The fact that families have to crowdfund lifesaving care creates the vulnerability but it doesn't force anyone to build an industrialized scam on top of it
Introducing “The Automatic Orphan Crusher 9000” complete with conveyor belt fed chutes and titanium jaws, no orphan can escape! Just place a piece of candy…”
That would be part of our Orphan Industries plan for managing output of your 9000s on the industrial floor. Sure. Monitor throughput and TTK right there from the app.
This framing is disingenuous. We're meant to say "tear down the orphan-crushing machine!" But in this case there's no machine, only human mortality. You're substituting a simple question ("why are we crushing orphans?") for a complex one ("who should pay for poor children's healthcare?")
No but it provides a framework to begin thinking about ways we can protect the vulnerable from these contemptible but totally predictable bad actors.
For example, families forced to publicly beg for money to provide their sick children with treatment. What societal structures enable this situation to occur? Who is profiting off of this structure?
Whether taxes, health insurance, the Church, or gofundme, technically all life saving care is mostly crowd-funded. Maybe not in some Wild West dystopia, but generally the pooling of funds seems to work better than solo funding.
Involuntary, progressive crowdfunding through government threat of violence (taxes) seems to work better than the other methods and most consider it humane. Americans have shown little interest historically in doing the humane thing, unfortunately.
There's a benefit to having a service tied to the individual receiving the service. For starters it put price pressure and competition on providing the service. When someone else is paying for something you don't have a signal of efficacy, in terms of pricing or quality.
To put another way, if I were facing some terminal illness I would want to have full control of picking the service even if it costs money. Sure, I would want "the best" specific to me and have someone else pick up the tab, but that's a fantasy, because no system or third party has as much skin in the game as me. That's why things like elective surgery are so cheap and competitive.
The problem is why do these treatments cost so much? What prevents competition and innovation. And my argument it's largely due to regulation and third party payer system
You’re confusing ideology with the way the world actually operates.
The general public doesn’t have enough information to make informed decisions when it comes to healthcare. This alone completely removes the usual market forces from providing any benefit when it comes to healthcare.
Cancer treatments don’t inherently cost that much money, the systems to ensure people are actually getting useful treatments are expensive. You can’t trust companies selling cures. You can’t trust every doctor when they have financial incentives to offer treatments. Insurance companies are in an adversarial relationship with providing treatments, which doesn’t result in efficient supervision here. Lawsuits offer some protection, but at extreme cost to everyone involved. Etc etc.
The net result of all these poor incentives is single payer systems end up being way more efficient, resulting in people living longer and spending less on healthcare.
> The general public doesn’t have enough information to make informed decisions when it comes to healthcare. This alone completely removes the usual market forces from providing any benefit when it comes to healthcare.
Why is it always "the general public" and not "I". Do you have enough information about decisions? Can I take away some of your rights? No, of course not. Everyone else is dumb except me.
I'm sorry but I refuse to believe some unelected, anonymous bureaucrat has my best interests in mind or can even know me anything about me such that I want to allow them to make health decisions for me.
The whole "anonymous bureaucrat" shtick doesn't land anymore. The purpose of having long-term non-political staff is so that operations don't change on a whim when some rogue director comes in and wants a second Ferrari. The reason government spends more AND is paradoxically more efficient is because most of the work of those bureaucrats is tracking, reporting, and reconciliation. That's the whole deal. Congress passes laws and in those laws is usually an obscene and near impossible amount of auditing.
I trust government staff far more than the decision of unregulated, greedy corporations who literally exist to extract the most money from whatever process they're trying to sell you.
Can you name someone that is a long-term non-political person that is making these decisions?
I have trouble believing empowering people who have no risk of losing their job and no one knows they exist is the best model for making decisions for other people.
Who runs Medicaid, Medicare or VA? Name the person. Who is held responsible? These are just words at this point and its an ideological battle. You have no idea.
>I have trouble believing empowering people who have no risk of losing their job and no one knows they exist is the best model for making decisions for other people.
You mean like the (non-medical doctors) third-parties contracted by my private insurance provider who routinely deny important care[0] and even reject pre-approvals for antibiotics for MRSA infections even after multiple interactions with several medical doctors confirming both the diagnosis (with accompanying pathology) and the appropriate course of treatment.
Yeah, you keep that rolled up newspaper handy so you can "Gub'mint bad! Bad Gub'mint!"
I hope you never have to deal with a life-threatening situation where your insurer flatly refuses to cover treatment until after you're dead or have body parts amputated.
> greedy corporations who literally exist to extract the most money
Every single product and service I am using in my life is made by a corporation. The clothes I wear, the food I eat, the car I drive, the PC I am making my living on.
Government?! Decaying infrastructure, lines at the DMV, crappy schools and killer hospitals.
You may trust the government if you want, but I will never. However, you are the only one pushing your choice onto me and reducing my options. I am fine with you using private or governmental services but you won't allow me this freedom of choice.
I don’t have enough information to make informed decisions here and you don’t either. Off the top of your head, how well educated is your dentist? You after all made an informed decision picking them. So how well did their background compare to others in your area. What where your concerns about their dental programs weaknesses and how was that offset by… Except no let me guess that never entered your mind did it.
> Off the top of your head, how well educated is your dentist?
My dentist cleans my teeth. If it's painful every time I come or I keep getting cavities I consider changing dentists. If they suggest I replace my teeth with veneers or something extreme, I consider someone else. And I'll do a few google searches.
So you didn’t look into their overall competence just the superficial aspects that occur to everyone. I agree that’s normal, but it’s also the underlying problem I was pointing to.
So you don’t need to continue, you just proved my point.
> I'm sorry but I refuse to believe some unelected, anonymous bureaucrat has my best interests in mind or can even know me anything about me such that I want to allow them to make health decisions for me.
I'm sorry to tell you that this is, but unelected bureaucrats are constantly making health decisions on your behalf. You may not want government bureaucrats, but bureaucrats already work in your employer's HR department, deciding on which insurer to partner with, and with what benefits. They are at your insurance company, doctors office, and hospital administration, negotiating and deciding which procedures and drugs are available to you without ever asking for your opinion. Bureaucrats you didn't vote for infest drug company's research and finance offices, determining the availability and cost of your present and future care. None of these even pretend to act in your interests.
I'd rather have some government bureaucrat preside over all the other predatory bureaucrats. I sure as hell wouldn't be make well-informed decisions in the ER, or after getting a cancer diagnosis. Further, it is impossible to compare provider quality and final costs for elective, cosmetic procedures when I'm under no time pressure or stress.
Sure, in that regard bureaucrats make sure my grocer has full shelves. There are likely dozens if not hundreds of people responsible for my local grocer just to make sure I have food.
I have no problem with bureaucrats. I want a choice. If I come in one day to find the shelves empty, I go somewhere else. If they make it difficult for me to check out, or are too expensive, I change. I just want choice.
You can choose to listen to the same unelected anonymous bureaucrats. Just log on to FDA or whatever, and follow their advice (e.g. follow the food pyramid). Only one of us wants to remove choice from the other, and that's the difference.
Time and time again large competing forces in the market are found to have colluded instead of directly competing with each other to drive price/cost down. What is it that still makes you believe that two (or n-number) of providers won't collude to charge an astronomical amount for a life-saving treatment?
Because if something sucks, someone comes up with something better and sells it for a profit. This is the history of pretty much every other good or service that is not heavily influenced by regulation and artificial barriers to entry
> Because if something sucks, someone comes up with something better and sells it for a profit.
This is basically a religious belief at this point. It's how a perfectly ideal free market might work, but we don't have any of these, especially in healthcare.
Do you not use private businesses or something? Do you not shop at a private grocer or order things from Amazon or use a private search engine?
Probably 99% of what I consume comes from private companies and the services generally get better over time, with some exceptions. Compare that to an experience with the TSA.
> Time and time again large competing forces in the market are found to have colluded instead of directly competing with each other to drive price/cost down.
Collusion and cartels never work on the long run. It's an unstable equilibrium, the incentive to reduce prices to capture more market is too great.
> What is it that still makes you believe
Competition. It's the only force keeping humans honest. That's why we must treat any barriers of entry in a market with extreme care. The only "failed" or "captured" market is a strongly regulated one.
Markets can remain irrational, or colluding, far longer than you can stay solvent (or even alive).
For example, while the Phoebus cartel only really lasted from 1925 through to 1939, 1000hr incandescent light bulbs remain the standard offering till present day. Profitable market manipulations are sticky.
The whole notion that markets are efficient is just a mathematical construct that has become very dogmatic for people. But if you look into the details, markets are efficient under the assumptions of perfect information and infinite time. Neither of those conditions are present in the real world: we neither have perfect information nor infinite time.
> 1000hr incandescent light bulbs remain the standard offering till present day
This proves in fact that all the cartel did was establish a standard, an optimal average between various tradeoffs when building an incandescent lightbulb: brightness, cost, efficiency and life span. Yes, the cartel behaved anti-competitively. The effect on the market? Nil.
> perfect information and infinite time
There is absolutely no requirement for this for markets to work. Markets work just fine with partial information and just-in time. When new information and new market participants appear, markets will self-correct. The only way to prevent markets from working is through government intervention.
In facts, free markets are the only system we have that works with incomplete info and reacts in real-time. Central planning will happily decide on incomplete info then never adapt. We saw that during communism when the Party decided allocate X resources for production of Y and it always resulted in a glut or shortages. Central planning doesn't work.
It's the obvious reality around me here in Eastern Europe. We were starving under communism before 1990 but are now enjoying the amazing wealth capitalism brought.
> it put price pressure and competition on providing the service
This is simply not true. Healthcare in the US is comparatively much more expensive than countries offering subsidized healthcare with comparable or better outcomes(1).
> it's largely due to regulation and third party payer system
Capitalism can't work in a market that's completely consolidated, and where people can't offer to not buy your service. Healthcare in publicly subsidized countries is much less expensive because it's regulated. Compare the price of simple drugs like insulin or asthma medicine if you need an easy example. Pharma companies still happily sell there, which is to say that the difference is pure profit on the back of sick people who don't have a choice.
My biggest grief against this individual payment system is moral though. I don't see the virtue in a system where kids have to put on a show to receive care. Or anyone for that matter, you'll give to a kid because they're cute and generate empathy, does it make someone ugly with no family less deserving of getting cured from cancer?
Because when you're dying you have no bargaining position. You can't just wait it out. And you're just a single client, whether you personally die or not does not meaningfully change their bottom line.
So it is a highly asymmetric bargaining situation where all the incentives are poorly aligned. Of course it is exploitative.
Okay, you have no bargaining decision when you have N providers, so we should get rid of all providers with a single provider because only then you'll be in better bargaining position.
And now your death will have a meaningful change to the career bureaucrat or politician that made the decision that led to your death.
Because power of an individual vote is much more powerful than the power to take your business elsewhere. That's if you can find out the responsible party that makes these decisions and they're not appointed but elected, otherwise you'd have to mount an influence campaign on the politicians with 90% re-election rate to change said bureaucratic leader.
All empirical evidence shows that single payer systems work better, producing far better outcomes at lower cost, than the US system. In fact, so much better that a single payer system is what Congress has chosen for itself!
But seems some prefer to believe a theoretical argument with no evidence to back it up.
“The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.”
> All empirical evidence shows that single payer systems work better, producing far better outcomes at lower cost, than the US system.
Agreed. Also, all empirical evidence shows that free-markets work better, producing far better outcomes at lower cost than either. Just look around at any less-regulated and thus free-er markets. Or just "reject the evidence" - your choice.
> die
I am middle-aged so I used plenty of health services in my life. I always had choices when in came to price and level of care and treatment. None of them were for the "dying" case. But I do have an insurance specifically for that case. I am a rational being so I plan in advance. No need for a government bureaucrat to decide my health care for me just in case some day I may be incapacitated.
When you have to choose a provider or you die, there won’t be a real downward pressure on price because there is no need to form a cartel to feed on this. You can see this in every single market of utility or de facto utility segments.
Some people seem to exist in a bubble where they believe that nothing bad will ever happen to them or their loved ones, so paying to improve society has no benefit to themselves.
What's 'paid' to the median child in education is a pittance compared to what the payers suck back out of them in old age during social security.
Public education is largely a scam to put 'original sin' of debt of children to society so when they grow up there is some plausible explanation that "we're a society" and they must feed into the pyramid scheme.
I hear you on intergenerational stuff. I just don’t think “public education is a scam” fits what most kids actually receive.
Kids are not only getting classroom time. They inherit a whole baseline that previous taxpayers built: safer streets, clean water, courts that mostly function, vaccines, roads, libraries, stable money, and the accumulated tech and culture that makes modern jobs even possible. That bundle is huge, and it starts paying out long before anyone is old enough to “owe” anything.
Also, adults are not literally trapped. People can move, downshift, opt out of a lot, or choose different communities. Most don’t, even when they complain loudly, and to me that’s a pretty strong signal the deal is at least somewhat reasonable. Not perfect. Not fair for everyone. But not a cartoon pyramid scheme either.
If there’s a real fight worth having, it’s making the burdens and benefits less lopsided across generations, not pretending the whole social investment in kids is fake.
But charitable causes perpetuate the problems by creating an industry around them rather than trying to find solutions for them. You can’t trust industry to solve civil problems like healthcare or housing, since they shouldn’t be problems in the first place. Its like trying to trust the free market to keep people from raping and killing each other—people will rape and kill with or without the market! Some level of coercion is necessary that free market principles cannot employ.
This isn’t about free market vs single payer healthcare. These kids are from poor countries. Unless you’re arguing for rich countries to offer literal worldwide healthcare.
> It's likely caused by the very same thing that causes human beings to
We’re not billiard balls. We have agency. Nothing causes a human being to choose to commit immoral acts vs. immoral acts. A human being may be put in a situation that may entice that person’s corrupt desires (we used to call this temptation), and responsibility while mitigating culpability is possible when someone’s rational faculties are overwhelmed, but the choice remains.
Blaming systems for theft is scapegoating and an evasion of responsibility. (To make this clearer by distinction: a starving man taking bread from an overstocked warehouse during a famine is not choosing to commit an immoral act; he isn’t stealing in the first place, as some share of that bread is his).
This really doesn't explain why particular places and times in history have much higher crime levels. If what you said was true then rule of law would have been the standard throughout history... it has not been.
> This really doesn't explain why particular places and times in history have much higher crime levels.
This is neither here nor there. As I said, temptations can arise that make things more attractive to certain people given their conditioning and the habituation of their desires. But ultimately, at the end of the day, we can refuse to indulge even strong desires. To the degree that we are in possession of our wits, we are culpable.
> If what you said was true then rule of law would have been the standard throughout history
I have no idea how this is supposed to follow, or even what this means.
Today a hope of many years' standing is in large part fulfilled. The civilization of the past hundred years, with its startling industrial changes, has tended more and more to make life insecure. Young people have come to wonder what would be their lot when they came to old age. The man with a job has wondered how long the job would last.
This social security measure gives at least some protection to thirty millions of our citizens who will reap direct benefits through unemployment compensation, through old-age pensions and through increased services for the protection of children and the prevention of ill health.
We can never insure one hundred percent of the population against one hundred percent of the hazards and vicissitudes of life, but we have tried to frame a law which will give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age.
This law, too, represents a cornerstone in a structure which is being built but is by no means complete. It is a structure intended to lessen the force of possible future depressions. It will act as a protection to future Administrations against the necessity of going deeply into debt to furnish relief to the needy. The law will flatten out the peaks and valleys of deflation and of inflation. It is, in short, a law that will take care of human needs and at the same time provide for the United States an economic structure of vastly greater soundness.
I congratulate all of you ladies and gentlemen, all of you in the Congress, in the executive departments and all of you who come from private life, and I thank you for your splendid efforts in behalf of this sound, needed and patriotic legislation.
If the Senate and the House of Representatives in this long and arduous session had done nothing more than pass this Bill, the session would be regarded as historic for all time.
”
I think it's more complicated than this. People with incurable diseases are desperate and sometimes resort to unproven, dangerous and very expensive treatments. Unfortunately, most people don't have enough money for that, so in order to afford them they try to obtain donations to pursue the treatment they think will save them. Places like Turkey, China, etc are heavens for this kind of medicine.
In a similar way we can say that every shop in Amazon can create own digital shop themselves, but marketing, sales channels and distribution is not easy to acquire.
Is there even standard practices to audit the effectiveness of charity? No accountability means they will always operate like a black box, and I’ve always thought black boxes create misalignments.
Money goes in, and good feelings come out. It certainly serves a purpose, but not the intended one.
Yes, it's called Form 990 and it is a requirement to publish it on a yearly basis to retain non-profit status. You can search for any US-registered NGO here for example: https://projects.propublica.org/nonprofits/
To put it in HN terms, this is what people here like to use to shit on Mozilla for how much they pay their executives while having zero insight into how much Firefox's for-profit competitors pay their executives.
> To put it in HN terms, this is what people here like to use to shit on Mozilla for how much they pay their executives while having zero insight into how much Firefox's for-profit competitors pay their executives.
It's dubious to say Google "competes" with Mozilla, because they pay Mozilla to develop Firefox to avoid antitrust issues, but it's easy enough to find CEO compensation for public companies.
Also, "Other companies pay their CEOs ridiculous amounts, so we're going to," is a poor justification, and just shows Mozilla execs are there to enrich themselves, and don't really care about the browser or community. But I guess they can't spend all of the money on Pocket and AI.
The IRS can audit the reporting, and if you lie on egregiously you can even go to jail. Granted that is very rare, and we currently have an anti-IRS administration, but that’s the basic enforcement mechanism.
The same people that audit your taxes, roughly with the same consequences for lying. Except the IRS is far more likely to send unannounced auditors to NGOs than they are to send them to for-profit companies or individuals. It's more of a hassle to get/retain tax-free status than it is to simply pay your taxes like everyone else (as it should be).
> Is that it?
Let me guess: you haven't clicked on "view filing", which leads to a roughly 20-pages-long document.
Do any real* societies have health care systems where everyone who needs cancer treatment gets the best available?
* by real, I mean large societies that aren't propped up by some bizarre economic quirk...eg maybe the sultan of brunei can personally pay for everyone bruneian citizen to get the best cancer treatment. But that's not a scalable solution
Whether or not non-productive individuals who don't do any work can own the means of production and reap the majority of the economic surplus from it is somewhat tangential to the question of who pays for whose healthcare.
There are plenty of capitalist nations that provide public healthcare on a large spectrum of coverage and quality.
In terms of waiting times to see a doctor or specialist (the only cases where stats for the US seem to be available), the US looks a touch better than average in waiting times for healthcare within comparable countries: https://www.oecd.org/en/publications/health-at-a-glance-2025....
Ahead of Canada, sure (they come worst here in both scenarios) but behind countries like the UK, Germany & the Netherlands that do have universal health care.
I prefer that over people having to start a GoFundme whenever they get sick. My relatives in Germany get necessary treatment as needed. There is the myth of no wait times in the US but from my experience there are also of wait times here.
The boy with cancer who is a main subject of the article and was scammed out of desperation to raise funds to cover his healthcare is in The Philippines.
"Aljin says treatment at their local hospital in the city of Cebu was slow, and she had messaged everyone she could think of for help."
The Philippines' constitution says access to healthcare is a human right. They have universal healthcare insurance, and public hospitals and medical centers.
The next one is the girl from Colombia. Colombia has a mostly public (with regulated private) healthcare system with universal health insurance.
The next one is from Ukraine. Ukraine has a government run universal healthcare system. Wikipedia tells me "Ukrainian healthcare should be free to citizens according to law," fantastic, but then it goes on, "but in practice patients contribute to the cost of most aspects of healthcare."
In first world countries with social healthcare systems like Canada and Germany and Australia, people with complex illnesses do not get coverage for unlimited treatments either, or general costs of being sick (travel, family carers, etc). There are many cases of fundraisers for, and charities which try to help, sick people in need in these countries.
Capitalism is not the reason not everyone with cancer is being cured and not chasing expensive treatments. Healthcare is something that you can throw unlimited money into. You'll get diminishing returns, but there will always be more machines and scans and tests and drugs and surgical teams and devices you can pay for. It doesn't matter the economic system, at some point more people will get more good from spending money on other things, and those unfortunate and desperate ones who fall through the cracks might have to resort to raising money themselves.
If you think there aren't long waits for non-emergency treatment in the US, you are lucky or a moron.
I needed a sleep study. An inpatient sleep study is booked 3 years out here. Good insurance.
Seeing that sleep study doctor in the first place just to get sent a $150 gadget that listens to me sleep? I waited two months. The follow up appointment? 3 months.
Do you know why non-emergency care waits that long? Efficiency. Turns out, hospitals want to not spend extra money on doctors they don't need whether they get paid by the government or this weird industry called "insurance" we have developed.
Go head, tell me about how you can get any treatment or any scan in a week without fail in our wonderful overpriced system.
In the US, twenty day wait list for a broken toe, seven month wait list for a neurologist, five month wait list for a deviated septum surgery, and good luck finding a PCP taking new patients.
This quality of service costs me and my wife ~$23,000/year.
Sure, we can walk into urgent care and get seen. I've also never had a problem walking into a walk-in clinic in Canada, either. The clinic's lobby and the doctor's car in the parking lot isn't as nice over there, though.
In capitalism it is easy and transparent: price, with the side effect of aligning society interests with those of the selfish individual.
Of course the strange and heavily regulated US health-care system is obviously far far away from a free market.
In socialism it's much more random: black markets, lists, lotteries, friends and network of connections. The side effect is that the most productive individuals are discouraged and punished, with the whole society lagging in effect.
Case in point: the EU that started lagging the USA so much in growth that ended up having to beg for basic defense when a blood-thirsty neighbor came hungry for land.
When I'm unconscious in an ambulance, I'm definitely in a position to appreciate all that price transparency the free market has provided, so I can rationally weigh up all my options calmly and objectively while my organs are shutting down.
The great majority of health care is not emergency health care. Actually, the fact that emergency health is so expensive is quite the incentive for preventive medicine. And for the rest, insurance is necessary. Like for house fires or floods: I get the insurance but I also check my wires and pipes regularly.
Can't think of a socialist country, but invite you to visit the German system. Significantly less costly for society and objectively better for the people falling ill (or just having a baby born).
And no, no lists, no lotteries or any of that other lies the conservative US media is spewing out to keep the masses pacified.
I strongly believe, that if US citizens were to experience German healthcare for a year and having to go back to the US system, that there would be riots. Because I don’t think anyone with first hand experience of both systems would ever want to return to the US system.
Yep, loving my gesetzliche Krankenkasse (public health insurance, which is more like "highly regulated insurance"), even more than I liked the Privatkrankenversicherung (less highly regulated, but still with better guardrails than a lot of things I've seen in the States) I was on my first decade in the system here. Sure, there are some specialists who won't accept it, or who will give you a sooner appointment if you're private pay, but in that situation, you have the option of declaring that you're a self-payer that quarter, and your public insurance will reimburse in the amount they normally would have for that procedure or exam. For things like an MRI, the full retail cost in Germany is still much lower than in the US (it was about 600 EUR for my back a few years ago, while I was still privately insured, and I still had to wait for reimbursment).
Even once I do hit the income threshold to switch back to private (switching back to fulltime work), I'm pretty sure I won't.
As far as doctor choice goes, I feel like I have more on the public insurance here (like 90% of the population) than I did with UHC in the early 2000's back in the US. I certainly have fewer financial surprises.
Healthcare in the US seems to cost about double per capita what it does in other developed countries with universial/social healthcare. Public spending in US is on-par with others, and then private spending is that much again. Standard of healthcare I've heard (and would hope) is world class if you can pay, but still something seems broken there to be sure.
But you have lists, queues, lotteries, whatever you call it. That's not a lie. The fact you think lists are a vast right wing conspiracy demonstrates your government is not really forthcoming about your healthcare system. There are lists everywhere. There are ambulance wait times, hospital emergency wait times, various levels of urgent and elective treatment wait times. There are procedures and medicines and tests that are simply not covered at all.
Now, obviously USA has queues and lists too. And I could be wrong but I'm sure I've heard that US private insurance companies are notorious for not covering certain treatments and drugs as well. I don't know what it is exactly these right wing people are saying about healthcare, I thought they did not like the American "Obamacare" though.
There definitely are lists. You don't just get the surgery or therapy you need the next day. You get the next free slot in the list of people queuing at the hospital/practice that still has free slots.
For example the first appointment you can get at my state funded therapist if you call today, will be in june. How is that "not a list"?
Or like, if you call most public GPs in my neighbourhood, they'll all tell you they're full and don't have slots to take on any new patients and you should "try somewhere else". How is that "not a list"?
There are multiple lists here in the NL. I called for a surgery and got put on the fast list (she said that if it weren’t urgent, it would be over a year wait). Your doc has a lot of influence on how urgent things are and how far you are willing to travel. I got in to see a therapist in a matter of weeks, because I was willing to travel out of the city; otherwise it will be months. The doc can see the lines and give you recommendations; all you have to do is ask to be seen sooner.
Doesn't work like that in Austria. Or my doctor's were unwilling to fake urgency to bypass the waiting system for me.
Anyway, do you not realize the fault with the system in your logic? Because if everything becomes urgent in order to bypass queues, then nothing is urgent anymore.
It doesn't fix the problem, you're just scamming the system to get ahead of the problem.
In my case, there was no faking urgency. I was pointing out that urgency puts you in a different line that gets priority (basically, cancellations from the longer line).
For some other things, you can travel further away to where there is less demand for what you need, and if you're willing, you don't have to wait as long. These are all different "lines" and they're the ones doing the schedule.
I wish I could have waited one year. 0/10, would not recommend that proceedure. FWIW, it's a very common, usually also scheduled long in advance (even in the US). Pretty much every man has to get one over 40; so it makes sense the wait list is long unless you've got something else going on.
>Ok but urgency is a different kettle of fish. Life threatening cases get urgency everywhere and immediate care everywhere.
Except it doesn't. At least not in the United States. I have Peripheral Artery Disease.
I had two completely occluded arteries in my left leg and a third that was mostly occluded and had an aneurysm to boot.
One day, that third artery collapsed and I was left with zero blood flow to my left foot.
The doctor had me go to the Emergency Room to get testing and imaging to have surgery the following week.
He did not simply schedule surgery, as that would have required pre-approval from my insurance company and, in fact, the insurance company denied the claim and did not approve the procedure (which saved my foot) until six weeks later -- at which time I'd have had to have my foot amputated without the angioplasty and arterial bypass.
In fact, after surgery the insurance company continued to deny my claims and refused to authorize pain meds (they sliced my left leg open from my hip to my ankle and rooted around to use an existing vein to bypass the blockage on one of my arteries) for those same six weeks.
Oh yeah, US healthcare is so much better. /rolls eyes. My insurer would have forced me to wait until I required amputation if I hadn't just gone ahead on an emergency basis as suggested (because it's not unusual for that to happen) by the surgeon.
And in case you were wondering, yes I have private insurance and pay nearly $1200/month just for me. In fact, my deductible for next year just went up 20% and my annual out of pocket doubled, yet I'm still paying essentially the same premium.
No. The US healthcare system is completely fucked and I hope you don't die or lose important body parts learning that.
They do? If they misdiagnose something, you can end up in the slow line instead of the fast one, or vice versa. Compared to them, you have no influence.
That's the difference between a corrupt and non-corrupt system rather than a capitalist vs socialist one. Nearly all European countries have an at least somewhat socialist healthcare system but in most you don't have to resort to those tactics.
the market / capitalism won’t correct itself, much people want to call it God/ perfect
Regulation, anti-trust laws try to correct somethings but many politicians are against those things because they limit the profit that can be made, profit first, that’s the corruption
> In socialism it's much more random: black markets, lists, lotteries, friends and network of connections. The side effect is that the most productive individuals are discouraged and punished, with the whole society lagging in effect.
Evidence: the vast majority of European countries who have socialized medicine and seem to be doing fine.
> the vast majority of European countries who have socialized medicine and seem to be doing fine
You do realize that the "vast majority" of European countries doesn't mean highly developed Western Europe, right?
Here in Central and Eastern Europe (where I live) socialized medicine is not "fine". You should visit some hospitals in Bulgaria or Romanian to get a more complete picture. We pay the state outrageous insurance costs every month then go and pay out-of-pocket in private hospitals when we actually need them.
>>In socialism it's much more random: black markets, lists, lotteries
>Evidence: the vast majority of European countries who have socialized medicine and seem to be doing fine.
That evidence of socialism working well, only works as long as there are enough resources to cover the needs of most people, basically some of the wealthier European countries.
But when those resources become scarce due to poor economic conditions and/or mismanagement, then you'll see the endless queues, black margets and nepotism running the system.
Evidence: former European communist countries who experienced both systems and where in some, nepotism to bypass lists still work to this day.
I think the 2024 Economics Nobel disproves this. It showed that nations with strong institutions create wealth - and it was a causative link they proved, not simply correlation.
How does that disprove what I said about abundance or lack thereof in socialized systems? Feels like an orthogonal issue.
Socialized systems don't work without abundance. How you generate that abundance is orthogonal to socialism since even countries that are wealthy on paper suffer from shortages and long waiting times in public healthcare leading to a gray-market of using connections to get ahead or more private use.
Both are true. Because when the abundance runs out, people start using nepotism to get what they need. You can see it in the tech job market now. More and more good jobs are only through networking. Meritocracy alone was enough during the times of abundance.
Rather, crony capitalism with no real competition (cartelisation in the absence of strong regulation). This invariably leads to Imperialism ... We see this with BiGTech today and the phenomena of "digital imperialism".
Capitalism is the reason those treatments exist in the first place. I don't see many cutting-edge cancer treatments coming out of Cuba, North Korea or Venezuela.
> you also need to tax it, to deliver benefits to your population
The benefits were already delivered by that strong and prosperous economy in form of products and services.
Taxation is of course necessary to fund government spending but we need to keep in mind its drawbacks: from discouraging productive activity and slowing economic growth to giving politicians funds to buy votes with populist social policies.
Strong and prosperous economy built by progressive tax rate that used to tax up to 70% of non-work income, and now tax most of it 27-29% (depending on the corporate taxe of the state). The people who can use loopholes to avoid income taxes also pay reduced consumption tax (they usually pay the 'Use tax' rather than sale tax in the US, and can basically ignore VAT in Europe).
That's a common misconception. Although the top tax rates were indeed high, they kicked in at such high income levels and included so many deductions and loopholes that the effective tax rate were much closer to 50%.
And it makes sense, considering human nature and motivation: how much would you work considering the taxation? Me:
0-20%: I work as hard, want to excel and advance; I will take risks and invest in entrepreneurial endeavors
20-40%: I will do my duty, 9-5 then hit the door to spend time with the family; actively seek low-responsibility low risk high stability and lots of benefits government jobs
>40%: f that s, I will take my welfare payments and do various cash jobs without declaring that income; stay in my parents basement playing Xbox, smoking weed and jerking off
Counting consumption and estate taxes, i'm pretty sure you're just above 40%, so i guess you're on benefits?
In the US, unless you or your family own a holding with a lot of companies, the country taxes you between 50 and 40% (well, 30 and 50%, but food stamps are a bit weird so i will exclude them here). If you manage to get rich enough to be able to optimize your taxation, you are only taxed on company profits (so 21% to federal, 27-29% depending on your state) and sometime use taxe (sales taxe doesn't really apply anymore).
I have benefited from VAT-free school furniture most of my life because my uncle owned a company that bought office furniture regularly, and VAT-free sport clothing/tools because of a similar scheme by his wife and her companies.
I assure you you pay more taxes overall than people holding a few companies, and the more you own, the easier it get to avoid VAT and taxes in general (the owner of the Yacht my sister used to cook for was hired by the Yachting company as the captain or something for his vacations: avoided VAT on buying the Yacht, avoid VAT on a personal cook, avoid VAT on food. And if this specific company loose a small amount of money every year, tax write-off baby!).
Zucman wrote The Triumph of Injustice: How the Rich Dodge Taxes and How to Make Them Pay.
It's an interesting read, and
Actually I've been lucky to practice what I preach all my life. Early in my career I realized that salaried employment is a rip-off: you pay through your nose for an illusion of safety and stability you don't want nor need. So I embraced risk and switched to contracting.
Having leftover income this way, I looked into investing. That's when I realized that being financially prudent, saving and investing was actually punished in the USA, taxwise, while borrowing and spending was encouraged. So I left the USA and returned to Eastern Europe.
Understanding that selling your time is much worse than selling a product drove me to entrepreneurship. Luck threw a little success my way and turned me financially independent.
Now I am semi-retired living from investments and small gigs and spending time with my family. My tax rate (income only, not consumption or VAT) is well under 20% on most of my income. I didn't do any effort to optimize it further, but I could if I must. I actually do not mind paying taxes, but I do respond to incentives and I am not afraid to relocate.
> If you manage to get rich enough to be able to optimize your taxation
Actually I did a little research and you don't need to be rich, you can do that with very little money. But then the gains for a few percent reduction aren't that great anyway so...
> you pay more taxes overall than people holding a few companies
I probably do, but I don't mind it. I think the rich are a net positive to our society because capitalism ensures they contribute to the society orders of magnitude more than they manage to keep. Also I lived under communism pre-1990 in a world without rich and I've seen how bad it is.
Sure, capitalism isn't perfect. No economic system is, mainly because they're all composed of us semi-evolved chimps. Every economic system has that problem. Getting rid of or severely constraining economic freedoms isn't a solution, it makes it worse.
Ok but if its taken you just three comments to get to "well... nothing is perfect I guess" where did that initial conviction come from?? Like why even play out this same argument if your heart isn't even in it? Is it a sense of obligation? If anything, you do your entire position a disservice by folding so quickly. It just goes to show noone deep down even believes these stories anymore, even we expect others to.
Like, yes, we are discussing an "imperfection" here! You are the one that asserting the greater perfection, not the lesser.
Market economy. Capitalism is a name for the bad thing-- "the accumulation of capital by some to the exclusion of others". Those who argue for a market economy usually claim that with their rule, it won't be accumulation of capital by some to the exclusion of others, with them assuring us that there will be free markets and competition.
Both actual capitalism, i.e. the bad thing, and this which can plausible be argued to be well-functioning market economies, are is often stabilized by adding elements of communism to the system-- publicly funded education, healthcare etc. This is one of the reasons why I as a vaguely socialism-influenced whatever I can reasonably be said to be see communism, i.e. a system characterized by the distribution principle "to each according to his need" as less revolutionary than the socialism distribution principle "to each according to his contribution". Communist distribution principles can coexist with ill-functioning market systems such as things which have degenerated into actual capitalism, whereas the socialist distribution principle can't.
Even in a pure unadulterated market economy that doesn't publicly fund healthcare you would expect to be able to protect yourself from high-impact low-likelihood events by means of an insurance. I find it hard to describe the US healthcare situation as anything other than a market failure
> I find it hard to describe the US healthcare situation as anything other than a market failure
The market is just reacting to the regulatory environment and all the political patches and shortcuts of same done to appease voters over the last 100 years. Fix that and the market will sort itself out.
Basically the US has mixed the worst aspects of for profit healthcare with the worst aspects of socialized healthcare. It underperforms while still costing obscene amounts of money.
I was shooting heroin and reading “The Fountainhead” in the front seat of my privately owned police cruiser when a call came in. I put a quarter in the radio to activate it. It was the chief.
“Bad news, detective. We got a situation.”
“What? Is the mayor trying to ban trans fats again?”
“Worse. Somebody just stole four hundred and forty-seven million dollars’ worth of bitcoins.”
Probably, but that isn't really something I say anything about in what I wrote. Instead, what I wrote is basically a terminology quibble with the use capitalism instead of market economy.
I don't think your statement is true absolutely, I think it's very possible to have pure market economies that are quite well-functioning, i.e. not monopolies etc., where many people are very rich but with some people being really poor, even to the point of not being able to afford healthcare or healthcare insurance, so I don't think it's guaranteed to be true, though I think it's mostly true.
> Communist distribution principles can coexist with ill-functioning market systems such as things which have degenerated into actual capitalism, whereas the socialist distribution principle can't.
You won't have to worry about distributing advanced cancer medications when they don't exist in the Communist version, because they weren't discovered. You can't fulfil a need with a drug you never risked a giant amount of funding and effort to discover.
It can be, but who decides what to work on? Capitalism puts risk and reward off to the side, to be done by experts. Why take the risk if you have no reward, and, conversely, why give someone a load of money to allocate if there's no risk for them if it fails?
the problem is your framing of the problem, not the questions you posed. it seems to me like you’re assuming that the only metrics for risk and reward are profit and cost. let me put it this way: do you find there to be any intrinsic value to the invention of antibiotics, or is such a development only worth the money that it can make for its inventor / discoverer? do you think that the cost of developing such technologies is worth it even if it does not gain any material income?
Let’s also imagine the other side of the equation. Can you not imagine any penalty or cost other than bankruptcy? Let’s say you are forced to allocate $1 million per year to research. is the only cost function you can imagine based on the risk of default?
I would say your problem is the framing :) You're assuming an outcome because you know antibiotics work. What is the incentive to spend $10m on research for a particular drug? It's not "because we know it ends up in a cure for X", because we haven't done the research yet. It's "because we think this will reach enough people to be useful and we'll commit a lot to this thing vs lots of other options."
You literally have the communist distribution principle for education at the primary level in the US, and it's a stabilizing element that allows you to stabilize your system despite having one of the harshest market economies in the world.
So I don't understand how your comment really relates to mine. My comment is basically me quibbling about terminology with the terms capitalism and market economy.
"the accumulation of capital by some to the exclusion of others"
This allows decentralised decision making for large grained resource allocation - for example should we build a factory for shoes, or for toothbrushes? - and is a good thing, as central planning has been demonstrated to not work if applied to the whole economy. (the converse, no central planning to any of the economy, has also been demonstrated to not work!)
However that accumulation can be (and nowadays usually is) orchestrated by a corporate entity, which in an ideal world would be almost entirely beneficially owned by retirees on an equitable basis.
What has gone wrong, is that the benefits of productivity enhancements (since 1970?) have flowed to capital more so than to workers - which not least prevents them from forming capital themselves (savings/pensions), hence rising wealth inequality.
Maybe, and you really believe that, then you do believe in capitalism as Louis Blanc defined it, even though he invented it as a way to characterize something which he regarded as bad.
But this kind of thing, i.e. capital accumulation by some to the exclusion of others, is, I think, objectively problematic in that it's not really compatible with free markets since capital ownership will be barrier to entry once capital has in fact been accumulated by some to the exclusion of others.
I agree that it is decentralized though, but sort of like how feudalism is decentralized.
What are you suggesting is the alternative? Please don't reference small homogenous countries the size of Minnesota as something that will work for the US.
I am curious: how else would you fund them? I sometimes donate & follow such cases and cancer treatments are expensive, especially experimental, custom ones. Worse, the rarer and more aggressive the disease - the more expensive the treatment and the slimmer the actual chances.
Thanks. I never understood why intelligent people, comparing for example the German to the US system can even blink and decide that the German system doesn’t work.
Yes, there is quite a bit to improve in the German system. No doubt there. But if I compare it to the abysmal situation in the richest country on this planet, I am left standing awestruck asking myself why. I really, genuinely cannot wrap my head around.
It's largely not up to people. 59% of Americans support Medicare for All[1], including over 1 in 3 Republicans, but how many politicians even talk about it?
If you vote republican, you do not "support medicare for all" no matter what you say to the poll.
Your vote has consequences, and republicans have been voting for people who objectively and loudly tell their voters that they have no intention of doing those things.
It's time for people who vote republican to own that they suck at picking who to vote for.
Tons of them also say they want recreational weed, but it's only republicans working to prevent that in most states, often literally ignoring citizen's initiatives and court cases to accomplish that.
I would take my insurance over public German healthcare in an instant. I would not trade.
Now maybe when I stop working that may be a different comparison. And its not like there is a choice, voting for a D doesn't magically get German healthcare.
That doesn't say how you would fund it, only what form of insurance is in place.
If the US were to shift to that model today, a country already heavily in debt would have to either take on more debt PR increase revenues in a manner that they wouldn't have been willing to in order to fund our already growing debts.
The debate over whether public or private healthcare is better is all well and good, but first we should be debating how the US would pay for it in the first place.
A Single-Payer-System would also be cheaper in the US. Nobody expenses as much on administrative cost, nobody pays so much as a % of GDP on Healthcare as you, still you have the worst health outcomes of all developed nations.
Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households
Looks like I don't have access to the full paper, but I would be extremely skeptical of any claims with such accuracy or certainty.
The healthcare industry in the US is massive and already full of corruption and inefficiency. Even if we are to assume giving politicians and bureaucracy more control over the system will reduce both issues, we can't predict how successful that will be.
Similar claims were made regarding the hopes for ACA reducing costs and here we are.
You are, of course, aware that the current US single payer system (Medicare) subcontracts their administration to private health insurance companies? And that the "overhead" typically discussed when talking about Medicare doesn't include said companies but is instead only the overhead of what it takes to shovel money from the IRS to private insurance companies?
No, this is not Medicare Advantage, in which Medicare just directly pays private health insurance premiums for enrollees.
There's also an often-overlooked issue, which is that some of the crowdfunded treatments are for things deemed "experimental" or whatever other label and thus not covered for even an insured person. This situation exists in both public and private healthcare systems. I'm not arguing in favor of a for-profit system with this, but people often miss this when they haven't personally run into uncommon health problems.
If a treatment isn't approved yet, you can usually submit a request for getting it paid.
You need to show that it has a chance of working (literature etc...) and it will be reviewed by a doctor from the "Medical Service" which is independent from the Health Insurers.
If they decide it should be paid, it will be paid (which is most of the time the case).
Otherwise you can go through the social courts. (No court costs for the insured person. You can get a lawyer reimbursed if you're poor)
Interesting. Do people win in any significant number of cases, or is it more like the "appeals" process in for-profit systems, where it's supposedly possible to win but generally does not happen?
From my limited experience it usually already gets approved by the Medical Service.
Especially within the University Hospitals who administer these treatments they already have the experience how to write these applications and know their counterparts
Expensive health treatments can easily bankrupt any western government. None of those developed countries can afford to spend their money indiscriminately on them. So instead they turn to waiting lists, death panels and very often saying no but not in your face (since that is politically frowned upon) but thought delays and countless committees and bureaucracy until the patient expires...
I know that's what you hear and read on Fox News and other "News Sources" daily.
But here in Germany, there are no "death panels" or long waiting times for cancer treatment.
Also we don't need "pre-auth" and other Bullshit before we start standard treatments.
The real death panels are sitting in your Insurance Companies Offices as seen by the news coverage around United Healthcare et al lately
I live in Eastern Europe and my "news sources" are friends in hospitals asking us to donate for desperate causes.
Governments-paid treatments are god-sent but many times the funds are limited so they only cover older, cheaper treatments. Approval and funds for newer ones come so late, sometimes too late.
Germany has one of the most developed economies on the planet so naturally has more spend on healthcare. But that can change and when the money is tight, tough choices have to be made. I'd make those choices for myself rather than trust the State to do it for me.
For a country with a $4.5 trillion GDP, a 6 billion deficit is a drop in the bucket and easily covered from taxes. It’s just a political question of what you want to fund.
For comparison, the New York City public transport system (MTA) runs a deficit of about $3 billion. Six billion for universal healthcare in a country of 83.5 million people seems like a total bargain.
To help you think a bit more clearly: the health insurance system is not a for-profit system, even though some people mistakenly hold on to the idea that it should be. It is a risk spreading mechanism.
I lived under the very system this principle enabled and I can tell you that without the profit motive we were cold and starving since there was no motivation for people to work and sew clothes or grow food.
I live under a system where even very expensive treatments are covered by the state using taxpayer money, and I'm not starving. Sometimes you need to optimize for human dignity.
10 Billions of that deficit are coming from the State paying insufficient contributions for unemployed insured people. It is a policy choice to offload those costs onto Publicly-Insured-People (excluding rich and healthy people) instead of funding them through taxes (including those groups).
The German Healthcare System also has some historically developed peculiarities that don't make much sense in today's age, but they are difficult to address without pissing people off (The duality of Private and Public Health Insurance, allowing the first one to get rich and very healthy people out of the risk pool, and then loopholes to switch back into the public system when they grow older and don't want to pay the then high prices in private insurance)
The Hospital Reform is already working to reduce costs by reducing the number of small hospitals, and concentrate them into bigger ones. (As a side effect, quality of care will increase too, since outcomes are correlated with experience)
Also more care will be shifted to outpatient setting.
Otherwise we are fighting with the demographic change. But these problems are also hurting all other developed nations including the US, where funding problems in Medicaid are also expected in the next decades
tl:dr We have problems due to the demographic change, but these are in line with other developed nations. There are some efforts to address them, but politicians are hesitant to do real reforms, because old people have the most voting power
I am yet to see any western nations go bankrupt for universal healthcare.
I have three second-hand cancer experiences from family here in Australia (Dad, Mum and my half-sister - under 35/yo). All three were detected early thanks to regular checkups and screening (covered under Medicare), treated in major hospitals (Dad was in a rural hospital, Mum and half-sister in Metro major city hospitals) and are all alive and certainly not in debt. The biggest cost was parking at the hospital, drinks from the vending machine and the PBS medication (all PBS medicine costs $31.60 for adults, and $7.70 for concessions).
Any PBS medication has the full-cost price printed on the label for reference, more often than not the printed prices go from $300 - $2,000, but I remember that these aren't the full price anyway since our government collectively bargains for cheaper prices on OS medication).
I can't imagine having to pay for treatment AND the insane full price of medications, it must be so much more stressful for families going through cancer treatment.
Americans, don't let the media and your government tell you otherwise. Universal healthcare is cheaper [0] and more effective than whatever archaic system you have now.
I am so god damn proud of our system in Australia, it's not perfect, but damn it's so efficient for critical care, thank heavens for Medicare and the PBS.
Oh and for those that say "well doctors aren't paid very well"... they are. My brother-in-law is a surgeon and he's doing pretty well for himself, bought a new Audi last month for his wife, heading to Europe for a month-long holiday with his family and just moved into a new house.
> So then you would expect life expectancy in the US to be higher than in Germany, France, UK?
Pretty soon, actually. EU countries are falling further and further behind economically. Health care costs are increasing, taking up an ever increasing slice of the government budget. Labor force participation rate is decreasing due to generous welfare and high taxes. Natality is plummeting. Attempts to increase retirement age are met with riots.
We're a technological backwater. AI research is done in USA and China - the benefits will mainly go there too. We can't even cool our cities: we're losing more people every year to heatwaves than the USA to gun violence. We're closing down nuclear power plants after years of shamelessly funding the Russian war machine for cheap energy.
Years of redirecting defense spending into social programs are coming back to bite us. Russia is hungry and aggressive, while the US is not protecting us anymore. What do you think will be the life expectancy under drone and rocket attacks?
Get real, even the poorest districts in the UK have the same average life expectancy than in the US
American life expectancy compares extremely unfavourably with the UK. The English seaside town of Blackpool has been synonymous with deep-rooted social decline for much of the past decade. It has England’s lowest life expectancy, highest rates of relationship breakdown and some of the highest rates of antidepressant prescribing. But as of 2019, that health-adjusted life expectancy of 65 (the number of years someone can be expected to live without a disability) was the same as the average for the entire US.
Also what you conveniently forget to mention, all European countries still spend less on Healthcare than the US, as a percentage of their GDP.
In absolute numbers this comparison would look even worse
So this isn't Defense Spending redirected to Healthcare
Private/public here in Japan works okayishly well. I have never heard of anyone getting bankrupted over medical bills, and have had loved ones going through surgeries and other complex issues.
I don't know, are your opinions about life and reality made up or you're just so credulous you are repeating whatever you see on social media?
Is it so hard to believe in today's day and age that somebody tries to learn and understand how the world around works using observation, published facts and deduction from as close to first principles as possible?
Is there a legitimately good reason for all those treatments to be so expensive, or is that, to a large degree, capitalism extracting capital from the market? Why is American insulin so expensive when compared to that from other countries?
> Is there a legitimately good reason for all those treatments to be so expensive
We can't really know, since only free markets can determine the price of a good or service (it's driven by supply and demand) and health care market is tightly regulated.
> Why is American insulin
Because of the regulatory barriers not allowing other providers to enter and sell insulin on the US market.
Theres a (now old) memo that specifically outlines which talking points carry most salience amongst the audience. Those terms are present here in your comment. (Luntz - The language of Healthcare 2009)
Even with waiting lists, people get healthcare. They get better health outcomes per $ spent. America can provide excellent cutting edge healthcare, which is especially great if you can afford it. At some point, you have to decide whether having most of the bell curve taken care of, is more / less important in terms of rhetoric and priority.
No, the root cause is that cancer exists. Or rather, that humans exist at all.
It's all very well and dandy that you can say "actually, there is a larger structural problem underlying it all" when meeting something bad, but it doesn't make that particular bad disappear.
We have over the years raised billions (maybe trillions) for cancer treatments and we seem to have made negligible progress in actually curing cancer. Will it ever succeed? So maybe there is a root cause for your root cause?
Unfortunately "cancer" is a very broad brush that covers a multitude of diseases.
Plus the phrase "cure" does a lot of heavy lifting. People seem to see a win here as being "here's a tablet, all cancer is gone."
So yes, we have spent an insane amount of money that can be ascribed to "cancer". (We've Also spent a lot on heart disease, diabetes and so on.)
But yes, we have got an extraordinary return on money spent. Treatments and survivability of common cancers (breast, prostate etc) have gone through the roof. Better screening, better education and much better Treatments lead to much (much) better outcomes.
Not all cancers are the same though. Some are harder to treat. Some rare ones are hard to investigate (simply because the pool is too small) but even rare cancers get spill-over benefits from common ones.
In terms of "cure" - that's not a word medicals use a lot anyway. Generally speaking we "manage" medical conditions, not cure them. "Remission" is a preferred word to an absence of the disease, not "cure".
In truth, we all die of something. Cancer is usually (not always) correlated with age, and living longer gives more opportunities to get cancer in the first place. So it's not like we can eradicate it like polio.
There are more than 200 known types of cancer, and most are very fundamental and serious. It's not something which can be easily prevented or even fixed by just taking some pill or eating different. Yet, progress has been very phenomenal over the decades. Cancer can be cured to some degree, people can survive, but progress goes type by type.
According to this US government site, 5-year survival rates across all cancer sites have improved from 50% to 75% between 1974 and 2017. (For men it started at more like 40%).
That’s not utterly transformative but I wouldn’t call it negligible either.
The brain cannot function outside the body. The brain needs your bone marrow to make red and white blood cells. The kidneys and the liver to filter and break down metabolic waste. Various other hormonal systems that affect how the brain works (c.f. the HN favorite "gut-brain axis"). A brain separated from the body could survive for a few weeks, but long term it would certainly die from neuron loss (i.e. dementia).
