@wjmaggos @wallabag
Slavery. Only by bringing back slavery can socialism work.

@Zeb

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.

@Zeb

do you consider having any government to be a form a slavery?

@wjmaggos
No. Just a socialist/communist government, which requires slavery to function.

@Zeb

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?

@Zeb @jeremiah

I generally agree re a full on socialist system. but universal health care isn't that. it's going beyond ambulances etc.

I shared the article above because it addresses these problems with incentives etc.

@wjmaggos @Zeb prior to "insurancization" and the massive growth of pharma in the 80s and 90s, we had a sane, efficient, private system that most people could interact with in cash.

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.

@jeremiah @Zeb

I'm open to such discussions but I'd love to hear it debated. Didn't people just often have a shittier life because of less care decades ago? I have psoriasis and it sucked before the meds I use today.

I do think we have to find a way to have more market pressure on health care costs.

@wjmaggos @Zeb Psorias is a fine example of a condition that, for many, can be treated in the bathtub with a few drops of bleach every so often... or thousands of dollars in ongoing "care" and drugs that manage symptoms rather than fix conditions.

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.

@jeremiah @Zeb

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.

@Zeb @wjmaggos this is the fundamental, proven, immitigable flaw with universal healthcare. It's either a timebomb of a grift sucking up more and more money, or it's substandard field medicine not fit for rural Cuba. There is no example of a sustainable (beyond a few decades) universal healthcare system anywhere in the world that provides timely care at parity with the US.

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.
@jeremiah @wjmaggos @Zeb

> 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*
@feld @wjmaggos @Zeb

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.
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@jeremiah @feld @wjmaggos

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.

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