facts and deduction from as close to first principles as possible?

Even with waiting lists, people get healthcare. They get better health outcomes per $ spent. America can provide excellent cutting edge healthcare, which is especially great if you can afford it. At some point, you have to decide whether having most of the bell curve taken care of, is more / less important in terms of rhetoric and priority.

We can't really know, since only free markets can determine the price of a good or service (it's driven by supply and demand) and health care market is tightly regulated.

> Why is American insulin

Because of the regulatory barriers not allowing other providers to enter and sell insulin on the US market.

As we all know, American insurance companies never deny coverage, nor do you ever have to wait in an American hospital. /s

It's all very well and dandy that you can say "actually, there is a larger structural problem underlying it all" when meeting something bad, but it doesn't make that particular bad disappear.

You're absolutely right.

The incentives are there. Our economy runs on incentives. Create a vulnerable group and the sharks smell blood in the water.

For example, families forced to publicly beg for money to provide their sick children with treatment. What societal structures enable this situation to occur? Who is profiting off of this structure?

    Local man embezzles $20,000 meant to keep 200 orphans from being crushed in the orphan-crushing machine.

Also, the scale seems much larger than $20k.

I mean almost the entirety of the US healthcare system is a industrialized scam engineered by middlemen

Involuntary, progressive crowdfunding through government threat of violence (taxes) seems to work better than the other methods and most consider it humane. Americans have shown little interest historically in doing the humane thing, unfortunately.

Plus the phrase "cure" does a lot of heavy lifting. People seem to see a win here as being "here's a tablet, all cancer is gone."

So yes, we have spent an insane amount of money that can be ascribed to "cancer". (We've Also spent a lot on heart disease, diabetes and so on.)

But yes, we have got an extraordinary return on money spent. Treatments and survivability of common cancers (breast, prostate etc) have gone through the roof. Better screening, better education and much better Treatments lead to much (much) better outcomes.

Not all cancers are the same though. Some are harder to treat. Some rare ones are hard to investigate (simply because the pool is too small) but even rare cancers get spill-over benefits from common ones.

In terms of "cure" - that's not a word medicals use a lot anyway. Generally speaking we "manage" medical conditions, not cure them. "Remission" is a preferred word to an absence of the disease, not "cure".

In truth, we all die of something. Cancer is usually (not always) correlated with age, and living longer gives more opportunities to get cancer in the first place. So it's not like we can eradicate it like polio.

Just one example, prostate cancer today has a 90+% 10 year survival rate, in 1970 that was 25%

That’s not utterly transformative but I wouldn’t call it negligible either.

https://progressreport.cancer.gov/after/survival

Replace the body.

The only fatal cancer in 2026 should be brain cancer.

Removing cancer from a body is tremendously simpler than making a new body.

Parents had enough problems to think about.

In a similar way we can say that every shop in Amazon can create own digital shop themselves, but marketing, sales channels and distribution is not easy to acquire.

Money goes in, and good feelings come out. It certainly serves a purpose, but not the intended one.

To put it in HN terms, this is what people here like to use to shit on Mozilla for how much they pay their executives while having zero insight into how much Firefox's for-profit competitors pay their executives.

Is the bottom line roughly:

Money received: 1000

Money used for good: 800

Labor: 200

Is that it?

Because I can assure you, that will not turn out well.

The same people that audit your taxes, roughly with the same consequences for lying. Except the IRS is far more likely to send unannounced auditors to NGOs than they are to send them to for-profit companies or individuals. It's more of a hassle to get/retain tax-free status than it is to simply pay your taxes like everyone else (as it should be).

> Is that it?

Let me guess: you haven't clicked on "view filing", which leads to a roughly 20-pages-long document.

It's dubious to say Google "competes" with Mozilla, because they pay Mozilla to develop Firefox to avoid antitrust issues, but it's easy enough to find CEO compensation for public companies.

https://www.sec.gov/answers/execcomp.htm

Of course people have published the numbers for well known companies:

https://www.jagranjosh.com/general-knowledge/highest-paid-ce...

Also, "Other companies pay their CEOs ridiculous amounts, so we're going to," is a poor justification, and just shows Mozilla execs are there to enrich themselves, and don't really care about the browser or community. But I guess they can't spend all of the money on Pocket and AI.

To put another way, if I were facing some terminal illness I would want to have full control of picking the service even if it costs money. Sure, I would want "the best" specific to me and have someone else pick up the tab, but that's a fantasy, because no system or third party has as much skin in the game as me. That's why things like elective surgery are so cheap and competitive.

The problem is why do these treatments cost so much? What prevents competition and innovation. And my argument it's largely due to regulation and third party payer system

The general public doesn’t have enough information to make informed decisions when it comes to healthcare. This alone completely removes the usual market forces from providing any benefit when it comes to healthcare.

Cancer treatments don’t inherently cost that much money, the systems to ensure people are actually getting useful treatments are expensive. You can’t trust companies selling cures. You can’t trust every doctor when they have financial incentives to offer treatments. Insurance companies are in an adversarial relationship with providing treatments, which doesn’t result in efficient supervision here. Lawsuits offer some protection, but at extreme cost to everyone involved. Etc etc.

The net result of all these poor incentives is single payer systems end up being way more efficient, resulting in people living longer and spending less on healthcare.

Why is it always "the general public" and not "I". Do you have enough information about decisions? Can I take away some of your rights? No, of course not. Everyone else is dumb except me.

I'm sorry but I refuse to believe some unelected, anonymous bureaucrat has my best interests in mind or can even know me anything about me such that I want to allow them to make health decisions for me.

I'm sorry to tell you that this is, but unelected bureaucrats are constantly making health decisions on your behalf. You may not want government bureaucrats, but bureaucrats already work in your employer's HR department, deciding on which insurer to partner with, and with what benefits. They are at your insurance company, doctors office, and hospital administration, negotiating and deciding which procedures and drugs are available to you without ever asking for your opinion. Bureaucrats you didn't vote for infest drug company's research and finance offices, determining the availability and cost of your present and future care. None of these even pretend to act in your interests.

I'd rather have some government bureaucrat preside over all the other predatory bureaucrats. I sure as hell wouldn't be make well-informed decisions in the ER, or after getting a cancer diagnosis. Further, it is impossible to compare provider quality and final costs for elective, cosmetic procedures when I'm under no time pressure or stress.

I have no problem with bureaucrats. I want a choice. If I come in one day to find the shelves empty, I go somewhere else. If they make it difficult for me to check out, or are too expensive, I change. I just want choice.

You can choose to listen to the same unelected anonymous bureaucrats. Just log on to FDA or whatever, and follow their advice (e.g. follow the food pyramid). Only one of us wants to remove choice from the other, and that's the difference.

I trust government staff far more than the decision of unregulated, greedy corporations who literally exist to extract the most money from whatever process they're trying to sell you.

I have trouble believing empowering people who have no risk of losing their job and no one knows they exist is the best model for making decisions for other people.

EDIT: Also the whole VA system.

You mean like the (non-medical doctors) third-parties contracted by my private insurance provider who routinely deny important care[0] and even reject pre-approvals for antibiotics for MRSA infections even after multiple interactions with several medical doctors confirming both the diagnosis (with accompanying pathology) and the appropriate course of treatment.

Yeah, you keep that rolled up newspaper handy so you can "Gub'mint bad! Bad Gub'mint!"

I hope you never have to deal with a life-threatening situation where your insurer flatly refuses to cover treatment until after you're dead or have body parts amputated.

[0] https://news.ycombinator.com/item?id=46291740

Every single product and service I am using in my life is made by a corporation. The clothes I wear, the food I eat, the car I drive, the PC I am making my living on.

Government?! Decaying infrastructure, lines at the DMV, crappy schools and killer hospitals.

You may trust the government if you want, but I will never. However, you are the only one pushing your choice onto me and reducing my options. I am fine with you using private or governmental services but you won't allow me this freedom.

Me personally, No.

I don’t have enough information to make informed decisions here and you don’t either. Off the top of your head, how well educated is your dentist? You after all made an informed decision picking them. So how well did their background compare to others in your area. What where your concerns about their dental programs weaknesses and how was that offset by… Except no let me guess that never entered your mind did it.

My dentist cleans my teeth. If it's painful every time I come or I keep getting cavities I consider changing dentists. If they suggest I replace my teeth with veneers or something extreme, I consider someone else. And I'll do a few google searches.

It seems pretty normal. You don't do this?

So you don’t need to continue, you just proved my point.

This is basically a religious belief at this point. It's how a perfectly ideal free market might work, but we don't have any of these, especially in healthcare.

Probably 99% of what I consume comes from private companies and the services generally get better over time, with some exceptions. Compare that to an experience with the TSA.

You're adorable! Do you believe in Santa and the tooth fairy too?

Or come here in Eastern Europe where we had the "pleasure" of trying both systems and see how free markets pulled us out of utter poverty.

Collusion and cartels never work on the long run. It's an unstable equilibrium, the incentive to reduce prices to capture more market is too great.

> What is it that still makes you believe

Competition. It's the only force keeping humans honest. That's why we must treat any barriers of entry in a market with extreme care. The only "failed" or "captured" market is a strongly regulated one.

For example, while the Phoebus cartel only really lasted from 1925 through to 1939, 1000hr incandescent light bulbs remain the standard offering till present day. Profitable market manipulations are sticky.

The whole notion that markets are efficient is just a mathematical construct that has become very dogmatic for people. But if you look into the details, markets are efficient under the assumptions of perfect information and infinite time. Neither of those conditions are present in the real world: we neither have perfect information nor infinite time.

> 1000hr incandescent light bulbs remain the standard offering till present day

This proves in fact that all the cartel did was establish a standard, an optimal average between various tradeoffs when building an incandescent lightbulb: brightness, cost, efficiency and life span. Yes, the cartel behaved anti-competitively. The effect on the market? Nil.

> perfect information and infinite time

There is absolutely no requirement for this for markets to work. Markets work just fine with partial information and just-in time. When new information and new market participants appear, markets will self-correct. The only way to prevent markets from working is through government intervention.

In facts, free markets are the only system we have that works with incomplete info and reacts in real-time. Central planning will happily decide on incomplete info then never adapt. We saw that during communism when the Party decided allocate X resources for production of Y and it always resulted in a glut or shortages. Central planning doesn't work.

Define "long run" - they have been already proven to have worked for years and in some cases even decades.

Pure misanthropic fantasy pretending to be sophisticated economics.

It's the obvious reality around me here in Eastern Europe. We were starving under communism before 1990 but are now enjoying the amazing wealth capitalism brought.

This is simply not true. Healthcare in the US is comparatively much more expensive than countries offering subsidized healthcare with comparable or better outcomes(1).

> it's largely due to regulation and third party payer system

Capitalism can't work in a market that's completely consolidated, and where people can't offer to not buy your service. Healthcare in publicly subsidized countries is much less expensive because it's regulated. Compare the price of simple drugs like insulin or asthma medicine if you need an easy example. Pharma companies still happily sell there, which is to say that the difference is pure profit on the back of sick people who don't have a choice.

My biggest grief against this individual payment system is moral though. I don't see the virtue in a system where kids have to put on a show to receive care. Or anyone for that matter, you'll give to a kid because they're cute and generate empathy, does it make someone ugly with no family less deserving of getting cured from cancer?

1: https://www.healthsystemtracker.org/chart-collection/health-...

So it is a highly asymmetric bargaining situation where all the incentives are poorly aligned. Of course it is exploitative.

And now your death will have a meaningful change to the career bureaucrat or politician that made the decision that led to your death.

Because power of an individual vote is much more powerful than the power to take your business elsewhere. That's if you can find out the responsible party that makes these decisions and they're not appointed but elected, otherwise you'd have to mount an influence campaign on the politicians with 90% re-election rate to change said bureaucratic leader.

Makes a lot of sense.

But seems some prefer to believe a theoretical argument with no evidence to back it up.

“The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.”

Agreed. Also, all empirical evidence shows that free-markets work better, producing far better outcomes at lower cost than either. Just look around at any less-regulated and thus free-er markets. Or just "reject the evidence" - your choice.

> die

I am middle-aged so I used plenty of health services in my life. I always had choices when in came to price and level of care and treatment. None of them were for the "dying" case. But I do have an insurance specifically for that case. I am a rational being so I plan in advance. No need for a government bureaucrat to decide my health care for me just in case some day I may be incapacitated.

* by real, I mean large societies that aren't propped up by some bizarre economic quirk...eg maybe the sultan of brunei can personally pay for everyone bruneian citizen to get the best cancer treatment. But that's not a scalable solution