Europe is also doing pretty well in several fields and you don't explain at all how tech in particular is affected by public spending.
Why take on a risky career path like being a doctor if best case you're half a million in debt and that's assuming you don't get weeded out at any point? It's no surprise we have shortages of engineers, doctors, nurses, teachers, etc.
Even a bachelor's degree is on average 32k for in-state at public colleges assuming you graduate in 4 years. Contrast that with my German peers who didn't pay anything and yeah, maybe I wouldn't have been a software engineer if everything else wasn't so volatile. I certainly don't feel as essential as doctors or nurses, especially now.
Sure it's cheaper to start a LLC in the US and you can hire/fire on a whim practically, but 63% of Americans don't have enough savings to cover a $500 emergency. Doesn't exactly leave a lot of wiggle room unless your parents have a basement for your MVP and some seed money.
Would you rather get the public health and education, or keep the 20k euro and find a solution for yourself?
I reckon that my health expenditures are 1000 per year, and I am self-taught, so I don't need the government for anything.
What we need is to make the public services Opt-in/Opt-out, so people who find it competitive like yourself can keep enjoying it.
Also, EU governments provide retirement benefits while the US's doesn't. This is the main expenditure for these governments.
Not saying that your argument has not some truth in it, but it's definitively wrong in the case of healthcare.
The US population not taking care of themselves is a public health problem not a medical care quality issue.
It's not in the top 5 by number of patients treated. Anecdotally I met people who went to Germany, Israel, India and Thailand for treatment, I never heard of anyone even discussing going to the US. The visas alone are a nightmare.
The U.S. has the largest concentration of the best research hospitals in the world.
I see someone shifting the goalposts here, first we were saying that US healthcare is not worse in any metric, then we started measuring it's success by medical tourism, now are down to some special rare diseases.
Let's come back to where we were before, measures per unit of money spent, US healthcare delivers worse outcomes that any other developed nation. Measured in average health of its citizen, the outcomes aren't great. Life expectancy, and other metrics aren't particularly amazing.
Of course, if you have the money to fly to the US, stay in the US and pay out-of-pocket for a medical procedure in the US, then yes, the US is a good destination. Which translates into: if you're rich, medicine in the US is great.
However, not all of us are rich. And definitely not all Americans are rich.
Sifted goalposts
> The average American pays more for healthcare over their live than the average European, and the outcomes are objectively worse.
remains true. No matter how you want to spin it and pretend that medical tourism affects this in any way.
Edit:
For 2015, https://www.usitc.gov/publications/332/executive_briefings/c...
- Medical tourism to US: between 100k and 200k per year
- Medical tourism from US to other countries: 150k to 350k per year
Europe is ~500 million people
US is ~ 360 million people
Medical tourism is a drop in the bucket.
>Americans cite cost savings as the most common reason to go abroad for health treatment, as medical procedures in foreign hospitals can cost thousands of dollars less than in the United States. This is especially true for those without health insurance—for an uninsured person, a knee replacement can cost $30,000 in the United States, compared to $12,000 in India. Many health travelers also go abroad for elective procedures such as cosmetic surgery that regular policies may not cover.
In other words, they largely go outside the US to save money on either cosmetic or routine procedures that, for one reason or other, US insurance won't cover.[1] Not same thing as the earlier discussion of rare or difficult conditions.
[1] Or they've chosen to not get health insurance. Post-Obamacare, this means that they are willingly paying the tax penalty for not having insurance. 91% of Americans have health insurance.
There was no earlier discussion of "rare or difficult conditions".
> 91% of Americans have health insurance.
That health insurance is often tied to the employer and wildly varies in what it offers. And you have to fight insurance tooth and nail to get what you need. Even on a good insurance.
Also, https://www.census.gov/library/publications/2021/demo/p60-27...
--- start quote ---
In 2020, 8.6 percent of people, or 28.0 million, did not have health insurance at any point during the year.
The percentage of people with health insurance coverage for all or part of 2020 was 91.4.
More children under the age of 19 in poverty were uninsured in 2020 than in 2018. Uninsured rates for children under the age of 19 in poverty rose 1.6 percentage points to 9.3 percent.
--- end quote ---
I can't imagine a European saying "yeah, we have 28 million uninsured, many of them kids, it's their own fault".
The total societal outcome -- spending vs outcome -- and therefore the average outcome too, for the USA as compared to most other developed countries... Pretty much sucks.
My US government provided pension will be something like $3500/month when I reach retirement age. This is in addition to any personal retirement savings.
People migrate to the US before the EU. Besides, US lifestyle (also a high tax country btw) is not the only possible alternative to european style quasi socialism (56% on the way there)
Incidentally I'd say most western countries are way too close to socialism, I'd rather see more private entities taking over security, healthcare and law making.
It's just that there is no money, so private EU companies suck so there is no money. The lack of strong companies doesn't imply socialism. Most people in Europe has most of their trade interactions with other individuals and private businesses.
How does that work?