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But the Dutch, French, Scandinavian, and others aren't, and the those systems is very comparable to that of Germany. Many of the ideas originate from far before WWII, and had a strong presence (and development) in Europe since events such as the French revolution.

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.

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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).

Help me educate myself. Provide some evidence.

Of those three areas, only the "more free time" element is easy to compare:

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"]

"More free time" isn't the claim I was skeptical of.

On the health care front, both the OECD and The Commonwealth Fund give the USA low marks compared to other Western democracies: http://en.wikipedia.org/wiki/Health_care_system#Cross-countr...

No comment on the 'luxury' claim; that's too subjective for me.

At the wikipedia page, all they do is compare spending (in $) to life expectancy. This is a terrible comparison, since lots of non-health care factors affect life expectancy. For example, life expectancy within the US is 85 for Asians, 78 for whites and 72 for blacks.

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.

Like many things in economics, it's imperfect.

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.

If you compare the US with Canada, which has a similar mixed ethnicity,...

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.

Ok, but the real difference is in spending. People in the US live to 78, Canadians to 81, according to that site, which isn't a huge difference. The difference in spending, however, is, which is why the US is such an outlier on that chart.

... and around ...

I was questioning the claim of "more luxury, more free time, and better health-care".

Much like free time, claims about costs are easily googleable.

I think that just a disagreement over how to interpret "best" - for an individual who can afford it the "best" health care is likely to be in the US. However, I suspect Europeans think of it as "pretty good health care for everyone" rather than "the absolutely the most effective health care for some".

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.

http://upload.wikimedia.org/wikipedia/commons/thumb/6/64/Yea...

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.

It is not as simple as that. There are many countries in which the official work day is less than the real work day. As an example, in Japan no-one leaves before the boss leaves (so it can be longer than the official time).

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.

My arithmetic may be wrong, but comparing the US figures with those of Germany, Americans work about 2 months more per year (8 hour days, 5 day weeks). Which is a lot.

For example, HDI (Human Development Index, used by the UN) measures three welfare factors (life expectancy, level of education, standard of living). Nine Western European countries rank higher than the US, six Western European countries are ranked lower (including the far more US-oriented UK). Some Southern European countries (Spain, Italy) are almost at US-level.

Source: http://en.wikipedia.org/wiki/List_of_countries_by_Human_Deve...

(I am not the original poster, but I thought I'd provide some info).

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.

Ignorance is bliss.

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.

And what makes people 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

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.

     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?

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.

When you're sunken in debt, how much freedom do you have left?

Exactly. You want better food at school cafeteria? The government has to pay. You want less death by secondary smoke? You need government intervention (which incidentally the USA have accepted now).

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.

Our diet is in large part a result of government intervention. Farm subsidies make distort the price of corn based products (HFCS for instance). The existence of government run schools prevent choice in school lunches.

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?

"And what makes people 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?"

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.

... are you suggesting that Americans are inherently more stupid than Europeans?

".. are you suggesting that Americans are inherently more stupid than Europeans?"

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).

Speaking of ignorance, it's quite obvious that you've never lived in Europe and get your information from Fox News. Try traveling sometime.

Excuse me but where did that "ignorance is bliss" come from? The poster asked for some information, I tried to provide it. Did I belittled American's achievements? No. Did I provide wrong data? No. So maybe I am not being ignorant as just naive. There was very little opinion in my comment. Anyway...

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

"Excuse me but where did that "ignorance is bliss" come from?"

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.

What makes you think that I don't have freedom? Or that I am stuck in my current system?

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.

If you look in more detail, it's not as big a problem as it appears.

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-...

"Would you rather be happier or have less freedoms?"

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?

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).

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?

They don't really, as Sweden alone has taken e.g. more Iraqi refugees than the USA.

"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"

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.

FYI: muslin isn't a race.

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?

Only one of those measures is even remotely related to the factors I asked for data on (working hours, health care or luxuries), namely the WHO rankings of health care. Unfortunately, the WHO rankings of health care are not actually rankings of health care. They rank a weighted average of health (25%), health inequality (25%), responsiveness (12.5%), responsiveness inequality (12.5%), and financial inequality (25%).

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...

(mini-rant: Well, to be honest I found your attitude a bit annoying. The poster mentioned three things. You asked for data. He provided one and your reply was: "Not sceptic of that", without specifying much. I provide different measures, including one covering one more of the three original points, and you complain that some of them are off topic. So yeah, if one gives you on topic data you are not sceptic of that, if one gives you partially on topic partially off topic, then you complain too. Not very polite, if you ask me. Anyway, on with the actual reply.)

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 are correct, I should have originally specified that I was only skeptical of the claims on health care and luxuries (since working hours are easy to look up). That was my mistake, and I offer my apologies.

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 didn't say you were impolite because you disputed the facts. But because you were giving very vague definitions of what you were exactly looking for, and instead just turned down people who offered numerical evidence. Had you been more clear what exactly you were after, I'd wouldn't have had a problem (disputing the relevance of facts I think it's alright).

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.

Financial inequality measures inequality in spending, not affordability.

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.

Somewhat of the inverse of more luxury: there is approximately 50% more poverty in the US than in Western European countries: http://www.un.org/esa/socdev/rwss/docs/2010/fullreport.pdf (page 38).

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