I think no one wants this personally, but there is so much money - and employment - behind the private pay system that it’s virtually impossible to reform it. There is also a real aspect that the system was designed by those in power to further a necessity to work, an overriding fear that people might idle or not work with maximum productivity. Once the system was laid down. With dozens of huge insurance companies and even more smaller ones, with billing departments, coding clerks, adjusters, claim processors, duplicated at every clinic, hospital, insurance company, and the constellation of other roles, partners, providers, it’s now employing millions of people just to operate this hideous machine of national suffering. Talk of reforming it into a single payer system or a socialized system is wildly unpopular with everyone who depends on the current system - millions upon millions of people, and deep spending companies supporting candidates. In a country where either politicians either win by a landslide due to partisan politics, in which case it doesn’t matter what constituents think, or the margins of victory are so narrow that you can’t afford to screw over millions and millions of people through direct action like legislation, the system is metastasizing. There are solutions to the health care problem from a consumer point of view, but the churn it would cause on the employment side would be profound and structural. My view is probably the best strategy is make money young here and emigrate to a place worth living, which is painful to say.

There’s very little I can see truly breaking American society but I think the stark stupidity of health care here is up on the top.