| ▲ | eru 14 hours ago |
| You can move to Singapore, if you want a better healthcare sector. (The UK spends very roughly half of what the US spends on healthcare in terms of percentage of GDP. That's total (public plus private) expenditure. Singapore spends very roughtly half of what the UK spends by the same measure. Health outcomes amongst the three countries are comparable. If anything, Singapore is healthier.) |
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| ▲ | orwin 13 hours ago | parent | next [-] |
| Singapore numbers ignore their underclass, which is significant. But you're right, if you're a westerner, Singapore's great. |
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| ▲ | eru 13 hours ago | parent | next [-] | | Any 'underclass' also contributes to GDP and consumes healthcare. How is any of this ignored? But yes, I agree that the US should let in more migrant workers. Good for the workers and good for the target country: cheap infrastructure is great! | |
| ▲ | rangestransform 12 hours ago | parent | prev [-] | | I wish the US could also use migrant labour like Singapore instead of the current system of turning a blind eye to illegal immigration out of necessity |
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| ▲ | georgeburdell 13 hours ago | parent | prev | next [-] |
| Singapore is the beneficiary of a neighboring impoverished itinerant workforce to supplement its own collapsing demographics with artificially cheap services. It’s hardly replicable most places. |
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| ▲ | eru 13 hours ago | parent | next [-] | | > It’s hardly replicable most places. How so? What's hard to replicate here? Many rich places could let in more migrant workers. It's good for the workers, and good for the receiving country. | |
| ▲ | zer00eyz 13 hours ago | parent | prev [-] | | So is the USA... | | |
| ▲ | georgeburdell 13 hours ago | parent [-] | | No it isn’t. Malaysians commute across the river daily and then return at night, having provided their services in exchange for compensation. Singapore gets the work without many of the associated problems with housing those people long term. As a result, there are some ridiculously niche jobs in Singapore that would not exist in another rich country, such as widespread domestic servitude and manual street sweeping | | |
| ▲ | eru 13 hours ago | parent | next [-] | | How is that different from people living in New Jersey and commuting to Manhattan? | | |
| ▲ | alex43578 13 hours ago | parent | next [-] | | Because unless you really just want to prop up only Manhattan’s statistics at the expense of NJ’s, it’s irrelevant to a discussion about US labor statistics. | |
| ▲ | vel0city 12 hours ago | parent | prev [-] | | New Jersey and Manhattan are both a part of the same country last I checked. Malaysia and Singapore are two different countries. Despite being right next to each other they have vastly different GDPs, standards of living, government benefits, etc. | | |
| ▲ | eru 12 hours ago | parent [-] | | Malaysia and Singapore used to be one country. New Jersey and Manhattan are in different states. But in any case, why so xenophobic? Borders are an administrative hassle, but they have no moral weight. | | |
| ▲ | vel0city 11 hours ago | parent [-] | | I didn't realize acknowledging NY and NJ are in the same country is a xenophobic take. Borders are a lot more than just a bit of paperwork or "administrative hassle". Central America is a very different place from US & Canada in many ways. Malaysia is quite a bit different from Singapore in a lot of ways despite such intertwined history. I'm not passing any moral judgement here, I'm just acknowledging current reality. Singapore and Malaysia are different countries. NY and NJ are two states in the same country. The relationship is very different. Even with "Imperium in imperio" in the US. To have a similar kind of comparison one would look at the cyclical migrant labor between the Southwestern US and Mexico. |
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| ▲ | rangestransform 12 hours ago | parent | prev [-] | | The US could achieve the same thing with a proper migrant labour program |
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| ▲ | pfdietz 12 hours ago | parent | prev | next [-] |
| Health outcomes in the US are affected by higher levels of obesity. If anything, the higher health spending keeps that from being worse. I expect Ozempic and the like to have a significant impact on this. |
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| ▲ | skinfaxi 12 hours ago | parent | prev | next [-] |
| Your statement prompted me to look at immigration options in Singapore. It seems it is pretty reasonable to get a visa as a foreign technologist. |
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| ▲ | eru 42 minutes ago | parent [-] | | Yes, if you are into tech, they really want you to come. Another benefit: they tell you pretty quickly whether your application is approved or not. |
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| ▲ | toomuchtodo 14 hours ago | parent | prev | next [-] |
| Europe is also excellent in my experience, specifically Portugal and Spain. My health insurance cost for a family of four in Spain is ~$2k/year as someone on a visa. In the US on an employer plan, it was ~$20k/year (premiums, copays, etc). |
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| ▲ | asa123 13 hours ago | parent | next [-] | | I think the commenter you responded to filtered first for countries with outcomes better or exceeding the US? Though I’m not sure Portugal and Spain automatically fall into that category | | |
| ▲ | eru 13 hours ago | parent | next [-] | | Oh, I picked Singapore, because I moved here. I picked US because that was the topic under discussion. And Britain because the parent comment talked about 'free' healthcare. | | |
| ▲ | asa123 12 hours ago | parent [-] | | complete misreading between the lines on my part then apologies | | |
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| ▲ | toomuchtodo 13 hours ago | parent | prev [-] | | I can only n=1, but most, if not all, experiences we've had obtaining medical care were better in Europe. Care specialist for my autistic kids, primary care, etc. From my unofficial surveys, many folks I know in the US are having a hard time finding various care providers, even if they have insurance. More data on this is always welcome. | | |
| ▲ | amanaplanacanal 12 hours ago | parent | next [-] | | It seems fairly common in the US to have a hard time finding a doctor that will take your insurance, especially so if you are on Medicaid. Even with good insurance, a lot are just not seeing new patients. More and more tasks are being pushed off onto nurse practitioners and physician's assistants. And the number of residencies is still limited by the AMA, so you aren't getting enough new doctors. | |
| ▲ | asa123 12 hours ago | parent | prev [-] | | I can believe this; it's my personal and anecdotal evidence (and that which is believed by family) that the maximum quality of US medical care is quite incredible, but any perceived median (accounting for accessibility and cost) is really quite shit |
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| ▲ | eru 13 hours ago | parent | prev | next [-] | | A quick search suggests that Spain spends around 9.3% of gdp on healthcare. The UK spends around 10.9%. Singapore is around 5.5%. | | |
| ▲ | toomuchtodo 13 hours ago | parent [-] | | While interesting facts, this is typically not the primary criteria which people use to decide where to expat to, versus availability and affordability. I cannot speak to the residency requirements of Singapore, but those of western Europe are very generous, as some who has helped folks leave the US for there. If you are in Spain on a tourist visa, and apply for the equivalent of a digital nomad visa while in country, you get three years as a temporary resident. At three years, you re-apply for another two years, and after those five years you can apply for permanent residency. 80% of your income must come from outside of Spain. They’ll even take a letter from a US W2 employer as income verification. If you have any resources you can recommend on immigrating to Singapore that would be helpful and relevant for folks considering it as an option (whether on an employment, student, or pension/non lucrative visa), I welcome them to add to my resources for distribution to those seeking an exit strategy. Thank you in advance. https://news.ycombinator.com/item?id=47161587 (resources) | | |
| ▲ | eru 13 hours ago | parent [-] | | Oh, I was purely talking about what healthcare costs society. I love it in Singapore, but if you don't want to live in a steam sauna, there are better countries for you. And if you are an American, I guess you don't even benefit from our more enlightened tax system anyway. | | |
| ▲ | toomuchtodo 13 hours ago | parent [-] | | > And if you are an American, I guess you don't even benefit from our more enlightened tax system anyway. https://www.irs.gov/individuals/international-taxpayers/fore... > If you are a U.S. citizen or a resident alien of the United States and you live abroad, you are taxed on your worldwide income. However, you may qualify to exclude your foreign earnings from income up to an amount that is adjusted annually for inflation. In addition, you can exclude or deduct certain foreign housing amounts. So there are mechanisms by which to avoid paying income tax to the US as as someone with a potential US tax liability living and working abroad, although it can be a facts intensive situation. Think like a Hacker, this is just another system and set of rules to hack ("How can I live outside the US, maximize my quality of life, pay the taxes due to my residency jurisdiction, while avoiding paying as much US federal income tax as possible?"). (For the 2026 tax year, the maximum Foreign Earned Income Exclusion (FEIE) is $132,900 per qualifying person, an increase from $130,000 for 2025. Married couples where both spouses work abroad and qualify can exclude up to a combined $265,800; the contents of this comment are for educational purposes only, and are not financial or tax advice, speak with a professional) |
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| ▲ | ricardobayes 13 hours ago | parent | prev [-] | | Yes and for something rare or complex, you can always fall back on the public health insurance. | | |
| ▲ | toomuchtodo 13 hours ago | parent [-] | | I appreciate the collectivism and it is a component of why I am happy to pay Europe any of the taxes they ask for. |
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| ▲ | logicchains 13 hours ago | parent | prev | next [-] |
| The US has around 4x the obesity rate of Singapore, which significantly reduces healthcare costs. |
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| ▲ | dominotw 12 hours ago | parent | prev | next [-] |
| > Health outcomes amongst the three countries are comparable. If anything, Singapore is healthier. healthcare is not for health. Its for sickness. Going to hospital doesnt make you "healthy" . We dont have any medicines to restore health to ppl suffering for diseases majority of healthcare spend goes to. Maybe those countries dont have sickly population in the first palce like usa where a majority have metabolic diseases. |
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| ▲ | kevin_thibedeau 13 hours ago | parent | prev [-] |
| Singapore has severe consequences for executives who violate the public trust. That makes it hard for sociopaths to rig the system for the elites. |
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| ▲ | glaslong 13 hours ago | parent | next [-] | | Stoppp, y'all really are making me want to move to Singapore with promises like that. | |
| ▲ | eru 13 hours ago | parent | prev [-] | | Maybe. Though Americans are free to vote for politicians who make similar laws, too. | | |
| ▲ | kevin_thibedeau 11 hours ago | parent [-] | | The people who make the laws are the wealthy who pay their think tanks and lobbyists to write them. Nobody gets elected without being owned by a puppet master. | | |
| ▲ | eru 41 minutes ago | parent [-] | | If only! If rich people had so much influence, Romney and Bloomberg would have been presidents. |
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