Or, he might be older than 30 and therefore not willing to deal with the puny two-week vacation allotment that is still socially acceptable from US employers.
Or, he might have children who will have to be educated someday, and see that a system that combines astronomical tuition plus fickle nonacademic factors in admissions ("extracurricular" criteria designed to give the privileged a huge advantage) is not good for their future.
Or, he might have lived in the Red States and be gay. Or, pardon the "he", she might be a woman. Or transgender.
I'm not disagreeing with you I just need help understanding. I get a job. My job offers health insurance coverage, which most do now. I pay a small fee (<$200) per month to get the coverage. If I get hurt I go to a doctor and the insurance covers the costs in full, so long as they accept that insurance. How is this not ideal? What would be better for the tax payer?
> Or, he might be older than 30 and therefore not willing to deal with the puny two-week vacation allotment that is still socially acceptable from US employers.
Outside of tech. I've found within the industry most employers have a flexible vacation policy.
> Or, he might have children who will have to be educated someday, and see that a system that combines astronomical tuition plus fickle nonacademic factors in admissions ("extracurricular" criteria designed to give the privileged a huge advantage) is not good for their future.
Can't argue with this one. I wholeheartedly agree.
> Or, he might have lived in the Red States and be gay. Or, pardon the "he", she might be a woman. Or transgender.
Eh. I'd say this is more based on location within a state. Go to Austin Texas and you'll have a better time than many other states that are "blue".
For people who don't think $200 every month is "a small fee". Folks on minimum wage might not agree with you on 'small', particularly if they're part-time. For people who don't have a job. For when your healthcare provider hasn't done a deal with your insurance. For having to do the paperwork in the first place.
David Sedaris talks about getting medical care while living in France. He tried to pay for it, and got "Oh, fix us up next time". On insisting, he got "oh, I suppose you could pay, if you really want to".
What would be better for the tax payer?
It's been pretty conclusively demonstrated that the US system is ridiculously expensive for the taxpayer with poor outcomes for society as a whole, compared to other systems.
Edit: I've never figured out how to do dot points on HN...
Red pill alert.
Your doctor accepting insurance is not guaranteed, or even likely, these days. As insurance companies become more aggressive against doctors, an increasing number are either deciding not to put up with that bullshit at all (in New York, half the doctors don't take insurance at all because there are enough richies) or to only accept a couple of plans (which you won't get, unless your company is union and the union does a hell of a job). Companies often buy cheapskate insurance where the network is thin, and you may need a specialist but be unable to get one (in network) for several months, or have to drive 100 miles. In an emergency, you pay a lot out of pocket. Possibly $20,000+. That's with insurance.
Most plans also have high deductibles ($2000+) these days, which means that the first $2000 of expenses you will pay. There's typically an exemption for an annual physical and for routine stuff, but getting seriously sick is beyond what most Americans can afford.
Oh, and if you have to buy individual insurance (your employer isn't big enough to get a group plan) then you will be paying a hell of a lot more than $200 per month for it. If you've ever had a serious illness, make it $2,500 per month. Cancer survivors are uninsurable if seeking individual plans (chemotherapy is carcinogenic, believe it or not). Diabetics are fucked.
Finally, if you deal with anxiety or depression or panic attacks (hey, it happens) you will get a lot of pushback from health insurance, even on unrelated claims, because statistically people with MH issues (especially depression) are more likely to just give up and eat losses, or fuck up on paperwork and eat losses, on claims that the insurer should technically pay.
American health insurance is, with no exaggeration, a 9/11 every 24 days. 45,000 per year. Many of those have insurance.
To me if health care is broken in the U.S., it is broken for two reasons: 1. medical coverage is tied to employment and 2. economic considerations are removed from the equation by insurance companies.
My two fixes to U.S. health care would be to allow (through de-regulation or regulation, whichever it requires) allow consumers to shop for healthcare based on their own desires for coverage (extreme catastrophic coverage, e.g. only cover procedures over $50K, all the way down to full coverage of toe nail clipping and nose wiping) without ties to their employer. This fix would remove the pre-existing condition problem. It is one solution the new healthcare exchanges attempt to provide.
To fix the second problem, I think health insurance companies and medical facilities should be required to show their prices for all treatments and procedures. If my health insurance will pay up to $5K for me to have my appendix removed and there is a doctor that I trust who will remove it for $250.00, I should be able to choose that doctor and my insurance premiums should reflect the choices that I make with my coverage.
If health care were handled like this, people could save thousands of dollars on their health coverage by making responsible decisions about what types of coverage to get and how much to spend on treatment. The money saved could be used to pay for things that are not required or to save for other lifestyle choices.
How about just being able to pay that 'small fee' without having it tied to an 'employer'? The 'employer' is normally paying a lot more than your share, so this 'benefit' just means craploads more money going to the insurance company instead of your pocket to make your own decisions with.
"Covers the cost in full"? Really? Rarely, unless it's something extremely basic, and you've got some excellent plan with an extremely low deductible. Which it sounds like you might - for that $200 you're paying, the employer is probably kicking in another $600+ (wild estimate based on past experience and discussions with colleagues).
Being able to have basic medical necessities provided to you should not be dependent on whether you're 'employable' (and 'employed') at any particular moment in time.
"Employer-provided" health insurance is one of the worst aspects of the mess that is healthcare in the US.
I understand that a significant majority of the United States' only offer limited annual leave (compared to Australia's 4 weeks).
I understand that a significant majority of the United States' suffers from an extremely high murder rate for a 1st world country.
This is a sample of why I don't want to live in the US, even though they have fast internet.
Seriously.
For murder rates, North America beaten by Africa only I believe.
Limited annual leave depends on the job. If you're in software engineering or similar, you're unlikely to have a problem. If you get offered a job that doesn't offer the annual leave you want, either negotiate for more, or just don't take that job.
I doubt your statement that a majority of the US has an extremely high murder rate. Some parts of the country certainly do, but much of the country is perfectly safe. The overall average rate is higher than other first-world countries, but that does not imply that most of the country has a higher rate. Crime is not spread out evenly.
You may want to look into why you understand things that aren't really correct, and figure out how that happened.
Australian politicians immediately started telling people not to visit the US because it's so full of guns.
Wait, actually, on second thought, I have. But that didn't have any impact on my opinion of the US.
The murder rate statistic "thing" (as you described it) is based on the actual murder rate statistics. And my knowledge of US gun control.
Not sure if it's still true but it was a funny statistic.
And the media here does portray the U.S. as a country where murder is uncommonly prevalent.
That sounds reasonable, but I thought I'd take a look.
It turns out that the Australian states with the worst murder rate (NSW & WA, 1.6/1000) would have been the fifth best in the US (after New Hampshire, Minnesota, Iowa and Hawaii)[1].
So yeah, most of the US does have a higher murder rate.
[1] 2011 figures, http://en.wikipedia.org/wiki/List_of_countries_by_intentiona...
Let me illustrate. The murder rate in Washington, DC is pretty high, at 13.9 per 100,000 (which I'll abbreviate as just 13.9 from here).
I live in the DC area. Does that mean that I live in an area with an extremely high murder rate? Nope. I live in Fairfax County, about 15 miles from downtown, but still well within the urban area. At first glance, Fairfax County is a collection of suburbs. However, this is kind of misleading, as the county has almost double the population of DC proper, about 1.1 million people. In 2011 (the most recent year I could find a figure for), there were 11 murders in Fairfax County, putting the murder rate at just under 1.0. That makes Fairfax County on par with or safer, on average, than every Australian state besides Tasmania.
And this isn't cherry-picked, aside from the obvious bit where I started out with it because I live here. neighboring Arlington County, for example, with a population of about 220,000, had no murders in 2011. Montgomery County had 16 murders in 2011 out of a population of about one million, for a somewhat higher murder rate of 1.6.
There is substantial variation within each jurisdiction as well. Large parts of DC is perfectly safe, with murders concentrated in certain areas:
http://apps.washingtonpost.com/investigative/homicides/
If you live in the northwest part of the city, you're perfectly safe. If you live in southeast, life is even more dangerous than the 13.9 average rate suggests.
DC is a somewhat special case, as a large urban area carved up into many jurisdictions. Other major US cities tend to have fewer local jurisdictions, which makes it harder to see the individual regions. Chicago, for example, has a population of 2.7 million within the city limits and that encompasses a huge range in terms of crime, from places where you'd never want to get out of your car to places that haven't seen a murder in years.
Yes, the US has more violent crime than other first-world countries, but it doesn't much apply to the average person. Much of this crime is criminal-on-criminal violence, and much of the rest is concentrated in poor and minority areas. That's not to excuse it at all, or to somehow imply that it makes it OK, but it is relevant when addressing what most of the country sees.
The rest of the world works exactly the same way too.
Yes, there are places in the us that have little violent crime. There are more places like that outside the US though, and taking population into account my point stands.
But the fact remains that most of the US does not suffer from extreme violence, and comparing the averages across countries doesn't do anything to dispute that.
Even though you claim to understand this, you didn't let it stop you from declaring that "most of the US does have a higher murder rate." How does that work, then?
In areas of similar population density, the murder rate in the US is higher.
Of course there are areas of the US that have very low population density, and an equally low murder rate.
I really can't keep track of just what you're actually arguing, nor do I care to keep trying.
It seems to me that the murder rate really is high for being a first-world country that isn't on the brink of collapse or recovering from it.
Lowest number is for places with less than 10,000 inhabitants (roughly, read the details that go with the source to know what this means.) For that we see a murder rate of 2.7 per 100,000.[1]
Countries in Europe that are higher than this: 4.9 - Belarus, 2009 8.6 - Moldova, 2011 9.7 - Russian Federation, 2011 (down from 18.9 in 2004) 4.3 - Ukraine, 2010 4.8 - Estonia, 2011 19.2 - Greenland, 2009 (this fluctuates wildly, 3.5 in 2007) 6.4 - Lithuania, 2011 4.4 - Albania, 2011 3.6 - Montenegro, 2011
Meanwhile the entire rest of Europe (44 other countries) is below that, and I picked the lowest rate of a reasonably-sized group out of the ones listed (26 million people.)
And it only goes up from there, in terms of murder rate - as high as 12.1 in some of the other groups. Also, this is not the only source and there are better analyses than mine out there that do a much better job of correcting for various things.
Similar data exists for healthcare, and I'd be happy to cite sources - our healthcare isn't great even when you can afford it.
[1] http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2012/c... [2] http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2012/c...
On the health care front, I have trouble finding anything that actually discusses the quality of care when you have access to the system, rather than discussing the quality of care for the country as a whole. This is the best I could find:
http://en.wikipedia.org/wiki/Comparison_of_the_health_care_s...
Relevant summary quote: "Overall, results for mortality favoured Canada with a 5% advantage, but the results were weak and varied. The only consistent pattern was that Canadian patients fared better in kidney failure."
Two major confounding factors are overall health of the population (essentially, how much of poor American health care outcomes are due to being fat) and unequal access. Statistics for the country as a whole ignore these, and therefore are not relevant when deciding how the American health care system will treat an individual who eats well and has decent insurance.
Again, the US health care system has deep problems that need some serious attention, but as best I can tell, they are financial, not actually problems with the quality of care that's delivered to those who are able to receive it.
Feel free to provide evidence for your claim as you still have not done so.
Here is one nonpartisan resource about healthcare I have offhand and a summary video by john green for those who don't feel like reading so much: http://theincidentaleconomist.com/wordpress/what-makes-the-u... https://www.youtube.com/watch?v=qSjGouBmo0M
Relevant points from it: no, obesity does not account for a significant portion; yes, it affects even those who pay; yes you need to look at a lot of data; and no the data does not agree with you.
The John Green video has 2 other links of interest in the description, too.
Your claims are still entirely unsubstantiated, and you keep throwing in more of them instead of backing your existing claims up with data.
For more on my reasoning, see my reply elsewhere:
https://news.ycombinator.com/item?id=7024053
And yes, a lot of it is handwaving and speculation. The data I'd need just doesn't appear to exist, since you'd have to take it down to the neighborhood level. That said, I think it's superior to discuss without data, while admitting that the data isn't there, than tho discuss with data that doesn't actually say what it's claimed to say.
Regarding healthcare, your first link does not mention inferior outcomes at all. It does not state, but heavily implies, that our outcomes are not significantly better or worse. I briefly searched around that site for other articles but couldn't find anything that discusses the health care system in isolation from the confounding factors. And there is no way I'm going to believe that obesity is not a significant factor here without something to back it up, given that obesity in the US is a factor in about 1/5th of all deaths.
- I understand that a significant majority of Korea's healthcare system is lacklustre, but cheap.
- I understand that a significant majority of Korea's only offer limited annual leave (1 week) (compared to Australia's 4 weeks).
- I understand that a significant majority of Korea suffers from an extremely suicide rate for a 1st world country.
This is a sample of why I don't want to live in South Korea even though they have the fastest, cheapest internet on Earth.
Or France
- I understand that a significant majority of France's healthcare system is quite good, but you pay out the nose for it in taxes even if you don't ever use it.
- I understand that a significant majority of the French support industry and infrastructure choking union strikes over tiny contract details
- I understand that a significant majority of France suffers from an extremely high racial segregation and discrimination problem
This is a sample of why I don't want to live in France even though they have the best cuisine on Earth.
Or Australia
- I understand that a significant majority of the Australia's healthcare system is lacklustre.
- I understand that a significant majority of Australians still support the Aboriginal segregation and forced adoption laws.
- I understand that Australia not only has a slow internet, but widespread and regular censorship of what sites citizens can go to.
- I understand that Australia doesn't even offer free speech protection.
This is a sample of why I don't want to live in Australia, even though it has nice weather.
I understand that a significant majority of Australians still support the Aboriginal segregation and forced adoption laws.
> I understand that Australia not only has a slow internet, but widespread and regular censorship of what sites citizens can go to.
You are greatly mistaken.
> I understand that a significant majority of the Australia's healthcare system is lacklustre.
It ain't perfect, but its significantly better than the US'
> I understand that Australia doesn't even offer free speech protection.
I know. This really sucks. We have "implicit" free speech, but it still sucks.
plus 10 days paid sick leave (cumulative) plus 10 paid public holidays per year