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rayineryesterday at 11:01 PM5 repliesview on HN

The U.S. spends more money on education per student than any OECD country other than Norway and Luxembourg. Yet it gets quite mediocre results. Why do you think the U.S. will be able to do public health care in a more cost efficient way than it does public education?

I favor universal health insurance, but you’re going to pay more, not less. European countries didn’t flip some magic switch where they saved a bunch of money by just “cutting out the profit.” They do it through measures like the UK NHS setting the standards of care, so in a malpractice lawsuit the entity that says what the doctor ought to have done is the same entity that bears the cost of unnecessary tests and procedures. Efficiency is also achieved by aggressively rationing providers such as MRIs, keeping health worker salaries low, etc. There is no stomach to do any of that in the U.S.


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derektankyesterday at 11:39 PM

>European countries didn’t flip some magic switch where they saved a bunch of money by just “cutting out the profit.”

They sort of have with pharmaceuticals (which to be clear is only maybe 10-15% of overall healthcare spending) by having the government negotiate drug prices nationally, instead of having individual insurers negotiate. This has monopsonistic effects, which really does cut the profit margins of drug manufacturers substantially. Of course, in many ways, they’re free riding on drug discovery funded by profits made overseas (particularly in America) but it does result in appreciable savings.

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applicativetoday at 2:06 AM

Primary Education (K–5): The U.S. spends 21% of its GDP per capita per student. This is exactly in line with the OECD average, which is also 21%.

Secondary Education (6–12): The U.S. spends 23% of its GDP per capita per student. This sits just slightly below the OECD average of 24%.

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Apocryphonyesterday at 11:28 PM

The U.S. system is neither fish nor fowl, there is more spending per capita than other countries' public systems and endless amounts of red tape because instead of one government bureaucracy you're also dealing with the insurance networks, the providers, etc. I certainly don't think it'll be automatically cheaper, but one can't help but think that the current system encourages hop-ons that exploit the inconsistencies and convolutions. It's like one big nightmarish parody of public–private partnerships.

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shimmantoday at 12:54 AM

There is zero evidence we would pay more for healthcare under medicare for all, what a bunch of neoliberal nonsense.

The idea that a for-profit system is more efficient than say medicare is hilariously out of touch. Medicare is one of the most popular programs in the country (like >80% from overall public, >90% from active users). There is no reason to deny such a program from the vast majority of Americans, unless you stand to profit from it.

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