Comment by skippyboxedhero
7 hours ago
the US has a bigger public healthcare system than, afaik, every European country. the reason why there aren't pitchforks is also because the US is a much richer country than Europe so people are happy to pay for more healthcare. if you are rich, the marginal value of money vs more time being alive is zero (an example is orthapedics for the elderly, the US spends a huge amount in this area relative to most European countries).
it is worth considering whether could a rational person could possibly disagree with the idea that the government is best placed to decide whether extending your life is a good investment (there are European systems that are not well run which resolve this unusual ways i.e. being unable to provide basic healthcare whilst giving hundreds of millions to PR agencies, sometimes run by people who happened to work for the government...total coincidence, to run media campaigns to "prevent" ill health).
it is not simple. there are largely private systems that run very well, funnily enough most of these are in Europe. there are public systems that run very badly, again many of these are in Europe. the discussion of public vs private is largely not relevant or particularly interesting (do people think that doctors just work for free in Europe? they do not, the incentives when you try to create a cheaper healthcare system by underpaying doctors, which exists in parts of Europe, creates some very bad situations i.e. an overreliance on doctors from Africa who have unknown training, Americans tend not to have imagined the scenario where healthcare is "free"/paid with taxes but they are being operated on by someone who can't speak English).
The US also pays relatvely more, not just absolute. Where could I see the US system delivering then? Not sure the data is so clear cut there.
Because aggregate statistics completely fail to recognise the massive philosophical differences in the system. It is like saying someone who buys Ferrari is getting ripped off because they aren't choosing to ride a bike.
The US pays more because it provides significantly greater coverage outside of aggregate statistics. All of the innovation in rare diseases is because of the US, in public healthcare systems some diseases are simply not treated because it isn't regarded as economic to do so. How do you even quantify that difference? It is like making a GDP comparison between 1800 and today, what price would someone in 1800 not to die of TB? Life expectancy of 20 years old in many countries? Anyone who compares the two things in terms of cost is a lunatic.
In short though, it is not obvious that a high-cost healthcare system is worse. The US system is inefficient, almost all of this relates to their decision not to use universal healthcare which leads to problems pricing insurance. However, this is not related to the system, there are many countries in Europe and worldwide which have effective private healthcare systems.
Not saying a high cost system is worse rather that seeing the benefits in data isn't so easy. Not clear what the "right" costs for a system should be, I reckon.
As to drug discovery etc.: I think, not easy to say how the world would look like if the US weren't offering the opportunities. What would be new equilibrium RoIs needed if the world were quite different (and, yes, I am aware of studies there).
> the US has a bigger public healthcare system than, afaik, every European country
In which metric(s)? Afaik, life expectancy is lower in the US than in most of western Europe. And Americans are known to pay much more than Europeans on healthcare, on average.
It's "bigger" in the sense it spends more money per capita. Something very American exceptionalist about the OP suggesting that this is somehow more relevant than it covering fewer people and treatments.
The point is that Europeans seem to believe that the US does not have a public healthcare system, it does.
I am not sure what your point is about covering fewer people either. The point of public healthcare systems is that there are redistributive, correct? The reason the US public healthcare system does not cover everyone is because there are people who can pay for their own healthcare...which is the same in Europe. I live in Europe, in a system with "free healthcare", I pay $100/month for private healthcare because queues for most things are multiple years long AND I pay $1-1.5k/month for other people to use the public healthcare system I can't use.
Life expectancy for a country of 300m compared with a subsection of Europe that is most wealthy...seems like a fairly disingenuous comparison.
Are you one of those people that believes most American schools are shooting ranges too?
All of the problems in the US are concentrated in subsections of the population (just as in Europe). America is a wealthy country that has a mix of south American and African problems attached to it. There is no healthcare system that is going to be able to fix this. Europe has the same problem, the difference is that share of the population was typically much smaller than the US.
I didn't say anything about the cost of healthcare on average. The US already has a public healthcare system, it doesn't work well expecting that to magically improve is not smart (again, particularly when you have evidence from other countries, even in magic Europe-land, that private healthcare can work effectively).
> Life expectancy for a country of 300m compared with a subsection of Europe that is most wealthy...seems like a fairly disingenuous comparison.
Always the same weird "You don't understand, America is really big" argument. GDP per capita is higher there than in anywhere in western Europe. Why is your healthcare system delivering worse results for much higher price? It's a simple question, and the answer is equally simple: private insurance acts as an useless and bloated middleman whose incentives are opposite to providing quality healthcare to its customers. They want to be paid the most in exchange for the least service. Couple that to a bought political class and you've got the least efficient healthcare system in the developed world.
> Are you one of those people that believes most American schools are shooting ranges too?
Strawman. I don't.
> America is a wealthy country that has a mix of south American and African problems attached to it.
???
If you mean to say that America is providing for the world, that's an insane position to hold. The USA are extracting much more wealth from these places than they are injecting.
> life expectancy is lower in the US than in most of western Europe
Could be more tied to poor diet and lifestyle, and not the healthcare system itself.
Like if you sit on the chair all day on your remote job, then move to the couch for after-work Netflix and PS5, while you drink soda and eat processed food, then the only time you leave your house is you drive your Tesla/F-150 to Walmart and McDonald's, there's no magic healthcare system in the world that can undo decades of self inflicted damage.
Meanwhile people in some impoverished balkan town could end up living longer because they spend their entire lives moving outdoor all day in fresh air and only eat organic what they grow on their plot of land, even if their hospitals and healthcare systems are significantly worse than what americans have.
There's way more variables to life expectancy than just the healthcare system.
So, are American just inherently less disciplined that Europeans? Is that the issue with healthcare in America?
I find this explanation very unsatisfying. You have to look at systems to understand what is actually happening.
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No, you don't understand, the government must do everything.
>the US has a bigger public healthcare system than, afaik, every European country.
Probably because Europeans commenting don't know how big Medicare and Medicaid are.