It's the rate of change. Things like NAFTA took many years to implement, and were debated and developed in the open. Everyone understood what would happen to the economy and that there would be a decade of transition.
> A huge part of our power was that we were safe and predictable and that's gone forever.
That is a big deal. The US has for a long time been seen as a stable economy that's easy to trade with because policy changes would take a long time to come into effect by which everyone had had the time to adjust.
Compared to the various stuff that was happening in Europe in the previous decades (at least here in the east) the US were a stable safe heaven where you could trust things wouldn't drastically change overnight.
That's what I thought after the first Trump administration. But the fact that we re-elected him proves that it wasn’t a one-off, we will always be four years away from the possibility of a wild regime change.
That’s why it would jar to be Vance and this reigime, Kay without Trump. 10 more years of both red and blue and enough change to undo and prevent this in the future could get it out.
Germany was reformed, Japan was reforms. These things take time
But the problem is the American people want this. This isn’t some dictator in Korea or Iraq or Venezuela, this is someone with full democratic support. There are many checks and balances in the American system to avoid a single person doing this amount of damage without having widespread support.
No, not even close. The basis for most of these actions requires novel legal re-interpretations to claim power from Congress for the executive, ignore time or scope limits, and remove expert judgement from what are often supposed to be consensus decisions. The courts cases over tariffs are highlighting the unprecedented claims for both the nature of the purported emergency and the scope of the response, but this shows up in many other areas such as inventing a “power emergency” to force coal plants to stay open over the wishes of the owners, communities, and state governments. We’ve never had anything like this level of direct economic interference in the modern economy - even things like WWII policies were at least targeted and based on a real threat.
No, every President does not declare tariffs by fiat using specious emergency powers that change day to day depending on who kissed their ass most recently.
Even setting aside whether the changes are good or not themselves, no President before has thrown away laws mandated by Congress the way the current President is.
Further, this wasn’t even considered a possibility and is only happening now due to a confluence of events…
- the Supreme Court passing rulings that essentially make the President unaccountable
- the SC passing rulings preventing Congress from delegating powers which in practice means a lot of laws Congress had passed in the past have essentially disappeared (since the agencies tasked with making decisions related to them are no longer allowed to)
- Congress becoming completely supine and giving away as much power as they can
- a President that has accepted and is operating on what was until now a fringe legal theory of unbridled executive power ie “unitary executive” theory.
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The first that comes to mind was the Keystone XL Pipeline.
Biden cancelled it with EO 13990 when it was pretty much done.
Would have been thousands of jobs, Canada wanted it too, it's safer than trucking/transporting by train. All just cancelled on a whim.
Then there's EO 14008 that put a moratorium on new oil and gas leases on federal lands and offshore waters. (fed land is 25% of oil production)
Regardless of your position on oil (I'm sure you have one), the point is those are two examples of disruption of an industry by EO from a previous president.
> The first that comes to mind was the Keystone XL Pipeline.
> Biden cancelled it with EO 13990 when it was pretty much done.
I'll admit to not being an expert on the Keystone XL Pipeline, but at least according to the timeline on wikipedia[1], the reason Biden was able to cancel it with an executive order was because Trump had approved it with an executive order, after people had tried and failed for years to get it approved the proper way (through the legislative and executive branches).
And even when Trump personally tried to make it happen, there were still years of court battles stopping construction, so when Biden came into office and ended it, it was in fact not "pretty much done" but apparently 8% done[2]
Seems like it again comes back to Trump just doing what he wants, and it was in fact him trying to unilaterally make it happen that caused that last four years or so of disruptions?
And never this sweeping: like when Japanese car manufacturers were threatening Detroit, the president negotiated with Congress and the response was targeted, not a random shotgun on other countries and industries.
True. I have not ordered a single product from the Heard Island and McDonald Islands since the tariffs were levied on them. I am champing at the bit for these to be reduced.
Haha, but every coffee, tea, snd chocolate provider I buy from has announced their prices going up and it’s not like there’s an American industry those taxes are supporting. Hawaii doesn’t have enough land to grow even a fraction of our domestic coffee consumption.
Yes: that’s kind of a textbook example of using tariffs strategically — there’s a valid argument that automobiles are a strategic industry worth protecting (just for military capacity alone) but they didn’t threaten to heavily tax coffee and chocolate from other continents at the same time or under the pretense that it would make those crops viable in the United States at scale.
This is true, but frontline healthcare staff wages are only one part of the problem. For specifics you can see details here (e.g.: US average front-line healthcare worker salary: €74.450, Germany: €40.522):
But even absent any movement there you have a lot of savings to be had away from that:
1. The U.S. medical administration costs have ballooned, in large part because of the highly adversarial billing system between insurers and practitioners. Medicare/Medicaid is much less (but not completely) unpredictable. Doctors complain bitterly about the prices at times, but the system is much more efficient.
2. U.S. insurance companies are woefully inefficient. To the point that companies complained bitterly when the ACA required them to pay out 80% of premiums as medical payments. Before that there were companies making more than 20% profits. The most efficient insurance companies today use about 12% of their revenues for non-medical care. In comparison Medicaid uses about 3.9%.
There are lots of other parts you could address as well:
1. Fraud drawn to the huge payouts for medical bills. If people's accidents were just covered as a normal part of life those payouts, and most of that fraud just goes away.
2. Malpractice insurance. This is like the first, but would mostly be solved by a combination of single payer and a working medical review system (seriously, what we have now is the definition of regulatory capture).
Wages for doctors and staff are not the cause of high medical bills.
The US spends something like $4.9 trillion dollars on medical care, and employs around 1 million physicians, 4.5 million nurses, or 9.8 million health care workers in total [1].
If this was paid out in wages the average health care worker would be make almost $500k/year. Compare that to the wage of the average doctor at $335k/year [2] or average nurse at under $100k/year. There is a lot of money in medical care that is not going to wages.
>The United States medical industry is one of the highest paying in the world.
Which the industry views as a historical accident, and now that they basically own all the hospitals and other companies, you can expect them to fix it.
I would expect neutering Doctor labor power will happen soon. This admin will get a small donation or two, and the republicans will insist that letting doctors have high wages is the sole cause of our expensive healthcare. They've never really cared about the truth, seeing as they have often claimed "Medical tort" is the cause of healthcare costs, even though places like Texas, which have limits of Medical tort payout don't have cheaper healthcare.
Medical tort is a large part of our bloated healthcare costs. The problem with these discussions is that our healthcare system is horrible and has many things going wrong, so both sides can simultaneously be right.
Doctor and nurses are not bureaucrats. Single payer would significantly reduce the bureaucracy in healthcare, and simplify everything for citizens and businesses.
The main cost driver in medical care is provider (nurse, doctor, etc.) wages, not bureaucracy or drug prices (though they're frequently cited). I have tired of posting sources for the statistics, but they are very easy to find.
From what I've heard from doctors online, a large chunk of their time is basically spent just coaxing insurance. They waste time figuring out what they can and cannot bill, tailoring that to every patient, and constantly keeping records of everything. I think, for many doctors especially in small practices, treatment is a minority of their time.
Obviously, paying someone 300K a year to sit on a 1 hour peer to peer explaining why they think they should do a surgery is just bad business. But, we do it, and I think a lot.
Exactly. You can believe the "main cost driver in medical care is provider (nurse, doctor, etc.) wages" all the live long day, until you realize they too spend a lot of their time dealing with bureaucracy. The true cost of bureaucracy cannot be accounted for by simply tallying the number of bureaucrats and their salaries.
So, let's look at UnitedHealth Group; do they deliver health care?
If there were single payer, what would their role be in the healthcare delivery process?
Apparently they made 2.3 billion in profits on 113 billion in revenue in Q3 of 2025. How much of that friction would evaporate if they weren't in the healthcare delivery infrastructure.
Compare UPS or FedEx to USPS; the first two companies are profit-seeking, yet very competitive with the 'public-oriented' (and legally privileged) USPS. Having the government in control does not necessarily lead to better value.
They are very competitive in the places where most people live, but the USPS delivers to many more places that the others do not, and still maintains cost competitiveness.
This turns out to be a decent analogy to healthcare: insurance companies do not provide the coverage, universality and simplicity that a single payer system would; instead, you'll get something like insurance coverage networks providing spotty and inconsistent care.
Either approach has upsides and downsides, but single payer, universal coverage for basic and emergency healthcare seems like a no-brainer.
I've lived in cities where the city ran the utilities; they were generally way cheaper than the utilities from PG&E.
The USPS is obligated to deliver letters at the same cost to everyone in the country, and they do a pretty okay job at it -- I've certainly had horrid events from UPS and FedEx, and those guys get to just pass the crap delivery tasks off to USPS if they don't like it.
Lots of old people in the USofA seem to like their government run medical insurance, same with people in the VA system.
The Doge crew spent months looking for fraud waste and abuse and I don't see any big law enforcement results from all the fraud they found, and I don't see anyone crowing over all the waste they curtailed.
It's possible that the world's more complex than you imagine, and that sometimes people just do their jobs (IE the bureaucrats) and hard problems get solved.
Now, tell me again, what part of the health care system is UnitedHealth? What critical problem do they solve?
$2.3 billion is nothing in a $5 trillion system. Doctors make around $500 billion in the US. Their wages are much more significant than insurance profits.
$2.3bn is profit after subtracting costs. Doctors charging time to deal with bureaucracy needed by insurance adds to the costs that are already factored into the revenue. Single payer wouldn't just eliminate the profit, but also those costs.
That's 2.3 billion in ONE QUARTER of 2025, on a revenue of 115 billion. In a quarter. There are four quarters in a year.
$5 trillion is how much is spent in all of healthcare in the USA for the whole year.
UnitedHealth's revenue was $500 billion (and net profits is 10 billion) for the year. For one insurance company. There are 6 that each have more than $80 billion per year in revenue. This isn't to mention the billing departments for each hospital, the claims processing providers smaller doctors need to enlist, the endless hours interacting with insurance companies, etc.
And tell me, please, what specific healthcare outcomes are driven by insurance companies?
Insurance companies are instrumental in ensuring that useless procedures arent performed. Over use of service is one of the biggest reasons for inflated costs in our healthcare system. Now to be clear I would prefer a medicare for all system implementing that, but under m4a doctor salaries are still a major issue that need to be addressed.
Basically all healthcare spending in the US goes through insurance companies, Im not sure why you have a problem with that. Under m4a medicare would spend trillions a year, would you be complaining about that too? Large profits would be a problem, but that doesnt exist. Our healthcare system is rotten top to bottom, insurance is part of that but imo it gets way too much blame for existing in the system the government has created.
Insurance companies basically mirror the reimbursement policies put in place by medicare. I'm sure most providers would gladly take lower reimbursement from a single provider over the chaos and pain driven by insurance companies right now.
Basically every provider does not take medicaid so I suspect you are wrong about that. Again Im not happy with the insurance situation, I just think its barely top 10 in terms of problems with our healthcare system. The bureaucracy is required because of our horrible fee for service payout system. Without getting rid of that m4a would still requires an army of billers because republicans would constantly be screaming about the government being scammed(and they wouldnt really be wrong, healthcare providers do tons of wasteful procedures and the bureaucracy is the only thing slowing that down(recent example I came across, currently we wake up obgyn's to perform emergency medically required abortion services at the hospital even though abortions can be done with a pill and the nocturnist can safely oversee the whole thing, no need to wake anyone up. This is only done so providers can charge us more money. This shit is happening constantly over and over again every time providers can find ways to nickel and dime us and patients have no choice)). We dont actually need single payer to get rid of fee for service so really I think private insurance is an orthogonal problem to the billing army.
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