by throw10920 | 2025-06-01 16:37:49+00:00
> So, across the entire industry of small private practices, it is thousands of insurers.

That's not really relevant. An individual small practice only has to deal with a very small fraction of that total count, and that's all that really matters.

> Right, but the reason these tasks because insanely complex is because they're taken and split into 1 million pieces, which are then scattered across multiple levels of government, multiple agencies, multiple private contractors, who then have their own contractors, and multiple laws across multiple decades.

> Our government, the US government, is not centrally planned where it matters. Every chance we get, we outsource as much as possible to the private sector. So one problem will become 1 thousand.

This is categorically wrong and indicative that you've never worked in the US federal government.

Even tasks entirely handled within a single agency are insanely complex.

This has literally nothing to do with contractors or outsourcing to the private sector, which you appear to be incorrectly pinning the blame on for the complexity.

This is a mix between some intrinsic complexity, partially due to the bureaucratic nature of large organizations, and a very large amount of incidental complexity within the federal government itself.

It's telling that, while I was working in the federal government, I met many people who complained about our healthcare, but not a single one suggested moving any of it into the government - because their personal, first-hand experience with the government's inefficiency and complexity allowed them to understand how extremely bad of an idea that would be.

In theory, it may be more efficient to have the federal government handle healthcare. But in the current state of the government, with the mismanagement and inefficiency and incredible overhead due to internal policies, it will factually not be more efficient for our current government. And trying to push single-payer healthcare on a government that is not ready for it and will result in worse outcomes is just straight-up malicious.

> Every other developed country figured it out, and so can we.

I looked up the most populated countries in the world[1] and the countries with the highest life expectation[2]. None of the top 10 countries in terms of life expectancy were in the top 10 of population - the United States is the 3rd most populous. And out of the top 10 countries ranked by population, the United States had the highest life expectancy of all of them.

The reason for this is because bureaucratic complexity scales superlinearly as the size of the organization, which is a function of the scope of its responsibilities. For a government, that means that complexity is superlinear function of population, scope, and employee count.

The government of United States, with its population of 347 million, is categorically incomparable to the government of Switzerland with its population of 9 million (which is the highest-ranked Western country on that list - Japan, the most populous country in the top 10 of life expectancy, not only has less than half the US at 123 million, but has a wildly different government and culture than any Western country, making it even more incomparable).

So, it's extremely inaccurate, naive, and dishonest to compare the US's healthcare to small European and Asian countries that have longer life expectancy. Our government, in its current state, would make healthcare massively worse, our population (and governmental complexity) is far higher than those nations, and we have the best life expectancy of any of the 10 most populous countries. The system is clearly working adequately, and even if it could be better, nationalizating healthcare or insurance is not the solution, unless and until fixes to the systemic problems in the government are implemented.

[1] https://www.worldometers.info/world-population/population-by...

[2] https://www.worldometers.info/demographics/life-expectancy/