Purchasing power is cool, but necessary goods (food, housing) prices* are raising much faster than wages. Yes, you can buy a new fablet and yet another pair of jeans for cheaper than ever, but what for exactly?
* Please do your own research as these facts are highly location-dependent.
Housing is an entirely different matter.
Individuals seldom pay the stick price. A $10k/month drug does not mean one pays $10k/month out of his or her own pocket. Same for a $1,000 emergency room visit. Or college tuition, due to generous financial aid and payment deferment programs (some universities have huge discounts for low and middle-class students).
So one must adjust prices for what one actually pays, not the MSRP.
Second, although people are spending a lot on healthcare, they are getting more healthcare and better healthcare, which is the key distinction. This means cutting-edge treatments for diseases that decades ago would have been fatal (a notable example is CML, which used to be fatal within 3-6 years of diagnosis but can now be managed as a chronic condition like diabetes).
Healthcare would be very cheap if drugs were limited to Advil and Aspirin, but also very bad. People would be irate if those were their only options. Not saying the system is perfect or that drugs are not overpriced, but one must take into account quality and quantity than just the price.
Rent, however, is an example of a cost that has exceeded inflation, but where there is no notable improvement in quality, and there are no payment deferment programs. People are paying more and more for the same 2-bedroom apartment. I suspect part of the problem is due to the difficulty of evincing deadbeat renters and due to regulation, so landlords pass the costs to renters both in the form of high rents and huge, upfront, multi-month down-payments. But also, the housing bust in 2008 created a construction shortage, so people who lost their homes in 2005-2010 found themselves with no option but to rent, and this created more demand, but also due to less housing constitution. Housing starts plunged in 2008 and never really recovered: https://www.census.gov/construction/img/c20_curr.gif
It has been proven fact that we (Americans) pay more than every other developed country for healthcare with poorer outcomes. It’s a racket, plain and simple.
https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more...
Women with insurance pay out of pocket an average of $3,400, according to a survey by Childbirth Connection, one of the groups behind the maternity costs report. Two decades ago, women typically paid nothing other than a small fee if they opted for a private hospital room or television.
But one must take into account the risk of complications; if something were to go really wrong, would you rather be in the US hospital or the UK one? I suspect the NHS is more affordable, but does not handle complications and individual patient cases as well as the US system.
How about this? Would you rather be in the US, or Japan, for such an emergency? Japan costs half as much as the US per capita (with even lower out of pocket costs), and beats us by every other measure. I'd rather be in the Japanese system than the American one for anything.
edit: The Japanese system, structurally, is very similar to the American system. It's not socialized, by and large. Private insurance through employers to private providers. Yet it costs half as much and works better. This points to something broken in the US system at a deeper level. Expanding on this, every civilized nation in the world has health care more or less on par with the US (fuck exceptionalism), for more or less half our cost. To the chagrin of liberals, "socialized medicine" isn't the obvious solution, because a lot of systems no more socialist than ours work well. And to the chagrin of conservatives, a lot of highly socialized systems also work better. The American system is uniquely fucked up.
Back to Japan. The key difference I can see between the two systems is that Japan has strict price controls. A government commission sets the prices for all medical products and services covered by insurance, with an eye to controlling costs while maintaining profitability. Insurers and providers have to control their costs internally, rather than jacking prices or doing many-to-many negotiations. Is this the key?
But I digress.
At any rate, the Japanese system clearly works, while the American system is clearly broken. One is selling the same product for half the price of the other. Assuming I'm right about the key differentiator being the Japanese price controls (I could be wrong), then it really makes me wonder why we aren't trying that. Seems like a great way to get costs under control (even shrinking), while preserving much of the complex market and avoiding radical change to almost 20% of the economy.
I think "critical utility services" touches on the importance, but doesn't go far enough. I believe a health care system that denies care purely out of poverty is immoral. A health care system that is the primary cause of bankruptcy for the middle class is immoral. A system that traps employees in jobs they hate, for fear of losing (or even changing) their insurance is both immoral and un-American - what's more American than quitting your job to get a better one, or start your own business? So our system is not just an economic failure, it's a moral failure. It's a stain on our honor and an insult to our values.
In conclusion, I do not give a fuck about "free market" here. I am not putting economic ideology ahead of moral imperatives, and I'm not choosing ideology over observable facts. If I wanted to choose ideology over economic reality, I'd be a communist.
The hospital charges my wife for her stay, my newborn son for his “stay”, her OB charged for the procedure, and the neonatologist charged. Whatever isn’t paid by insurance automatically becomes our responsibility, with no recourse to dispute.
We are actively working to leave this country.
Germany is, by all accounts, amazing. It's where my wife and I holiday and we've contemplated opening a B and B there a few years down the road. If I were coming to the EU fresh I'd be looking closely at Germany, Denmark, or the Netherlands.
http://www.bluecard-eu.de/eu-blue-card-germany/ is very relevant for a skilled migrant interested in Germany.
I can't comment on Colombia though.
https://www.cia.gov/library/publications/the-world-factbook/...
> [You] must take into account ... the racial makeup of America
Oh? Are black people not really counted for the purposes of birth stats? Why? Poorer genetics? Poorer healthcare access? Again, how would poorer healthcare access jibe with your "best in world" medical care?
I would love to see a good study that tries to disentangle the various correlations here...
Again, if you've got great health cover you can probably do better in the US. If you haven't, then you might not.
As someone who has lived in the UK, Australia, and the US, probably not the US?
Also, "Infant Mortality Rates of Countries, deaths per 1,000 live births[1]":
* Australia - 4.7
* United Kingdom - 4.8
* United States - 6.2
Apparently the statistics say we're not as good at "[handling] complications and individual patient cases" as you believe we are.
[1] https://www.infoplease.com/world/health-and-social-statistic...
Provide evidence for this claim, or stop trying to disparage an entire nation's healthcare system.
There have been attempts made to correct for these discrepancies. They end up accounting for a large fraction (but not all) of the difference in infant mortality rates, if I recall correctly.
Most of the rest of the effect is that premature births that everyone considers "births" have a higher prevalence in the US (for various reasons, not all of which are clear). Premature births have higher mortality, obviously.
https://uk.reuters.com/article/us-health-infants-mortality/u... is actually trying to look at an apples-to-apples comparison, and a few things jump out at me:
1) Birth defects. I wonder how much of this has to do with differences in abortion availability and again differences in definition of "birth". Many other countries count a child that dies within some number of days after birth from birth defects as a stillbirth, not an infant mortality event.
2) SUID (aka SIDS) is a huge contributor in the US. In the US this is highly concentrated in ehthnic groups that are largely missing in the comparison countries. Why that is is a good question, but makes this comparison less apples-to-apples.
To know where you'd want to be you want to know the outcomes for your specific demographic in the different countries, which is not something that gets reported very much...
From your own source, literally doesn't help your case at all.
The bit you quoted does not negate my two points about the data in that article.
But just to be very clear, Connecticut is cited as having an infant mortality rate that is slightly above the comparison country rates. Note that those countries were picked for a comparison because they have the 6 lowest mortality rates in Europe. [1]
Anyway, Connecticut is maybe somewhat similar to the comparison countries in terms of ethnic group demographics (mostly negating my point (2)) and has a more expansive definition of "infant mortality" than those countries last I checked, which is part of my point (1).
Mississippi, at the other end of the spectrum, has a vastly different ethnic makeup, has much worse abortion availability (increasing the number of babies with birth defects carried to term). And still has the more expansive definition of "infant mortality".
Now I'm not saying that it's a good thing that Mississippi has higher rates of SUID/SIDS. And I'm not saying limited abortion availability for cases when the child wouldn't survive is good. But I am saying that drawing conclusions about US healthcare here, as opposed to other societal factors, requires apples-to-apples comparison. And drawing conclusions about outcomes for a specific case (specific family) requires understanding whether those societal factors apply to it.
Or to put it another way, families that are willing to do an abortion when told their child, if carried to term, would not live more than a few months will have a lower infant mortality rate than families that are not willing to do said abortion.
One other thing which _is_ mentioned in the study itself but not in the article: "survival rates among preterm infants in the US were found to be very similar to those of the same European countries". Please model that with the "the US just sucks" model.
[1] The numbers in the actual study: Connecticut has an estimated FTIMR of 1.29 with a 95% confidence interval of 1.08 - 1.53; note that they don't have an actual hard number for reasons I haven't figured out yet. The six European countries involved are Austria, Denmark, Finland, Norway, Sweden, and Switzerland. Their numbers range from 0.97 to 1.24 according to the study.
The vast majority of the 'generous' college financial aid is loans with partially subsidized interest rates. Default rates on these loans are high and keep rising.
http://www.chicagotribune.com/business/ct-drug-price-sofosbu...
Costs $1000 in the US and $4 in India.
On top of paying premium prices for things, I also avoid emergency care on occasion that I would rush to if I had affordable insurance.
I wonder where you find ER visits for $1,000 ? I'm pretty sure in our mid size city with 5 or so big hospitals, the cost is much higher than that. I was treated some years ago with antibiotics and pain meds, given a bill over $4,000 - and I had refused the mris and xrays the doc wanted to order.
8 weeks later I got a notice from the hospital that they knew the address of the property I owned and suggested I pay.
"$10k/month" - some meds are $10k for one day. Sometimes one of the drug companies will donate a two day supply in an emergency, however I routinely shudder at the thought of going to the ER and getting hit with a $15k bill for a day and needing meds beyond that.
College tuition has been interesting in our state, they say it's free now, but previously I found that a lottery sold to people as a method to pay for college was only available to those under 25 and whatever other stipulations. I've heard of programs for women, for minorities, etc. There was one college in town supposedly offering scholarships to white people, and they had a great program I was interested in, but it was way across town and the expenses for travel and books was enough to make it a nice thought only.
"they are getting more healthcare and better healthcare" No, I am not getting better healthcare. Certainly there are others who find paying the retail cost of doctor visits and drug prices ridiculous. Certainly I am not the only one that has had a doc or nurse practitioner suggest tests that I cant afford and deny to provide comfort in the name of stopping a possible opiod crisis.
Funny, you say "would be very cheap if drugs were limited to Advil and Aspirin" - Advil and Tylenol are the main line of defense for health issues where I am, it's relatively cheap, certainly not as effective as some prescription drugs, but the cost of the doc visit alone puts them out of reach mos weeks.
Part of the rent / housing costs problems are indeed from the slow down of building some years ago, but there are many other factors putting pressure there, many of those factors have people profiting at the pain of others in a similar way.
I think the housing thing will level out, this is something where capitalism can work. Hospitals having impenetrable territory protected by regulations and drug companies being sneaky with patents however, I don't think that's as fair of a set of guidelines for capitalism to work it magic well.
https://www.kff.org/other/state-indicator/life-expectancy-by...
https://mises.org/wire/how-government-regulations-made-healt...
My country (Uruguay) is the total opposite, it has some nasty warts, but socialized basic medicine + the option of purchasing better healthcare if wanted seems like a much better system.
https://www.firstthings.com/blogs/firstthoughts/2009/07/most...
Also the US develops most of the drugs used by those other countries. IF Drug companies charged UK prices in America, they would not be profitable. Someone has to pay the bill for drug development. In this case, it's the US.
https://qph.fs.quoracdn.net/main-qimg-90fb34d138bbf4ebc946ca...
it's not a libertarian view, just the data.
First of all that source is from a pseudo-intellectual religious journal and carries little to no weight in my opinion, even if it did they admit that those numbers are differentiated by early screening in the US and this has little to do with treatment quality, such a statement on quality would need to control for this difference in screening.
>Also the US develops most of the drugs used by those other countries. IF Drug companies charged UK prices in America, they would not be profitable. Someone has to pay the bill for drug development. In this case, it's the US.
Only 5 of the top 10 largest Pharmaceutical companies are American and 3 of the top 5 are European so this statement is just not true.
Your quaint views on Economics are obviously libertarian, in the failed American political party sense, and frankly the data is not on your side.