Airborne_Again wrote:
Funny you mention Saudia Arabia and Qatar. These are in practise slave states and they also have very large oil incomes. Not difficult to have low taxes then.
This was directly in response to the statement that those with the highest standards of living have the highest tax rates. From what I’ve heard of people living in Saudi and Quatar the issues it’s very good for all of their national citizens, the issues are more with the brought in workers, maybe a more extreme sort of version of the gastarbeiter?
Airborne_Again wrote:
Can you please stop calling people names?
Could you please not accuse me of calling anyone names? I didn’t. I pointed out very gently the parallels in that statement to a previous strong leader of germany, who didn’t like monopolies by an outside other. liked large and strong social programs, etc, etc.
I’m incredibly fond of Germany and have noticed with my german friends that they often speak in the group “we germans” “you english” whereas british seems to be more interested in he individual. Perhaps this is culturally leads to the like of strong, involved government.
Peter wrote:
There is certainly a strong national psyche along the lines of “let me enjoy the greasy fatty sh*t food because if I bugger up my health I will see a doctor and the NHS will fix me”.
That’s just not true. People don’t think like that. I have never met a person who thinks “Well the NHS will fix me, I won’t care about my diet”. People who don’t care about their health won’t care about their health regardless of healthcare provision. They know being ill sucks regardless of the healthcare system already, which if you’re looking at deterrent effect would be enough.
If they did, then in the USA where healthcare is ruinously expensive even if you’re insured, then everyone should be thin, fit and healthy, the very image of Adonis. Yet obesity and bad eating is even more prevalent there than it is in the UK.
Re credit cards and US health care, the norm is to ask for your insurance card. I have several options for insurance with my employer and choose the most expensive and most flexible – no preapprovals for any provider etc. The cost is 3.6 percent of my gross salary covering both my wife and I (health expenses are untaxed) but I’m making pretty good money these days, within my peak earning years. There are also affordable copays for anything but preventative care but that covers a lot. Those making say half as much at my employer can if they wish hold their percentage at a similar level by accepting more process: an assigned primary physician, pre approvals etc.
I also buy dental insurance, the most expensive of two options at my employer costing IIRC about $40/month for my wife and I. Anything preventative is paid without any copay, and my wife recently had a crown replaced for $200 out of pocket. It’s a good deal IMHO.
My salary in Europe with a good employer like say BMW (I’m in Germany as I write this, surrounded by BMW employees) would be roughly 50-60% of what I make in the US. I plan on retiring early in the US and will use savings to pay for health insurance to bridge the period before we are 65 and eligible for old age health care. The total cost for three years will be about the same as the extra I earn annually by being in the US.
Interesting insight, Silvaire. In Germany you pay 14% of your gross income for mandatory public health insurance, 7% of which is paid by the employee and 7% by the employer. It is usually deducted from your paycheck automatically, thus functioning like a form of tax in practice (but not legally).
But lo and behold, the German system still delivers better medical outcomes for much lower cost than the US, which spends 16% of GDP on healthcare vs 11% in Germany while achieving a shorter lifespan, higher infant mortality, higher rates of obesity, diabetes etc. and much higher morbidity and mortality for poor people.
Of course, with you only paying 3.6% vs my 14% I can see why you would prefer your system. But what happens if you have a serious injury (multiple trauma from a plane crash or motorcycling, for example) or suffer from Sepsis, Stroke or intracranial hemorrhage? Are you still fully covered for all operations, intensive care treatment for weeks, rehabilitation etc.? Because I am…
Silvaire wrote:
Re credit cards and US health care, the norm is to ask for your insurance card.
Agreed 
skydriller wrote:
It is pretty much the same as the US system, in that you walk in and the first thing they want is your credit card and insurance details,
Yes, my US health insurance covers accidents and rehab etc including e.g. motorcycle accidents in Europe (but when overseas with a higher ‘out of network’ deductible)
The secret with minimizing percentages is to make the denominator as large as possible. Also my employer pays half for me, but not my wife.
the German system still delivers better medical outcomes for much lower cost than the US, which spends 16% of GDP on healthcare vs 11% in Germany while achieving a shorter lifespan, higher infant mortality, higher rates of obesity, diabetes etc. and much higher morbidity and mortality for poor people.
All ways of funding health care must deliver pretty much the same outcome – for a given kind of population, available treatments, medical expertise, etc – regardless of whether funded by taxpayer or directly by the user.
The only way to do anything very different would obviously imply that
That’s just not true. People don’t think like that. I have never met a person who thinks “Well the NHS will fix me, I won’t care about my diet”.
They don’t think that literally consciously but they act like it
I‘m with @medewok here.
The austrian (healthcare, social) system is similar to the german one.
I spend a lot of time in the US, and I like it very much. If you’ve got money (more so than less), it’s great. But if you remove the rose tinted glasses you get some pretty extreme stuff there that we do not have here. Millions without proper health insurance, college degree debt, „right to work“ states, waiters living of tips etc.. over the years I got to know some hotel reception staff. Some have a degree. When they finish their shift in the hotel they go and work a second job in retail. Not a nice life if you ask me. They do have a nice military, you got to hand them that.
I’m not all for bureaucrats and I’m also not saying the government is always better than the private sector. But, from my anecdotal observation, the US can be a pretty hard and cold place if you’re unlucky. The society there is very diametrical. Wild guess: compare scandinavian crime statistics vs USA.
Special feature on health care:
The austrian system is based mostly on GP family doctors. You cannot simply change those as you please, unless they are on vacation and have named a substitute. They usually accommodate you your entire life, from childhood on, (until they retire) and so have a good feel for you (patient history and all that). More importantly, they keep the most expensive part of the healthcare system, namely the ultra specialist general hospitals, free from unnecessary workload. Treating the flu in an ER trauma center isn’t really efficient at all. We are talking several thousand Euros per night. The family doctors will also refer you to a specialist if required. You have to go by that way, unless you pay privately. If your family doctor doesn’t have a contract with the healthcare system, you can still go there, pay privately and then get a refund proportional to what a doctor connected to the system would get.
Obviously, every small town mayor would love a modern clinic close by. But recently those have been downscaled. Instead of implementing clinics in every small town and outfitting them with specialist stuff that is then hardly ever used, the larger metro areas have huge hospitals with all the new toys/procedures and if necessary patients are airlifted to those (recently also at night using NVS goggles). Makes sense to me. And who doesn’t love helicopters?
Having said that: We do have some cultural problems here once in a while, when somebody bypasses this system and goes straight to the hospital. There are debates about introducing a small fee to incentivize not going straight to the ER for every minor illness.
Disclaimer: total healthcare amateur here. Just sharing anecdotal experience.
They don’t think that literally consciously but they act like it
Educate people. Oh wait, then they’ll stop consuming all this shit. Not good for the stock market.
Tax alcohol, cigarettes, fat and sugar! Oh wait, that’s interfering with my freedom.
Politics is tough I guess :)
From what I’ve heard of people living in Saudi and Quatar the issues it’s very good for all of their national citizens, the issues are more with the brought in workers,
…who make up 88% (!!) of the population in Qatar and about 33% of the population in Saudi Arabia.
maybe a more extreme sort of version of the gastarbeiter?
You could say that. The kafala system which is applied in both Saudi Arabia and Qatar make foreign workers little more than slaves (particularly in Qatar).
Not too difficult to make it very good for your national citizens under such circumstances.
