Looking from outside your system is scary. I don't get how anyone could defend it in earnest.

What I think you will find is usually defended is not the healthcare system itself, but the idea of not "paying for the bad decisions of others".

It would be great if we didn't all have to pay for the bad decisions of the people who hold to those opinions.

Even kids who grew up wealthy and attended Harvard might go on to murder a health care executive. This article sums it up pretty cleanly IMHO, the health care system in America is infuriatingly unfair. Is the goal to help people or just extract extract extract until they are dead?

https://news.northeastern.edu/2024/12/10/luigi-mangione-unit...

Easy - they will say providing it for everyone is communism and by default bad. Despite spending more on healthcare than every other developed nation and having a robust and well funded by the taxpayer healthcare system for the selected few. But suddenly it's not communism if you're treating veterans and old people not just all of your citizens.

Honestly, I don't think anyone would defend the healthcare system itself in the US.

What they would defend is the premise of returning value to shareholders. And of course, that's what most for-profit healthcare and insurance companies are set up to do. The largest shareholders are typically retirement and pension funds.

That can be applied to almost anything, of course, but if you look at the "enshittification" of most markets in the United States, you'll notice that the process began in earnest around the time that the Baby Boomers began to retire. The Boomers, mathematically speaking, did not have enough children to sustain increasing returns on investments through market expansion. When you have fewer people to extract wealth from, you have to extract more from the average person in order to keep up the numbers, and that's ultimately what we see here and across many sectors of the US economy. You have a generation that was told they would have as good of a retirement as their parents' generation, while also being told that they didn't need to produce the human capital in order for that retirement to happen with the same margins as before.

The effect is a generation that gets their basic healthcare met by the taxpayer through Medicare, while getting their retirement checks paid for by their children being squeezed on everything from real estate to healthcare to transportation costs. It's the tyranny of the gerontocracy.