[Arnt]

That reply is a bit factual... I want to talk about why it came to be this way.

Medicine has advanced to a point where some serious illnesses can be kept at bay for decades. People with some formerly mortal diseases can get medicines that cost $100k/year and/or professional help every day, and live well for thirty years.

This means that each of rich societies has to choose:

1. Raise health insurance rates until the budget covers everything that's possible medically. However, in some rich countries, people's after-tax income is only a few doublings above the current health care plus pension costs...

2. Decide that some treatments aren't worthwhile, ie. everyone with Hyperthis or Abnormalthat Syndrome gets cheap palliative treatment and a peaceful, gentle death.

3. Decide on a per-patient basis, often involving numbers such as "cost of treatment" and "years left of productive life".

Option 1 is the humane way, but slightly impossible. Options 2 and 3 involve treating people like dollar signs, one way or another. It's an unpleasant choice, not an avoidable one.

[LyndsySimon]

You've missed the way that it's done absent state intervention, which is perhaps a modification of #3:

    Decide on a per-patient basis, treating the illness when the individual or their family can afford the cost of treatment.

[Arnt]

There are many minor variations. Another common one is the variation where you you pick an insurance plan before your illness, and the insurer later decides on the details on behalf of all of its insured individuals. And... but they're all minor variations.

[kgwgk]

> slightly impossible

Nice way to put it.

[knuththetruth]

Option 4:

Decommodify every aspect of healthcare, from the education of doctors to the hospitals themselves. Invest massively in basic medical science research and provide the corresponding advancements and technologies free of charge to the healthcare system.

These treatments cost 100K because of the economic arrangements from which they emerge, not because that’s some inherent (or even sane) price. For a more concrete contrast, Japan has a healthcare system based almost entirely on government set prices for procedures and has better outcomes than the US.

[Arnt]

€100k per year isn't very many hours of professional attention per day. A nurse for an hour or two per day, a physician once or twice per week, an occasional consultation with another, some expensive equipment, and of course education and general facilities for all these professionals... it adds up.

How much is the fully loaded cost of one of your own your own working hours?

[knuththetruth]

I think a more useful question is how is it that developed countries like the US and UK have widespread unemployment, but no shortage of need of this kind of work? Perhaps the economy is massively misaligned in who and what it serves.

[Arnt]

From a quick look the NHS alone appears to employ slightly more health professionals than there are long-term unemployed in the UK, so perhaps the economy is massively misaligned... and perhaps it isn't.

[knuththetruth]

The NHS is well known to be suffering a staff shortage in GPs and other care workers, which will only be worsened in light of the immigration restrictions coming with Brexit.

This of course also ignores that all of the unemployed would never be funneled into healthcare alone, but in other social services and infrastructure work for which there is similar, dire need.