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by xvector 634 days ago
In the UK you also pay insane taxes and your _median_ citizen in the UK has far less disposable income after all expenses including healthcare, according to OECD metrics. In software engineering specifically, I'd make a third of my current income in the UK.

I'd much rather make 3x as much in the US and still get free healthcare through my employer, with shorter waiting lists and better treatment outcomes than the NHS.

And we also have "skip the line" services here as well.

My family have worked as doctors both in the UK (NHS and private), and the US, and they vastly prefer the US system from an outcomes and efficiency perspective.

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Commonwealth Fund studies like the one in the article tend to be quite biased and pushing a very specific agenda.

But in reality, we have far better mortality rates (1) for serious diseases: 48% better outcomes for cancer, as an example.

When people with serious problems want treatment, they come to our system if they can afford it, because we actually do have better outcomes regardless of what these highly biased studies say.

1: https://www.politico.eu/article/cancer-europe-america-compar...

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Edit: People calling my argument a "strawman" should really try living in both systems for a year with a chronic, serious health condition.

They will very quickly find that the US system is far better than the NHS. We get seen more quickly, our doctors can afford to actually spend time on us, more effort goes into root-causing a problem, we have more treatment options, etc.

It's easy to theorycraft online and look at the "on paper" metrics from highly biased studies and come to the wrong conclusions.

5 comments

> your software engineers make a third of what they make here

Is this topic for discussing health care systems or the SW engineering salary dick measuring Olympics? Because those are two different unrelated topics.

Which country pays its software engineers the most is not some yardstick for measuring national quality of life of its average citizens, and whether SW engineers get paid a lot is totally irelevant to the people who are not working or aspiring to be SW engineers.

I bet the disabled US vets, homeless people or McDonalds workers in the states also don't give a fuck that their SW engineers are the best paid in the world but would probably feel a bit cheated learning that despite living and paying taxes in the richest country in the world, their peers in poorer EU countries get much more benefits and better quality of life.

>I bet the disabled US vets, homeless people or McDonalds workers in the states

Those two groups share interesecting means by which their healthcare is provided. Surprise! Its the government. So when people have doubts about an implementation of "Universal Healthcare" you shouldn't be surprised when you can acknowledge that as you said " but would probably feel a bit cheated learning that despite living and paying taxes in the richest country in the world, their peers in poorer EU countries get much more benefits and better quality of life."

Irrelevent but homeless people don't really pay taxes in any meaningful sense.

It's always fun how the strawmen appears instantly when you discuss this subject.

We pay marginally more in tax, sure. How that is relevant to healthcare, however, is a mystery, given we spend less tax money per capita on healthcare than the US does. It's not healthcare that is the reason our taxes are higher, but other services.

I'm sure doctors prefer the US system. That's unsurprising - the US system pays doctors vastly large amounts. It also costs patients vastly larger amounts. So speaking of bias...

> In the UK you also pay insane taxes and your software engineers make a third of what they make here. At my big tech, as an IC5 I was making more than our UK Directors.

How strange. When I moved from US to UK within a FAANG I took a fractional pay drop and got an RSU topper. After leaving and working as a UK employee in an international org I make more than a lot of US directors. Perhaps the difference comes from the value you brought to the company?

One thing that is objectively true though is that, outside of the whinging from software devs in the 1% that no one really cares about, the outcomes and efficiency of the US system sucks compared to every other western nation.

> They will very quickly find that the US system is far better than the NHS. We get seen more quickly, our doctors can afford to actually spend time on us, more effort goes into root-causing a problem, we have more treatment options, etc.

Nothing stops you from choosing extra insurance in the UK too if you believe you need that level of cover.

The only reason you're comparing it to the NHS instead of an equivalently expensive UK private healthcare plan is that the NHS provides good enough universal coverage that most people don't feel the need for more.

But the US equivalent would be to compare it with Medicare and Medicaid.

In the UK, not only would I pay massive taxes for healthcare, but then I'd also have to purchase private healthcare anyways.

The US is far cheaper, even according to OECD metrics (disposable income after all expenses incl. healthcare.)

Okay, and what about all the other people who aren't blessed enough to be SWEs? They should just rot and go into medical debt for the rest of their lives for daring to get sick?