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Comment by anamax | Hacker News Reader

> As for poverty in the US, 1 in 8 are in poverty if you use the CIA-polished statistics. I say CIA-polished because the CIA also says the US spends 12.5% of its GDP on healthcare. According to the OECD, it is more like 15.3%. By comparison, France (top healthcare in the world according to the WHO) spends around 9.5% or so.

Note that US GDP is also significantly higher.

Also, healthcare costs are affected by things that healthcare can't actually affect. Consider obesity.

Also, the existence of working govt programs in other countries does not imply that the US govt could do as well with comparable programs. For example, the US govt spends about as much per person as France does. Since the US govt services appear to be significantly worse ....

No, military spending doesn't account for the difference.

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>Note that US GDP is also significantly higher.

Maybe I am missing something, but this should mean that the US can afford to do more. No?

>No, military spending doesn't account for the difference.

I didn't say anything about military spending. Where is that coming from?

> Maybe I am missing something, but this should mean that the US can afford to do more. No?

It implies that spending a larger fraction of GDP on healthcare can be acceptable, but you suggested that spending a larger fraction of gdp on healthcare was a bad thing.

So, what do you have in mind by "do more"? (Of course, being able to afford to do more and actually doing more are very different.)

> >No, military spending doesn't account for the difference.

> I didn't say anything about military spending. Where is that coming from?

"military spending" is the typical reply when someone points out that the US govt spends as much per person as "high tax, high service" countries yet doesn't provide the same level of services.

Spending money may be necessary, but it isn't sufficient.

Okay, I think I see where you are coming from. Let me clarify what I said.

> you suggested that spending a larger fraction of gdp on healthcare was a bad thing.

I was probably in a rush when I wrote 'do more' and so apologise for any confusion. My meaning was not communicated well. If the data say anything, it is that the way the money is spent counts more than how much money is spent. That being said, getting the medical establishment and Big Pharma to take a pay cut is a Herculean task.

> "military spending" is the typical reply

I suppose for some it is, and the US does spend plenty on war. But I would agree with what I understand as your underlying point: The money needs to be spent better before more money is spent on anything.

> That being said, getting the medical establishment and Big Pharma to take a pay cut is a Herculean task.

Apart from the obvious cases of fraud (which seem to be concentrated on govt programs) and reducing some of the monopolies (including things that should be OTC), it's not clear that they're significantly overpaid. (Yes, I know about the "marketing" argument, but that includes free drugs to poor people and it's how folks find out that what they have is treatable. I see both as good. And allowing old people to have sex is a good thing.)

We want people buying Cadillacs (and Mercedes) because that's how we get good things in Toyotas.

A lot of US health spending is triggered by things that are outside the healthcare system. The only thing that the healthcare system can do is refuse coverage, and no one will admit to that.

>A lot of US health spending is triggered by things that are >outside the healthcare system.

Can you give examples of this?

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