Comment by ethbr1
3 months ago
> Maybe starting with principles and making yearly changes that can easily be undone or redone by future administrations is the only path forward.
I'd trend in the opposite direction. The death of bipartisanship (due to changes in media, education, and gerrymandering: none likely to change soon) render democracies incapable of solving large problems over a multi-voting cycle timespan effectively.
Ergo, the best solution is to punt to an independent body, in the same way central bank management was done.
It makes more sense to have democratically-elected government responsible for and deciding the details, but not the strategic arcs.
Healthcare, national debt / budget deficits, military procurement, voting rights enforcement, education policy would all be better off in consistent hands, even if occasionally less capable ones.
Sometimes, it's more important to keep to an approach than have the optimal approach.
Now? Most democracies get the worst of both worlds there.
The problem, at least in our American mindset, is that since America’s birth, there has been a marked reluctance to have unelected bodies be responsible for anything that impacts the people, ESPECIALLY anything that presumes some globalization intention or some overarching aristocratic ruler (and with good reasons).
Central banking works because problems are instantly catastrophic to the system, whereas healthcare systems are not that fragile. They can survive broken for a long time.
Everybody is okay having a central lender of last resort because the problem is technical, typically unemotional, and in general, benefits every participant equally (because everybody loses is the system collapses).
Healthcare is different in that it affects MY decisions on a regular basis. America is individualistic and self reliant. We never want some government bureaucrat deciding what treatment [I] should or shouldn’t get if [I] can afford it with my own independently earned money. [You] should take care of [Yourself], save your own money, eat healthy, exercise, or not, and live with your consequences.
States have power too. So it does not matter much if some Bernie politician has some fantasy about some central single payer system that has some theoretical average benefit if it restricts ME from making my own choices.
Other countries have other cultures and foundational principles, so Bernie may have better luck there.
But not here.
Is it limiting? Probably for this case. But the fact is the system works for many other things. Everyone wants to come here. It’s the best country in the world etc etc. It does not have to be perfect. But it’s the best we get with the philosophy that made the country what it is.
Does it suck for healthcare? Overall, probably. But not for [ME].
We saw the system has limitations in other cases (think pandemics etc, but even now, many Americans can’t forgive the politicians that kept them imprisoned in their own homes).
You have a right to life, liberty, and pursuit of happiness. But not to anything that must be provided by someone else, like healthcare.