If I subscribe to an RSS feed it's because I'm interested in the content. I might appreciate better ways of filtering, but I still want to see all of the items in the feeds.
I do the opposite (eg, I read HN via RSS), and definitely don't want to see all of the content.
My reader (newsboat) is good at showing items at-most-once, and (at least the way I use it) punts to a browser to display content on the rare occasions I have further interest. Does this count as sufficiently-non-email-clienty for TFA's purposes?
I can't think of any credible reason not to have universal healthcare at this point.
Maybe 20 years ago but there is too much empirical data across multiple countries and environments now.
Assuming our cost for care drops commiserate to what's been seen in other countries we could use the saving to increase merit scholarships for the contributing young as a introductory form of UBI.
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." ?
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.
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.
> 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:
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.
Other places can only afford universal healthcare to begin with because their healthcare sector is not nearly as corrupt or shackled by a huge amount of government regulation that was only put in place here for self-serving reasons. It's not about the model of provision, it's about whether the sector itself is sustainable. U.S. healthcare is doomed by its vast spiraling costs even after controlling for its supposedly higher quality.
>Other places can only afford universal healthcare to begin with because their healthcare sector is not nearly as corrupt or shackled by a huge amount of government regulation that was only put in place here for self-serving reasons.
> healthcare sector is not nearly as corrupt or shackled by a huge amount of government regulation
Healthcare is not corrupt. Insurance companies are corrupt.
And regulation is lacking in Health Insurance and enforcement is lacking in healthcare. (So many doctors that have committed malpractice just switch hospitals.
> U.S. healthcare is doomed by its vast spiraling costs even after controlling for its supposedly higher quality.
Healthcare costs are high because of insurance companies and private equity, not doctors and hospitals.
So please stop with these right wing baby bird food regurgitation.
> Healthcare is not corrupt. Insurance companies are corrupt.
There’s a crazy amount of corruption in the healthcare space. Some of the medical fraud busts that come out every year have staggeringly large sums attached. In some areas there are still schemes that openly recruit poor people to use their information to bill for medical care that is not actually necessary or provided. It’s wild.
> Healthcare costs are high because of insurance companies and private equity, not doctors and hospitals.
Sorry, the world isn’t so simple that you can pick your villains (insurance companies and private equity) and declare everyone else to be free from blame. There’s a lot of bad behavior in these systems at every level. Yes, including some doctors.
If we removed insurance overhead entirely, your healthcare costs wouldn’t change more than a few percent. It’s amazing that everyone united against insurance companies as the cause of high healthcare costs when they barely take a few percent of the overall spend.
> Healthcare costs are high because of insurance companies and private equity, not doctors and hospitals.
It is actually the opposite.
UnitedHealth, one of the 'worst' insurers in terms of denials, has a profit margin of ~5% [0]. It is mainly the providers that overcharge, under the guise of "the less and lower we bill, the less and lower insurance pays us".
Insurance only works if there is at least as much going into the pot as is going out. What do you think would happen if insurances weren't denial hawks?
Get angry at your doctor for overcharging you whilst using insurance companies as the heel.
The reason UnitedHealth has such a low profit margin is that their profit margin is capped by the ACA's Medical Loss Ratio provision. They fraudulently get diagnoses for their insured patients to upcode and incur more charges to Medicare Advantage that they can collect their profit from. Any doctor could have told you this has been going on for years.
https://www.google.com/search?q=UnitedHealthmedicare+advanta...
If the government were the insurer, it would not have the same incentives to commit this fraud.
As a person who moved to US from Europe recently I can say that prices charged by US healthcare providers are ridiculous - all overpriced 10-20x compared to my home country.
> Healthcare is not corrupt. Insurance companies are corrupt.
¿Por qué no los dos? Guess what, it's a lot more likely that insurance companies will go corrupt if what they interact with - healthcare - is corrupt.
> private equity, not doctors and hospitals.
Guess what is limiting private equity's ability to compete amongst themselves in expanding the effective provision of healthcare and driving costs lower for the ultimate stakeholders i.e. patients? That's right: doctors, hospitals (including those that are nominally not-for-profit, but where the profits just turn into salary for those who can control that flow of money) and government regulation throughout the sector.
No, they could not have, based on the voting records of the previous 30 years of the federal US Congress. Even what they have passed only by the skin on their teeth.
The only federal wealth redistribution policy in the US in my lifetime of almost 4 decades only had a 6 month window of passing in 2009. And half the population still hates it, and has worked and succeeded at gutting major parts of it.
Even better you can have both like a lot of countries in Europe. The access to public healthcare also keeps the premium down. Extensive cover for a family of four is less than 200 in Spain a month out of pocket.
Actually in Spain Social Security is 30 to 40% of what you earn. From the remainder 60% it is up to 50% in IRPF taxes, so you could pay 70% of what you earn.
The trick is that Franco hid the social security tax in the company side so normal people don't see it, but it is there.
Over that there is IBI for your house, there is IVA on anything you buy, and there are central bank inflation taxing anything you own in absolute terms.
Oh don't get me started on the taxes. Just the solidarity tax they added from the younger generation to the pensioners makes my blood boil. How about cutting the top pensions and returning some of the money to the bottom of pile instead. The tax regime is also destroying small independent businesses.
But we have at least the option of additional private coverage and it is not crazy expensive like in the US.
Abortion is currently too divisive in the US to get a national health care system going. One side will absolutely refuse to include it and the other will absolutely require it. If one side brute forces it there will be immense backlash.
Along similar lines it isn't clear that having the federal government controlling healthcare at a more fundamental level is a good idea. Many (most?) would shudder at the thought of this administration controlling healthcare.
You can absolutely have a stab at it. Estimate how long models last for, amortise over that time/number of calls. We've seen enough models go out of fashion for that to be reasonably done.
Presumably because Sweden is selling some of that cheap power to Germany.
The solution to which is to generate even more power in Sweden (so you can sell it off cheap and have it cheap too) or that Germany produces power more cheaply so that it's not giving Sweden so much money for electricity. Both of these should happen if the market is set up well.
The company that runs it for the government, or the company who owns it for the government?
If the government owns the infrastructure, but outsources the day-to-day running to a company that's one thing. But if the infrastructure is owned by the third party then that's a lot harder to deal with.
> If the government owns the infrastructure, but outsources the day-to-day running to a company that's one thing
This is still very problematic. To be honest, even using foreign hardware or propietary software is problematic. But you should reduce dependence as much as possible because it is a huge vector that should the foreign government decide to turn on you openly or secretly, it could bring you down before you have a chance to detect what is happening. I believe wars between developed countries will operate at this level (i.e. by targeting foreign dependency chains whether it be national systems for id or simply cutting undersea cables)
I agree that it's still problematic. But you can recover from that by hiring your own staff and slowly taking over the running of the system. No doubt there would be issues, but it would be doable.
Recovering from "Your critical national infrastructure is physically owned by someone else" is much trickier.
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