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Comment by radmuzom | Hacker News Reader

Well, Netherlands has a better minimum wage compared to the US even after adjusting for PPP. [1]

Private insurance companies are regulated by the government and MUST offer a core universal package including the cost of all prescription medicines. They must do this at a fixed price for all. [2]

Taking into account these two facts, the article makes sense and provides good reasons why the system works. Looks like progressive policies with healthy government regulation always works better than the free market.

[1] http://www.theatlantic.com/business/archive/2013/09/how-amer... [2] http://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands

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In fact the free market always works better than government regulation in every scenario. Which is why all the countries following the modern welfare state model are in disastrous economic condition and sinking by the day. From Japan to Denmark to the Netherlands (the people of Denmark and the Netherlands are two of the most indebted peoples on earth per capita) to France to Italy to Greece to Spain to Portugal, to even the US (the world's largest welfare state). Nearly every welfare state in the world, to the degree that it is a welfare state, is collapsing. It's also why Europe is still stuck in a depression, with its GDP below 2006 levels, and set to stay that way for another decade.

It was a free market for healthcare in the US that produced the greatest healthcare system in the world, with the best doctors and hospitals, prior to the government's first major moves to nationalize parts of the system nearly 50 years ago. It also produced by far the greatest innovation, across all aspect of the health / medicine field.

If you want to argue that, at least get your facts straight first. In Europe, the stronger welfare states of Northern Europe and Scandinavia has had much stronger economies during the financial crisis. They have also had much better success retraining their work force when industrial jobs has been lost to the cheaper Asian countries.

There are many reasons why (most of) Europe is in a depression right now. One of the important ones is the financial crisis that started in the US and spread across the world, where European banks were invested up to their ears. Another is the former tiger states of Ireland and Portual, where low company taxes attracted money which was invested in a real estate bubble which popped when the economy tanked. A third is the Euro experiment which didn't really pan out the way politicians had hoped (to put things mildly).

So there is a whole complex of reasons for the current situation and no one can really point out any single one as more important with any confidence. But one of the few things we do know is that welfare states have generally fared better in the crisis, not worse.

Just FYI, the Nordic countries had been in a process of scaling back their welfare states considerably leading up to the financial crises and are still struggling to achieve sustainability (except Norway which has a mountain of oil).

It is the southern european states that have spent lavishly on behemoth welfare states that are struggling the hardest, forced into harsh austerity as a condition of bailout by wealthier states.

Well, it's all relative here. The welfare state has been getting slimmer over the past 20 years. But to understand what has changed, one needs to look at the details. It is mainly the work loss insurances that pays out over a shorter period out time.

Defense spending is also continously down in all the mentioned countries. But investments in health care and education has paid off well during the same time period, and there is no democratic mandate to lessen it.

Compared to the US it would still look like a socialist model. The southern countries (not states) have spent a lot of money, but not necessarily on classic social insurance systems, so I don't really think it compares. Their main problem is that their underlying economy was much too weak for what they've been spending.

Slimmer, but also just more efficient in some respects. The Nordic countries aren't afraid to experiment and innovate, which is perhaps the real Nordic model.

Interesting that you take exception to my use of the word state. I generally regard the word interchangeable with any sovereign territory outside of a US context, as does much of the international relations field.

> Looks like progressive policies with healthy government regulation always works better than the free market.

Can you elaborate? Since the US is far from a free market when it comes to healthcare I'm not sure how you are making that comparison...

I am doubtful whether the free market exists anywhere in the world (please correct me if I am wrong). My theory is that whenever it tends to exist, a few corrupt players (government or private) will tend to game the system and take all the riches for themselves and the market will not be free any more. That is because the Econ 101 which free market theorists tend to talk about does not take into account human psychology which is far more important.

The alternative is a shared sense of social well-being(not socialism or communism) with healthy government intervention, rather than individualism which Americans seem to be fond of. I would accept a lower GDP where people are happy (subjective) over the American way of life any day.

Then why do free market systems produce by far the greatest standard of living as compared to any other system? To the degree that countries use the free market, they're prosperous, it's that simple.

If you were right, Hong Kong would have been impossible.

People like to reference Scandinavia. Well, Swedes in the US possess a higher standard of living than Swedes living in Sweden do.

And Sweden's modern boom the last two decades was produced by a shift toward the free market, rather than away from it. Previously it was mired in a long-term stagnation brought on by heavy welfare state policies.

The free market version of the Untied States produced the first, and by far the largest, true middle class in world history. There isn't even a close second. Prior to the the US abandoning the free market system 40 years ago, it was basically at the top of the pile in nearly every metric, from education to savings to growth to upward mobility to standard of living; along with an amazing college system that was affordable, and an affordable healthcare system that was the best in the world.

If the welfare state worked, it wouldn't be collapsing rapidly all around the planet. The debt piled up faking prosperity under the welfare state system has begun to come due, and all those gains that were pulled forward to pretend the system worked, are eroding.

I disagree with many statements, but I want to focus on two:

> why do free market systems produce by far the greatest standard of living as compared to any other system

What other system do you mean? I don't see two systems to choose from. Every wealthy nation and most poor ones have a 'free market' system with some social welfare programs. The question is what degree of social welfare do we want to provide?

> The debt piled up faking prosperity under the welfare state system has begun to come due

In fact Western economies grew enormously in the last 40 years. The U.S.'s recent debt and economic problems are because of reckless governance:

When Bill Clinton left office the government was running a surplus and the economy was growing. Under the Bush administration, the Republicans (and the blame falls heavily on them this time, there's no point in being falsely even-handed):

* Cut revenue (taxes) significantly

* Greatly increased costs unnecessarily by invading Iraq

* Greatly increased costs unnecessarily by failing to regulate the financial sector, resulting in the worst economic catastrophe since WWII. This greatly impacted revenue (reduced economic activity reduces tax receipts) and expenses (increasing demand for social welfare, and bailing out critical industries).

* Malpractice in governance, attempting even to default on the credit of the United States to score a political point!

Balancing the budget with excellent economic performance and social welfare policies was and is possible. We did it under Clinton. If you greatly both cut revenue and increase costs, and conduct malpractice in governance, then yes you will have a lot of debt and other problems.

Really? adventured says the US left the free-market system forty years ago and you reply with criticism against Bush?

I agree that there are no free market systems anywhere and that corruption is a huge problem. That's universal and not just related to healthcare.

I would say that another alternative would be full transparency in costs and prices, that way the public can understand what they are paying for. One example is an Oklahoma City surgery center showing their prices online for all to see. http://kfor.com/2013/07/08/okc-hospital-posting-surgery-pric...

Ultimately I have no faith in what the US is doing, mainly because it's the same problem all around: the government get's involved in a negative way, then years later claims it's the only thing to fix the problem by becoming more involved. Yet it never actually address's the issues from the beginning.

That the parent was downvoted (and reading some other posts) shows what I unfortunately have come to expect, which is a low standard of discussion on HN about these issues. There is an aggressive negative reaction to anything that challenges the radical libertarian orthodoxy by suggesting that a social welfare program, especially a European one, could work well.

It's not intellectually honest and not valuable to discussion, and we should raise our standards. I expect that almost everyone reading HN understands the following: If you've drawn a conclusion before seeing the facts, you aren't open to new ones, and you think a complex issue is black and white, you're acting dumb. Also, it blocks innovation when new ideas are evaluated based on their adherence to prior orthodoxies. Finally, knee-jerk reactions have no value. Let's use the same intellectual skills we apply to technology to address other issues too.

While I certainly won't take issue with your last paragraph, aren't you just taking exception to the fact that people disagree with you? You don't really know why the people who down-voted the parent comment did so, and are projecting a certain viewpoint upon those folks. That doesn't seem terribly honest or valuable either. Of course, you could very well be right, but I'm guessing if the down-voting were of an opinion you did not agree with, there'd be less of this "we should raise our standards" talk.

For my part, I would say that the parent made a couple of statements which were weakly-linked to the content of the article, and then ended it with what sounded like a victory lap ("Looks like progressive policies with healthy government regulation always works better than the free market."), which sounded kind of smug given that there seemed to be a few steps of the proof missing.

As an American living in the Netherlands, I've thought quite a bit about the different approaches taken to social welfare here and at home. If anything, my experiences have left me with much less certainty about which strategy is "best". They seem to optimise for different value systems.

> aren't you just taking exception to the fact that people disagree with you? You don't really know why the people who down-voted the parent comment did so, and are projecting a certain viewpoint upon those folks. ... I'm guessing if the down-voting were of an opinion you did not agree with, there'd be less of this "we should raise our standards" talk.

I'm not and your guess is wrong.

First, do they disagree with me? What is my opinion? Aren't you doing what you accuse me of?

You're right that I don't know the reasons for the individual downvotes. However I'm confident in the pattern I've observed in this discussion and others on HN. I think the aggressive, dogmatic responses, the lack of value in many comments, and the voting patterns (including for my comment, for which -2 is way overboard) are obvious.

If you care, my opinion is that I don't know enough about the subject to form one, that without a proposed pension system there is nothing to have an opinion about (i.e., it's too hypothetical), and especially that it would be valuable to me and to our society to have intelligent discussion about it. The signal-to-noise ratio of the libertarian orthodoxy makes it difficult to find any valuable contribution from them, and their shouting down of anyone who disagrees also doesn't help. They may have good points in policy, but the standard of discussion needs to be raised.

Uh huh. Pro tip: using the phrase "radical libertarian orthodoxy" is a strong indicator that perhaps you're not really interested in even-handedness.

sipior doesn't know me or speak for me. I refer anyone interested in my opinions and thoughts to my own posts.

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