[mr_overalls]

The United States is still the only country in the developed world without a system of universal healthcare.

Breathlessly comparing the USSR's economic policies with the raising of taxes to cover such a fundamental service betrays a staggering ignorance of economics and history.

[john_moscow]

Oh, I happened to live on both sides of the globe and have a fairly sound explanation. Europeans (that have the only universal healthcare system of comparable quality) have a concept of doing your duty. It's when a tool manufacturer won't deliberately put shittier wiring to make the motor fail short after the warranty expires. It's when a dentist won't claim you have 3 extra holes and then keep pretend-drilling your teeth for 30 minutes and bill you for it. It's when an advisor will actually try to find a solution fitting you the most (as opposed to the one paying the highest commission). U.S. culture is different. Like it or not, it's about making a quick buck and hopefully not ending up in prison. That's great for startups and high-risk ventures, but it will never work with setups when you just assume people to do their job well and not try to stiff you in some way.

Russian culture is very similar, so when USSR implemented centralized planning, people resorted to just stealing what they could. Like literally, your way to get some meat for the lunch would be to know the guy that works on a sausage factory, who would steal a piece for you in exchange for some vodka your cousin stole from the distillery. This eroded the trust between people to the point where you cannot start most types of business because your employees will randomly steal shit from you no matter how much you pay them. Hence, high petty crime. Hence, endless feuds between neighbors. You have no idea how low the ship can sink without people realizing that something is wrong.

What always worked in the entrepreneurial cultures like the American one is set proper incentives. Simple, transparent rules that people would agree upon, and let them compete with each other. If you have 10 dental practices, and 2 of them charge you for the holes you don't have, the customers will move to the remaining 8. If a hospital starts charging unreasonable fees to feed extra levels of bureaucracy, a bunch of pissed off MDs will open a competing one. But we are not doing that. We have low interest rates that allow established players to scoop up competition with cheap debt. We have complex bureaucratic systems that make opening a new hospital without a 8-figure investment virtually impossible, and then we wonder why people's entrepreneurial energy gets directed towards creative billing rather than actually delivering value.