Trump's Promises

[tobetrained]

@Pozzible in reverse of your posts: re undocumented workers/taxes. That was directed to another with the @ . I can talk to others, you know! I was following up on a mini-simultaneous convo on topic throughout this one.

Re: Nurses chart. Well, you need to adjust for cost of living or per capita incomes. In the UK, poverty can defined in a number of ways. The government links to  the following charity.

Government site [think before following links] [think before following links] [think before following links] https://commonslibrary.parliament.uk/research-briefings/sn07096/

Joseph Rowntree Foundation - a nonpartisan poverty charity
[think before following links] [think before following links] [think before following links] https://www.jrf.org.uk/uk-poverty-2025-the-essential-guide-to-understanding-poverty-in-the-uk 

That foundation has a calculator
[think before following links] [think before following links] [think before following links] https://www.minimumincome.org.uk/results/

This says, for a single person without kids, UK poverty is about 30.5k/yr GBP.

Here is the pay guide from the nurses job board Nurses.co.uk: [think before following links] [think before following links] [think before following links] https://www.nurses.co.uk/nursing-pay-guide

• They report, the starting point for qualified nurses (stated as "band 5") is 31.0k/yr GBP -- effectively poverty.
• They also state the average nurse salary is around 39k/yr GBP. This is poor, by multiple definitions.

They're not the worst across care providers. Here the Commonweath Fund -- which I believe you mentioned as defining the US as worst of developed countries. It definitely is used by progressives. 
[think before following links] [think before following links] [think before following links] https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024

In the chart below is their overall score and rank (shaded gold). I then added two variables to expand the data:

• Nurses' average salary, adjusted for per capita income
• Primary Care Physicians' average salary, adjusted for per capita income

The US moves to 4th overall (see column, "New") while Germany drops to 10th and considerably by the Commonwealth Fund's metric definitions (from -0.15 to -0.45):

to that end, that's why I tried to quickly get info on Germany in my post yesterday. You're correction I can see when asking for the data in a one-off question. so, let's correct the record to that from the 50% to 75%, german docs still practicing domestically after 10 years. Tho, I still get the 50% figure when asking for increments, from 1- 3-, 5-, and 10-year increments in one or a series of AI questions.

But I don't want spend more time looking into it!  It really wasn't that relevant from my point:

In the universal care systems, costs are controlled by low nurse and doctor pay, and they're regulated which limits worker economic freedom.

Interestingly, and this gets to the German doc convo a bit too, both US and Switzerland jump with incomes. The source your AI used, @Pozzible, notes German doctors leaving predominately come to the US and Switzerland due to better salaries and advanced technologies, among countries in Asia for same, ~30% of those who leave Germany.

Here's a specific link to the issues in the German healthcare system due to low wages:

[think before following links] [think before following links] [think before following links] https://schengenvisainfo.com/news/germanys-healthcare-staff-shortage-crisis-to-further-deepen-without-foreign-doctors/

Edited 11 hours ago by tobetrained
corrections.

[Pozzible]

@tobetrained I responded to some of these ideas in a long response to your DM last night. I didn’t realize that you had already left that conversation and I was takling to myself. 

Adjusted salaries don’t take into account all the other social benefits that doctors/nurses get by living in their respective countries. Again, such things child care, vacations, crime, culture, happiness, quality of education for their families (and cost of healthcare for their families.) And all of that isn’t taking into account current political turmoil in US.

I know things aren’t great in UK; but some of that is due to Brexit. And, of course, there are lots of different models for UHC around the world. I briefly lived in Finland and was incredibly impressed after two visits to the ER. But then other professions there are pretty terrific, too. The education system is remarkable. And teachers are highly respected, valued, and paid. 

If universal healthcare is such a failure, by now many of the countries would be abandoning it. Has ANY country moved from a UHC model to emulate US system? I asked Chat GPT5….

“Has any country that has had universal healthcare abandoned it for a market-based system?”

“Surprisingly, the answer is no country that has fully implemented a universal healthcare system has ever dismantled it and replaced it with a purely market-based model.

Once universal healthcare is established:

Political legitimacy: Citizens view healthcare as a right, not a commodity; attempts to remove it are politically suicidal.

Public dependence: Millions rely on coverage daily — removing it would cause mass instability.

Economic inefficiency of private markets: Countries that rely more on private insurance (e.g., U.S.) show higher costs and worse outcomes, deterring others.

Entrenched institutions: Hospitals, billing systems, and training pipelines are designed around universal coverage.

In contrast

The United States remains the only high-income democracy never to have adopted full universal coverage.

U.S. reforms (Affordable Care Act, Medicare, Medicaid) expanded access but retained a mixed private/public structure.

✅ Bottom line:

No country that has achieved true universal healthcare has ever abandoned it for a market-based system.

The political and social costs of reversal are simply too high — and the evidence shows universal systems deliver more efficient and equitable outcomes.

 

So, I remain convinced that almost all other countries have indeed figured out how to make UHC work.

[tobetrained]

@tallslenderguy and co, on the Ukraine topic from way back in page 1, this continues what I had suggested was the latest round in that discussion, our pressuring Europe to stop buying Russian energy (which helps fund their war effort). This being the second stick-approach with Europe. (first being for them to get to NATO defense agreements of 2% GDP, which now many are; and they've been increased to 5% GDP by 2030)

[think before following links] https://www.bbc.com/news/articles/c17p54edxljo

[tobetrained]

@Pozzible I didn't know how that worked, DM. I tried deleting a different message -- as there seems to be a limit on number of messages -- then everything went away.

Right, no country will drop UHC as it is political suicide: see current US shutdown! Which is why certain programs shouldn't be added in the first place !! haha.

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Current Trends in Private Health Insurance in Europe

Rising Demand: The demand for private health insurance is increasing due to constrained public healthcare systems and long waiting times. Patients are seeking quicker access to medical services, leading to a shift towards private options.

Market Growth: The European health insurance market was valued at approximately €283.1 billion in 2023 and is projected to grow at a compound annual growth rate (CAGR) of 6.31%, reaching around €405.3 billion by 2029. This growth is driven by an aging population and the increasing complexity of healthcare needs.

Coverage Variability: Health insurance structures vary significantly across Europe. Some countries have socialized systems, while others offer a mix of public and private insurance. In many nations, health insurance is mandatory, requiring contributions to national funds, while in others, it is voluntary.

Technological Integration: The integration of technology in healthcare is transforming service delivery. Digital health solutions, telehealth, and health management platforms are becoming more prevalent. These innovations aim to improve efficiency and patient outcomes, shifting the focus from reactive treatment to proactive health management.

Health Protection Gap: There is a growing recognition of the health protection gap, where many individuals lack adequate coverage for medical expenses. Insurers are focusing on bridging this gap by offering more comprehensive policies that include critical illness and disability coverage.

source: researchandmarkets.com

Increase in Private Health Insurance Among Europeans

Reasons for the Shift

Long Waiting Times: Many public healthcare systems in Europe face significant delays, prompting individuals to seek quicker access through private insurance.

Quality of Care: Patients often prefer private healthcare for perceived better quality and more personalized services.

Financial Pressure: Rising out-of-pocket costs in public systems lead some to opt for private insurance to mitigate financial risks.

Key Statistics

Year     % Population with Private Insurance; Notable Trends Point
2023     ~30% (some level, not necessarily full coverage);  Increased interest in private options post-pandemic
2025     ~35%+ (some level, not necessarily full coverage); Continued dissatisfaction with public services

This trend indicates a significant shift in healthcare preferences among Europeans, with many opting for private health insurance to ensure timely and quality medical care.

source: lek.com
[think before following links] https://www.lek.com/insights/hea/eu/ar/private-healthcare-demand-europe-rising-demand-and-changing-preferences

Those % seemed very high. It's from survey data in the context "had you done this" and not a tally of actual agreements. example: yesterday 70% of people watched TV or streamed video, but the rate at any one moment would be like 25%. I did read UK's private market was 8% (latest) and expected to pass 10% soon, for instance -- yet, below, ~45% in the UK have used private insurance at some point in time (first column below).

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YIKES: a market-driven decision -- people deciding for themselves. I think this suggests, long-term, we will all move to a mixed system. Government to require or provide super basic care with incremental private options -- either full or select coverage (e.g., someone may opt not to get eye care coverage).

[Pozzible]

12 minutes ago, tobetrained said:

Right, no country will drop UHC as it is political suicide: see current US shutdown! Which is why certain programs shouldn't be added in the first place !! haha.

That’s an interesting way to view it. So, we should never have banned slavery because to reinstate it would be political suicide. I see how this works! 😉

 

10 minutes ago, tobetrained said:

think this suggests, long-term, we will all move to a mixed system. -- either full or select coverage (e.g., someone may opt not to get eye care coverage).

I think almost everywhere is already a mixed system. And a good first step is for “government to require or provide super basic care with incremental private options.” Which is sorta what ACA along side premium subsidies does.