Being critical about billionares is empirically supported. Trump wouldnt exist if not supported by other psychopaths and now he selects even more unethical bootlickers for offices and rewards equally deranged amigos.
Jazz9k just drank too much coolaid from billionare owned and election meddling twitter, i guess.
Personal anecdote...
My uncle is an auto mechanic in Scotland (Scottish NHS) and my brother-in-law is an auto mechanic in WV, USA.
Both have similar health care outcomes - they have ready access to quality care, specialists, etc. ER/A&E is available. The biggest difference is the perceived cost and stress incurred by that cost. My uncle doesn't give much thought to health care - he can work, retire, whatever and be assured a reasonable level of care. My BIL will work to 65 or beyond, fighting red-tape the entire time, then retire and still have to deal with supplemental programs.
Looking at another uncle, who was a small business owner in Scotland vs my father (also small business owner), it's similar to above, just with more money at stake. Uncle also purchased additional insurance on top of NHS for faster access to selective care, still cost less than insurance in the US, even after accounting for tax differences.
American's kid themselves when they say the Western Europe has higher taxes. Once you account for medical care, college funding, and other similar things, it's pretty close.
The RAND Round 5.1 study (2023) puts US commercial insurer payments at 254% of Medicare rates for identical procedures. That's the mechanism behind the international gaps — it's not complexity or quality, it's that commercial insurers negotiate against chargemaster list prices rather than against cost. The HCRIS cost-to-charge analysis (3,193 hospitals, FY2023) puts median markup at 2.6x actual costs.
I think this difference mostly disappears if you group Americans by wealth. So wealthy Americans have similar life expectancies to those in other countries. It's really the poor that are most affected by our dystopian healthcare system, which is probably a big part of why it never gets fixed.
The obesity adjustment is worth quantifying. US adult obesity: 42% (CDC). UK: 28%, Australia: 31%, Germany: 22%. Those gaps are real, but they don't explain a 2.5x per-capita spending differential. The Commonwealth Fund's 2021 analysis controlled for age, income, and chronic condition burden; the US still spent roughly $5,000 more per capita than the next-highest spender (Switzerland).
Obesity also matters less than assumed in hospital pricing: a hip replacement costs $29,000 commercially in the US regardless of patient BMI, vs. $15,000 in Germany and $9,000 in Spain (iFHP 2024). The cost structure is in the pricing system. Johns Hopkins researchers estimated eliminating US obesity would reduce healthcare spending by about 12%, real but not 2.5x. Repo with methodology: https://github.com/rexrodeo/american-healthcare-conundrum
Hvae you considered that America is a much larger and much more diverse country that these other countries and and it is very different social norms? Obesity is a major problem in America and it is not the fault of the doctors. I wonder if this has anything to do with it?
I went to a Math/CS magnet program for high school with selective admissions. It wasn't racially diverse and 90% Asian, but most of them were born into working class families. Virtually everyone went to top universities and did extremely well. My brother who went to a top tier private school used my teacher's math curriculum.
They eliminated the selective admissions after I graduated and now the program is worse. The teachers teach less because the students cannot learn. The students don't go to top universities anymore. But it is diverse and equitable.
I don't want to live in a world where I must buy my children access to education. Not getting into a good university and being forced to suffer the consequences of my actions made me realize the value of hard work.
If from 0-18, the determinant of my children's success is how much money I spend on them, I'm not teaching them to be better than me.
OP is sharing their experience, and you are sharing yours. neither experience is universal, and it has nothing to do with wanting to privatize education. rather it is a call for reform of the school system. (all public schools should adopt the montessori method in my opinion for example. it's not expensive. it takes just one year of training for teachers)
journalists are like our own simon willinson: they need to put food on their plate by networking with powerful entities that fly them out to conferences
My experience is that the folks in charge of spending and making decisions are looking at AI as another means of outsourcing. Payroll, ERPs and CRMs went from commodity software to subscription services and anything that is subscription based is getting scrutinized much more heavily now.
You missed my point. Upfront cost is not the only cost in business. And I still stand by it that shared infrastructure costs for example are way more efficient than everyone doing a half-arsed version of whatever it is.
I agree with you in the short term but what makes you think companies will even be asking AI to write bespoke software or setup any kind of infrastructure in the long term? Theoretically AI would handle all of this for you with much greater fidelity and accuracy than any human could manage. Any business processes would be handled by the AI which already has all of your corporate data. Why would I need a SaaS service when I could have the AI do the task or generate the answer? Why would I send data to a SaaS when I can just give it to the AI? Granted I don't believe we are anywhere close to such a scenario, but it seems to be the trajectory that we are on.
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