Category: Hot Takes

Pros and Cons of American Healthcare

I have spoken at some length about the shortcomings of the US healthcare system in comparison to other nations’ systems, the latter including a broad spectrum of both public and private systems which make the US a notable outlier. This has left some with the impression that I see no redeeming qualities in the US system, or worse yet, that I might be presenting a one-sided and biased view. Thus, in the interest of fairness and balance, I have compiled a pro-and-con list. Starting with the merits of the status quo:

Pros:

  • Medical debt peonage is extremely profitable for the owning class, and creates a strong incentive against political rabble rousing
  • Being left penniless is a pretty good incentive for people not to use the healthcare system, meaning a lot of people die young before they can cost the system money
  • Having dozens of different regulatory tide-pools with each state running its own Medicaid, plus different parts of Medicare, plus VA and military, plus each state’s marketplace each with several different companies, instead of a single unified framework means that states and companies can experiment with different things, if there was ever an incentive to do so
  • Keeping healthcare tied to employment, either through job benefits or work requirements, makes workers afraid to bargain for higher wages, which benefits large businesses
  • Between 20% and 40% of US economic activity is tied to the healthcare sector, creating millions of well paid, highly educated, white collar jobs, which act as a lifeline subsidy for the runaway interest created by the student loans taken on by healthcare workers
  • Privatizing profits from manufacturers, insurers, and hospitals means that the stock market basically always wins, which is vital for millions of elderly relying on privatized pensions in absence of social security reforms
  • The concentration of capital in metropolitan hospitals makes them actually pretty good at treating rare conditions, provided you can pay out of pocket, and peerless for conducting research and training
  • The ethical drama of choosing between treatment and other living expenses has created the basis for countless works of art such as Breaking Bad
  • No healthcare system in the world is as good at treating firearms related injuries

Cons: 

  • People who don’t get treatment until an emergency can’t be ignored tend to cost more in the end
  • Cost analysis on the basis of individual appointments or plan years prioritizes quick fixes over actually treating and preventing the drivers of poor health
  • Keeping between a third and half of your economic activity in one sector feels not very dynamic free market
  • Resulting morbidity and mortality rates make the US look really bad compared to peer nations like Kazakstan, Botswana, and Cuba
  • To religious traditions that assign value to human life besides dollars generated to shareholders, the system is morally abominable

Hot Takes

It’s been a busy week, and I have not been able to finish any of the things I have started writing recently. But since I’ve made a renewed personal commitment to try and get myself to post things consistently, instead here are a collection of assorted hot-takes. The sort of things that might be tweeted, if I had any desire to tweet. 

If someone is going to require you to go watch/read/see a thing online, they should be obliged to send you a direct link to that thing. If that link doesn’t work, I am not obligated to hunt it down.
If you park in an electric vehicle spot, I will henceforth assume that your car doesn’t need gasoline. If it has any in it, I will do you the favor of siphoning it out. 
As of this year, experts estimate the number of spam and scam calls has eclipsed the number of legitimate phone calls. With this in mind, if you call me and your number does not come up on my phone, your call will be going to voicemail. 
Handicap spots are for people who need them. Your permission to park there has nothing to do with how long you’ll be parked, whether you remain with your vehicle, what kind of car you drive, how big your wallet is, or what power you have over the rest of the facilities. If I have a handicap tag and you don’t, you’re in my spot. 
On a related note: it’s true that under the Americans with Disabilities Act, accessible restrooms / stalls are not exclusive to those who rely on them. However, those that need them don’t always have a lot of options. I get that sometimes when you gotta go, there’s no time to look for other options, and okay, fine. But while I’d hope that you would clean up after yourself regardless, if you are leave a handicap stall worse than you found it, you are a horrible person.
There is a difference in a public space between giving your kids room to explore, and letting them run wild. This is up to you to find the balance. However, if your children are causing property damage, are infringing on my personal space, or are making such a ruckus that I have to turn up my music volume above that which is required by the ambient noise of the surroundings, you are failing.