The (north) American healthcare system



I’m open to looking at different types of ways to pay for healthcare.

In the US, you or your employer pays for this via an insurance system rather than through direct taxation. What I want to know is, is their equivalent of income tax/national insurance lower than ours in the UK, providing people with the necessary ‘disposable’ income to cover this cost?

I could just google it, but where’s the fun in that?

Hmm, interesting…


i believe everyone over there is very pleased with the current healthcare system and it is often cited as a shining example of how things should work


Dunno, but we have a better healthcare system which is what matters


It’s a false premise because of how expensive in both absolute and relative terms healthcare is there, but no.


New York’s the greatest if you get someone to pay the rent.


What I find really fascinating about reading American attitudes to this stuff online (in various nerdy places) is how commonplace the attitude of “well sure it’s expensive, but that’s just how much these things cost” is. There’s a massive blind spot there about the fact that this is simply not true of other countries and that they’re getting absolutely rinsed by healthcare providers. As if because that’s the way it is in the US, that’s the way it must be.


Better overall system for sure. Better individual cases of care? Not sure.



North America has the highest average spend for health care around $10000 each a year.

The UK budget for health care was 116.4 billion for 2015/2016. Divide that through by 60 million makes £1940 each for two years. Making a grand saving of about £7000 a year per person.

Fucking bargain.


Yeah but paired with the knowledge that theirs is so much better than anyone elses so it’s worth it


As ever with things in society, everyone would be better off if we spent way more on poor people. But rich people are going to be cunts, so…


Depends what for. I doubt stroke care is anywhere near as good in the US as it is in the UK for instance.

Think “we” need to stop obsessing about models of healthcare. There is no golden system.

One of the biggest problems with the NHS at the moment is the absorption of both cost and space through the dearth of social care. This needs to be addressed two-fold:

  • Tax increases to fully (re)invest in social care. Now.
  • Attitudes towards care of elderly relatives within families which in the UK are absolutely diabolical.


We’re even below other countries with universal healthcare, such as Australia, Canada and Ireland.


The American ‘model’ is effectively the worst form of regressive taxation. Some employers pay for decent health insurance but this tends to disproportionately benefit wealthier people. Even then, there isa complicated tiering system which dictates the level of patient co-pay (vs the flat ~£8 co-pay on prescriptions through the NHS). And of course that is before the excess you’ll be paying on hospital services (beds, tests, operations, sterilised gloves…)
There are some arguments against the UK model (patients aren’t financially disincentivised from ‘wasting’ GP or ER time) but the US is straight-up the worst model in the developed world.


This reads badly. More of a challenge within a generally good system than an argument against it.


Lots of replies, but no one’s actually answered my question yet.


If you’re rich, possibly yes. If you’re poor, definitely not.


Might need to get some specs on the NHS mate, it’s been answered.


Yeah I only have anecdotes to go on here. When my mother-in-law fell ill, the speed with which she was seen, given scans, given a diagnosis, scheduled for surgery, given follow-up treatment etc was mind-boggling. Lightyears beyond comparative stories I’ve heard from people in the same situation in the NHS. But of course, if she (or her insurance) couldn’t have paid for it, I guess it would have been very different, which is horrific.


The biggest difference is that health insurance doesn’t cover everything. Per my comment above, there is a tiering system for drugs. You’ll be required to co-pay at varying levels for different products. Which is why, say, treatment for cancer can often bankrupt families, even if they have health insurance. Your variable cost of healthcare is much higher. So a straight-up national insurance contributions comparison doesn’t work. If you never had to use healthcare services then you might be better off in the US than paying your standard UK contributions, but there’s much more risk of cost escalation over there.