Comment by Broken_Hippo | Hacker News Reader

Comment by Broken_Hippo | Hacker News Reader

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Of course the problem is that the US is such a big country with huge immigration and scandinavian countries arent so it's always hard to compare.

I really don't understand why it being a big country would make things difficult. Any sane person would adjust the needs dependent on state and smaller. Norway's population is about the same as Indiana's, but is more sparsely populated - so some of the same problems as the western states. The benefit of the US being large would be that there are more pools to draw money from. And there are just as many opportunities to save money.

For example, Norway will send a nurse to one's home up to 6 times a day. For free. Even if you live on a cabin on an island or on a mountain. Why? Simply because it is still cheaper than a nursing home, overall. And as a bonus, folks tend to live longer and be happier with life.

As far as immigration goes, it is impossible to compare. But: Not every immigrant gets free healthcare. I get the state healthcare because my immigration status is family immigration - my spouse is Norwegian. If I were here for a job, however, I'd have to pay for health insurance. Of course, they'll still treat someone that pays cash and still treat emergencies. I don't really see how this would be an issue in the US either so long as the laws were set up correctly.

I'll further add that I think the healthcare is a bit different if folks are coming from an EU country - there are agreements in place about health care and things like that. Again, I don't see why this wouldn't be the case in the states.

That's because you haven't considered how big the US is and you haven't considered that the US is mostly a land of immigrants not a land of people who lived their almost all their lives for several generations.

Healthcare systems like the scandinavian are established over decades as the young needs to pay for the old until they get old themselves and have to get covered by the young.

This kind of system is more or less impossible in the US and it would be extremely expensive.

That doesn't mean the current system in the US is any good, it's horrible to say the least. But the scandinavian dream isn't possible in the US and I have yet to see anyone showing any actual proposal that would work given the setup with federal and state and what they can decide.

> This kind of system is more or less impossible in the US and it would be extremely expensive.

That's literally how Social Security works, and the fact that more guest workers pay payroll taxes into the system than are eligible to collect benefits from it actually makes it slightly cheaper than it would otherwise be.

That's how social security works and it works great in countries with little immigration not in countries like the US where there have historically been.

*That's because you havne't considered how big the US is and you haven't considered that the US is mostly a land of immigrants not a land of people who lived their almost all their lives for several generations."

I'm American. The first one is easy enough to consider. I can drive to Sweden in the same or less time than it would have taken me to get out of Indiana. I know it is big. I just don't see how that is an excuse. It isn't like you can't customize health care to a geographic area so it serves the needs of the people best. There are multiple ways to do that.

And that bit about immigration? That's propaganda 101 in school. Trust me, I'm aware. I fail to see how that is an issue. Most folks in the US aren't new immigrants: They are at least 2nd to 3rd generation. Even if I take the higher numbers I saw - around 25% - most folks are still just Americans. I don't really see how that affects anything. Don't most folks still want healthcare? Do immigrants avoid health care? Don't most of these families have at least one working adult paying into the tax system?

And of course it would be expensive - the current system is expensive. But it isn't efficient now, and that can easily be changed. Just because you haven't seen a proposal you'd be happy with doesn't mean it can't work. Most of the proposals I've seen in the US are more focused on preserving health insurance companies instead of focusing on getting health care ot everyone.

You are missing two important things here.

Homogenous and small.

These countries are homogenous which also means politically. You will be hard pressed to find any real fundamental political differences between parties in the scandinavian countries.

They are all on the left side of Sanders.

Furthermore, it matters quite a lot that you are dealing with a fairly limited population who all suffers from more or less the same issues because they genetically are alike.

And again keep in mind the Scandinavian countries have budgets which means that you can't always get the treatment you want/need even if you had the money.

Again I am not saying the US system is good it's obviously not.

But a single-payer system in the US just isn't realistic or attractive for that matter.

The problem in the US is the price, but that price is held up artifically not because of the market. So we need to remove the things that make the price go up that hight. That IMO would be a much better approach than trying to mimick scandinavian countries as great as they are for their population (but definitely not without it's problems)

Again, I don't see the size as anything but an excuse against it. Surely in the US, it would have to be adapted to different areas' populations. I'm not convinced Indiana is so much less homogenous than, say, Sweden. They are definitely not all on the left side of Sanders.

And again keep in mind the Scandinavian countries have budgets which means that you can't always get the treatment you want/need even if you had the money.

I don't know where you get this sort of information. I will never not be able to afford my medication. I broke my arm and got immediate, affordable treatment and had paid time off work even though my job was seasonal. In the US, with insurance, I would have struggled, not only with hospital bills, but with work. If you have an issue that they cannot treat in the country, you can travel outside of the country for treatment. Even if you are poor and have no money - the state does that. There are private hospitals and clinics around - if you have money, you can use them. They aren't always that much more expensive and the waiting period for non-emergency stuff is less.

The bottom line is that you are against a single payer system. That's fine, be honest, but please make sure your actual facts are facts instead of things people hear.

You know nothing about me.

It sounds like you don't want to see the problem which makes it hard to have any discussion.

The size is a problem given that you would need to be able to offer consistent care across the nation this is exactly the kind of problems that single payer systems deal with. They are an actual problem in the scandinavian countries and these countries are small. Federal is federal.

I am not against a single-payer system. I grew up with one as I am Danish so I want a single-payer system. Especially as I have been having 2 melanomas and might likely get more and live in the US. I just wont work here and I won't be able to get the kind of care that I get now.

I know both systems pretty well that's where I get that information from I been living in both and experienced both.

> Not every immigrant gets free healthcare

I think it depends on the job. If you work for a foreign company and are temporarily in Norway (e.g., spending a quarter at the Olso branch from your HQ elsewhere), you're on the hook for your own insurance: https://helsenorge.no/bo-i-utlandet/posted-workers-outside-t...

If you immigrate to Norway for a job, you're covered like everyone else: https://helsenorge.no/foreigners-in-norway/employee-from-a-c...

Another thing to keep in mind is the Scandinavian countries are resource rich with comparatively low populations - Norway has oil, Sweden has timber and iron ore, Finland has timber, etc. These helps build excess in their budget

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