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Comment by eru | Hacker News Reader

The US spends more per capita on their social safety net than almost all other countries, including France and the UK.

The US spends around 6.8k USD/capita/year on public health care. The UK spends around 4.2k USD/capita/year and France spends around 3.7k.

For general public social spending the numbers are 17.7k for the US, 10.2k for the UK and 13k for France.

(The data is for 2022.)

Though I realise you asked for sane policies. I can't comment on that.

I'm not quite sure why the grandfather commenter talks about unemployment: the US had and has fairly low unemployment in the last few decades. And places like France with their vaunted social safety net have much higher unemployment.

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> The US spends more per capita on their social safety net than almost all other countries, including France and the UK.

To a vast and corrupt array of rentiers, middlemen, and out-and-out fraudsters, instead of direct provision of services, resulting in worse outcomes at higher costs!

Turns out if I’m forced to have visits with three different wallet inspectors on the way to seeing a doctor, I’ve somehow spent more money and end up less healthy than my neighbors who did not. Curious…

It's easier to see your own society's faults. The NHS also has waste, most obviously the deadweight loss caused by queuing. I know someone who went back to get treated to her own country. Not remarkable except that country was Ukraine.

Yes, because the UK’s two dominant (and right wing) parties have been actively sabotaging it for years, chasing after a despicable dream of homegrown middlemen and fraudsters, envious as they are of the unchecked criminality of their friends from across the pond. Quelle surprise, things have gotten worse.

Spending grew about 8% a year under New Labour on average, which doesn't seem like sabotage to me.

Also if both dominant political parties are supposedly so against the NHS, why don't they just abolish it?

They need to be sneaky. Same with a lot of other unpopular policies which nevertheless (somehow...) have support from "both sides".

They need the public to (nominally) assent to it first, otherwise it'd be suicide. They're using the republican playbook: overburden the sector with tasks and regulations while underfunding it, and allow for private competition that is not subject to the same regulatory burden. Then in a decade or so, you can claim that the "free market" works better and the public won't kick up too much of a fuss.

That seems like a weird conspiracy. Why would the parties secretly want to do something that the voters don't like? Are they not power-hungry?

By the way, how is that the republican playbook? What does any of this have to do with the desire to remove King Charles as the head of government? https://en.wikipedia.org/wiki/Republicanism_in_the_United_Ki...

> It's easier to see your own society's faults.

Neither the US, UK or France are my own society.

I lived in the UK for a few years on and off. I agree that rationing by queuing is less efficient than rationing by money. Singapore does a much better job: they always have a co-payment (even if that's often that just for symbolic/ideologic reasons, and less so for rationing).

It’s not just how much you spend on healthcare, but what that spending actually delivers. How much does an emergency room visit cost in the U.S. compared to the UK or France? How do prescription drug prices in the U.S. compare to those in the EU? When you look at what Americans pay relative to outcomes, the U.S. has one of the most inefficient healthcare systems among OECD countries.

If you want to see an efficient healthcare system in a rich country, have a look at Singapore. They spend far less than eg the UK.

You imply the UK is a rich country...

Yes?

So stealing from all the colonies wasn't enough?

Yes. The empire was mostly a giant money pit.

You're looking at costs, not outcomes. Our outcomes aren't in alignment with our costs.

(Too many people getting their metaphorical pound of flesh, and bad incentives.)

This. My intent was to refer to outcomes. My hypothetical country was one where being unemployed might lose you various luxuries but would still see you with guaranteed food on the table and a roof over your head. Under such conditions there's no need to consider a rise in the unemployment metric to be a major downside except for the inevitable ballooning cost to the tax base.

The UK tried that experiment in the 80s [1], it didn't work well.

[1] https://en.wikipedia.org/wiki/Thatcherism

> Though I realise you asked for sane policies. I can't comment on that.

I don't think you are disagreeing with them.

Yet GDP is a measure of costs.

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