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Comment by jobs_throwaway | Hacker News Reader

> US health care which is probably one of the worst in the world

Not really. If you have money, the US system is one of the best. It just really, really sucks if you don't have money.

Isn't it universally true that if you're rich your life can be much easier? With enough wealth the actual health care system does not matter much. Neither does the country in which health care services are rendered. You just pay and get things done, and maybe even take some vacation while at it. However, given that not every one of us is rich, the point is to optimize the whole thing such that the little folk can still survive and get their health issues addressed.

No that isn't universally true. There's plenty of countries (eg Cuba) with entirely state-run healthcare systems where more money won't get you better care.

What % of the US population would you think have to pay to get that "best" care?

Would a household making $250,000 have enough to pay for that best care? That would mean 2% [1] of US household. Other comment in the thread mentioned earning "6 figures" and not being able to pay.

A health system that is affordable to 2% of the population is definitely not working.

[1] https://www.factcheck.org/2008/04/americans-making-more-than...

That source is from 2008. Now (https://dqydj.com/household-income-percentile-calculator/) its at 11%. And its not a binary. Anyone making six figures (nearly half of households) should be able to easily afford the best care. I'm sure there are people with spending problems who are exceptions to this.

US health care outcomes are really not great, even if you are rich. Yes, you live longer than poor people in the US, but still do worse than Europeans, even those with lower incomes [0]. All while spending much more [1]. It's a system designed to siphon money from wherever it can (individuals, governments, companies, etc.), not to provide the best health care.

[0] "in some cases, the wealthiest Americans have survival rates on par with the poorest Europeans in western parts of Europe such as Germany, France and the Netherlands." https://www.brown.edu/news/2025-04-02/wealth-mortality-gap

[1] https://ourworldindata.org/us-life-expectancy-low

Well, everything is great if you have money. I was talking about the health care as a system.

If, as someone with money, you look across systems, the US is one of the best. That's the point I'm making. There's plenty of places where all the money in the world won't buy you the quality of care you can get in the US.

Quality of care available to wealthy people is an important factor in evaluating a system. In the US, there are many millions of wealthy people who the system is great for.

I have money and it still sucks. Perhaps you're thinking of billionaire money?

How much money and how does it suck?

At ~$250k TC I get better care than I could in any of the socialized systems. Concierge care, advanced treatments if I want/need them, out of pocket max that is easily affordable, etc

> ~$250k TC [..] Concierge care

Can you elaborate on concierge care? I have never heard of anyone in tech around or below that compensation receiving https://wikipedia.org/wiki/Concierge_medicine

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