Boston: The Hub of Brat Pack-dancing future congresswomen

The "just world" fallacy is the one that lets you believe that because you're a moral and righteous person, if something bad happens to you by sheer impersonal bad luck, then the rest of us have to bend over backwards to help you no matter how bad of a card you drew.

Yeah, there's the dumbasses gunning for Darwin Awards by eating themselves to death, but there's also the people who through no fault of their own suffer a debilitating stroke at a young age, or discover way too late that even though they're in the prime of their lives have incurable cancer. That stuff happens too, and as much as the instinct toward empathy and self-preservation makes you want to believe that there's a magic button somewhere that if we just push it will cure all disease and take all the ouch out of the world, there isn't one.

Suffering is part of the human condition. Maybe it builds character, maybe it's God testing you, or maybe it's just bad shit that happens to good people for no reason at all, but the incontrovertible fact is that it does happen and you can't prevent it. Maybe you can transfer it around the edges: trade crippling physical pain for a not-quite-as-crippling financial burden, or maybe you can't. Maybe you can lower the risks for yourself by watching what you eat and taking care of your own body, but that's just working around the edges.

But what all sorts of people like to do is live in a fantasy land where there are magic words you can say to the universe, like "socialism" or "medicare for all" that fix all the booboos and have no downsides at all to them. Life doesn't work that way. You can establish single-payer healthcare the way they do in the UK, and it will work for a while, but after that initial honeymoon period, people will stop going to medical school if the pay is crap and you'll be reliant on importing physicians into your country from poorer countries the way the have to in the UK (one of the arguments against Brexit was that medical care would suffer because it would be harder to bring in foreign doctors). That's going to work for a while, but it isn't sustainable in the long term because you can't expect people to work for less than they can command forever.

You can have a quasi-governmental option like medicare and medicaid. But that's just going to paper over the problem. Hospitals lose money on medicare and medicaid patients. And hospitals whose patient populations skew heavily medicare and medicaid have less money to work with than hospitals that aren't, and care suffers because doctors and nurses and medical technicians aren't chained to any place...they have to be paid market rate so you either have to have fewer of them for more patients or people of lesser quality who will take a lower salary.

You can have entirely governmental options like the VA. But because of the culture of a regrettably large fraction of the federal workforce in this country, that just begets corruption and waste and lower quality. You could say that that's just because the private sector lures away the good people and if there were no private option, then all the good people at BI and MGH and the like could work at the VA...and that'd be true until it isn't. Remember what's happening in the UK...they can't get enough Brits to go med school, they have to import people from abroad. You put in an NHS over here, you'll start having that problem here too. And there are only so many third worlders with medical degrees to go around. If people aren't going to med school because they don't think they'll have a career worth having at the end, you can't keep papering over that forever.

Adulthood is being at peace with all of this in some measure.

we could put together a study run by trained professionals to evaluate the overall level of care given to patients in VA hospitals. Maybe the study could even be run by phDs at some well-respected academic institution such as Dartmouth. Maybe it could even be linked by the commenter you're replying to so you could read it and address the specific points it raises rather than assume it's based on PR materials.

Nah, that'll never happen. The "Roman reading something" part of it, anyway.