Comment by GFischer | Hacker News Reader

Comment by GFischer | Hacker News Reader

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"fifteen percent of the US economy (by dollars)"

Well, right there you have a problem. The U.S. has a larger % of the economy tied up in healthcare, and arguably worse services than any other civilized country:

http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS

the countries with the very best healthcare spend 10% of their GDP, the U.S. spends 7% MORE (17% according to the World Bank). And we're talking about very inefficient bureaucracies in most cases.

Every time I read about it, I'm amazed at how they can be so screwed up.

I have better healthcare than 99.9 of the U.S. population and I live in Uruguay - it is literally unbelievable for many that I can pay U$ 40 and get unlimited ER services with an ambulance at my door, doctor house visits for something like a fever, and amazing healthcare for U$ 150/month (plus small co-pay costs).

http://internationalliving.com/2013/06/the-worlds-best-healt...

And that's taking into account a very inefficient bureaucracy, with a corruption case affecting the government's perception right now.

http://www.latinnews.com/component/k2/item/61446.html?period...

Edit: further downthread, another poster found out the exact same data earlier

https://news.ycombinator.com/item?id=8130257

Second Edit: in any case, the solution is going to be very hard and will require a very strong leader - I'm sorry for the U.S. that Obama didn't turn out to be the solution. There are no easy answers, I can understand what tptacek says about the Republicans not wanting such a massive nationalization of 17% of the GDP, and I can understand the Democrats looking at the mess and wanting to get it under their control.

I don't know if the U.S. has a strong surgeon's union, but there are several healthcare unions here in Uruguay that can raise their salaries at will by threatening (and actually going on) strikes.

Can you explain how you have better healthcare than 99.9% of the US population?

You realize the wealth of the top 10% of Americans, right? That inherently means you're wrong, and you were exaggerating to a hyper extreme.

I don't think you are likely to have better healthcare than the top 50% of Americans in fact. The top 50% of Americans have healthcare coming out their ears, in terms of spending, check-ups, early diagnosis, and in fact too much medical care - which is part of the cost problems, Americans are the most over-tested and over-doctored people in the world.

You realize very few Americans with a full time, decent paying job are not covered by proper health insurance, right? That gives them access to some of the best medical treatment options, doctors, and technology on the planet.

The US has many of the best health facilities and doctors in the world. In fact the US healthcare system is first world, it's the cost structure that is the problem, not the quality of the facilities and doctors.

You're right, I did add an extra nine (it was a bit hyperbolic), but I would still stand by saying that I get better healthcare in Uruguay than 95% or so of Americans.

The net worth for a one percenter in the United States is about 8 million dollars, or a salary of about 160.000 a year. To be a five percenter, you just need to earn about 80.000 a year, so yes, I definitely have better healthcare than someone making 80.000 in the U.S.

https://news.ycombinator.com/item?id=7257345

How do I believe I have better healthcare? Exactly in the opposite situations to check-ups - in situations where I need urgent medical services, or when there's an expensive or complicated condition requiring specialist services.

In the U.S., ambulance service is EXTREMELY limited and expensive (how the hell can it cost 20.000 dollars for a visit?), and you basically cannot have home visits by a doctor. I pay U$ 25 for ambulance services, and for an extra U$ 5 I get house visits by a doctor (as long as it's reasonable and I don't overuse the service).

Look at this stat:

http://en.wikipedia.org/wiki/House_call

"In the early 1960s, house calls by doctors were 40% of doctor-patient meetings. By 1980, they were 0.6%."

compare to a freaking 76.6% in Uruguay

heck, it seems it's a disruption-ready area:

http://edition.cnn.com/2014/07/31/health/doctor-house-call-a...

"The US has many of the best health facilities and doctors in the world. In fact the US healthcare system is first world"

Absolutely true. If I had a strange disease, or I wanted to be operated on by the absolute best doctors, I'd go to the United States.

It's the treatment for the "common man" which fails miserably.

I can get an appointment for any specialist within a week, and if it's a serious condition and I'm not picky, next-day or same-day (this is not true of most Uruguayans, I pay extra for that). Every Uruguayan can, and usually does, get at least once a year, same-day house doctor visits.

If I got one of these expensive conditions (say, the discussed cure for Hepatitis C), government will pay for my treatment (ok, there's lobbying, delays, sometimes bribes and other problems, but they will end up paying).

If I need a transplant, there's a national transplant service, same for prothesis, burns, cancer, etc.

Not a single Uruguayan has to file bankrupcy due to medical conditions (he can get destitute due to not working, which is a different problem).

So, Americans might be over-doctored in early health care, but they don't have access to some services which seem basic and essential, and are believed to be every man's right in my country.

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