Well thought out, well said, and I agree completely.
The fact that change must be deliberated is not an excuse for a system that intentionally makes change difficult or near-impossible just as a matter of principle. Sometimes failure to react to changing circumstances is far more risky than blocking change just on the general principle of distrust of change. On the matter of health care, for instance, every advanced nation on earth has implemented guaranteed universal health care. The UK did it in a sea change of social reform after the Second World War, Germany has had it since the time of Bismarck, and Canada caught up through a series of rapid reforms mostly in the 60s. The US has been arguing about it for a century, and aside from a few baby steps, has made virtually no progress in a hundred years.
No, they all lack perfection, but virtually any of them is far better and enjoys far stronger popular support than a system that costs more than twice as much as the OECD per-capita average, delivers substandard results, and leaves tens of millions of Americans with little or no meaningful health care or entirely uninsured. Most UHC systems have strong popular support and are also often strongly championed by the medical establishment which understands the tradeoffs and overall advantages to provider and patient alike.
But in the US, what you have is a series of SCOTUS decisions – themselves a consequence of the political process – that now grant virtually unrestricted power to special interests like health insurers and their lobbyists. Combined with built-in legislative inertia, it pretty much guarantees that UHC cannot happen in any foreseeable future.
But by God, you have your pennies and your paper dollars, both of which are needlessly costly to the treasury and serve no purpose whatsoever, just like the worthless uselessness of commercial health insurers. And you’ve successfully fought off the threat of the metric system, being one of three really special countries in the world – Liberia, Myanmar, and the USA – which hasn’t adopted the metric system. Kind of fits with the third-world health care strategy.
As opposed to the current US system, which has all of those serious criticisms at the same time. I challenge you to name any UHC plan from anywhere in the developed world that has any problem which is not shared by the US system. Long wait times? Surprises from things not being covered that the patient thought were? Death panels? We’ve got it all, for only twice the cost.
A huge thing to understand is the tension between states and the federal government.
When the country was founded, the states saw themselves as self governing entities. Our federal government had almost no power under the Articles of Confederation. But without some sort of federal power, the government was doomed, so we had the Constitutional Convention and came up with a Constitution. But we’ve been internally fighting over states rights vs. federal rights from day one. And a lot of what we are saddled with in government is a result of trying to compromise between the two - hence everything from the stupidity of the electoral college to the makeup of the House of Representatives and the Senate.
Its actually not at all a total pile of garbage. Its been successful and fairly stable for a few hundred years - with the exception of our little foray into Civil War (over the states rights to determine if slavery was a thing or not - really about slavery, but under the banner of states rights). There aren’t many governments today that can say the same - and none that have the landmass and population.
ISTM that “states’ rights” remains to this day a dog-whistle term for a state’s right to exercise some form of bigotry, whether it be the traditional target of African Americans, or more recently the LGBT community, Hispanics, or Muslims. Granted there are legitimate reasons for states to retain some level of administrative autonomy, but it’s striking how often “states’ rights” is just code for the aforementioned.
I agree with the OP. How can the US be described as anything other than a abject failure. People are fleeing like rats from a sinking ship. NO ONE even wants to emigrate here anymore. Who do people go to when they needs some international effort to get organize and done? Not the US-- we’re at the bottom of the list. What was last real innovation that came out of the US? All the new technology is being invented elsewhere.
We’re doomed.
ETA: Thanks, Richard Parker. I’m often astonished when someone compares the US to a country like New Zealand. Nothing wrong with NZ (been there, loved it), but it’s 1/100th the size (closest order of magnitude).
Often, but it sometimes has come up in other areas. The ACA Supreme Court cases about the expansion of Medicare was not bigotry, it was a small government argument. Local control of schools - and the anti-Science movement - you can pin it on bigotry but its more complicated than that. Land use. Fights against the EPA. Abortion (again, you can chalk it up to bigotry, but its complicated).
It’s also just not that legitimate a point to bring up. “Hey, ever notice that Free Speech complaints are most often brought up when Nazis are defending their views? Free Speech is just a dog whistle term”.
It was characterized as a small government argument. But if you add “poor people” to the list, it was flat-out bigotry against another underclass. The same crowd clamoring against “big government” has no problem with it when it suits their purposes, like corporate handouts or local pork spending on military projects.
Most of the stuff there except abortion is related to anti-science with regard to climate change denial, the school stuff also touches on teaching religion and evolution denial, and abortion arguments tend to be rooted in theocratic views of religious supremacy. So yes, I agree that those are not strictly bigotry except a kind of regressive anti-intellectual bigotry. States’ rights is not always about classical bigotry, but as I said, it’s striking how often it is. And the rest of the time it seems to be about something equally stupid where a divergence is desired from predominant national values.
Somewhere in there a phrase like “in spite of, not because of” is badly needed in reference to US politics. Like how a country with such boundless natural resources can have such staggering national debt, or how the wealthiest country in the world has so much abject poverty, or how the wealthiest country in the world still cannot manage to have basic universal health care.
Actually I can see that universal health care would very likely lead to significantly longer wait times than we have now. The problem is that complaining about it is very much akin to complaining that after Rosa Parks it is much harder for a guy to find a seat at the front of the bus. The increase of wait times from short to long for those with insurance is the natural consequence of others’ wait times decreasing to never to long.
Almost every system makes change nearly-impossible; those which don’t, make it absolutely impossible.
The rest of your post is mostly uncited nonsense, especially the bit about UHC being absolutely impossible to achieve because the Supreme Court is in the pockets of Big Business. Do you really think the UK has ever been that different? And yet they did it.
It’s a parliamentary system; it happens. That doesn’t mean the civil service didn’t show up to work.
The USA has a strong presidency to avoid that; yet we still have “government shutdowns” where most of the civil service gets laid off, and seats on the federal bench (I guess I have to specify that that means judgeships) that go vacant for several years on end. Strong presidencies can be dictatorships, where the President has the authority to tax & to make law; they can fall apart in short order; or, just this once, one, ever, in all of history, made it about 200 years before finally falling apart in utter impotence.
The next generation of Yanks are going to have to write a new constitution.