Complexity.
There are too many parties. There are too many bespoke party-party contract. There are too many new middle-parties being created, with their own contracts. There are too many systems. There's too much tech debt.
That's a reason improvements to the US healthcare system have generally been via HHS/CMS imposing standardization mandates ('or no Medicare payments').
But providers, facilities, and insurers (most operating on low margins) can't be collectively more meta-efficient without simplifying the system.
Single payer / Medicare for all is a critical start not because of coverage, but because of simplicity.
There are so many intractable problems with the current system simply by virtue that changing anything about them requires 100s of parties to update 10,000s of party-party contracts and interfaces.
That's the biggest source of waste in the current system: constant duplicative re-engineering.
Health insurance company margins are meaningless. All the large insurers are actually "pay-viders", meaning they own huge (and growing) chunks of the physicians (providers) they pay out.
Go read STAT's Colossus investigative series on the myriad ways UnitedHealth Group abuses this structure. All the other pay-viders do the same.
Pay-viders can "generate x% profit" for any value of x. They control all the relevant levers, which also by coincidence eliminates any incentive in the entire system to reduce costs.
They are required by law to only make a certain value of x, and so, surprise surprise, they all make x!
Where do you think that money comes from?
You could just delete united healthcare and save bucketloads of money. They don’t actually do anything anyone wants, other than extract money as a middleman.
Iran military is trying alright.
I never understood these kinds of arguments and they always come from those defending US military might.
Either they can do it or they cannot, if "the US public wouldn't support the immense cost in lives and treasure it would take to do it" is true, which it appears to be, then the US Military cannot control Hormuz.
So it means we aren't fighting in Iran the way we would in defending a hypothetical invasion of the lower 48 states, great.
But does it mean we'd fight any differently in the South China Sea, a Russian incursion into Poland, etc. Unclear, and presidential whim based.
Of course, other Presidents have been willing to put in some sort of effort to make to make a case. And usually have some of theory of victory or purpose. And generally avoid making weird random claims about invading NATO allies.
The entire 25+ year GWOT era has resulted in 7k American military personnel dying.
Vietnam that number was closer to 60K in 8 years, when US population was also 33% lower.
Dramatically different impact on society.
Sending marines to take an island in Hormuz or a carrier under fire in the South China Sea might look a lot closer to Vietnam than GWOT in a hurry.
All the money in the military has gotten us, almost certainly, the ability to conquer virtually any plot of land anywhere on the planet at any time.
But that does not (thankfully) intrinsically generate the political resolve required to do so.
Democracy and markets are beautiful things. It's fantastic that it can constrain even a military as mighty as the US and a commander in chief as braindead as Trump.
I've seen the same logical fallacy used everywhere; including people hyping Russia and China.
They don't though
People always say this, but I suspect Americans are more unhealthy in general and actually need more healthcare per person.
We have a development pattern where people barely walk, but less walk or cycle to work.
I don't see how they could manage that without a full-scale invasion and control of Iran. It's far too easy for Iran to launch drones/torpedoes from small watercraft or from nearby land. I expect they could control Hormuz for a while, but it would be very expensive and I'd expect the logistics to break down fairly quickly if the economics doesn't stop it first.
I suppose "could" here is a bit of a stretch. Like technically, yes, you could if you whipped up your country into enough of a frenzy to support it. Hell, Iraq happened (twice), so I suppose it has historical precedent. And yes, a full-scale invasion of a fully committed US military should absolutely be able to conquer and hold Iran. But I can't imagine any circumstance where that's possibly going to happen in today's reality (outside of an Iranian terrorist event on USA soil, for instance).
I doubt that - Iran is very large and would require something like conscription in the US to get anywhere near the required amount of troops. The US doesn't have a great track record with conquering and occupying other countries.
This is like saying "I could easily afford a Ferrari. It's just that I wouldn't be able to make the interest payments on the loan". Military conquest is more than just guns.
And nice cop you have there. Its because the US public didn't want it. Not because US military capabilities were up to the mark. Nice try.
Was the 300 billion war reparations US signed to pay also something that the US public wanted?
Vietnam is more like asking the question, could the US Military occupy all of Iran? Which I think the answer is essentially No, just like Vietnam.
The strait is one small objective , and the US had lots of successes in Vietnam with capturing key strategic areas, they just couldn’t cover that into a successful occupation
Last I checked war reparations are paid by the losing side to the winning side.
US military strength is air and naval forces. Not ground troops. They will get slaughtered if they go against Iran on the ground let alone Yemen.
It's sad, the idiots who signs the deployment is signing the death warrant of the US ground troops. This is not Afghanistan.
The military might be capable of a ground invasion and succeeding. It would be Pyrrhic. Even if Iran was a genuine nuclear threat (I am not convinced at this point that Iran would launch a nuke at anyone if they had it), is it worth 500k dead Americans?
There was never a path to victory that didn't involve ground troops. We aren't losing in Iran because of military incompetence, but policy incompetence. Previous administrations did not do this because the cost was well understood.
There has never existed a military who could win this conflict without ground invasion. This was understood when this administration started it.
My point is these two things are inseparable, and to conflate them is simply Call of Duty-esque military fantasy. It's a feel good war story that doesn't actually reflect the reality of actually winning a war.
If the US military does not have the ability to hold, occupy, and install allied regime change, then the US military cannot win a war with Iran. You cannot separate the short term wins from the long term objectives. No one looks at Imperial Japan and says "they easily bombed pearl harbor, but due to policy failures they couldn't keep control of the South West Pacific theatre.
The US winning WW2 wasn't just dropping the nukes and high fives. There was rebuilding the Japanese nation, aligned to the US, becoming a long term ally.
This is no different than Afghanistan. Future humans aren't going to look back and say "the US easily controlled Afghanistan for 12 years, and then just returned to the Taliban". The lessons learned will be the US failed to hold Afghanistan and the Taliban returned to power and it was a military failure.
No matter how you dress it up, I can't afford the ferrari.
The USA and its allies could sustain the Afghanistan occupation indefinitely, but chose not to(prematurely, in my opinion).
In Afghanistan, the west chose to lose, but victory was possible. We were(we, I was there in 2010) winning hearts and minds of the younger generation but abandoned them. Another Donald victory.
Iran is an impossible situation.
https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
The costs of medicare, medicaid and CHIP to tax payers are about what most Europeans pay in tax for universal health care, but then they also need to pay for health insurance for themselves.
As for controlling Hormuz, the US military absolutely could control Hormuz. I'm confident it's quite capable of it. It's that the US public wouldn't support the immense cost in lives and treasure it would take to do it, and maintain that control. No other military could even try, but the the USA could. It's not a matter of lack of military capacity.