Comment by nandomrumber
4 months ago
It’s kinda good the planet gets to run both experiments, and more.
The EU approach seems to want to insert government in to contracts between private individual and those they do business with, and the US approach seems to want to maybe allow too much power to accumulate in those who wield the mercantile powers.
The optimal approach probably lies in the tension between multiple loci.
It's one experiment because both systems are competing at the same time for global resources both in cooperation and competition with each other and other actors. Additional both systems exist in such widely different contexts that any comparison would be inaccurate because other factors such as geographic and historical have a large impact on any measured results.
The US approach is more than that, for instance if every employee in a business pushes for a contract that says workers will negotiate as a block and pay new union dues, and the contract says new hires will be bound by that too, that's illegal in many states. Not just the normal "right-to-work" restrictions, the contract isn't valid even if unanimously agreed on by every current employee (union security agreements). But for shareholders they all set it up like that, with votes weighted by dollars. A new shareholder can't buy someone's shares and government says it's illegal for him to be bound by the voting structure.
And secondary strikes are also illegal in the US under Taft-Hartley.
The optimal approach appears domain specific and granular, too.
As for domain specificity:
I don't know any Europeans who'd prefer to have American healthcare.
I don't know any European technology companies that hold a candle to the sheer breadth and depth of capabilities brought into the world by Google, Apple, Microsoft, Amazon, Nvidia, AMD, Intel, OpenAI, or Anthropic.
Yes, Mistral, Nokia, OVH, and SAP exist, but compared to the alternarives, they exist in the way the American healthcare system exists compared to its alternatives.
As for granularity:
Perhaps we want American style governance for building the tech, but then European style governance for running it?
The American model of governance was created for a world with very distant nation-state threats but a large number of colonial threats, which is why it's centered around "every man for themselves" (in spite of FDR's best efforts). On the contrary, European governance was basically developed during the Revolutionary Wave, which was sweeping all across Europe, that monarchies found that the only way to appease the people was to give into their reforms - and often rapidly because of the domino effects of revolutions. In other words, American governance was built from the ground up, while European governance had to be adjusted within the existing environment and monarchical government frameworks.
In fact, European governments weren't even well-defined in their current state up until the end of WW2, in spite of how much Europeans like to take potshots against USA for being a "young" nation.
This does make the American form great for working with uncharted territory (how to handle new tech, how to exploit the earth in new ways, etc.) while the European form is more reactionary (how do we keep the people appeased, how do we provide a better standard of living, how do we alleviate hardship).
Perhaps the ideal mix of the two, between the frontier-style governance and European-style reactionism, like the Swiss model.
> I don't know any Europeans who'd prefer to have American healthcare.
Selfishly I think my American healthcare is better than anything I ever had in the UK. I can see a doctor within 2 weeks even a specialist, I can actually get a sleep study, my doctor will actually listen to me rather than tell me I'm just getting old, go home and take an ibuprofen.
In terms of health outcomes, the UK generally has higher life expectancy and lower maternal mortality rates than the US - but that said, even the richest Americans face shorter lifespans than their European counterparts.
The real focus and point of contention should be that the US healthcare system is exponentially more expensive per capita than any European model, but is worse for almost all health outcomes including the major litmus tests of life expectancy and infant mortality. In some cases, the wealthiest Americans have survival rates on par with the poorest Europeans in western parts of Europe such as Germany, France and the Netherlands.
https://www.brown.edu/news/2025-04-02/wealth-mortality-gap
Americans average spend on inpatient and outpatient care was $8,353 per person vs $3,636 in peer countries - but this higher spending on providers is driven by higher prices rather than higher utilization of care. Pretty much all other insights in comparing the two systems can be extrapolated from that fact alone imo.
https://www.kff.org/global-health-policy/health-policy-101-i...
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specialists in two weeks is definitely not the norm everywhere in the US. it's certainly not in Seattle.
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I think you should also balance your take by asking people who recently lost their job what they think about their healthcare. I’m sure you’re aware of that, and my point is rhetorical, but that’s the trade off here, it isn’t only about what it looks like when things go right, you should also consider what happens when things go wrong. It’s also enlightening to see what happens many times when people “did everything right” and still got shafted by the US system. See: Sicko for instance https://m.youtube.com/watch?v=YbEQ7acb0IE
I suspect the time it takes to see a specialist in the UK depends on how urgently the issue needs to be addressed. The real advantage you have is that you can be seen by a specialist within two weeks even for non-urgent stuff. That’s not to dismiss your need though. The definition of medical urgency and comfort don’t align well.
The US has world-class healthcare, if you can pay for it. If you can't, then you're getting the healthcare equivalent to a third-world country.
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You can and get that in the UK, surely?
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> I don't know any Europeans who'd prefer to have American healthcare.
Probably depends a lot on where you are in Europe. Some countries have long waiting lists for surgeries (life saving ones) and access to doctors is very limited (too few, months to get an appointment) so it sucks as well if you are in such a situation
Here in America we have to wait months for the privilege of paying out the nose.
>I don't know any Europeans who'd prefer to have American healthcare.
Some 50-100k Europeans fly to the US to get American healthcare every year.
Ok, so about 0.0134%, Parent comment’s point is that -the average European- absolutely does not want the US healthcare system in Europe. Simply due to our shared believe healthcare is a basic right and should be universally available to everyone.
Those who have the financial means to travel to the USA for medical treatment do so largely due to running out of conventional options at home, experimental treatments or specific doctors who are regarded as the best in their particular field.
Most of the US outbound medical travel is due to treatment at home being too expensive and risking pushing entire families to bankruptcy.
The fact that 100k europeans fly to the US for medical treatment is factual, but does not equal them wanting the US healthcare system in Europe.
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Just as a contrasting data point, some estimates are that well over a million Americans travel overseas for medical care every year.
https://www.amjmed.com/article/S0002-9343%2818%2930620-X/ful...
This is mostly to obtain cheaper care. In general America does seem to have some of the best care in terms of quality. It’s just also some of the least affordable.
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So the other 99.987% of Europeans agree with the parent comment?
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I couldn't find a source for this with a quick couple of searches, could you provide one?
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That isn’t the flex you think it is lol
I don’t want to rain on your parade, but you would be more fair by replacing these companies with VCs, because they’re the ones lifting real weight here.
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