Health care costs in US vs Europe | Health care system | Heatlh & Medicine | Khan Academy


SALMAN KHAN: I’m here
with Doctor Laurence Baker from Stanford
Medical School, and we’re going to talk about
health care costs, or health care economics, which
you’re an expert in. LAURENCE BAKER: I like to spend
a lot of time thinking about– [INTERPOSING VOICES] SALMAN KHAN: So all
of these charts, which all seem to have
a similar shape here, these are, essentially,
measures of how much we’re spending on health care. So this first one right
here, what’s this? Total health spending 1960-2009. And it says, United States. LAURENCE BAKER: This
is the United States. This is data that’s compiled
by the federal government every year since, well,
1960 and this figure is– SALMAN KHAN: And this isn’t
adjusted for inflation. LAURENCE BAKER: That’s
not adjusted for anything. That’s the total dollar
value that the folks in the federal government who
like to calculate this number have come up with
for the amount we spend on health care in a year. SALMAN KHAN: OK. So someone looking just at
this data point might say, OK. Maybe it’s not
inflation-adjusted. Maybe the inflation curve is
also growing at some rate here. But the absolute numbers
do seem to be large. By 2009, I guess it’s
already– well, 2009. We’re already several
years passed that. two and a half
trillion dollars just to get people clear to
what we’re talking about. This is in billions. This is 2,486 billion. So that’s $2.4
trillion, and then that’s predicted to
almost double by 2019. And our GDP is on the
order of $15 trillion. So it’s a significant chunk
of everything that we produce. LAURENCE BAKER: That’s a big
chunk of everything we produce. Yeah, going up rapidly. Hard to predict a little
bit, but all the trends are up and so we’re
worried about– SALMAN KHAN: And this is
on a per capita basis. So I guess there’s
two ways to think about why costs are going up. One is that maybe we just
have a lot more people or, that on a per person
basis, we are spending more. And this chart seems
to imply the latter. LAURENCE BAKER: This says,
on a per person basis, we’re spending more. Still not inflation
adjusted in this chart. But going from
$100 or so in 1960 to $8,000 in the last
couple of years– and you can see the trend
since, say, 2005 in there. It’s up and it’s up
pretty steeply just in the last little bit. And headed for maybe
$13,000 or $14,000. SALMAN KHAN: $13,000 or $14,000. That’s a nice sub-compact
car one could buy. Not to say what’s
more important. And so this next
chart right over here is actually that calculation
as a percentage of GDP. And, to me, this is, maybe, one
of the most relevant things, because that
adjusted for things. It doesn’t directly
adjust for inflation but it says, as a percentage of
all of the goods and services as an economy that we are
doing, this is a percentage. So this is an interesting
one right here. So in 1960, roughly
5% of everything that all the goods and
services Americans produced, 1 in 20 of that,
of our energies, was spent towards health care. And now it’s looking like,
in the next few years, it’s going to be
approaching 20%. It’s already in the upper teens. LAURENCE BAKER: Yeah, its past
15%, 16%, and we’re headed up. The last year or so, maybe,
it was a little slower growth, but you can see the trend over
the last decade or two decades. It’s up up and up. So you’re right. When health
economists, when people who think about
this more deeply, want to think about
health care spending two and a half trillion
is an interesting number. 8,000 is an interesting number. But this one captures
population growth to a large extent,
captures inflation. And the fact that we’re
spending one seventh, roughly, of our productive capacity on
health care is interesting– SALMAN KHAN: And closely
approaching– actually, it’s already one sixth
and approaching one fifth of everything that
we do is about health care. And I guess there’s a
couple of things there. Maybe we’re getting healthier,
I guess, is one possibility. Or maybe we aren’t and
then something is weird. LAURENCE BAKER: Well, that’s
the really interesting question. We can think about
why this is going up, but at the end of
the day, you’re happy if we’re
spending this much and if we’re spending
more than other countries, we’re spending more
than we did last year, if we’re getting
healthier because of it or if we’re getting happier. Interesting question if we
want to count happiness. It doesn’t make us healthy,
but if we’re getting something we value, and we’re getting
worried, and we get worried– SALMAN KHAN: There are
many forms of happiness that do not make you healthy. [LAUGHTER] LAURENCE BAKER: At
the end of the day, this may be our
biggest question. SALMAN KHAN: Some will act
directly against your health. And that goes straight
into this chart which you’re talking about. Maybe we should or maybe we
shouldn’t compare ourselves to other countries. And this is comparing
ourselves to other countries. So this chart right over here. This is the blue graph. So we are this light
blue [INAUDIBLE] same. So this is us. This is the United
States right over here. That is us, the United States. And if we compare to other
developed countries with, I guess, not too
different demographics– LAURENCE BAKER: Yeah, the
overall developed countries, industrialized
countries, countries where the standard of living
is in pretty good shape. SALMAN KHAN: They have a
broad– it’s not a homogeneous– LAURENCE BAKER: Not
entirely homogeneous. Some people will argue the
US is more diverse than– SALMAN KHAN: The United
Kingdom is quite– LAURENCE BAKER: –pretty
diverse countries, generally. Certainly countries
with immigration issues that the US has,
countries with lower income and higher income
populations that the US does. So they’re pretty diverse. SALMAN KHAN: Right, I mean,
when you look at this, maybe this is the
real chart to look at, because this is the
percentage of GDP but also puts it in
context of other countries. And that’s where they’re all
kind of bundled around in this, I don’t know, the low end. What is this, actually,
the UK– I didn’t realize– is actually at the low end
as a percentage of GDP. And France is at
the high end of GDP. LAURENCE BAKER: Yeah, so
I’ve done a little picking and choosing of the
European countries. Yeah, there are some
that are a little higher, but nobody comes
close to the US. These are the big ones. UK is the lowest in
the world, really, of the developed countries,
the European countries. And France, Germany,
Canada, are commonly compared to the
US at 10% or 11%. So we’re 50% higher,
60% higher than those double what’s
going on in the UK. SALMAN KHAN: And do we
know why we’re doing this? Where is that going? Where are we spending money that
these other countries aren’t? LAURENCE BAKER:
Right, so two places. Ultimately, the
economics of it would say, if you’re spending
more than somebody else, how much stuff you buying, what
kind of things you’re buying, and then the price that
you’re paying per thing. So we’re talking either
about prices or quantities. So it’s a little bit of both. If you compare us
across countries, we buy more of some
kinds of services than other countries buy. There’s some interesting
comparisons– SALMAN KHAN: So we might
get more MRI’s per person or something like that. LAURENCE BAKER: We certainly
do get more MRI’s per person. It’s interesting. It’s not that we have more
doctors per capita, say, or more hospital
beds per capita. It’s not that we get more
primary care visits in the US. It’s actually true that,
in many European countries, you get more primary
care visits, more time with your primary care
doctor then we get in the US. But if you were
picking a poster child, it might be the MRI or
something more sophisticated, something more expensive,
specialists visits, lots of tests, and
things like that, that we buy in the United States
that they don’t buy in Europe. And that drives up
our health care costs. SALMAN KHAN: So we
definitely are buying more and it’s costing us more for– LAURENCE BAKER: And
the price is also different in the United States. There’s some people who
have done studies of this. There’s always
little bits of debate about how you define
these prices exactly, but we pay doctors–
if you’re finding doctors’ annual
incomes, they’re going to be higher in
the United States. That is to say, we’re paying,
in some sense, a higher price for a year of work from a
doctor than they pay in Europe. We’re paying a higher price for
our hospital administration, for our staff in the hospitals,
things we tend to pay more. So we buy more things. We tend to buy more of
the more expensive things. And we tend to pay
a higher price. SALMAN KHAN: Do
you know, roughly, how much of the
health care dollar goes towards salaries
versus drugs versus things like MRI’s and the kind of fixed
costs like MRI’s and hospital beds and things like that? LAURENCE BAKER: Yeah, so some
of this you can figure out. We could almost put another
slide up on there on the screen there. The US health accounts
will tell you something like doctors and hospitals
and drugs– drugs, 10% or 15%, a little less than that. I would have to go back and
look at the data on physicians. But physicians– let’s say that
hospitals and physicians are 20% or 30%– I hesitate to
give you look the number. SALMAN KHAN: It’s not 90% LAURENCE BAKER: It’s not 90%. SALMAN KHAN: When
we say hospitals– so that includes
outpatient and inpatient? LAURENCE BAKER:
Yeah, so there’s lots of ways these health
accounts get broken up, physicians, hospitals, emergency
departments, different kinds of equipment and things that
get purchased, there’s research and there’s buildings,
and all that– SALMAN KHAN: So just
[INAUDIBLE] none of these things do make up the bulk of it. We had a video
about drug pricing, but drug pricing by
itself is not the reason why we’re out here. And physician pay by
itself is not the reason why we’re out there. All of these are contributing. All of these we’re getting
more of and we’re paying for. LAURENCE BAKER: It’s a mix. At the end of the
day, it’s going to be a bunch of things like
this all thrown together. We buy more stuff. We tend to buy more
expensive stuff. We buy it from people
who we pay a lot. We buy more specialist visits. For example, in the
US, we pay specialists a higher annual salary
than we pay generalists, and that comes
out in the prices. SALMAN KHAN: They don’t
do that in Europe? LAURENCE BAKER:
Europe does pay more, but everybody is shifted down. All the physicians
are shifted down. And I think the
specialists are probably shifted down more in Europe
than the generalists are. We pay more for our
prescription drugs here. We pay more for– SALMAN KHAN: Now,
what are we getting in terms– other than more
Mercedes in the doctors’ parking lots. I’m kidding. I’m kidding. Although, you do
see a lot of those. It seems to be the car of
choice when I visit the doctor. And my wife’s a physician. Obviously we all work
with many, so, they’ve worked very hard
so, I’m not going to make any statement about
they’re underpaid or overpaid, especially relative to some
people I knew in the finance world, I would say that
they’re definitely underpaid. LAURENCE BAKER: Possibly, yes. SALMAN KHAN: Yes. They’re above Mercedes
in that world. And so are we getting
anything in exchange for this? Are we getting less wait times? Are we getting better
access to our doctors? What are we getting or
what do we know about that? LAURENCE BAKER: Well,
so this is the debate. This is in, maybe, a microcosm
one of the big debates we’re having in
the US right now. We’re spending more every year. We’re spending more
than other countries. If it was clear we were twice
as well off, twice as happy– SALMAN KHAN: And
we’re growing faster. LAURENCE BAKER: And
we’re growing– yes, it depends on how you
look at the timing, but we’re growing a little
faster in some years. Our health care costs go up 10%. If we knew we were 10% happier
this year with our health care system, we would be happy. And that’s the big debate. There are some cases
where the US– there are things you can point to. We have fewer waiting
lines for some services, and some of the
countries that keep the costs down have more lines. It’s also not the
case that they have waiting lines for everything
and the really serious stuff doesn’t tend to have
long waiting lines. We get easier access to some
of the high tech stuff, which we like it, and so that
drives up our spending but maybe makes us happy. SALMAN KHAN: It may or may
not lead to better outcomes. So it makes us
happy that we feel like we’re getting
better customer service. Instead of waiting three
months for a procedure, we’re getting it in three weeks,
which would make me happier. I mean, objectively, I would
be much happier about that. But what happens when we
look at the overall outcomes? Life expectancy, and people
dying from heart disease, or whatever? LAURENCE BAKER: This
is kind of a mixed bag. Some of the most
commonly cited figures are cases where
the US doesn’t do as well as some
European countries. We spend a lot more and we don’t
do better on life expectancy. We don’t do better
an infant mortality. There are some cases where
the US does really well, especially things where
access to the high end stuff can make a difference. And so there are
some situations where it looks like we buy the kinds
of things that are really going to make us healthier. But it’s not across the board. And some of the really
interesting ones are cases where there’s
fairly inexpensive stuff that looks like it would work
well and improve outcomes, and sometimes we’re not
doing the inexpensive stuff that other countries are doing. And it’s coming out
to maybe hurt us. We wouldn’t be having the debate
if we were clearly better off, but it’s really the case that,
in only some of the measures, do we end up better off. We don’t always
vaccinate our kids more. We don’t always get
people screened more for cancers and
things like that. But sometimes we do. So there are success
stories here. SALMAN KHAN: Now,
one thing that’s interesting about looking
at this chart a little bit deeper is that it doesn’t
look like this is something that, you know, since
the American Revolution that we’ve been spending
double as a percentage of GDP relative to everyone else. I mean if I just look at
this chart right here, it seems like us and
Canada, we were right along very similar to each other
to about the early ’70s. And then we’re still
in kind of that pack with Germany and France. I guess, relative to the
UK, we actually always have been higher. But then right around
this time period, the late ’70s,
early ’80s– that’s where we really
started to break off. Was there some
policy shift there? LAURENCE BAKER: So there’s not
a tangible, specific policy shift. What starts happening in the
US there is we start adopting and we start shifting toward
the higher-end stuff more. And some of that’s the part– SALMAN KHAN: That’s where
the technology started to really get– LAURENCE BAKER: I think
that’s mainly the story. We started to
really– the research in things, the development that
went on in the world, really from 1940, ’50, ’60, started
to produce the capacity to do new and expensive things. And the US grabbed those and
other countries in the world were less quick to
grab them, maybe, you would say more careful. Maybe you would say
too careful, too slow. But the US, as you see
there, really quickly started to put up specialized
hospitals, started to buy the fancy
equipment, and you can see what kind
of came out of it. SALMAN KHAN: And to some degree,
probably, the whole world benefited from that because
you’re going back to the drug pricing or the MRI manufacturers
were able to get those returns and, hopefully,
much of that they’re able to reinvest and not spend
too much on other things. But it is fueling– LAURENCE BAKER: Yeah,
the innovation– there’s always these kinds of questions
that swirl around here. If the US pays a lot
of money and that comes back into innovation
then everybody benefits from, including us, maybe it’s OK. I think there are people
who debate whether we got enough innovation,
enough benefits that’s tangibly related to our spending
to make our spending worth it, but there are some cases
where that probably happened. And so there’s some
subtlety to the question. I always say, if
you’re the Yankees and you’re going to pay the
huge amount for the big payroll and the big stars, people
expect you to win every time. And that’s the US’s challenge. If we’re going to
pay the big bucks– SALMAN KHAN: We
should show results. LAURENCE BAKER:
–we really like we want to show results every time. And sometimes we
do get the results, but it’s not often enough. SALMAN KHAN: It’s not ambiguous. We’re not winning the
championship every year. Very interesting.

100 Replies to “Health care costs in US vs Europe | Health care system | Heatlh & Medicine | Khan Academy”

  1. How much does the profit of health insurance companies in the US contribute to higher health care costs here in the US, Sal?

  2. @voiceofreason467 lol he quite obviously does understand it. He's talking about growth in GDP per capita spending on healthcare.

  3. What an idiotic interview.

    On one hand they agree that the specialists and doctors and high tech equipment are not the leading cause of the jump in price and just a FEW minutes later, that's what is to blame.

    When asked what happened in the 1970's, TECHNOLOGY was blamed for higher prices in America and us ADOPTING the tech unlike U.K.

    That's B.S.

    We have a FOR profit system with administration costs through the roof. Europe doesn't and has better healthcare across the board.

    The End.

  4. You know, it is like camping. You don't want to lug around a 100 pound bag while hiking 25 miles up a mountain. So you plan what you need. You look at each object. One knife may be 5oz, another is 3oz. The 5oz knife may be nice, but you need to save weight. You look at your cups. Do you really need thermal insulation, or can you take the noninsulated cup that is 1oz lighter? Every tiny item adds up. You need to plan ahead and pay attention to the smallest detail.

  5. normal wait time to see a general care doctor in japan is under 48 hours, and lots of ppl are seen same day. I took me 10 days to get in to see my doc and cost me significantly more while he spent only 5 mins with me. healthcare in the usa is a joke.

  6. You guys don't know what your'e talking about. If you spend more money it dosent mean your'e Getting a better service .People in the US pay more because the private health Insurance cost a ton in other country you pay nearly nothing!!!! plus better service

  7. @haguylerman for individuals with certain illnesses like myself, private health insurance is sometimes preferred. in canada for example, individuals with cf can't get the medication called pulmozyme simply because the government can't afford to pay for it. in the us, people with cf get pulmozyme and live longer, more pleasant lives. not trying to argue too much, but sometimes private markets are superior to a "one-size fits all" government policy.

  8. U.S healthcare system: if you can afford it, the quality is the best in the world, but not everybody can afford it. The U.S has the best doctors in the world, but unfortunately not everyone can afford the health-care here.

    Other healthcare systems: you won't
    be financially screwed, but the quality may not be the best.
    There's always a tradeoff, and of course there are other factors to consider.

  9. If you compare the numbers, virtually all European countries are healthier than the US. Less child mortality, less stratification. I do think that health in Europe is "too cheap" and the health sector, especially nurses and doctors would deserve more money, but usually pharmaceutic and technical companies will hold your health for ransom, so increasing health care spending doesn't do the doctors and nurses any good.

  10. @phazon100 I doubt that about lower quality… even if you only take the richer Americans and compare them to less stratified countries like Germany…..

  11. when I was in France, I had to wait 6 months to get an appointment with an ophtalmologist to get my prescription glasses.

  12. @dannyledwith21 But in Canada couldn't you privately order that drug? It's not like it's banned is it? So there, you get some, if not maybe the best of both worlds?

  13. @tutortronix South Korea has a national health insurance (NHI) system covering the whole population. It was introduced by popular demand and is much cheaper than the private USA systems.
    North Korea is a completely nasty military dictatorship with no democracy or right to know. it is not even comparable.

  14. How many 9/11 first responders have died since 2001 because they cannot afford healthcare? When even the heroes are left to die, something is wrong. Unfortunately too many people have outsourced their opinion forming process to the highest bidder, and the highest bidder can be the highest bidder because they're the best people at getting money from other people, so they're the last people that should be listened to.
    A graph showing insurance company profits over the time would be interesting too

  15. @sinistar99 i suppose, but that's not really what i'm talking about. i'm talking about having an insurance plan that will cover your medication. here in the us you can get an insurance policy that covers that medication. in canada, where there is no private insurance market, you would have to pay for the medication in full (if it's possible to purchase the medication at all), which is insanely expensive ($100 a dose i believe).

  16. @tutortronix Any other country might be a fairer comparison than North Korea which has a policy of 'Army first' and has a dead man as head of state. It is really a lunatic nation still officially at war with much of the world apparently.
    It was more like a national liberation movement that got taken over by thugs.
    Most of the world has socialized healthcare and is a much better example.
    No system is perfect. Many in Europe have world class systems with much better coverage for much less.

  17. @tutortronix A variable you should consider is Govt itself.
    Anarchy is a system of Govt. as is plutocracy, military dictatorship, democratic republics etc. What counts is who's Govt. whether there is open debate and information etc.
    In reality few systems are either fully state or fully private. In general they tend to be socialized with elements of market providing services.. what fails are dogmas where people's health gets trumped by $ for bosses, corps & arms. including in Nht Korea.

  18. @tutortronix A variable you should consider is Govt itself.
    Anarchy is a system of Govt. as is plutocracy, military dictatorship, democratic republics etc. What counts is who's Govt. whether there is open debate and information etc.
    In reality few systems are either fully state or fully private. In general they tend to be socialized with elements of market providing services.. what fails are dogmas where people's health gets trumped by $ for bosses, corps & arms. including in Nht Korea.

  19. @HatchetsNCleavers And That 20,000 was a Bush admin ordered study from a Republican congressional committee. Harvard has it at over 45k…. But yeah even if it's only 20 that's pretty deplorable.

  20. @tutortronix "no mention of governmental involvement in terms of cause" You don't think there's governmental involvement in European health care? Less? If anything there's MORE and it's much much cheaper and in 36 cases better. So if there is a causal relationship between government involvement and health care costs it's a positive one. This goes against the knee jerk "government is always bad" idiological nonsence people substitute for rational thought.

  21. From a Canadian perspective on 12:20, why expenditure rose relative to Canada. Public health care results in less administration costs that you see in a private system.

    1959 – Premier T.C. Douglas announces plan to introduce a prepaid medical–care program.

    1962 – First universal Medicare in North America.

    1981 – Canada Health Act

  22. that's weird, i expected the UK to be pretty high considering the healthcare is a free public service and so more of its GDP goes towards it. and i expected the US to be low considering the health care is privatised and you have to pay for it

  23. Well 60% of the people in the US are overweight. Being fat brings health issues (so the people say).

    Now what could a part the problem be…

    European people don't visit the hospital for every fart neither

  24. @TheSelfishAltruist interesting. i always thought the main reason why healthcare wasn't free was because of the US population and the strain it would put on the public budget. most countries with free healthcare have a relatively moderate population (40-60 mill). this is precisely the reason why the UK govt wants to privatise healthcare; because of the increase in population and hence the increasing healthcare costs

  25. @naruto2710 You have fallen for the propaganda that in all situations public provision = bad/inefficient and private = good/efficient. Free markets in healthcare don't work well because customers (patients) do not have the expertise to buy efficiently, so they are at the mercy of providers. The result in the US is that providers have fleeced them and the industry works, not to make people healthy, but to enrich doctors, drug companies etc

  26. @gartner101 lol. i think you've replied to the wrong person. i actually agree with you and was complaining that the UK govt wants to privatise our healthcare service- at least partially anyway. i think you were meaning to reply to TheSelfishAltruist

  27. @TheSelfishAltruist haven't been getting your comments.very interesting, where are you from and what are your qualifications; you seem to know so much. i've always heard that the NHS system is popular amongst other countries but considering what you've said why haven't america adopted a similar approach? would it be less feasible due to the american political system, i.e. its a federal state and it would be complicated to implement.

  28. @naruto2710 (continue) lastly, i always hear the argument that although partially privatising health may be cheaper and economic, it may result in a reduction in the quality of service because priorities will shift from care to profit, is this likely?

  29. @evan13579b What do you get for your money(tax) => certainty you will be taken care off when you forget your wallet at home… Isn't it nice to know people will fight to keep you alive even though you don't have the money. And if it happens you're not bankrupt? If you buy something in group it'll be most likely cheaper also. I'am a Belgian republican, and all Belgian republicans think like this.

  30. @evan13579b You buy things with the work you did in the past. If a stranger is drowning in a lake, will you put effort into saving him? Don't you see it as an duty to save somebody live if possible? Money is delayed service in return which can be used for a nice house, nice car, nice wife or to save somebody's live. I agree you should motivate people to work even harder by rewarding them, but some things everybody deserves. In our Healthcare system it's impossible to get denied for anything.

  31. I will compare the Europe system as a Store brand and the American as a A-brand
    Store brand: A product of merely the same quality as a A-brand, but with no marketing and ad costs. Accessible to everybody
    A-brand: A high quality product whom is also heavily marketeered with ads and lobbying. With the marketing they want to create an extra emotional value. Accessible to only a limited group.

    These types are translated from dutch, its possible you use different terminology.

  32. @evan13579b Ok, I don't feel as much empathy towards them. I feel it is still their right to be healthy, my priority goes to those of my country, those who help bearing the economy and are giving me wealth(consumption).

    Good to see a non-patriotic USAman, you blame your gouvernement far more for the 66.000 citizens killed in Iraq then you blame the taliban for the 4000 americans killed on 9/11.
    NOT, And thats natural because you have more empathy for americans like I have for Belgians.

  33. @evan13579b "you can outnumber people on and vote"= democracy
    Try to find somebody here in Belgium who is against the healthcare? Try to find a politician. And I was thinking the USA was preaching that all their wars where about bringing democracy? Again, I belong to the republican party of Belgium. Christian faith still has allot of influence in the USA, how is this selfishness justifiable (I'am an atheist)? Our healthcare costs about 3.254 euro/person how much do you pay each year?

  34. @zer0lis Because socialism can be bad to, the unions these days think very shortsighted. They don't look at the future competitiveness, the future national treasury. Sometimes it's a good choice to loose something and keep the rest than loose everything.

  35. @evan13579b Democracy is latin: demos = the people and cracy >kratos = strength/rule
    You should educate yourself about democracy. Are you saying a minority vote should be worth more than a vote from the majority. A system where the minority rules the majority is called a dictatorship. If the majority of the people are homeless, there is something seriously wrong with the system and then it should be changed.

  36. @evan13579b Only a majority can vote away your house, not only a single homeless vote. Like I said before, the minority can't rule the majority.

    If the majority thinks it is in the benefit of the majority to take away your house, they should be able to and I hope with some compensation. But I don't see how this could happen because it wouldn't solve anything.

  37. @evan13579b If my home would be a democracy, that would be correct. My home is not a democracy, but the state is. The choice is up to you in what system you wich to live in. Democracy is not always the best answer to a problematic state, for exemple Russia or China. To my opinion the people over there are better off with dictatorship because their economy isn't evolved enough, also I think the ethnic differences between the peoples would tear apart the country's.

  38. @evan13579b I think that every civilization should have democracry as a goal. But you can't have a successful democracy when the majority of the people is uneducated. People who are uneducated won't have a way to check the argument made by his politician. This makes them very vulnerable to populism. In a dictatorship decisions are made much faster which can boost the economie. Socialism do not necessarily harm the economie, bad decisions do. The economie depends on consumption.

  39. @evan13579b How socialism can boost the economie => If a large portion of the population is educated with a higher degree, allot of company's will invest in Belgium for their R&D. We can no longer compete with china in manufacturing, don't you think? Yesterday a Belgian farmaceutical company attracted 1biljon euro(1.3biljon dollar) from a US investor. Yet, we are more expensive in hours we are able to compete because of our know-how. We pay nearly nothing for education.

  40. @evan13579b Ways to do things?Ways to handle the economie? You get knowledge, which you can use to form a good opinion. I'll give you the exemple of Santorum, in his campaign he said the dutch commit euthanasia on elders an deceased without their permission (the biggest lie, verry offensive) . Then the hole of Europe thinks, how the hell can they take Santorum seriously? Then I think, they must be unable to think for themselves. This can mean two things, they are dumb or just poorly educated.

  41. @evan13579b Allot of politicians back their arguments up with false facts. Before people could read, the church controlled everything. They could say what they wanted, there was no way to check. Nowadays we've become again illiterate for what the bankers are saying, what the lobyists are making the politicians do. How can you check if the facts given by politicians are true, if you don't really understand them?

  42. @evan13579b Can you distinguish false economic facts from genuine economic facts and do you understand all Terminology? Here in Belgium the politician are prohibited to be sponsort for their campaign by anyone but the state. All the contestants get the same chance on getting elected because they get the money from the state. Which means that lobbyists have very limited political influence. In schools there are inspectors, they evaluate all individual teachers. Everything is very seculair.

  43. @evan13579b These days every company here in Belgium searches somebody with a bachelor degree (if you're not in construction) and someone who speaks Dutch, French, English. I ones had a friend who went to an American(USA) school in Turkey, he told me the level of education was extremely bad and very slow. Why are you so convinced about free market? How much can save each year with 2 children and a home, a car? Experience is most definitely very importent, but you always need a basis.

  44. @evan13579b What dutch organization? I'am happy to tell you that this is false and you can not trust Santorum. It is ok to give the mother the right to choose if she can handle this extremely precious burden. I would not want my girlfriend to abort the fetus, but I would respect her opinion. No mother will think of it lightly, it will always be a very tough decision. The fetus feeds from the mother and shares DNA and it is still a FETUS not yet human. It is humain to support the choice.

  45. Europe and Canada have better health insurance payment systems and health care systems for its people then the US has.

    They pay less for health insurance for both the individual/famiily,
    and for Businesses.

  46. @evan13579b I see a fetus as a potential human live. In Belgium abortion is possible till the 14th week. At that time the heart, hands, brain and other organs are present, but are only at the beginning of development and have minimal operation. My girlfriend and I would never consider abortion if it wasn't for some disease or rape. Abortion should be possibile for those in real need, its not your opinion that makes a fetus full human live. We are pro live, we are both vegetarian(no hippie).

  47. @evan13579b Have you read it? The average is, 4 days. 60% of the lives which were shortened came from pain and symptom control(heavy painkillers). Only 3% of the lives shortened were due euthanasia. The rest were talked over with the Family before stopping the treatment because people don't have to live their last days in painful machines(chemo) when they are certain to die.

  48. @evan13579b Being educated made me much less small minded. It must be because you're religious, that you see it as no right of the mother to choose. You see the fetus as a product of some GOD, while I see it as something that caries my and her genes. A fetus is like an egg that must be bred in order to get a live out of it. Sometimes a mother has to flee the nest to save herself and her future chances in a family.

  49. @evan13579b And how would that come? If you first isolate the rich from the people by asking huge entry fees. Then they attract all the geniuses from the 3th world to boost their statistics up. When the criteria are having ass much geniuses as possible, there is a big chance you might win. The stupid part is, those geniuses go back to their country's of origin. In Belgium everybody is accepted and learns multiple languages, the education are by other standard maybe even better.

  50. @evan13579b My girlfriend studies for teacher primary education. Its a bachelor of 3 years where she has allot of psychology. She has to speak her french just as fluent as her native language (dutch). She can't make one mistake or she's failed. And this is just the beginning. Just want to say, the teachers are very highly educated and they know what they're are doing and how vulnerable kids at that age are.

  51. @evan13579b This is your opinion, while I see it as a potential human. You can not compare puberty to having nearly no brain yet. I'am sorry I assumed you were religious. I've said my girlfriend and I are vegetarian. I'am vegetarian because I find it horrible to kill, just for my comfort(meat). The moment, my live depends on killing an animal(vitamins), I will do so. If my future child would have a handicap or my wife would be having a desease I would choose an abortion.

  52. @evan13579b What would you prefere? Die 4 days earlier without pain in comfort with you family. Or die painfully and slowly? You can choose either way, hospitals don't profit by killing you earlier.

  53. @evan13579b Languages gives me chances to get an international job. It gives me a commercial benefit that I can speak the language of my trade partner. I'am most certainly not a language teacher and my girlfriend neither. Because of this "It'll go my way" arrogant behavior the BRICK country's don't really like the USA. Learning the language of your neighbor is the way to show your respect. Language gives you a benefit in export, which is the best way to grow as an economie.

  54. @evan13579b Belgium is split in two parts, a poor French part and a rich Dutch side. To be political correct, teachers have to able to speak both languages fluently. I also said she had allot of psychology where she is mainly thought how to teach to children a certain branche. She might have particular political bias, but that doesn't mean she will be able to express that? It will be obviously be better than in the US, she will be able to give the evolution theory.

  55. @evan13579b I have a question for you? Are you against the huge lobby influence in the USA politics? And should the politic be state funded(campaigns included)?

  56. Good video, but it seems to miss the fact that there is an explosion of obesity in the US which impacts health care costs . When you have young people getting type II diabetes, when people in their 40's, 50's and 60's are in and out of the hospital with multiple PREVENTABLE health problems, this drives health care costs way up. This is not to bash obese people, but it is a fact that they cost the health care system (and ultimately anyone who pays for health insurance) a lot of money.

  57. Maybe so. But I think you're missing the bigger picture. It is the Health Insurance company that is the sham. They're basically middlemen stepping in and taking your money. We need to abolish the health insurance scam. Have the gov't pay for our insurance; and have private citizens pay out of pocket for elective treatments.

  58. This comment makes no sense to me. The insurance companies that I voluntarily pay for are taking my money, but the government isn't when it is using my tax dollars to fund someone elses health care costs?

  59. kawola's comment is correct but only if you accept Healthcare is a necessity for every citizen. If you can easily afford high quality comprehensive healthcare (100% cover 100% of the time no matter what the illness including cost of prescription drugs) then you are in an economic position denied most Americans. One of the main reasons your premium is so high you are supporting a multi $billion profit making insurance company that is acting as pimp between you and your families medical needs.

  60. Wow the US buys expensive things, too bad so many people can barely afford and get screwed over by the insurance companies.. At least in the UK you can be assured of free at the point of access health care for most things.

  61. then we should do away with insurance and be direct with the company that provides the services. Insurance became a monopoly because of government intermingling. It will only continue.

  62. Many countries have UHC systems all supply on average higher rated healthcare to the average citizen the old US system at far lower cost. Many like the UK's NHS are single payer tax paid others will have a variety of ways to ensure affordable access to all. Many kinds of insurance can quite happily be privately run for profit homes,cars, income because this will depend on the customers personnel circumstances(not everybody owns a home or a car) but every body needs healthcare.

  63. Some UHC systems appear to be at a lower costs because there is more preventative measures that have already been in their society before. Japan is an example. Either way you yourself do not like listening to bureaucratic governing boards trying to define what is best for you or others. They are just politicians who only care about their term. Only human interaction solves things, Not longly written scripts by lawyers sold to you that can self contradict.

  64. you know that the affordable helathcare act was written by a lawyer named Charles B. Rangel. Yeah that's right, He Was a lwayer, Like mostly ALL of the representatives in the house. No freaking wonder why congress is so corrupt. All of them have had a career on trying to find loopholes in the law. Unfortunately there where no loopholes in this case when it was brought to the attention of the supreme court, They simply took the livingist approach to do whatever it took to get it passed.

  65. Which shows another problem with the modern world. Livignists. Aka the parasites, They consistently try to interpret the constitution as something that is living and try to redefine things. That is why in modern times there is such a large issue with healthcare to begin with. Because so many laws have been passed for it already. Big insurance companies did become the way they did for a reason. And that was because of big government.

  66. Most legal documents will be written by lawyers. Who defines the limit of your healthcare or does it depend on how much money you have? It really does not matter the facts speak for themselves if the US healthcare system was so good why the need for major reform even the opponents of Obamacare say things must change. I have human interaction with my Dr. It's my Dr (which I choose) who diagnoses who advises who prescribes it is my Dr who will pass me those with greater expertise if needed.

  67. a lawyer/politician? Someone who mixes the instability of emotions with law is just god awful. The affordable healthcare act wasn't written simply either. It is a giant mess of literature that gives the fed too much control.

  68. but that is my point. The fact that almost every member of congress is a lawyer that mostly ALL went to the same university in law. Proves how corrupt the system really is. though this current congress isn't nearly as bad as the congress was in the 30's.

  69. The fact that most of the people in your congress seemingly went to the same law school shows either you have a shortage of quality law schools in the US (I doubt it) or that particular one takes the best of the best.

  70. In all honesty I can't say that much about Obamacare but from what I read about it does seem an over complicated way of doing things. Why not a simple system that supplies affordable healthcare to every citizen with as far as is possible every citizen making a contribution yet leaves free market competition for those that can afford to choose. Yes, it would mean every citizen including the rich making a contribution via the tax system but the y do that now for the likes of Medicare.

  71. that particular one actually has a monopoly (likely) with lisencure that only few institutions are able to provide in law degrees. Which prevents competition between other potential institutions. Either way if congress and the rest of the branches where actually doing their job. Then you'd only see about 20% of the fed you see today then they states could decide what they want to be and manage their own healthcare.

  72. The best laws aren't written with hundreds of pages, They are kept short simple and straight foward just like the constitution, Which is only 4,543 words. Vs regulations fda which are THOUSANDS upon THOUSANDS of words some of which self contradict. Point is, you don't need such an astonishing amount of retarded regulations that criminalize everyone.

  73. Why don't you compare the graphs to how many people actually get sick, how many gets cured, and the effectivenes of the systems? Would't that say more about how the different countries spend their money?

  74. 40mill werent insured out of 315mill, now Obamacare has insured those other 40mill, please dont say shit if you dont live here.

  75. No one pays 60-70% in taxes, and only people who earn a lot of money will be taxed the maximum of 45-57% (57% is the max. tax in the world). And in the countries where they have a tax rate that high, doctors won't gain anything from refusing to treat a patient when treatment is posible, Their job is to help the people in need of it, not to think about the economics of it.
    Don't act like you know the european health care system, when you know you don't know anything about it at all.

  76. First, I'm sorry about the last remark, it was rude and I had a bad evening, so thank you for responding so nicely 🙂
    Hollande said that he would do what you just said under the election in France, but he has changed his mind so that the 75% tax will only concern companies and not individuals. Neither laws have been implemented yet.

  77. To me there is a difference between earning a lot of money and being rich. I am brought up by parents who earn just enough to have to pay top tax. And at least where i live (denmark) you only have to pay top tax of the money you earn in addition to the 457.620 dkk a year (roughly 60000 euro) you must earn to qualify for top tax.

  78. And my parents could still afford a two stored house, a car and three holiday trips every year. So yes, i would say that they earn a lot of money, but no they are not rich.

  79. It costs more because they can charge more because people all have insurance, private or government. If you had grocery insurance, you'd only buy steak and lobster! Why budget if it's covered?

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