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Comment by m_mueller | Hacker News Reader

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 in diverse but smallish cities, lots of cars, lots of guns, high (but still way lower) health spending, all quite comparable - except Swiss have one of the highest life expectancies and can expect treatment for everything treatable while for many Americans this seems to become some sort of raindance.

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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 money per capita is still much higher, which lowers the relative cost of, say, medical equipment.

The private healthcare in Switzerland is also compulsory and insurers are forced to offer a basic, non-profit plan. Furthermore, individual payments may be subsidized by the government. It's therefore not that different from Obamacare, nor are private insurers left to the devices of the "free market".

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.

I called your comparison of the two countries absurd. It's not obvious that you're Swiss, it's obvious that you're out of touch and it's common for Americans to make some simplistic argument, pointing at fringe countries like Norway or Switzerland as an example.

You point at some facts that happen to be similar (when adjusted) for the US and Switzerland, but it's rather arbitrary. What the hell does gun ownership have to do with healthcare? And of course, like most industrialized countries, there are "lots of cars"...

The absolute difference in wealth doesn't affect just medical equipment, it affects practically everything besides labor. One of the reasons why labor is so expensive is the high taxes (VAT etc). When the government subsidizes that expensive labor, it'll get a big part right back.

You also edited your post to agree more with mine (i.e. Obamacare), when the original point was more like "private insurance can work look at Switzerland!".

Yes, it can work, if you're wealthy Switzerland and you regulate the fuck out of everything. Touche...

btw. I never edited in Obamacare, it was in there from start. The US has enormous wealth, with a purchase power per capita almost as high as an average Swiss, times 300 million. I think Americans should stop making excuses. I don't see what's wrong with comparing anything internationally - you have 150 experiments with different parameters, there's no reason not to use that knowledge if you want to figure out on how to improve or what not to do.

switzerland is by far the most expensive health care system in the EU. Crucially it doesn't outperform by very much either.

It's certainly not the most effective, that would probably be Japan. My point was that Switzerland has probably one of the systems closest to the US, so it's the easiest to compare and would also be one of the easiest for the US to copy, were it not for all the pharmaceutical lobbying going on (maybe Trump will solve that?)

I just like to use it to point out how the common American argument against universal healthcare don't really apply.

"it's socialist!" - no, you can have a system where everyone pays in according to insurer determined risk factors, pay less overall and still be within what people at minimum wages can afford. Below that you subsidize with taxes, but that costs very little compared to total health spending.

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