> I can't think of any credible reason not to have universal healthcare at this point.

When you grab em by their Amygdala, the naked monkeys will do what you want. Even to their own detriment.

As soon as they are in fight-or-flight-mode, (most) people cannot be reasoned with.

Sad but true

> When you grab em by their Amygdala, the naked monkeys will do what you want. Even to their own detriment.

Even to their own death (and the death of friends/family):

* https://en.wikipedia.org/wiki/Dying_of_Whiteness

* https://www.goodreads.com/book/show/40697553-dying-of-whiten...

It sounds like a great idea, then a government shut down happens.

> It sounds like a great idea, then a government shut down happens.

Single payer / universal healthcare ≠ doctors/nurses are government employees (necessarily).

You go to your local health care provider, show your card, and received treatment. The single payer (government) then gets billed and money is transferred to the providers account.

If the government is shutdown, there could be a delay in payment in outstanding bills, but that does not mean health care providers shutdown. Medicare ran during the last shutdown:

* https://www.nbcnews.com/health/health-care/government-shutdo...

* Telehealth was: https://www.pbs.org/newshour/health/medicare-patients-go-wit...

Social Security cheques went out too:

* https://www.cbsnews.com/news/social-security-government-shut...

* https://en.wikipedia.org/wiki/2025_United_States_federal_gov...

Lots of stuff can potentially be automated, and so continue to run.

It's possible for some of that to continue, but we really don't know what would happen if we directly connect payrolls and finances of the healthcare industry to the federal government in the US. It's a fair question how such a big connection would suffer when the government is punitively closed in a faustian bargain as part of a political struggle, as seems to be common recently.

There might be a few top-down emergency provisions to ensure checks go out to keep the system from toppling, but I wouldn't work if my pay is frozen and neither would my plumber, electrician, lawyer, etc. The last few shutdowns have run over a month - that can easily exceed the cash reserves of most businesses (that would be providers) and large businesses would shutter or have layoffs before burning that much cash.

We can't be so confident in how a $5T/year system would react if its primary cash flow valve is turned off, is all. Handwaving away the scope and complexity doesn't help anything.

> It sounds like a great idea, then a government shut down happens.

How about fixing the government so it can’t be shut down because a few hundred politicians can’t agree on the next budget?

Neither party is interested in amending the Constitution, which would be necessary, and even if they were, the country is so deeply divided that it would likely be unsuccessful except maybe to knock a few inalienable rights off the list.

> How about fixing the government so it can’t be shut down because a few hundred politicians can’t agree on the next budget?

"Thanks I'm cured" material. You're not the first person to think of that, and the fact that it hasn't been done yet probably means it can't be done very easily.

Just because the fed exists doesn’t mean the entire economy shuts down with the government.

It depends on how it’s structured.

Strictly from a realpolitik standpoint, universal healthcare like the systems found in Europe is unlikely to happen because too much of the American economy is tied up in healthcare and healthcare services. People trying to improve the system here in the US would be better served by looking for a fix that's uniquely American (ACA, all-payer rates, public option, etc.), rather than trying to tear out what we have and replace it with universal healthcare.

Mandatory disclaimer that I don't like our health insurance or healthcare prices any more than anybody else does, and in a perfect world I'd love to have universal healthcare instead.

Plenty of european systems involve private insurance fyi. It’s not all single payer

Doctors are the primary and most numerous beneficiary of the American status quo. And have you seen the houses they live in? In 99% of America, doctors live in the nicest biggest houses there are in town. What's more, doctors are politically and socially untouchable. Even saying what I've said will probably have people itching to respond that doctors earned their huge salaries, that medical bankruptcies are completely unrelated, that doctors actually have little political power, that some doctoring organization has released some feel-good vague statements about fixing the system (but nonetheless not actually financially backed the candidates that might fix it), etc. How doctors are actually the victims and it's all the insurance companies, even though doctors have way more political and social sway than insurance corps. How doctors are the victims of the executive leadership of hospitals, even though those executives are usually MDs as well..

How can the problem be fixed if we don't even talk about it? How do you even negotiate with, "Yeah but you're going to need a doctor some day, so you better not be critical of them in any regard." ?