3 ms·

The US federal government also spends more per capita on healthcare than almost every other nation.

by buildartefact 4y ago

nightski 4y ago
Median after tax income per capita in the U.S. is really high as well, almost at the top.
- acdha 4y ago
  Less so after you correct for all of the things which we have to pay for out of pocket: health insurance, copays, drugs, etc. but also things like education, childcare, retirement, transportation, and often housing. I’ve known a number of people from Europe or Asia and all of them commented on how they thought they’d be making more here based on the raw income numbers, and how much more stressful it was here because you had to do more work yourself to get the same or lesser quality.
  - nightski 4y ago
    A lot of those things are based on life circumstances. If you have a large family in a major metropolitan area making the median income then yeah you might be worse off. If you are a tech worker in a small city or town then it can be quite lucrative. You have a lot of control over these variables, especially when younger.
    - notch656a 4y ago
      >Less so after you correct for all of the things which we have to pay for out of pocket: health insurance, copays, drugs, etc. but also things like education, childcare, retirement, transportation, and often housing. You end up paying for those things in other countries where you're provided them but not directly charged for it. The difference is in the USA for most of those if you don't pay you simply don't get the service, while in other countries you get the service but the tax-man may come and put you in jail if you don't pay for them. It's an individual choice but I prefer getting to pick (at least a little bit) how to spend that money personally rather than the government entirely deciding for me, although I can see how someone coming from a place where government does all that would find it uncomfortable.
      - buildartefact 4y ago
        But that’s the point: you’re already paying more in taxes for healthcare than anyone else in the world, and then you’re paying again to an insurance company. You’re literally paying twice.
  - hot_gril 4y ago
    So I buy health insurance and save money however I choose for later expenses. I don't see how it's easier or less stressful to bring the government into that loop, unless I don't care at all.
    - acdha 4y ago
      It’s all the stuff you left out: for example, you’re spending on average 2-3 times more so you’re probably not actually saving more. Finding providers will require you to spend a lot of time finding doctors, dentists, specialists, etc. who you like, accept your insurance, and are accepting patients. Often the intersection of those things requires substantial travel to areas without transit so how that whatever medical needs you develop don’t preclude driving. If you did have any real medical needs - even common life events like an uncomplicated natural pregnancy – you’ll need to have tens to hundreds of thousands of dollars saved to avoid needing to negotiate a payment plan. That’s even more pricey if you need medication or care for an ongoing basis. Because the doctors are for-profit, you’re going to be steered towards unnecessary services and you’ll need to review every bill to make sure only things you approved are listed - hospitals are notorious for having some random out-of-network specialist pop in for 30 seconds to add $15k to your bill. Because your insurance company is for-profit, be prepared to need to escalate or threaten to sue to have necessary treatment authorized. Your doctor’s medical expertise is secondary to Fred in claims processing, hope whatever you have doesn’t get worse in the meantime! Also because your doctor and insurance company are for-profit, expect either of them to stop doing business with the other any time it’s more profitable. There’s no guarantee that anyone in-network will be available in your area and you’ll likely need to haggle to get permission to go out of network. None of that is great to deal with while your family is caring for someone with whatever issues need testing and it’s made even more fun by the knowledge that almost nobody in what you’d consider a peer country has to deal with anything like that much hassle.
      - hot_gril 4y ago
        > It’s all the stuff you left out: for example, you’re spending on average 2-3 times more so you’re probably not actually saving more. What I spend on health insurance is far less than the difference in pay I'd get working in a peer country as a SWE, even if ignoring the difference in taxes. I'm not saving up tens of thousands of dollars for common life events; it's covered. And the opportunities are better here. My family members and friends from Iran and Lebanon tell each other, France or Germany is better if you want to sit on an entry-level job (which some do), US is better if you're ambitious. There's a real brain drain.
- deleted 4y ago
  [deleted]

The US federal government also spends more per capita on healthcare than almost every other nation.

nightski 4y ago

Median after tax income per capita in the U.S. is really high as well, almost at the top.

acdha 4y ago
Less so after you correct for all of the things which we have to pay for out of pocket: health insurance, copays, drugs, etc. but also things like education, childcare, retirement, transportation, and often housing. I’ve known a number of people from Europe or Asia and all of them commented on how they thought they’d be making more here based on the raw income numbers, and how much more stressful it was here because you had to do more work yourself to get the same or lesser quality.
- nightski 4y ago
  A lot of those things are based on life circumstances. If you have a large family in a major metropolitan area making the median income then yeah you might be worse off. If you are a tech worker in a small city or town then it can be quite lucrative. You have a lot of control over these variables, especially when younger.
  - notch656a 4y ago
    >Less so after you correct for all of the things which we have to pay for out of pocket: health insurance, copays, drugs, etc. but also things like education, childcare, retirement, transportation, and often housing. You end up paying for those things in other countries where you're provided them but not directly charged for it. The difference is in the USA for most of those if you don't pay you simply don't get the service, while in other countries you get the service but the tax-man may come and put you in jail if you don't pay for them. It's an individual choice but I prefer getting to pick (at least a little bit) how to spend that money personally rather than the government entirely deciding for me, although I can see how someone coming from a place where government does all that would find it uncomfortable.
    - buildartefact 4y ago
      But that’s the point: you’re already paying more in taxes for healthcare than anyone else in the world, and then you’re paying again to an insurance company. You’re literally paying twice.
- hot_gril 4y ago
  So I buy health insurance and save money however I choose for later expenses. I don't see how it's easier or less stressful to bring the government into that loop, unless I don't care at all.
  - acdha 4y ago
    It’s all the stuff you left out: for example, you’re spending on average 2-3 times more so you’re probably not actually saving more. Finding providers will require you to spend a lot of time finding doctors, dentists, specialists, etc. who you like, accept your insurance, and are accepting patients. Often the intersection of those things requires substantial travel to areas without transit so how that whatever medical needs you develop don’t preclude driving. If you did have any real medical needs - even common life events like an uncomplicated natural pregnancy – you’ll need to have tens to hundreds of thousands of dollars saved to avoid needing to negotiate a payment plan. That’s even more pricey if you need medication or care for an ongoing basis. Because the doctors are for-profit, you’re going to be steered towards unnecessary services and you’ll need to review every bill to make sure only things you approved are listed - hospitals are notorious for having some random out-of-network specialist pop in for 30 seconds to add $15k to your bill. Because your insurance company is for-profit, be prepared to need to escalate or threaten to sue to have necessary treatment authorized. Your doctor’s medical expertise is secondary to Fred in claims processing, hope whatever you have doesn’t get worse in the meantime! Also because your doctor and insurance company are for-profit, expect either of them to stop doing business with the other any time it’s more profitable. There’s no guarantee that anyone in-network will be available in your area and you’ll likely need to haggle to get permission to go out of network. None of that is great to deal with while your family is caring for someone with whatever issues need testing and it’s made even more fun by the knowledge that almost nobody in what you’d consider a peer country has to deal with anything like that much hassle.
    - hot_gril 4y ago
      > It’s all the stuff you left out: for example, you’re spending on average 2-3 times more so you’re probably not actually saving more. What I spend on health insurance is far less than the difference in pay I'd get working in a peer country as a SWE, even if ignoring the difference in taxes. I'm not saving up tens of thousands of dollars for common life events; it's covered. And the opportunities are better here. My family members and friends from Iran and Lebanon tell each other, France or Germany is better if you want to sit on an entry-level job (which some do), US is better if you're ambitious. There's a real brain drain.
deleted 4y ago
[deleted]