It’s almost as if it’s part of a pattern, where the top 75% in the US do better than France, while the stronger French safety net is better for the bottom 25%.
If you scroll two comments up, you'll see the most crucial difference: free healthcare. Healthcare-related expenses can bankrupt an entire family in the US, even with great health insurance...
Then there is free education, but let's leave that aside for now.
Now, because the US has a weaker safety net, some people fall into gaps where they make too much to qualify for Medicaid and not enough to have good health insurance, or go bankrupt despite having good health insurance. But that happens to a small percentage of the population. Most people do fine with their employer paid insurance or Medicare, and get to spend their extra money on more consumption.
As to free education. If US colleges were like French ones, we could have free college too: https://mises-media.s3.amazonaws.com/styles/max_1160/s3/spen.... We spend more government money in higher education, as a percentage of GDP, than France. We still have to charge people tuition because our colleges are far more opulent. Most French universities are what Americans would consider commuter schools. Focused on instruction rather than research with most students staying local and living at home. Even then, free college just isn’t that valuable of a benefit. The average tuition at a public school in the US is $10,000 a year. The total cost of a degree is $40-50,000. And remember, most Americans don’t get a college degree (and neither do most French.) Over a career, the value of tuition free college for the average American comes nowhere near the extra taxes and lower income they’d have in France.
That's so bullshit.
What matter is of course not the difference between tuitions fees than taxes.
What's matter is that everybody, even the ones that can't afford the tuitions fees can access university. Which you can in France, which you can not in Europe.
I am the living example of that. I come from a family what would never have been able to afford me US schools tuitions fees. And still I am engineer, thanks to the European systems.
Here is the more fixed one :
> Over a career, the value of tuition free college for the average American comes nowhere near the extra taxes and lower income they’d have in France
That is so bullshit.
What matter is not, of course, the difference of cost between tuition fees and taxes.
What matter is that everybody, even the ones that can not afford the tuition fees can access University and proper education. Which you can in France and most of European countries, and which you cannot in USA.
I am the living example of that. I come from a family what would never have been able to afford to pay US schools fees. And still I am engineer, thanks to the European system.
You keep saying "The UK"[1] NHS denies treatment to patients, but you can't ever say what treatment is denied, instead pointing to stuff that's readily available. (Which is surprising, because if you actually cared about the truth you'd easily find examples of care that isn't available.)
I've never seen a post by you about the English NHS which isn't wrong. Doesn't it worry you that every single post you make about the English NSH is wrong?
[1] There isn't one NHS. There are 4 separate systems, controlled by different governments.
I don’t always agree with his:her conclusions and I’m sure sometimes he/she is wrong, but the content is generally better than 95% of posts on HN.
But he consistently misrepresents information about healthcare in other countries.
I tend to prefer a system where you fail because you are not good enough, to a system where you fail because the pockets of your parents are not deep enough.
The stories I have been told of difficult classes in the EU are mind-bending. They seem to be incentivizing ~80% of the class to drop out. There is no way the majority of people are not suited for, say, IT. They may not want to do it, but that doesn't mean they are not capable of doing it.
To pick a statistic, their maternal mortality rate is 1/3 of the US.
Because the US is a wealthier country overall it can waste more money and receive worse results. That isn't an argument in favor the US healthcare system.
Also, do you realize that the graph you are citing isn't tracking the cost of US healthcare to a US citizen, it is literally saying Americans spend 5% of their personal income on health insurance. It is not counting the taxes they already pay, the cost to their employers, etc.
Note also that trying to compare health outcomes between countries is extremely difficult. Asians in the US live longer than Asians in countries with excellent healthcare systems like Japan.[1] Puerto Rico has a similar life expectancy to Denmark or Germany, even though if it were a US state it would be the poorest.
Maternal mortality rate varies by a factor of 10 between US states. The maternal mortality rate in West Virginia is only a somewhat higher than Germany and the UK, while the rate in New York is twice as high and New Jersey is four times higher. Massachusetts and California are lower than France.
[1] Asian American men live longer than white women.
Did you use PPP to evaluate value?
As for education per percentage spending paints a distorted picture. A more thorough comparison is needed accounting for the cost of education, population size, absolute numbers as opposed to percentages. Otherwise I agree that the US has fancier, more exclusive higher education institutions and that professionals with a degree are paid much better than in France.
Private insurance is a tiny cost of average 30 Euro and reimburses you for damages. Does not pay for healthcare. Entirely different kind of insurance.
In US, a single copay with health insurance can take triple this, most common ones are few hundred USD, baseline insurance is still expensive. However, yearly it's... Still more expensive as double the percentage of GDP than France.
Please try to understand the specific statistic I am citing. I’m talking about non-premium out of pocket costs: https://www.oecd.org/health/health-systems/OECD-Focus-on-Out... (chart on page 1).
The reason I quote that figure is because there is a myth that even though Americans mostly have private health insurance paid by their employer, they somehow still spend all this money on deductibles and co-pays.
The other figure I’m citing (the 5%) are not what Americans pay in total, but what Americans have to pay out of their salaries. The reason I cite that is most Americans have employed-paid insurance, which is not counted in their income. So if you just take income and subtract the total cost of healthcare per person, you get an incorrect number, because people don’t pay most of that cost out of their income. You have to look at what people pay out of pocket on premiums and copays.
I grew up in the lower middle class in France, and I have what's considered great healthcare in the US. In France, I would never think twice before going to the doctor (i.e primary care) when I had a medical issue. In the US, I still think it twice even though my copay is not a big dent in my budget. And that's not counting WTF happens in the US if I loose my job.
That’s the point of co-pays, and that’s why France has them. According to the OECD statistics I posted elsewhere in this thread, per capita expenditures on non-premium out of pocket expenses (things like co-pays and deductibles) are the same in the US and France.
There’s more than an order of magnitude between those two numbers here. You can look at your OECD statistics, or look at the experience of people who’ve actually lived there.
Medicaid simply isn't the healthcare panacea for the poor that some make it out to be when they say, "But the poor already have coverage!". And it ignores the fact that there's millions of people just above the income cutoffs whose state of poorness is pretty indistinguishable from those that get coverage, but they're still completely on their own.
First: 400% of the poverty line is not very high, so premiums for people just over that line can still be very unaffordable.
Second and more importantly, ACA coverage is generally not very good, especially at the low silver tier covered in that %10 income cap. Pointing at the ACA ignores the fact than plenty of people with coverage still are faced with insurmountable debt, sometimes loss of home, and often bankruptcy. As long as hundreds of thousands of people each year have bankruptcies tied to medical issues, there's nothing about the US system you can point to, be it Medicaid, Medicare, ACA subsidies or anything else, that can surmount the argument that the US system fails people in this respect when compared to other countries with universal coverage.
I'm not saying those countries are always better in every respect, but one thing they have is that they don't cause their citizens to lose their entire way of life, their home, and ability to live above poverty levels when faced with treatable medical issues.
The tax burden is higher because education, public transport, agriculture and social (mostly retirement) are paid in tax rather than mostly privately.
US has the private system for retirement plans and it sometimes fails utterly. The nationalized one does not, though it may not be as big of a payout. And education saddles people with debt, as well as causes cost (admin) inflation.
Growth is not tied to employment policy, but only cost of labor. It correlates almost 1:1 as selfish big businesses move or outsource where it's cheaper. (Including big tax breaks. USA doesn't have these enough to balance very expensive employment.)
Example from EU: Poland has 4,6% and France 1,8%. Switzerland 1,1% and Finland 2,6%. The number for France is not too dissimilar from USA and not anything special. Poland has baroque labor (improving) and especially tax laws.
Medical bankruptcy was a big problem, but under the ACA the yearly out of pocket max has all but eliminated these.
Is the statement in some way unclear? Care to suggest a rephrasing?
A better phrasing would be "subsidized healthcare".
Not any more [1]. The Trump administration has sufficiently weakened ACA that you can now get insurance that isn't sufficient to prevent you from getting a huge bill if you have the temerity to have a heart attack or something else expensive like that.
Or you might not even have insurance, since they also killed the tax penalty for not having insurance.
Fiber optical connexion cost +- 30 euros and "unlimitted" 4G LTE mobile data plan cost +- 20 euros(including roaming). It's a lot more affordable than what AT&T or Comcast offer...
That's not a typo. salt.ch/fiber