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Comment by ilikehurdles | Hacker News Reader

Leaving your 20s and 30s with a career you enjoy, basic benefits such as health insurance, retirement funding, and paid time off, and the ability to afford a reasonably sized home without falling into tremendous amounts of debt seems less and less likely each year. I have a lot of family who have moved from the EU to the US and back to the EU, I have also lived there myself, and I'm intimately familiar with their day-to-day. If the average American knew what the benefits and lifestyle are like for a middle-class German family, all those totally disconnected accolades about job and GDP growth that our oligarchs like to shower upon us would do nothing to prevent work strikes and riots in the streets.

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You can also arbitrage different strengths and weaknesses of countries to improve your quality of life.

I was born in EU where I got access to all the benefits you're mentioning, such as free health care, free computer engineering BS+MS degree for myself, and social security providing for my aging parents. However, job opportunities as a software engineer there were ridiculously bad, both in terms of quality of work, and compensation (99% of my college mates ended up, and are still, working in mind-numbing boring consultancy shops paying less than an average skilled blue-collar job).

So, as a single, young, healthy and educated person I immigrated to the US, where a massive world of opportunities, not possible in EU, opened up to me. I'm blessed to be earning way more than the EU economy, with all its safety nets, would be able to support. And I'm doing very interesting work.

Once I get tired of this, or if a major health catastrophe happens, I will go back to EU with significant 7 figures savings, and keep enjoying the EU benefits.

All I'm saying is: I have lived in EU for 23 years and in the US for 10, and the opportunities for personal growth that the US provides are simply unseen anywhere else, so don't automatically discount the US system as bad, romanticizing the lifestyle abroad. Every individual has their own dreams and expectations for their lives, so to each their own.

Kinda similar thing here. But ironically, this is eroding the country away. Once you get a considerable amount of job seekers that got free education elsewhere and can retreat back for major healthcare issues, the inflation-adjusted salary levels drop to a point where you can't afford those things off your regular paycheck. So North America is becoming a rather weird place that attracts the brightest people from all over the world only to offer them the conditions where they will likely not afford having a family and will not pass their knowledge and traits to the next generation.

Do you ever question your moral integrity? You’re in the US taking advantage of a society that doesn’t have good social systems and which is why the wage in the US is high for skilled work. Then whenever you get sick you’ll return to a society with good social support but at the cost of lowering high wages. Seems you’re taking advantage of everything with ignorance and or desire. Whatever the case may be, I’m curious to your thoughts on this and I assume you’ve thought of it before.

Hate the game, not the player.

If it becomes a big enough problem, then EU countries could change their laws to make government-funded medical care conditional on paying certain amounts of taxes in-country.

> Hate the game, not the player.

I agree with this, I'm not sure why I'm being downvoted for asking though because I think anyone would be curious to read personal testimony of their own situation. I would question myself if taking advantage of being in a country that strips social programs for keeping wages high for skilled employees. It's not like paying taxes negates that reality.

I would encourage you to read the comment at https://news.ycombinator.com/item?id=20346775 and answer that.

Done, also thanks for writing your views. It's nice to read reasoning and more so from tech people because it's somewhat relatable being the same field as myself.

> Hate the game, not the player.

That's a lame excuse for anti-social behavior. "Somebody has to get those kids addicted".

Read some Kant, then ask yourself what would happen if everybody acted that way, taking all the benefits and then silently stepping out when it's time to give something back.

I know about the categorical imperative, but people aren’t saints. They follow incentives. The fix is to create incentives that make it easier to behave better, not chastise people for doing what benefits them.

That said, I fail to see how his behavior is antisocial. He’s creating far more wealth in his current job than he could in the EU. If he ever moves back, he’ll bring millions of dollars with him and inject it into the local economy.

> I know about the categorical imperative, but people aren’t saints

It's not about sainthood, it's about ethics.

> The fix is to create incentives that make it easier to behave better, not chastise people for doing what benefits them.

Breaking the rules will always give him more benefit, unless we "chastise" (that is: punish) that behavior. There's little we can do to make not murdering people that stand between him and riches "better" but making him believe that we will punish him.

Clearly, relying on ethics and/or rational acting won't work with that kind of people.

> That said, I fail to see how his behavior is antisocial.

There would be no society if everybody acted like him.

> If he ever moves back, he’ll bring millions of dollars with him and inject it into the local economy.

He will, as he stated, only move back if he gets seriously ill and requires the social net to catch him. He will only come back if he's going to cost money.

I am curious, how would you have acted in my shoes? A few alternative options I can think of:

1) Not even try to move to the US to pursue the dream of a world-class tech career (dream I had since I was 12), stay in my own EU country with a mind-numbing consultancy job (which again, it's the only kind of employment available since the country is mostly rural with a limited software industry) to be fully consistent with morals. This also means I won't be able to financially help my parents as a sign of gratitude for all they've done for me, since my salary will be barely enough to keep me afloat.

2) Move to the US and completely renounce to my EU citizenship, so I won't ever have a way to go back and "take advantage" of my EU country (meaning I wouldn't even be able to see parents and family without an immigration visa).

3) Move to the US, keep the EU citizenship, but completely deny to myself the option of eventually moving back if needed. So, if I get a massive debilitating cancer that will force me to quit my job and lose my health insurance in the US, I'll die without treatment and all alone (loving family is all in EU) but with morals.

4) Move to the US, keep the EU citizenship, keep the possibility of eventually moving to EU, but to be consistent with morals find a way to donate to my EU government a few hundreds/thousands a month to keep contributing to the social safety net even if I'm not a resident there (I don't believe that's even physically possible?). But certainly that wouldn't be enough to cover the expenses my government paid for my education, so I should also find a way to refund that?

5) Move to the US, keep the EU citizenship, and start a countdown mandating that in exactly N years (where N cannot be certainly changed!) I will move back to EU regardless of where I am in my career or health status, so I won't be able to just move to the EU at the most convenient time.

I'm asking because it's easy to talk about problems at a philosophical level, but please try to step down from your judging pedestal and come back to the real world with real problems, thinking what YOU would have done in practice.

> 1) Not move to the US to pursue a world-class tech career, stay in EU with a mind-numbing consultancy job to be fully consistent with morals.

I know plenty of people in the EU that work in IT, get paid very well (compared to their peers) and do not work in a consulting company. Especially for very talented people, I haven't heard of any stories about not finding interesting, fulfilling work.

> 3) Move to the US, keep the EU citizenship, but completely deny to myself the option of eventually moving back, so if I get a massive debilitating cancer that will force me to quit my job and lose my insurance in the US, I'll die with morals.

Since you renounce your duties to the society that gave you your free education and upbringing, renouncing the benefits sounds fair, yes. Living and dying by your personal convictions is what I respect in people. Living by them only while it's convenient and stopping to do so when they get tested just means that you don't actually have any.

> 4) Move to the US, keep the EU citizenship, keep the possibility of eventually moving to EU, but to be consistent with my morals find a way to donate to my EU government a few hundreds/thousands a month to keep contributing to the social safety net (I don't believe that's even possible for non-residents).

That's another option, I'm sure you can find a way if you want to.

I don't mind the emigration part at all, it's the reasoning I dislike. Saying "I don't like the bureaucracy" or "I don't like the population density" or "I don't like the language/food/culture/tv program" etc, that's perfectly fine in my book. But saying "I've taken all I can, it's time to move on, otherwise I'd have to give back. Oh well, I might come back if I ever get needy again and there's more to take" is not in my book. Living in a society that finances your education and catches you if you fall comes at a cost. Ducking out when the bill comes isn't what I'd do.

>Since you renounce your duties to the society that gave you your free education and upbringing, renouncing the benefits sounds fair, yes. Living and dying by your personal convictions is what I respect in people. Living by them only while it's convenient and stopping to do so when they get tested just means that you don't actually have any.

Why not formalize it by saying one should lose citizenship automatically under these circumstances? If you don't agree with that, then realize you are drawing a line somewhere, and deanmoriarty is merely drawing the line in a different place. Both of you are the same, and are merely quibbling with the degree by which you are the same.

> Why not formalize it by saying one should lose citizenship automatically under these circumstances?

For practical reasons. It's hard to formalize and having people be stripped of any citizenship is shit. I don't mind the idea of losing your previous citizenship once you acquire a new one, that's fine.

I'd much prefer a system where education etc is fundamentally free but is converted into a loan if you emigrate. Society X invests into you, you want to jump ship to Y so you pay back what X invested into you, possibly in multiple installments or an additional income tax.

Thanks for your reply.

One more question for you, to understand the scope of your philosophy: I don't plan on having kids ever, and to be honest my reasoning is partially driven by the fact that I see them as an unnecessary financial and time burden on me and my partner (she agrees).

Does that mean that in your world view we don't deserve a place in society at all, because if everyone was like us we wouldn't have a society at all in a few decades, so once again I am living by exploiting all the financial and time commitments spent by other people in raising other humans for my benefit?

No.

I'm also not against suicide, even though society would end if everybody did it. It's about your interaction with others where your morality matters. Whether you have children or not is your personal decision and is up to you, similarly to burning your possessions. It's when you're contemplating to burn other people's possessions that the do/don't questions arise.

I have empathy for your situation if your dream was from the age of 12 to be in the tech career and only obtainable in USA. I had a dream that wasn't work-related and I wasn't able to obtain it. Yes, dreams are worth a lot and makes me find your situation exceptional compared to someone just in it for the money. Myself, I chose to move away from the USA because being a software engineer could be done in Canada and it had nothing to do for my dream. Heck, even if money would have financed my dream, I wouldn't have wanted to work in the US for financing my dream because I've seen too much dread before graduating that was rooted by how US culture only cares about themselves. Anyway I guess you're okay morally if your dream has good merits as well. Like whatever you're making isn't just some mindless product for socially conditioning certain demographics and into buying a product that has no real extension to life in a positive way.

>Read some Kant, then ask yourself what would happen if everybody acted that way, taking all the benefits and then silently stepping out when it's time to give something back.

I know this comment will trigger a bunch of people, but for me a sign of maturity is when people realize the categorical imperative isn't all it's hyped up to be.

I was a big believer of the categorical imperative since my teens - years before I had heard the phrase or heard of Kant. But the more I understood statistics and its role in the world, the more I realized the categorical imperative is only a first order way of looking at things. Once you take into account human psychology, and its inevitable spread statistically, you realize that in many cases, viewing things with a categorical imperative lens is not only futile, but counterproductive. One needs to take that spread into account (i.e. realize that all people will not behave as you do) to get an optimal solution. The question to ask is "What behavior/policy will get the best outcomes given the differing behaviors you will see in society?"

Personally, I realized I was dodging difficult issues by invoking the categorical imperative.

That's my thought on the categorical imperative in general. Regarding this specific case: Various commenters have already mentioned that some countries do indeed make it hard for you to use their healthcare if you've not been paying into the system all these years. I know one guy who ran into this - he spent most of his career outside making big bucks, and then retired in his country which provides socialized medicine. They told him they will not cover conditions he developed while he was not paying into the system (essentially, pre-existing conditions when he moved back). He has to pay full cost to get treatment for those services.

deanmoriarty is not the sole actor here. The US, as well as his country of citizenship are quite capable of ensuring they don't get exploited. If either country thinks this is abuse, they are welcome to modify their policies.

And BTW, yes, part of the reason people in the US get paid high salaries may be due to the lack of socialized health care. However, there is no implicit social contract in the US to spend that money for medical care in the US. In fact, I'd argue the social contract is quite the opposite. The US is making the message clear: "We will not provide you with socialized healthcare. You are free to pursue whatever medical care as you wish." Which includes going abroad.

> One needs to take that spread into account (i.e. realize that all people will not behave as you do) to get an optimal solution. The question to ask is "What behavior/policy will get the best outcomes given the differing behaviors you will see in society?"

The categorical imperative isn't about "is it likely that everybody will act like me" but "would it be good if everybody acted like me". You'll likely not end humanity if you start murdering your neighbors, because most people will not follow your example. Your murder might not even get noticed, so even the statistics won't change - and yet you'll probably agree that there's an ethical problem involved in murdering your neighbors.

I do agree with you that we shouldn't use Kant as the one-size-fits-all solution. Don't rely on telling people (or people understanding!) not to throw their trash everywhere, just put up a trash can so they can throw it in there. It is a solid framework for judging acts, but has it's weaknesses of course. The whole "the murderer is coming for your friend who is hiding in your bedroom, are you allowed to lie to him to save your friend" thing is something where I don't agree for example.

> The US is making the message clear: "We will not provide you with socialized healthcare. You are free to pursue whatever medical care as you wish." Which includes going abroad.

Sure, externalizing costs will provide advantages.

>The categorical imperative isn't about "is it likely that everybody will act like me" but "would it be good if everybody acted like me".

I know what it's about. My point is that in many tough situations, following it leads to suboptimal solutions (not just for me, but for society). It is not a good way to decide the morality of many things.

>You'll likely not end humanity if you start murdering your neighbors, because most people will not follow your example. Your murder might not even get noticed, so even the statistics won't change - and yet you'll probably agree that there's an ethical problem involved in murdering your neighbors.

I would agree, but I don't need the categorical imperative to decide this. It's not as if this is a tough scenario that the categorical imperative made a lot easier to analyze.

That's already how it is and has been for a long time in many EU countries, e.g. Poland, when you need to pay NFZ premiums to qualify for NFZ (i.e. state) health insurance.

I don't see it that way.

I am very committed to this country (US) and in fact I am also pursuing the citizenship process as a sign of long term commitment to it. The option of going back to EU is certainly something I keep in mind considering my European citizenship, but I don't necessarily look forward to it, at least not more than, say, all the hundreds of thousands (if not millions) of people planning to move abroad or to a different state when they want to retire and/or switch gears in life. I hope to be a productive member of this society for many decades.

Also, I am paying a massive amount of taxes to the US (effective tax rate in a coastal city can easily get to 40%+ on a tech salary), so I'm not taking advantage of anything at all.

By your logic, I should also question my moral integrity because I am not planning to ever have kids (personal reasons), so I am effectively relying on others to spend their own money/time to raise new human beings that will provide services to me and pay for my social security when I'll be old, which doesn't make any sense.

A single person making $200k/year in San Francisco will pay an effective rate of 34% in federal, state, and payroll taxes. Only your marginal rate is above 40%, but income taxes are of course graduated.

You don’t hit 40% until about $400k (in SF at least). So ya, if you are paying 40%, you are definitely in the 1%.

Yes, 400-500k is about the right range of compensation in SF for a senior software engineer working at FAANG, and that's about my number. Also, I'm single and renter so I get no tax benefits at all. But I'm not complaining about having to pay those taxes, it's a very reasonable price to pay for the massive opportunity being given to me, which I appreciate even more coming from EU, as I was saying before.

Got it, people often mistake their marginal rates for their effective rates and think they are paying much more than they really are. The jump of only 6% seems a bit small actually for an extra $200k in income, but thats America.

It likely won't work.

As soon as he gets US citizenship, exit tax will be placed on him and now if he wants to quit US citizenship he pays a big exit tax and US citizens are taxed on their global income, so whenever he works next, he also pays taxes to the US.

Curious to hear more details on this, but this is my current understanding:

First, exit tax is not just contingent on citizenship, but also on long term permanent residency, so I am effectively already under that rule, citizenship or not. Also, while the exit tax is for sure draconian, it doesn't mean you'll have to necessarily pay a huge amount, it merely depends on the unrealized gains you have in your assets. In my case that's relatively small since I'm not a homeowner and I've been paying capital gain taxes all along.

Second, most countries in the world (including the one where I have EU citizenship) have tax treaties with the US so that individuals who pay income or other taxes in a foreign country where they are resident for fiscal purposes will effectively obtain a foreign tax credit against the US taxes, avoiding double taxation. Since taxes in EU are higher than US, one wouldn't have to pay anything at all to the US. I've been dabbling with the US foreign tax for years myself due to some passive income generated in my home country, and I've always been able to claim full credit for it when filing my US taxes.

Third, my plan would not be to "work next" somewhere in EU. When/if I decide to leave (which may be never), with 7 figures in assets I should be able to live a modest lifestyle out of passive income in my original EU country (very cheap cost of living), so taxes would be minimal, if any at all.

The exit tax is not some wealth/estate tax that will make a huge dent in your assets, it's simply making capital gains tax due on the date of leaving US, not on the date of the sale of capital asset. It's extremely easy to pay zero exit tax when you leave US: just liquidate all your positions, so that you only own cash. This way, you'll just pay capital gains tax instead of exit tax. Of course, there's no reason to do that, because both are equal.

From an Individualistic perspective, as you loosely outlined, the US is unparalleled. However, from a collectivist perspective, which we are discussing in this thread, the US is empirically and emphatically bad.

As a south american living in the EU, I grew up hearing people saying "ah, in the US..." and while probably they were thinking back to a time when the US wasn't as terrible as it is now, it's a bit irritating for me to hear that kind of stuff considering that I graduated in the top university of my country with a masters in engineering and had to pay nothing because university is free and for everyone. I've met so many american expats in Europe who basically fled their student debt by emigrating. And that's just one thing, the fact that healthcare isn't free, people avoid calling for ambulances because they cost money, and people are jailed because the prision system has become a very profitable business.

Every day I see headlines like this and I think "surely soon enough it will get bad enough that people will support universal healthcare" or really any "socialist" policy. Every day I am mistaken.

If people actually did the research they'd see that these policies are just good common sense for them, but too many of our voters are lied to by the media they consume, so I worry things will never change.

Assuming the trend continues, at some future time there will reach a tipping point. Historically, once a population becomes so oppressed by those in power that it starts pushing into fundamental needs (food, shelter, etc), the population finally revolts and it's usually not a pretty picture.

Unfortunately (or perhaps fortunately in most other contexts), those revolution level standards of living are tremendously lower than what your average citizen has now even though we complain about home ownership and health care we still have places to live and emergency rooms. I'm not saying I'm willing to accept this level of modern indentured servitude, I'm saying most are.

For awhile, we had a generally progressive labor movement in the states where average citizens demanded improvement and progress. It seems to have reached a sort of stagnant state of complacency at some point and began to decline with much of that culture and momentum dying off in the process (not being passed on to future generations). Now, people just shake their heads and accept things the way they are instead of fighting for improvement in their lives. How do you educate the general population and convince them to support movements to continue to increase US workers' standards of living? I don't know the answer to that question.

I see an additional problem with the sort of bifurcation trend we're seeing in the middle class where people seem to be shifting to either upper middle or lower middle. The upper middle are typically more educated and so hammered in the rat race trying to salvage what remains for themselves, they can't find the time to support everyone else's rights. The lower middle typically aren't as educated: college is absurdly expensive and cultural + economic trends lead many of our most talented away from teaching (where many should be). This leaves the lower middle to be more susceptible to adopting media manipulation/ideology trends that aren't in their interests. I have a very bright and good friend who recently retired who told me if he was my age, he'd seriously consider migrating out of the country but he's retired and has a family. I hate to say it but sometimes I feel a tendency to agree with his evaluation and that's sad in one of the wealthiest countries in the world that has been a beacon of democracy and growth for many years.

I am from the same country as the commenter: there is a free public system of healthcare. I'm not using it. There is private insurance as well: I'm not using it either. Im doing cash pay for visits and they cost 20U$S each.

The universal care works against my usage in the case of Argentina, but I can still handle myself privately without hassles. The problem in the US is NOT that it lacks a public option.

Sure, healthcare can be super cheap as long as you stay healthy. What are you going to do if you get cancer? What if you break your leg in 5 places and need months of rehab? Just because you aren't sick now doesn't mean that healthcare is irrelevant.

I don't have specific statistics but in argentina the public hospitals that deal with cancer are decaying institutions and the people that I know have cancer use private insurance.

So didn't solve it either.

Im contesting the idea that public healthcare is what 1) lowers cost 2) guarantees good care

In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax.

Eg. impressions of Germany is that it's a nice place and all but they insist on paperwork/formalisms too much (for example apartment rental process is ridiculous) and it doesn't seem to be very upwardly mobile (you get taxed a lot so it's hard to accumulate capital when starting from mid level income for eg.).

That's not true here in the UK. People do use private healthcare but they're in the minority and it's usually for expediency rather than quality. Many very rich people still get treatment on the NHS. It's very, very good.

In fact most private healthcare delegates back to the NHS anyway.

" it doesn't seem to be very upwardly mobile (you get taxed a lot so it's hard to accumulate capital when starting from mid level income for eg.)."

I don't think that's true. You can get free/cheap schooling and health care is always there for you. I would agree it's easier to move upward than in the US where it seems one of the big secrets for success is to have wealthy parents. Coming from Germany and now living in the US I am also not sure if the taxation in the US is that much lower when you add all taxes together. And if you or your partner has any serious health issue it's very likely that this will cost way more than any taxes you pay less.

I agree, but this isn't the issue here. The issue is that poor people can't even access basic healthcare (can't even call an ambulance) without falling into massive debt. Free healthcare > no healthcare at all.

This reflects my experience in Canada. It's really hard to figure out how much of your taxes goes specifically towards health care, but we put a significant amount of effort into a calculation a few years ago and came up with a number in the same ballpark as the premiums for a very good private plan in the US. The problem is then trying to compare the composition; there are lots of aspects of the Canadian public plan that are superior to the USA, notably access to frontline services and certain widely used drugs (in the news: cheap insulin w/o a prescription). There are also many components that are vastly inferior, like timely access to diagnostics or procedures that seem "quality of life" related but really are not (ex: delayed hip replacements lead to major health issues).

So it's not just free vs. pay, but also what exactly you're buying. Unfortunately the single public payer in Canada system is a sacred cow, much like the idea of "socialized medicine" in the US is a non-starter. Everyone just digs their heels in and holds to the extremes, so the idea of small experiments of change never gets much traction...

> It's really hard to figure out how much of your taxes goes specifically towards health care, but we put a significant amount of effort into a calculation a few years ago and came up with a number in the same ballpark as the premiums for a very good private plan in the US.

The magic is that everyone gets this healthcare. Not only those able to afford the premiums for a very good private plan. On the one hand this is straight socialism. On the other it prevents bankruptcy (and downward economic mobility) due to serious health issues and allows access to quality healthcare to students, entrepreneurs, those between jobs, etc.

I don't understand how someone in the US can consider themselves more "free" than in more socialist countries when they're deeply beholden to their employers for basics like medical care.

Medicaid provides free health care to 74 million low income Americans: https://en.wikipedia.org/wiki/Medicaid.

Not everyone qualifies for Medicaid, and those who do must regularly jump through hoops in most states. It's obvious some states are trying to push people off Medicaid even if they don't have other insurance.

Really? Can you give some ballpark estimatives?

I’m really interested on how much of your salary can you save after paying not just taxes but kindergarten, health insurance, unemployment insurance, pension plan, 25-ish paid vacation days etc.

Living in Germany I manage to get around 45% of take home money after fixed costs and taxes, from this I manage to save around 35% and could probably push a little bit more if I wanted to have a more miserable life and didn’t travel that much on vacations.

> In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax.

My impression is that this varies a lot by country. For example that might be true in Australia and Canada, but not France or Germany. There are many different ways to implement universal healthcare.

My experience is completely different. I'm in Canada and the ER wait lists are usually a couple of hours. I'm also seeing a specialist in Toronto for procedures requiring image guided sclerotherapy. I bet I'd be fighting tooth and nail with insurance companies to cover that sort of procedure, which would likely run in the 100s of thousands of dollars, yet here I am getting it for "free" no questions asked.

I've never once even thought about money or insurance at all when receiving healthcare and I couldn't imagine thinking about costs when I'm already worried about my health. Americans are delusional if they think their system is better.

What makes you think Canadians don't need to battle for coverage?

"Then I found out that this other country — which I thought had a healthcare system that was so superior to the U.S. — doesn't test for the tumour marker that saved my life, and doesn't cover this drug that is responsible for pushing my cancer into remission after traditional chemotherapy failed to do that."[1]

[1]https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-...

It's not a perfect system, and of course cutting edge drugs take longer to get approved for coverage under pharmacare. This is an election issue, and it's very possible that we get national pharmacare coverage over the next few years, and cases like these are the driving force.

The difference is that we as a country are willing to pay more taxes so that every single person gets drug coverage, and it's reasonable to expect that this will happen in the near future, even for expensive cutting edge drugs.

>In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax.

This is true, but this is not that bad. The basic social security indeed stop being a thing once you earn enough. But if you earn that much, your work will provide you with an insurance that start at 50€/month to 250€/month that will cover A LOT of what you would have to pay in a private care clinic. You will still have to pay for the surgeon (especially if he is well known), but not the full cost.

The Argentinian government has collected taxes from its 50% child-poverty rate to fund your education so you could leave the country.

That is not an example of successful policy.

If the argentinian government wasn't riddled with corruption and people who literally stole most of public money then there wouldn't be a child poverty rate of 50% and engineers like myself wouldn't dream of emigrating.

Nevermind that I was one of those poor children.

But yes, the "policy" is the problem. Not the big heads stealing money.

The true act of corruption is that the poor pay for the rich.

4% of the national budget goes to public universities, and IVA is half the taxes levied by the federal government. There are no doubts of who is the giving and who is the receiving in this case. IVA is collected 60% on the bottom 50% of the population meaning its slightly regressive.

The first thing you can do to help the poor is to stop giving money to the rich: you can lower IVA by 1% if public universities were self funded.

Healthcare in the US used to be a lot simpler and cheaper. But costs continue to rise faster than the rate of inflation for decade after decade and the price started becoming an issue so people had to start complicating and reducing the quality their plans to save money, but those were short term fixes because the costs continue to rise faster than inflation and now we're stuck with plans that are complex and have limited offering and are still unaffordable.

Worse, all of the complexity has its own costs which are now just compounding the problem.

At this point any sane person should be saying that our private market approach to healthcare is an experiment that unfortunately failed, but the gravy train is too big and too fast to stop quickly. Nobody in Washington or even the state legislatures can get traction on a replacement without drawing the ire of extremely well funded political interests.

As a Brit I'm bewildered by the poor state of the basic working conditions Americans put up with. It's more similar to what my relatives in China get than the base line benefits and conditions in Europe.

On the flipside, I am amazed that Brits put up with going to college for 4 years to be a developer and living in a very high cost of living place like London, to make $50-65k a year after 10 years of experience.

Many differences for many different people / lifestyles.

I’ll probably get downvoted for this, but a strong argument can be made that the European welfare state has only been made possible due to massive US defense subsidies and economic stimulus during the post WWII/Cold War. This doesn’t mean that the US has a good excuse for relatively poor domestic social services vis a vi many European states, but let’s also be real about what allows Germany, France, etc to provide “free” healthcare and other social subsidies.

In the particular case of Germany, defense spending is only 1.2% (this stat is easily found via google). I’d rather have Pax Americana (which arguably is in decline) over the past 70 years providing stability in Europe, helping to lift hundreds of millions of East Asians out of agrarian subsistence, etc than slightly cheaper healthcare. Although, tell that fact to someone who receives huge, opaque medical bills for simple procedures in the US and they probably wouldn’t take too kindly to that line of reasoning...

I think the US defense subsidy is underrated, as is generational wealth in Europe accumulated over hundreds of years by plundering, enslaving, and colonizing the rest of the world.

Europeans don't want to hear that though, they like to imagine they're just simply more civilized than barbaric Americans.

The US defense budget is more than that of the rest of the top 10 combined. There are many things that could be said about it, but underrated is a bit of a stretch, to say the least. You could cut it by two thirds and the so-called pax americana people like to mention wouldn't be threatened in the least.

>hundreds of years by plundering, enslaving, and colonizing the rest of the world.

This has got to be the most egregous case of pot calling the kettle black I've read in a while.

Let’s try to consider the arguments in isolation without resorting to ad hominem.

The apple doesn't fall far from the tree.

It is exactly those plunderers, enslavers, and colonizers that, well, colonized the new world and built their economies on top of slavery which eventually became independent countries.

>This has got to be the most egregous case of pot calling the kettle black I've read in a while.

Both countries have terrible histories in these respects, but I think a fair case can be made for Europe having a longer period of this sort of method of wealth accumulation(/theft?) opposed to the US. The US shouldn't be cast as some sort of bystander in that same context--just a younger protege.

> but I think a fair case can be made for Europe having a longer period of this sort of method of wealth accumulation

The US territory itself was conquered using exactly those European advantages you speak of. US history is not separate, it's a spin-off from the European one. The US history without Europe ended with the settlers and their expansion, and they brought "Europe" with them. You can't claim a US history that is separate and didn't benefit from European history, given what actually happened there and by whom it was done.

>You can't claim a US history that is separate and didn't benefit from European history, given what actually happened there and by whom it was done.

I agree and wouldn't claim such, but you also cannot claim all the wealth was inherited through past practices from European colonialism. Much wealth was obtained under policy and practice by a sovereign US government and population. Once the US declared independence and became an independent nation, anything thereafter was conducted on its own accord under its own independent governmental system, free of the history of Europe with respect to responsibilities of practices. I wouldn't claim people instantaneously dropped their past inherited cultural beliefs or acquired wealth that kickstarted the process, but from them on, responsibility falls on the US.

Several wars, atrocities and theft of land from native Americans during continued expansion (trail of tears comes to mind), african american slavery used for production, exploitation of various other immigrant populations for wealth production--those practices fall squarely on the shoulders of the US and, in many cases, led to increased wealth and land in US. It is an offshoot of European history but when it comes to pointing fingers, the separation can certainly be made.

Such practices could have been abandoned by the US but continued onward, largely due to the tightly interwoven history you mentioned. Again, neither group can claim a rosey history but I would argue Europe had a headstart (if nothing else, just due to the arrow of time...).

European countries wouldn't be as wealthy in a world which hadn't seen colonialism, but they would exist...

> The US defense budget is more than that of the rest of the top 10 combined.

Not quite. It's slightly less than the next 8.[1] Also, that number appears to include the $79B spent by the Department of Veterans Affairs[2], which is exclusively used to support post-service personnel.

There's a lot of shit we can and should cut, but let's not distort the facts.

[1] https://sipri.org/sites/default/files/2019-04/fs_1904_milex_...

[2] https://en.wikipedia.org/wiki/2018_United_States_federal_bud...

The word underrated in the context means that it is not given sufficient credit for enabling European countries to spend more of their wealth on social services, not that it is less large than in it is.

> This has got to be the most egregous case of pot calling the kettle black I've read in a while.

The point remains that the kettle is black, regardless of who calls it so.

>This has got to be the most egregous case of pot calling the kettle black I've read in a while.

I know Britain extracted lots of wealth from India tho, the European continent became quite rich through colonisation efforts and once they had enough stimulus to fuel their economies, they became industrial powerhouses.

Not all country have such dynamics, Europeans really need think it through. Why Europe is rich and India is not? Why US can't offer free healthcare when Europe can.

India is rich though? There are also plenty of non-European countries offering free healthcare?

30%+ of all medical spending in the U.S. is wasted, so one doesn't really have anything to do with the other.

Do you have a source for that?

http://www.nationalacademies.org/hmd/Reports/2012/Best-Care-...

And then on top of that doctors in America kill somewhere between a quarter and a half million people per year[1].

[1] https://www.cnbc.com/2018/02/22/medical-errors-third-leading...

Interesting angle, but the US war machine has also trampled on the rights and freedoms of thousands. Look no further than Operation Menu in Cambodia, or the countless regime changes we funded in South America.

Surely we could have our cake and eat it too, in this case? Bear the brunt of defense spending but also not waste time on needless wars and coups, and put that towards a welfare state?

It's hard to tell if a war is going to be "needless" until it's over.

Was Vietnam a needless war?

How about the Korean war? Was that needless too?

The Korean War is universally and intentionally ignored in such discussions, because to bring it up as an example of a needless war when eg discussing Vietnam is to proclaim the South Koreans should be living like the North Koreans right now. That is, it's to say that they should be enslaved under Communism and living at the very bottom of third-world style conditions. So nobody will dare to say that, they'll just ignore the Korea outcome and focus on Vietnam as the example instead.

Well I think the exercise of power inherently will result in killing people, manipulation, lies, and general suffering inflicted on some group of unfortunate people.

Not sure it’s as easy as taking a dollar from funding Western Hemisphere coups and putting it towards health care. I think it’s also important to try to appreciate the security concerns of politicians and policy makers during the Cold War when attempting to prevent Soviet/Russian influence from creeping into the hemisphere (Monroe Doctrine).

The thing is we don't really know what the world would look like today without post WW2 USA hegemony. Before that, the world was far more violent under what was essentially European hegemony than it is today. Instead of plundering at will, arbitrarily breaking countries up, and colonizing - the USA has taken an approach of world police. And yes, lots of mess ups and greed fueled wars. But the USA has carried the brunt of this policing and the world is safer than it has ever been in the post industrialized period. for the record, Europeans generally thought of themselves as more civilized and sophisticated than the people they were colonizing and the crude Americans. This is not a new perception Europeans have of themselves and is perhaps part of general European identity.

So, we don't know how many of these wars and coups have been "needless" to maintain the peace we have. Perhaps many of them have led to less peaceful times globally, but we can't go back and A/B test this hypothesis. But we shouldn't just assume the world would be peaceful or even more peaceful without continued USA intervention into the affairs of others. Perhaps it would, but history does not suggest so.

> But the USA has carried the brunt of this policing and the world is safer than it has ever been in the post industrialized period.

Maybe since 1989 or so. But if we're talking post-WW2, the Cuban missile crisis nearly erupted into global nuclear war. There were also a number of other near-misses up until the collapse of the USSR. That doesn't seem very safe to me.

I'm not even at odds with the idea that the US playing world police has done good for the world. I'm merely pointing out that when you allow anyone to be world police, you can't do that without some form of accountability. You simply cannot trust people to do good things and hope they won't abuse their power, because with no accountability, they will.

And that's what's happening right now. We have detention camps on the border because there's no accountability for power abuse, we have an entirely unnecessary campaign of bombing that murders children in Yemen because nobody will put their foot down and hold Saudi Arabia accountable. China has detention centers (disguised as "vocational schools") because nobody will hold them accountable. Pharmaceutical companies can jack up the price of insulin 700% over 20 years (FTR, inflation over the 1996-2016 time period was 53%) because there is no accountability.

We'll always need someone to watch the watchers, basically. Because if we don't, they'll abuse their power and trample on the rights of others. And I know the original post was about healthcare, but this still holds true. All of these things are happening at the cost of the standard of living of the average person, because those in power are not accountable to those they represent.

> I’ll probably get downvoted for this, but a strong argument can be made that the European welfare state has only been made possible due to massive US defense subsidies and economic stimulus during the post WWII/Cold War. This doesn’t mean that the US has a good excuse for relatively poor domestic social services vis a vi many European states, but let’s also be real about what allows Germany, France, etc to provide “free” healthcare and other social subsidies.

> In the particular case of Germany, defense spending is only 1.2% (this stat is easily found via google). I’d rather have Pax Americana (which arguably is in decline) over the past 70 years providing stability in Europe, helping to lift hundreds of millions of East Asians out of agrarian subsistence, etc than slightly cheaper healthcare. Although, tell that fact to someone who receives huge, opaque medical bills for simple procedures in the US and they probably wouldn’t take too kindly to that line of reasoning...

I may be misunderstanding your point, but are you attributing European stability to American military power?

I don't think you misunderstood. That commenter was definitely making that argument. Do you have thoughts on that?

I found it amusing to hear the American military occupation of Germany described as a subsidy.

It worked out better than the Russian military occupation of Germany.

I don’t think it’s much of a stretch to say that the only thing keeping Russian tanks out of Berlin is the US military/nuclear umbrella.

I think this is a bit of a stretch now, but it was absolutely true - for West Berlin, at least - from 1945 through 1989.

It is much of a stretch. Of a total lunacy variety.

Germany spends a bit over 10% of its GDP on healthcare. Even the US are only spending 3.2% of their GDP on defense. So even if Germany or some other European country did decide to raise their military spending and (for some reason) decided to pull the money for that out of their healthcare budget, it'd only make a relatively minor dent. It'd be painful, but it's certainly no either-or thing.

There may be some truth to this, but I also think we choose to spend exorbitantly on military of our own accord. It is not the EU lobby that has kept us from massively reducing our military spending. Charitably, it is our own fear and uncertainty about what would happen if we massively reduced our military footprint. More cynically, the military is a big money maker for defense contractors and am entrenched jobs program. I think there is truth to both things: I certainly fear what would happen if we decided to stop investing in overwhelming force, but I'm also frustrated by the entrenched interests that seem to make it politically impossible to reconsider our posture. But I don't think it has much to do with propping up the European welfare state.

Agreed on your first point.

Although I think massive US defense spending during the Cold War was the primary factor in deterring the Soviets from tank rushing the Fulda Gap (and Soviet domination of Europe in general). I think it’s pretty clear that the Soviets were aggressively opportunistic in expanding their political and military influence (Hungary in 1956, etc)

What's the strong argument?

Germany spends 11.14% of GDP on healthcare or 442B. The US by contrast spends 17.07% of GDP on healthcare or 3498B. Therefore the US spends more and still lacks a comparable system.

Additionally the amount Germany saves by under-spending on defensive wouldn't offset the cost of the wealthfare state for example if Germany spent 3% (the US spends 3.5% on defense) of its GDP on defense instead of the current 1.2% they go from spending 47B to 119B. That extra 72B is less than 17% of their total healthcare costs, which again, are much lower than the US'.

This whole argument is a US Conservative talking point that has little to no basis in fact. When you look at the underlying data, it simply doesn't hold up, the cost of medical care and defense are orders of magnitude different and the US's system is so inefficient, even with the savings after decreasing defense spending from 3.5% of GDP to 1.2% (extra 472B/year) it wouldn't function well.

I’m not arguing that the US healthcare system is more efficient (it definitely isn’t). I’m arguing the political and economic conditions present in post-91, EU-integrated, unified Germany were only made possible in part by constant military and political deterrence provided in part by US defense spending. US military power also increased the politician and diplomatic leverage of the West during the Cold War (the most obvious example being NATO).

Might want to factor in what the US defense gets out of that continued military presence, especially as a relay for operations in the Middle East.

US military spending makes us considerably less safe.

> US military spending makes us considerably less safe.

I see you're based in the UK. In that case, you might want to contact Parliament and let them know, because the UK is currently engaged in most of the same war efforts in the middle east that the US is.

That’s quite BS knowing France has a much better healthcare system compared to the US and also can nuke any country to death. Defense spending and healthcare are clearly unrelated.

I read somewhere France still has colonies somewhere in Africa.

Sure, but the "if it wasn't for our military you'd all be speaking Russian/German" angle is about as relevant to arguments that European countries are better than the US at promoting public health as "if it wasn't for our colonialism you'd all be speaking Native American" is to arguments that Silicon Valley is better than Europe at promoting VC-led innovation and growth. US military spending is not the reason the US politicians and political culture has chosen to prioritise tax cuts and healthcare middleman profits over citizens dying of preventable diseases over the last half century

The US could have been a Great Power and built a better public healthcare system.

Just that. And at least in Germany health care isn't even paid for by the government. Rather the government defines minimum things to be covered and sets limits for non-private health insurance premiums in % of gross salary.

You say 17% like that is a small amount. That could easily break their welfare system if they had to extract that shortfall via more taxes or contract their healthcare system.

Also the military is not the only way the European healthcare system is subsidized by the US. Americans finance the drug research that pushes the world forward. If the US adopted European healthcare regulations the incentives for drug research would plummet, and healthcare innovation would slow to a crawl

They spend 11 and the us spends 17%. Do you think German health care somehow gets more expensive if they spend more on their military?

By the way, compare EU military spending to the US, not that of one country.

> The combined military expenditure of the member states amounts to just over is €192.5 billion. This represents 1.55% of European Union GDP and is second only to the €503 billion military expenditure of the United States. The US figure represents 4.66% of United States GDP.

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

Unless the EU wants to have military places all over the world like the US and equally extraordinary military expenses, for whatever strange reason, far outspending anyone located near Europe, that sounds like plenty enough money for the military. Of course, it seems to me the US uses much of that money for what elsewhere might be called "socialism" and "central economic planning" because doing so directly would never fly with the American public. So it's labeled "defense" and then it's fine.

> Americans finance the drug research that pushes the world forward.

I see claims like that a lot because for some reason some (few but vocal) Americans seem to take personal offense at any suggestion something might not be "the best", I have yet to see even a bad source for it, never mind a good one.

I can tell you German health care is shit too in so many ways that I'd be hard pressed to recommend it as a model to any nation, but according to the actual data it seems it's still better than the US system. Disclosure: I'm German but lived and worked in the US for a decade.

I also think cost alone is not a good path of argument. Costs on an economy level are circular - they are somebody else's income. Also, much of health care is "optional", whatever level people want. The more important point is what does that money flow achieve. According to the analysis I am aware of it achieves less, in the US, on average.

And US military spending since WWII wasn't and isn't high out of the goodness of American's hearts either. The US spend that much because it was beneficial at least from the point of view of those who got to make those spending decisions, and I'm sure they didn't have "foreigners" interests in mind but their own.

Last time I checked the Swizz, Germans and Brits were major players in drug and medical R and D.

Most of the important deep tech happens in university done by post grads, not by for-profit companies.

Drug development in the US is expensive due to the dysfunctionality that exists within the FDA.

Yes and those Swizz Germans and Brits are making the majority of their money from the US

> Last time I checked the Swizz, Germans and Brits were major players in drug and medical R and D.

Where do you think those European drug companies get the bulk of their revenues from to do that R&D in the first place?

They make their money off the U.S market!

> Drug development in the US is expensive due to the dysfunctionality that exists within the FDA.

No, drug development is expensive because it's expensive. The EMA & co. are not substantially different in their requirements and expense than the FDA is. Regardless, even still, half of the R&D conducted in the entire world is funded directly by the US.

Drug companies also spend more on marketing than R&D, and given that marketing drugs is largely banned in other nations, the bulk of it is also spent in the US.

Further, that R&D is often more production development of drugs or drug families first identified in public research efforts. The pipeline for which has been drying up in recent years because of gov't austerity - and in response the billions per drug brought to market number has been going up for the commercial drug company efforts.

Per capita amounts are more relevant here:

442B in Germany is 5K per capita. 3498B in the US is 11K per capita.

So the spending difference is even more in US's favour.

"I’ll probably get downvoted for this, but a strong argument can be made that the European welfare state has only been made possible due to massive US defense subsidies and economic stimulus during the post WWII/Cold War. "

As a German that's actually something I agree about with Trump. Europe lets the Americans often do the dirty work for them (an example would be Yugoslavia in the 90s where nothing happened until the Americans started doing something). Europe should be paying more for its own defense.

But that shouldn't be an excuse for a lot of dysfunctional policies in the US. The health care system is expensive and bad. Mass incarceration is very expensive and disenfranchises large population groups. A lot of low income workers are being exploited without recourse.

I also question if the US really needs to spend as much on military as it does.

I have the same sentiment but that was more or less part of the US strategy for maintaining peace in the world during the Cold War. As someone once said the purpose of NATO is to "keep in the US in, the Russians out, and the Germans down". It's a bit unfair to the Germans to blame both wars on them but the strategy of extending American protection over the Western European powers means they won't have to be too heavily armed as long as there is guarantee that the US can come rescue them in case of an invasion. I think the system stayed in place after the war and without a threat of invasion, why wouldn't the Germans and other Western allies dial down the defense budget even more?

" I think the system stayed in place after the war and without a threat of invasion, why wouldn't the Germans and other Western allies dial down the defense budget even more?"

I think it's time for Europe to grow up and stand on their own feet.

I don't necessarily disagree with this, but I can understand why Germany would be reluctant to significantly expand its military, and I can understand even better why the entire rest of Europe (especially, but not only, Russia) would prefer to have Germany protected by American nukes and not German nukes.

I somewhat agree with your point, but defense spending in the U.S. is only 3.1% of GDP. It's likely that we could have both Pax Americana and universal health care if the public/private divide were allocated differently. Medicare spending is roughly on par with defense and covers the most expensive patients; the government already pays for 64% of healthcare spending. Bump spending up to about $1T (5% of GDP) and you've got universal health care.

If you look at what Germans actually give up in exchange for the social safety net, it's the ability to get fabulously wealthy. If you're say a high-achieving software engineer or surgeon, it's possible to make roughly 10x more in the U.S. than in Germany - and that's saying nothing about startup founders or CEOs. Hence, people who fit into those categories tend to emigrate.

Your personal value system will determine whether you value the ability to get fabulously wealthy over the ability to know that you'll always have health care and education for your kids. There's a pretty strong selection bias within countries though: many people in America moved there (or their ancestors did) because of the ability to get fabulously wealthy, while the people left behind in the Old World tended to stay because they valued stability. That's perhaps why proposals for a strong social safety net haven't gotten much traction, particularly in the post-80s boom.

I think this is actually a great point. To expand on it a bit further, imagine that the US ceased to exist tomorrow. Europe would have to massively increase its own defense spending, or else risk that China or Russia would decide to walk right in.

That massive increase would have to come at the cost of social services, or else further increase their already considerable debt-to-gdp ratio.

> let’s also be real about what allows Germany, France, etc to provide “free” healthcare

Germany doesn't provide free healthcare, it has a compulsory insurance purchase system. Both Germany and France spend less on both a per capita and per GDP basis on health than the US does, so they need no subsidy; in fact, their more efficient healthcare systems are a vastly larger subsidy to the rest of their welfare system than US’s defense spending is. (Moving defense spending from their current levels up to US levels would cost them 1-2% of GDP, moving healthcare spending from current levels up to US levels would cost 8-9% of GDP.)

The reason the US can't afford the rest of a European-style welfare system isn't the (huge, but still not a big deal in this instance) amount the US spends on defense, but the mind-bogglingly enormous amount the US wastes on the most wasteful and inefficient healthcare system in the world, which would be fairly in line, in per GDP costs, with many universal healthcare systems if you considered only the public expenditures, and not the (slightly larger) private share of health spending.

There's also the issue that there is not a "US health system". There are 50 slightly different health systems. Health insurance is still a state-level thing with different state-level requirements. We can't create a German-style compulsory insurance system until something is done about that.

Of course, nothing except political will is stopping individual states from doing so.

> We can't create a German-style compulsory insurance system until something is done about that.

Germany also has, IIRC, a mix of federal (including the basic mandate and baseline standards) and state-level rules for health insurance.

Oh, maybe there is something of a model in Germany then.

The US government spends more than many other OECD governments on health care. Not enough Americans know this basic fact.

Your argument is based on a faulty premise: Germany actually spends just a small bit more on government health care. Meanwhile the US spends vastly more on health in total when you add private spending.

https://www.healthsystemtracker.org/chart-collection/health-...

Having military bases in Europe (if that's what you're referring to) is mutually beneficial to the the U.S and Europe but I wouldn't call it a subsidy. It's done primarily to preserve America's global sphere of influence.

The economic stimulus ended in the 50's, the cold war 30yrs ago.

You can have free healthcare as well as Pax Americana. If anything I believe that free healthcare (and a better education system) would keep Pax Americana around a lot longer.

Agreed with your last point.

The US didn’t fund European security due to its kind nature. Rather, it was due to realpolitik concerns that there would rise another violent, genocidal European hegemon bent on world domination which would invariably threaten US security.

Some of the reasons for exorbitant health costs are not due to budget. The legislature actively attempts to obscure market conditions by allowing insurance companies to not publish prices. Remember that the US spends more as a percentage of GDP on health care than any other country.

Totally agreed + upvoted.

Using military spending as a percentage of GDP is a huge oversimplification, and ignores many other huge factors.

For one thing, those countries tend to have higher taxes, especially on higher incomes.

More importantly, they spend Much less than the US per-capita on healthcare despite better overall outcomes [1], which is the real indictment of the US healthcare system, and the reason, as you point out, that the US has little excuse for it's healthcare conundrum.

1. https://www.healthsystemtracker.org/chart-collection/health-...

What about Canada? The United States has traded with us to great profit for both parties, but you could hardly call that a subsidy.

The US spends an enormous amount on healthcare, we just get less for every dollar...

You could have your Pax Americana, equivalent healthcare, and more money in your pocket!

A first class surgeon earns in Spain around lets say 3000-5000 Euro/month (minus taxes).

The same first class surgeon in USA doing exactly the same job would earn... dunno, 25000 dollars? Probably more.

This is pretty much wrong, Germany's welfare state in particular goes back to _1883_ (https://en.wikipedia.org/wiki/Healthcare_in_Germany#History).

Do you have much experience with middle class life in the U.S. outside certain dysfunctional big cities?

For a household with employer-covered health insurance, which is most households, out-of-pocket spending (employee contributions + cost sharing) is about $3,000: https://www.commonwealthfund.org/publications/issue-briefs/2.... For a median household, the German health insurance tax of 7.5% (employee portion) would be more than that.

Most people in both countries don't go to college. In the U.S., the ones who do have a median monthly payment of $220: https://studentloanhero.com/student-loan-debt-statistics. That's about 5.5% of median income for college graduates 0-5 years out.

As to housing, the median new house in the U.S. is twice as big as the median new house in Germany: http://demographia.com/db-intlhouse.htm.

As to retirement, the German pension system is not particularly if at all more generous than Social Security.

Offsetting those benefits is the fact that Americans make a lot more money at the median. Adjusted for purchasing power, the median American makes about $5,000 per year more than the median German. That's enough to pay for the extra out-of-pocket health insurance and student loans, and that's not even accounting for the American's much lower taxes.

I'm glad you pointed this out as the voice of reason. I can't believe all of the anti-American sentiment in this thread. I still firmly believe that any American who is willing to work hard and avoid drugs can have an amazing life. I'm not even that hard working and do fine. Every super hard working person I've known is doing well, most better than me. I have two cousins who became pipefitters, and both make in the 150-200k range per year. I know a family friend who works package handling part time, and part time he drives a truck and trailer doing hauling, oddjobs, moving, etc. He is nearly a millionaire at this point. None are college educated. The biggest problem USA has is people who expect/demand that since they went to college, they deserve a job and money. Or folks who think that working at all should provide them a nice lifestyle. It may have been that way at one point, but not in a long time. Unfortunately, those are a lot of vocal voices.

That reminds me of this twitter thread about our healthcare system. There are absolutely heartbreaking stories on there. The one that really sticks in my mind is the parents who were paying off and earlier ER trip and were literally waiting in the parking lot of the ER again with a fevered child, waiting to see if seizures started or the fever broke.

https://twitter.com/AllOnMedicare/status/1124042436345569286

I don't look at insurance in that way at all. Insurance is just another way for the government to tax me as far as I am concerned. If something goes wrong they will find a way to not help me, whatever it takes, they will find a way. They force me to have it and I just assume that money goes directly into their employees pockets and into campaign contributions. The US is incredibly corrupt and if you want to live hear you need to understand that you can't get sick. If you do get seriously sick or injured you are better off blowing your own brains out.

> If the average American knew what the benefits and lifestyle are like for a middle-class German family

In a pure numbers comparison, you tend to get higher salary in the US. I guess an American making $100k in the US would not easily consider a $70k job in Europe, because it immediately seems like a downgrade.

Not everyone bothers to go into details, like cost of healthcare, pension, daycare, school fees when applicable, tax rates and whether there is property tax or not, cost of commute, typical cost of a home, groceries etc.

> I guess an American making $100k in the US would not easily consider a $70k job in Europe, because it immediately seems like a downgrade. ... Not everyone bothers to go into details, like cost of healthcare

If you're making $100,000 at a job in the US your healthcare is being covered - often entirely - by the company you're working for.

Somehow this point is routinely ignored on HN in these discussions. Good paying jobs in the US almost always come with great healthcare coverage. Employers cover half the people in the US with health insurance. On average the higher your pay, the more of your insurance cost is likely to be paid for by your employer.

That style of higher income healthcare coverage and its tremendous qualities, like very expeditious access that embarrasses countries like Canada (which have superior overall systems), is why the US healthcare system still exists as it does. Higher income voters that don't want to give up what they have.

> If you're making $100,000 at a job in the US your healthcare is being covered - often entirely - by the company you're working for.

Zero deductible, zero copayments for you and your family?

Well, if you have an insurance where the yearly out-of-pocket that you pay in deductibles and copayments is capped in say $3000, it's not a big dent on that $100k.

Especially since a lot of us Ameticans are already in the streets

I'd have to disagree about work strikes and riots, given how conditioned this country has been to lick the boots of the powerful, as a large chunk of this country sees itself as "temporarily displaced rich". Hacker News comments are frequently hyper individualist in a way that, outside a few coastal bubbles, makes up the political view of a majority of people in this country, including plenty of self-described liberals. This is only going to change after the massive inverted-pyramid generational demographics of this country shifts, and giving our increasingly anti-immigration policies and a below-replacement birthrate, I honestly believe this country is trapped in a death spiral. Or maybe I'm just in a bad mood...

> "temporarily displaced rich"

So many people in America believe this, that they would be rich or successful if it weren't for X. X is different based on race, gender, and geographic location but the sentiment is the same.

The reason politicians like Trump are so popular right now is that they're successfully speaking to that shared sentiment and not to any one specific issue.

The political parties are basically comprised of groups with non-conflicting sentiments who are willing to support each other's ideologies.

I don't think you're recognizing the effective tradeoffs that exist between the German and US economies. In Germany per capita average individual consumption is more than 30% lower than the US. ($25,000 thousand per capita vs. $36,000)

That translates into some major differences in material living conditions. The average German home is about 50% smaller than the average American home. Germans have 30% fewer cars per capita. Meat consumption is 20% lower.

Many German homes don't have common household appliances that Americans take for granted. 30% of Germans don't own microwaves. Same for dishwashers. Most Germans don't have air conditioners. Only 42% of German homes have clothes dryers. Only 50% have freezers.

It's not just an issue of America being stupid. Things like strong social safety nets, universal healthcare, and free university all come with major major economic tradeoffs. Europeans do sacrifice a lot in terms of middle-class luxuries to enjoy those benefits.

You may say that things like bigger houses, fancy appliances and steak dinners aren't worth the stress and struggle, you need to recognize that that's a personal preference. One that many Americans are unlikely to agree with you on.

The reality is that Germany is a fundamentally different culture than America. And most Americans wouldn't choose to sacrifice their creature comforts for a Western European lifestyle. I'd be shocked if any more than a small percent of Americans would move into a house half with half their current square footage, even in exchange for free healthcare and eight weeks of vacation.

[1]https://en.wikipedia.org/wiki/List_of_countries_by_household... [2]https://www.elledecor.com/life-culture/fun-at-home/news/a765... [3]https://en.wikipedia.org/wiki/List_of_countries_by_vehicles_... [4]https://www.homeappliancesworld.com/2018/09/18/the-growth-of...

You should also check the average savings per person in Germany vs USA (both total and percentage). Not buying tons of random shit doesn't always mean you can't afford it.

But you are right, it largely comes down to the mentality/preference on how to spend your money.

I had just some medical issues that resulted in me being hospitalized for a month (while receiving tons of care in terms of specialists, MRIs, X-Rays, CT scans, ultrasounds, drugs).

I can imagine this kind of random thing ruining somebody financially or at the very least eating heavily into their savings. I received majority of my salary during that time and the final bill was $0.30 for 3 months worth of new expensive drugs I have to take.

So yes, choose between safety nets or fancy appliances / larger houses / steak dinners (all of which people with decent jobs can still afford any time of course)

Americans are a prideful people that share commonalities such as fear of an unknown and distrust of governing institutions.

As such, you cant really gain consensus with them by talking about other countries and what Americans are missing. You have to flatter their ego and avoid bruising it, make ideas seem homegrown.

I’ve reintroduced legislative changes in the US modeled after the exact laws that I helped pass in European area countries. In America it absolutely has to appear as an original idea that Americans came up with first and independently.

There really is an art to consensus.

edit since I am rate-limited for the next two hours: I am referring to the people in power that matter for the next decade

FWIW, half of this country desperately wants to be more European in our approach to government, so I'm not sure where your generalizations are coming from. And this site has a healthy population of Europeans who clearly have a chip on their shoulder about American geo-political dominance, so, you know, "both sides..." and all that.

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