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As a Brit who moved back home a few years ago after 7 years in the US, I am also very interested in this debate.
To be honest, since moving back, it feels like my standard of living has continued to improve along the lines of a typical mid-life success sequence. Lots of stuff is cheaper in the UK; groceries, phone plans, and pharmacy items are all examples. The NHS makes private health insurance strictly unnecessary, but as the NHS gets more stretched, more and more of us middle-class Brits have it. But my wife and I pay £250/month for a very nice private policy that covers us and the kids and has very good deductibles and copays.
On the other hand, wages are dramatically higher in the US (if my wife were working in the US in an equivalent role, she’d be earning 3x her current salary). Also, US suburban house prices and sizes are extremely reasonable by UK standards.
One extra bit of context that may be useful: British people love to moan, whether it’s about the weather, public transport, or overpaid celebrities. It’s practically a national pastime. Similarly, we like to talk about national decline, precisely because we have generally quite positive associations with the past; these differ across the political spectrum, of course, with eg the left being more likely to get nostalgic about pre-Thatcher days of strong unions and national industries, but they’re there. Brexit has supercharged a lot of these pessimism/declinism narratives, with the globalist side of the political spectrum keen to point to Brexit as the cause of this new phase of decline (even worse than the previous one!). So I’d caution Americans and other non-Brits from getting too sucked into this — while Britain does have real problems, the whole debate is also systematically infested by national psychodrama.
Standard of living is steady because Britain is still consuming a lot. That's not a contradiction if the country is funding that consumption through more debt (both public and private) or through selling assets. That's not sustainable, and part of the recent economic problems has been people realizing that the party can't go on like this forever with no sign of growth.
Every country has it's own self-image and psychodrama - Britain's is only noteworthy because it's the one most legible to Americans, and because it is probably going to destroy the country if it carries on.
If I've learned anything from observing the American Debt drama, it's that increasing debt is the most sustainable thing in the world.
The UK, isn't America. America has gotten away with high levels of debt because it is growing. It also faces a less steep demographic hill.
US tfr is like 1.65, UK is like 1.62, not a huge difference. Immigration levels per capita are similar, the UK is notably higher officially but the US sees more illegal migration which probably cancels that out.
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Most of this comes down to "Britain is the second-largest Anglo country after the US, with Canada and Australia in distant 3rd and 4th place". And the UK isn't going to be destroyed by poor governance, if it is destroyed by anything it will be large scale population movement/change, and that's as true for France and Germany and Sweden as it is for the UK.
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£250/month, especially when it's for what I assume is some sort of gap insurance to cover what the NHS can't, sounds really high to me. That's ~$320 a month. Here in the US, at my last 3 or 4 employers, the monthly premium for the nicer plans has never been more than about $200/month after my employer's contribution. And there are always high deductible plans that are significantly cheaper than that.
Wasn't employer health insurance in the US started off as a way around caps on salaries/high taxes? Instead of paying Jim Smith $5,000 a month and he pays the full whack of taxes on that, you pay Jim $3,000 and offer him a health insurance scheme?
Something like that anyway, and then it became a way of enticing workers in tight labour markets - we offer health benefits! - and now it's become the way you pay the sky-high prices for medical care, and the prices can be sky-high because the providers assume everyone will be paying via insurance?
As such, this is another way that trying to transfer incomes has shot ourselves in the foot. We wanted to transfer incomes, so we came up with ideas like capping salaries or putting high taxes on high salaries. But the market still wants to pay people for skills, so various benefit schemes arose. Many of them have been slowly neutered, but the "healthcare and education are wonderful" effect makes it difficult to pull back on employers contributing to healthcare.
However, the guiding principle for healthcare policy is transferring incomes from the young, wealthy, and healthy to the old, poor, and sick. To do this without letting people in on the secret of just how insanely much it is doing this, it has to be designed in a way to maximally hide everything that is happening. So, nobody sees. Sure, I can kinda see how my mother is able to fight cancer using the best treatments in the world, hopping in to and out of the hospital as her condition goes up and down, while only paying her OOPM for the year so she doesn't even have to think about the "cost" of any given treatment choice... but I can't really see all the millions of people who are essentially forced to pay for it.
The side effects of all of this hiding are pretty brutal. First, since no one knows how much any actual thing costs, it leads to all the price inflation/"discount" games and ultimately, more money going to the healthcare industry. Since the healthcare industry benefits from this, they're more than happy to work with the government on the income transferring piece as a sort of baptists/bootleggers union. Second, they have to actually figure out how to force people to pay into the scheme, which results in the punishments needing to be harsh for people who are young and/or wealthy and/or healthy who try to opt out of having their income transferred away. Since it turns out to be slightly difficult to simply coerce individuals directly (see the individual mandate SCOTUS case) and because historical efforts to futz with the tax system resulted in widespread employer plans, by far the best mechanism the government can use to force people into this income transfer is by coercing employers. After all, they're the ones currently footing the accounting bill for a massive amount of the hidden costs!
The final result is a massive and perverse system that absolutely crushes people for, for example, lose their job and suddenly realize that buying their own insurance is incredibly expensive. We try to transfer incomes back to these folks via a variety of means, but the whole edifice of constant problems stems from our constant desire to transfer incomes more and more, in every situation possible, but trying to hide how much we're doing it.
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Huh, I hadn't actually heard that before but seems to be so, plus taking advantage of the new tax deduction.
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It’s £250/month for a family of four with a £150 annual deductible, and it’s specifically to allow us to get electives done quickly in fancy hospitals.
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It might be hard to compare but I have a decent gap insurance in Sweden and that is like 18$ a month and I've never had any co-pay. Let's say we have a family of four, thats about 70$ a month (rates are different for children and usually bundled with other insurance policies so it makes it hard to add them up).
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Most PMC employers in the UK like mine pay for private health insurance with no monthly premium. This includes all of big tech, finance, consulting, corporate law etc.. The deductible is usually pretty reasonable. £250/month for two people is pretty reasonable, it's mainly to guarantee you a US-style of care in case you get cancer or something else very serious, where you might spend weeks in hospital. I still think the figure seems high though, looking at the BUPA website and pricing in young people with no underlying conditions etc..
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