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Comment by maximente | Hacker News Reader

you've inappropriately reduced this into three bins, ignoring all nuance which is the actual hard part of the problem.

in option G, how much $ do we spend on terminally ill patients in order for them to have a few more days with their loved ones?

or how about smokers who will as a result of their actions will cost spades more than "good souls"? or type 2 diabetics on dialysis?

this false trilemma is largely useless and only presents one side of a moral choice and even then ignores the other prickly of it (read: the people paying for this glorious utopia and where the lines are drawn when it comes to saying no)

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Either the system we have today works because we put enough money into it, and therefore would continue to work if we nationalized; or our system has unjust failures that we should seek to rectify.

We already pay for our healthcare in the US, we just do it predominantly via employer-contributed job benefits, and existing Medicare/Medicaid. The money for the bulk of healthcare is already there, but there are people falling through cracks all the time.

Is your position that bringing everyone's healthcare up to Medicare's baseline is too expensive? Where is the extra cost coming from?

> Either the system we have today works because we put enough money into it, and therefore would continue to work if we nationalized; or our system has unjust failures that we should seek to rectify.

That is very bad reasoning. Most things don't get cheaper when they get nationalized. There is some evidence healthcare may be different in this regard, but the point is: costs are not invariant under nationalization.

> Is your position that bringing everyone's healthcare up to Medicare's baseline is too expensive? Where is the extra cost coming from?

Cost of providing the existing service is not the only cost worth considering. The other issue is opportunity cost of innovation. Right now there are powerful incentives for people to innovate in the healthcare space, particularly in pharmaceuticals. But also in prosthetics and the procedural space. Nationalization is likely to crimp those incentives, and thereby lead to less innovation over time.

> or how about smokers who will as a result of their actions will cost spades more than "good souls"? or type 2 diabetics on dialysis?

Why not just tax the cigarettes and subsidise bike roads instead of car roads?

> in option G, how much $ do we spend on terminally ill patients in order for them to have a few more days with their loved ones?

Zero. They would be explicitly avoided care if they are known being unable to return to work nor parent somebody (higher-order parenting such as grandparents, uncles, aunts count too).

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