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Notes -
No. Absolutely not. When I spoke of demolishing institutions, I wasn't referring to the health insurance industry, I'm referring to the institution of Congressional aides. Of "legislators" who don't actually legislate.
Why? To what end? If you want to fix the portion of the health industry problem for which Congress is responsible, you have to "fix" Congress. But, like so much of the US Federal government, the only way to "fix" Congress is to tear it out and replace it with something else. As you note, health care CEOs "don't have much space for a radical change"… and if "radical change" is what you want, the only way we're getting it is overthrowing the United States Government.
So no, I don't mean a "glorious proletarian revolution" in healthcare. The opposite direction, really. The glorious Caesarist reaction when we finally get our Augustus, who ends the Republic.
For example, nobody is angry at this guy: https://x.com/OcrazioCornPop/status/1868084582425170121 - who openly admits at passing healthcare policy by deception, and now we are witnessing the fruits of his labors. Nobody even remembers he existed - and he will be writing the next "healthcare reform", whatever it is, and one after that - or somebody who is exactly like him. Did you ever hear discussing anything about that anywhere in MSM or among those internet people that this week are all healthcare experts?
Yes, and? What do you want here?
Suppose indeed that people were angry at Gruber; that there was less anger directed at healthcare CEO, and more at policy architects like this guy. So what? What would it accomplish? Gruber, or someone like him, would still be making these policies. You complain that "will be writing the next "healthcare reform", whatever it is, and one after that - or somebody who is exactly like him," but even if you got your way and people were "directing equal hate to their local congress-critter", that would still be true.
It is the nature of Congress, as it currently exists, to do this sort of thing. And Congress, like most institutions these days, cannot be fixed, only replaced. You don't want Gruber, "or somebody who is exactly like him" writing the next "healthcare reform"? Then start working to overthrow the US government, because that's the only way it happens. Anything else is just pointless venting.
Hopefully, reframing the conversation from "greedy capitalists kill grandmas" to "healthcare policy matters and we must pay a lot of attention to it and demand much better from The Experts (TM) and relentlessly shame those who dared to lie to us and lead us to the mess we have, and demand from the future ones to be candid with us and provide solutions that look better".
I hope that if by some miracle we found in ourselves, as a society, a way to move conversation from murdering CEOs to discussing policies, then we could also find a way to improve those policies or at least have people en masse understand what those policies are and what are their consequences, so it won't be as easy for the next Gruber to deceive people. I don't exactly expect it, but I hope.
Replaced with what? How? The founders of the current government have done a lot of work to lay the philosophical and practical foundations of the system now in place. It is true that it has diverged from the original intent significantly, but at least if we proclaim as a goal to return to that, we may rely on that work to understand what has to be done and why. What is your foundations and where you want to move, beyond destroying the US government?
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So that sometime, somewhere, somehow we could eventually learn to associate the problems we have with the people we appoint to solve those problems who instead cause even worse problems, and then maybe, just maybe, we start trying to realize maybe there's a better way to do things than just giving all the power to whoever looks most slick on TV and then murdering random rich people because it feels good. They way to solving the problem must go through at least seeing the problem, and I am observing just the opposite - a giant effort to avoid any hint of looking in the general direction of the problem.
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