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USA Healthcare is 19.5% of GDP. Canada + Australia + UK + (a few similar countries) average 10.5% of GDP. The USA healthcare price gouges via run away prices.

USA Healthcare is 19.5% of GDP. Canada + Australia + UK + (a few similar countries) average 10.5% of GDP. The USA healthcare price gouges via run away prices. Healthcare corporations corrupting congress is the fuel that forces this on people (and breaks a free market).

chii 4y ago
But looking from another perspective - if healthcare is 20% of GDP, an awful amount of people are therefore paid directly due to this "waste". Any improvement in efficiency would mean those people lose out on jobs. A new use for them must be found, or there will be massive unemployment (at least, short-medium term).
- Invictus0 4y ago
  Yes, and we should also think of the blacksmiths and the elevator operators, milkmen and horse carriage drivers, who will unfortunately be out of a job if we make our society more efficient.
  - cuteboy19 4y ago
    Why not go further still. Smash a window so that window makers can make a living, slash someone's tires so that tire companies can employ more people.
    - hutzlibu 4y ago
      I heard some people in all seriousness explain, that they throw their garbage just on the way and not in a bin, to create cleaning jobs.
    - JackFr 4y ago
      I’ll go one better - pay they rat catchers per rat so they start breeding them.
      - jkestner 4y ago
        aka https://en.wikipedia.org/wiki/Great_Hanoi_Rat_Massacre https://en.wikipedia.org/wiki/Great_Hanoi_Rat_Massacre
- richiebful1 4y ago
  My current job depends on the current system being wasteful (healthcare insurance administration). But I'd much rather have to find a new job in a new industry than have the current healthcare system of the United States.
- seandoe 4y ago
  Not sure why you're getting down voted so bad. It's a valid point. I recognize that there is waste and inefficiency in the system, but I can guarantee that any effort to "streamline" or cut "waste" will inevitably hurt everyday people... Even outside of job cuts.
  - cuteboy19 4y ago
    If keeping existing inefficiency protects jobs, perhaps introducing new inefficiency creates jobs? But that would mean that we should force people to do wasteful things in order to stimulate the economy! Thankfully the economist bastiat solved this absurdity in 1850. https://en.m.wikipedia.org/wiki/Parable_of_the_broken_window https://en.m.wikipedia.org/wiki/Parable_of_the_broken_window
    - chii 4y ago
      > we should force people to do wasteful things in order to stimulate the economy! you laugh, but this is exactly what the US gov't does, esp. with military budget allocation. Why do you think all sorts of military products are split into different pieces for manufacturing, separated into different states? It certainly doesn't help efficiency. I'm not saying that healthcare shouldn't be improved via efficiency increases - it needs improving! But let's not kumbaya and ignore the plight of those whose livelihood would be disrupted (and not of their own fault).
- hattmall 4y ago
  Most want be unemployed they will just make a lot less. Doctors, Surgeons and administrators are barely breaking 6 figures in many socialized systems, and those come with far higher tax burdens typically.
- specialist 4y ago
  Yup. For the (downvoting) peanut gallery: aka "political economy". Obama Admin's compromises wrt ACA reform vs jobs has been written about. Another example of political economy is two different efforts to address climate crisis, with very different outcomes. During the Obama Admin, the push was for carbon taxes. Wonks loved it. Logical, concise, moral. Complete nonstarter. Because carbon taxes has no built-in constituency that's willing to advocate and defend it. Whereas in 2020, progressives pushed "green new deal" themed industrial policy and investment strategy. Made most everyone a benefactor. Millions of jobs. 100s of billions of dollars. Much better political economy.
- smcl 4y ago
  This is a peculiar perspective to see on HN. Isn't the entire business model of startups and YC based on ruthlessly "disrupting" industries using efficiency gains achieved through technology, causing the same sort of unemployment? Why should healthcare billing and administration be any different?
  - granshaw 4y ago
    Actual founders are maybe 0.1% of the HN reader base. Most everyone else are tech workers not looking to disrupt anything.
    - smcl 4y ago
      I'm mostly interested why the USA suddenly becomes pro-worker when it comes to this expensive and inefficient healthcare system they have. I swear you could be talking to the most hardline GOP guy who wouldn't spit on a trade unionist if they were on fire ... but if you mention, say, single-payer healthcare they'll start weeping for the all the workers in hospitals' billing departments and in health insurance companies who will lose their jobs. I mean I don't want anyone suffering either (one would hope you'd have adequate social safety net to take care of these people until they find another job) but it's such a bizarre exemption to carve out
      - robertlagrant 4y ago
        No, they're worried that single-payer would increase healthcare costs and/or decrease quality. They might be wrong, but that's not why they'd be worried.
        smcl 4y ago
        I've heard that too, but I have heard on multiple occasions that this will cause a lot of people employed in the field to lose their (sometimes quite well paying) jobs working in billing.
        4y ago
- cycomanic 4y ago
  There was a quote by an opposition politician in Germany to the argument that Germany should buy the Eurofighter (which had huge cost overruns etc.) because it creates jobs. Loosely translated: "We can also build a pyramid for Helmut Kohl [chancellor at the time] if the goal is to create jobs".
  - trashtester 4y ago
    The defence industry is treated like that in every country. Part of the reason why a country wants to retain some military industry domestically, is to ensure production capacity during a security crisis (kind of like for agriculture). It's not just "jobs", but "jobs" with that particular skillset. For instance, Germany is producing the Leopard 2. They may export most of them during peacetime, but should they need to, they could start pumping out those tanks for the Bundeswehr instead. Furthermore, with the skills available domestically, it would take much less time to repurpose VW/BMW/Audi factories to also produce weapons.
- taneq 4y ago
  Or maybe it would mean that more people actually receive quality care? In AU, at least, our waiting periods for pretty much everything are ridiculous.
- anon_123g987 4y ago
  Two economists are walking in a forest when they come across a pile of shit. The first economist says to the other “I’ll pay you $100 to eat that pile of shit.” The second economist takes the $100 and eats the pile of shit. They continue walking until they come across a second pile of shit. The second economist turns to the first and says “I’ll pay you $100 to eat that pile of shit.” The first economist takes the $100 and eats a pile of shit. Walking a little more, the first economist looks at the second and says, "You know, I gave you $100 to eat shit, then you gave me back the same $100 to eat shit. I can't help but feel like we both just ate shit for nothing." "That's not true," responded the second economist. "We increased the GDP by $200!"
  - chii 4y ago
    They did produce $200 worth of value - i'm sure if the first economist didn't enjoy watching the 2nd eat some shit, he wouldn't have paid. You used a wrong allegory to try to demonstrate a point that noone was making.
jaarse 4y ago
I’m a Canadian, and I would never want to give up our single payer system. That being said, Canada has a huge health care problem right now. Frequently they need to close emergency services in major (& minor) cities at night due to staff shortages. The wait times for basic diagnostics is on the order of months (not days or weeks). For example, a relative of mine has lost 90 pounds since the start of the year, complained of chest pains and couldn’t (still can’t) swallow. They just got a basic scan after 6 months of waiting to confirm a baseball sized tumour in their lungs. For many years we ran with just the bare minimum of staffing and equipment to keep costs low, and now, due to a number of factors our system can’t keep up. Waste is not good, but a little bit of extra capacity (and cost) isn’t a bad thing when it comes to emergency services.
- mikepurvis 4y ago
  To be fair, I think at least some of that is burned out healthcare professionals quitting after two+ of pandemic ridiculousness. (Ridiculousness not being the pandemic itself, but inadequate resources, planning, and political cover from all levels of government.)
- multiplegeorges 4y ago
  Much of the current failures are due to conservative provincial governments (looking at you, Ontario...) purposely underfunding before and into the pandemic. We are now reaping what they have sown. This is a classic "underfund to prove the system doesn't work thus we must privatize it!" move.
  - antasvara 4y ago
    How much do you estimate this is being underfunded, and do you believe proper funding for healthcare would push the percentage of GDP closer to the US number?
    - adgjlsfhk1 4y ago
      You're assuming the US healthcare system isn't equally underfunded. The US has massive doctors shortages (especially in rural areas), and that's not counting all the care the US just doesn't do because people instead just die since they can't afford to go to the hospital.
abigail95 4y ago
AU is closer to double that
- gravelc 4y ago
  Reference please. This says 10.2% as of 2020 : https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure https://www.aihw.gov.au/reports/health-welfare-expenditure/h...
throwtheacctawy 4y ago
dang 3y ago
We detached this (mostly off-topic) subthread from https://news.ycombinator.com/item?id=32744719 https://news.ycombinator.com/item?id=32744719.

chii 4y ago

But looking from another perspective - if healthcare is 20% of GDP, an awful amount of people are therefore paid directly due to this "waste". Any improvement in efficiency would mean those people lose out on jobs. A new use for them must be found, or there will be massive unemployment (at least, short-medium term).

Invictus0 4y ago
Yes, and we should also think of the blacksmiths and the elevator operators, milkmen and horse carriage drivers, who will unfortunately be out of a job if we make our society more efficient.
- cuteboy19 4y ago
  Why not go further still. Smash a window so that window makers can make a living, slash someone's tires so that tire companies can employ more people.
  - hutzlibu 4y ago
    I heard some people in all seriousness explain, that they throw their garbage just on the way and not in a bin, to create cleaning jobs.
  - JackFr 4y ago
    I’ll go one better - pay they rat catchers per rat so they start breeding them.
    - jkestner 4y ago
      aka https://en.wikipedia.org/wiki/Great_Hanoi_Rat_Massacre https://en.wikipedia.org/wiki/Great_Hanoi_Rat_Massacre
richiebful1 4y ago
My current job depends on the current system being wasteful (healthcare insurance administration). But I'd much rather have to find a new job in a new industry than have the current healthcare system of the United States.
seandoe 4y ago
Not sure why you're getting down voted so bad. It's a valid point. I recognize that there is waste and inefficiency in the system, but I can guarantee that any effort to "streamline" or cut "waste" will inevitably hurt everyday people... Even outside of job cuts.
- cuteboy19 4y ago
  If keeping existing inefficiency protects jobs, perhaps introducing new inefficiency creates jobs? But that would mean that we should force people to do wasteful things in order to stimulate the economy! Thankfully the economist bastiat solved this absurdity in 1850. https://en.m.wikipedia.org/wiki/Parable_of_the_broken_window https://en.m.wikipedia.org/wiki/Parable_of_the_broken_window
  - chii 4y ago
    > we should force people to do wasteful things in order to stimulate the economy! you laugh, but this is exactly what the US gov't does, esp. with military budget allocation. Why do you think all sorts of military products are split into different pieces for manufacturing, separated into different states? It certainly doesn't help efficiency. I'm not saying that healthcare shouldn't be improved via efficiency increases - it needs improving! But let's not kumbaya and ignore the plight of those whose livelihood would be disrupted (and not of their own fault).
hattmall 4y ago
Most want be unemployed they will just make a lot less. Doctors, Surgeons and administrators are barely breaking 6 figures in many socialized systems, and those come with far higher tax burdens typically.
specialist 4y ago
Yup. For the (downvoting) peanut gallery: aka "political economy". Obama Admin's compromises wrt ACA reform vs jobs has been written about. Another example of political economy is two different efforts to address climate crisis, with very different outcomes. During the Obama Admin, the push was for carbon taxes. Wonks loved it. Logical, concise, moral. Complete nonstarter. Because carbon taxes has no built-in constituency that's willing to advocate and defend it. Whereas in 2020, progressives pushed "green new deal" themed industrial policy and investment strategy. Made most everyone a benefactor. Millions of jobs. 100s of billions of dollars. Much better political economy.
smcl 4y ago
This is a peculiar perspective to see on HN. Isn't the entire business model of startups and YC based on ruthlessly "disrupting" industries using efficiency gains achieved through technology, causing the same sort of unemployment? Why should healthcare billing and administration be any different?
- granshaw 4y ago
  Actual founders are maybe 0.1% of the HN reader base. Most everyone else are tech workers not looking to disrupt anything.
  - smcl 4y ago
    I'm mostly interested why the USA suddenly becomes pro-worker when it comes to this expensive and inefficient healthcare system they have. I swear you could be talking to the most hardline GOP guy who wouldn't spit on a trade unionist if they were on fire ... but if you mention, say, single-payer healthcare they'll start weeping for the all the workers in hospitals' billing departments and in health insurance companies who will lose their jobs. I mean I don't want anyone suffering either (one would hope you'd have adequate social safety net to take care of these people until they find another job) but it's such a bizarre exemption to carve out
    - robertlagrant 4y ago
      No, they're worried that single-payer would increase healthcare costs and/or decrease quality. They might be wrong, but that's not why they'd be worried.
      - smcl 4y ago
        I've heard that too, but I have heard on multiple occasions that this will cause a lot of people employed in the field to lose their (sometimes quite well paying) jobs working in billing.
        4y ago
cycomanic 4y ago
There was a quote by an opposition politician in Germany to the argument that Germany should buy the Eurofighter (which had huge cost overruns etc.) because it creates jobs. Loosely translated: "We can also build a pyramid for Helmut Kohl [chancellor at the time] if the goal is to create jobs".
- trashtester 4y ago
  The defence industry is treated like that in every country. Part of the reason why a country wants to retain some military industry domestically, is to ensure production capacity during a security crisis (kind of like for agriculture). It's not just "jobs", but "jobs" with that particular skillset. For instance, Germany is producing the Leopard 2. They may export most of them during peacetime, but should they need to, they could start pumping out those tanks for the Bundeswehr instead. Furthermore, with the skills available domestically, it would take much less time to repurpose VW/BMW/Audi factories to also produce weapons.
taneq 4y ago
Or maybe it would mean that more people actually receive quality care? In AU, at least, our waiting periods for pretty much everything are ridiculous.
anon_123g987 4y ago
Two economists are walking in a forest when they come across a pile of shit. The first economist says to the other “I’ll pay you $100 to eat that pile of shit.” The second economist takes the $100 and eats the pile of shit. They continue walking until they come across a second pile of shit. The second economist turns to the first and says “I’ll pay you $100 to eat that pile of shit.” The first economist takes the $100 and eats a pile of shit. Walking a little more, the first economist looks at the second and says, "You know, I gave you $100 to eat shit, then you gave me back the same $100 to eat shit. I can't help but feel like we both just ate shit for nothing." "That's not true," responded the second economist. "We increased the GDP by $200!"
- chii 4y ago
  They did produce $200 worth of value - i'm sure if the first economist didn't enjoy watching the 2nd eat some shit, he wouldn't have paid. You used a wrong allegory to try to demonstrate a point that noone was making.

jaarse 4y ago

I’m a Canadian, and I would never want to give up our single payer system. That being said, Canada has a huge health care problem right now. Frequently they need to close emergency services in major (& minor) cities at night due to staff shortages. The wait times for basic diagnostics is on the order of months (not days or weeks). For example, a relative of mine has lost 90 pounds since the start of the year, complained of chest pains and couldn’t (still can’t) swallow. They just got a basic scan after 6 months of waiting to confirm a baseball sized tumour in their lungs. For many years we ran with just the bare minimum of staffing and equipment to keep costs low, and now, due to a number of factors our system can’t keep up. Waste is not good, but a little bit of extra capacity (and cost) isn’t a bad thing when it comes to emergency services.

mikepurvis 4y ago
To be fair, I think at least some of that is burned out healthcare professionals quitting after two+ of pandemic ridiculousness. (Ridiculousness not being the pandemic itself, but inadequate resources, planning, and political cover from all levels of government.)
multiplegeorges 4y ago
Much of the current failures are due to conservative provincial governments (looking at you, Ontario...) purposely underfunding before and into the pandemic. We are now reaping what they have sown. This is a classic "underfund to prove the system doesn't work thus we must privatize it!" move.
- antasvara 4y ago
  How much do you estimate this is being underfunded, and do you believe proper funding for healthcare would push the percentage of GDP closer to the US number?
  - adgjlsfhk1 4y ago
    You're assuming the US healthcare system isn't equally underfunded. The US has massive doctors shortages (especially in rural areas), and that's not counting all the care the US just doesn't do because people instead just die since they can't afford to go to the hospital.

abigail95 4y ago

AU is closer to double that

gravelc 4y ago
Reference please. This says 10.2% as of 2020 : https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure https://www.aihw.gov.au/reports/health-welfare-expenditure/h...

throwtheacctawy 4y ago

dang 3y ago

We detached this (mostly off-topic) subthread from https://news.ycombinator.com/item?id=32744719 https://news.ycombinator.com/item?id=32744719.