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by aranchelk 902 days ago
American healthcare is an easy target, plenty to criticize.

There are complicating factors here:

We culturally, societally, and philosophically don’t really know how to make decisions about end-of-life care, and death in general.

We also lack an agreed upon moral framework for how to care for people with diminished cognitive capacity (the extreme being permanent vegetative state).
1 comments
mikem170 902 days ago
A lot of money is spend on end-of-life care, trying to keep someone alive on their deathbed for an extra month or two, and people don't seem to want to talk about the diminishing returns of some of that care, and the opportunity costs - the other people that could have been helped more with those resources.

It's a thing, even if ignored. We're paying big premiums for that to insurance companies as part of our wages and taxes.

I wonder if other countries do significantly better?

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AlexandrB 902 days ago
Forget the costs, there's unnecessary suffering inflicted on patients with some forms end-of-life care. Overwhelmingly doctors - who have witnessed such care - firsthand, sign DNRs to avoid going through that[1].

[1] https://www.saturdayeveningpost.com/2013/03/how-doctors-die/

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holoduke 902 days ago
But your taxes are too low. For example the Netherlands does have a good system. But a 50k car costs 120k in the Netherlands. From your 80k salary 35k goes to the state as taxes. On most products you buy 21% is tax. If someone dies his money is 50% tax. Give 100k as a present. 30k is tax. And so on.
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mikem170 901 days ago
I've got the Netherlands spending 10.02% of their GDP on health care in 2018 [0], and the U.S. spending 16.68 in that same year [1]. If it were just a matter of money wouldn't that mean that the U.S. is already doing more?

Or is something else making a difference?

How does the Netherlands handle end-of-life care? I see in 2013 that 3.4% of all deaths in the Netherlands were people who chose euthenasia [2]. Maybe that saves their system a lot of money? Maybe they look at end-of-life differently?

In the Netherlands how do they make decisions about who gets possible life saving treatments versus who does not? does anybody who wants state of the art chemo get it, even if they are 80+ years old?

[0] https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locat...

[1] https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locat...

[2] https://vivredignite.org/en/2014/09/recent-euthanasia-number...

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