Comment by 59percentmore
16 days ago
Things that are more expensive in the US for no reason:
Healthcare
Internet access
College
sighs and adds "The very act of making a purchase"
At least we have cheap gas? farts
16 days ago
Things that are more expensive in the US for no reason:
Healthcare
Internet access
College
sighs and adds "The very act of making a purchase"
At least we have cheap gas? farts
Healthcare and college are "Baumol cost disease": because they depend on skilled workers, much of that is the same as "American salaries are higher than in the rest of the world", and unlike manufacturing or software (+) you can't outsource it to lower-wage countries.
(+) there still seems to be a massive wage premium for "being physically in a San Francisco office" even if most of the work is being done by an AI, which cannot be sustainable
because code is only a small part of software development. don't forget ping pong tables. lol. I'm both making a valid point and making fun of it too.
You can make all sort of excuses but we literally felt bad for 1:1 exchange students paying 2k a month while we paid 2k a year.
Their education was not 10x ours and their economy was only a few % over ours per capita.
I dunno, telehealth with foreign doctors while maybe in-person nurses could lower costs substantially.
If it was this simple, then high costs would be limited to the labor-driven portion of the bills.
This is not the case.
Bit for bit, internet access is cheaper in America than it is in Canada or Australia.
Canadians like myself have ~40% of our provincial taxes spent on healthcare, so in my case about ~8% of my gross income. Somewhere in the tune of $20k/yr. While I was living in Seattle and filing American, quite a bit less of my gross income went to healthcare. Just food for thought.
But that is not because it's less efficient. With the Canadian system being socialzed and 20k$ being just 8% of your income it is to be expected that you would pay moch more than the median person into the system.
"I make $250k CAD a year, my experiences must be representative of, and relevant to, the masses," is a wild thought to have.
Well, maybe I spoke too soon, because my private American healthcare turns out to also be about 8% of my gross income (of $60k)(before copays and my deductible)(and also it's crap). Twinsies!
But yes I agree that it would be awful to have my health needs taken care of and a mere ~160k USD left to spend on everything else.
Oh I certainly don’t think it’s representative to that of the masses, I was sharing an anecdote.
I think either way both of us are in really good shape. In my experience the quality of American care is better in nearly every regard (having experienced both pretty intimately), but the simplicity and the peace of mind of the Canadian system has its benefits too. In either case you end up paying.
> But yes I agree that it would be awful to have my health needs taken care of and a mere ~160k USD left to spend on everything else.
I’m confused - do you actually think it’s awful?
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> Canadians like myself have ~40% of our provincial taxes spent on healthcare
Worth noting that taxes in the US are a lot lower than they should be because a large portion of government expenses are financed with debt. Canada owns over 400B in US debt, so that's Canada "subsidizing" US taxes.
Also, yes, that's how healthcare works: when you're young and less sick, you tend to pay more than you get out of it, and then it reverses as you get older.
Canada has a huge debt problem at the provincial and federal level. The provincial level even covers for the cities spending problems.
What do you mean "quite a bit less of my gross income went to healthcare"? Are you factoring in the insurance premiums paid by your employer? For many people that is both an invisible and significant health care cost.
there is a big chunk of people who wouldn't afford healthcare in the USA but still have access to in Canada. I don't mind paying more taxes if this means everyone has healthcare access.
That’s pretty comparable actually. The most recent quote I received for private healthcare in the US was just under $2,000 per month ($24,000 per year).
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Internet access isn't particularly expensive in the US.
Healthcare, education, and housing are expensive in the US for the same primary reason: political interventions that simultaneously subsidize demand and restrict supply.
it is for what you get. the US LEC and CLEC system sucks, and I had wayyyy more options in the EU, and in fairly upfront and straightforward ways.
e.g. https://documentscontractuels.orange.fr/les-offres-orange-mo...
The EU doesn’t have the challenging scope and geography of the US, no?
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// subsidize demand and restrict supply
I have never seen anyone articulate this so crisply.
The government has created a situation with the student loans thing where basically anyone can borrow 500k to get an obviously useless degree.
Are the colleges going to ensure they collect that money? Obviously yes.
> The government has created a situation with the student loans thing where basically anyone can borrow 500k to get an obviously useless degree.
The point applies even to the useful degrees, and more broadly to the universities irrespective of any particular degree program. Student loans and scholarships make demand almost completely inelastic -- totally insensitive to price increases. Universities compete to attract the best students, and a major mechanism for doing that is to invest in non-academic amenities, such that tuition prices are funding much more than literal tuition. Combine these two factors together, and you have a feedback loop of continuous price inflation.
Similar factors are at work in the healthcare and housing sectors, with the most important element being that external subsidies eliminate price elasticity on the demand side of the equation, and completely obliterate the dynamics that ensure downward price pressure in normal markets.
You can add Pre-K education to that list. It's on par in terms of costs with sending your kids to college.
This is why people are moving out of the US in droves, the universities are empty and nobody goes to the doctor.
Internet access sort of has a reason: the US is geographically huge and more sprawled out. But that's not enough to explain all of the difference.
Why was that not a problem in the mid 1800s when we crisscrossed the entire country with railroads and telegraph cables?
Sure is funny how FDR had us spend a little cash 100 years ago to ensure even the remotest farm gets electricity, and we already gave ISPs a shitload of cash to do the same, but now "We can't" build telephone poles to rural places. Even though those same places already have telephone poles for power and telephone.
AT&T was able to leverage it's monopoly position and defense industry relationship to basically invent everything that runs the modern world (and were compelled to license those advancements out) while modern monopolies can't even dig some holes.
Sounds like we need some more "Consent Decrees" and a DoJ that makes large companies scared.
We damned every single river in the nation. We built so much railroad that it crashed the industry. We built those railroads purposely in places where nobody lived and then willed towns into existence around them. We built the interstate highway system.
Why can we suddenly not build anything? Maybe it's because people keep insisting, against all historical evidence, that we can't, and they don't even try.
That really explains only small parts. Even the horrible suburbs have little real reason to be that expensive. In the end it is really about lacking actual free market and enabling corporate capture as voted by the voters.
That’s not the reason. The required build out has actually already been been paid for: https://www.huffpost.com/entry/the-book-of-broken-promis_b_5.... But the US is so politically broken that corporations could just pocket the money without actually providing the infrastructure.
That does even begin to touch on crazy laws banning people from setting up their own ISP to compete: https://www.techdirt.com/2024/11/07/16-u-s-states-still-ban-....
> the US is geographically huge and more sprawled out.
There is ample historical evidence that this is a poor excuse.
Long ago, leaders in the US understood the value of universality. You'll likely recognize this as the Network Effect, Metcalfe's Law, etc. Back in the day, they called this "universal service." That thinking was central to the policies established for both electrification and phone service in the US: it wasn't then, and isn't now, truly universal, but what could be feasibly accommodated was, even when costs were/are quite high.
It wasn't lost on the people of those times that such policies inherently meant the cost of including sparsely populated, distant areas would be subsidized by concentrated areas. Before those systems appeared, the founders welded the same thinking into the US constitution in the form of the US postal service, with exactly the same knowledge and concerns.
We've lost that. The change happened prior to the advent of the internet. You're free to attribute this to whatever you wish; I won't offer my view on that, except to say there are no innocents: every argument that fingers ebil capitalists can be countered by examples of urban leaders damning government policies that subsidize non-urbanites. What I know with certainty is, if packet switched networking was somehow a thing in the 19th century, availability would be a given for almost any structure more significant than a hunting cabin in the US today, complete with common carrier, service baselines and rates established with clarity.
That might explain internet pricing in North Dakota, but it doesn't explain it in NYC or DC or LA.
I pay $40/mo for 500mbps in my Bushwick apartment - is that considered expensive?
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