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Originally Posted by someone123
I think this reflects the bias toward superficial characteristics I was talking about earlier. Most people evaluate cultural differences on the basis of how obvious and apparent they are, but there's no reason why these differences must be considered the most important. I think the most interesting differences are the ones that have the largest impact on the way people think and behave and consequently the way they live.
The health care you get has a very big impact on your life, and the lack of public health care in the US is pretty directly related to how much people there buy into the extreme free market rhetoric that has become a key feature of US culture.
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Arguably it has less to do with ideological factors. The separation of powers and federalism, among other things, can make overhauling the health care system difficult. There is also path dependency; a well entrenched private health insurance system is difficult to uproot.
That said, describing the American health care as free market in any sense is wrong. 1/3 of Americans receive public health insurance from the US government; this will climb to 1/2 of Americans by 2022. Meaning that more than 160 million Americans will be insured by the US government. Quite possibly the largest public health insurance plan in the industrialized world.
Moreover, private health insurance companies are extensively regulated, to the point where it is even difficult to say whether it is 'private' in any substantive sense. Firstly, profits are regulatorily capped. Secondly, and perhaps most importantly, insurance companies are constrained in using actuarial data to determine premiums -- determining insurability, as you may imagine, is the heart of what insurance companies do. And this, too, is regulatorily constrained.
Finally, even to the extent it is ideologically based, there is substantial ideological diversity on the topic.
To use the rhetoric of some neoliberals in the US and paint the entire US with that brush is not just an unfair overgeneralization, it is also simply wrong. That neoliberals invoke some mythical historical unregulated version of the US is sad and entirely inaccurate. I've been studying American regulations for the last 2.5 years and I can provide you with sources if you'd like.
Seriously, to use the neoliberals to paint the US or to assume their views reflect US policies is like using UKIP as the basis for describing UK culture.
The US is thoroughly a mixed market economy with extensive regulations. I 100% grant that many of those regulations are not optimal. They are the product of compromises between numerous groups (some of which really should not have as much influence as they do, like corporations) and systemic gridlock. But the US is extensively regulated. There's no free market.