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Comment by ksec | Hacker News Reader

If we take a look from a Global Perspective, US has the cheapest iPhone ( All prices excluding sales Tax ), and everywhere else had it more expensive. i.e The $1K Prices may be making a big waves in US, but elsewhere in the world they have been paying that much for an iPhone already.

And in terms of iPhones / Population / Apple Store, the US has it most. While in Japan 60% of the Smartphone are iPhone ( i.e Higher the US usage ) they have less then 10 Apple Stores. And it is the same everywhere else, which means any mark up in a certain countries has nothing to do with its Operation with in, and more to do with a Sales Tax, Global Pricing structure.

For Example, HongKong used to have the cheapest iPhone around the world, it was priced the same as US and because there are no Sales tax, it was 10-15% cheaper. Making HK the trading ground for all of SEA region or mainly China. ( Hence Tim Cook continue to blame HK market is more of a delusion rather then fact. ) Around iPhone 5 Apple started to put up additional $100 USD to ALL iPhone price in HK, as a way to combat the black market trading, and if everyone else where making money of it, why not keep the profits itself?

What has all these got to do with $1K iPhone. Well Apple already knew certain people are buying at those prices, again why not make a product that fit those segment? And to re balance the prices across the Globe?

And we have known for long there is no way to make the cutting edge devices every 12 months and ship 200M+ of it. They will need a product that only 10-20% of those 200M will buy, and have the best technology in it.

And mind you, shipping cutting edge technology to 20-40M user a year isn't any easier then the 200M+ iPhone.

View on HN

Yep the base price for a Iphone 7 Plus in Sweden is 1100$. Not sure it makes sense comparing prices like this though. In Sweden the cost of an iphone does not compete with your ability to get access to health care or education for example.

The Swedish price also includes 25% VAT, as well as the cost of consumer protection afforded by Swedish/EU laws (which in the US you have to pay extra to get through AppleCare - although AppleCare does go further)

iPhone 7+ currently in Hungary is 1174.6378 US Dollar

27% VAT <3

#wordlclass

Using credit cards in the US give a pretty high level of consumer protection (over and above usual consumer protection laws) although not as much as buying an explicit warranty.

That doesn't protect you against accidental breakage. Outside of that, I rely on actual consumer protection laws, which aren't so hefty in the US - hence folks using credit cards to get some extra protection. It isn't like you are taking a big risk with Apple or your phone company ripping you off anyway.

http://europa.eu/youreurope/citizens/consumers/shopping/guar...

> That doesn't protect you against accidental breakage.

Check your cardholder agreements. Mine do.

> Check your cardholder agreements.

Only some of us haven't kept those in many, many years. And the one I had back then certainly didn't have such things, but it might have changed since the late 90's. For myself personally, it doesn't seem worth the hassle. Another bill every month that is non-necessary when I could just save some money to cover such things or get it repaired. It kinda sucked not having an actual card in the US, but here it isn't.

Is this sort of thing common on credit cards nowadays? I saw two replies mentioning their banks, and I'm now wondering how widespread such a thing is.

I don't see my credit card as "another bill"; in fact I use it to autopay as well as make daily purchases, so it becomes "the only bill" (or, one of the only).

Yeah, you can autopay on debit cards too, but I don't trust that as much.

Purchase protection is pretty common on good credit cards.

You drop it and break the screen at your own fault and your card will replace it? Sorry I don't buy it.

For first 90 days AmEx "Purchase Protection" covers theft/accidental damage up to the cost of the item, without premiums or special fees. Just use the card to buy it. https://www.americanexpress.com/us/credit-cards/features-ben...

It's only for 120 days but, e.g. this is from one of Chase's cards: What's covered: "Eligible personal property that has been damaged, stolen, or involuntary and accidental parting with property within 120 days from the date of purchase"

This is in addition to a year of additional warranty protection and various other purchase protections.

That text wouldn't cover accidental damage due to your own fault.

It certainly does. Most of Chase's cards cover up to $500 per occurrence. The Sapphire Reserve, and I believe Ink Preferred, cover up to $10k per occurrence. There are plenty of accounts of people taking advantage of these benefits online.

What card(s) do you have that have this protection?

I'm genuinely curious if credit card companies get involved with warranty-related actions, or really anything beyond the fitness and accurate representation at the time of purchase. As far as I can tell, thigs like AppleCare and EU VAT protections cover an almost entirely exclusive set of concerns, namely, the fitness of the product after initial purchase.

I'm not knowledgeable enough to compare directly to VAT, but many credit cards extend a product's existing warranty (90 days to two years, depending on the card), and some offer things like 90-day purchase protection (if the price changes or if merchant/manufacturer won't accept a return, the credit card will).

Purchase protection took care of a theft I had in my house last month. They just needed a receipt and a police report, and the purchase price was refunded a few days later.

I think there's some confusion here as to what VAT means.

VAT in the EU (or anywhere else really that has the concept of VAT) normally affords no additional consumer protections on its own. It's a tax, not dissimilar at a high level to sales tax in the US, applied to goods or services at time of sale.

Thanks for the response. This is something that's not well known to me and in the age of retailers trying to upsell the same thing for a fee, I'm not surprised that it is obscured.

In all fairness, it's not a standard thing. Most of the extended card protections that go beyond purchase dispute resolution/defective product come from various premium cards more so than basic no-charge ones.

The Costco visa adds additional 2 years of warranty to all electronics purchased at Costco. It's a nice little feature.

I can only speak to my personal experience, but my Citi Premier card has pretty good coverage for theft and accidental damage, albeit with a relatively short coverage window compared to something like Apple Care. I'd have to look it up, but I think it was about 6 months post-purchase.

Why are you bringing up healthcare on an iPhone discussion? Trying to figure out how it is relevant to the pricing of an iPhone in Sweden.

As a European, I noticed that discussions held here about X in the US _always_ converge against their healthcare.

"Salary in the US is higher" - but heir healthcare sucks

"Weather in California is nicer than in Oslo" - But you don't have healtcare

"New York is such a great city to live in" - But you're left for dead

You got it right, it's difficult to imagine for a European what it's like to deal with having no medical care if unemployed.

In addition, the fact that's part of every discussion gives a hint of how much of an issue this is.

Well, you can buy partly subsidized or receive fully subsidized healthcare (ACA/Medicaid). That's on top of programs like COBRA and in worst case scenarios welfare from the state, county, or federal levels. We also have CHIP on the federal level which is a separate program just for children, where the parents may have insurance but for some reason cannot insure their kids. That's on top of what the states themselves offer, but that's sort of rolled into the ACA nowadays, which makes more sense.

We're at 8% uninsured, which is nothing to brag about, but its far from a free for all post-apocalypse where people keel over in their desks or in the unemployment line. Its also important to note that those numbers include illegals who can't or won't get insurance due to citizen status and 1/3rd to 2/3rd of that number actually qualify for various insurance programs, but for some reason aren't seeking it (aside from citizen status).

We absolutely have a big problem with the rural poor and insurance, which is a hefty 14-20% of that demographic. I'm not sure what the fix here is especially considering rural states are heavily conservative and fight off ACA and Medicare/Medicaid expansion regularly.

upvoted. as far as the rural areas vs ACA are concerned - before ACA a lumberjack/construction/handyman/hunting-fishing guide etc type dude could by themselves cheap health insurance that wouldn't break the bank off-season. now it's an ordeal.

The problem there is that low rent health insurance didn't cover anything. You'd had catastrophic plans with $2,500+ deductibles and a cap at $25k. It didn't cover preventative maintenance, doctor visits, kids, drugs, etc. It only made sense in a "what if I injure myself at work, but not too seriously" kind of way.

I imagine ACA mandated insurance is a net boon here even if the monthlies are more.

Strange how the US healthcare setup is largely unchanged over many years, yet the general perception is that it's suddenly total chaos. I'm not saying the status quo is best, but we didn't suddenly plunge into a crisis.

It's been incredibly bad for at least ~3 decades. A sick person with insurance without a dedicated advocate (relative or friend) watching out for them non-stop will likely end up having several care screw-ups occur to them, and with a bill ludicrously rather than just insanely large and probably a few things in collections (even if they can pay them) if said advocate doesn't spend a couple hundred hours fighting insurance and hospital billing and mailing regulators and wrestling a mountain of paperwork and bills.

Watched this process with sick relatives in the 90s, and it was already fucked-up then. Gone through it with my wife's 3 pregnancies and a couple family illnesses in the last 5ish years. Same thing. It's a broken, evil system that ruthlessly exploits and crushes anyone without the time, wits, and wherewithal to fight it every step, and it has been for a long time. I think what changed is we have much better exposure to what it's like elsewhere, so more of us are aware that there is no reason whatsoever to keep hurting people this way.

Good points. Which leads to the question, when everybody has "free" healthcare, who gets the top docs, and who gets the bottom and average docs?

In general, you can always skip the whole gov't funded healthcare system to get a particular private service at a full cost, and some (though not most, depends on the specialty - plastic surgery will but trauma neurosurgery won't) of the top docs will work in this manner.

Other than that, the patient-doctor match gets mostly allocated on the basis of location and narrow specialty, or with limited availability; e.g. if you want a particular popular doc, then (s)he might have a queue, so you either wait when they become available or pick someone else.

Not sure. How's it work in the entire rest of the OECD?

The people with inside connections, more power, or who make extra payments get the top docs. Regular folk get the rest.

If that's true, then it's more or less the same, no?

Agreed. Except I think the "free" setup is much more expensive.

Are you kidding?

Look up how much US spends on healthcare and how much rest of the world does.

That's an impossible comparison -- "rest of the world."

Is your point, "we spend so much today that we couldn't possibly spend more under a different legislative regime."??

Do you have a reference?

Look at what other OECD states spend per capita. Compare to how much the US spends per capita. For a real WTF look at how much public money the US already spends per capita. This is all a google away. The safe bet based on available data would be that moving our system to be more similar to any of those used by other OECD states would significantly reduce our spending while having little effect on health outcomes.

It's possible some other reforms that differ radically from those systems would improve things, and maybe even be better than anything other OECD states do, but since we have a wealth of real-world data about how the existing systems work and only speculation about most others, it's a much safer move to base reforms on the ones that are observably better than ours in the real world.

What ashark said - you can't do worse in healthcare spending than USA

Almost everyone is politically motivated in some way to slam the healthcare system; nobody is politically motivated to defend it.

Personally I'd offer the somewhat-feeble defense that it isn't as bad as people say it is, but I'd stop far short of calling it good... because I've got my own political axes to grind too, even if they are nearly diametrically opposed to the local consensus. But it isn't actually true that the American health system requires you to sign into indentured servitude the moment you walk in the emergency room door, and injects you with strychnine and tosses you out the door if you can't pay enough to satisfy the bureaucracy this week. Ambulance crews do not prowl the street and abduct unsuspecting European tourists and force them to donate blood before they're allowed to escape. Doctors do not actually giggle with glee and make "chaching!" noises when giving you bad diagnoses.

> Ambulance crews do not prowl the street and abduct unsuspecting European tourists and force them to donate blood before they're allowed to escape.

Why would they? The US produces a surplus of blood and tissue, to the point that many other countries (particularly in Europe) have to purchase to from the US to address their own shortages.

> Strange how the US healthcare setup is largely unchanged over many years, yet the general perception is that it's suddenly total chaos.

It's been horrible for a long time (and there's been outrage for a long-time: while it got derailed and we got nothing out of it but HIPAA, the bad state of healthcare and plans to reform it were central to the Clinton campaign in 1992—and while Clinton tried for a complicated scheme involving insurance companies, polling showed majority support for single-payer even then; the ACA is often pointed out to be a copy of Romneycare in Massachusetts, but what is less commonly pointed out is that both are copies of something proposed by the insurance industry and embraced by the Republican Party as a desirable national reform direction shortly after Clinton's reform effort failed, because even then it was widely perceived that something had to be done.)

> I'm not saying the status quo is best, but we didn't suddenly plunge into a crisis.

No, we've been in a crisis for more than a generation.

> what is less commonly pointed out is that both are copies of something proposed by the insurance industry and embraced by the Republican Party as a desirable national reform direction shortly after Clinton's reform effort failed

It's less-commonly pointed out because it's not really true.

It's true that there was one bill, in 1993, that was proposed by a Republican and which happened to somewhat resemble the Affordable Care Act at a very high level. However:

a) It was proposed by a Republican senator from a very blue state (Rhode Island)

b) That Republican senator lost his next re-election bid

c) The bill never received a vote

e) The bill was only one of many GOP-sponsored healthcare bills that year

f) Conservative and moderate Republicans strongly criticized the bill

g) While it bore some resemblance to the ACA at a very high level, it was a very different bill in details and implementation, so it's misleading to suggest that supporting one and not the other would be hypocritical. There were a lot of things Democrats like about the ACA that weren't in Chafee's bill, and there are a lot of things that Republicans might like in Chafee's bill (or the ANHRA in the House) that were not present in the ACA.

Sure, there were a number of different subsidized-private-insurance schemes over the years (including the one briefly rhetorically embraced by George W. Bush but, again, that never went far legislatively) that differed from the ACA model in that only HDHP/HSA plans would be subsdized.

> so it's misleading to suggest that supporting one and not the other would be hypocritical

I wasn't suggesting that, I was illustrating that the perceived problem and many elements of the potential solution space have been part of the national dialogue for a long time.

Price of healthcare is driven by a luck of supply (medical professionals, hospitals, affordable drugs) and supply is limited by regulation (expensive and ridiculously long educational process for physicians, huge liability and regulatory burden for practitioners and hospitals, very long and expensive approval process for moving a new drug through FDA, plus again liability cost) .

Regulation in turn is driven by lobbying efforts of large professional groups (trial lawyers, AMA, large pharma etc).

In another word it is a corrupted system that manages stay afloat as people in power legally able to get their cut through lobbying.

People are getting relatively poorer in comparison to their health care costs. So yes, we have been getting worse, and at some point the character of a problem changes into a crisis, which can seem "sudden".

> People are getting relatively poorer in comparison to their health care costs.

That's not really true; total expenditures have increased, but that's largely because the treatments and care that people are choosing are different (and more expensive) than previous ones.

Put another way: today you can still get the same type and quality of care that was available in the 1960s, and it'll be cheaper than it was in the 1960s (measured in 2017 dollars). You just probably don't want it, because it's nowhere near the current expectations and standards of quality of care.

> Put another way: today you can still get the same type and quality of care that was available in the 1960s,

No, in many cases you can't because the techniques and absence of procedural and other safeguards are no longer up to the standard of care in the profession, older drugs are no longer produced, etc.

It's a lot more expensive than it used to be. https://data.worldbank.org/indicator/SH.XPD.PCAP?locations=U...

Ok, the price increased. And, let's ignore related factors such as the increased cost of medical education and advances in medical care (my aunt got a new heart a year ago!)

My view of the mainstream story is that things went from ok to chaos within the past, say, 3 years.

Instead, the costs have been steadily rising while voters have repeatedly opted not to make changes.

Thought experiment: what if gas or milk prices had increased at the same rate? Education cost has increased a lot, but that's mostly inflated by student loans that I predict will implode like subprime mortgages.

> Instead, the costs have been steadily rising while voters have repeatedly opted not to make changes.

Have voters done that, though? I mean look at the trouble Republicans are having repealing the ACA. Voters seem to not want to repeal it. It seems like only the Republican leadership actually wants it repealed. My understanding is that when you ask individual voters of all stripes, they agree that pre-existing conditions should not stop you from getting affordable healthcare, and that lifetime limits are unfair across the board. But those are the things the Republican leadership wants to axe first.

Look at all the congressional seats the Democrats lost (and the POTUS seat) after Obama pushed through his plan.

It's always harder to repeal a law, versus blocking it from passing. As soon as a law is passed, it's the new status quo. And recall how close the recent repeal vote was.

Why haven't we repealed the laws against weed and poker yet?

Look at all the votes the Democrats lost after a bunch of states effectively blocked blacks and students from voting.

> You got it right, it's difficult to imagine for a European what it's like to deal with having no medical care if unemployed.

you buy subsidized insurance. do Europeans really think the USA is just a free for all ?

Yes, or worse. I'm American. I live in Norway. Most folks I talk to from other countries - not just Europe - find the American health care system to be cruel and too expensive for the common person.

And by the way, I do not buy subsidized insurance. I pay my taxes, and I have health insurance. My taxes pay for health insurance. There is nothing else to pay to get that, other than a small fee for the doctor out of pocket up to a certain amount. No doctor, no medicine = no payment. Other than taxes, assuming I'm working and paying taxes.

Nit: "everyone" pays taxes - you get healthcare even if you don't pay any taxes (eg: college student without taxable income, unemployed not receiving benefits (yes, there's income tax on unemployment benefits)).

That's a very small bit of the population, but you are right. Nearly everyone gets health care, minus some classes of immigrants. I knew there were taxes on unemployment benefits (and i'm not opposed to that). But even the folks not paying employment taxes generally pay tax through food, transportation, entertainment, and other things.

There's a point below which you can't afford any kind of even subsidized insurance. Not if you want to keep paying rent, buy food, car insurance to keep going to work, phone bill, electric bill and so on. Whereas in the part of Europe where I live, the less you have the less healthcare costs you.

EDIT: The less it costs for the same quality.

I'm not really sure where you get your information. Anyone can get Heath insurance from the healthcare.gov marketplace.

Your salary requirements factor into the price. Someone making only 17k a year is capped at $54 a month premium. There are caps at certain salary intervals.

> Whereas in the part of Europe where I live, the less you have the less healthcare costs you.

100% true for the US as well. Please don't listen to news or internet comments. Verify the facts!

If you are not getting subsidized because of income, you have to pay for everyone else who is subsidized.

I was buying plans from health care exchange for 2 years and my last plan for two (parent and child) cost me 500$ per month with 6500 deductible per person - 13000$ total.

So effectively I had only a catastrophic insurance but was forced to pay for some subsidized guys who had a platinum plan with no deductible for 54$ per month. Worst situation for people like me!

Before that point you qualify for free insurance through one of many government welfare programs. Learn about the system before you criticize it.

That's actually not true in any of the states that didn't sign on to the ACA Medicaid expansion, which, yes, was designed so that between exchange subsidies and Medicaid eligibility there would be affordable subsidized or government provided coverage across the whole spectrum where people didn't have employer coverage or the ability to afford unsubsidized coverage.

It's also not true of extremely high cost of living areas such as NYC or the bay area where you're living beyond your means long before you qualify for government programs based on poverty levels that are calculated averaged across the nation.

The system has warts. There are good reasons to criticize it. But saying we leave the poor dying in the streets because, well, fuck 'em they're poor, is both untrue and insulting.

> But saying we leave the poor dying in the streets because, well, fuck 'em they're poor, is both untrue and insulting.

Well, except that it's exactly true that that’s why the “warts” that you acknowledge which do, in fact, deny swaths of the poor access to care are tolerated.

Subsidized insurance which still gives you costs for healthcare and sometimes doesn't cover certain tests or treatments that are considered not essential, such as birth control to treat polycystic ovaries or a blood test to diagnose functional sexual hormone levels(such a test would also detect polycystic ovaries, which untreated results in further health complications), More effective antibiotics for infection, multiple kinds of mental health medication, and dermatological medication. Not to mention confusing limitAtions of location of treatment due to network effects.

They do because that's how most educated Americans describe their country to Europeans.

You walk into an emergency room and get treated without paying a cent.

Emergency rooms only have to stabilize you, they don't have to treat you. It's a big difference.

> Emergency rooms only have to stabilize you, they don't have to treat you. It's a big difference.

No, and you don't want an emergency room treating you, because emergency physicians aren't trained to provide anything other than acute care.

That said, the point is moot, because once a patient is stabilized, if they need further care, they'll be admitted, and receive care from an internist.

Afterwards, they'll receive a bill for a rather large amount, which the hospital doesn't expect them to actually pay (but for legal reasons is required to present them with). If they know about this, the uninsured patient can almost always get away with paying less than 5-10% of the total (initial) bill, and the hospital writes off the remainder so the bill is paid in full (ie, it does not get sent to collections). Of course, most patients don't know any of that.

The billing situation is 100% fucked, and the reasons for that are way too long to explain here, but it's not true to say that an unemployed person without insurance can't receive anything but acute care from a hospital, or that they would necessarily have to end up in debt for doing so.

> That said, the point is moot, because once a patient is stabilized, if they need further care, they'll be admitted, and receive care from an internist.

No, they often won't, because while ER stabilization without regard to ability to pay is mandatory, subsequent admission and treatment is not.

If the condition is not stabilized in the ER, they may be admitted for stabilization to fulfill the mandate, but there is no mandate for admission for treatment after stabilization.

> No, they often won't, because while ER stabilization without regard to ability to pay is mandatory, subsequent admission and treatment is not. If the condition is not stabilized in the ER, they may be admitted for stabilization to fulfill the mandate, but there is no mandate for admission for treatment after stabilization.

That's not really true, and it's a common misconception that arises due to the way the ER mandate is specified in law (explicitly, and via a single bill), as opposed to the confluence of a few different regulations.

In short, because of the intersection of ways in which hospitals are and are not allowed to discriminate against patients by insurance status, what ends up happening in practice is that the decision to admit a patient is rarely made with the patient's insurance status as a determining factor.

That's especially true for public hospitals, but it's true of many private hospital situations as well. (Note that this doesn't apply to the decision of which hospital to admit a patient to - a single ER which has more than one associated hospital may decide to admit a patient to the public hospital instead of the private one based on their insurance status).

Seriously, if I believe what everyone comments on HN I would think hospitals are turning sick or injured people away.

My mama taught me to not talk about things I don't know anything about. I wish more people listened to their mamas.

To the curious Europeans out there, if you lose your job you can stay on your job's health plan for 18 months while you look for new work. If you're unemployed that long then you'd qualify for Medicaid after that, the government insurance program for the poor. If for whatever reason you really didn't have insurance you will nevertheless never be turned away from any hospital emergency room. This "die in he street because you have no insurance" is a myth and total hogwash.

> Put another way: today you can still get the same type and quality of care that was available in the 1960s,

If you can pay the full premiums, including the part your employer paid while you were employed.

> If unemployed that long then you'd qualify for Medicaid after that, the government insurance program for the poor.

You don't qualify for Medicaid based on duration of unemployment; whether, and in what form, you would qualify for Medicaid depends on income, assets, and state you live in (Medicaid is a state-run program with some federal standards, though even the most basic broad-strokes qualifications differ between states, especially between those participating in the expansion under the ACA and those not.)

> If for whatever reason you really didn't have insurance you will nevertheless never be turned away from any hospital emergency room.

But will be booted into the street from the ER after stabilization without treatment of the underlying condition.

> This "die in he street because you have no insurance" is a myth and total hogwash.

Except that people do, in fact, die because of lack of health insurance in the US.

http://www.pnhp.org/excessdeaths/health-insurance-and-mortal...

Make sure mama also told you these two things... Cobra insurance after losing your job requires you to pay the full premium which can be upwards of 10k per year. Also Medicaid has a very low asset threshold that you can still qualify unless you are pregnant, have young kids, disabled or elderly. ACA subsidy is the best shot for most in this situation but who knows how long till it is dismantled.

It's not hogwash when actual, documented cases exist of people not going to the emergency room for fear of being crushed to death by the debt from an ER visit. And COBRA doesn't just give you free insurance for 18 months, you have to pay the full premium for it. If you're unemployed, how in the hell do you expect to pay the full premium as opposed to the premium that you were paying before that was subsidized by your employer?

You've clearly never, ever been in a position where money was an issue for you. Especially not to the point where you felt your life was in danger because of it.

> You've clearly never, ever been in a position where money was an issue for you.

I have.

Oh, ok. /s

If you had been, you wouldn't be handwaving away legitimate concerns over the system of healthcare. Considering you didn't even address any of the points I mentioned, I have a feeling you have no response.

I was reminded of this again over the weekend when listening to this story on the radio: http://www.npr.org/2017/09/10/549489252/emperor-x-we-are-muc...

"Like many musicians, Matheny went years with minimal health insurance, or none at all. In Germany, with no insurance, he wound up in debt of about €30,000 — roughly $35,000. That's what Matheny calculated he would have owed in the U.S. if he did have insurance."

Healthcare sucks AND it's ridiculously expensive.

My healthcare plan costs me $1,200/month for my family of 4. It went up nearly 30% this year and is expected to do the same next year. Give it a few years and it will be $2,000! I have a good job, but if that keeps going I won't have any choice but pay the fine/tax.

So back to the $1,000 phone. If all phones cost $1000 - I'd be more likely to go without one.

If you're Christian check out medishare (and other alternatives). Disclaimer: I'm not a still for them.

Yes! As a twenty something single I was shocked that people saw paying $200 out of pocket each month as a privilege that comes with working. Clearly, for me it was a pure waste because I used exactly zero dollars worth of health care myself. Of course, people with infants absolutely need it. I had a coworker who had basically the same story as Jimmy Kimmel (newborn with heart defect). I can't imagine how much quality care would cost if he didn't have health insurance through work. I mean at some point there were apparently dozens of specialists involved with the case... I'm sure each of them are billed at hundreds of dollars each hour.

I just want to say that at the end of the day there is no solution other than reducing the cost: be it healthcare or education or retirement...

I also skipped getting health insurance in my 20s, which I deeply regretted when I needed unexpected emergency surgery to remove a diseased organ.

The hospital that did it was religiously affiliated and knocked a huge amount off my total hospital stay, but I still paid a lot out of pocket.

What's worse is, until the ACA came along, that bout of uninsured surgery made me uninsurable from then on--I had "pre-existing condition". The ACA has made it possible for me to actually buy health insurance at all again.

Of course, I'm still hoping the Medicare for All movement starts gaining steam...

Until you have a catastrophic health issue like say total kidney failure at 18 which happed to some one I know or you need a transplant I dread to think what my recent kidney transplant would costs in the USA as opposed to the UK

not getting healthcare as a 20-something is popular, but incredibly shortsighted.

> not getting healthcare as a 20-something is popular, but incredibly shortsighted.

My idea is that it is not something that you should have to think about. I mean I understand it is a difficult topic because you have these outliers that can totally destroy your life if you have a baby with a malfunctioning heart or whatever but it comes back to the question of what we think is fair. I sincerely believe that healthcare is too expensive. The problem is that nobody who is in a position to cut costs has the incentive to do so.

I mean I hear all these complaints about medicare from providers like oh there are restrictions on what you can bill and what you can't and I am just thinking "good" because otherwise the doctor will put every single patient who comes in with a stomach ache through an MRI without using any of her judgment. I mean it looks badly on her if one out of a thousand patients turns out to have something she didn't catch but it doesn't hurt her at all for all those 999 useless MRI and the cost of those. The hospital is happy because they already have the machine and the technician who is there so is drawing salary so they have an incentive to maximize the use of the machine and the technician.

I am hopeful for medicare for all but we should remember that this is not the end of the problem. There are no silver bullets. As a society, we have to constantly make difficult choices and I for one support "death panels" which to me means that certain cases where the cost is too great AND the outcome is not good enough can and should get denied.

> where the cost is too great AND the outcome is not good enough can and should get denied.

I'm not completely clear on the point you're trying to make, but this is how things work in socialised healthcare. Not everything is paid for - instead the money that is available is spent on those that return the best value-for-money balanced against not being unfair on an individual level. The question of whether to MRI everyone with tummy pain is translatable into a clinical question and can be tested in clinical studies.

In the UK we work on using a QALY - or quality-adjusted life-year to help with these sorts of decisions. They are used on boards in NICE (for general health-provisioning guidance) and the cancer drugs fund [1] which aims to give quick guidance on the fast-developing and expensive field of anti-cancer therapies.

Sure there are no silver bullets, but issues you bring up are being tackled to a relatively sophisticated degree in other countries.

[1] https://www.england.nhs.uk/cancer/cdf/

> Sure there are no silver bullets, but issues you bring up are being tackled to a relatively sophisticated degree in other countries.

That's perfect! One more question: how do you handle things like tobacco, alcohol, sugar, daredevils (think jackass the TV show)?

I'd say for most of us in the US it's a non-issue -- you either have it, or you don't, and that hasn't changed a ton in the past few decades. I don't go around thinking "man, if I was in Sweden, I'd ALSO have health care just like I do today".

A discussion about pricing is a discussion that includes purchasing power in its scope. Cost of living is relevant to that discussion.

I think it's probably a proxy for talking about "discretionary income" or something. My kid may have more discretionary income than I do if he doesn't have to pay a mortgage and utility bill every month. So a higher cost may actually be more affordable if other things don't have to be paid for.

I don't really know how to compare countries like that- but I would wager somebody has tried.

Because in most of Europe, sales tax (which therefore is added onto the purchase of your new iPhone), will in some part go towards the funding of universal coverage free-at-point-of-use healthcare.

In the US you get your phone cheaper. But you buy your healthcare.

Most Europeans would prefer to pay more for their phone and know everybody in their neighbourhood gets free medical for life in return.

Before the ACA a family of 4 could get health insurance from the private market for 350 a month or 4200 a year and it's tax deductible. In Germany, a family of 4 making 75k$ a year pay 7.5% or 5,625$.

The US system was cheaper and comparable. Now it's dramatically more expensive for the same cost. All we got from the government is expense. This is why many here are not pro-single payer.

You can't make comparisons like that.

Take a look at the U.S. public healthcare expenditure per capita. It's higher than countries like the U.K. (with fully tax-funded healthcare), probably even Germany. And that's before accounting for private funds.

Again your example is a poor way of comparing things, but you didn't even factor in how much you pay towards Medicare/Medicaid.

Last time I checked, in the UK I pay less towards the NHS and the best private health insurance I could find, combined, than I'd be paying in the U.S. in taxation towards healthcare alone.

All these comparisons between the US and Europe regarding healthcare are useless. The common suggestion that the US would need a 20% VAT or higher income tax to afford universal healthcare is absolutely false.

> Before the ACA a family of 4 could get health insurance from the private market for 350 a month or 4200 a year and it's tax deductible.

Or not at all, depending on pre-existing conditions, continuity of past coverage, and other factors.

Which is a fair, but statistically insignificant point. We had a lot of uninsured that could have afforded insurance without government aid. Now we have to get aid to afford anything.

You could say the same thing a different way. I'd like to see a study comparing total costs of the two over a decade.

In Europe you pay more taxes but pay less at the doctor.

In US you pay less taxes but might pay more if you need to go to a doctor.

Sales tax is a state thing and many US states don't have it. For example Florida doesn't have Sales Tax or Income Tax.

Probably because prominent American politicians brought up iPhones in health care discussions recently. "And so maybe, rather than getting that new iPhone that they just love and they want to spend hundreds of dollars on, maybe they should invest in their own healthcare." - Actual statement by actual (now retired) American member of Congress in March.

The iPhone is more expensive in part because it includes a 25% sales tax...

My point was that there are other factors than price which influences whether or not someone will buy something if you look at the entire world. I just gave two example of such factors. And I'm surprised this was not obvious.

You don't think someone's ability to buy an iPhone or any other product at a certain price depends on how much money they earn/they are left with at the end of the month?

If money is that tight then a brand new $1000 iPhone might not be a wise choice.

It's also the userbase or the marketing there (unsure which one). I was in Sweden few years ago, gislaved / hestra, and overall nothing else was being sold besides iPhone. It came as a shock to me.

Only one of the tech toys stores that we visited had Samsung at the time.

Looks like your view is biased by what stores you visited. All stores where I live sell a mixture of brands, with the obvious exception of the Apple store.

I think the largest stores are Elgiganten, Mediamarkt, Netonnet and all of those sell a mixture.

A quick look at price comparison site for my area shows 80 stores selling iPhone 7 and 72 sellingg Galaxy S8. And that includes the Apple stores.

Fully agreed. I can't imagine Sweden having less choices than Norway, considering full EU membership and Norway being known for its lack of choice.

> For Example, HongKong used to have the cheapest iPhone around the world, it was priced the same as US and because there are no Sales tax, it was 10-15% cheaper.

Could you explain this differently? If it had the same price as the US (converted to HKD), and no sales tax, it would be the same price as buying it in (say) Oregon:

https://en.wikipedia.org/wiki/Sales_taxes_in_the_United_Stat...

> Since January 2017, 5 states (Alaska, Delaware, Montana, New Hampshire and Oregon) do not levy a statewide sales tax

I took this as meaning that it was 10~15% cheaper than surrounding countries/territories due to no sales tax, hence being used to fuel black market all around SEA: a 5% margin on an iphone obtained in HK would still be cheaper for the final Japanese buyer than a "home-bought" iPhone (8% VAT).

>and everywhere else had it more expensive.

Once you correct for VAT and currency, you'll find a lot of foreign iphone sales aren't really expensive. USA pricing does not include taxes and the dollar is fairly strong now.

>Well Apple already knew certain people are buying at those prices, again why not make a product that fit those segment?

I think the larger issue here is that Apple can't maintain 2008 level pricing a decade later especially as China stops being so cheap for labor. Toss in US consumers buying on credit for 24 months and its a no-brainer we'd see price jumps. Apple isn't taking a cut on its margins, so it has to do a price increase eventually.

That's on top of the phones having expensive high quality components, NAND shortages, and the cost of rare earth elements going up every so often. Prices aren't scaling for components it seems. A high quality display in 2017 isn't the same price of one in 2008, plus inflation. A modern SoC now has to support HDMI, displayport, 4-8 cores, LTE, etc all come at a component cost as well as a licensing cost. Modern phones are more or less mini laptops now, so the dream of a 'simple' ARM device is long dead. We more or less have the desktop re-invented on ARM platforms and expect them to do anything from calls to word processing to 3D gaming. That's a far cry from the original iphone and its simple apps and simple OS.

Perhaps this is the old man part of me talking, but I absolutely fell in love with smartphones in the early days. My Treo was a wonder and the iPhone twice so. The simplistic aspects of it was incredible. Everything was snappy. Apps were a couple megabytes, if that. It did the minimum I needed and then some. Now, of course, that's all changed, but for a few years there I kind had the star-trek like device I always imagined. Now I'm back to a mini-desktop, lag, big complex apps, a near unusable mobile web, constant nags for reviews/notifications, etc. The only saving grace is that a lot of that is abstracted away from me as I move towards a lot of automation and voice interfaces (voice commands, google home, etc) and I simply developed lowered expectations of the mobile experience.

Another way to look at this is that everywhere else in the world that iPhone will cost $1500-$2000 (depending on version). Will those people still be willing to pay that much for it?

> Around iPhone 5 Apple started to put up additional $100 USD to ALL iPhone price in HK, as a way to combat the black market trading,

This post is informative, but can I suggest that we not adopt the "black market" nomenclature for cases where people buy hardware in one location, and then re-sell it?

Companies like Apple may brand this a "black market", but that implies that companies have a right to perform perfect price discrimination across the world.

https://en.wikipedia.org/wiki/Price_discrimination

I suggest we reserve the phrase "black market" for cases where contraband is being exchanged, or for cases where items were obtained through crime (e.g. the sale of stolen goods).

I would say "black market" is fair if any part of obtaining and reselling the device is illegal. For example, in the early 80s there were US tariffs on RAM chips from Japan, if I recall correctly (I might have the country wrong). But some companies found they could buy in Japan, move them to another country, and then import them into the US via this other country without the tariff. It was illegal because they were still manufactured in Japan. When the government found out, those importers got in trouble. I would count those as black market since they were being brought into the country illegally.

Is that the case we're talking about here? Buy in HK with no taxes, then sell in another country without paying the taxes? If so, that still sounds "black market" to me. I'd think you'd have to pay the taxes in the country of sale regardless of where you obtained the device. If that's not what we're talking about, then I agree it's probably not fair to label them "black market."

True. I spent around $1000 for my iPhone few months back. This was for the 32GB one and it was on special.Prices for the 128GB were just ridiculous. I was a bit surprised when I saw headline of this article because we have been paying over $1000 for ages now.

For a while they were cheaper in Japan with sales tax than in the US without tax.

The sticky price structure of Apple was severely undercut by the price of the yen. They fixed it now, though.

Everywhere else had it more expensive, but everywhere else IPhone are... well not niche, but definitely way less pervasive

> US has the cheapest iPhone

It is interesting to note among Developed countries, the US has the cheapest everything.

Cars, computers, building materials, clothes, TVs. You name it, it is cheapest in the USA.

It is interesting to note this is because people in the US have much less disposable income than people in other developed countries. Companies can charge higher prices in other developed countries because people have enough money to pay it, but they can't in the US.

> people in the US have much less disposable income than people in other developed countries

Is this true? I always heard it was the other way around:

https://en.m.wikipedia.org/wiki/Household_income

http://www.investopedia.com/articles/markets-economy/090616/...

And median: https://en.m.wikipedia.org/wiki/Median_income

>"It is interesting to note this is because people in the US have much less disposable income than people in other developed countries"

I am curious did you just make this up? This is a completely bogus statement. The US is actually amongst highest per capita disposable income countries. See:

http://www.investopedia.com/articles/markets-economy/090616/...

https://www.currencyfair.com/blog/which-country-has-highest-...

That's why the iPhone is cheaper in Thailand and Korea where the median and mean incomes are lower .... Oh wait, it isn't.

Median income Thai and Korean people don't buy iPhones.

This is actually a) not true and b) not relevant to the original argument. I was amazed by how many people I met in Thailand and Korea who were struggling to meet $500 rent that had iPhones. More importantly, the original post argued that price of iPhone was directly correlated with disposable income.

Are those people with iPhones in Korea and Thailand buying on installment or paying by the month/renting the phones instead of buying?

Really? To me it seems like the US has a higher disposable income per household (after taxes) [1]:

US ~41k, Switzerland ~36k, France ~30k and Germany ~32k

[1]: http://www.oecdbetterlifeindex.org/topics/income/

In Argentina and Brazil taxes are so high that it's often cheaper to travel to the US just to buy a laptop like a MBP (for instance, the cheapest touch bar model is about $3k USD). And to give some perspective: the average salary over there is ~10 times lower than here in the US.

I would say it's the distribution that matters. https://data.oecd.org/chart/4VMU

"It is interesting to note this is because people in the US have much less disposable income than people in other developed countries."

Is this a commonly known thing? First I've heard it. I would have figured it would be the opposite given our overall tax rate compared to somewhere like Sweden is infinitesimally smaller. Can you point to some analysis/citations for this?

It does seem to make sense in my mind as, anecdotally, when I was in Germany I noticed a large number of high end Audis and BMWs. Cars that are $80k in the US would be well over $100k in Germany. (This is perhaps an oversimplification of the situation given that there are a great deal more factors involved in the pricing of German-made cars within Germany vs. selling the same cars in a much more competitive foreign market like the US'.)

The tax rate is lower, but the places charging those taxes do generally use them for providing public services that individuals would be paying for directly or indirectly, so that likely offsets part of it.

Past there, I'd suspect that it comes down to society as a whole having a more positive outcome, while individuals potentially having slightly worse outcomes. If we lower everyone's income in taxes but reinvest that money in healthcare and mental health services, quality education, etc, then we lift a lot of unproductive members of society up and have them all producing for us as well. The middle class may earn slightly less, but we can basically chop the lower classes/poverty stricken individuals right out of the equation - Sweden has 1% of the population below the poverty line, while the US has 15% - that's going to skew the average upward quite a bit.

It's not true at all. Things are cheaper in the US because it doesn't have high sales taxes and the huge order sizes means its cheaper

Typical US sales tax of 0-6% versus typical European VAT of 20-25% certainly makes a big difference too.

The funny thing with taxes is that in the end, if you pay the government or a company it makes no difference. However, if you pay the government they invest it in public schools, streets, health-care. Companies benefit the shareholder.

How is this related to what we're talking about here?

Those goods are also cheaper than in most developing countries as well. As in, the pair of Levi's that cost you $40 in Amazon will run you much higher in developing countries. Sure, you can get cheaper jeans from other local brands, but Levi's is seen as premium quality

are you including VAT in European prices? Any comparison needs to be worked back to price before taxes.

> "And in terms of iPhones / Population / Apple Store, the US has it most. While in Japan 60% of the Smartphone are iPhone ( i.e Higher the US usage ) they have less then 10 Apple Stores."

pet peeve of mine is then vs than.

A fun thing to do is search "less then" in google news.

Yeah, don't write about it though, this has cost me -1 karma. I guess people like this less /than/ i expected.

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