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[parent] [thread] 13 comments
1. gottor+(OP)[view] [source] 2024-08-11 00:35:41
> we let our legacy ICE vehicle manufacturers dictate the terms of the shift to electric

Is that true? There was a policy push here to sell EVs, though there of course is continuing debate about what the magnitude of that push should be. The market so far in the US has spoken against greater adoption of EVs, for various reasons.

OP's article doesn't mention or discuss two very salient factors: one, that EV use in Shanghai is massively subsidized, both at the point of sale (EVs are free to register, whereas ICE vehicle registration starts at $15k) as well as to the producers; and two, whether such a subsidy is in fact for the long-term benefit of the public.

> other countries have a more stable and hour-for-hour productive workforce because their workers can get preventative care and treatment for illnesses quickly and without a fuss

No one would argue that healthcare in the US couldn't be improved, but I disagree that the payment model is the biggest issue. The way I see it, the biggest issue by far is that people are just very, very unhealthy! A full three quarters of adults are either overweight or obese. No country can have a cost-effective healthcare system with this kind of population.

And the distribution of healthcare spending is extremely lopsided, with the top 5% of spenders accounting for over half of all healthcare expenditure, and the bottom half of spenders comprising a mere 3% of spending[0]. (A few countries with socialized healthcare are starting to toy with the idea of just letting those high spenders die, with assisted suicide.) I don't know that a better system can be achieved without first promulgating a culture that values being healthy.

[0]: https://www.healthsystemtracker.org/chart-collection/health-...

replies(1): >>socksy+e4
2. socksy+e4[view] [source] 2024-08-11 01:46:41
>>gottor+(OP)
In a system where healthcare is socialized, you also get strong incentives to introduce policies that can reduce that cost. Examples would include the UK's ban on cigarette branding, introducing a tax on sugar in soft drinks, and banning smoking in public spaces.

Where I live in Germany we have a system I would characterise as somewhere in-between a fully socialized single payer system and the American system (you have insurance companies you choose between, but you're required to have some kind of insurance, and there are a set of "public" insurances that must meet a certain standard at a certain price). But here I can't buy a sugar free Fritz Limo, nor go to a popular bar or club without inhaling smoke.

Obviously countries can enact such policies without socialized health care, and things are not all sunshine and rainbows in the NHS. But I reckon that waiting around until there's a healthy populace before bringing in a better health system might not necessarily be the best strategy.

replies(3): >>froh+B5 >>klipt+s6 >>roenxi+g9
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3. froh+B5[view] [source] [discussion] 2024-08-11 02:09:32
>>socksy+e4
> But here I can't buy a sugar free Fritz Limo, nor go to a popular bar or club without inhaling smoke.

too many double negations?

where I live in Germany, smoking is plain banned in clubs. and sure there are sugar free drinks both on the menu and in shops.

so I don't get what you mean?

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4. klipt+s6[view] [source] [discussion] 2024-08-11 02:24:18
>>socksy+e4
> you have insurance companies you choose between, but you're required to have some kind of insurance, and there are a set of "public" insurances that must meet a certain standard at a certain price

That's basically Obamacare. Except in the US most people still get health insurance through their employers.

replies(2): >>seanmc+47 >>Diogen+hd
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5. seanmc+47[view] [source] [discussion] 2024-08-11 02:36:00
>>klipt+s6
The conservative heritage foundation got the idea from Switzerland. Romney then adopted it from the heritage foundation Massachusetts and Obama decided it was the path with the most Republican (and so bi-partisan) support so pushed it for the rest of the country.
replies(1): >>underl+b9
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6. underl+b9[view] [source] [discussion] 2024-08-11 03:15:16
>>seanmc+47
Obama worked really hard to get Republican buy-in. He held that big meeting with Congress that was meant to be a sort of a summit (where they stonewalled him), and even let Pelosi kill the public option. Nothing doing; the problem wasn't that it was good or bad policy, it was that it was Obama's policy (after it was Romney's, after it was the Heritage Foundation's).
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7. roenxi+g9[view] [source] [discussion] 2024-08-11 03:18:48
>>socksy+e4
> In a system where healthcare is socialized, you also get strong incentives to introduce policies that can reduce that cost. Examples would include the UK's ban on cigarette branding, introducing a tax on sugar in soft drinks, and banning smoking in public spaces.

Strictly speaking the incentives don't change much. People have a strong incentive to stay healthy no matter what system is in place, and the insurance companies have a strong incentive to make sure people know about the risks of sugar drinks etc.

replies(1): >>aaomid+pd
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8. Diogen+hd[view] [source] [discussion] 2024-08-11 04:40:55
>>klipt+s6
Both the public and private insurances are far more regulated in Germany than Obamacare.

If you're on a public insurance in Germany, you rarely pay any substantial copay, and there's no concept of a deductible. Not only that, but the price of the policy is a percentage of your income (capped at some absolute upper limit), so if you make little, you pay little.

Prices paid by public insurers to healthcare providers are fixed, and even the private insurers aren't allowed to pay providers more than a certain multiple of the public rate.

In other words, in Germany, the government has a much stronger hand in setting prices for both patients and insurers than under the Obamacare system.

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9. aaomid+pd[view] [source] [discussion] 2024-08-11 04:43:00
>>roenxi+g9
I don’t think you’re really getting incentives here.

For example, countries with socialized healthcare have significantly more walkable and bikeable cities. That’s not a coincidence.

replies(1): >>roenxi+Ld
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10. roenxi+Ld[view] [source] [discussion] 2024-08-11 04:50:53
>>aaomid+pd
That example is silly. It implicitly suggests that if a country suddenly switched to a fully socialised healthcare system their cities would suddenly becoming more walkable. Or if an economy liberalised then their cities would magically become less walkable. The chains of causality there are absurd.

The most plausible link would be if people couldn't afford cars under a socialised healthcare system; but I doubt anyone is going to try and argue that seriously.

replies(1): >>defros+ae
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11. defros+ae[view] [source] [discussion] 2024-08-11 05:01:00
>>roenxi+Ld
> It implicitly suggests that if a country suddenly switched to a fully socialised healthcare system their cities would suddenly becoming more walkable.

No. It does not. Not "suddenly" or "magically".

What does happen is that social health concerns and advice feed back into other public policy making decisions.

Advertising agencies get contracts for campaigns to improve health awareness, walking and biking paths become routine considerations in city planning, etc.

This takes decades to iterate through from non existent to commonplace.

replies(2): >>aaomid+nk >>roenxi+uw
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12. aaomid+nk[view] [source] [discussion] 2024-08-11 07:06:22
>>defros+ae
Yup thank you
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13. roenxi+uw[view] [source] [discussion] 2024-08-11 10:28:20
>>defros+ae
Yeah sure. You got any references for this ridiculous linkage of local town planning and healthcare funding scheme?

You might like to check whether the layout of the citys involved were decided on before or after the invention of the car - and the introduction of universal health care - before you post anything. That'll probably come up.

replies(1): >>defros+6x
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14. defros+6x[view] [source] [discussion] 2024-08-11 10:38:29
>>roenxi+uw
Quite the attitude you're sporting there sparky.

https://www.youtube.com/watch?v=YXoHCDK9kfM

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