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Free market-based US healthcare system? Which US are we talking about?

Australians (and other outsiders) use that term when talking about aspects of the US because that is the Hollywood picture of how the US functions. That is the lie that is sold, and people outside have no way to know it’s not true. Even today there are hundreds of millions of Americans who say they live in a free market and that it’s the best thing ever.

> Australians .. use that term when talking about aspects of the US because

Australians have a weird sense of humour - it's clear from here that most aspects of US economics are decidedly not free markets but so many US citizens never shut up about "free markets" and have such a bicameral Capitalist v. Communist view of the world that it makes sense to just deadpan nod along.

Maybe reread https://news.ycombinator.com/item?id=41856242 and ask yourself if the article really thinks the US health system is a proper Adam Smith free market .. or just a "US free market" with extra heavy air quotes.


"Free market" is one of the best examples of a technical term people use with complete confidence despite not knowing what it really means. Furthermore, even if you do know what it means you probably remember it as something you learnt on day 1 of economics class before learning all the reasons they never really exist and what governments try to do about that.

I’m not sure that the impact on the debtors is even the worse part. The removal of any apparent consequence for the cost of education also seemed to remove an incentive for the university to provide a quality product.


For number 2, how did you come up with the very narrow 15 year window of birth from 1980 to 1995? I was born in 1963 and for the entirety of my upbringing it was a forgone conclusion that the lack of post high school education had a dire and inescapable consequence in future earning and socioeconomic status.


I was born in the mid-70s, and nobody told me "Just go to college, any college, and major in anything." That was never the narrative.

It was "Go to a top-N college, major in one of these very carefully enumerated majors that tend to result in good career trajectory (business, engineering, medicine, and so on), and maintain a very good GPA throughout." The messaging was very clear, from parents, teachers, and guidance counselors: Don't go to film school or a Tier-2 university and major in history, if you want a career.

I'm not sure when the "Go to any school, and do whatever" messaging started but it was not happening in the 90s when I was in high school.


I grew up in the latter half of the 90's and the narrative I remember was that it was a time when even like entry-level secretary jobs started requiring degrees (a phenomenon which may or may not have been exaggerated), and the reasoning was "it doesn't matter what it's a degree in, they just want to see that you have the capability to see something through to the end and not drop out"


was still told this and i graduated college in 2024. it did work out for me, but for the vast majority of ppl in my graduating class, unless they double majored from B School or did a proper STEM degree, they’re unemployed


Because at that time an engineering degree still had some weight because not everyone can get it. This inflation 9f degrees caused the degrees to have way less value only for the next generation


The Boy Scout rule.


Yes, along with capitalism, free markets, anti-union - once you have enough positive confirmation bias momentum on words already agreed upon as bad, then all you need is a little ad hominem implication nudge and you captured a large number of readers.


> along with capitalism, free markets, anti-union

On the other side you have socialism, DEI and cisgender. You really don't have to make a point to get that section riled up, just mention the term. (One could literally start a speech to the respective crowds by repeating a single word, e.g. corporations or socialism, taking a dramatic pause, and get a strong response.)

And again, it's safe to toss out policy feedback that obsesses over these terms. (Both the far left and right also have a weird obsession with capitalising random words. I think it seems evocative of Enlightenment-era English?)


Absolutely. It goes both ways. I just realized I may have implied otherwise. I was sticking to the negative words that go with corporation.


Yea I have a hard time distinguishing focusing on return vs focusing on product. They’re complimentary, not mutually exclusive. I hope those implementing my investments are focused on both.


Disagree; consider enshittification; that process embodies the essence of focusing on return vs product.


Hopefully they won't change propellant to high pressure cow manure


In context it is too early in the cycle for SpaceX to begin enshittification. Wait until they start cutting Mars passenger’s legroom…


Oh gawd, now that's a not pleasant thought. Thinking of long haul space flights in terms of today's air travels. I shudder at the thought of being in the middle seat for the duration of that trip


There’s no reason for that. There’s no shortage of space in transit, and plenty of ideas for making transit comfortable (inflatable habitats or reusable cyclers, for example).


> There’s no reason for that.

It's the exact same reason as it is now for air travel...profits. It doesn't matter the size of the ship. If you can squeeze the space to increase the number of occupants per flight on the same ship, you increase revenue. That's all corporate bean counters will care about. I would not be surprised if they hire a similar team that airlines have now that get paid to specifically redesign seats to squeeze more in per flight.


There's no air in space, so there's no need for aerodynamics. Inflatable structures allow for quite a bit of volume during transit without much impact on structural mass. This is not analogous to airplanes.


Yes this exactly. Our entire economy is enshittified and becoming more so daily, and it's precisely because we've become a 100% production for profit economy. Eventually you lose the plot when you do that.


I think they were responding to the general claim that clinical trials can’t be faked, not the specific one from the article.


If enough people wanted the same cars as the Vox author wants, they’d be made.


Not if you set up the market such that other cars are significantly cheaper. The market is only free to respond to demand when an intersection of demand and regulation makes it economical.


I thought it was an observation of a market that is primarily free.


Correct. While there are many rules and regulations that affect the auto markets, ultimately cars, including Europe, have grown in size because of market forces (I.e. what consumers prefer)


The entire article this comment thread is attached to is a liturgy of all of the policies affecting this market, and all the distortions created by the various actors.


Despite tariffs and regulations that restrict how "free" the market is compared to other vehicle markets overseas?


At the expense of other families not a party to the monopoly.


Unions: join us, let's increase our bargaining power together and improve all our economic situations.

Anti-union workers: No.

Also anti-union workers: Look at these union workers making more money than us, at our expense.


That's not a contradiction. Unions can and often do become just as dysfunctional as any other kind of government. People abuse their power and force out those that won't go along with it.


So do companies. What's your point?


> At the expense of other families not a party to the monopoly.

Corporate profits are unpaid wages. Non union workers can organize, it is a choice. Otherwise, continue being economically impaired by corporate shareholder and management actors on your own time. If you don’t organize against corporations, they would extract until there is nothing left (broadly speaking, some companies don’t embody this ethos, but many do).

Union support is highest amongst Gen Z, so you’re just waiting for older conservatives and anti union folks to age out for the pendulum to swing back from the damage Reagan did. 1.8M voters age 55+ age out every year, half of those folks are still in labor force participation, while 4M voters turn 18 ever year. It’s a demographics and electorate turnover story more than anything (trajectory + time horizon).

https://www.marketplace.org/2023/01/03/gen-z-is-the-most-pro... (“Marketplace: Gen Z is the most pro-union generation”)


> Corporate profits are unpaid wages.

what about corporate losses then?


Layoffs, pay freezes, cuts to wages/bonus/raises, etc?


They're not reasons for a CEO to get a multi million exit package.


A lot of leftist argue for worker owned businesses. Wouldn't that mean that losses would effectively be owned by the workers?


What do you think happens when a company is losing money?

It's not like the shareholders are just eating that loss out of the goodness of their hearts. Instead there are layoffs, cancelled projects, and pay cuts. All of those are workers bearing the cost of the losses.


Are discounts then customers pilfering the pockets of the workers? Combo deals?

How consistent is your ideology really?


> Are discounts then customers pilfering the pockets of the workers? Combo deals?

No. That's marketing. Marketing is a strategy used to help turn a profit. Giving away that profit to shareholders makes absolutely no contribution to the ability of a business to turn a profit. Those aren't remotely close to similar.


And what's wrong with that?


I'm sorry you're choosing to let corporations exploit you instead of fighting with us for better wages. But that's kind of on you, not on us.


People can have bad individual experiences with unions. A not very pro-union friend ("They're not all good, you know.") told me about her early career as a typesetter, how she taught herself how to repair the linotypes and letterpresses, the difficulties after unionization, and their shop's eventual shuttering. She felt that the union had taken things over and then failed them.

When I asked her how the hell non-computerized typesetting was even still a job in the 80s, she looked kind of thoughtful for a minute and just said "huh".


The world is shades of grey, not black and white. My only experience with union work is as a non-union developer brought in to fix the software of union government developers. They were legitimately terrible at their jobs, unable to code anything or be useful outside of QA work. I made significantly more money than their capped government salaries as well. The flip side is their job, healthcare, and families were much more secure than mine.

I’m fine with people being lifted up, but it’s very frustrating when your coworkers carry no burden and do nothing. I have no idea about other industry, but in government it’s so hard to let people go that no one bothers to even start the paperwork, they just hire non-union contractors to do the actual labor. Worst of all worlds.

This is average middle America, not a tech hub in any way. I’m a fairly average dev.


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