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

A discussion about US health care costs. Created by Sal Khan.
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Пікірлер: 104

  • @FriendofBill-2005
    @FriendofBill-200512 жыл бұрын

    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.

  • @asrr62

    @asrr62

    Жыл бұрын

    that is just wrong.

  • @nriab23
    @nriab2312 жыл бұрын

    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.

  • @johnlaycock1941

    @johnlaycock1941

    28 күн бұрын

    The health care system in the USA is a profit making business like any other business.

  • @Thegamemakur
    @Thegamemakur12 жыл бұрын

    Thank you for this!

  • @therealrealist67
    @therealrealist6712 жыл бұрын

    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?

  • @Actongue
    @Actongue12 жыл бұрын

    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.

  • @derbigpr500
    @derbigpr50013 жыл бұрын

    @tutortronix They actually go to germany, norway, sweden, switzerland, france, austria to get treated too...yes.

  • @davijeph
    @davijeph11 жыл бұрын

    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.

  • @ijamesza016
    @ijamesza01613 жыл бұрын

    This is awesome :D

  • @Melthornal
    @Melthornal13 жыл бұрын

    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.

  • @MichellleBellle
    @MichellleBellle11 жыл бұрын

    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.

  • @annoloki
    @annoloki13 жыл бұрын

    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

  • @dannyledwith21
    @dannyledwith2113 жыл бұрын

    @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).

  • @jchengimpact
    @jchengimpact12 жыл бұрын

    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

  • @vapssu
    @vapssu13 жыл бұрын

    yay more economic vids

  • @Cyno7
    @Cyno712 жыл бұрын

    @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?

  • @electronpusher604
    @electronpusher6047 жыл бұрын

    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?

  • @dannyledwith21
    @dannyledwith2113 жыл бұрын

    @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.

  • @sinistar99
    @sinistar9913 жыл бұрын

    Emergency room for regular health care for people who are uninsured costs us a lot.

  • @theleadershipspace
    @theleadershipspace2 ай бұрын

    Does the rise of HMO’s in the 1970’s account for the breakaway in price dynamics between the US and other countries?

  • @davijeph
    @davijeph11 жыл бұрын

    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.

  • @gartner101
    @gartner10112 жыл бұрын

    @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

  • @Cyno7
    @Cyno712 жыл бұрын

    @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.

  • @SalsaTiger83
    @SalsaTiger8313 жыл бұрын

    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.

  • @WecksyRex
    @WecksyRex13 жыл бұрын

    @voiceofreason467 He's also talking about total health spending as a percent of GDP increasing.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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)?

  • @Cyno7
    @Cyno712 жыл бұрын

    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

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    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.

  • @tetleydidley
    @tetleydidley13 жыл бұрын

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

  • @pmccarthy001
    @pmccarthy00113 жыл бұрын

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

  • @sinistar99
    @sinistar9913 жыл бұрын

    @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?

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @Cyno7
    @Cyno712 жыл бұрын

    @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

  • @humanhiveanomaly
    @humanhiveanomaly13 жыл бұрын

    Isn't the AMA great?

  • @phazon100
    @phazon10013 жыл бұрын

    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.

  • @Beauweir

    @Beauweir

    4 жыл бұрын

    I think you will find you will get amazing doctors and nurses for free in other 1st world countries. I'm not sure why you assume just because the US screws over its citizens, financially, that it has the best healthcare in the world.

  • @phazon100

    @phazon100

    4 жыл бұрын

    Beauweir we do have universal healthcare. It’s called Obamacare. Obama made our healthcare better.

  • @davijeph
    @davijeph11 жыл бұрын

    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.

  • @marsCubed
    @marsCubed13 жыл бұрын

    @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.

  • @BarronFarlig
    @BarronFarlig11 жыл бұрын

    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?

  • @davijeph
    @davijeph12 жыл бұрын

    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.

  • @SalsaTiger83
    @SalsaTiger8313 жыл бұрын

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

  • @WecksyRex
    @WecksyRex13 жыл бұрын

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

  • @Cyno7
    @Cyno712 жыл бұрын

    @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

  • @davijeph
    @davijeph11 жыл бұрын

    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.

  • @jasonbeattie4362
    @jasonbeattie43624 жыл бұрын

    US has more unnecessary treatments because the doctors are incentivised to give them. The UK benefits from economies of scale when it buys its drugs. The NHS is one organisation buying the drugs. The UK spends far less on legal fees and insurance related to medicine mal practice

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @dannyledwith21
    @dannyledwith2113 жыл бұрын

    @phazon100 preach it brotha

  • @baron8107
    @baron810712 жыл бұрын

    @phazon100 And then there's the way the doctor handles it.

  • @aSheeple
    @aSheeple13 жыл бұрын

    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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @TotalProFoSure
    @TotalProFoSure7 жыл бұрын

    I swear you sound like DJ vlad.

  • @MichellleBellle
    @MichellleBellle11 жыл бұрын

    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.

  • @eyyy2271
    @eyyy22717 жыл бұрын

    Single-payer. NOW.

  • @MichellleBellle
    @MichellleBellle11 жыл бұрын

    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.

  • @sinistar99
    @sinistar9913 жыл бұрын

    @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.

  • @MichellleBellle
    @MichellleBellle11 жыл бұрын

    your channel info says different

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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).

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @Darusdei
    @Darusdei12 жыл бұрын

    @phazon100 according to mistreatmeant statistics, even that is not exactly true...

  • @sinistar99
    @sinistar9913 жыл бұрын

    @iasedu And so are the weemen! lol.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @gartner101
    @gartner10112 жыл бұрын

    @Hperman09 Are you paying attention. Europeans spend LESS on healthcare but get better health outcomes

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MichellleBellle
    @MichellleBellle11 жыл бұрын

    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.

  • @hagilerman6803
    @hagilerman680313 жыл бұрын

    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

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @nolastnamegiven87
    @nolastnamegiven8712 жыл бұрын

    kkk

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @marsCubed
    @marsCubed13 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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?

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @MrTheLoones
    @MrTheLoones12 жыл бұрын

    @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.

  • @TheeImmortalPhoenix
    @TheeImmortalPhoenix13 жыл бұрын

    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.

  • @bretert
    @bretert7 жыл бұрын

    Europe had excellent socialized healthcare due to their homogenetic societies. All that is about to change.

  • @b1141

    @b1141

    6 жыл бұрын

    I've been saying that for years. Small population, homogeneous group makes it easy to have universal healthcare. Once a population gets to a certain size costs EXPLODE

  • @LagartoPT

    @LagartoPT

    6 жыл бұрын

    Why do Americans talking about Europe sound so ignorant ?

  • @meiketempel8430

    @meiketempel8430

    6 жыл бұрын

    I don't think Americans really know what Europe is actually like

  • @Donnah1979

    @Donnah1979

    6 жыл бұрын

    Silly Americans: 1) We're all human beings. 2) a bigger population gives a bigger tax income 3) Pretty much ALL other countries have figured out how to do this. If you can't figure out how to implement Universal Health Care at a Federal level, then you could at least implement it at the State-level. 4) You don't know S**t about Europe, so don't even try.

  • @marsCubed
    @marsCubed13 жыл бұрын

    @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.