Those are alarming factors about the industry. I am saddened by these greatly. Thank you for sharing them.
It's not all bad news. Some are definitely in it to try to make people better. I actually was ahead of the curve - most Oncologists and people working in oncology last an average of 7-9 years before changing their fields or moving in to something more adjacent. I lasted a lot longer. The system is brutal in the states.
The issue is the medical field is for profit in the states. It wasn't always that way, but since LBJ took office, things started to change and go mroe private. Everyone knows Kaiser Permanente, right? But did you know Kaiser used to have WWII ship yards that made insane amounts of money? If not for him, we wouldn't have had liberty ships in the numbers we did(
https://en.wikipedia.org/wiki/Henry_J._Kaiser). You could argue he is the pinnacle of the American dream.
He did so well, he created a health care system for his employees and their entire families. And this basically brought on the entire employer and private health care system we see stateside. It wasn't intentional - no one had great health care in 1942, after all. But it opened the door to privatize it, shuttering state hospitals along the way.
Zoom to today - it's become an industry. No where else in the world is it described as such. In fact, most other health systems now rely on the US to do all the R&D and put up the investments so their systems can reap the benefits later at greatly reduced costs. Here's an example:
Under our system here in Ireland, which I will be the first to tell you is not great, to get a CT scan done can take weeks or months if it is elective and not an emergency - for a charge of €50. But, without any insurance, you can go to a semi state run/privatised clinic like we used to have stateside and pay to have it done, likely within days. I did this for my MIL - it cost me €450. You won't be getting a ct scan in any hospital or clinic for that much stateside. You can also get medical insurance. It is available from the state or privately. It usually costs 40-60/mo, and they can not turn you down for having a condition. But, they don't need to, if you have a condition the state run hospitals usually are already treating you at a reduced cost. If you had private insurance, that scan would be free in a private clinic at 40-60/mo.
Yes, everyone in the health system makes less money in Europe than they do stateside. This is why you see a lot of foreign nationals in our US health system, afterall. They get affordable education in Europe, then some relocate to the states to make more cash. Having said that, Bayer, Pfizer, GSK, Siemens and Philips do a killing stateside(almost literally -
https://biopharmguy.com/links/country-belgium-all-location.php - and thats not including manufacturers) . YOu'll see a lot of Belgian companies doing this. They aren't Belgian, they are just taking advantage of the corporate tax system there. Which is under attack by the EU as we speak, of course.
Yes, the income taxes are much more in Europe. Well, it depends. Most systems are heavily graduated. So, like for myself, I pay no income taxes since I make so little. Up to about €19-32K in most systems, your income tax is almost negligible(but your tax burden is still up there for road taxes, cars, etc unless you modify your behavour like we did - purchasing small cars, diesels, etc). After that, it spikes quite a bit, up to 59% for over 150K or so like in some Scandivian countries. AJ could tell you what it is like in the UK. It used to be really bad there - it was the reason the Beatles wrote the song 'tax man'. 19-1 over something like 100k at the time. WTF? You want to make your wealthy move to Belize? That's how you do it.
Well, I also paid very little income taxes when I was stateside. To avoid incriminating myself, let's say it was shockingly low. If I made as much here in Ireland, the tax load would have been 5X higher. But that company declared bankruptcy and reformed later. As you do in the states.
As an interesting anecdote, I recall my business partner once telling me a clinic in San Antonio needed some equipment delivered, 90 miles, that week - in something like 3 days time. It wasn't heavy stuff, but it was tecnical stuff that you had to know what you were doing to uninstall it and pack it. I didn't want to do it, so I told them it would be $1,900 and the check had to be there upon arrival. They paid.