How #Socialism in the 21st Century Could Work
via @wallabag
https://jacobin.com/2026/05/market-socialism-capitalism-ownership-exploitation
for many people, capitalism just means we get to choose among a few slave masters. we can't get ahead and then something expensive like a natural disaster or health care emergency shows up. we can't afford to buy a house and landlords can be shitty. education is expensive. inflation.
I'm not for communism but I am for a lot more socialism mixed in with my capitalism.
@wjmaggos
Me too! I would love to live in a socialist country were I can have a few slaves.
I would have a bodyguard driver that has good build and a state-issued car, a cook who has good teeth and hygiene, plus at least 3 different sex slave concubines, that I would keep separate so they don't get their periods at the same time of the month.
What's the state policy on flogging your slaves? I would like to punish them when I'm in a bad mood. Man...slavery is awesome.
@wjmaggos
No. Just a socialist/communist government, which requires slavery to function.
I don't understand where you're drawing the line then. what makes it slavery? Is an ambulance ok but not universal health care? Roads but not subsidized public transportation? Public schools for lower grades but not college? Housing assistance for veterans but not cops and firefighters?
@wjmaggos
It's not about the services. It's about who does them.
You can have ambulances and universal health cares and all that. The question is always: who will do them? Supply X demand.
Universal heath care you need to force people to become doctors (since they are paid the same as a barista) and enslave them later so they don't escape - like Cuba does.
Why would anyone build roads or drive the entire day instead of streaming games?
Who would build the houses for house assistance?
When private personal insurance began rolling out in earnest in the 70s and 80s, initially, it offered private practices, on average, more than their usual fees, but usually required them to charge those fees of all patients... fees began to steadily rise across the board: The insurance essentially necessitated itself by distorting the private market.
Universal healthcare systems are not the solution. Around the world, including our neighbor to the north and our very special friend the UK, we can see universal healthcare systems are either a disaster or a timebomb without exception where the care is anywhere near parity with the US.
Additionally, universal healthcare systems are far more difficult to regulate (as any state bureaucracy is) and all but immune to change and efficient operation, somewhat a mirror of the baroque interface between care providers and multiple obnoxious state and private insurance systems here: often times an office has specialist staff just for billing (this additional labor is another distortion of the market and a guaranteed increase in prices.)
Reigning in insurance and pharma, not socialization, is the solution: return to what has been demonstrated to work very well here.
To do so is to reduce complexity, administrative overhead, and cost automatically.
Medicine has been approximately modern since the post-war era (early 1950s), with a massive increase in sensor and information technology through the mid 70s and and into the 90s; most of the improvements are earlier detection and often avoidance of problems rather than better solutions to those problems.
Within the pharma industry drugs, antibiotics especially, slowed in discovery/development rate from the 80s on as pharma began looking to deal with feefees, limp dicks, and hair loss.
I agree re pharma incentives but that's capitalism, not socialism. I'll also agree that universal health care can mess up incentives etc. But I'm sure there's lots of older people today living better than previous generations did. And countries with universal care have better outcomes than the US for less $.
The chlorine in pools helped but nothing like the treatments today. In my experience the current problem is the companies trying to prevent the drugs from going generic.
@wjmaggos @jeremiah
Old people live better today in countries with universal care for now, while the population and business are willing to pay over 50% in taxes to subsidize it. With it, as always, it has inflated the cost of health care high and beyond.
But that won't last much longer because governments have been already printing money to cover for their eternally growing deficit and declining tax revenue.
Taxing the wealthy is how we created the liabilities we have now that require further taxing of the rich.
In Canada, the rational compromise between the cost of patient care and constraints is MAID, and they're starting to roll it out in the UK, too.
you don't like MAID, you'd rather the people who can't afford care suffer and die sooner. save the rest of us money.
I'll agree costs go up when there's no pressure to lower them. I think we can have universal coverage and also better incentivize competition to lower costs. and better share the costs that remain among those who will only save less by paying more taxes.
@wjmaggos @jeremiah
Honestly I think we should expand MAID...a LOT!
We should provide MAID to single mothers who fraud welfare, illegal immigrants, old people that require medical care and violent criminals. There are too many people alive that shouldn't be and making it easier to painlessly pass away is a good solution.
It doesn't solve the main issues but make the transition less awful for those people who will simply violent die when the system collapses.
We could also put the illegals into the military, that is, use them as weapons by deploying them to countries who would benefit from a great deal of enrichment and multiculturalism.
Getting stuck in Liberia with a pair of sandals and a tarp instead of going back home after getting busted might be a strong incentive against further immigration, as well as a strong incentive for self-deportation.
> It's either a timebomb of a grift sucking up more and more money
which is why you need healthcare to not be a free market then and the government basically has to hold a gun to the heads of the vultures in the healthcare industry and tell them they will never be allowed to profit more than X percent from their expenses to research/manufacture medicines and no, their "advertisements" do not count as a valid expense. Why are we allowing these monsters to spend $10M on a drug and then $500M on marketing anyway?
> or it's substandard field medicine not fit for rural Cuba
except Cuba had the some of the best healthcare in the world even while we were embargoing the fuck out of them. Remember when Michael Moore took 9/11 workers there to get treatment they couldn't get in the USA??
This isn't an intractable issue, it just requires steps that most countries will never take. Especially America.
I don't believe that America highly regulating the healthcare market will somehow "end drug research and development" -- not for one second, especially when a ton of the breakthroughs happening aren't even coming from this country anyway, but from places with cultures that are much different because the people care about and respect their neighbors and have a sense of community/collectivism that won't happen here.
The government being able to supersede any medical patents and self-manufacture would be an effective price control governor on things too. If people need it and it's too expensive, someone has to do something. A healthy population is way better for the GDP and the health of the nation than letting Pharma rake in billions.
We also have to care enough to root out corruption and fraud but nobody ever wants to apply the required resources to do it, we always just half-ass it and then let the people opposing it use it as an example of why something can never work.
TL;DR we're fucked without culture change, but it's *possible*
Watching Sicko today is pretty funny, especially in the context of developments in healthcare both in Cuba and the NHS since he filmed that piece.
Some of the criticisms remain valid, of course, but it's kind of like watching An Inconvenient Truth today.
Cuba was able to provide some good medical care and training with the Soviets footing the bill for their fuel, energy, and food. Once they were on their own, suddenly, their socialism wasn't able to feed themselves, maintain their hospitals, schools, or infrastructure. Their model had been to export rum, sugar, cigars, some medicines, and doctors. Doctors were Cuba's equivalent of "Panda diplomacy" with higher stakes.
This returns to the major theme here: socialism doesn't work, even if it appears like it might for a while.
Doctors in Cuba are slaves. Socialism works if you implement slavery.
Doctors in Cuba are not allowed to charge extra for their services, they are shot if they try to flee the country and, if they manage anyway, the government kill their relatives back home. They also have mandated work hours and no retirement, obviously.
> Reigning in insurance and pharma, not socialization, is the solution: return to what has been demonstrated to work very well here.
This won't happen for the same reason universal healthcare isn't happening here: all those people in insurance and administration will lose their jobs.
Nobody wants to campaign on forcing 3 to 5 million people out of their jobs and trying to figure out how to keep communities that rely on their existence afloat.
There are choices, but most people don't want to make them or consider them until it hurts bad enough for long enough -- that's human nature regardless of the situation, which is why mediocrity reigns.
3-5 million people being useless is nothing new in America, and being held hostage to insurance companies to keep them in skittles does not serve the majority interest. They have no problem laying off and overworking their own, why should we care if they're out?
Surely their skills are infinitely useful and transferrable, invaluable human resources that they are, right?
YES! Which is why, in communist/socialist countries, EVERYONE ends up working for the government. Since the pay is the same, better get the useless job where you can't be fired and can use your position to be bribed and enrich yourself.
Influence/connections become the de-facto wealth (like in the soviet union, venezuela, cuba, china, and now in the us and canada).
Government becomes the upper class, the rest are the eternal underclass.
> It's not about the services. It's about who does them.
> You can have ambulances and universal health cares and all that. The question is always: who will do them? Supply X demand.
why have we had a nursing shortage for so long if our glorious free market should be activating and paying them so much money that we have a massive influx of new nurses?
There's clearly a high demand. But nothing is being done. Patients are just getting worse care. People don't want to become a nurse for shit pay, but something in our free market is broken that is holding down their wages.
What do we have to do to fix this?
The nursing shortage was mostly due to DEI excluding men, lack of nursing schools and a surprisingly complicated process to bring and onboard foreign nurses. It's also VERY heavily regulated by the government, there's zero free market about it.
If companies could hire freelancer Nurses without registering as Registered Nurse (RN), pass the NCLEX-RN licensure exam and obtain a state license (which are capped), THEN the situation would improve.
Fix this? Reduce government.
All insurance inflated health care systems pay the upper few dozen doctors a big fraction of the salaries. Around here the upper layer of hospitals earns >300k while a nurse hoovers around 60k.
Either limit hours worked to 45 and split in two (we'll find doctors who value quality over quantity) to improve care or reallocate some of it in the midlayers where mistakes are being noticed.
And with "we" I mean anywhere.
Limiting the work hours is good in theory but there are a shortage of doctors with the current system, that even mandates doctors to work a minimum according to the ACGME regulations.
If you cut the shifts in half and need to find DOUBLE the number of doctors at such low pay rate, where would anyone find them? The only option is what the UK has done: importing fake doctors from India.
And then iotrogenic causes shoot through the roof.
No, make emegency servixes pay royally, ambulant less and stationary "calm".
We have 70% women doctors. They all vanish at 35. Hmmm. When they can have the "calm" section they'll more likely work part time through. Sorry, I rather have the small bird in my hands than the big one on the roof.
Anyway, the free falling number of rural GPs is the bigger problem.
> maybe if hospitals weren't bound to medicare which caps payouts they wouldn't get throttled.
This one I don't agree with. If you have no insurance at all, hospitals will give you a better price than with insurance. It's a huge discount. And I'm pretty sure it's even less than the medicare caps.
So they're OK with a low cash price but once you involve a 3rd party payer they crank up the prices and expect more. Why?
I know for like vets and dentists it's because it takes near 6 months for them to get paid so they gotta float it for a while and it's probably similar for hospitals.
If they could get paid faster I'd bet the prices would go down too.
@Zeb
do you consider having any government to be a form a slavery?