Healthcare has consistently been one of the biggest drivers of US GDP and job growth numbers for years now.
This is one of the major things that has helped explain why US consumer sentiment has been so out of step with headline numbers like employment, consumer spending, and GDP.
It also helps explain why there's so many economists are saying they see limited evidence of a "K-shaped economy", and say they see positive numbers throughout the distribution. It's very difficult to choose not to buy healthcare.
So perhaps we'll never get to a better healthcare+insurance market (nee "Free") through government, but eventually we will just all work in healthcare, and barter our nursing and dental skills in secret away from the insurance coders.
You can move to Singapore, if you want a better healthcare sector.
(The UK spends very roughly half of what the US spends on healthcare in terms of percentage of GDP. That's total (public plus private) expenditure. Singapore spends very roughtly half of what the UK spends by the same measure. Health outcomes amongst the three countries are comparable. If anything, Singapore is healthier.)
Because it is? Migrant workers get sent away when sick or hurt, they don't benefit from healthcare.
They don't get treatment, and have to come back to their country. It's the same in the UAE, except there even if you're a westerner, if you work a manual job you will get sent to your country if you get seriously hurt (ask any sailor).
[Edit] btw I just talked to my sailor friend, I was wrong, it doesn't matter if you're a westerner or not, if you are a sailor or a docker in Singapore, you will have to pay from your own pocket for healthcare or get back home, same as UAE.
I wish the US could also use migrant labour like Singapore instead of the current system of turning a blind eye to illegal immigration out of necessity
Europe is also excellent in my experience, specifically Portugal and Spain. My health insurance cost for a family of four in Spain is ~$2k/year as someone on a visa. In the US on an employer plan, it was ~$20k/year (premiums, copays, etc).
I think the commenter you responded to filtered first for countries with outcomes better or exceeding the US? Though I’m not sure Portugal and Spain automatically fall into that category
I can only n=1, but most, if not all, experiences we've had obtaining medical care were better in Europe. Care specialist for my autistic kids, primary care, etc. From my unofficial surveys, many folks I know in the US are having a hard time finding various care providers, even if they have insurance. More data on this is always welcome.
It seems fairly common in the US to have a hard time finding a doctor that will take your insurance, especially so if you are on Medicaid. Even with good insurance, a lot are just not seeing new patients. More and more tasks are being pushed off onto nurse practitioners and physician's assistants. And the number of residencies is still limited by the AMA, so you aren't getting enough new doctors.
I can believe this; it's my personal and anecdotal evidence (and that which is believed by family) that the maximum quality of US medical care is quite incredible, but any perceived median (accounting for accessibility and cost) is really quite shit
Oh, I picked Singapore, because I moved here. I picked US because that was the topic under discussion. And Britain because the parent comment talked about 'free' healthcare.
While interesting facts, this is typically not the primary criteria which people use to decide where to expat to, versus availability and affordability. I cannot speak to the residency requirements of Singapore, but those of western Europe are very generous, as some who has helped folks leave the US for there. If you are in Spain on a tourist visa, and apply for the equivalent of a digital nomad visa while in country, you get three years as a temporary resident. At three years, you re-apply for another two years, and after those five years you can apply for permanent residency. 80% of your income must come from outside of Spain. They’ll even take a letter from a US W2 employer as income verification.
If you have any resources you can recommend on immigrating to Singapore that would be helpful and relevant for folks considering it as an option (whether on an employment, student, or pension/non lucrative visa), I welcome them to add to my resources for distribution to those seeking an exit strategy. Thank you in advance.
Oh, I was purely talking about what healthcare costs society.
I love it in Singapore, but if you don't want to live in a steam sauna, there are better countries for you. And if you are an American, I guess you don't even benefit from our more enlightened tax system anyway.
> If you are a U.S. citizen or a resident alien of the United States and you live abroad, you are taxed on your worldwide income. However, you may qualify to exclude your foreign earnings from income up to an amount that is adjusted annually for inflation. In addition, you can exclude or deduct certain foreign housing amounts.
So there are mechanisms by which to avoid paying income tax to the US as as someone with a potential US tax liability living and working abroad, although it can be a facts intensive situation. Think like a Hacker, this is just another system and set of rules to hack ("How can I live outside the US, maximize my quality of life, pay the taxes due to my residency jurisdiction, while avoiding paying as much US federal income tax as possible?").
(For the 2026 tax year, the maximum Foreign Earned Income Exclusion (FEIE) is $132,900 per qualifying person, an increase from $130,000 for 2025. Married couples where both spouses work abroad and qualify can exclude up to a combined $265,800; the contents of this comment are for educational purposes only, and are not financial or tax advice, speak with a professional)
Singapore is the beneficiary of a neighboring impoverished itinerant workforce to supplement its own collapsing demographics with artificially cheap services. It’s hardly replicable most places.
How so? What's hard to replicate here? Many rich places could let in more migrant workers. It's good for the workers, and good for the receiving country.
No it isn’t. Malaysians commute across the river daily and then return at night, having provided their services in exchange for compensation. Singapore gets the work without many of the associated problems with housing those people long term. As a result, there are some ridiculously niche jobs in Singapore that would not exist in another rich country, such as widespread domestic servitude and manual street sweeping
New Jersey and Manhattan are both a part of the same country last I checked.
Malaysia and Singapore are two different countries. Despite being right next to each other they have vastly different GDPs, standards of living, government benefits, etc.
New Jersey and Manhattan are in different states. But in any case, why so xenophobic? Borders are an administrative hassle, but they have no moral weight.
I didn't realize acknowledging NY and NJ are in the same country is a xenophobic take.
Borders are a lot more than just a bit of paperwork or "administrative hassle". Central America is a very different place from US & Canada in many ways. Malaysia is quite a bit different from Singapore in a lot of ways despite such intertwined history.
I'm not passing any moral judgement here, I'm just acknowledging current reality. Singapore and Malaysia are different countries. NY and NJ are two states in the same country. The relationship is very different. Even with "Imperium in imperio" in the US.
To have a similar kind of comparison one would look at the cyclical migrant labor between the Southwestern US and Mexico.
Because unless you really just want to prop up only Manhattan’s statistics at the expense of NJ’s, it’s irrelevant to a discussion about US labor statistics.
> Health outcomes amongst the three countries are comparable. If anything, Singapore is healthier.
healthcare is not for health. Its for sickness. Going to hospital doesnt make you "healthy" . We dont have any medicines to restore health to ppl suffering for diseases majority of healthcare spend goes to.
Maybe those countries dont have sickly population in the first palce like usa where a majority have metabolic diseases.
Health outcomes in the US are affected by higher levels of obesity. If anything, the higher health spending keeps that from being worse. I expect Ozempic and the like to have a significant impact on this.
The people who make the laws are the wealthy who pay their think tanks and lobbyists to write them. Nobody gets elected without being owned by a puppet master.
There will never be a better healthcare because the true cost of fixing a body more often than not far exceeds the value that body produces.
People run to dismiss this with "well we need a different system then", but the problem is a fundamental one on par with "eating your cake and having it too".
The only way to get as close as possible to "good" healthcare is to have enough money to pay for everything out of pocket.
"The only way to get as close as possible to "good" healthcare is to have enough money to pay for everything out of pocket."
This isn't possible. Healthcare is a finite resource and having universal, government care not only puts your life into the hands of the government (see the UK for an example where parents are not allowed to take their children out of the hospital) but offers worse outcomes.
When you are young and healthy, it's great. As you age, life-or-death surgeries have long wait times. This can be seen in any country with universal care. My aging relatives in Canada are going through this right now and have been forced to come to the US to get surgery in months rather than waiting years.
MAID has been great for healthcare costs in Canada. Many people that would otherwise have been costing the system money, are now a benefit. The sad realization is that government-run programs need MAID to cut down on costs.
I know lots of expats living in Asia that are now getting older. They have to go elsewhere to get any surgeries done, because of this exact reason.
To make it better, we should only have insurance for surgeries that can't benefit from the free market and are relatively rare. Common surgeries and procedures should have no insurance. The prices would eventually fall to levels that were affordable.
The masses don't want plans like this. They like easy solutions that sound good when you say them and don't take a whole lot of thought besides an elementary school level of thinking.
It turns out that when you make a massive profit motive to sell expensive fancy interventions, health outcomes suffer.
You see this to an even more extreme degree amongst the ultra rich and powerful, who are often using cutting edge, experimental treatments, and often reaping the downsides of being on that edge (though of course also the upsides).
They are looking at the outcomes of specific procedures because they are interested in the health care system quality. Looking at things like life expectancy would make it impossible to disentangle them from other factors like lifestyle or environment.
Sure, but it's only six (6) specific illnesses. There are tens of thousands of illnesses. I'm almost 100% confident you could cherry pick any six illenses to get any outcome you want.
Edit: Seems the lead author is also a vocal supporter of universal healthcare, being a senior fellow of the Center for American Progress. So yeah, probably why it's such a strange setup, and what compelled me to check since this kind of thing is super common for "activist research".
I guess the takeaway is to always take a study for what it is, rather than what it paints itself to be.
No, I didn't make the argument they were obscure, in fact they all are from a set of common illnesses that....also contains thousands of illnesses. Again, this is the kind of stuff you see with "activist research". Why would they only do 6 instead of hundreds or thousands? I'm sure you see my point.
There are also other oddities like using median county wealth rather than household wealth. In many wealthy counties there are still poor areas, I know more than a few. In fact if you look at the appendix, most of the households in the study are, well, average or poor. They also don't include absolute numbers or definitions for the illnesses.
All in all, it's a bad study, and clearly made to color in an agenda.
There will never be a perfect healthcare system, sure, but the US healthcare system is just bad, and can be improved. We pay more for worse outcomes on average compared to most developed countries. Obviously it's just not working, I think it's indisputable at this point.
> the true cost of fixing a body more often than not far exceeds the value that body produces
i softly agree but also think that a body does not need to generate value to pay for the costs in order for the whole process to sustain itself. Monitoring the stars for asteroids heading towards earth provides no market value, for example, but we can still afford to do it. so it's a matter of cost and available expenditure. the market is not net 0, so its possible to generate enough value to have enough to afford healthcare as an expense as a society
what are the costs of fixing a body? The residency pipeline is a bottleneck on labor, but assuming that gets sorted out and AI is capable of guiding any reasonable person through the process, why cant the cost of labor for a doctor drop dramatically?
i would guess limited resources are the biggest blockage, but i dont know how to break down a $20k hospital bill for giving birth into its actual costs. its hard to believe that really needs to be $20k.
I actually think its the opposite. there is so much friction with healthcare and the process of healing is slow enough that costs are inflated because the overall operating cost for the entire facility including rent, ER, having people on standby, who knows what else, all need to be recovered through whatever volume they process and they arent processing as quickly as the resources are able.
healthcare needs do not subscribe to a neat work schedule, and so we have to pay a lot of market prices to have the right availability at all times. but thats not a true cost, it is a result of accounting and underutilization
This is one of the major things that has helped explain why US consumer sentiment has been so out of step with headline numbers like employment, consumer spending, and GDP.
It also helps explain why there's so many economists are saying they see limited evidence of a "K-shaped economy", and say they see positive numbers throughout the distribution. It's very difficult to choose not to buy healthcare.