5 ms·

Things that are more expensive in the US for no reason: Healthcare Internet access College sighs and adds "The very act of making a purchase" At leas

Things that are more expensive in the US for no reason: Healthcare Internet access College sighs and adds "The very act of making a purchase" At least we have cheap gas? farts

api 2mo ago
Internet access sort of has a reason: the US is geographically huge and more sprawled out. But that's not enough to explain all of the difference.
- Ekaros 2mo ago
  That really explains only small parts. Even the horrible suburbs have little real reason to be that expensive. In the end it is really about lacking actual free market and enabling corporate capture as voted by the voters.
- alistairSH 2mo ago
  That might explain internet pricing in North Dakota, but it doesn't explain it in NYC or DC or LA.
  - joenot443 2mo ago
    I pay $40/mo for 500mbps in my Bushwick apartment - is that considered expensive?
    - alistairSH 2mo ago
      By US standards? No, probably not. But, a quick search indicates you can get similar broadband in Glasgow, Scotland for ~15 GBP/month. And Rome, Italy looks like ~25EUR/month.
      - stefanfisk 2mo ago
        I’m in Stockholm, and our condo HOA (BRF) includes 1Gbps per unit in the fee for all units because billing individually would cost more in admin than the service itself. We have FTTP and then cat6 to each unit.
        Symbiote 2mo ago
        In Copenhagen mine is billed individually, and is 75kr for 1Gb/s. About $10. Otherwise the same system.
        joenot443 2mo ago
        That sounds really convenient! Is it a new building? I know the odd American or Canadian build will have that, but only the newer and more expensive ones.
        stefanfisk 2mo ago
        The building is from the 1940s. But this is a pretty common setup for condos in Swedish cities. Rentals usually have access to the same infrastructure but at higher prices due to kickbacks demanded by the landlords from the ISPs. The backbone of it all is a state owned fiber connecting the cities together with municipal fiber. But even outside of the cities FTTP is quite common. There are companies which specialize in finding rural areas where there’s enough interest to justify the cost of connecting them and then coordinating getting an economic association setup to own and manage the local infrastructure.
        Hikikomori 2mo ago
        I had that in Sweden 20 years ago. Typically our local municipality put fiber whenever they dug up anything, so fiber is everywhere.
        whizzter 2mo ago
        This is something to underscore, US people always talks about how "big and sprawling" the US is, but there's fiber at my fathers house in Northern Sweden that's in an area with similar population density to Wisconsin or whatever rural US state you want to pick. Some kind of city(iirc) managed fiber and he can switch commercial operators (And speeds/prices) by contacting them to get new terms, that's an actually free market.
      - marcyb5st 2mo ago
        Just did my internet contract for my apartment in rural Italy (a town of around 2k people in the Verona province). 1Gb symmetric is indeed 25EUR/month. I added a few stuff on top like static IPv4 and reached 32EUR/month.
    - dawnerd 2mo ago
      I’m paying 100 bucks for 2.5gb fiber in socal. I don’t consider that expensive either. I’ve seen internet prices internationally and they kinda suck outside of some areas that have decent providers - but that goes for the US too.
- stefanfisk 2mo ago
  That’s not the reason. The required build out has actually already been been paid for: https://www.huffpost.com/entry/the-book-of-broken-promis_b_5839394 https://www.huffpost.com/entry/the-book-of-broken-promis_b_5.... But the US is so politically broken that corporations could just pocket the money without actually providing the infrastructure. That does even begin to touch on crazy laws banning people from setting up their own ISP to compete: https://www.techdirt.com/2024/11/07/16-u-s-states-still-ban-community-owned-broadband-networks-because-att-and-comcast-told-them-to/ https://www.techdirt.com/2024/11/07/16-u-s-states-still-ban-....
- topspin 2mo ago
  > the US is geographically huge and more sprawled out. There is ample historical evidence that this is a poor excuse. Long ago, leaders in the US understood the value of universality. You'll likely recognize this as the Network Effect, Metcalfe's Law, etc. Back in the day, they called this "universal service." That thinking was central to the policies established for both electrification and phone service in the US: it wasn't then, and isn't now, truly universal, but what could be feasibly accommodated was, even when costs were/are quite high. It wasn't lost on the people of those times that such policies inherently meant the cost of including sparsely populated, distant areas would be subsidized by concentrated areas. Before those systems appeared, the founders welded the same thinking into the US constitution in the form of the US postal service, with exactly the same knowledge and concerns. We've lost that. The change happened prior to the advent of the internet. You're free to attribute this to whatever you wish; I won't offer my view on that, except to say there are no innocents: every argument that fingers ebil capitalists can be countered by examples of urban leaders damning government policies that subsidize non-urbanites. What I know with certainty is, if packet switched networking was somehow a thing in the 19th century, availability would be a given for almost any structure more significant than a hunting cabin in the US today, complete with common carrier, service baselines and rates established with clarity.
- mrguyorama 2mo ago
  Why was that not a problem in the mid 1800s when we crisscrossed the entire country with railroads and telegraph cables? Sure is funny how FDR had us spend a little cash 100 years ago to ensure even the remotest farm gets electricity, and we already gave ISPs a shitload of cash to do the same, but now "We can't" build telephone poles to rural places. Even though those same places already have telephone poles for power and telephone. AT&T was able to leverage it's monopoly position and defense industry relationship to basically invent everything that runs the modern world (and were compelled to license those advancements out) while modern monopolies can't even dig some holes. Sounds like we need some more "Consent Decrees" and a DoJ that makes large companies scared. We damned every single river in the nation. We built so much railroad that it crashed the industry. We built those railroads purposely in places where nobody lived and then willed towns into existence around them. We built the interstate highway system. Why can we suddenly not build anything? Maybe it's because people keep insisting, against all historical evidence, that we can't, and they don't even try.
Gormo 2mo ago
Internet access isn't particularly expensive in the US. Healthcare, education, and housing are expensive in the US for the same primary reason: political interventions that simultaneously subsidize demand and restrict supply.
- red-iron-pine 2mo ago
  it is for what you get. the US LEC and CLEC system sucks, and I had wayyyy more options in the EU, and in fairly upfront and straightforward ways. e.g. https://documentscontractuels.orange.fr/les-offres-orange-mobile_fit_3788.pdf https://documentscontractuels.orange.fr/les-offres-orange-mo...
  - jimbob45 2mo ago
    The EU doesn’t have the challenging scope and geography of the US, no?
    - db48x 2mo ago
      The problem in the US is less of a geography problem and more of a regulatory one. Many towns and cities in the US gave the cable companies local monopolies back in the 50s and 60s. There are technical reasons why this worked ok (not well but perhaps better than the alternatives) for television, but now that the same rules have stretched to apply to delivery of internet access they no longer have any technical basis. So at this point they’re just a barrier to competition and exist only to raise prices. The good news is that modern fiber systems blow cable internet out of the water. It is far cheaper to supply symmetric gigabit internet to every customer over fiber than over cable. Fiber just has more bandwidth to go around. And because it’s a different technology it is not subject to the same local monopolies that cable is encumbered with. This means that the free market is correcting the problem and has been for a decade. In many parts of the country it is now possible to get internet that is faster and cheaper than what is available in the even the best built parts of Europe. The main obstacle to that build–out is probably local permitting. Many large cities require new permits, with public comment periods for each and every one of them, for every single block that an ISP lays fiber for. Cities like San Francisco have imposed a glacial pace on their ISPs.
joenot443 2mo ago
Bit for bit, internet access is cheaper in America than it is in Canada or Australia. Canadians like myself have ~40% of our provincial taxes spent on healthcare, so in my case about ~8% of my gross income. Somewhere in the tune of $20k/yr. While I was living in Seattle and filing American, quite a bit less of my gross income went to healthcare. Just food for thought.
- StrauXX 2mo ago
  But that is not because it's less efficient. With the Canadian system being socialzed and 20k$ being just 8% of your income it is to be expected that you would pay moch more than the median person into the system.
- 59percentmore 2mo ago
  "I make $250k CAD a year, my experiences must be representative of, and relevant to, the masses," is a wild thought to have. Well, maybe I spoke too soon, because my private American healthcare turns out to also be about 8% of my gross income (of $60k)(before copays and my deductible)(and also it's crap). Twinsies! But yes I agree that it would be awful to have my health needs taken care of and a mere ~160k USD left to spend on everything else.
  - joenot443 2mo ago
    Oh I certainly don’t think it’s representative to that of the masses, I was sharing an anecdote. I think either way both of us are in really good shape. In my experience the quality of American care is better in nearly every regard (having experienced both pretty intimately), but the simplicity and the peace of mind of the Canadian system has its benefits too. In either case you end up paying. > But yes I agree that it would be awful to have my health needs taken care of and a mere ~160k USD left to spend on everything else. I’m confused - do you actually think it’s awful?
    - bluealienpie 2mo ago
      I think the main issue that the NHS model of 10+ years ago worked when fully funded. The Canadian model is a mix match of US healthcare and Medicare. Some drugs aren’t covered, some procedures take forever, and you don’t get guaranteed doctor. Many European healthcare system have solved the issues we have, but Canada has refused to adopt any sensible system.
gnz11 2mo ago
You can add Pre-K education to that list. It's on par in terms of costs with sending your kids to college.
pjc50 2mo ago
Healthcare and college are "Baumol cost disease": because they depend on skilled workers, much of that is the same as "American salaries are higher than in the rest of the world", and unlike manufacturing or software (+) you can't outsource it to lower-wage countries. (+) there still seems to be a massive wage premium for "being physically in a San Francisco office" even if most of the work is being done by an AI, which cannot be sustainable
- sharts 1mo ago
  I dunno, telehealth with foreign doctors while maybe in-person nurses could lower costs substantially.
- sharemywin 2mo ago
  because code is only a small part of software development. don't forget ping pong tables. lol. I'm both making a valid point and making fun of it too.
- porkpieshoe 2mo ago
  If it was this simple, then high costs would be limited to the labor-driven portion of the bills. This is not the case.
- avadodin 1mo ago
  You can make all sort of excuses but we literally felt bad for 1:1 exchange students paying 2k a month while we paid 2k a year. Their education was not 10x ours and their economy was only a few % over ours per capita.
xyzelement 2mo ago
This is why people are moving out of the US in droves, the universities are empty and nobody goes to the doctor.

Things that are more expensive in the US for no reason: Healthcare Internet access College sighs and adds "The very act of making a purchase" At least we have cheap gas? farts

api 2mo ago

Internet access sort of has a reason: the US is geographically huge and more sprawled out. But that's not enough to explain all of the difference.

Ekaros 2mo ago
That really explains only small parts. Even the horrible suburbs have little real reason to be that expensive. In the end it is really about lacking actual free market and enabling corporate capture as voted by the voters.
alistairSH 2mo ago
That might explain internet pricing in North Dakota, but it doesn't explain it in NYC or DC or LA.
- joenot443 2mo ago
  I pay $40/mo for 500mbps in my Bushwick apartment - is that considered expensive?
  - alistairSH 2mo ago
    By US standards? No, probably not. But, a quick search indicates you can get similar broadband in Glasgow, Scotland for ~15 GBP/month. And Rome, Italy looks like ~25EUR/month.
    - stefanfisk 2mo ago
      I’m in Stockholm, and our condo HOA (BRF) includes 1Gbps per unit in the fee for all units because billing individually would cost more in admin than the service itself. We have FTTP and then cat6 to each unit.
      - Symbiote 2mo ago
        In Copenhagen mine is billed individually, and is 75kr for 1Gb/s. About $10. Otherwise the same system.
      - joenot443 2mo ago
        That sounds really convenient! Is it a new building? I know the odd American or Canadian build will have that, but only the newer and more expensive ones.
        stefanfisk 2mo ago
        The building is from the 1940s. But this is a pretty common setup for condos in Swedish cities. Rentals usually have access to the same infrastructure but at higher prices due to kickbacks demanded by the landlords from the ISPs. The backbone of it all is a state owned fiber connecting the cities together with municipal fiber. But even outside of the cities FTTP is quite common. There are companies which specialize in finding rural areas where there’s enough interest to justify the cost of connecting them and then coordinating getting an economic association setup to own and manage the local infrastructure.
        Hikikomori 2mo ago
        I had that in Sweden 20 years ago. Typically our local municipality put fiber whenever they dug up anything, so fiber is everywhere.
        whizzter 2mo ago
        This is something to underscore, US people always talks about how "big and sprawling" the US is, but there's fiber at my fathers house in Northern Sweden that's in an area with similar population density to Wisconsin or whatever rural US state you want to pick. Some kind of city(iirc) managed fiber and he can switch commercial operators (And speeds/prices) by contacting them to get new terms, that's an actually free market.
    - marcyb5st 2mo ago
      Just did my internet contract for my apartment in rural Italy (a town of around 2k people in the Verona province). 1Gb symmetric is indeed 25EUR/month. I added a few stuff on top like static IPv4 and reached 32EUR/month.
  - dawnerd 2mo ago
    I’m paying 100 bucks for 2.5gb fiber in socal. I don’t consider that expensive either. I’ve seen internet prices internationally and they kinda suck outside of some areas that have decent providers - but that goes for the US too.
stefanfisk 2mo ago
That’s not the reason. The required build out has actually already been been paid for: https://www.huffpost.com/entry/the-book-of-broken-promis_b_5839394 https://www.huffpost.com/entry/the-book-of-broken-promis_b_5.... But the US is so politically broken that corporations could just pocket the money without actually providing the infrastructure. That does even begin to touch on crazy laws banning people from setting up their own ISP to compete: https://www.techdirt.com/2024/11/07/16-u-s-states-still-ban-community-owned-broadband-networks-because-att-and-comcast-told-them-to/ https://www.techdirt.com/2024/11/07/16-u-s-states-still-ban-....
topspin 2mo ago
> the US is geographically huge and more sprawled out. There is ample historical evidence that this is a poor excuse. Long ago, leaders in the US understood the value of universality. You'll likely recognize this as the Network Effect, Metcalfe's Law, etc. Back in the day, they called this "universal service." That thinking was central to the policies established for both electrification and phone service in the US: it wasn't then, and isn't now, truly universal, but what could be feasibly accommodated was, even when costs were/are quite high. It wasn't lost on the people of those times that such policies inherently meant the cost of including sparsely populated, distant areas would be subsidized by concentrated areas. Before those systems appeared, the founders welded the same thinking into the US constitution in the form of the US postal service, with exactly the same knowledge and concerns. We've lost that. The change happened prior to the advent of the internet. You're free to attribute this to whatever you wish; I won't offer my view on that, except to say there are no innocents: every argument that fingers ebil capitalists can be countered by examples of urban leaders damning government policies that subsidize non-urbanites. What I know with certainty is, if packet switched networking was somehow a thing in the 19th century, availability would be a given for almost any structure more significant than a hunting cabin in the US today, complete with common carrier, service baselines and rates established with clarity.
mrguyorama 2mo ago
Why was that not a problem in the mid 1800s when we crisscrossed the entire country with railroads and telegraph cables? Sure is funny how FDR had us spend a little cash 100 years ago to ensure even the remotest farm gets electricity, and we already gave ISPs a shitload of cash to do the same, but now "We can't" build telephone poles to rural places. Even though those same places already have telephone poles for power and telephone. AT&T was able to leverage it's monopoly position and defense industry relationship to basically invent everything that runs the modern world (and were compelled to license those advancements out) while modern monopolies can't even dig some holes. Sounds like we need some more "Consent Decrees" and a DoJ that makes large companies scared. We damned every single river in the nation. We built so much railroad that it crashed the industry. We built those railroads purposely in places where nobody lived and then willed towns into existence around them. We built the interstate highway system. Why can we suddenly not build anything? Maybe it's because people keep insisting, against all historical evidence, that we can't, and they don't even try.

Gormo 2mo ago

Internet access isn't particularly expensive in the US. Healthcare, education, and housing are expensive in the US for the same primary reason: political interventions that simultaneously subsidize demand and restrict supply.

red-iron-pine 2mo ago
it is for what you get. the US LEC and CLEC system sucks, and I had wayyyy more options in the EU, and in fairly upfront and straightforward ways. e.g. https://documentscontractuels.orange.fr/les-offres-orange-mobile_fit_3788.pdf https://documentscontractuels.orange.fr/les-offres-orange-mo...
- jimbob45 2mo ago
  The EU doesn’t have the challenging scope and geography of the US, no?
  - db48x 2mo ago
    The problem in the US is less of a geography problem and more of a regulatory one. Many towns and cities in the US gave the cable companies local monopolies back in the 50s and 60s. There are technical reasons why this worked ok (not well but perhaps better than the alternatives) for television, but now that the same rules have stretched to apply to delivery of internet access they no longer have any technical basis. So at this point they’re just a barrier to competition and exist only to raise prices. The good news is that modern fiber systems blow cable internet out of the water. It is far cheaper to supply symmetric gigabit internet to every customer over fiber than over cable. Fiber just has more bandwidth to go around. And because it’s a different technology it is not subject to the same local monopolies that cable is encumbered with. This means that the free market is correcting the problem and has been for a decade. In many parts of the country it is now possible to get internet that is faster and cheaper than what is available in the even the best built parts of Europe. The main obstacle to that build–out is probably local permitting. Many large cities require new permits, with public comment periods for each and every one of them, for every single block that an ISP lays fiber for. Cities like San Francisco have imposed a glacial pace on their ISPs.

joenot443 2mo ago

Bit for bit, internet access is cheaper in America than it is in Canada or Australia. Canadians like myself have ~40% of our provincial taxes spent on healthcare, so in my case about ~8% of my gross income. Somewhere in the tune of $20k/yr. While I was living in Seattle and filing American, quite a bit less of my gross income went to healthcare. Just food for thought.

StrauXX 2mo ago
But that is not because it's less efficient. With the Canadian system being socialzed and 20k$ being just 8% of your income it is to be expected that you would pay moch more than the median person into the system.
59percentmore 2mo ago
"I make $250k CAD a year, my experiences must be representative of, and relevant to, the masses," is a wild thought to have. Well, maybe I spoke too soon, because my private American healthcare turns out to also be about 8% of my gross income (of $60k)(before copays and my deductible)(and also it's crap). Twinsies! But yes I agree that it would be awful to have my health needs taken care of and a mere ~160k USD left to spend on everything else.
- joenot443 2mo ago
  Oh I certainly don’t think it’s representative to that of the masses, I was sharing an anecdote. I think either way both of us are in really good shape. In my experience the quality of American care is better in nearly every regard (having experienced both pretty intimately), but the simplicity and the peace of mind of the Canadian system has its benefits too. In either case you end up paying. > But yes I agree that it would be awful to have my health needs taken care of and a mere ~160k USD left to spend on everything else. I’m confused - do you actually think it’s awful?
  - bluealienpie 2mo ago
    I think the main issue that the NHS model of 10+ years ago worked when fully funded. The Canadian model is a mix match of US healthcare and Medicare. Some drugs aren’t covered, some procedures take forever, and you don’t get guaranteed doctor. Many European healthcare system have solved the issues we have, but Canada has refused to adopt any sensible system.

gnz11 2mo ago

You can add Pre-K education to that list. It's on par in terms of costs with sending your kids to college.

pjc50 2mo ago

Healthcare and college are "Baumol cost disease": because they depend on skilled workers, much of that is the same as "American salaries are higher than in the rest of the world", and unlike manufacturing or software (+) you can't outsource it to lower-wage countries. (+) there still seems to be a massive wage premium for "being physically in a San Francisco office" even if most of the work is being done by an AI, which cannot be sustainable

sharts 1mo ago
I dunno, telehealth with foreign doctors while maybe in-person nurses could lower costs substantially.
sharemywin 2mo ago
because code is only a small part of software development. don't forget ping pong tables. lol. I'm both making a valid point and making fun of it too.
porkpieshoe 2mo ago
If it was this simple, then high costs would be limited to the labor-driven portion of the bills. This is not the case.
avadodin 1mo ago
You can make all sort of excuses but we literally felt bad for 1:1 exchange students paying 2k a month while we paid 2k a year. Their education was not 10x ours and their economy was only a few % over ours per capita.

xyzelement 2mo ago

This is why people are moving out of the US in droves, the universities are empty and nobody goes to the doctor.