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Comment by atoav | Hacker News Reader

What I as an European always found weird is the fact that this is a political minefield in the US. As if there are not enough nations that have shown how health care can be organized in a good way for the benefit of all, for decades, all while having thriving economies.

It happened more than once to me that in online discussions an US-american told me a thing was "not possible" that I grew up with my whole life. I am not sure if I would've become a freelancer if I had to worry about my state just letting me die if things don't work out.

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The best explanation I can come up with (as an American) is that a large portion of Americans are incapable of rational thought when it comes to healthcare policy. They've somehow been led to believe that their system is run by the "market" and that that no system could possibly function better. The fact that many other countries do better does not matter. I find it best to analyze these people as if they were religious zealots rather than rational thinkers.

They're just misinformed. The US health care industry is among those most heavily enmeshed with government at all levels (regulation, gatekeeping employment, funding/subsidizing, etc.). Whether you think it's good or not, most everyone would agree that level of involvement would result in a heavy distortion from what the free market would provide on its own.

One rhetorical approach might be to say that since this is already the case, let's acknowledge that reality, then decide whether to increase/decrease/alter that reality.

I don’t think it’s just that they’re misinformed. It’s the fact many can’t even consider that they might be wrong. Often they take a critique of the American system as a critique of them personally. It’s totally counterproductive to any potential improvement of society. I find it quite depressing.

> It’s the fact many can’t even consider that they might be wrong.

What you mean like saying that the only explanation for disagreeing with them is not being capable of rational thought?

This is a major problem in American politics, maybe the biggest problem. Neither side is willing to accept they might be wrong, or even partly wrong. Or even really listen to the other side's position.

I agree with you that that other countries have better healthcare, and we should try and make ours like theirs. But ad hominem attacks on the other side are not productive and do nothing to convince them.

> What you mean like saying that the only explanation for disagreeing with them is not being capable of rational thought?

Honestly, what are you talking about? What am I disagreeing with exactly? Could you be a little more specific?

> I agree with you that that other countries have better healthcare, and we should try and make ours like theirs. But ad hominem attacks on the other side are not productive and do nothing to convince them.

How is this an ad hominem? I’m making these statements in general to a certain audience on hacker news. I’m not making it to any specific individuals. Just because I think many Americans are idiots doesn’t mean I tell them that directly. I pretend like their nonsense isn’t nonsense because they’re more receptive to that. In other words, I do basically the opposite of ad hominem attacks when engaging with these people. I talked to them quite patiently. But yes I do believe many of them are morons.

Edit: The more I read your post the more confused I get. What side am I on exactly? The side that believes that American healthcare outcomes could be better? I could hold that opinion even if I thought more—not less—deregulation is necessary. I’m not complaining about people who want to improve American healthcare even by making things “more free market”. I’m complain about idiots (and yes they are idiots) who can’t fathom that other systems might have better outcomes because they are “socialist”. They don’t even consider statistics and analysis they just conclude the US is better because our system must be. That is inexcusable and basically incompatible with any progress in society.

I see, I misunderstood what you were trying to say, because I have never encountered anyone who didn't think the American health care system could be better. Although, I don't doubt that such people exist.

You haven’t met Americans who think European systems are worse because they are “socialist”? Seriously? It’s a pretty common political talking point. I’m kind of amazed you wouldn’t have been exposed to these ideas.

Sure, but they don't think that american health care is good. They think the solution is for the government to be less involved in healthcare, or at least make it more competitive.

You misunderstood my point. Whether a system is "socialist" or "market" says nothing about whether a system is good or whether it is better than another. The only way to measure whether a healthcare system is good is by looking at the outcomes of that system. The comparison to programming would be if people declared a program written in rust to be better than a similar program written in python simply because of the language. That makes no sense. It is certainly possible to produce programs written in rush that are worse than ones written in python.

The point is that the measure of the quality of healthcare systems shouldn't be whether they are socialist or something it's looking at life expectancy, efficacy, cost, etc. Those are the things that actually matter. Hence "but they don't think that American health care is good" is missing the point. A common talking point in the US is that American healthcare is better because it's not socialist (or some essentially equivalent argument). It's total nonsense. An introspective American with a little humility might wonder "I've been led to believe my system is better because it is not socialist, but outcomes in other systems I consider socialist seem better". An introspective American might wonder if this belief "the solution is for the government to be less involved in healthcare, or at least make it more competitive" is truly worth holding given that so many supposedly less competitive systems have better results.

Maybe in summary, think in terms of actionable information about systems and not nebulous undefined dogmas such as "socialist" or "market".

well, markets with broken incentives can be dangerous for humans, especially when the product is your life, which is literally priceless.

I know many people who oppose "socialized healthcare", and they definitely agree that the current system is broken, but they think the solution is to decrease government involvement and/or make it more competitive.

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