Europe is also doing pretty well in several fields and you don't explain at all how tech in particular is affected by public spending.
Why take on a risky career path like being a doctor if best case you're half a million in debt and that's assuming you don't get weeded out at any point? It's no surprise we have shortages of engineers, doctors, nurses, teachers, etc.
Even a bachelor's degree is on average 32k for in-state at public colleges assuming you graduate in 4 years. Contrast that with my German peers who didn't pay anything and yeah, maybe I wouldn't have been a software engineer if everything else wasn't so volatile. I certainly don't feel as essential as doctors or nurses, especially now.
Sure it's cheaper to start a LLC in the US and you can hire/fire on a whim practically, but 63% of Americans don't have enough savings to cover a $500 emergency. Doesn't exactly leave a lot of wiggle room unless your parents have a basement for your MVP and some seed money.
Would you rather get the public health and education, or keep the 20k euro and find a solution for yourself?
I reckon that my health expenditures are 1000 per year, and I am self-taught, so I don't need the government for anything.
What we need is to make the public services Opt-in/Opt-out, so people who find it competitive like yourself can keep enjoying it.
Also, EU governments provide retirement benefits while the US's doesn't. This is the main expenditure for these governments.
Not saying that your argument has not some truth in it, but it's definitively wrong in the case of healthcare.
The US population not taking care of themselves is a public health problem not a medical care quality issue.
It's not in the top 5 by number of patients treated. Anecdotally I met people who went to Germany, Israel, India and Thailand for treatment, I never heard of anyone even discussing going to the US. The visas alone are a nightmare.
The U.S. has the largest concentration of the best research hospitals in the world.
I see someone shifting the goalposts here, first we were saying that US healthcare is not worse in any metric, then we started measuring it's success by medical tourism, now are down to some special rare diseases.
Let's come back to where we were before, measures per unit of money spent, US healthcare delivers worse outcomes that any other developed nation. Measured in average health of its citizen, the outcomes aren't great. Life expectancy, and other metrics aren't particularly amazing.
Of course, if you have the money to fly to the US, stay in the US and pay out-of-pocket for a medical procedure in the US, then yes, the US is a good destination. Which translates into: if you're rich, medicine in the US is great.
However, not all of us are rich. And definitely not all Americans are rich.
Sifted goalposts
> The average American pays more for healthcare over their live than the average European, and the outcomes are objectively worse.
remains true. No matter how you want to spin it and pretend that medical tourism affects this in any way.
Edit:
For 2015, https://www.usitc.gov/publications/332/executive_briefings/c...
- Medical tourism to US: between 100k and 200k per year
- Medical tourism from US to other countries: 150k to 350k per year
Europe is ~500 million people
US is ~ 360 million people
Medical tourism is a drop in the bucket.
>Americans cite cost savings as the most common reason to go abroad for health treatment, as medical procedures in foreign hospitals can cost thousands of dollars less than in the United States. This is especially true for those without health insurance—for an uninsured person, a knee replacement can cost $30,000 in the United States, compared to $12,000 in India. Many health travelers also go abroad for elective procedures such as cosmetic surgery that regular policies may not cover.
In other words, they largely go outside the US to save money on either cosmetic or routine procedures that, for one reason or other, US insurance won't cover.[1] Not same thing as the earlier discussion of rare or difficult conditions.
[1] Or they've chosen to not get health insurance. Post-Obamacare, this means that they are willingly paying the tax penalty for not having insurance. 91% of Americans have health insurance.
There was no earlier discussion of "rare or difficult conditions".
> 91% of Americans have health insurance.
That health insurance is often tied to the employer and wildly varies in what it offers. And you have to fight insurance tooth and nail to get what you need. Even on a good insurance.
Also, https://www.census.gov/library/publications/2021/demo/p60-27...
--- start quote ---
In 2020, 8.6 percent of people, or 28.0 million, did not have health insurance at any point during the year.
The percentage of people with health insurance coverage for all or part of 2020 was 91.4.
More children under the age of 19 in poverty were uninsured in 2020 than in 2018. Uninsured rates for children under the age of 19 in poverty rose 1.6 percentage points to 9.3 percent.
--- end quote ---
I can't imagine a European saying "yeah, we have 28 million uninsured, many of them kids, it's their own fault".
Stop inventing arguments for other people, and then bravely fighting these arguments.
> found that the 91% figure is indeed accurate, so could only come up with the above as riposte.
Yes. It's a valid riposte: I cannot imagine a European proudly "debunking" something by saying "yeah, we have 28 million people uninsured, it's their own fault"
> The US mixed system of public and private healthcare coverage is quite similar to the system used in Germany, Switzerland, and other countries
It's not.
> Before Obamacare, about 85% of Americans had health insurance.
Before, during, and after Obamacare 100% Europeans (well, not entirely true [1]) have insurance
> or a German who changes jobs and neglects to transfer coverage to a provider that serves his new industry.
Your medical insurance is not tied to your job in Germany (or anywhere in Europe).
> Yes, 85%. Again, contrary to what Reddit told you.
You keep inventing arguments for your opponent and bravely debunking them. The only numbers I provided are taken directly from US Census.
[1] some (8 in 2016, 4 in 2020) countries in the EU have lower insurance rates. However:
- these countries keep increasing coverage or implementing reforms to bring universal healthcare (Cyprus an Ireland)
- even "uninsured" still have free access to emergency care and care during pregnancy (e.g. Romania)
The US is a country of 330 million. I can say that out of 80 million Germans at least 2-3 million (3%) are without health insurance. Is that something to be "proud" of? Or, as I said, are such gaps inevitable in any health-insurance system that a) requires some sort of membership (i.e., almost all developed countries outside the UK NHS), plus b) the US's unique situation of another 3-4% without health insurance inherent from having 10 million illegal aliens within its borders?
>> The US mixed system of public and private healthcare coverage is quite similar to the system used in Germany, Switzerland, and other countries
>It's not.
In what way are the systems greatly different? In both the US and Germany/Switzerland/etc., people obtain insurance from either a variety of private sources (in the US, nonprofit or for-profit) or public (in the US, Medicare, Medicaid, military Tricare, Indian Health Service). Post-Obamacare, the US also mandates that those without insurance obtain it from some source, whether public or private.
Now, you may quibble and say that the hundreds of German sickness funds are not really "private" because they are nonprofit, but they are independent from the government like their US counterparts, both nonprofit (example: Kaiser) and profit (example: Aetna). Both countries' systems differ from, say, the UK NHS (which handles both payment and delivery), the Canadian single-payer system (which handles payment, with no alternative allowed by law), or the Australian system (single-payer, but with a heavy emphasis on encouraging people to move to private plans).
>Your medical insurance is not tied to your job in Germany (or anywhere in Europe).
I didn't say that insurance in Germany is tied to one's job. However, German coverage offerings, providers, and types of providers (public or private) differ depending on whether one is an ordinary private-sector employee, a government employee, or student. Also, German employers pay for part of employees' premiums, as in the US.
>- even "uninsured" still have free access to emergency care and care during pregnancy (e.g. Romania)
This is true as well in the US; the EMTALA law prohibits turning away anyone from hospitals regardless of ability to pay.
The US:
- insurance is largely tied to employer
- insurance providers go out of their way to not cover, well, a lot
- even having good insurance still often means you need to spend a significant amount of time fighting the bills
- you have to navigate the maze of "this doctor at this hospital is out of network"
- yes, you won't be turned away at the hospital even if you're uninsured, but you will be saddled with the bill
Rando on the Internet: how is this different?
> Now, you may quibble and say that
You may keep pretending that you you can invent the arguments for me.
I will not engage in this thread any longer. Adieu.
- German public insurance is priced according to income, not health condition. Preconditions aren't a thing°
- You know that the treatment is covered before it begins. There are no surprise costs. There are rarely any costs at all, except for a 5-10€ deductible that cannot go above a certain monthly amount.
- It covers your dependents for free.
- It covers students for very cheap.
- It covers you in all of the EU, by law. This includes internships abroad.
Basically, you can trust your insurance to fully cover all necessary care, with no exceptions.
OP, this is a good intro to German health insurance. It's written for foreigners. https://allaboutberlin.com/guides/german-health-insurance
So you throw an accusation that you literally pulled out of your rear and will not dignify the point that your interlocutor made with any response?
I think this has gone well past reasonable discourse and we can no longer assume good faith from you.
The total societal outcome -- spending vs outcome -- and therefore the average outcome too, for the USA as compared to most other developed countries... Pretty much sucks.
My US government provided pension will be something like $3500/month when I reach retirement age. This is in addition to any personal retirement savings.
People migrate to the US before the EU. Besides, US lifestyle (also a high tax country btw) is not the only possible alternative to european style quasi socialism (56% on the way there)
Incidentally I'd say most western countries are way too close to socialism, I'd rather see more private entities taking over security, healthcare and law making.
It's just that there is no money, so private EU companies suck so there is no money. The lack of strong companies doesn't imply socialism. Most people in Europe has most of their trade interactions with other individuals and private businesses.
Compare this with the cut throat competition in Sillicon Valley or the international arena.
That's how you end up with non existent tech offerings in Europe.