Just want to point out that it's not really about pure free market vs. pure socialism. Look at Singapore and to a lesser extent, China, and ask yourself why they can deliver cheaper healthcare, education and housing. What actually matters is HOW the state intervenes. Both intervene on the supply side but maintain forced individual responsibility/savings, and competitive elements to optimize for affordability which produces better outcomes per dollar. By contrast, in France and the US, when the government intervenes they tend to restrict supply and subsidize demand which is the WORST of both worlds. > USA spends 18% of GDP on healthcare > France spends 11.5% > Singapore spends only 4.5% while achieving higher life expectancy than the other two In Singapore, market signals are preserved because: a) individuals bear meaningful costs / use their own (forced) savings (Medisave, CPF) b) delivery involves private contractors and competing providers c) resale and private markets clear at market prices d) subsidies are targeted rather than the open-ended demand boosters in the West that inflate prices e) fraud punished severely And even though China has more government control of land, capital, and key sectors (which creates distortions), they still cultivate market signals in production and allocation which brings their healthcare spending to 6% of GDP
My post about France went viral. Thousands of likes. Many Americans told me: "Democrats aren't socialists. America will never be France." I want to answer that seriously, step by step. Start with a simple observation. Look at what has gotten cheaper in America over the last 25 years: TVs, phones, software, clothes, toys. Now look at what has exploded: college tuition, healthcare, childcare, housing. What separates the two lists? The first lives in competitive markets. The second is exactly where government is most involved: subsidies, mandates, licensing, zoning, regulation. College. Washington lends students almost unlimited money. Universities know the money will always come, so they raise tuition and hire more administrators. The student pays the bill for twenty years. More government money, higher prices. Housing. Why can't a nurse buy a home in the city where she works? Not because of capitalism. Because of zoning laws, permits, environmental reviews, years of procedure to build a single building. The most expensive places to live in America are the places where it's hardest to build. When building is nearly illegal, prices explode. Healthcare. The patient almost never sees the price. A third party pays, regulations limit who can compete, and costs climb year after year with no one able to say no. So here is the trap. The problems you suffer from are not the failure of free markets. They are the places where the market has already been replaced by the state. And the solution you're being offered is more of the same. That's the Trojan horse. It always works the same way. A real problem. A generous-sounding promise. A program that makes things worse. Then the failure of that program becomes the argument for the next one. People who lived under communism in Poland learned to recognize the lie and the mask the lie wears. The lie never presents itself as a lie. It presents itself as compassion. In France we are at the end of that road. Debt we can never repay. Young people who can't afford a home. Our best people leaving. And every few years our cities burn. Nobody voted for this. They voted for one more generous promise, fifty years in a row. If you're a Republican, share this with the Democrat in your life. Not to win an argument. To start a conversation. If you're a Democrat, I'm not asking you to switch teams. I'm asking you to look at the pattern. Wherever the state took over, life became unaffordable. Don't fix the failures of government with more government. Stay American. Ask for less state, not more.

Last edited Oct 14, 2026 · 9:54 AM UTC

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Replying to @MsMelChen
people get blinded by ideology when mechanism design is all that matters
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West needs to embrace Charlie Munger: “Show me the incentive and I'll show you the outcome”
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Replying to @MsMelChen
They also restrict supply. You can’t build hospitals without approval. Med schools are capped on admissions. US subsidizes demand and restricts supply - Arnold Kling
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You think building hospitals is easier in France or in China? US or in Singapore? Of course it requires government approval
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Also extremely safe
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Replying to @MsMelChen
Point taken, but don't Singaporeans also follow healthier lifestyles, have stronger sense of community, etc. etc. etc...?
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Replying to @MsMelChen
I’ll also go to bat for UAE, where I live at the moment, which is basically the American system but done from first principals; mostly insurance paid by employers, but with price lists and no insane admin costs and discounts everywhere. If I go to the GP, her rate is $60 for 15 mins, I pay $6 and the insurance company $54. My medicine is $10, I pay $1 and the insurance $9. Simple, with no made-up $6000 rate that only exists on some spreadsheet or contract somewhere, and no after-billing for a $300 blood pressure check from a random nurse that I didn’t request and didn’t need. Worst are the US and UK models, at either end of the spectrum.
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Replying to @MsMelChen
Studwell’s argument kind of supports this. He looked at China, Japan, Taiwan, Vietnam, and South Korea - a mix of capitalist and communist, “northern” and “tropical” - and outlined a 3 part movement that took place in each. 1. Break up the feudal landholders. 2. Make finance serve production. 3. Protect/promote production. He doesn’t rate Singapore because it’s too much of a finance driven city-state. It’s an interesting thesis/pattern!
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Replying to @MsMelChen
THIS "e) fraud punished severely" The 8th Amendment prohibits SG level of punishment. Caning and hanging go a long way to maintain civil order. Thought you'd like to know.
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Replying to @MsMelChen
China’s system, hospitals and medical schools, was established decades ago with taxpayers' money. For a long time, the system has favored government employees in major cities, while largely neglecting the healthcare needs of rural populations, esp for significant diseases.
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Replying to @MsMelChen
Its easy to produce when your government places a low value on human life as communists do.
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Replying to @MsMelChen
Great points. The US has processes where fraud and corruption have infiltrated and taken over.
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Replying to @MsMelChen
I like e),,, without enforcing laws, including anti fraud, a segment of the population will simply ignore laws.
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Replying to @MsMelChen
China is in a fail state and will soon cease to exist because of severe lack of breeding. Ya'll just refusing to see it won't change the outcome. Nothing China is doing can be seen as successful given the inevitable outcome of failing reproduction.
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Replying to @MsMelChen
Singapore’s current health expenditure was 4.49% of GDP in 2023, compared with 11.52% in France and 16.69% in the United States (World Bank/WHO). Life expectancy at birth was also higher in Singapore in 2024 than in either country. The post attributes the spending difference to forced savings (Medisave/CPF), competing providers, market-clearing prices, targeted subsidies, and severe fraud penalties. It supplies no measurements or linked evidence that isolates the contribution of any of those mechanisms. The spending difference is documented. The causal explanation is not established by the evidence in the post. Whether the same mechanisms would produce comparable results in a larger open country remains open.
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Replying to @MsMelChen
Singapore is also a very very high trust society….the amount of fraud and waste isn’t close to the west. Additionally open border immigrants get free healthcare and it is subsidized by the people that pay. And much of the healthcare system is a jobs program on the admin side as well. When we did live in Singapore the quality and price was amazing.
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Replying to @MsMelChen
And Singapore can thrive because they REALLY rule over the 30% of Immigrant populations to ensure they have cheap labor supply. Again, Singapore is the Charles Murray/Paul Ehrlich demographic plan on earth.
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Replying to @MsMelChen
"Singapore spends only 4.5%" Had to look this up, but it's true apparently. Singapore must simply provide less healthcare, and it bears detailed study what it does not provide without seemingly any measurable consequences.
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Replying to @MsMelChen
A Healthcare overhaul needs to be next on Trump's list. They still use a fax! Medical records on discs! It is a joke. MRIs for small specific parts of the body? Scan the whole thing you retards. Maybe we can detect a problem...early. Publish prices. Competition.
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Replying to @MsMelChen
I nominate you to remake US Healthcare. While your at it I hope you execute Zeke Emmanuel and that Hans Gruber guy
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Replying to @MsMelChen
I thought Singapore set up their health care system (how to finance it) with the help of Duke University. I'll need to study this more to better understand how they maintained price discipline. I have a guess based on what you wrote, but I'll need to confirm that.
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Replying to @MsMelChen
Singapore is the most libertarian dream society ruled by the Iron Fist Home Owners Association by the elite. There is also a reason why Singapore has such low fertility rates.
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Replying to @MsMelChen
Definitely. It's the same reason that we call an ambulance in an emergency. The problem is always how, and how much we intervene in a situation. The problem with most government intervention is that it's enshrined and continued in perpetuity. And that compounds negatively, and significantly over time.
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Replying to @MsMelChen
This 100% Singaporean system is a terrific model - hope we can get there. Also look at Swiss. China - meh, we don't have and never will that level of government control.
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Replying to @MsMelChen
This is very correct. I've tried to say similar things to people I know but it's like banging your head against a brick wall.
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Replying to @MsMelChen
You’re right but it’s also about asymmetric information in both education and healthcare, one side holds the cards. That’s the definition of market failure. On healthcare there’s also the issue of scope of practice. Dental hygienists and Physician Assistants are limited
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Replying to @MsMelChen
I have experienced health care in the PRC. There's cheap, and then there's cheap.
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Replying to @MsMelChen
The American System of political economy of Alexander Hamilton built the US economy in the 19th century. The Meiji revolution, Bismarck, Sun Yat-sen & Li Kwan Yu were applying the same system.
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Replying to @MsMelChen
Cost of labor is the biggest factor. Doctors get paid way more in US than Asia.
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Replying to @MsMelChen
@grok are China and Singapore racially and ethnically diverse countries?
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Replying to @MsMelChen
Well, the American system benefits the Big Pharma, Big Insurance, Big Government and legacy media, so yeah, it'll be here to stay!
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Replying to @MsMelChen
@mathewkobliska I’m interested in your thoughts on Mellissa’s post, I do think we can learn something from China, and her thoughts on Singapore … well I have never even thought of Singapore as a country that we might be able to learn from but now I do.
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Replying to @MsMelChen
SG achieves per-capita GDP equal to Hong Kong's, w/ double the savings rate. So, an even freer-market approach works twice as well. China also operates by de facto forced savings, but the savings accrue to the State, not the individuals. And China did this by forcing a whole generation of women into a form of Rose-the-Riveter lifestyle where they weren't allowed to have more than one child, thus freeing up their labor.
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Replying to @MsMelChen
In healthcare we just pay more. Medicare rates are not based on supply and demand. If Medicare said we will pay x most physicians would have to take it. Medicare accounts for a huge amount of health expenditures
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