It's America-centrism to think that all welfare and modernism is brought to the world by the USA. One typical anecdote a former exchange student told me, that some high school kids in the USA believed (this was at the end of the nineties) that European countries do not have their own radio channels ;). Go educate yourself, the average Western-European citizen has more luxury, more free time, and better health-care than the average citizen of the United States (I know, I have visited the US often).
The primary advantage of the US is that it is far easier to set up a company, and make it really big. If you make it, you will be rich and wealthy. If you fail, you will hit rock bottom. It is a consequence of the system, wages, taxing, etc.
Help me educate myself. Provide some evidence.
http://en.wikipedia.org/wiki/Working_time
From those statistics it does look like the average citizen of the United States probably does work more hours in a year than the average citizen of the EU.
[Edited to remove the comment about "but not by a huge factor"]
No comment on the 'luxury' claim; that's too subjective for me.
Life expectancy in Japan is 83.
Hypothesis: ethnicity plays a strong role in determining life expectancy. The fact that Japan is 99.4% Asian while the US is only 5% Asian may drag the US down a bit.
If you compare the US with Canada, which has a similar mixed ethnicity, the dollars to life expectancy is still way better in Canada.
To save some time, I think the typical libertarian argument is to admit the system in the US actually does stink in terms of costs, and argue that if only we had a truly free market, where people could instruct their ambulance drivers to drive around shopping for the best price/performance ratio for their emergency surgery, then things would be better in the US.
This just goes around and around and around, though, doesn't it. I somehow suspect we won't see "health care economics problems solved on niche web site" as tomorrow's headlines.
I love to talk about this stuff with people in person, but the bandwidth of a web site is just too low - people write books on these subjects, for pete's sake.
False. Canada has more long lived Asians and far fewer short lived Blacks (and "some other race") than the US.
http://en.wikipedia.org/wiki/Demographics_of_Canada
http://en.wikipedia.org/wiki/Demographics_of_the_United_Stat...
In any case, I'm not asserting that ethnicity is the only factor affecting life expectancy. My claim is that many factors affect life expectancy and health care is way down the list in terms of magnitude (once you reach first world levels). Thus, using life expectancy as a proxy for health care is simply a terrible idea.
... and around ...
Much like free time, claims about costs are easily googleable.
I'm in the UK so I rather like knowing that everyone has access to pretty decent healthcare which is free at the point of delivery. If I want fancier stuff or a slightly nicer room or more quickly than what the NHS can provide I can always go private. However, I've never done that and I don't know anyone who has for anything major.
I'm surprised that what are generally considered the richest countries are all at the bottom: Netherlands, Sweden, Norway, France, Germany, etc. The difference in working hours between those and the US is huge: 1307 - 1362 hours/year compared to 1777 hours/year.
Also, in some countries there are many people working for themselves (such as in small businesses). These people generally work more than the official time.
I had a family member work for 14 hours a week (10 hours saturday and sunday) while starting their own business (this went on for two years).
Small business owners break the law a lot and work more than the allotted time.
Source: http://en.wikipedia.org/wiki/List_of_countries_by_Human_Deve...
As he pointed out it's difficult to find objective data. But you can check:
* Human Development Index (http://en.wikipedia.org/wiki/List_of_countries_by_Human_Deve...): the USA is at position 13. It includes things like life expectancy and education.
* Satisfaction with Life index (http://en.wikipedia.org/wiki/Satisfaction_with_Life_Index):the USA is at position 23.
* World Health Organisation ranking of health care: (http://en.wikipedia.org/wiki/WHO%27s_ranking_of_health_care_...): the USA is at position 37
* Education index (http://en.wikipedia.org/wiki/Education_Index): the USA is at 19
* Income inequality (Gini coefficient): (http://en.wikipedia.org/wiki/Gini_coefficient) USA has a score of 47 (out of 100 for maximum inequality). EU has an average of 31
I am sure there's many other indices. And I am also sure that a lot of complains could be thrown on each of these. But I think overall they paint a pretty consistent picture of the USA.
I would rather have the chance of making it big (or fail) than have the government take most of it away with huge taxes and strict rules that make it really difficult to have a successful business.
"It includes things like life expectancy and education."
Life expectancy is low because of the vast amount of people that eat crappy food (and don't exercise) in the US. I don't think this is going to change any time soon (unless it's mandated by the government).
"Income inequality (Gini coefficient)"
This to me just means that in those other countries, the government is re-distributing wealth. People aren't earning more wealth. The government is taking wealth away from people by force and giving it to the rest.
The only thing I do agree with is our bad education system system. However, our higher education institutions are some of the best in the world.
I also wonder sometimes if the reason our "satisfaction of life" index is low is because of liberal democrats that want us to be more like Sweden, Denmark, and Finland.
Would you rather be happier or have less freedoms?
I also find it really funny because Sweden, Denmark, and Finland are not only very homogeneous, but very racist. It's very difficult to go against what is considered "normal" (IE: groupthink).
Life expectancy is low because of the vast amount of people that eat
crappy food in the US.
Could it be that crappy food is sold starting from the school's cafeteria? Could it be that people don't have enough time to cook or eat at better restaurants?
This to me just means that in those other countries, the government is
re-distributing wealth
I would rather have the chance of making it big (or fail) than have the
government take most of it away with huge taxes and strict rules that
make it really difficult to have a successful business.
....
Would you rather be happier or have less freedoms?
I'm not saying one is better than the other, but it seems to me that you've got no idea of how Consumerism works.
When you're sunken in debt, how much freedom do you have left?
Having a government is not such a bad thing. Even Americans used to embrace regulations, until Reagan and the "get the government off my back" idea spread out. Regulations are what help internalise in the price externalities such as these. You could tax unhealthy food, or subsidise healthy food. But somehow this is felt as a wound to people's freedom of doing anything they want, including eating crap if they want.
And freedom is all great: pity for those poor people who are so poor that their only choice is eating crappy food, and who can't afford preventive measures such as cancer screening.
However I do agree that government should play a role in regulating second hand smoke, as that is an instance of one individual using coercive force over another (making me inhale your smoke in public). Although even that issue is a slippery slope. Do we ban cars because their exhaust is toxic?
Could it be that crappy food is sold starting from the school's cafeteria? Could it be that people don't have enough time to cook or eat at better restaurants?"
Crappy school food does need to be changed. If people "don't have enough time" to cook or eat better, it's because they are lazy. You need to make time for these things.
"It could also mean any number of things ... like a middle-class that is better represented, or that the distribution of wealth is more efficient."
Either way, it's not something I want.
"Oh, the freedom argument :)
I'm not saying one is better than the other, but it seems to me that you've got no idea of how Consumerism works."
I do know how consumerism works. I also know the alternative is having the government make those choices for me.
"When you're sunken in debt, how much freedom do you have left?"
I have tons of freedom, because I am responsible with my money (IE: no debt). The people "sunken" in debt got that way because they spent money they didn't have and were foolish enough to do it on a credit card with huge APR.
There were many people during the housing crises that knowingly got a mortgage they couldn't afford because "the banks let them do it". When those same people couldn't pay their bills, they blamed those same banks. This is pure stupidity.
No. I'm suggesting that there will always be stupid and lazy people wherever you go. Many countries in Europe attempt to legislate it away by taking away by making choices for you (More social programs and restrictions on private alternatives). For some, this is fine, because they will be better off. For others, it just means less freedom and less choices.
In the US, we are free to make our own choices (and for some people, this means failing).
Life expectancy may be low because people eat crappy food, but the eat crappy food because they are cheap. Sure it costs money for countries in the EU to push people towards better diet and you may object to that as a socialist government. But why should health care be only measured in terms of cures rather than prevention? I'd say both are important.
Second point. I perfectly agree with you, on the Gini coefficient and on other point. In EU countries there is a smaller gap. If you look at averages (what the original poster was talking about) the very skewed American distribution matters.
The USA has an excellent health care... if you can pay for it. It has an excellent education system... if you can pay for it. You can take plenty of holidays... if you don't need the extra money. And so on.
But the number of people that can afford those in the USA is so small that when you look at the average, most are worse off.
Do you not want to have wealth redistribution? Fine, don't. I don't live in the USA so it doesn't affect me. At your election vote whatever you prefer. But the article linked here was suggesting a different view of what may be a better balance. You like your way of living: suit yourself. shrug
People that don't have freedom and are stuck in one system don't know what they are missing.
"But the number of people that can afford those in the USA is so small that when you look at the average, most are worse off."
The majority of people (last I heard it was > 70%) have some form of health care in the US. Our health care system does need to be reformed, but to say the majority of the population has no health care is just wrong.
In how many countries have you lived in?
Having some form of health care is not the same as having good health care, and most definitely not the same as having the best health care that the USA provides.In fact, I am puzzled how you can quote a statistics like that with a straight face: you are saying that less than 30% of the population doesn't have any form of health care! That's A LOT!!!
A quick check online (I don't have time to find better data) gave me this: http://en.wikipedia.org/wiki/Uninsured_in_the_United_States
which quotes around 15% of the population WITHOUT insurance. And to those you may need to add all those whose insurances don't cover everything you may have.
14 million are de-facto insured - they are eligible for medicaid but have not bothered to sign up. If they ever require insurance, they can sign up and medicaid will pay for their treatment (medicaid doesn't care about preexisting conditions). Another 23 million are uninsured for 4 months or less, presumably because they declined COBRA.
Fun fact, from the wikipedia page: the states with the biggest percentage of uninsured people border Mexico. I wonder how much of the problem could be solved by enforcing immigration law.
http://www.washingtontimes.com/news/2009/jun/25/who-are-the-...
http://en.wikipedia.org/wiki/Worldwide_Press_Freedom_Index http://en.wikipedia.org/wiki/Democracy_Index#2008_rankings
The US does better in economic freedom indices, not surprisingly, since there is much more market regulation in the EU:
http://en.wikipedia.org/wiki/Index_of_Economic_Freedom_histo...
What do you prefer, freedom of speech and democracy, or economic freedom?
Oh, lovely, we’re very racist, are we? Compared to what, USA? I hear the same anti-muslim, anti-mosque rants from Americans that I hear from fellow Swedes. You complain about illegal immigrants, we complain Eastern-Europeans, ”They’re here to take our jobs”. We complain about paying for refugees and asylum-seekers, you complain about... I don’t know, do you have that issue?
FYI: muslin isn't a race.
"You complain about illegal immigrants, we complain Eastern-Europeans, ”They’re here to take our jobs”. We complain about paying for refugees and asylum-seekers, you complain about... I don’t know, do you have that issue?"
I'm glad we agree that it's not the paradise that so leftists claim it to be.
Oh, I know, it’s a fabric.
I'm glad we agree that it's not the paradise that so leftists claim it to be.
So you really didn’t have a point, did you? Just wanted to blurt out a few insults?
Go read the actual report: http://www.who.int/whr/2000/en/whr00_en.pdf
Only 37.5% of the ranking is even peripherally related to health care, namely health outcomes (measured by DALE, Disability Adjusted Life Expectancy) and responsiveness (how satisfied patients are). The US is #1 in responsiveness and #24 in DALE (4.5 years behind Japan at #1 and 0.5 years behind Germany at #22).
It's unclear how significant the gap in DALE is, since lifestyle and genetics strongly affect DALE. Fun fact: life expectancy for Japanese Americans is higher than for Japanese (84.5 in the US [1], 82.6 in Japan). Within the US, life expectancy varies from 44 (Lakota Men) to 86 (Chinese American Women), a gap of 42 years.
To actually rank health care, one would need to measure medical outcomes for specific medical diagnoses, adjusted for patient quality. E.g., it would need to answer questions like "given a group of non-overweight white males aged 45-55 with prostate cancer, how many survive at least 5 years?".
[1] http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2...
Your definition of health care is who got the best doctor. But the point is that there's a lot more than that to good health care. If a country has better diet, or a less polluted environment, or people are less stressed (which itself can cause further problems, including physical problems), then I think all of that should be included.
Why shouldn't the average health be counted? Is preventing an illness less effective than curing it? And what's the point of measuring how good are your doctors or facilities if a lot of people cannot afford those?
(edited for grammar.)
You provided more data unrelated to health care and luxuries. One of your data points looked (at first glance) to be directly on point, but on further examination it turned out not to be. I pointed this out. I'm sorry that you consider disputing your facts is impolite.
Preventing an illness is great, and I'm strongly in favor of it. However, you are expanding the term "health care" beyond it's normal use. A quick google search finds definitions for "health care" similar to the following: "The prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions."
Being ethnically Japanese, visiting the gym or living in a less polluted environment is not health care by the usual definition, even though it affects health. If you want to define health care as "anything which improves health", be my guest. With that definition in mind, I agree that the US has a poor health care system. But when you use a non-standard definition of terms, it's helpful to clarify that.
I was simply arguing against the idea that the WHO rankings provide strong evidence that the US has poor health care, with health care defined as per the definition I quoted. The WHO rankings don't even attempt to study that question.
I agree health care is a badly defined word. And if you want to restrict yourself to services offered by medical professionals then I am fine.
Then I can argue with you that yeah, the USA is not so bad on the actual services provided. Although given the quality of the service changes with how much you can pay, we should really look at the average health care offered (hence those who can't pay and are not insured would count as horrible service). Also having universal health care helps simply because people can take much more advantage without worrying if it's worth the money. For example screening for diseases or cancer. And where I live now (UK) doctors will also check your weight, discuss how you can improve your diet and so on. Not sure then if these would count in your definition or not.
I think anyway that the guy you replied to meant a broader concept of health care. When the government subsidises screening or healthy food at schools then I would have counted those under health care.
Incidentally I guess that's why the WHO used those other data that you disliked. Financial inequality matters because richer people can afford better health care.
The way they calculate it is to take sum |marginal_spending[i] - avg_marginal_spending|^a (I think a is 3, but I'd have to double check, I do recall that a > 1). So if 50% of people pay $1000 out of pocket for health care and 50% pay $0, you are penalized for being unequal. If everyone pays $2000 in taxes, the inequality penalty is zero. That's nothing but a penalty for non-socialized medicine and for copayments.
It's such a screwed up measure that increasing health or responsiveness for some of the population (or lowering costs for some, but not all) can reduce your score (if the magnitude is large enough)!
If you want to measure the baseline level of healthcare in a country (e.g., the bottom fifth percentile, or something), go ahead and do it. The WHO didn't do that. They ranked nations in order of how closely their health care systems resembled what some WHO bureaucrats thought an ideal health care system would look like.
Before it was unified in 1870, Germany was made of a number of small independent kingdoms, loosely associated through the Holy Roman Empire until 1806, then through the German Confederation from 1815 until the unification under Prussia's dominance in 1870 [2].
This late unification (in comparison with France or England for example, which already had an embryo of a unified central state as early as the XIIIth century [3]) explains the non-centralised nature of the German state and economy. The Allies had very little to do with it.
1: http://countrystudies.us/germany/151.htm
2: http://en.wikipedia.org/wiki/Holy_Roman_Empire#Modern_period
3: http://en.wikipedia.org/wiki/History_of_France#Saint_Louis