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> This is absurd. There is plenty of money, we could tax something like...

We could spend less money.

In Education we spend far more than the 80's and have less to show for it.

In healthcare we have astronomical costs that have not bought us more vitality, but an extended morbidity. Gone are the days of grandmothers with sinewy arms maintaining huge gardens. Obesity in the early 2000's was at "crisis" levels and it's gotten so much worse that we just stopped talking about it. But we can keep the numbers up a bit here and there.

In infrastructure we let car-first build-out destroy everything Jane Jacobs said we were going to lose. Valuable things that cost no money at all, but are too intangible for top-down planning to notice.

The failure of imagination isn't finding new people to juice. It's finding ways to be effective. I agree they are very bad at their jobs, but I don't think finding a new way to tax the rich is any more creative or sustainable. I think it's the same failure of imagination that you fear.




You are right.

We could spend less money on healthcare by adopting Medicare4All or similar.

We could cut the military budget _dramatically_ without impacting our national security.

And yet both parties have done little but increase the extent to which our countries is beholden to banks.


I disagree, I don't think payer-side things are why healthcare is expensive, but payee-side things (hospitals, pharmacy benefit managers, docs, and the choices that flow from them) + obesity/T2D. I think this is pretty clear from where the money goes and why people in the US need so much healthcare in the first place, and that hamming about insurance is 95% a canard.

If you think you can replicate the healthcare success of [pick your model country] without also replicating their obesity rates, doctors salaries, amount of testing and prescriptions, etc, you will find that who pays for it all is the least of your concerns. As Americans consider it, we probably have too much "healthcare", not too little.

Others have spent far more time than me on this if you're interested: https://randomcriticalanalysis.com/2020/01/31/i-created-a-pr...


The US is pretty close to a lot of the rest of the OECD in obesity rates (in particular, UK/Australia/NZ) https://data.oecd.org/healthrisk/overweight-or-obese-populat...) while costing twice what other systems pay for healthcare.

The stuff about pharmacy benefits and doctor salaries are artifacts of our weird way of paying for things. I'm not sure why you're portraying them as separate, isolated issues.


Or we could fix medicare and medicaid and make them actually efficient. No need for medicare for all.

We just need to fix billing, end price fixing, and massively deregulate - certificates of need, bans on telemedicine, pay for procedure etc. This will actually fix it. Medicare and Medicaid are incredibly expensive and inefficient.


> Medicare and Medicaid are incredibly expensive and inefficient.

This appears to be, at the very least, debatable:

https://www.healthaffairs.org/do/10.1377/hblog20110920.01339...


>In healthcare we have astronomical costs that have not bought us more vitality, but an extended morbidity. Gone are the days of grandmothers with sinewy arms maintaining huge gardens. Obesity in the early 2000's was at "crisis" levels and it's gotten so much worse that we just stopped talking about it. But we can keep the numbers up a bit here and there.

Even funnier is we can blame our covid 19 failures on being unhealthy: https://www.cnn.com/2020/05/17/politics/us-health-conditions...

Obviously this a bit of shift the blame (played by both parties), but we can see that reaching for this argument means we really have failed on the healthcare and preventative medicine side - covid19 just calls this out.




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