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Added the link to my list of reading. Looks very interesting. I do share your cynicism that we have no tolerance for real change politically. The charge of socialism meets every single proposal that involves a little more government involvement.


Lack of government involvement is not the problem with U.S. healthcare. There is government intervention everywhere. My rule of thumb for determining whether an industry is a free market or not, is that I ask the question, "Can I start a business to solve the problem? Or am I legally prevented or constrained from doing so?" In the U.S. I am legally barred from implementing most of my business ideas that would fix the healthcare system, so I do not consider it a free market.

The problem with U.S. politics in general is that it is fractured. Policy is determined by the interplay of powerful, organized factions. Any government intervention gets captured by these factions, and the policy ends up hurting the general interest rather than making things better.

Here is a comment I made a while ago where I explain how American politics works in practice: http://news.ycombinator.com/item?id=557298


NO ONE WANTS A FREE MARKET SOLUTION FOR HEALTHCARE.

get over it.

a free market solution means dying baby gets turned away when parent has no money. otherwise it is not a market solution. no one wants this. no one. move to somalia, you can implement your plan there, life is cheap.

healthcare is not a business. no civil society is going to let you decline cusomters who cannot pay when it comes to keeping the baby alive.


I would think that not killing babies would be the kind of publicity advantage that really sets a business apart from its competition.


Reputation-based consumer feedback isn't a desirable mechanism in an industry where unsatisfied customers are dead customers (as opposed to e.g. dead batteries).


Only when it's a paid customer's baby.




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