I have been thinking why UBI and single-payer healthcare is totally unworkable in America. With fears of AI leading to mass-unemployment constantly in the news, the idea of a UBI is often touted as a solution. Democrats similarly have pushed for wealth taxes and universal healthcare, and neither have made much ground.
A California wealth tax has been “just around the corner” or “put to a vote” for what seems like forever now. Democrats have threatened one for years, yet it always amounts to empty rhetoric or gets bogged down and delayed due to political inertia. It’s like the shadowy menace of a horror film, that when the light is turned on, there is nothing there.
In healthcare, Americans prefer individualized treatments rather than the cookie-cutter approach often associated with universal healthcare. They want to set the terms, with no effort spared, even if this means totally speculative, costly treatments for end-stage diseases that may only add months of life. Scaled to millions of people and an aging population, it’s clear this isn’t viable.
But it’s more than costs; the ethos or culture of America plays a huge role, and makes America uniquely unsuitable for either UBI or universal healthcare. Americans are highly individualistic, on either side of the aisle. They value ownership highly. Many classically-minded liberals like the idea of a large, progressive state that protects workers’ rights, provides immigrants with first-rate legal representation, and makes housing, education, and healthcare abundant and affordable, but wince at the idea of having to raise their taxes much to pay for it.
The second major negative factor is bad demographics. America has too many large populations of low or non-contributing groups, such as the old, low IQ, and infirm. This is tolerable if such non-contributors are greatly outnumbered by the young, smart, and productive of good moral character, but America is like an inverted pyramid, where highly-productive people are a minority and support everyone else. So this strains already thin public resources.
The below conversation summarizes the situation perfectly
What's stopping us?
Our bottom quintile, which is composed of violent people with high time preference and an average IQ 15 points below the national average.
The Norwegians don't have this kind of problem. Unlike your neighbors the Swedes, who formerly did not have it but…
— Eric S. Raymond (@esrtweet)
[July 4, 2026]
This is how you get the juxtaposition of cutting-edge AI and other tech–but also potholes everywhere, decaying infrastructure, everything locked behind glass at the store, grocery stores removing the handles from bags, McDonald’s no free refills, etc. It’s as if America is simultaneously becoming wealthier and poorer. Something as seemingly inconsequential as handle-less bags is also a sign of the times. Capital is both pouring into AI and flowing out of everything else. America can afford acres of datacenters, but is seemingly regressing in almost every way.
So imagine Silicon Valley or Manhattan–but scaled to the entire country–where you have all these young, high trust and smart people, but who are also enthusiastic about paying high taxes. So combine Nordic tax rates with American ingenuity and Silicon Valley demographics, and it could work (emphasis on could). But actual Silicon Valley or Manhattan is the opposite in regard to taxes.
Or in other words, “we” cannot have nice things because of bad demographics, an aversion to taxes, ingrained cultural factors largely unique to America, and too much tolerance of people whose actions lower social trust. Singapore and China have laws in place to promote pro-social behavior, but in America this is off-limits.
The reality it’s, no one wants to pay for a high-trust society with nice infrastructure and a good single payer system. It makes sense when you think about it: if you’re already wealthy, it’s rational to pay into the system as little as possible, as you can just avail yourself of the better private options anyway, for far less money than having to pay a large tax. The wealthy and high earners of Nordic and Asian counties (pretty much everywhere but America) are the norm of being guided by a sort of “moral duty” to pay into the system even when they obviously consume far less than they pay in.