I had a health crisis in France • Hacker News Board

Re: I had a health crisis in France

#171

Post by walshemj » Sun, Nov 20, 2016, 2:17 PM UTC

fiatjaf wrote: post #144

jdub wrote: post #74

Earlier quoted context omitted.

There's another way to look at it that I don't think the USA will be ready to understand any time soon: Universal health and education are (key parts of) freedom. You can even put a market spin on it: None of the risks involved in starting a small business in Australia have to do with health care for myself, or for people who might consider joining my small business as employees. I've never felt as if I'm giving up a…

That impression probably comes from the fact that you're not on the payer side of the bills, you're always on the receiver side.

Not so every month I see line on my pay check for National Insurance.

I am now a net beneficiary but for the first 30+years of employment I wasn't that's how it works.

Re: I had a health crisis in France

#172

Post by m_mueller » Sun, Nov 20, 2016, 2:18 PM UTC

galacticpony wrote: post #103

m_mueller wrote: post #67

Earlier quoted context omitted.

IMO the US health system needs stricter regulation. Switzerland is doing fine with a system very similar to Obamacare, with one important difference: Item prices for health services and goods are regulated by the government. Yes I know, small rich country yada yada - but if you look at it a bit more closely, the average Swiss is not that different from the average American - GDP per capita, median income, most live i…

Have you ever been to Switzerland? I have and I find this comparison absurd. It is a very small, very wealthy country with almost none of the structural problems faced in the US. The nominal GDP in Switzerland is actually much higher than in the US, it's just that the country is way more expensive to live in. Therefore, when adjusted for cost-of-living (PPP), the GDP are about equal. Of course, the absolute amount of…

Hmm. First you call my post absurd, then you basically repeat everything I've written. The only point really left is that medical equipment is cheaper for Swiss. I really don't think this makes much of a difference - the main difference cost wise is what we both wrote: Regulations such that health providers and insurers have strict boundaries. Btw. I'm Swiss, if it hasn't been obvious already.

Re: I had a health crisis in France

#173

Post by walshemj » Sun, Nov 20, 2016, 2:25 PM UTC

gerty wrote: post #72

I heard an argument some time that European healthcare and health R&D is indirectly subsidised by the US. The mechanism at works is 1) US consumers are ripped off by pharma; 2) pharma's higher profits lead to higher investment in R&D; 3) everyone profits from that and in the European case negotiate lower prices. I've always wondered to what extent this is true.

allowing the government to negotiate for the best price would be a start

Re: I had a health crisis in France

#174

Post by walshemj » Sun, Nov 20, 2016, 2:27 PM UTC

lumberjack wrote: post #20

thro32 wrote: post #11

Real problem in US with health (and education...) is that cost has skyrocketed out of control. How much is hearth bypass ? $30k? Other countries do that for $4k with similar quality and better post-op care. Public health care will just transfer more money from poor to corporations (like with education). You need to fix the leaks first, for example sponsor medical tourism to other countries, etc...

I don't think "the cost skyrocketed out of control". The cost is simply reflective of the leverage the health care provider and all the middle men in between hold against the patient. It's just that in other countries you have the government setting up a monopsony and dictating costs and salaries. I don't see how charging $30k for a heart bypass is unreasonable for somebody making $50k/year.

And what proportion of the US population has $30K spare cash that they can use in this way.

Re: I had a health crisis in France

#175

Post by candiodari » Sun, Nov 20, 2016, 2:27 PM UTC

Retric wrote: post #75

ekianjo wrote: post #31

Earlier quoted context omitted.

> Europe has better life expectancy, Diet has a lot more to to about that than medical care.

US has 75% higher infant mortality than France which has a real impact on life expectancy.

It doesn't. Deaths from <5 year olds are explicitly excluded from life expectancy statistics. You'll find them under infant mortality.

Re: I had a health crisis in France

#176

Post by nraynaud » Sun, Nov 20, 2016, 2:37 PM UTC

fiatjaf wrote: post #140

"I pay an annual income tax of about 23%." So you don't pay any kind of VAT? That also wouldn't mean anything, if the State is not taxing you so much, but it still has money to finance these things, it is obviously because it is taxing other people a lot more and using the money to treat your health. I would not find it very good to have my needs fulfilled with stolen money, as you seems to be finding.

VAT is 20% in France, and the biggest source of income for the State. But social security has a separate budget and is not paid by taxes, but by special levees on salaries and income.

Re: I had a health crisis in France

#177

Post by vixen99 » Sun, Nov 20, 2016, 2:37 PM UTC

YeGoblynQueenne wrote: post #112

I think I (living in the UK, currently an EU country) understand the mentality behind the US healthcare system(s). I think it's along the lines of "Why should I pay for someone else's healthcare?". I've heard similar arguments from British people (I'm rather more socialist in my outlook than average, for a UK resident, I fear) and I don't really have an answer to that. Why indeed? I'm probably conditioned to answer t…

Your virtue signaling trivializes a vastly difficult issue. The immensely complex question remains, putting aside the problem of organizing a massive state system, of how you balance non-infinite resources with never-ending demand continually extended by medical advances of which people naturally enough wish to take advantage? Given no financial constraints, you don't have to be a socialist to assent to free health treatment for all comers.

Re: I had a health crisis in France

#178

Post by steeve » Sun, Nov 20, 2016, 2:37 PM UTC

ekianjo wrote: post #47

ThePhysicist wrote: post #14

Earlier quoted context omitted.

In France you pay 0 % taxes for the first 9.700 € of income, then 14 % for everything up to 26.791 €, then 30 % for everything up to 71.826 €, then 41 % for everything up to 152.108 € and 45 % for everything beyond that [1]. Hence 23 % effective tax rate sounds reasonable for an average income of around 50.000 €. The tax system in many European countries is similar btw, as is the health system. [1] https://fr.wikiped…

You don't live in urban centers like Paris with 50k revenue.

Yes, you do. Looks like you don't know what you're talking about.

Re: I had a health crisis in France

#179

Post by switch007 » Sun, Nov 20, 2016, 2:38 PM UTC

antirez wrote: post #21

This is normal on all western Europe states. However France has very high standards in general about health care and is regarded as one of the best systems. I think it's time for US citizens to accept that most of Europe has better life expectancy, lower infant mortality than US, and to be ill is not a financial tragedy. Moreover the treatment that a low-income and high-income citizen receives is very similar, so the…

Regarded by who as one of the best? I'd like to see how far down that ranking the NHS is now.

Re: I had a health crisis in France

#180

Post by douche » Sun, Nov 20, 2016, 2:46 PM UTC

ThomPete wrote: post #121

tomp wrote: post #91

Earlier quoted context omitted.

> Obama was going in the right direction Can you expand on this? I've heard many critics of Obamacare (that say it doesn't actually work that well in reality), and in general, it seems that it was only tackling a part of the problem. In Europe, you usually have a single payer, single buyer and single executor (or at least each of those is very regulated, so there's less chance for exploitative monopolistic behaviour…

The primary issue with the system before Obama was two-fold. 1) Too many young people didn't insure themselves meaning that the relatively low cost of having them as insured couldn't be used to balance out the higher cost needed for later on in life. This was putting the primary burden of the cost on the older generations. By forcing everyone to pay the idea was that you could even out the cost. 2) Pre-existing condi…

> 1) Too many young people didn't insure themselves meaning that the relatively low cost of having them as insured couldn't be used to balance out the higher cost needed for later on in life. This was putting the primary burden of the cost on the older generations.

As to one, ObamaCare is still failing, because too many young people are able to do the math and realize that, if they don't have chronic conditions or children, the IRS penalty for not having insurance is significantly cheaper than the premiums on the high-deductible, terrible plans that are available to them at any reasonable price. For anything less than a catastrophic illness or injury, the ObamaCare plans I have seen just don't make any sense.