Frank Casa

And I have seen block lists where most of the stuff is toxic and should be blocked, but then mixed in there are people who pissed off the person maintaining the block list, usually over some petty dispute or the fact that they voted for the wrong guy in the last election. Unfortunately a lot of these distributed block lists wind up becoming the maintainer’s personal weapon against enemies.

When you have large organizations, such as giant insurance companies or governments, dictating whether people can have care or not, when they ultimately say no to certain people, they will be mad, and perhaps set their targets on the CEO’s or government bureaucrats that denied their care.

25 years ago, health care used to be more affordable. That was before the insurance companies paid for everything, and before hospitals were privatized and consolidated. Doctors could not charge a lot because people paid cash, and people would choose doctors with affordable rates. But now with copays, people think that the doctor costs $30. So the doctors charge hundreds of dollars to the insurance companies, knowing that if the patients paid cash themselves, they would refuse to pay such high charges. These higher fees just get passed back to the patient in the form of higher insurance premiums. So insurance is inflationary. The cost of healthcare is pushed up.

Government insurance tries to handle this by putting caps on what providers can charge, but you still have the problem of rationing of healthcare based on available funds, and it also gives bureaucrats control over your healthcare. It has all of the same problems as private health insurance, except it is run by the government. And if it is centralized, you can’t go anywhere else for a second opinion. If they say no, you are screwed. So that is not ideal either.

If you abolish all private healthcare, then you only have government clinics, and the problem with that is that they can deny you care if they don’t like you (a political dissident) or if they don’t have the budget to pay for everyone’s care.

Instead of any of those, you need some kind of system that is not inflationary, is affordable, and that gives people choices in their care. If one provider says no, they can go to another. The current system is really bad, but most of the alternatives that people suggest are just as bad or worse. If you want a better system, it must include patient choice.

We see how that works. Governments take 40% or more of your income, or insurance companies have outrageous rates. And then the bureaucrats keep part of your money for themselves, and then tell you whether you get healthcare or not by restricting use to the money you paid them. Why should I pay for government administrators to have huge salaries just to manage the money I gave them?

I would rather pay for a doctor’s visit out of pocket with cash, and earn interest or invest the money that would otherwise go towards taxes or insurance fees in my own health savings account.

Most people can afford routine healthcare costs. It is the major medical that is the problem. For that, you need something like insurance, either run by the government, a cooperative, or a private company. You also pay people enough where they can put money away into a health saving account and retirement account. So wages would need to rise for that. And you need a safety net for people who cannot afford insurance, funded by taxpayers and charities. You don’t have to centralize things to do any of that.

Routine healthcare should never be free, except for those in poverty. It just leads to inflation and rationing of routine healthcare.

I take that back. There is on form of free healthcare for the patient, and that is provided by charities and religious organizations who accept donations. Then, and only then, does the patient not pay. Because if it is run by the government, the patient pays direct or indirect taxes to pay for the healthcare.

With Harris Health, if you qualify for free healthcare, you get a “gold card” that gives you free healthcare. You have to qualify based on your household income and household size. Others are provided services based on a sliding scale based on their income.

And there is no such thing is free healthcare. You either pay for it in advance via taxes or insurance premiums, or you pay at the time of service. It is not free, and will never be free.

Systems can be made to be more efficient and more affordable, but they will never be free since it takes resources and labor to run a healthcare system.

I never said Texas has universal health care. I said that certain counties in the state have universal health care.

One thing I don’t understand is why some people are against charity and religious organizations running hospitals next to government-run hospitals. One is funded by donations, and the other is funded by taxes. If we wind up with universal care using multiple providers, what is the problem? The end goal is that people get the care they need, and they are more likely to get that when there is more than one gatekeeper.

The United States is huge. You could fit all of Europe inside the U.S. Yet they don’t have ONE Europe-wide healthcare system. Each country has their own. At the very least, each state should have its own health care system, although a local network would be better. And we should not abolish charity and religious organizations from running hospitals. They should be part of the health care ecosystem as well. That way people have a choice in care since there are multiple providers.

How? I never said we abolish hospitals run by charities or religious organizations. You can have a government-run healthcare system run alongside charities and religious organizations. I don’t think hospitals should be for profit, though. But the government does not have to be your only choice.

Of course, this just highlights the problem with centralized care. If local universal care run by the government turns away people because it is underfunded, what do you think a nationwide government run healthcare system will do when it is underfunded? The same thing! They will deny care just like the insurance companies do. And you won’t have any choice in the matter since they are the only provider and/or they control the money spent on your healthcare.

As I said, the system is not perfect and it needs to be improved. And it is better than Canada telling people to choose euthanasia because the government doesn’t want to pay for their care, or when the UK denied care to a little girl, and then refused to let her leave the country to get healthcare elsewhere. They don’t provide universal healthcare either, despite their claims.

Yes, unfortunately it does not get a lot of publicity. Most people outside of Texas don’t even know something like this exists.

Here is the one for Harris County, Texas. #^[1](https://www.harrishealth.org/about-us/harris-health)

Other major counties in Texas have this as well.

Yes, we already have that in many major counties in Texas, and it seems to be working very well. We provide universal healthcare, unlike the rest of the country, and yet taxes are still low, and people have a choice of providers.

I would still make some recommendations that would make it better. Now we just need to refine and duplicate the model nationwide.

Before the greedy consolidated healthcare into mega-organizations and privatized hospitals, most hospitals were run by charities, religious organizations, and local governments (usually counties). People paid cash for routine healthcare, which kept prices low, and had major medical insurance for major expenses. People had control over their healthcare.

The system was not perfect, but it was a lot better than what we have today. And we can do a lot of things to make such a system better, such as requiring hospitals to provide indigent care to those who cannot afford to pay (i.e. free or reduced cost healthcare) in exchange for not paying taxes. If they chose not to provide indigent care, then they are taxed, and that tax money is used to fund government-run hospitals and clinics.

You don’t have to centralize healthcare to provide universal healthcare. There are a number of ways to do it.

How decentralized is Funkwhale? Does everything go through their website, or do you host your own version and you get the music directly from the artists?

This is what I suspected. I can get behind blocking actual Neo Nazis and hate groups, and illegal content, but when it becomes “blocking anyone who disagrees with me” that can easily be abused, especially if the people running the list can’t tell the difference between Nazis, MAGA, Republicans, Centrists, and Libertarians. Or someone who can’t tell the difference between a tankie, a communist, a socialist, a democratic socialist, or an anarchist. Contrary to some people’s beliefs, all of these things are not the same.

People are welcome to block whomever they wish and have the power to curate their own feeds, but when someone else does it, and there is no way to opt out of that, then it becomes censorship or suppression of information.

Context: If you want to give people choice and power in healthcare, you need to decentralize it, not centralize it. Because greedy people like centralization since it gives them money and power.

Makes sense. Universal healthcare advocates and insurance CEOs both want a monopoly, one by the government and the other by capitalists. Either way, you have no choice in the matter. They dictate whether you get healthcare or not.

And someone who is against Nazis might want to read Mien Kamph, not because they agree with Hitler, but because they want to understand the enemy so they can be better equipped to stop Nazis.