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Comment by giancarlostoro

7 hours ago

It sounds like a great idea, then a government shut down happens.

> It sounds like a great idea, then a government shut down happens.

Single payer / universal healthcare ≠ doctors/nurses are government employees (necessarily).

You go to your local health care provider, show your card, and received treatment. The single payer (government) then gets billed and money is transferred to the providers account.

If the government is shutdown, there could be a delay in payment in outstanding bills, but that does not mean health care providers shutdown. Medicare ran during the last shutdown:

* https://www.nbcnews.com/health/health-care/government-shutdo...

* Telehealth was: https://www.pbs.org/newshour/health/medicare-patients-go-wit...

Social Security cheques went out too:

* https://www.cbsnews.com/news/social-security-government-shut...

* https://en.wikipedia.org/wiki/2025_United_States_federal_gov...

Lots of stuff can potentially be automated, and so continue to run.

  • It's possible for some of that to continue, but we really don't know what would happen if we directly connect payrolls and finances of the healthcare industry to the federal government in the US. It's a fair question how such a big connection would suffer when the government is punitively closed in a faustian bargain as part of a political struggle, as seems to be common recently.

    There might be a few top-down emergency provisions to ensure checks go out to keep the system from toppling, but I wouldn't work if my pay is frozen and neither would my plumber, electrician, lawyer, etc. The last few shutdowns have run over a month - that can easily exceed the cash reserves of most businesses (that would be providers) and large businesses would shutter or have layoffs before burning that much cash.

    We can't be so confident in how a $5T/year system would react if its primary cash flow valve is turned off, is all. Handwaving away the scope and complexity doesn't help anything.

> It sounds like a great idea, then a government shut down happens.

How about fixing the government so it can’t be shut down because a few hundred politicians can’t agree on the next budget?

  • Neither party is interested in amending the Constitution, which would be necessary, and even if they were, the country is so deeply divided that it would likely be unsuccessful except maybe to knock a few inalienable rights off the list.

  • > How about fixing the government so it can’t be shut down because a few hundred politicians can’t agree on the next budget?

    "Thanks I'm cured" material. You're not the first person to think of that, and the fact that it hasn't been done yet probably means it can't be done very easily.

Just because the fed exists doesn’t mean the entire economy shuts down with the government.

It depends on how it’s structured.