HEALTHCARE IS ALL ABOUT WHO PAYS FOR WHAT

[jaeger19]

That's fine, but "people" are not obligated to accept baseless assertions as fact. Just for example, you judged the productivity of a French doctor versus U.S. based on wRVUs. I'm not sure where to find that data for the French (I did look, but CMS doesn't have data on foreign doctors that I could find), but why is that a good metric for quality healthcare? Would you as a patient rather have 5 minutes or 15 if you have a problem? France has depending on the source roughly twice the number of doctors per capita, they cover everyone, pay less than we do, and get great results. I don't see the evidence their system is inferior.

Then you tell us the quality of new doctors is crap because the best and brightest want to be in finance or tech, but then if that's true (I'd think at best it's only partially true, and who knows how you judged this), how is that evidence our system is so much better? You use RVUs to judge, then whine that in the U.S. there's more hours, stress and lower pay, to hit the RVUs in part.... Our doctors are paid a lot more, in part because the costs of medical school, then years of residency making crap pay working 100 hours a week leaves a big debt to pay off. Is that good or bad? Is it the decade post college before a doctor makes a comfortable living that discourages some hot shots who can make good money in tech a week into their first job?

Etc. I don't see a coherent comparison of one system to the other anywhere.

Well.. lets start with how difficult it is to compare one system to another.

For example. Its well established that the US pays far more than other countries.
We do. But no one really wants to discuss what the really means and why.

First... what does it mean to "pay for healthcare". ?
Most americans think it means paying for doctors visits, equipment etc... BUT most americans don;t pay for that healthcare. They pay for HEALTH INSURANCE. which then pays for healthcare and drives the healthcare system.
So while our legislators want to "lower the cost of healthcare".. and push reimbursement to medical providers down.. surprise surprise.. the ones that benefit are the insurance companies who are under no obligation to pass any savings on.

Second we need to really discuss the various ways of what is considered healthcare and why is the us expensive.
So for example.. things like cost shifting.

In france.. as pointed out.. Doctors make less. BUT.. the state has paid for their education.
Meanwhile in america.. medical providers make more.. but have to pay for their education at a significant cost.. 8 years of higher education in the US is not cheap.

So in France the cost of education is shifted away from healthcare.. and into the education system. Which makes the US look more expensive.

In france.. if you work a really tough physical job, you can retire pretty early on their social security. 55 for physical jobs.
So in france.. the fellow working on hard concrete all day, retires at 55 and gets a pension.

In the US.. that same fellow would not be eligible for retirement with full benefits until 65. So he has to spend another 10years working on hard concrete all day. And so that extra 10 years of hard labor means that when he is ready to retire... he needs a back surgery,.. or maybe a knee replacement, or a hip replacement.. that the fellow in france didn;t have to have.

So in france.. the cost was shifted from healthcare.. to their retirement system. making healthcare in the US look more expensive.

In France, if you take care of an elderly parent, there a numerous avenues for reimbursment, from tax credits to help to outright being paid to take care of your parents.
So in france.. you could have an elderly person that has a bad leg, that can;t get around, but.. while the state insurance may not cover them for a new knee so they can get around. It does provide help so that they can get by with help from their family etc.

In the US, the person will qualify for a new knee.. so that they can be more functional and continue to live indepedently.

The point being, is that simply looking at "healthcare costs"... is not a very valid way of seeing the whole picture.

this is just a small example of the issues in comparing healthcare systems and what they really cost.

You have all sorts of other issues, like demographics of obesity, sedentary lifestyles, smoking, alcohol use, stress etc, vacation time, etc,, that all factor in on why a country may pay more for healthcare than another.

 

[JasperL]

I have no idea what your age is, however I am old enough to remember when healthcare was affordable. I barely noticed the copayments or my share of the health insurance premiums deducted from my paychecks. Ultimately the HMOs blew that up and the so-called Affordable Healthcare Act made it ten times worse

Yes, very unpopular.

I'll just say that it's amazing that for decades all the GOP has managed on healthcare is to sit in the back and scream "YOU'RE DOING IT WRONG!!!" for healthcare. That's an incredible record of dismal failure, don't you think? If you think the ACA made things ten times worse, how incompetent do the GOP have to be to have offered nothing better in a decade?

It's so easy to point at ACA and say that's terrible. The hard part is doing it better. I quit caring what the right had to say on healthcare long ago, until they offer something up themselves in enough detail to see how badly their plan will also suck, which it will, because at some level any plan will have massive downsides. Then they can pass it. Then I'll give a damn.

 

[jaeger19]

It's not about whose fault it is, but what exists in reality. And the national policy subsidizes crap foods like wheat and corn, and corn sweeteners, and so make those goods incredibly cheap per calorie versus a healthy diet of meat, fruit, veggies. So if you don't have much money and you want to feed your family as cheaply as possible, what do you buy? You sure as hell don't buy whole foods, but crap processed stuff that's loaded with highly refined carbs, seed oils and sugar, all of them subsidized, and all of them contributing to the obesity epidemic, and a diet that our nutrition experts tell us is actually pretty healthy. Gosh, wonder why that is? Oh, right, a few massive companies control the vast majority of processed food and so wield a great deal of power.

And then the advice to the obese, poor or not, is CICO, and so eat less, move more, but that fails just about 100% of the obese, so the advice is given knowing it will fail, and then we all blame the obese for not succeeding following advice that fails roughly 100% of the obese. They're ALL apparently weak willed slobs....

Very true.
And then you have other issues such as work. Its hard for the family to eat right, when to make ends meet and to qualify for those extra welfare.. both mom and dad have to be working. I have patients where mom leaves for work at 6 to be at work at 7 and gets home at 4. While dad leaves at 5 to get to work at 6 to work to 2 and get home at 3 in the AM. Meanwhile the kids all have different schedules between school and practice.
Not a lot of time for meal prep, shopping etc. So what does make sense? Prepared foods that are high in fat, sugars etc but need little preparation. Like , hey kids.. tonight its chicken nuggets made in the air fryer. Or boxed mac and cheese.. yum.. etc

then other social changes like the reduction in gym classes in schools. And even bicycling. Cripes.. most of the kids in my kids highschool class graduated without knowing how to even ride a bicycle.

 

[jaeger19]

I'll just say that it's amazing that for decades all the GOP has managed on healthcare is to sit in the back and scream "YOU'RE DOING IT WRONG!!!" for healthcare. That's an incredible record of dismal failure, don't you think? If you think the ACA made things ten times worse, how incompetent do the GOP have to be to have offered nothing better in a decade?

It's so easy to point at ACA and say that's terrible. The hard part is doing it better. I quit caring what the right had to say on healthcare long ago, until they offer something up themselves in enough detail to see how badly their plan will also suck, which it will, because at some level any plan will have massive downsides. Then they can pass it. Then I'll give a damn.

Aint going to happen. The right in the gop has paralyzed the GOP and preventing anything resembling any common sense solutions to healthcare.

My fear is that the same is happening in the democratic party.

 

[LetsGoBrandon]

I'll just say that it's amazing that for decades all the GOP has managed on healthcare is to sit in the back and scream "YOU'RE DOING IT WRONG!!!" for healthcare. That's an incredible record of dismal failure, don't you think? If you think the ACA made things ten times worse, how incompetent do the GOP have to be to have offered nothing better in a decade?

No, actually the failure goes to the the democrats who went one party rule with no political cover on Obamacare. And they paid for that with massive losses at the state level and loss of the the House of Reps in 2010, as well as the Senate in 2014. The smart thing to do would have been seriously negotiating with the republican party to come up with a healthcare plan that both sides and the American people would have accepted And to suggest that the GOP has offered nothing in the last decade is a flat out lie.

It's so easy to point at ACA and say that's terrible. The hard part is doing it better. I quit caring what the right had to say on healthcare long ago, until they offer something up themselves in enough detail to see how badly their plan will also suck, which it will, because at some level any plan will have massive downsides. Then they can pass it. Then I'll give a damn.

If you quit caring about what the opposition party had to say, then you are part of the problem. To you it's all about the democrat party. The reality is that if both parties seriously negotiated, we could end up with a healthcare plan that both sides could live with. It would be give and take, but would include aspects that the democrats demand such as "pre-existing condition" coverage and a republican demand such as a true market based approach rather then insanely stupid government mandates,

 

[jaeger19]

No, actually the failure goes to the the democrats who went one party rule with no political cover on Obamacare. And they paid for that with massive losses at the state level and loss of the the House of Reps in 2010, as well as the Senate in 2014. The smart thing to do would have been seriously negotiating with the republican party to come up with a healthcare plan that both sides and the American people would have accepted And to suggest that the GOP has offered nothing in the last decade is a flat out lie.

No its not. and I am a republican. Remember the years of "repeal and replace. Cripes years off it.. and when the republicans had the all three branches of government? Bupkiss.
the truth is..that the republicans have no plan.

If you quit caring about what the opposition party had to say, then you are part of the problem. To you it's all about the democrat party. The reality is that if both parties seriously negotiated, we could end up with a healthcare plan that both sides could live with.

Yep.. but the republican party cannot negotiate with the democrats because the trumpers and right wing control the party. Case in point.. obamacare is patterned strongly after Romneycare. I.e. patterned after the healthcare Mitt Romney helped preside over in his state.
And when Romney ran for president, the right wing in the party made Romney run from his healthcare.
I will never forget when OBama in debate said "well Mitt, obamacare looks just like what you did"... and that gave Romney a perfect chance to say "well right..I did it first and here is where obamacare went wrong".

Obama basically admitted the Romney was the expert. And Romney had to run from that position because of the right wing of the party.

It would be give and take, but would include aspects that the democrats demand such as "pre-existing condition" coverage and a republican demand such as a true market based approach rather then insanely stupid government mandates,

Actually, the only way you can have a market based approach in healthcare is if you mandate that everyone obtain health insurance.

IF you don;t.. then what people will do is simply buy healthcare insurance when they get sick.. then get rid of it when they aren;t.. and there is no way the free market can withstand that.

OR you simply have people go without insurance and then go into the hospital when they are very sick and get treatment without having to pay for it. Which again.. the free market cannot withstand.

now.. unless you want to let a 8 year old boy without health insurance be turned away from lifesaving car at the hospital... the only way you can get the free market to work is if everyone has insurance.

 

[JasperL]

No, actually the failure goes to the the democrats who went one party rule with no political cover on Obamacare. And they paid for that with massive losses at the state level and loss of the the House of Reps in 2010, as well as the Senate in 2014. The smart thing to do would have been seriously negotiating with the republican party to come up with a healthcare plan that both sides and the American people would have accepted And to suggest that the GOP has offered nothing in the last decade is a flat out lie.

Sure, they have a bunch of plans, some of them napkin length. The problem comes in getting them through Congress. They've failed at that for decades, and promised their "replace" plan since the day ACA was signed.

If you quit caring about what the opposition party had to say, then you are part of the problem.

Let's be clear what I do not care about - what they SAY. You or some GOP hack can promise the moon, cheaper, better, covers more, "MARKETS!!!" etc. but none of that matters until it's reduced to a piece of legislation so that we can all see EXACTLY what the plan will do, and who it will screw over, and all plans will screw someone over. Once we know all that, get the massive healthcare industry lined up against it (or for it, depending) then line up the votes and I'll start caring.

What I do not care about are people like you crapping in the ACA with no better alternative.

To you it's all about the democrat party. The reality is that if both parties seriously negotiated, we could end up with a healthcare plan that both sides could live with. It would be give and take, but would include aspects that the democrats demand such as "pre-existing condition" coverage and a republican demand such as a true market based approach rather then insanely stupid government mandates,

See, when you say "true market based approach" you just tell me you don't know much about healthcare. We subsidize employer-based healthcare by about $200 billion, per year, for starters. Then there's Medicare, Medicaid, VA. If you want to zero all those out so we get to a "true market based approach" then that has a 0.0000% chance of getting done, and so it's DOA. Actually it's not DOA because it will never be proposed.

So I know you don't really want that, so it's impossible to know what you mean by "market based." For starters, a "market based" system cannot provide protection for those with pre-existing conditions and Democrats may demand it, but if we did away with that across the board, the entire country would be up in arms. You might have 1 of every 2 people at least being charged an insane amount because they're obese, high blood pressure, metabolic disease, etc. Every employee that gets employer provided insurance is insured without regard to pre-existing conditions. Fine, get rid of that requirement, and then the plan will fail, guaranteed.

That's what the "market" would do and did do, which is why we protected those getting insurance at work. If not our system collapses, but that's an "insanely stupid government MANDATE" that I'm sure you quite like. So you don't have a problem with "government mandates" I'm sure, but some mandates, that don't benefit you.

Etc.....

 

[Lafayette]

Healthcare is commerce like anything else. It's never free.

Bollocks!

You seem blind to the factual evidence. In Europe healthcare is Virtually-Free because governments have posted laws that make it so. It is a key component of any Bill of Rights - but that task seems Mission Impossible in America.

The United States has no single nationwide system of healthcare insurance. Health insurance is purchased in the private marketplace or provided by the government to certain groups. And "certain groups" just aint good enough.

It should be for everybody just like military protection of the US! Why the difference between Healthcare and the DoD? Where's the war by which we need the DoD ... !?!

Private health insurance can be purchased from various for–profit commercial insurance companies or from non–profit insurers. It is nonetheless far, far, far more expensive than in Europe - and whyzzat?

According to the AAMC (and don't bother finding its full name because they don't give it on their site), in 2018-2019, the average cost of public medical-school is $36,755 per year for in-state students and $60,802 for out-of-state students. That's only one reason why privatized-healthcare costs so damn much in America!

So, if you don't care to live as long as possible, then, yes, do continue with a blind attitude as regards the necessity of a National Healthcare System for America.

LONGEVITY

National Healthcare is a CENTRAL-COMPONENT of longevity. People who live in countries that have an NHS tend to live longer than those in countries that do not. See here: The Influence of Universal Health Coverage on Life Expectancy ...

 

[bave]

That's fine, but "people" are not obligated to accept baseless assertions as fact. Just for example, you judged the productivity of a French doctor versus U.S. based on wRVUs. I'm not sure where to find that data for the French (I did look, but CMS doesn't have data on foreign doctors that I could find), but why is that a good metric for quality healthcare? Would you as a patient rather have 5 minutes or 15 if you have a problem? France has depending on the source roughly twice the number of doctors per capita, they cover everyone, pay less than we do, and get great results. I don't see the evidence their system is inferior.

Oh, there is merit to the argument about whether productivity is the metric for quality, I don't disagree there. The easiest comparison is with surgeons FWIW, because it is very easy to track surgical cases comparatively in medicine. If you want to see how much someone actually gets done, over a large sample size, you pull up an ortho, neuro, or CT surgeon since you can see their number of cases per year, by case, and then compare. This is then extrapolated into wRVUs as the comparison metric. MGMA is the biggest source for tracking these data points, but they only do it for select locations (ie: Canada, Germany, France and Japan I believe).

Not all doctors are equal. France/UK specifically have a lot of GP physicians, but far fewer specialists. Good GPs are going to get you a bang for your buck, but life saving issues are almost always in specialist land. I would argue that the primary reason France has good results is that they are far healthier as a society. It's obesity, obesity, and obesity. Fat people chew up resources like crazy and then die sooner.

Then you tell us the quality of new doctors is crap because the best and brightest want to be in finance or tech, but then if that's true (I'd think at best it's only partially true, and who knows how you judged this), how is that evidence our system is so much better? You use RVUs to judge, then whine that in the U.S. there's more hours, stress and lower pay, to hit the RVUs in part.... Our doctors are paid a lot more, in part because the costs of medical school, then years of residency making crap pay working 100 hours a week leaves a big debt to pay off. Is that good or bad? Is it the decade post college before a doctor makes a comfortable living that discourages some hot shots who can make good money in tech a week into their first job?

Well, you can look at class ranks being accepted into med school. You can look at the USMLE scores for match rankings. You could look at the competitive program match rates. They are all showing more or less the same thing. The physicians being churned out today don't resemble their peers from a decade or two ago, let alone three or four.

I would counter that our docs get paid more because they are simply working longer and doing more, certainly because they are incentivized to do so. Also, keep in mind that the median household income in France is almost half that of the US. So you have to adjust their average earnings across the entire spectrum. A doc in France making half what a doc here makes is going to be roughly in line with everyone in France making half what their US peer would make, right?

FWIW, there are no more 100 hour weeks in residency. ~20 years ago they shifted to the 80 hour week, then ~10 years ago to the 60 hour week. Most attendings will tell you that has had a serious negative impact on the quality of resident at graduation, dangerously so.

And then the advice to the obese, poor or not, is CICO, and so eat less, move more, but that fails just about 100% of the obese, so the advice is given knowing it will fail, and then we all blame the obese for not succeeding following advice that fails roughly 100% of the obese. They're ALL apparently weak willed slobs....

So I was out at dinner last night with some friends, 4 of whom happen to by physicians (ENT, Neuro, Ortho, ENT) and this came up. I asked them how often their weight loss counseling has made a difference, the answer universally was give or take 1%. This has been shown in various studies as well. Americans don't want to take responsibility for their health, instead they want a gastric sleeve and a pill.

Edit: The cost of medical school has very little to do with income, imo. One good reason, docs rarely have to pay it back themselves. If you graduate with $300k in student loan debt, you can very easily find a job that will forgive that entire amount over 6-8 years. Sometimes you pay the tax on the forgiveness, sometimes no.

 

[danielpalos]

We could solve this problem via capitalism in a market friendly manner that conforms to equal protection of the laws.

Right-wingers only proclaim their love for Capitalism in socialism threads.

 

[Lafayette]

An irrelevant point. Good healthcare should benefit ALL members of society.

Yes!

Healthcare is commerce like anything else. It's never free.

No, it a service in many countries offered by the state - and uniquely private (amongst developed nations) in nature.

That is really not the issue - in Europe, which has an average lifespan 3/4 years longer than yours in the states it does benefit everybody because it is mandated by the state and provided by the state as well.

Which means that those working in state-mandated hospital services are working for the state at state-level salaries. Of course, what people do is work at a state-hospital in Europe and then move over to a much better paying private-hospitals.

The "American Hospital" in Paris one such. From its website:

N°1 in terms of Patients satisfaction
According to the Haute Autorité de Santé, which oversees the National Patient Satisfaction indicator in France, the American Hospital is France's top-ranking healthcare institution in terms of patient satisfaction, ahead of all other public or private facilities providing medical, surgical and obstetric services

However, the American hospital in Paris is covered only partially by the French healthcare-system. So, if interested in going there, be sure to inquire about its standard fees. Which are only partially reimbursed to those members also of the French Medical System as bonafide residents of the country ...

 

[Lafayette]

And every time the government takes more control of healthcare, the more expensive it gets.

Maybe in America, but not in other more sane parts of the world. Like the European Union where I live.

I am an American permanent resident of France and have benefited from both costless National Healthcare Services (NHS) and nearly free post-secondary education for my kids. Yes, like other residents of France my taxation pays for both the French NHS and France's post-secondary school system (run also by the French government).

Which means I never pay doctors for their services because the NHS does that. And I subsidize the cost of a post-secondary education at around 500/700 dollars a year, which is ridiculously low by American standards.

And much the same would be available as well in any European Union country in which I lived.

Eat your heart out ...

 

[danielpalos]

Healthcare is a right to the extent equal protection and uniform operation of the laws is also a right.

 

[danielpalos]

Hypothetically, we could solve simple poverty in a market friendly at the rock bottom cost of a form of minimum wage that merely compensates for capitalism's natural rate of unemployment. Is a single-payer or multi-payer system more optimal? We could require the public sector to offer a public option to "compete" with the private sector.

 

[LetsGoBrandon]

Maybe in America, but not in other more sane parts of the world. Like the European Union where I live.

I am an American permanent resident of France and have benefited from both costless National Healthcare Services (NHS) and nearly free post-secondary education for my kids. Yes, like other residents of France my taxation pays for both the French NHS and France's post-secondary school system (run also by the French government).

Which means I never pay doctors for their services because the NHS does that. And I subsidize the cost of a post-secondary education at around 500/700 dollars a year, which is ridiculously low by American standards.

And much the same would be available as well in any European Union country in which I lived.

Eat your heart out ...

You make it sound quite rosy, however............

French medics warn health service is on brink of collapse​

French medics warn health service is on brink of collapse

Doctors and nurses protest outside the French health ministry amid strikes at dozens of hospitals

www.theguardian.com

 

[LetsGoBrandon]

Bollocks!

You seem blind to the factual evidence. In Europe healthcare is Virtually-Free because governments have posted laws that make it so. It is a key component of any Bill of Rights - but that task seems Mission Impossible in America.

The United States has no single nationwide system of healthcare insurance. Health insurance is purchased in the private marketplace or provided by the government to certain groups. And "certain groups" just aint good enough.

It should be for everybody just like military protection of the US! Why the difference between Healthcare and the DoD? Where's the war by which we need the DoD ... !?!

Private health insurance can be purchased from various for–profit commercial insurance companies or from non–profit insurers. It is nonetheless far, far, far more expensive than in Europe - and whyzzat?

According to the AAMC (and don't bother finding its full name because they don't give it on their site), in 2018-2019, the average cost of public medical-school is $36,755 per year for in-state students and $60,802 for out-of-state students. That's only one reason why privatized-healthcare costs so damn much in America!

So, if you don't care to live as long as possible, then, yes, do continue with a blind attitude as regards the necessity of a National Healthcare System for America.

LONGEVITY

National Healthcare is a CENTRAL-COMPONENT of longevity. People who live in countries that have an NHS tend to live longer than those in countries that do not. See here: The Influence of Universal Health Coverage on Life Expectancy ...

You are correct in that American Healthcare is the most expensive, and we would like to fix that, however a nanny government is not the answer and your healthcare in France is not free. You pay for it in your taxes.

 

[danielpalos]

Organizing more militia could be one way for persons who may be unemployed to get more exercise while learning on the job.

 

[Lafayette]

You are correct in that American Healthcare is the most expensive, and we would like to fix that, however a nanny government is not the answer and your healthcare in France is not free. You pay for it in your taxes.

But it is "free" to me and all others who show the necessity.

Screw the notion of a "Nanny-government" that seems a personal fixation of yours. Yes, I am paying for healthcare in my taxes and not to a Nanny Government. When a country joins the EU it accepts to install a NHS according definitions/descriptions defined by EU-law. The countries are obliged to accept it in that form and they are held responsible for any and all transgression of that law.

Healthcare in Europe is available to all-citizens-of-a-member-state at no or very low cost! No country is excepted - and when necessary if needed in a foreign-country member of the EU your home-country will pay the bill!

I cannot see why the above could not work in exactly the same manner in the US. It's been working here in Europe since the 1950s ...

 

[danielpalos]

We should require Government to fix a Standard for a public sector option or equivalent.

 

[LetsGoBrandon]

But it is "free" to me and all others who show the necessity.

Screw the notion of a "Nanny-government" that seems a personal fixation of yours. Yes, I am paying for healthcare in my taxes and not to a Nanny Government. When a country joins the EU it accepts to install a NHS according definitions/descriptions defined by EU-law. The countries are obliged to accept it in that form and they are held responsible for any and all transgression of that law.

Healthcare in Europe is available to all-citizens-of-a-member-state at no or very low cost! No country is excepted - and when necessary if needed in a foreign-country member of the EU your home-country will pay the bill!

I cannot see why the above could not work in exactly the same manner in the US. It's been working here in Europe since the 1950s ...

Which part of the French system is near collapse did you not understand? And no the French system would not work in the USA. France has a population of roughly 65 million. The US has a population of roughly 360 million and we can barely handle Medicare.

 

[Lafayette]

$400,000

Which part of the French system is near collapse did you not understand? And no the French system would not work in the USA. France has a population of roughly 65 million. The US has a population of roughly 360 million and we can barely handle Medicare.

The same National Healthcare System is implemented throughout the European Union - that's 27 countries and 448 million people - about 120 million more than the US!

If the US post-office can work in every state, why not a National Healthcare System? Americans are too dumb to handle it? Is that what you are saying!?!

Ditto post-secondary education. An American student from a middle-class family likey cannot pay the average annual cost of college and tuition. From here:

The average cost of college* in the United States is $35,720 per student per year. The cost has tripled in 20 years, with an annual growth rate of 6.8%.

• The average in-state student attending a public 4-year institution spends $25,615 for one academic year.
• The average cost of in-state tuition alone is $9,580; out-of-state tuition averages $27,437.
• The average traditional private university student spends a total of $53,949 per academic year, $37,200 of it on tuition and fees.
• Considering student loan interest and loss of income, the ultimate cost of a bachelor’s degree may exceed $400,000.

Here's the spread of annual household income in the US:

Annual household income in U.S. dollars	Percentage of U.S. households
35,000 to 49,999	11.6%
50,000 to 74,999	16.5%
75,000 to 99,999	12.2%
100,000 to 149,999	15.3%

How many of those families earning less than $50K a year can afford to send their kids to university? How many in the next range from $50-to-75K? My guess is that not more than 20% of households can afford the cost of a post-secondary degree in the US - and a good-many would have to go into debt to finance it!

My Conclusion: Without a major effort to upscale state-school post-secondary education affordably by the Federal government without a post-secondary level degree the middle-class kids are going to have one-helluva-hard-time making a decent living in the US ... !

So what's the problem that Americans do not seem to grasp? Too many think that nothing has changed. When in fact since the 1990s significant changes in the America economy have actually occurred. Manufacturing jobs have gone downhill (barely 8% of the workforce nowadays) and Services Jobs have exploded. But the services-industries jobs (typically-but-not-all) require a higher degree-level - called "post-secondary"! (The cost of which is shown above!)

 

[Lafayette]

You make it sound quite rosy, however............

French medics warn health service is on brink of collapse​

French medics warn health service is on brink of collapse

Doctors and nurses protest outside the French health ministry amid strikes at dozens of hospitals

www.theguardian.com

Also on the news tonight: That the number of people afflicted by newest version (Coronavirus) has peaked and expected to decline this week. That is taken from the number-count published daily.

So, like other countries that have been already though the Coronavirus attack, more than likely this one will affect the EU far less.

No, it aint rosy here in France. But, you're referenced article is about a minority of French medics that strike because the are dead-exhausted. Yes, this happens - Covid has been a long two-year haul.

But, given the lower numbers of afflictions from newest version, Coronavirus, we (here in Europe) are perhaps at the end of what has been a long two-year struggle.

Time will tell ...

 

[bave]

What he is failing to mention is that the French university level education system is absolute shit. Sure, it's largely free, but you get what you pay for. France had 3 schools in the top 150 globally, with the first being ~50th, all three being in Paris, and all three being nigh impossible for a French student to attend. Meanwhile, the US has 102 of the top 150 schools.

At the same time the Median household income in the US is a mere ~80% higher than that of France.

France is a dying nation, that's the only reason you threw open the doors to immigration. It has been dying since WW1.

 

[bave]

You're referenced article is about a minority of French medics that strike because the are dead-exhausted. Yes, this happens all over - even in the US. But, given the lower numbers of afflictions from Coronavirus we (here in Europe) are perhaps at the end of a long two-year struggle.

Time will tell ...

The EU has a whole has performed almost identically to the US in terms of COVID medical outcomes. However they have enormously underperformed in economic terms. Yet again the EU dropped the ball and fell further and further behind.

 

[LetsGoBrandon]

But, given the lower numbers of afflictions from newest version, Coronavirus, we (here in Europe) are perhaps at the end of what has been a long two-year struggle.

That's the one thing we agree on. Omicron is quite likely leading us to the endemic stage.