The Trump approach would only make sense if the system itself had broken down so much that leading it no longer provided anything positive for America. But this is not the case, and therefore the actions of the Trump admin are a premature abdication of power.

The Trump admin’s actions are those of someone who wants to abandon their role in heading and shaping the system, for the opportunity to dominate within it. But while this can feel like it’s a greater form of power, it’s actually not.

Who has more power, the person who picks up the bill in the restaurant, or the person who gets the free dinner?

And who has more power, the headteacher of a school, or the biggest kid in the playground?

I'll be publishing an extended version on substack in a week or so too.

It seems most likely that we simply can import healthcare workers due to the English language, rather than that we must.

We need to recognise that despite underlying realities of the ageing population etc, our extreme reliance is a choice, not an inevitability.

Britain and interestingly, Ireland, are the big outliers in Europe. But contrary to what it often said, Britain doesn't actually lose that many graduate doctors to e.g. Australia, nor do we get our health service on the cheap via imported labour compared to other countries.

The NHS and the care system is of course highly reliant on immigration (36% of hospital doctors and 30% of nurses), but we are an extreme case. Before the Boriswave the rates, especially of nurses and care workers, were significantly lower - policy still makes a big difference.

Source for US healthcare spending:
www.cms.gov/data-researc...

Source for total UK health expenditure: ons.gov.uk/peoplepopula...

Source for NHS spending as % of GDP:
ifs.org.uk/publications...

And due to ageing populations, the same problems are inexorably increasing spending are common to both.

Total US health spending was 17.3% of GDP in 2022, a much higher total percentage than in Britain (11.1%).

39% of spending in the US is public (Medicare and Medicaid) vs 82% in Britain.

But because total spending is higher, as a % of GDP the US publicly funded % is still high.

So British public spending is about 1.5x America's. But nearly all British people also *use* the healthcare they are paying for.

Whereas the American taxpayer does not use the healthcare they pay taxes for, it goes to the retired/disabled (Medicare) and the poor (Medicaid).

I already wrote on Sweden and Denmark on substack. Will follow the Netherlands and might write on it too.

www.willsolfiac.com/p/getting-to...

www.willsolfiac.com/p/live-laugh...

I've thought for a long time that the only way Germany could become less insane on asylum is if their closest European partners basically forcibly changed the European norm.

- Removal of the automatic right to a permanent residence permit after 5 years. Now asylum seekers may still be required to return once it is deemed safe.

Given that this worked in Denmark and Sweden, I'd expect it to work in the Netherlands too.

How long till Germany follows.

Mine discusses Sweden's change, how it came about, and what it really means. Basically, asylum has been cut. Other forms have not yet, but may be in future. And indeed it does have lessons for Britain.

www.willsolfiac.com/p/live-laugh...