4 ms·

These statistics don’t take into account things like the disproportionately high cost of healthcare in the US, so percentage of dollars spent isn’t an especiall

These statistics don’t take into account things like the disproportionately high cost of healthcare in the US, so percentage of dollars spent isn’t an especially meaningful measure. Social Security payments maybe, but you would have to compare relative age of populations and account for how the wealthy escape paying into the system at anything like a progressive level. As this article demonstrates, Americans are great at paying out lots of money into private systems without receiving good material returns on these investments. By contrast, for example, my great grandmother in the UK paid into various state taxes regimes all her life. In return, she received very good quality healthcare, home care and long term care in old age, and social housing after the death of her husband. She was a working class person who suffered a lot of hardship, but lived to be 99. In the US, she probably would’ve ended up bankrupt and dead on the street much earlier.

heavyset_go 7y ago
> These statistics don’t take into account things like the disproportionately high cost of healthcare in the US, so percentage of dollars spent isn’t an especially meaningful measure Yep. The US spends more than double what countries with universal coverage spend on healthcare[1]. Those countries also have better health outcomes on nearly every metric[2] and manage to cover all of their citizens. [1] https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita?sa=X&ved=2ahUKEwj8tZuoyr3lAhVvkuAKHZ96BtMQ9QF6BAgMEAI#/media/File:OECD_health_expenditure_per_capita_by_country.svg https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... [2] https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/ https://www.healthsystemtracker.org/chart-collection/quality...
- sol_remmy2 7y ago
  Doctors in the US are also grossly overpaid compared to other countries: https://www.medscape.com/slideshow/2019-international-compensation-report-6011814#2 https://www.medscape.com/slideshow/2019-international-compen... We will need to reduce doctors salaries by atleast 50% if we want to tackle high healthcare costs..
  - heavyset_go 7y ago
    Doctors' salaries are not responsible for skyrocketing healthcare costs in the US[1]. [1] https://i1.wp.com/investingdoc.com/wp-content/uploads/2017/08/admin-jobs-1024x512.jpg https://i1.wp.com/investingdoc.com/wp-content/uploads/2017/0...
    - adventured 7y ago
      > Doctors' salaries are not responsible for skyrocketing healthcare costs in the US Your chart doesn't show anything useful to the point you're trying to make. It shows a massive percentage increase in the admin side as expected, without showing the base it started from, and it does not show any percentage or specific figure break-out on related costs by each group. You need to show each group and what is being spent on them. Ideally also show the cost increase related to physician and nurse total compensation over the last eg 10, 20, 30 years so we can see how much cost inflation there is related to that segment of US healthcare over the prime years of healthcare cost inflation.
    - tptacek 7y ago
      Whatever the growth in administrative work in health care may have been since 1970, administrative costs are not primarily responsible for our healthcare costs; even Elizabeth Warren's own estimates of admin cost savings in M4A peg them at under 15%. Meanwhile: the dominant component of US health spending is in fact inpatient and outpatient procedures --- services delivered by physicians and trained health care specialists --- and those people do in fact make significantly more money in the US than they do in the UK, Europe in general, or Australia.
  - kwhitefoot 7y ago
    For a supposedly free market country it's odd that the US allows the supply of doctors to be restricted. Removing restrictions on the numbers of doctors who can qualify would automatically reduce the average income while increasing the supply of doctors. See https://www.quora.com/Who-or-what-controls-the-number-of-medical-doctors-in-the-U-S https://www.quora.com/Who-or-what-controls-the-number-of-med... for more information.
  - 7y ago
rayiner 7y ago
> These statistics don’t take into account things like the disproportionately high cost of healthcare in the US, so percentage of dollars spent isn’t an especially meaningful measure. It depends what you're measuring. OP is talking about Americans' willingness to "invest in their own people." That's an issue of "money in" not "results out." On healthcare, for example, U.S. governments spend 8% of GDP. That's on the middle-high side compared to the rest of the OECD: https://www.oecd.org/els/health-systems/Country-Note-GERMANY-OECD-Health-Statistics-2015.pdf https://www.oecd.org/els/health-systems/Country-Note-GERMANY.... We just manage to cover a fraction of the population for similar levels of spending. The same is true for our public education--we spend more get less. That suggests a very different narrative than what OP was saying. "We spend so much on education, why are our kids falling behind?" Versus: "Why aren't Americans willing to invest in education?" The problem isn't that America isn't "willing to invest in its own people." It's that Americans get far less in the way of public services for the amount of money they spend. It's a problem of efficiency, not generosity. > Social Security payments maybe, but you would have to ... account for how the wealthy escape paying into the system at anything like a progressive level. The earnings cap for Social Security is common in OECD countries, and our cap is higher than most: https://www.forbes.com/sites/ebauer/2018/04/28/so-hey-why-not-just-remove-the-social-security-earnings-cap/#62917e1e2b23 https://www.forbes.com/sites/ebauer/2018/04/28/so-hey-why-no.... (Comparisons are a bit difficult. France, for example, has a cap on Social Security taxes, but no cap on healthcare payroll taxes. But the U.S. has no cap on Medicare taxes, and we pay Medicaid out of income tax, which is highly progressive.) It's also funny you use the U.K. as an example. The maximum state pension in the U.K. amounts to about $10,000/year. The average U.S. Social Security payment amounts to $17,500 per year. > As this article demonstrates, Americans are great at paying out lots of money into private systems without receiving good material returns on these investments. Except health insurance, the U.S. is generally behind Europe in terms of privatizing public services. For example, not even Republicans are talking about privitizing Social Security, but some level of privitization of retirement accounts is common in other countries: https://www.ssa.gov/policy/docs/ssb/v66n1/v66n1p31.html https://www.ssa.gov/policy/docs/ssb/v66n1/v66n1p31.html. Australia, Denmark, and Sweden are examples of countries that have partially privitized their Social Security by imposing mandatory participation in private pension systems as part of the overall retirement system. Transit systems in Europe are often privately operated, while in the U.S. they're almost all publicly operated. 91% of American students attend publicly managed schools, below the OECD average of 82%: http://www.oecd.org/pisa/50110750.pdf http://www.oecd.org/pisa/50110750.pdf. Spain, South Korea, Belgium, Ireland, the Netherlands, and Australia are countries where 1/3 or more (70% in Belgium) of students attend private schools. In the OECD, it's common for private schools to receive government funding (via voucher-like systems). Sweden, Finland, Germany, the Netherlands, Ireland, and Spain, are examples of countries where private schools receive more than 60% of their funding from the government. The EU is undertaking a vast reform that would require opening up local utilities to competition: https://europa.eu/rapid/press-release_MEMO-14-19_en.htm https://europa.eu/rapid/press-release_MEMO-14-19_en.htm. Among other things, it could speed up the privatization of water systems in Europe (private water systems are already fairly common there, but basically unheard of in the U.S.)

heavyset_go 7y ago

> These statistics don’t take into account things like the disproportionately high cost of healthcare in the US, so percentage of dollars spent isn’t an especially meaningful measure Yep. The US spends more than double what countries with universal coverage spend on healthcare[1]. Those countries also have better health outcomes on nearly every metric[2] and manage to cover all of their citizens. [1] https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita?sa=X&ved=2ahUKEwj8tZuoyr3lAhVvkuAKHZ96BtMQ9QF6BAgMEAI#/media/File:OECD_health_expenditure_per_capita_by_country.svg https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... [2] https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/ https://www.healthsystemtracker.org/chart-collection/quality...

sol_remmy2 7y ago
Doctors in the US are also grossly overpaid compared to other countries: https://www.medscape.com/slideshow/2019-international-compensation-report-6011814#2 https://www.medscape.com/slideshow/2019-international-compen... We will need to reduce doctors salaries by atleast 50% if we want to tackle high healthcare costs..
- heavyset_go 7y ago
  Doctors' salaries are not responsible for skyrocketing healthcare costs in the US[1]. [1] https://i1.wp.com/investingdoc.com/wp-content/uploads/2017/08/admin-jobs-1024x512.jpg https://i1.wp.com/investingdoc.com/wp-content/uploads/2017/0...
  - adventured 7y ago
    > Doctors' salaries are not responsible for skyrocketing healthcare costs in the US Your chart doesn't show anything useful to the point you're trying to make. It shows a massive percentage increase in the admin side as expected, without showing the base it started from, and it does not show any percentage or specific figure break-out on related costs by each group. You need to show each group and what is being spent on them. Ideally also show the cost increase related to physician and nurse total compensation over the last eg 10, 20, 30 years so we can see how much cost inflation there is related to that segment of US healthcare over the prime years of healthcare cost inflation.
  - tptacek 7y ago
    Whatever the growth in administrative work in health care may have been since 1970, administrative costs are not primarily responsible for our healthcare costs; even Elizabeth Warren's own estimates of admin cost savings in M4A peg them at under 15%. Meanwhile: the dominant component of US health spending is in fact inpatient and outpatient procedures --- services delivered by physicians and trained health care specialists --- and those people do in fact make significantly more money in the US than they do in the UK, Europe in general, or Australia.
- kwhitefoot 7y ago
  For a supposedly free market country it's odd that the US allows the supply of doctors to be restricted. Removing restrictions on the numbers of doctors who can qualify would automatically reduce the average income while increasing the supply of doctors. See https://www.quora.com/Who-or-what-controls-the-number-of-medical-doctors-in-the-U-S https://www.quora.com/Who-or-what-controls-the-number-of-med... for more information.
- 7y ago

rayiner 7y ago

> These statistics don’t take into account things like the disproportionately high cost of healthcare in the US, so percentage of dollars spent isn’t an especially meaningful measure. It depends what you're measuring. OP is talking about Americans' willingness to "invest in their own people." That's an issue of "money in" not "results out." On healthcare, for example, U.S. governments spend 8% of GDP. That's on the middle-high side compared to the rest of the OECD: https://www.oecd.org/els/health-systems/Country-Note-GERMANY-OECD-Health-Statistics-2015.pdf https://www.oecd.org/els/health-systems/Country-Note-GERMANY.... We just manage to cover a fraction of the population for similar levels of spending. The same is true for our public education--we spend more get less. That suggests a very different narrative than what OP was saying. "We spend so much on education, why are our kids falling behind?" Versus: "Why aren't Americans willing to invest in education?" The problem isn't that America isn't "willing to invest in its own people." It's that Americans get far less in the way of public services for the amount of money they spend. It's a problem of efficiency, not generosity. > Social Security payments maybe, but you would have to ... account for how the wealthy escape paying into the system at anything like a progressive level. The earnings cap for Social Security is common in OECD countries, and our cap is higher than most: https://www.forbes.com/sites/ebauer/2018/04/28/so-hey-why-not-just-remove-the-social-security-earnings-cap/#62917e1e2b23 https://www.forbes.com/sites/ebauer/2018/04/28/so-hey-why-no.... (Comparisons are a bit difficult. France, for example, has a cap on Social Security taxes, but no cap on healthcare payroll taxes. But the U.S. has no cap on Medicare taxes, and we pay Medicaid out of income tax, which is highly progressive.) It's also funny you use the U.K. as an example. The maximum state pension in the U.K. amounts to about $10,000/year. The average U.S. Social Security payment amounts to $17,500 per year. > As this article demonstrates, Americans are great at paying out lots of money into private systems without receiving good material returns on these investments. Except health insurance, the U.S. is generally behind Europe in terms of privatizing public services. For example, not even Republicans are talking about privitizing Social Security, but some level of privitization of retirement accounts is common in other countries: https://www.ssa.gov/policy/docs/ssb/v66n1/v66n1p31.html https://www.ssa.gov/policy/docs/ssb/v66n1/v66n1p31.html. Australia, Denmark, and Sweden are examples of countries that have partially privitized their Social Security by imposing mandatory participation in private pension systems as part of the overall retirement system. Transit systems in Europe are often privately operated, while in the U.S. they're almost all publicly operated. 91% of American students attend publicly managed schools, below the OECD average of 82%: http://www.oecd.org/pisa/50110750.pdf http://www.oecd.org/pisa/50110750.pdf. Spain, South Korea, Belgium, Ireland, the Netherlands, and Australia are countries where 1/3 or more (70% in Belgium) of students attend private schools. In the OECD, it's common for private schools to receive government funding (via voucher-like systems). Sweden, Finland, Germany, the Netherlands, Ireland, and Spain, are examples of countries where private schools receive more than 60% of their funding from the government. The EU is undertaking a vast reform that would require opening up local utilities to competition: https://europa.eu/rapid/press-release_MEMO-14-19_en.htm https://europa.eu/rapid/press-release_MEMO-14-19_en.htm. Among other things, it could speed up the privatization of water systems in Europe (private water systems are already fairly common there, but basically unheard of in the U.S.)