> The article by Himmelstein et al1 in this issue of the The American Journal of Medicine documents that health care expenses were the most common cause of bankruptcy in the United States in 2007, accounting for 62% of US bankruptcies compared with 8% in 1981.2

https://pmc.ncbi.nlm.nih.gov/articles/PMC6366487/

> Table 1 displays debtors’ responses regarding the (often multiple) contributors to their bankruptcy. The majority (58.5%) “very much” or “somewhat” agreed that medical expenses contributed, and 44.3% cited illness-related work loss; 66.5% cited at least one of these two medical contributors—equivalent to about 530 000 medical bankruptcies annually.

There's about 500 000 medical bankrupcies in US per year. That's huge.

Also - medical debt (not even bankrupcy necessarily) contributes significantly to homelessness:

https://publichealthpost.org/health-equity/medical-debt-home...

https://pubmed.ncbi.nlm.nih.gov/32513034/

> two-thirds [of homeless interviewed] reporting current medical debt. Almost half reported trouble paying medical bills for themselves or family members. Almost one-third believed medical debt was in part responsible for their current housing situation. More than half with medical debt incurred this debt while they were covered under insurance. People who had trouble paying medical bills experienced a more recent episode of homelessness 2 years longer than those who did not have such trouble, even after controlling for race, education, age, gender, and health status

Badly controlled medical system with bad incentives caused opioid crisis.

Bad incentives (government and healthcare system earning money on people getting sick instead of losing money on them) also makes it less likely for the system to focus on healthy work-life balance (paid maternity leave, paid vacations, good preventive care, education for healthy lifestyle) and instead focuses on expansive aftercare.

> Bad life expectancy is concentrated in the poorest Americans. Which is not a good thing to say about this country, but it does mean that most Americans live longer.

I've seen this defence many times, in different contexts, and it always strikes me as very strange. Why do you assume most Americans are rich? And why do you assume they are the ones that matter? Very weird. But let's take it at face value.

Looking at the graph of life expectancy vs percentile of income - US seems to be below 80 years for 50th percentile:

https://preview.redd.it/at-every-income-level-us-americans-l...

Which would make your point false regardless of the weirdness of it.

Another interesting graph: https://ourworldindata.org/cdn-cgi/imagedelivery/qLq-8BTgXU8...

I would not call it "OK".

> What do we call a place like Hungary which is quite a bit below the US here?

I could do the trick you did, sayign that Hungary has the same life expectancy as Illinois, and richer parts of EU has better life expectancy, therefore Hungary doesn't matter. That would be disingenious tho. It does matter, and healthcare in Hungary obviously isn't doing OK. It is more cost-effective than US tho.

Also my bad, it's 65.7% for US and 87.3% for Poland

It's objectively not "working OK" for most Americans, especially when you consider how much you spend for subpar results.

Source: https://www.worldometers.info/demographics/life-expectancy/

Now you can blame it on bad lifestyle, addictions, car culture, crime rate, etc. All true, and idiotic healthcare system is indirectly influencing all of that.

That's because GDP measures how much you did in one year, and wealth is accumulated over centuries.

Using GDP to measure wealth is like using speedometer to measure distance. You can be the fastest on the road at the moment, but if you just started driving and people drove faster than you for 100 years it doesn't mean much.

You need to integrate it over time.

So why not make fun of them? There's no downside.

https://www.oocities.org/stanislaw_lem/opowiadania/opowiadan...

A solution for a military AI gone awry that built a terrifying electro-dragon was obviously to build a super-electro-dragon.

So now instead of improving the tools of biology so we can actually understand it deeply - we increase complexity of IT so we have to rely on muddy, side-effecty tools of biology to try to infer some of the properties of the systems we made. That's depressing.

And if we're talking businesses, building crews etc. - this is what they actually need: https://img.linemedia.com/img/s/flatbed-truck-3-5t-Volkswage...

Or just a regular van more likely, cause rain is a thing.

VW crafter with dual cab uses 57% of its length for the flatbed, largest F150 - 39%. Notice how the engine fits into this tiny vedge-shaped hood.

https://i.imgur.com/KopGeTi.png

Same idea as American trucks, more cargo space, higher usable load, can be loaded from all sides, completely flat bed, no wheel cutouts, fits 6 people inside, burns less fuel. All because there's no ridiculously huge hood, wheels and engine.

Let's be honest here. American pickup trucks are not about the usability, they are about ego.

How is a tall hood increasing your family comfort? It only increases your ego.

Same with going from 99% to 99.5% efficiency. It still reduces the cooling needed by half.