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Comment by HenryBemis | Hacker News Reader

You get downvoted a lot, but I challenge anyone to name a country that hasn't slashed _hard_ social benefits, pensions, % of GDP for healthcare, and similar..

I get it that some countries have had a plethora of scammers (prescribing pregnancy meds to men so docs can hit quotas and get bonuses/bribes from pharmaceutical companies, people trying to fake blindness to get an early retirement, etc.

But overall reduction of cost with reduction of salaries will ultimately lead to worse healthcare.

A friend was in Germany skiing this past winter. The 10k population town he was staying didn't have a paediatrician and they had to drive 2h to get care for their kid. In Germany, in 2025. I wonder how this very town will be in 2030 or 2050 with that trend..

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It's a tough reality to face. Problems are piling up for the west that aren't easily solved, and not just with social benefits. Something as mundane as aging sewage systems is starting to become a real problem in many countries.

Demographic collapse is hardly unique to "the west". Have a look at the population age histogram in China, South Korea, and Japan.

Both to you and the parent:

I don't think that in a 10k ski-town there aren't kids. They definitely got 'young' people living there having kids.

I was reading the Systemantics yesterday and they discuss how a 'system' does not 'solve' a problem, but it breaks it down to smaller (easier to hide) problems. The book uses as an example the "garbage collection in a town", and how this one-big-problem breaks down to 100-small-problems. So the "we need rebalance our fiscal blah-blah" eventually breaks down to "no extended leave for new mothers", "not every doc-specialization in towns below 50k", and so on.

Absolutely. I seem to recall South Korea having a TFR well below one last time I checked. That doesn't mean we're not facing problems in the west, and specifically the Nordic countries, which is what TFA is about.

I have similar concerns. We have nurses watching way more patients, working unbelievable hours.

16 hour shifts with no notice, 60 hour work weeks, and often disgusting work does not make for an attractive field, so I’m not surprised there’s a massive shortage issue.

This will probably only get significantly worse in the Certified Nursing Assistant field which mainly involves the most manual of labors - changing bed pans, cleaning patients, etc. with many of the same shortage problems. (And way less pay, of course)

> docs can hit quotas and get bonuses/bribes from pharmaceutical companies

This is a common thought. It is incorrect. I’m a doctor. I have gotten pharma money for talking for their drug once, which was absolutely game-changing and which I would speak for without money (sugammadex is the generic name, if you want to look it up). I get lunch twice a year. The age of free vacations is long gone.

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