5 ms·

Things with massive government involvement and heavily regulated like are incredibly more expensive: health care, housing and education. Meanwhile, things prov

by nickpp 5y ago

Things with massive government involvement and heavily regulated like are incredibly more expensive: health care, housing and education. Meanwhile, things provided by the free market have become incredibly less expensive and more powerful: technology, communication, entertainment. Nothing to do with your rich vs poor class wars.

rocgf 5y ago
Gonna leave out housing and education, but for healthcare, you are painfully incorrect. European countries has vastly more regulated healthcare and yet pay about an order of magnitude less for it.
- nickpp 5y ago
  You have a good point, USA healthcare has the worst kind of regulation: it did lots of damage and helped very little. But Western European countries (which you probably compare to) had an immense, unspoken advantage: an incredible supply of highly educated, unexpensive health care work force - the Eastern Europe. If you want to truly compare the healthcare of USA with Europe's please include countries like Bulgaria, Ukraine, Serbia, Romania, Moldova and so on. Yes, it's cheap. But you truly get what you pay for.
  - oblio 5y ago
    You can't compare Eastern Europe like that, though. Romania has a GDP per capita of 1/6th the US one and it spends a pitiful percentage of its GDP on healthcare, about 5%. The US spends 18%. So the US has 18 times more money (!) for healthcare. The other ones are even worse, Moldova's GDP per capita is 1/20th the US one. So probably 30 times more money spent by the US on healthcare. It's like comparing a maglev train to the original steam locomotive :-)
    - nickpp 5y ago
      You are ignoring what EE countries spend on training countless health care workers who then emigrate and work as cheap and highly educated in the West. And health care cost increase exponentially with quality, not linearly. Bleeding edge research and medical advances appear in the USA mostly. And mostly everybody enjoys the fruits.
      - oblio 5y ago
        I keep hearing about US research but Europe has huge pharma companies: Germany has a bunch, France some more, Switzerland, the UK. The US has a very parasitic healthcare system so I wonder how much their expenses are for actual research.
        thehappypm 5y ago
        The US’s pharma have done a ton with pandemic medicine. Pfizer, Moderna, J&J, Novavax, Gilead, Merck..
        oblio 5y ago
        Biontech researched the Pfizer vaccine. It's a German company. AZ is British.
        thehappypm 5y ago
        Pfizer developed the treatment Paxlovid.
        oblio 5y ago
        https://www.voanews.com/a/european-drug-regulator-recommends-two-new-covid-19-treatments/6357712.html https://www.voanews.com/a/european-drug-regulator-recommends... The first one is Swedish and the second is British. The US is much better at creating visibility for its accomplishments.
  - rocgf 5y ago
    You want to compare the richest country in history with Moldova? I'm not sure I see the point. My point was very simple. Out of all of the world's developed countries, the USA is the one with the most expensive healthcare, despite less regulations. My point was that regulation by the government does not lead to "incredibly more expensive healthcare", as you have have stated. From there, comparing the USA to Bulgaria is simply beside the point, the conversation was about regulation leading to "incredibly" higher costs.
    - nickpp 5y ago
      And my point was just as simple: those developed countries enjoy the benefit of cheap, educated doctors from Eastern Europe. Without them, their health care would be much more expensive.
      - rocgf 5y ago
        So, in the end, you're accepting that regulation is not the determining factor then. Not even sure what exactly you think the proportion of foreign-born medical staff is in Europe. As far as I can find, the maximum is ~30% in the UK, while in Germany is 7%. But either way, to think that this is somehow the reason why Americans pay way more than anyone else for basic stuff like insulin and medical bills is ridiculous in my eyes. Even if what you say is true for Western Europe, there are other countries (pretty much all) with highly-regulated healthcare and they all pay less than the US. But I'm sure there's some niche reason for why that would never work in the US.
        nickpp 5y ago
        No I am saying regulation just guarantees you pay more. How much more depends how bad that regulation is. In USA, the situation is pretty much FUBAR.
oblio 5y ago
You're completely right. Yet in 99% of your peers, OECD countries, those regulated domains are generally more regulated, not less. And we're talking about 40 countries or so, many as diverse as the US, big enough to be comparable. How do these data point for into your narrative?
- nickpp 5y ago
  I believe that those regulated domains are generally much more expensive in all those countries, no?
  - oblio 5y ago
    You don't need to believe anything, you can check for yourself. The numbers are easily available online. Healthcare is 2-3-4 times <<more expensive in the US>>. Education is generally <<free or very cheap outside the US>>. Housing is expensive outside the US, too, a bit less so. I feel the problem is not regulation in the US, it's that you half ass it. Americans are all about "rugged individualism" and "small government" when advanced societies are advanced because large groups of people work well together, which is the opposite of individualism. I've been in places where there is an extreme emphasis on individualism and they generally they don't look good (for example Eastern Europe does it due to a huge negative legacy of forced collectivism).
    - nickpp 5y ago
      Nothing is "free" anywhere - it's just paid from a different pocket. From people's taxes in those "other" countries. And the quality of state-provided healthcare is significantly worse than in US. Most people with means get private medical insurance skipping the one purchased by their taxes entirely. Eastern Europe has two huge problem completely overshadowing their advantage from less regulation: a strong culture of corruption instilled by the years of communism and a gigantic brain drain to a west more than happy to lower their own costs (in health care as well) with the best of the cheap, highly educated Eastern workforce.
      - 5y ago
dtech 5y ago
Government is also heavily involved in car manufacturing and air travel those have become much cheaper. The real reason is non-scaling vs scaling, IP like tech and entertainment and internet are incredibly cheap to scale. Manufacturing has also become a lot cheaper and automated. In contrast, things that are supply constrained (housing) or mostly depend on human labour have become expensive. A nurse spends approximately the same time per patient as 100 years ago, a car requires a fraction of the human labour compared to 100 years ago.
- nickpp 5y ago
  Houses are supply constrained not because they're expensive to build (there technology helped) but because it's incredibly difficult to be allowed to build, due to... you guessed it - the countless rules and regulations. There is a deficit of qualified nurses not only because it takes time and money to train one but also because you are not legally allowed to hire one even if you find it, without the necessary papers and certifications. More regulations! So even if I agree with you - the human labor cost has increased and things dependent on it have become more expensive, the supply is artificially constrained by regulations as well. Imagine if it was illegal to hire programmers without a certification from a government approved body. Would we still enjoy this explosion of incredibly cheap software in everything?
- kiba 5y ago
  Cars are very expensive, not because of the car in themselves, but the infrastructure and land use policies required to make them convenient. Think of parking lots and roads. A more compact society would simply be less costly to maintain, and you can use public transit to scale transportation. Housing is only very expensive because of land use policies and we don't build enough of them. Once we have a more liberal land use policies, then maybe labor costs will start to matter.

by nickpp 5y ago

rocgf 5y ago

Gonna leave out housing and education, but for healthcare, you are painfully incorrect. European countries has vastly more regulated healthcare and yet pay about an order of magnitude less for it.

nickpp 5y ago
You have a good point, USA healthcare has the worst kind of regulation: it did lots of damage and helped very little. But Western European countries (which you probably compare to) had an immense, unspoken advantage: an incredible supply of highly educated, unexpensive health care work force - the Eastern Europe. If you want to truly compare the healthcare of USA with Europe's please include countries like Bulgaria, Ukraine, Serbia, Romania, Moldova and so on. Yes, it's cheap. But you truly get what you pay for.
- oblio 5y ago
  You can't compare Eastern Europe like that, though. Romania has a GDP per capita of 1/6th the US one and it spends a pitiful percentage of its GDP on healthcare, about 5%. The US spends 18%. So the US has 18 times more money (!) for healthcare. The other ones are even worse, Moldova's GDP per capita is 1/20th the US one. So probably 30 times more money spent by the US on healthcare. It's like comparing a maglev train to the original steam locomotive :-)
  - nickpp 5y ago
    You are ignoring what EE countries spend on training countless health care workers who then emigrate and work as cheap and highly educated in the West. And health care cost increase exponentially with quality, not linearly. Bleeding edge research and medical advances appear in the USA mostly. And mostly everybody enjoys the fruits.
    - oblio 5y ago
      I keep hearing about US research but Europe has huge pharma companies: Germany has a bunch, France some more, Switzerland, the UK. The US has a very parasitic healthcare system so I wonder how much their expenses are for actual research.
      - thehappypm 5y ago
        The US’s pharma have done a ton with pandemic medicine. Pfizer, Moderna, J&J, Novavax, Gilead, Merck..
        oblio 5y ago
        Biontech researched the Pfizer vaccine. It's a German company. AZ is British.
        thehappypm 5y ago
        Pfizer developed the treatment Paxlovid.
        oblio 5y ago
        https://www.voanews.com/a/european-drug-regulator-recommends-two-new-covid-19-treatments/6357712.html https://www.voanews.com/a/european-drug-regulator-recommends... The first one is Swedish and the second is British. The US is much better at creating visibility for its accomplishments.
- rocgf 5y ago
  You want to compare the richest country in history with Moldova? I'm not sure I see the point. My point was very simple. Out of all of the world's developed countries, the USA is the one with the most expensive healthcare, despite less regulations. My point was that regulation by the government does not lead to "incredibly more expensive healthcare", as you have have stated. From there, comparing the USA to Bulgaria is simply beside the point, the conversation was about regulation leading to "incredibly" higher costs.
  - nickpp 5y ago
    And my point was just as simple: those developed countries enjoy the benefit of cheap, educated doctors from Eastern Europe. Without them, their health care would be much more expensive.
    - rocgf 5y ago
      So, in the end, you're accepting that regulation is not the determining factor then. Not even sure what exactly you think the proportion of foreign-born medical staff is in Europe. As far as I can find, the maximum is ~30% in the UK, while in Germany is 7%. But either way, to think that this is somehow the reason why Americans pay way more than anyone else for basic stuff like insulin and medical bills is ridiculous in my eyes. Even if what you say is true for Western Europe, there are other countries (pretty much all) with highly-regulated healthcare and they all pay less than the US. But I'm sure there's some niche reason for why that would never work in the US.
      - nickpp 5y ago
        No I am saying regulation just guarantees you pay more. How much more depends how bad that regulation is. In USA, the situation is pretty much FUBAR.

oblio 5y ago

You're completely right. Yet in 99% of your peers, OECD countries, those regulated domains are generally more regulated, not less. And we're talking about 40 countries or so, many as diverse as the US, big enough to be comparable. How do these data point for into your narrative?

nickpp 5y ago
I believe that those regulated domains are generally much more expensive in all those countries, no?
- oblio 5y ago
  You don't need to believe anything, you can check for yourself. The numbers are easily available online. Healthcare is 2-3-4 times <<more expensive in the US>>. Education is generally <<free or very cheap outside the US>>. Housing is expensive outside the US, too, a bit less so. I feel the problem is not regulation in the US, it's that you half ass it. Americans are all about "rugged individualism" and "small government" when advanced societies are advanced because large groups of people work well together, which is the opposite of individualism. I've been in places where there is an extreme emphasis on individualism and they generally they don't look good (for example Eastern Europe does it due to a huge negative legacy of forced collectivism).
  - nickpp 5y ago
    Nothing is "free" anywhere - it's just paid from a different pocket. From people's taxes in those "other" countries. And the quality of state-provided healthcare is significantly worse than in US. Most people with means get private medical insurance skipping the one purchased by their taxes entirely. Eastern Europe has two huge problem completely overshadowing their advantage from less regulation: a strong culture of corruption instilled by the years of communism and a gigantic brain drain to a west more than happy to lower their own costs (in health care as well) with the best of the cheap, highly educated Eastern workforce.
    - 5y ago

dtech 5y ago

Government is also heavily involved in car manufacturing and air travel those have become much cheaper. The real reason is non-scaling vs scaling, IP like tech and entertainment and internet are incredibly cheap to scale. Manufacturing has also become a lot cheaper and automated. In contrast, things that are supply constrained (housing) or mostly depend on human labour have become expensive. A nurse spends approximately the same time per patient as 100 years ago, a car requires a fraction of the human labour compared to 100 years ago.

nickpp 5y ago
Houses are supply constrained not because they're expensive to build (there technology helped) but because it's incredibly difficult to be allowed to build, due to... you guessed it - the countless rules and regulations. There is a deficit of qualified nurses not only because it takes time and money to train one but also because you are not legally allowed to hire one even if you find it, without the necessary papers and certifications. More regulations! So even if I agree with you - the human labor cost has increased and things dependent on it have become more expensive, the supply is artificially constrained by regulations as well. Imagine if it was illegal to hire programmers without a certification from a government approved body. Would we still enjoy this explosion of incredibly cheap software in everything?
kiba 5y ago
Cars are very expensive, not because of the car in themselves, but the infrastructure and land use policies required to make them convenient. Think of parking lots and roads. A more compact society would simply be less costly to maintain, and you can use public transit to scale transportation. Housing is only very expensive because of land use policies and we don't build enough of them. Once we have a more liberal land use policies, then maybe labor costs will start to matter.