The overwhelming majority of a person's expenditures (Housing, education, medical, most of the food you buy at the grocery, many forms of transportation) are not covered by VAT. Many forms of energy (residential electricity, gas) are covered at a vastly reduced VAT.
And, again, the giant bugbear that is health insurance rears its ugly head on the US side. See the overall 'Taxes as a % of GDP' comparisons.
Edit: I stand corrected about taxes as % of GDP. You are right, that the UK is at 33.5%. [1] Unfortunately, again, that doesn't include the percentage of US spending on healthcare - which is 17.8% of its GDP, with much of it coming out of after-tax dollars, instead of pre-tax ones. (Medicaid and Medicare make up about a third of that - and are, obviously, financed by taxes.)
> And, again, the giant bugbear that is health insurance rears its ugly head on the US side
Sure, yes, that's a bigger non-tax expense for individuals in the US. The US having by far the least efficient healthcare system in the world is a huge problem.
> See the overall ‘Taxes as a % of GDP’ comparisons.
Yes, I’ve updated my post to address your wildly inaccurate “Taxes as a % of GDP” comparison, using the most recently published OECD data which shows that you were close for the US, and way low for the UK.
And I've updated my post to point out the mountain of US post-tax healthcare spending, that in the UK, largely comes out of pre-tax pounds.
At the end of the day, Americans still pay, and pay more. 26% in taxes, and then another ~11% in non-government-covered (non-Medicare/Medicaid) healthcare spending.
I've been corrected (my initial data was wrong, I've updated my post), and I agree on both points.
I do, however, posit that when it comes to determining whether an economy/society/??? is healthy (which is the conversation in this sub-thread), we need to look at all of these 'costs of life/business'. So, yes, the sticker price on the UK looks rough, but add it all up... And it comes out to be pretty similar. As it turns out, providing similar forms of services costs... About the same, across the developed world.
Really? I have top of the line healthcare through my employer in the US, which also covers my wife and teenage daughters, which costs me essentially nothing. NHS in the UK is collapsing, but even if it didn't, qualitatively it's orders of magnitude worse than what one would receive in the US through one's employer:
Months to years for an appointment, incompetent doctors and a bureaucracy that puts Kafka to shame.
> Really? I have top of the line healthcare through my employer in the US, which also covers my wife and teenage daughters, which costs me essentially nothing.
Very few people in the US have top of the line healthcare (hence, why its “top of the line” and not “typical”), and if you do it costs a lot per covered person, even if it is less visible because instead of a salary deduction instead a large chunk of money that the company is willing to pay for your labor just goes straight to an insurer without being part of your nominal pay.
(I, too, as I suspect is fairly common for HN readers given the demographic tendencies, have excellent healthcare in the US, abd most of the cost isn’t a salary deeuction, but the cost is nontrivial.)
> NHS in the UK is collapsing, but even if it didn't, qualitatively it's orders of magnitude worse than what one would receive in the US through one's employer:
Over 1/5th of US workers (not residents, people actually employed) aren’t eligible for any employer health insurance, and for many of the rest it is quite bad, with very high out of pocket costs if you actually need any non-preventice care. NHS may be worse than what you or I have through our employers, but “top of the line” isn’t the usual experience.
> Yes US healthcare has issues but it's nowhere near as bad as UK.
...if you are part of the relatively narrow elite in the US with top of the line coverage, and for that the US pays more than a time and a half what the UK does as a share of GDP, and more than double what the UK does per capita...while leaving over 12% of adults and 5% of children uninsured.
So you have an employer paying tens of thousands a year to get you health insurance, leading to a situation where only the most well off can have access to healthcare. The NHS is struggling because there's a shit load of people to treat with very little means. The US healthcare system is doing well because it leeches money off of the most well off and lets the poorest die.
> money off of the most well off and lets the poorest die.
A very significant proportion of US population is covered by Medicaid and if more if you add Medicare. In fact the US government spends almost 50% more on healthcare than Britain does (and that’s only public spending..). The problem is that the system is simply extremely inefficient.
Just look at Switzerland healthcare is privatized to a much higher degree than in the US yet still more accessible…
combined with ever increasing inequality offers a much better explanation. Inequality is high in the US too but at least they have a lot of growth which means that the bottom 80% or so are at least not getting poorer.
That may be the reality that some experience, I obviously couldn't say they are wrong.
But it isn't always the case. Where we live the NHS is excellent, appointments are fine, doctors are competent, and we've had no issues with bureaucracy. There is literally nothing I'd complain about, and we have double-digit interactions with the NHS each year.
The only fly in the ointment is the recent nurse strike happened on a day the wife was scheduled for some surgery, so that was cancelled. But I support them in that, and the rescheduled date is less than a month later.
There are issues everywhere, but there's no way I'd swap any of it for the US version. And always bear in mind that negative talk sells more papers/gets more eyeballs than positive.
That’s a specific issue caused by the Tories deliberately running it down. Pre-2010, the situation was very different. You didn’t have things like the Annual Winter Crisis (which now extends through to autumn).
Luckily, Labour will win the next GE, so they can start to turn this around.
Pre 2010 (well pre 2008 to be fair) UK had a higher or similar per capita GDP as the US, now it’s not even close. If the current trend continues it will be almost double in a few years.. Other European countries have been doing a bit better but it has clearly been a ‘lost decade’ in most of Western Europe and you can’t really blame the tortes for that.
> Other European countries have been doing a bit better
The UK has had the worst pandemic recovery almost anywhere in the developed world. How many other countries have an annual "Winter Crisis" in their healthcare that's extending into autumn and summer?
The Tories have been in power since 2010. They're the common factor in the many issues the UK is currently facing.
Everything that happened since Brexit is a disaster and it’s mainly the fault of conservative party and their voters (also labor picking comrade Corbyn to be its leader meaning there weren’t really any reasonable alternatives..). Combine that with the overall trend of decline/stagnation across Western Europe and you’ve got something…
Look at Switzerland. Fully privatized (too a much higher degree that the US in fact) very high quality yet significantly cheaper (still much higher total spending than any other European country). Yet the US government alone (so excluding private spending) spends about the same on healthcare (as % of GDP) as Britain but without even basic universal coverage…
And, again, the giant bugbear that is health insurance rears its ugly head on the US side. See the overall 'Taxes as a % of GDP' comparisons.
Edit: I stand corrected about taxes as % of GDP. You are right, that the UK is at 33.5%. [1] Unfortunately, again, that doesn't include the percentage of US spending on healthcare - which is 17.8% of its GDP, with much of it coming out of after-tax dollars, instead of pre-tax ones. (Medicaid and Medicare make up about a third of that - and are, obviously, financed by taxes.)
[1] https://www.oecd.org/tax/revenue-statistics-united-kingdom.p...