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It’s kinda good the planet gets to run both experiments, and more. The EU approach seems to want to insert government in to contracts between private individua

It’s kinda good the planet gets to run both experiments, and more. The EU approach seems to want to insert government in to contracts between private individual and those they do business with, and the US approach seems to want to maybe allow too much power to accumulate in those who wield the mercantile powers. The optimal approach probably lies in the tension between multiple loci.

hx8 11mo ago
It's one experiment because both systems are competing at the same time for global resources both in cooperation and competition with each other and other actors. Additional both systems exist in such widely different contexts that any comparison would be inaccurate because other factors such as geographic and historical have a large impact on any measured results.
anonym29 11mo ago
The optimal approach appears domain specific and granular, too. As for domain specificity: I don't know any Europeans who'd prefer to have American healthcare. I don't know any European technology companies that hold a candle to the sheer breadth and depth of capabilities brought into the world by Google, Apple, Microsoft, Amazon, Nvidia, AMD, Intel, OpenAI, or Anthropic. Yes, Mistral, Nokia, OVH, and SAP exist, but compared to the alternarives, they exist in the way the American healthcare system exists compared to its alternatives. As for granularity: Perhaps we want American style governance for building the tech, but then European style governance for running it?
- jojobas 11mo ago
  >I don't know any Europeans who'd prefer to have American healthcare. Some 50-100k Europeans fly to the US to get American healthcare every year.
  - lionkor 11mo ago
    I couldn't find a source for this with a quick couple of searches, could you provide one?
    - csande17 11mo ago
      I'm not GP, but https://www.trade.gov/survey-international-air-travelers-siat https://www.trade.gov/survey-international-air-travelers-sia... suggests that in 2024 about 0.4% of European travellers to the US told the government they were coming to receive medical treatment, and https://www.trade.gov/feature-article/december-and-annual-2024-total-international-travel-volume https://www.trade.gov/feature-article/december-and-annual-20... says about 13 million people from Western Europe visited the US in 2024, and if you multiply those numbers you get 50k.
  - theturtle32 11mo ago
    That isn’t the flex you think it is lol
  - saghm 11mo ago
    So the other 99.987% of Europeans agree with the parent comment?
    - Auracle 11mo ago
      No, they just can’t afford it or don’t need it.
      - dpark 11mo ago
        Most people prefer healthcare they afford over healthcare they can’t. (Most, not all. There are a surprisingly large chunk of Americans who seem to vote Against their best interests in a lot of areas.)
      - saghm 11mo ago
        I would argue that "don't need it" could just as easily be because they have better healthcare closer to home.
  - stwr 11mo ago
    Ok, so about 0.0134%, Parent comment’s point is that -the average European- absolutely does not want the US healthcare system in Europe. Simply due to our shared believe healthcare is a basic right and should be universally available to everyone. Those who have the financial means to travel to the USA for medical treatment do so largely due to running out of conventional options at home, experimental treatments or specific doctors who are regarded as the best in their particular field. Most of the US outbound medical travel is due to treatment at home being too expensive and risking pushing entire families to bankruptcy. The fact that 100k europeans fly to the US for medical treatment is factual, but does not equal them wanting the US healthcare system in Europe.
    - jojobas 11mo ago
      That's about how many need it, can afford it, and can't wait for an appointment in half a year.
      - teiferer 11mo ago
        Idk .. I injured my knee playing soccer (tore a bunch of ligaments) a few months ago. Wasn't life threatening. Still, got care after waiting for about an hour, xray and all. On a Saturday. In Sweden, single payer insurance. I paid only about $20 out of pocket.
  - dpark 11mo ago
    Just as a contrasting data point, some estimates are that well over a million Americans travel overseas for medical care every year. https://www.amjmed.com/article/S0002-9343%2818%2930620-X/fulltext https://www.amjmed.com/article/S0002-9343%2818%2930620-X/ful... This is mostly to obtain cheaper care. In general America does seem to have some of the best care in terms of quality. It’s just also some of the least affordable.
    - jojobas 11mo ago
      US is not the only destination for Europeans, they also go to Thailand and wherever. Few Americans go to Europe. It's not affordable, but when money is not the issue you go to the US.
    - spogbiper 11mo ago
      i'm one of the Americans. went to South america for a dental procedure that was 12k in the US, 2.5k there. very modern facilities, they had some better tech than my american dentist. if you can speak a bit of spanish, i highly recommend looking into it for expensive dental stuff.
- scarby2 11mo ago
  > I don't know any Europeans who'd prefer to have American healthcare. Selfishly I think my American healthcare is better than anything I ever had in the UK. I can see a doctor within 2 weeks even a specialist, I can actually get a sleep study, my doctor will actually listen to me rather than tell me I'm just getting old, go home and take an ibuprofen.
  - bobthepanda 11mo ago
    specialists in two weeks is definitely not the norm everywhere in the US. it's certainly not in Seattle.
    - ptero 11mo ago
      This is likely very regional. As a single data point, raising the family in the Boston area for the last 25 years I do not recall not being able to see a doctor the same day for the regular scares, from ear pains and high fever to falling and later vomiting (is this a concussion?). A few times when we needed to see specialists, we often saw them within 24 hours; occasionally longer but I would say with a median of 48-72 hours. Even things that are clearly not urgent (for dermatologist "hey, I have forgotten about skin checks for the last 2 years, can we do the next one now", for ENT "hey, my son is getting nosebleeds during high intensity sports; can you check if there is a specific blood vessel that is causing problems"?) always happened well within two weeks. Three caveats to this happy story: 1. This is Boston area with likely the highest concentration of medical practitioners of all kinds in the US. I had good insurance with a large network, decent out-of-network coverage and for most cases not needed a pre-approval to see a specialist. 2. Everyone is generally healthy and our "specialist needs" were likely well trodden paths with many available specialists. 3. Our usage of the doctors, as the kids became generally healthy teenagers and adults, dropped significantly in the last 5-7 years. I hear post-covid the situation is changing and I may be heavily skewing to the earlier period.
      - bobthepanda 11mo ago
        At least from what I can see, COVID and the changes in attitudes towards medical professionals are driving a lot of burnout and leaving the profession; and since then economic pressures are squeezing private practices out of existence and a lot of specialists end up working for private equity now.
- YouAreWRONGtoo 11mo ago
  [dead]
- pyrale 11mo ago
  I don’t want to rain on your parade, but you would be more fair by replacing these companies with VCs, because they’re the ones lifting real weight here.
- ekianjo 11mo ago
  > I don't know any Europeans who'd prefer to have American healthcare. Probably depends a lot on where you are in Europe. Some countries have long waiting lists for surgeries (life saving ones) and access to doctors is very limited (too few, months to get an appointment) so it sucks as well if you are in such a situation
  - TylerE 11mo ago
    Here in America we have to wait months for the privilege of paying out the nose.
- fakedang 11mo ago
  The American model of governance was created for a world with very distant nation-state threats but a large number of colonial threats, which is why it's centered around "every man for themselves" (in spite of FDR's best efforts). On the contrary, European governance was basically developed during the Revolutionary Wave, which was sweeping all across Europe, that monarchies found that the only way to appease the people was to give into their reforms - and often rapidly because of the domino effects of revolutions. In other words, American governance was built from the ground up, while European governance had to be adjusted within the existing environment and monarchical government frameworks. In fact, European governments weren't even well-defined in their current state up until the end of WW2, in spite of how much Europeans like to take potshots against USA for being a "young" nation. This does make the American form great for working with uncharted territory (how to handle new tech, how to exploit the earth in new ways, etc.) while the European form is more reactionary (how do we keep the people appeased, how do we provide a better standard of living, how do we alleviate hardship). Perhaps the ideal mix of the two, between the frontier-style governance and European-style reactionism, like the Swiss model.
cma 11mo ago
The US approach is more than that, for instance if every employee in a business pushes for a contract that says workers will negotiate as a block and pay new union dues, and the contract says new hires will be bound by that too, that's illegal in many states. Not just the normal "right-to-work" restrictions, the contract isn't valid even if unanimously agreed on by every current employee (union security agreements). But for shareholders they all set it up like that, with votes weighted by dollars. A new shareholder can't buy someone's shares and government says it's illegal for him to be bound by the voting structure. And secondary strikes are also illegal in the US under Taft-Hartley.

hx8 11mo ago

It's one experiment because both systems are competing at the same time for global resources both in cooperation and competition with each other and other actors. Additional both systems exist in such widely different contexts that any comparison would be inaccurate because other factors such as geographic and historical have a large impact on any measured results.

anonym29 11mo ago

The optimal approach appears domain specific and granular, too. As for domain specificity: I don't know any Europeans who'd prefer to have American healthcare. I don't know any European technology companies that hold a candle to the sheer breadth and depth of capabilities brought into the world by Google, Apple, Microsoft, Amazon, Nvidia, AMD, Intel, OpenAI, or Anthropic. Yes, Mistral, Nokia, OVH, and SAP exist, but compared to the alternarives, they exist in the way the American healthcare system exists compared to its alternatives. As for granularity: Perhaps we want American style governance for building the tech, but then European style governance for running it?

jojobas 11mo ago
>I don't know any Europeans who'd prefer to have American healthcare. Some 50-100k Europeans fly to the US to get American healthcare every year.
- lionkor 11mo ago
  I couldn't find a source for this with a quick couple of searches, could you provide one?
  - csande17 11mo ago
    I'm not GP, but https://www.trade.gov/survey-international-air-travelers-siat https://www.trade.gov/survey-international-air-travelers-sia... suggests that in 2024 about 0.4% of European travellers to the US told the government they were coming to receive medical treatment, and https://www.trade.gov/feature-article/december-and-annual-2024-total-international-travel-volume https://www.trade.gov/feature-article/december-and-annual-20... says about 13 million people from Western Europe visited the US in 2024, and if you multiply those numbers you get 50k.
- theturtle32 11mo ago
  That isn’t the flex you think it is lol
- saghm 11mo ago
  So the other 99.987% of Europeans agree with the parent comment?
  - Auracle 11mo ago
    No, they just can’t afford it or don’t need it.
    - dpark 11mo ago
      Most people prefer healthcare they afford over healthcare they can’t. (Most, not all. There are a surprisingly large chunk of Americans who seem to vote Against their best interests in a lot of areas.)
    - saghm 11mo ago
      I would argue that "don't need it" could just as easily be because they have better healthcare closer to home.
- stwr 11mo ago
  Ok, so about 0.0134%, Parent comment’s point is that -the average European- absolutely does not want the US healthcare system in Europe. Simply due to our shared believe healthcare is a basic right and should be universally available to everyone. Those who have the financial means to travel to the USA for medical treatment do so largely due to running out of conventional options at home, experimental treatments or specific doctors who are regarded as the best in their particular field. Most of the US outbound medical travel is due to treatment at home being too expensive and risking pushing entire families to bankruptcy. The fact that 100k europeans fly to the US for medical treatment is factual, but does not equal them wanting the US healthcare system in Europe.
  - jojobas 11mo ago
    That's about how many need it, can afford it, and can't wait for an appointment in half a year.
    - teiferer 11mo ago
      Idk .. I injured my knee playing soccer (tore a bunch of ligaments) a few months ago. Wasn't life threatening. Still, got care after waiting for about an hour, xray and all. On a Saturday. In Sweden, single payer insurance. I paid only about $20 out of pocket.
- dpark 11mo ago
  Just as a contrasting data point, some estimates are that well over a million Americans travel overseas for medical care every year. https://www.amjmed.com/article/S0002-9343%2818%2930620-X/fulltext https://www.amjmed.com/article/S0002-9343%2818%2930620-X/ful... This is mostly to obtain cheaper care. In general America does seem to have some of the best care in terms of quality. It’s just also some of the least affordable.
  - jojobas 11mo ago
    US is not the only destination for Europeans, they also go to Thailand and wherever. Few Americans go to Europe. It's not affordable, but when money is not the issue you go to the US.
  - spogbiper 11mo ago
    i'm one of the Americans. went to South america for a dental procedure that was 12k in the US, 2.5k there. very modern facilities, they had some better tech than my american dentist. if you can speak a bit of spanish, i highly recommend looking into it for expensive dental stuff.
scarby2 11mo ago
> I don't know any Europeans who'd prefer to have American healthcare. Selfishly I think my American healthcare is better than anything I ever had in the UK. I can see a doctor within 2 weeks even a specialist, I can actually get a sleep study, my doctor will actually listen to me rather than tell me I'm just getting old, go home and take an ibuprofen.
- bobthepanda 11mo ago
  specialists in two weeks is definitely not the norm everywhere in the US. it's certainly not in Seattle.
  - ptero 11mo ago
    This is likely very regional. As a single data point, raising the family in the Boston area for the last 25 years I do not recall not being able to see a doctor the same day for the regular scares, from ear pains and high fever to falling and later vomiting (is this a concussion?). A few times when we needed to see specialists, we often saw them within 24 hours; occasionally longer but I would say with a median of 48-72 hours. Even things that are clearly not urgent (for dermatologist "hey, I have forgotten about skin checks for the last 2 years, can we do the next one now", for ENT "hey, my son is getting nosebleeds during high intensity sports; can you check if there is a specific blood vessel that is causing problems"?) always happened well within two weeks. Three caveats to this happy story: 1. This is Boston area with likely the highest concentration of medical practitioners of all kinds in the US. I had good insurance with a large network, decent out-of-network coverage and for most cases not needed a pre-approval to see a specialist. 2. Everyone is generally healthy and our "specialist needs" were likely well trodden paths with many available specialists. 3. Our usage of the doctors, as the kids became generally healthy teenagers and adults, dropped significantly in the last 5-7 years. I hear post-covid the situation is changing and I may be heavily skewing to the earlier period.
    - bobthepanda 11mo ago
      At least from what I can see, COVID and the changes in attitudes towards medical professionals are driving a lot of burnout and leaving the profession; and since then economic pressures are squeezing private practices out of existence and a lot of specialists end up working for private equity now.
YouAreWRONGtoo 11mo ago
[dead]
pyrale 11mo ago
I don’t want to rain on your parade, but you would be more fair by replacing these companies with VCs, because they’re the ones lifting real weight here.
ekianjo 11mo ago
> I don't know any Europeans who'd prefer to have American healthcare. Probably depends a lot on where you are in Europe. Some countries have long waiting lists for surgeries (life saving ones) and access to doctors is very limited (too few, months to get an appointment) so it sucks as well if you are in such a situation
- TylerE 11mo ago
  Here in America we have to wait months for the privilege of paying out the nose.
fakedang 11mo ago
The American model of governance was created for a world with very distant nation-state threats but a large number of colonial threats, which is why it's centered around "every man for themselves" (in spite of FDR's best efforts). On the contrary, European governance was basically developed during the Revolutionary Wave, which was sweeping all across Europe, that monarchies found that the only way to appease the people was to give into their reforms - and often rapidly because of the domino effects of revolutions. In other words, American governance was built from the ground up, while European governance had to be adjusted within the existing environment and monarchical government frameworks. In fact, European governments weren't even well-defined in their current state up until the end of WW2, in spite of how much Europeans like to take potshots against USA for being a "young" nation. This does make the American form great for working with uncharted territory (how to handle new tech, how to exploit the earth in new ways, etc.) while the European form is more reactionary (how do we keep the people appeased, how do we provide a better standard of living, how do we alleviate hardship). Perhaps the ideal mix of the two, between the frontier-style governance and European-style reactionism, like the Swiss model.

cma 11mo ago

The US approach is more than that, for instance if every employee in a business pushes for a contract that says workers will negotiate as a block and pay new union dues, and the contract says new hires will be bound by that too, that's illegal in many states. Not just the normal "right-to-work" restrictions, the contract isn't valid even if unanimously agreed on by every current employee (union security agreements). But for shareholders they all set it up like that, with votes weighted by dollars. A new shareholder can't buy someone's shares and government says it's illegal for him to be bound by the voting structure. And secondary strikes are also illegal in the US under Taft-Hartley.