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I think the US could easily solve this if they wanted to, but from my (Dutch) point of view: - The US is philosophically much more egotistic than other develop

I think the US could easily solve this if they wanted to, but from my (Dutch) point of view: - The US is philosophically much more egotistic than other developed countries - Politically the US is the most divided western country with its two party system - Money in politics means it's one of the most corrupt, preventing solutions that could serve its citizens - Conservative media does a very good job at keeping at least 50% of the country comically uninformed - The "American Dream" gives people the impression that working hard solves everything and that their country is the best in the world period - Religion is not focussed on empathy at all anymore, if it ever was The billionare .0001% will probably do their utmost to keep the status quo, as evidently, they are the ones that are profiting from the current situation and they are the ones calling the shots for the next 3 years. The US is doing very good in a lot of areas, but I think collective egotism is preventing it from reaching its true potential.

kulu2002 9y ago
Very true. While chasing American Dream people of America have become very much business minded and profit-centric. American egoism basically means looking for "Whats in it for me?" everywhere.
staticelf 9y ago
The funny thing is that, per capita, many european countries has more billionaires than the US. That's saying something about "The American Dream" imo. What I meant is that the billionaires maybe doesn't need to uphold the status quo?
- spiderfarmer 9y ago
  And that taxes aren't as bad as they think.
  - mrarjen 9y ago
    Taxes would be a whole of a lot better if they didn't let you pick all the products and then during payment add the % of tax on top of it! Just include it in the price!
    - raquo 9y ago
      I disagree. In Russia an average employed person never even has to file income tax declaration, and any local sales taxes are included in the final price. People don't even know how much they're taxed. All they know is that income tax is 13%, they don't realize how many other taxes are added up to both their salary and the products they buy. As much as the mental overhead of expecting a sales tax on checkout annoys me, I'll suffer through it so that everyone has a constant reminder that the government is taking its cut.
      - mrarjen 9y ago
        It will show in details regarding the price/payment here (Netherlands) Beats getting unexpected extra costs suddenly added for me personally... and in Amerika when eating out you even have to pay part of the salary for the staff afterwards...
      - tobylane 9y ago
        How much of what you pay for gas is taxes deducted at various levels? If it's foreign oil did it pay other governments, like the Panama or Suez Canal? Knowing what the take is for what you buy in person is such a tiny portion of the bigger picture. And with the county/state/federal variations how closely do you keep track of who is ripping you off and who is using the money well?
    - jejones3141 9y ago
      Only "better" in the sense that tax withholding is, i.e. it hides just how much of your money the government seizes. A friend of mine has a print of a painting showing soldiers around a large container holding goods and money that citizens were being forced to pay in tribute. The central figure in the painting is a man--I think his family is with him. I don't remember whether the painter shows him actually putting something in the container or not, but he's looking daggers at those guarding the tribute and enforcing its collection. That look reflects how people should think of paying taxes, and things like VAT and tax withholding that lull the host into not realizing just how much he or she is being taken for need to go away.
- dagw 9y ago
  per capita, many european countries has more billionaires than the US. I wouldn't say 'many'. The 'top' countries are places like Iceland, Guernsey, Monaco and Cypress which are skewed due to their tiny populations. The only country which can realistically 'compete' in this metric are Norway, Sweden and Switzerland. That being said, if we're talking "The American Dream" then simply measuring the number of billionaires isn't a useful metric. We should really focus on self made billionaires rather than people who became billionaires due to inheritance. On that metric I believe the US still leads the pack.
  - pjc50 9y ago
    > Guernsey, Monaco and Cyprus Tax havens. The billionaires themselves are usually "citizens of the world" who live in hotels or a series of holiday homes. Countries don't "have" billionaires in any kind of possessive sense any more. Instead they compete in the hope that billionaires will pass through and trickle down some wealth.
  - robbiep 9y ago
    Whilst the US has more self-made billionaires than Europe [0] the US has lesser social mobility than Europe (less the UK), rendering the idea of 'the American dream' more a dream than a possibility [1, 2] Healthcare is a price-inelastic good. Not having some form of pricing controls is a licence to rip the heart out of a population. [0] https://howmuch.net/articles/billionaires-map https://howmuch.net/articles/billionaires-map [1] https://www.theatlantic.com/business/archive/2016/07/social-mobility-america/491240/ https://www.theatlantic.com/business/archive/2016/07/social-... [2] https://www.brookings.edu/wp-content/uploads/2016/07/02_economic_mobility_sawhill_ch3.pdf https://www.brookings.edu/wp-content/uploads/2016/07/02_econ...
    - true_religion 9y ago
      The article concludes the usa has lower social mobility simply because the very rich, are now much richer thus it is harder to move to that income group.
  - staticelf 9y ago
- deleted 9y ago
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mehrdadn 9y ago
[Edit: sigh, never mind.]
- robert_foss 9y ago
  Having only two options forces the two to be different, more options provides you with a better spectrum of political ideology.
- spiderfarmer 9y ago
  I don't think so, because you might agree more easily with "other people" on several issues and therefore switch more easily to another party.
- aristidb 9y ago
  In a five party system, it is quite common for voters to not feel too much allegiance to any party in particular.
  - teekert 9y ago
    Exactly, here in the Netherlands you still need a majority, this is often formed from 3 or more parties that have to negotiate a lot before coming up with a plan.
  - cbcoutinho 9y ago
    That depends on what you determine is important to you. In the Netherlands there is a 'Party for the Animals', which doesn't compromise on anything and is quite literally a protest one-issue party. Obviously they don't get as much done as other more diverse political parties, but people still vote for them because the party at least shows everyone else that there are citizens who care enough about animals to have a protest vote and have the chance to at least sit in congress.
- em500 9y ago
  In most multi-party systems, parties are always forced to compromise and cooperate to get anything done, since it's almost impossible to get a single party majority. Dutch governments are almost always formed by 2 to 4 parties (usually a centrist party plus either left- or right-leaning parties) which largely prevents swings to extremes.
falsedan 9y ago
> - Politically the US is the most divided western country with its two party system This sounds like you think that political pointscoring drives up health care costs, but the UK & AU both have strong, long histories of two-party politics & have much lower health care costs.
- SilkRoadie 9y ago
  The US system allows one party to freeze out another for periods of time due to control of different chambers. There were government shut downs under Obama.. I think that shows how terrible the US system is at the moment. Other countries like the UK and AU will typically have the ruling party in control of a majority. The US seems to almost always be running some sort of minority government due to loss of one of either the senate or house.
  - falsedan 9y ago
    > Other countries like the UK and AU will typically have the ruling party in control of a majority. That's not my understanding or experience, and I'm a voter for both. The number of governments where the ruling party controlled both chambers is fairly rare. AU elects the upper chamber on a different schedule to the lower, so often a new government (in the House of Reps) will face an opposition-controlled Senate. I think this is the same as the US system. The UK has it worse with the House of Lords, which aren't elected and thus won't ever change hands directly from a General Election result. Also note that the voting tradition in AU is that if Labour gains control of the Federal government, then the Liberal/National Coalition generally gains control of the state legistlatures (and vice versa). Perhaps you mean that a UK or AU lower chamber facing a hostile upper chamber is still functional and productive compared to the equivalent in the US. I think the threat of blocking supply or a vote of no confidence (or in the AU, a double dissolution) helps these governments be more willing to compromise with their opponents & pass legistlation, in the absence of a majority. > some sort of minority government A minority government is a rather specific term, and can be easily misunderstood when used to refer to an opposition-controlled upper house (which doesn't ever really exist in the UK). Could you please be more specific?
  - 9y ago
zaptheimpaler 9y ago
The US IS the greatest country in the world (* AT salesmanship *). That about sums up the concept of "The American Dream" for me.. their government is extraordinarily good at selling certain worldviews & suppressing others, both to their own citizens and to the world. Turns out that salesmanship, psychological influence & media control is a pretty powerful combination. They even routinely manage to sell invading & plundering other nations as "defense". Its a brilliant idea to sell to your citizens as a nation or industrial tycoon... that "we are the greatest because of hard work, hard work implies success, and success implies hard work", and then watch your citizens/employees define themselves by work so that the nation/corporation gets wealthier and more powerful. All the while common sense (or statistics) will tell you that money begets money & power begets power, the rich get richer and the poor usually stay poor. Unfortunately the American Dream idea is not always good for the workers themselves but the people selling the idea were not too concerned about that :) They simply sell just enough mental health care to keep you productive but docile on the side!
ThomPete 9y ago
You are missing a very important point which is that the US is a country of immigration and of different states and the US is a very very very big country. You can't compare it to Holland or Denmark or even Germany. These solutions won't work here. America IS the land of opportunity and I would challenge you to find any other country which provides better opportunity and still protect your rights as well. Edit: The land of opportunity doesn't mean the land of equality and the expression was never intended to be that. America is not egoistic it's just a very hardcore country because it's built on top of people who with their lives at stake started exploring and setting up local societies. So the country is build on tough women and men. They aren't more selfish or egoistic than any other person, their reality is just different than a little country like holland or my own (Denmark).
- spiderfarmer 9y ago
  The US is a big country with different states, but so is the EU. The policies of Holland, Denmark or Germany could definately work in the US, if only the people developed a different stance on criminal behavior, healthcare, guns and taxes, America is the land of opportunity for some people. There are a lot of other countries with a lot of opportunities and freedom. More than 2 million people are incarcerated in the US right now. Where's the freedom in that? America is very egoistic and hard country, built on the lives poor people who were left behind by their fellow countrymen. With their stance on criminal behavior, healthcare, guns and taxes, the people in the US are definately more egoistic than people in more social democracies.
  - ThomPete 9y ago
    You are confusing things here. Incarceration has nothing to do with what we are talking about. No one ever said the US is perfect. We are talking about whether 1) you can apply scandinavian style healthcare to the us (you can't) and whether the US provides more opportunities than other places (it still does) It's not equal and it's not trying to be equal either. EU isn't big geographically compared to the US and it's not as sparsely populated as the US is. That's what I mean with big. Yes, America is the land of opportunity for some. I don't think we were debating obvious truths here. The point is that America does, in fact, provide much more opportunities. That doesn't mean everyone is going to make it. That's never been the point about that expression anyway. The US isn't more selfish if we actually look at how many volunteer in the US that alone would show that it's not that simple.
Joeri 9y ago
Counterpoint from a fellow european. I found americans to not be more selfish, but more appreciative of self-reliance. In europe in most countries the philosophy is that of the nanny state, taking care of its citizens no matter what got them into a care-needing situation. In much of the US there’s much more a perception of responsibility for your own success, with negative individual outcomes being considered a necessary evil linked to personal freedom. Looking at the stats clearly the US needs a little more nanny state to generate better outcomes for the bottom half of the country. But equally europe needs more appreciation of self-reliance and entrepreneurship to enable a richer startup culture and let the EU become an economic leader instead of follower.
- mrpopo 9y ago
  > But equally europe needs more appreciation of self-reliance and entrepreneurship to enable a richer startup culture and let the EU become an economic leader instead of follower. Does it? Is the purpose of a nation state to compete with others based on economic metrics? Yes, I know that most countries are doing that, but in a thread where we compare individualism/selfishness with nanny/"charity" state, shouldn't this competition be questioned?
  - spiderfarmer 9y ago
    Yes it should be questioned. Would I enjoy being filthy rich, while my neighbour is struggling with his hospital bills? Hell no. For me government is about taking care of the sick, poor and vulnerable as much as taking care of wannabe millionairs.
    - logicchains 9y ago
      >Would I enjoy being filthy rich, while my neighbour is struggling with his hospital bills? Hell no. Nobody would stop you from helping with your neighbour's hospital bill if you were filthy rich.
      - scarface74 9y ago
cdoxsey 9y ago
Your comment about religion is incorrect. Americans are very generous: https://givingusa.org/giving-usa-2017-total-charitable-donations-rise-to-new-high-of-390-05-billion/ https://givingusa.org/giving-usa-2017-total-charitable-donat.... Conservative Evangelical Churches spend an enormous amount of time and money helping people. For example: The Southern Baptist Convention runs the third largest disaster relief organization in the country behind the Salvation Army (also religious...) and the Red Cross. I could give lots of other examples. I'm not sure where this perception about religion is coming from. Maybe in Europe the church is largely dead, but that's not true in the US.
- pjc50 9y ago
  > I'm not sure where this perception about religion is coming from. Mostly the high-profile anti-abortion campaigning (which by extension poisons all women's healthcare and sex education discussions), and homophobia. And the segregation. https://www.nytimes.com/2017/07/17/opinion/why-im-leaving-the-southern-baptist-convention.html https://www.nytimes.com/2017/07/17/opinion/why-im-leaving-th... > Maybe in Europe the church is largely dead "Europe" is a huge place that's a lot more diverse than the US. Christianity is still official state religion in various places; Germany still has tithing baked into the tax system! http://www.telegraph.co.uk/news/worldnews/europe/germany/11380968/Compulsory-income-tax-on-Christians-drives-Germans-away-from-Protestant-and-Catholic-churches.html http://www.telegraph.co.uk/news/worldnews/europe/germany/113... Ireland is in the middle of the long process of evicting its theocracy.
- weberc2 9y ago
  Also, the Salvation Army is an evangelical church, and it is one of the most significant charities in the US.
  - SolaceQuantum 9y ago
    The Salvation Army has a history of homophobic and anti-lgbtq policies and practices.
    - 9y ago
Fej 9y ago
What's the Dutch perspective on American media?
- spiderfarmer 9y ago
  We don't watch much American (news) media, but our own journalists say they try to not directly quote the hyperpartisan, hyperbolic, fear-instilling American media but go to the source whenever possible.
- w0utert 9y ago
  >> What's the Dutch perspective on American media? My perspective on American media is that even though everyone has access to (mostly) unbiased, factual sources, quality investigative journalism, uncensored internet etc, for some reason a very large cross-section of the population willingly chooses to believe the partisan crap and plain and simple bullshit peddled by outlets like Fox News and (to a somewhat lesser degree) MSNBC. I regularly visit the US, and frankly I'm appalled by the downright evil crap that seems to be on 90% of the time on televisions everywhere in public. I would be thoroughly embarrassed if the situation at home would be even remotely comparable. And now you have a POTUS that actively promotes to make the situation even worse by labeling anything he dislikes as 'fake news', while at the same time spreading easily falsifiable information as truth. I really have no idea how the US got to this place. The problem is not that the US does not have free press, but there seems to be a level of partisanship that feeds this vicious cycle of misinformation, always putting the blame at the other side, and a total disregard for simple facts that things could be so much better for everyone if the two sides would actually try to work together and find compromises for once. The health care system is just an example of this. Even though there are countless examples of developed countries that have a much better system with significantly lower costs because of things like single-payer insurance, maximum tariffs, etc, somehow the american people don't want it 'because socialism' or whatever nonsensical argument based on the in-grained illusion of the 'American Dream' of a merit-based society where everyone decides their own fortune. Meanwhile social mobility in the US is among the lowest of all developed nations. The level of cognitive dissonance really is mind-blowing.
  - deleted 9y ago
perseusprime11 9y ago
As an american I tend to agree with your viewpoint except for one- We are still the best in the world :)
- tobylane 9y ago
  Can you expand on that?
- spiderfarmer 9y ago
  Show me all the indices where the US is #1 and I'll take your argument in consideration.
- ionised 9y ago
  At what?
- richardthered 9y ago
  As measured .. how? I understand liking your country. I'm an American, too. I like my country, a lot. But, I think that the phrase "we are the best in the world" gets thrown around a lot as a meaningless platitude. It gets used more as a "my team is the Yankees"-style of statement. e.g. expressing your preference/allegiance, rather than meaning what it actually says, which is that the US is the 'best' in the world. To be the 'best' at something, you need to define how you're measuring that. Healthiest? Happiest? Longest life span? Because when you look at actual metrics for these types of things, across multiple countries, the US does not rate at the top. Have you seen this clip of Jeff Daniels in "The Newsroom"? https://www.youtube.com/watch?v=wTjMqda19wk https://www.youtube.com/watch?v=wTjMqda19wk ("America is not the greatest country in the world anymore")
vowelless 9y ago
Your comment has almost nothing to do with the actual point raised in the article and is just a general tirade critical of the US. How does your comment relate to the the main cause of issues in American healthcare: raw cost of care? Why should it take 10s of thousands of dollars to get 20 mins of general anesthesia (like it costed me, billed to my insurance)? And what does that cost have to do with "empathy" or "ego" of Americans?
- tobylane 9y ago
  Because you're told that the flawed way OP set out is the better way despite the lack of results.
  - pas 9y ago
    Could you explain your comment please? It's not clear (at least I don't get it), what do you mean by flawed way and better way.
    - tobylane 9y ago
      Take the first point, "The US is philosophically much more egotistic than other developed countries". If all Americans accepted that they as a whole would pay less if they pre-paid in taxes rather than post-treatment bills then the country would be better off. What's stopping them accept this is the overlap of media, politicians, rich people (and maybe more, not my area of expertise) telling you that isn't true. The better way is to ignore them, to let money speak not money holders. That can be expanded on with another point, the American dream. If the millionaires tell an American dreamer that something isn't a good idea the dreamer will consider it a roadblock to their own riches.
      - vowelless 9y ago
        > If all Americans accepted that they as a whole would pay less if they pre-paid in taxes rather than post-treatment bills then the country would be better off. > What's stopping them accept this is the overlap of media, politicians, rich people (and maybe more, not my area of expertise) telling you that isn't true. The better way is to ignore them, to let money speak not money holders. Or perhaps this is just not true. See adventured's comment. And also, why should all Americans prepay in taxes to subsidize 10s of thousands of dollars for one 20 min anesthesia session? Why should they continue encourage these insane health care costs by pre paying for them? How is the country better off this way?
dominotw 9y ago
I bought biking shorts yesterday it was an American medium/European large. Americans eat way too much easy carbs and "unhappy" meat. Sure there are other reasons but this is the reason they spend so much. Ppl would be willing to pay healthcare for others who fall on bad times, but most sick ppl are ppl who made bad lifestyle choices and everyone knows this.
christophilus 9y ago
I agree with a lot of your points, but "Religion is not focused on empathy at all anymore, if it ever was" is a bit of a blanket statement and is mostly untrue. It is certainly true for certain fundamentalist groups. Those are the loudest groups but are a minority among religions here in the states. I was raised Protestant and am now Catholic. The mainline Protestant churches, the majority of the Catholic church, and every Jewish and Muslim organization I've encountered-- all very much focus on social justice. The USCCB (Catholic bishops) were big proponents of Obama Care before they realized it would contain some clauses that ran afoul of magisterial Catholic teaching. In general, I'd say that religion here has a heavy focus on empathy. [EDIT: spelling]
- jcranberry 9y ago
  I'm too young to remember, but I feel that religion or religious people in America used to be deeply empathetic. Every single person I've known from the Greatest Generation seem to have strong senses of empathy and generally live mindfully. Nowadays it seems that a lot of that has died out in most places though...except for like, Utah...
IanDrake 9y ago
You’ve confused the problem with solution. The problem is government (as I will attempt to explain), so the solution can not be more government. Healthcare started to go very wrong in this country when the government stepped in [1]. Because of tax laws, it became more economical for employers to provide healthcare insurance. This has all sorts of consequences. 1) I don’t pay the premiums, so it doesn’t matter how often I go to the doctor. It is essentially free to me. 2) I’m not price sensitive about the service the insurance pays for and I’m not price sensitive for the premiums paid by my employer. 3) Having customers who are not price sensitive reduces incentives to lower prices. Then there are the government regulations that limit the supply of healthcare services[2]. Then there’s out out of control sue-happy society who are encouraged to sue everyone if they don’t like their outcome[3]. We need tort reform. The problem with Europe is that you guys don’t seem to understand the difference in scale, culture, and demographics between our situations. You guys have small nations with homogeneous cultures. So, you’ll have to excuse us for not taking your advice. The closest you’ve come to rivaling the US government is the EU and look how well that’s going. It’s a hard problem and we’re actually doing pretty good. 1- http://www.americanthinker.com/articles/2009/09/understanding_the_cause_of_hea.html http://www.americanthinker.com/articles/2009/09/understandin... 2- https://scholarlycommons.law.case.edu/cgi/viewcontent.cgi?article=1152&context=healthmatrix https://scholarlycommons.law.case.edu/cgi/viewcontent.cgi?ar... 3- https://www.forbes.com/sites/rickungar/2010/09/07/the-true-cost-of-medical-malpractice-it-may-surprise-you/#14e39b372ff5 https://www.forbes.com/sites/rickungar/2010/09/07/the-true-c...
- clavalle 9y ago
  Do you go to the doctor when you don't need to? Going to the doctor is essentially free to me as well and I haven't gone in years. Elasticity of demand goes both ways. States like mine (Texas) have instituted tort reform. What happened? Insurance prices stayed the same and the insurance companies pocketed the difference. Also, hospitals had far less incentive to self-police their employees so we ended up with a lot of bad doctors and surgeons blithely continuing their malpractice. As for scale: cost-sharing scales phenomenally well. Larger scale is an argument for national healthcare in the US. I've never understood the perceived mechanism between the 'culture and demographics' argument.
ChemicalWarfare 9y ago
I'll just pick on the low hanging fruit here: >> Conservative media does a very good job at keeping at least 50% of the country comically uninformed... goes both ways depending on your "camp". it's funny though how this contradicts your point about US being "divided" since clearly this statement is as partisan as it gets. >> The "American Dream" gives people the impression that working hard solves everything and that their country is the best in the world period what's wrong with that exactly?
- clavalle 9y ago
  >>working hard solves everything and that their country is the best in the world period >what's wrong with that exactly? I think I can answer this. The Puritan work ethic is great. Working hard actually does solve many, many problems. So, why is there an issue? When it is assumed that working hard fixes all problems, then it is also assumed that if there are problems then the reason must be that someone didn't work hard enough to solve that problem. This causes people to dismiss problems as if they know the root cause when they really don't. This is a huge problem. As for the 'best in the world, period' issue? Well, when you're convinced you are already the best, why work to improve? If there are problems showing, then it must be a fundamental characteristic of life or the situation we find ourselves in (the 'we have a very heterogeneous society so other nation's solutions couldn't possibly work here' argument comes to mind), not that we could possibly need to improve. We're already the best! Resting on one's laurals. Never a good thing.
brightball 9y ago
I've always thought the biggest "root cause" issue of what we see is that our political system doesn't handle trial and error well at all...anymore. In the last 100 years the US has moved much more towards consolidated federal policy. Federal level policy comes with a lot of issues. First, combining politics with trial and error doesn't work in a 2 party system. 1 party will point out its flaws, while the other party will pretend they don't exist or be defensive about those flaws. The country will be left with people who feel the pain of that problem and those who do not. The ones who feel the pain will vote to end the pain, regardless of anything else. The ones who don't feel the pain won't see the big deal and will focus on other issues...and those other issues will be seen as issues that the other party was voting "against". The other issue is that with federal policy, the entire country suffers from the consequences of issues. Once the legislation is in place, it's nearly impossible to change or remove so if you think there MIGHT be an issue you're better off voting staunchly against it. State level policy doesn't suffer from this issue. With 50 states and a national idea that all policy should be state level, we'd have 50 experiments. If one state tried something and it worked, other states would research what they did and follow suit. If it didn't work, they'd stay away. Or try something new. County/City level is even better. That's why when people were selling the ACA as "what Romney did in his state" were missing the point. The point was that was state level...so other states could follow if they wanted. It didn't mean that should be the policy at a federal level. The entire point was that it was a state level policy. At the federal level and in the election, Hillary wouldn't even acknowledge there were problems with the ACA and IMO that is what cost her the election, because new premium letters started coming out just before election and there was a lot of pain to go around.
- clavalle 9y ago
  >The point was that was state level...so other states could follow if they wanted. When it comes to cost-sharing schemes the bigger the pool the better -- costs are more predictable the more people are in the pool. I agree with the general idea that laboratory democracy is a good idea but health care costs, 'insurance' etc. are well understood and best handled at the largest level possible. Hillary acknowledged problems with the ACA but believed that it needed to be patched, not re-written from scratch. I agree. A few patches that would have a big impact: A national public option to force competition (along with cross-state selling of insurance -- but not one without the other or at least that cross-state selling of insurance must be done across all states if offered that way) would go a long way to pushing competition and reducing perverse incentives that the ACA created with the 'profits based on percentage spent on care' scheme. Redefining full-time employees as full-time equivalents for defining thresholds within the law. This was a flat-out mistake that pushed some employers to do some very silly things. Create incentives for patients to shop around for the best cost of care. Require some level of transparency in pricing even if it is only common treatments and tests. The mandate would have to stay. The choice is, have a mandate and force people to buy insurance they need or don't have a mandate and force people who buy insurance to pay for the health risk of those who mistakenly believe they shouldn't have to pay for their own.
OscarTheGrinch 9y ago
Indeed. The cancer at the heart of the american dream can be summarised by the cry of the rugged individualist: "Why should I pay for your health care?"
- Cshelton 9y ago
  Wrong. Many Americans, including myself, think of personal responsibility first. Actions may have consequences, period. I exercise regularly, eat healthy, keep the amount of sugar/glucose I consume to a minimum, keep alcohol and drug use in check and I don't smoke. Those are MY life choices. Nobody forced me to do any of the above. I choose to live this way because I want to remain healthy and hopefully life a long, healthy life. So why do I ask the question of "Why should I pay for your health care"? If an individual smokes regularly, eats McDonalds weekly or more, does not exercise or even attempt too, does not get adequate sleep, is morbidly obese for a large portion of their life (due to their decisions above), and regularly partakes in a large amount of alcohol and drug use, it is almost CERTAIN that their cost of health care, especially later in life, will be magnitudes higher. Those are decisions THEY made. Not me, not the government, themselves. So no, I will not pay for your healthcare when you make the decision to live a life like that. Take responsibility on yourself. Want to ignore your body? Fine, but don't make me pay for it. Unfortunately, a larger percent of our population is obese, which is one of the largest causes of other complications that end up costing our healthcare system a considerable amount. If we could focus that money into solving health issues that are not the cause of an individuals' actions, we would have cancer solved by now. But no, we spend it on the guy who is 55 and weighs 450 lbs because he ate fast food every fucking day for the last 25 years. No. Just No.
  - atonse 9y ago
    Sorry this is just such a bad, bad, bad example. It completely ignores so many facts: 1) Your example ignores accidents that happen: people get sick even when they've got healthy lifestyles, people are hurt in accidents, etc. Sometimes you have a baby prematurely born that has to stay in the NICU for months, already running up a $1 mil bill before they've even come home. Childhood cancers. 2) A lot of what gets people unhealthy is also things that they aren't aware of. We've only in the past 5-10 years had more awareness of just how much sugar is in EVERYTHING. Same goes for chemicals, pesticides. These are all choices that consumers haven't actively made, but were made for them by money'd interests. 3) Would you say the same about your parents? About your loved ones? About your children that ate too much candy, or drove too fast in their teenage years? Probably not. My opinion is that American society (of which I'm a part of) has gone too far in the direction of individuality and "I've got mine, screw you" – and we're all suffering for it. We no longer think as a collective, but instead just look at everything through the lens of ourselves. Healthy people included. You just don't know it yet.
badwulf 9y ago
> - Conservative media does a very good job at keeping at least 50% of the country comically uninformed And liberal media keeps the other 50% uninformed. > - Religion is not focussed on empathy at all anymore, if it ever was Citation needed. > The billionare .0001% will probably do their utmost to keep the status quo, as evidently, they are the ones that are profiting from the current situation and they are the ones calling the shots for the next 3 years. Can you elaborate on this? What makes you think all billionaires are worried about making more billions? If I look at Bill Gates or Mark Zuckerberg, they don't seem to be worried about earning more money. > The US is doing very good in a lot of areas, but I think collective egotism is preventing it from reaching its true potential. What if what you have right now is your true potential?
ctlby 9y ago
As a European immigrant to the US, it pains me to see such misconceptions so widely held. Some of this is complete nonsense, but some stems from a mix of unsophisticated thinking and a profound lack of understanding of the country. > The US is philosophically much more egotistic than other developed countries A weakness and a strength, see below. > Politically the US is the most divided western country with its two party system Political gridlock and fighting is largely irrelevant because the commercial sphere is the real motive force of the country. This point seems especially difficult to comprehend for Europeans accustomed to pervasive state participation in daily life. The vibrancy and diversity of the capitalist economy here is unparalleled. > Money in politics means it's one of the most corrupt The corruption flows from America's egotism; money is a red-herring. Political fund-raising is about relative success, not absolute (you just need to outspend your opponent), so the vast amounts in play are simply a function of a zero-sum arms race: American society deploying its ever-growing wealth to buy a fixed quantity of political influence. $1M creates no more obligation than $1000 if the latter is sufficient to win. > Conservative media does a very good job at keeping at least 50% of the country comically uninformed This is just silly. Fox News is 95% of "conservative media," and viewership on any given night is 2.6 million people, ~0.8% of the population. Multiply by whatever fudge factor you want to get to total viewership. You've got a ways to go to get to half the country. > The billionare .0001% will probably do their utmost to keep the status quo Paranoid, conspiracy-minded nonsense. > The "American Dream" gives people the impression that working hard solves everything and that their country is the best in the world period. This is very true, conditional on you being capable. The USA has an immensely deep bench of talent and does an excellent job assimilating talent from around the world. All of these talented people are immensely incentivized to deliver, and they deliver in spades! Their contributions pull the rest of the world up with them, despite all the inequality belly-aching from collectivist types. If you are a person of intelligence and ambition, there is no better place than the US to maximize your gifts. > The US is doing very good in a lot of areas You're damn right it is! Most curiously to me, many Europeans bemoan the state of our lower and middle classes, despite those same people doing _better_ than their European counterparts on almost every material measure at almost every decile! [try to play with e.g. EDHI by DECILE at http://www.lisdatacenter.org/data-access/ http://www.lisdatacenter.org/data-access/ > but I think collective egotism is preventing it from reaching its true potential. Perhaps. It certainly makes it more difficult to solve certain collective action problems, but it also encourages citizens to tackle problems others find trivial. I doubt, for example, that Twitter could have been built outside the US: the a priori use is to selfishly broadcast thoughts about me, me, me; the vast social utility is an emergent property.
thescribe 9y ago
I am probably what you would consider an extreme conservative, but I wanted to thank you for sharing your perspective. What do you mean by: > The US is philosophically much more egotistical than other developed countries. It isn't a criticism that I had heard before.
deaddodo 9y ago
> Conservative media does a very good job at keeping at least 50% of the country comically uninformed A bit of an oversimplification. More like it keeps about 25-30% convinced they'll someday be a CEO of a corporation, so to vote in the interest of businesses. There's another 5-10% that have zero issues taking advantage of that naiveté for their own end goals. But, on the other side, you have a highly apathetic and disillusioned crowd who hardly show up to vote. And, who can blame them? The system seems built against their own interests. But it's a self-destructive thought process.

kulu2002 9y ago

Very true. While chasing American Dream people of America have become very much business minded and profit-centric. American egoism basically means looking for "Whats in it for me?" everywhere.

staticelf 9y ago

The funny thing is that, per capita, many european countries has more billionaires than the US. That's saying something about "The American Dream" imo. What I meant is that the billionaires maybe doesn't need to uphold the status quo?

spiderfarmer 9y ago
And that taxes aren't as bad as they think.
- mrarjen 9y ago
  Taxes would be a whole of a lot better if they didn't let you pick all the products and then during payment add the % of tax on top of it! Just include it in the price!
  - raquo 9y ago
    I disagree. In Russia an average employed person never even has to file income tax declaration, and any local sales taxes are included in the final price. People don't even know how much they're taxed. All they know is that income tax is 13%, they don't realize how many other taxes are added up to both their salary and the products they buy. As much as the mental overhead of expecting a sales tax on checkout annoys me, I'll suffer through it so that everyone has a constant reminder that the government is taking its cut.
    - mrarjen 9y ago
      It will show in details regarding the price/payment here (Netherlands) Beats getting unexpected extra costs suddenly added for me personally... and in Amerika when eating out you even have to pay part of the salary for the staff afterwards...
    - tobylane 9y ago
      How much of what you pay for gas is taxes deducted at various levels? If it's foreign oil did it pay other governments, like the Panama or Suez Canal? Knowing what the take is for what you buy in person is such a tiny portion of the bigger picture. And with the county/state/federal variations how closely do you keep track of who is ripping you off and who is using the money well?
  - jejones3141 9y ago
    Only "better" in the sense that tax withholding is, i.e. it hides just how much of your money the government seizes. A friend of mine has a print of a painting showing soldiers around a large container holding goods and money that citizens were being forced to pay in tribute. The central figure in the painting is a man--I think his family is with him. I don't remember whether the painter shows him actually putting something in the container or not, but he's looking daggers at those guarding the tribute and enforcing its collection. That look reflects how people should think of paying taxes, and things like VAT and tax withholding that lull the host into not realizing just how much he or she is being taken for need to go away.
dagw 9y ago
per capita, many european countries has more billionaires than the US. I wouldn't say 'many'. The 'top' countries are places like Iceland, Guernsey, Monaco and Cypress which are skewed due to their tiny populations. The only country which can realistically 'compete' in this metric are Norway, Sweden and Switzerland. That being said, if we're talking "The American Dream" then simply measuring the number of billionaires isn't a useful metric. We should really focus on self made billionaires rather than people who became billionaires due to inheritance. On that metric I believe the US still leads the pack.
- pjc50 9y ago
  > Guernsey, Monaco and Cyprus Tax havens. The billionaires themselves are usually "citizens of the world" who live in hotels or a series of holiday homes. Countries don't "have" billionaires in any kind of possessive sense any more. Instead they compete in the hope that billionaires will pass through and trickle down some wealth.
- robbiep 9y ago
  Whilst the US has more self-made billionaires than Europe [0] the US has lesser social mobility than Europe (less the UK), rendering the idea of 'the American dream' more a dream than a possibility [1, 2] Healthcare is a price-inelastic good. Not having some form of pricing controls is a licence to rip the heart out of a population. [0] https://howmuch.net/articles/billionaires-map https://howmuch.net/articles/billionaires-map [1] https://www.theatlantic.com/business/archive/2016/07/social-mobility-america/491240/ https://www.theatlantic.com/business/archive/2016/07/social-... [2] https://www.brookings.edu/wp-content/uploads/2016/07/02_economic_mobility_sawhill_ch3.pdf https://www.brookings.edu/wp-content/uploads/2016/07/02_econ...
  - true_religion 9y ago
    The article concludes the usa has lower social mobility simply because the very rich, are now much richer thus it is harder to move to that income group.
- staticelf 9y ago
deleted 9y ago
[deleted]

mehrdadn 9y ago

[Edit: sigh, never mind.]

robert_foss 9y ago
Having only two options forces the two to be different, more options provides you with a better spectrum of political ideology.
spiderfarmer 9y ago
I don't think so, because you might agree more easily with "other people" on several issues and therefore switch more easily to another party.
aristidb 9y ago
In a five party system, it is quite common for voters to not feel too much allegiance to any party in particular.
- teekert 9y ago
  Exactly, here in the Netherlands you still need a majority, this is often formed from 3 or more parties that have to negotiate a lot before coming up with a plan.
- cbcoutinho 9y ago
  That depends on what you determine is important to you. In the Netherlands there is a 'Party for the Animals', which doesn't compromise on anything and is quite literally a protest one-issue party. Obviously they don't get as much done as other more diverse political parties, but people still vote for them because the party at least shows everyone else that there are citizens who care enough about animals to have a protest vote and have the chance to at least sit in congress.
em500 9y ago
In most multi-party systems, parties are always forced to compromise and cooperate to get anything done, since it's almost impossible to get a single party majority. Dutch governments are almost always formed by 2 to 4 parties (usually a centrist party plus either left- or right-leaning parties) which largely prevents swings to extremes.

falsedan 9y ago

> - Politically the US is the most divided western country with its two party system This sounds like you think that political pointscoring drives up health care costs, but the UK & AU both have strong, long histories of two-party politics & have much lower health care costs.

SilkRoadie 9y ago
The US system allows one party to freeze out another for periods of time due to control of different chambers. There were government shut downs under Obama.. I think that shows how terrible the US system is at the moment. Other countries like the UK and AU will typically have the ruling party in control of a majority. The US seems to almost always be running some sort of minority government due to loss of one of either the senate or house.
- falsedan 9y ago
  > Other countries like the UK and AU will typically have the ruling party in control of a majority. That's not my understanding or experience, and I'm a voter for both. The number of governments where the ruling party controlled both chambers is fairly rare. AU elects the upper chamber on a different schedule to the lower, so often a new government (in the House of Reps) will face an opposition-controlled Senate. I think this is the same as the US system. The UK has it worse with the House of Lords, which aren't elected and thus won't ever change hands directly from a General Election result. Also note that the voting tradition in AU is that if Labour gains control of the Federal government, then the Liberal/National Coalition generally gains control of the state legistlatures (and vice versa). Perhaps you mean that a UK or AU lower chamber facing a hostile upper chamber is still functional and productive compared to the equivalent in the US. I think the threat of blocking supply or a vote of no confidence (or in the AU, a double dissolution) helps these governments be more willing to compromise with their opponents & pass legistlation, in the absence of a majority. > some sort of minority government A minority government is a rather specific term, and can be easily misunderstood when used to refer to an opposition-controlled upper house (which doesn't ever really exist in the UK). Could you please be more specific?
- 9y ago

zaptheimpaler 9y ago

The US IS the greatest country in the world (* AT salesmanship *). That about sums up the concept of "The American Dream" for me.. their government is extraordinarily good at selling certain worldviews & suppressing others, both to their own citizens and to the world. Turns out that salesmanship, psychological influence & media control is a pretty powerful combination. They even routinely manage to sell invading & plundering other nations as "defense". Its a brilliant idea to sell to your citizens as a nation or industrial tycoon... that "we are the greatest because of hard work, hard work implies success, and success implies hard work", and then watch your citizens/employees define themselves by work so that the nation/corporation gets wealthier and more powerful. All the while common sense (or statistics) will tell you that money begets money & power begets power, the rich get richer and the poor usually stay poor. Unfortunately the American Dream idea is not always good for the workers themselves but the people selling the idea were not too concerned about that :) They simply sell just enough mental health care to keep you productive but docile on the side!

ThomPete 9y ago

You are missing a very important point which is that the US is a country of immigration and of different states and the US is a very very very big country. You can't compare it to Holland or Denmark or even Germany. These solutions won't work here. America IS the land of opportunity and I would challenge you to find any other country which provides better opportunity and still protect your rights as well. Edit: The land of opportunity doesn't mean the land of equality and the expression was never intended to be that. America is not egoistic it's just a very hardcore country because it's built on top of people who with their lives at stake started exploring and setting up local societies. So the country is build on tough women and men. They aren't more selfish or egoistic than any other person, their reality is just different than a little country like holland or my own (Denmark).

spiderfarmer 9y ago
The US is a big country with different states, but so is the EU. The policies of Holland, Denmark or Germany could definately work in the US, if only the people developed a different stance on criminal behavior, healthcare, guns and taxes, America is the land of opportunity for some people. There are a lot of other countries with a lot of opportunities and freedom. More than 2 million people are incarcerated in the US right now. Where's the freedom in that? America is very egoistic and hard country, built on the lives poor people who were left behind by their fellow countrymen. With their stance on criminal behavior, healthcare, guns and taxes, the people in the US are definately more egoistic than people in more social democracies.
- ThomPete 9y ago
  You are confusing things here. Incarceration has nothing to do with what we are talking about. No one ever said the US is perfect. We are talking about whether 1) you can apply scandinavian style healthcare to the us (you can't) and whether the US provides more opportunities than other places (it still does) It's not equal and it's not trying to be equal either. EU isn't big geographically compared to the US and it's not as sparsely populated as the US is. That's what I mean with big. Yes, America is the land of opportunity for some. I don't think we were debating obvious truths here. The point is that America does, in fact, provide much more opportunities. That doesn't mean everyone is going to make it. That's never been the point about that expression anyway. The US isn't more selfish if we actually look at how many volunteer in the US that alone would show that it's not that simple.

Joeri 9y ago

Counterpoint from a fellow european. I found americans to not be more selfish, but more appreciative of self-reliance. In europe in most countries the philosophy is that of the nanny state, taking care of its citizens no matter what got them into a care-needing situation. In much of the US there’s much more a perception of responsibility for your own success, with negative individual outcomes being considered a necessary evil linked to personal freedom. Looking at the stats clearly the US needs a little more nanny state to generate better outcomes for the bottom half of the country. But equally europe needs more appreciation of self-reliance and entrepreneurship to enable a richer startup culture and let the EU become an economic leader instead of follower.

mrpopo 9y ago
> But equally europe needs more appreciation of self-reliance and entrepreneurship to enable a richer startup culture and let the EU become an economic leader instead of follower. Does it? Is the purpose of a nation state to compete with others based on economic metrics? Yes, I know that most countries are doing that, but in a thread where we compare individualism/selfishness with nanny/"charity" state, shouldn't this competition be questioned?
- spiderfarmer 9y ago
  Yes it should be questioned. Would I enjoy being filthy rich, while my neighbour is struggling with his hospital bills? Hell no. For me government is about taking care of the sick, poor and vulnerable as much as taking care of wannabe millionairs.
  - logicchains 9y ago
    >Would I enjoy being filthy rich, while my neighbour is struggling with his hospital bills? Hell no. Nobody would stop you from helping with your neighbour's hospital bill if you were filthy rich.
    - scarface74 9y ago

cdoxsey 9y ago

Your comment about religion is incorrect. Americans are very generous: https://givingusa.org/giving-usa-2017-total-charitable-donations-rise-to-new-high-of-390-05-billion/ https://givingusa.org/giving-usa-2017-total-charitable-donat.... Conservative Evangelical Churches spend an enormous amount of time and money helping people. For example: The Southern Baptist Convention runs the third largest disaster relief organization in the country behind the Salvation Army (also religious...) and the Red Cross. I could give lots of other examples. I'm not sure where this perception about religion is coming from. Maybe in Europe the church is largely dead, but that's not true in the US.

pjc50 9y ago
> I'm not sure where this perception about religion is coming from. Mostly the high-profile anti-abortion campaigning (which by extension poisons all women's healthcare and sex education discussions), and homophobia. And the segregation. https://www.nytimes.com/2017/07/17/opinion/why-im-leaving-the-southern-baptist-convention.html https://www.nytimes.com/2017/07/17/opinion/why-im-leaving-th... > Maybe in Europe the church is largely dead "Europe" is a huge place that's a lot more diverse than the US. Christianity is still official state religion in various places; Germany still has tithing baked into the tax system! http://www.telegraph.co.uk/news/worldnews/europe/germany/11380968/Compulsory-income-tax-on-Christians-drives-Germans-away-from-Protestant-and-Catholic-churches.html http://www.telegraph.co.uk/news/worldnews/europe/germany/113... Ireland is in the middle of the long process of evicting its theocracy.
weberc2 9y ago
Also, the Salvation Army is an evangelical church, and it is one of the most significant charities in the US.
- SolaceQuantum 9y ago
  The Salvation Army has a history of homophobic and anti-lgbtq policies and practices.
  - 9y ago

Fej 9y ago

What's the Dutch perspective on American media?

spiderfarmer 9y ago
We don't watch much American (news) media, but our own journalists say they try to not directly quote the hyperpartisan, hyperbolic, fear-instilling American media but go to the source whenever possible.
w0utert 9y ago
>> What's the Dutch perspective on American media? My perspective on American media is that even though everyone has access to (mostly) unbiased, factual sources, quality investigative journalism, uncensored internet etc, for some reason a very large cross-section of the population willingly chooses to believe the partisan crap and plain and simple bullshit peddled by outlets like Fox News and (to a somewhat lesser degree) MSNBC. I regularly visit the US, and frankly I'm appalled by the downright evil crap that seems to be on 90% of the time on televisions everywhere in public. I would be thoroughly embarrassed if the situation at home would be even remotely comparable. And now you have a POTUS that actively promotes to make the situation even worse by labeling anything he dislikes as 'fake news', while at the same time spreading easily falsifiable information as truth. I really have no idea how the US got to this place. The problem is not that the US does not have free press, but there seems to be a level of partisanship that feeds this vicious cycle of misinformation, always putting the blame at the other side, and a total disregard for simple facts that things could be so much better for everyone if the two sides would actually try to work together and find compromises for once. The health care system is just an example of this. Even though there are countless examples of developed countries that have a much better system with significantly lower costs because of things like single-payer insurance, maximum tariffs, etc, somehow the american people don't want it 'because socialism' or whatever nonsensical argument based on the in-grained illusion of the 'American Dream' of a merit-based society where everyone decides their own fortune. Meanwhile social mobility in the US is among the lowest of all developed nations. The level of cognitive dissonance really is mind-blowing.
- deleted 9y ago

perseusprime11 9y ago

As an american I tend to agree with your viewpoint except for one- We are still the best in the world :)

tobylane 9y ago
Can you expand on that?
spiderfarmer 9y ago
Show me all the indices where the US is #1 and I'll take your argument in consideration.
ionised 9y ago
At what?
richardthered 9y ago
As measured .. how? I understand liking your country. I'm an American, too. I like my country, a lot. But, I think that the phrase "we are the best in the world" gets thrown around a lot as a meaningless platitude. It gets used more as a "my team is the Yankees"-style of statement. e.g. expressing your preference/allegiance, rather than meaning what it actually says, which is that the US is the 'best' in the world. To be the 'best' at something, you need to define how you're measuring that. Healthiest? Happiest? Longest life span? Because when you look at actual metrics for these types of things, across multiple countries, the US does not rate at the top. Have you seen this clip of Jeff Daniels in "The Newsroom"? https://www.youtube.com/watch?v=wTjMqda19wk https://www.youtube.com/watch?v=wTjMqda19wk ("America is not the greatest country in the world anymore")

vowelless 9y ago

Your comment has almost nothing to do with the actual point raised in the article and is just a general tirade critical of the US. How does your comment relate to the the main cause of issues in American healthcare: raw cost of care? Why should it take 10s of thousands of dollars to get 20 mins of general anesthesia (like it costed me, billed to my insurance)? And what does that cost have to do with "empathy" or "ego" of Americans?

tobylane 9y ago
Because you're told that the flawed way OP set out is the better way despite the lack of results.
- pas 9y ago
  Could you explain your comment please? It's not clear (at least I don't get it), what do you mean by flawed way and better way.
  - tobylane 9y ago
    Take the first point, "The US is philosophically much more egotistic than other developed countries". If all Americans accepted that they as a whole would pay less if they pre-paid in taxes rather than post-treatment bills then the country would be better off. What's stopping them accept this is the overlap of media, politicians, rich people (and maybe more, not my area of expertise) telling you that isn't true. The better way is to ignore them, to let money speak not money holders. That can be expanded on with another point, the American dream. If the millionaires tell an American dreamer that something isn't a good idea the dreamer will consider it a roadblock to their own riches.
    - vowelless 9y ago
      > If all Americans accepted that they as a whole would pay less if they pre-paid in taxes rather than post-treatment bills then the country would be better off. > What's stopping them accept this is the overlap of media, politicians, rich people (and maybe more, not my area of expertise) telling you that isn't true. The better way is to ignore them, to let money speak not money holders. Or perhaps this is just not true. See adventured's comment. And also, why should all Americans prepay in taxes to subsidize 10s of thousands of dollars for one 20 min anesthesia session? Why should they continue encourage these insane health care costs by pre paying for them? How is the country better off this way?

dominotw 9y ago

I bought biking shorts yesterday it was an American medium/European large. Americans eat way too much easy carbs and "unhappy" meat. Sure there are other reasons but this is the reason they spend so much. Ppl would be willing to pay healthcare for others who fall on bad times, but most sick ppl are ppl who made bad lifestyle choices and everyone knows this.

christophilus 9y ago

I agree with a lot of your points, but "Religion is not focused on empathy at all anymore, if it ever was" is a bit of a blanket statement and is mostly untrue. It is certainly true for certain fundamentalist groups. Those are the loudest groups but are a minority among religions here in the states. I was raised Protestant and am now Catholic. The mainline Protestant churches, the majority of the Catholic church, and every Jewish and Muslim organization I've encountered-- all very much focus on social justice. The USCCB (Catholic bishops) were big proponents of Obama Care before they realized it would contain some clauses that ran afoul of magisterial Catholic teaching. In general, I'd say that religion here has a heavy focus on empathy. [EDIT: spelling]

jcranberry 9y ago
I'm too young to remember, but I feel that religion or religious people in America used to be deeply empathetic. Every single person I've known from the Greatest Generation seem to have strong senses of empathy and generally live mindfully. Nowadays it seems that a lot of that has died out in most places though...except for like, Utah...

IanDrake 9y ago

You’ve confused the problem with solution. The problem is government (as I will attempt to explain), so the solution can not be more government. Healthcare started to go very wrong in this country when the government stepped in [1]. Because of tax laws, it became more economical for employers to provide healthcare insurance. This has all sorts of consequences. 1) I don’t pay the premiums, so it doesn’t matter how often I go to the doctor. It is essentially free to me. 2) I’m not price sensitive about the service the insurance pays for and I’m not price sensitive for the premiums paid by my employer. 3) Having customers who are not price sensitive reduces incentives to lower prices. Then there are the government regulations that limit the supply of healthcare services[2]. Then there’s out out of control sue-happy society who are encouraged to sue everyone if they don’t like their outcome[3]. We need tort reform. The problem with Europe is that you guys don’t seem to understand the difference in scale, culture, and demographics between our situations. You guys have small nations with homogeneous cultures. So, you’ll have to excuse us for not taking your advice. The closest you’ve come to rivaling the US government is the EU and look how well that’s going. It’s a hard problem and we’re actually doing pretty good. 1- http://www.americanthinker.com/articles/2009/09/understanding_the_cause_of_hea.html http://www.americanthinker.com/articles/2009/09/understandin... 2- https://scholarlycommons.law.case.edu/cgi/viewcontent.cgi?article=1152&context=healthmatrix https://scholarlycommons.law.case.edu/cgi/viewcontent.cgi?ar... 3- https://www.forbes.com/sites/rickungar/2010/09/07/the-true-cost-of-medical-malpractice-it-may-surprise-you/#14e39b372ff5 https://www.forbes.com/sites/rickungar/2010/09/07/the-true-c...

clavalle 9y ago
Do you go to the doctor when you don't need to? Going to the doctor is essentially free to me as well and I haven't gone in years. Elasticity of demand goes both ways. States like mine (Texas) have instituted tort reform. What happened? Insurance prices stayed the same and the insurance companies pocketed the difference. Also, hospitals had far less incentive to self-police their employees so we ended up with a lot of bad doctors and surgeons blithely continuing their malpractice. As for scale: cost-sharing scales phenomenally well. Larger scale is an argument for national healthcare in the US. I've never understood the perceived mechanism between the 'culture and demographics' argument.

ChemicalWarfare 9y ago

I'll just pick on the low hanging fruit here: >> Conservative media does a very good job at keeping at least 50% of the country comically uninformed... goes both ways depending on your "camp". it's funny though how this contradicts your point about US being "divided" since clearly this statement is as partisan as it gets. >> The "American Dream" gives people the impression that working hard solves everything and that their country is the best in the world period what's wrong with that exactly?

clavalle 9y ago
>>working hard solves everything and that their country is the best in the world period >what's wrong with that exactly? I think I can answer this. The Puritan work ethic is great. Working hard actually does solve many, many problems. So, why is there an issue? When it is assumed that working hard fixes all problems, then it is also assumed that if there are problems then the reason must be that someone didn't work hard enough to solve that problem. This causes people to dismiss problems as if they know the root cause when they really don't. This is a huge problem. As for the 'best in the world, period' issue? Well, when you're convinced you are already the best, why work to improve? If there are problems showing, then it must be a fundamental characteristic of life or the situation we find ourselves in (the 'we have a very heterogeneous society so other nation's solutions couldn't possibly work here' argument comes to mind), not that we could possibly need to improve. We're already the best! Resting on one's laurals. Never a good thing.

brightball 9y ago

I've always thought the biggest "root cause" issue of what we see is that our political system doesn't handle trial and error well at all...anymore. In the last 100 years the US has moved much more towards consolidated federal policy. Federal level policy comes with a lot of issues. First, combining politics with trial and error doesn't work in a 2 party system. 1 party will point out its flaws, while the other party will pretend they don't exist or be defensive about those flaws. The country will be left with people who feel the pain of that problem and those who do not. The ones who feel the pain will vote to end the pain, regardless of anything else. The ones who don't feel the pain won't see the big deal and will focus on other issues...and those other issues will be seen as issues that the other party was voting "against". The other issue is that with federal policy, the entire country suffers from the consequences of issues. Once the legislation is in place, it's nearly impossible to change or remove so if you think there MIGHT be an issue you're better off voting staunchly against it. State level policy doesn't suffer from this issue. With 50 states and a national idea that all policy should be state level, we'd have 50 experiments. If one state tried something and it worked, other states would research what they did and follow suit. If it didn't work, they'd stay away. Or try something new. County/City level is even better. That's why when people were selling the ACA as "what Romney did in his state" were missing the point. The point was that was state level...so other states could follow if they wanted. It didn't mean that should be the policy at a federal level. The entire point was that it was a state level policy. At the federal level and in the election, Hillary wouldn't even acknowledge there were problems with the ACA and IMO that is what cost her the election, because new premium letters started coming out just before election and there was a lot of pain to go around.

clavalle 9y ago
>The point was that was state level...so other states could follow if they wanted. When it comes to cost-sharing schemes the bigger the pool the better -- costs are more predictable the more people are in the pool. I agree with the general idea that laboratory democracy is a good idea but health care costs, 'insurance' etc. are well understood and best handled at the largest level possible. Hillary acknowledged problems with the ACA but believed that it needed to be patched, not re-written from scratch. I agree. A few patches that would have a big impact: A national public option to force competition (along with cross-state selling of insurance -- but not one without the other or at least that cross-state selling of insurance must be done across all states if offered that way) would go a long way to pushing competition and reducing perverse incentives that the ACA created with the 'profits based on percentage spent on care' scheme. Redefining full-time employees as full-time equivalents for defining thresholds within the law. This was a flat-out mistake that pushed some employers to do some very silly things. Create incentives for patients to shop around for the best cost of care. Require some level of transparency in pricing even if it is only common treatments and tests. The mandate would have to stay. The choice is, have a mandate and force people to buy insurance they need or don't have a mandate and force people who buy insurance to pay for the health risk of those who mistakenly believe they shouldn't have to pay for their own.

OscarTheGrinch 9y ago

Indeed. The cancer at the heart of the american dream can be summarised by the cry of the rugged individualist: "Why should I pay for your health care?"

Cshelton 9y ago
Wrong. Many Americans, including myself, think of personal responsibility first. Actions may have consequences, period. I exercise regularly, eat healthy, keep the amount of sugar/glucose I consume to a minimum, keep alcohol and drug use in check and I don't smoke. Those are MY life choices. Nobody forced me to do any of the above. I choose to live this way because I want to remain healthy and hopefully life a long, healthy life. So why do I ask the question of "Why should I pay for your health care"? If an individual smokes regularly, eats McDonalds weekly or more, does not exercise or even attempt too, does not get adequate sleep, is morbidly obese for a large portion of their life (due to their decisions above), and regularly partakes in a large amount of alcohol and drug use, it is almost CERTAIN that their cost of health care, especially later in life, will be magnitudes higher. Those are decisions THEY made. Not me, not the government, themselves. So no, I will not pay for your healthcare when you make the decision to live a life like that. Take responsibility on yourself. Want to ignore your body? Fine, but don't make me pay for it. Unfortunately, a larger percent of our population is obese, which is one of the largest causes of other complications that end up costing our healthcare system a considerable amount. If we could focus that money into solving health issues that are not the cause of an individuals' actions, we would have cancer solved by now. But no, we spend it on the guy who is 55 and weighs 450 lbs because he ate fast food every fucking day for the last 25 years. No. Just No.
- atonse 9y ago
  Sorry this is just such a bad, bad, bad example. It completely ignores so many facts: 1) Your example ignores accidents that happen: people get sick even when they've got healthy lifestyles, people are hurt in accidents, etc. Sometimes you have a baby prematurely born that has to stay in the NICU for months, already running up a $1 mil bill before they've even come home. Childhood cancers. 2) A lot of what gets people unhealthy is also things that they aren't aware of. We've only in the past 5-10 years had more awareness of just how much sugar is in EVERYTHING. Same goes for chemicals, pesticides. These are all choices that consumers haven't actively made, but were made for them by money'd interests. 3) Would you say the same about your parents? About your loved ones? About your children that ate too much candy, or drove too fast in their teenage years? Probably not. My opinion is that American society (of which I'm a part of) has gone too far in the direction of individuality and "I've got mine, screw you" – and we're all suffering for it. We no longer think as a collective, but instead just look at everything through the lens of ourselves. Healthy people included. You just don't know it yet.

badwulf 9y ago

> - Conservative media does a very good job at keeping at least 50% of the country comically uninformed And liberal media keeps the other 50% uninformed. > - Religion is not focussed on empathy at all anymore, if it ever was Citation needed. > The billionare .0001% will probably do their utmost to keep the status quo, as evidently, they are the ones that are profiting from the current situation and they are the ones calling the shots for the next 3 years. Can you elaborate on this? What makes you think all billionaires are worried about making more billions? If I look at Bill Gates or Mark Zuckerberg, they don't seem to be worried about earning more money. > The US is doing very good in a lot of areas, but I think collective egotism is preventing it from reaching its true potential. What if what you have right now is your true potential?

ctlby 9y ago

As a European immigrant to the US, it pains me to see such misconceptions so widely held. Some of this is complete nonsense, but some stems from a mix of unsophisticated thinking and a profound lack of understanding of the country. > The US is philosophically much more egotistic than other developed countries A weakness and a strength, see below. > Politically the US is the most divided western country with its two party system Political gridlock and fighting is largely irrelevant because the commercial sphere is the real motive force of the country. This point seems especially difficult to comprehend for Europeans accustomed to pervasive state participation in daily life. The vibrancy and diversity of the capitalist economy here is unparalleled. > Money in politics means it's one of the most corrupt The corruption flows from America's egotism; money is a red-herring. Political fund-raising is about relative success, not absolute (you just need to outspend your opponent), so the vast amounts in play are simply a function of a zero-sum arms race: American society deploying its ever-growing wealth to buy a fixed quantity of political influence. $1M creates no more obligation than $1000 if the latter is sufficient to win. > Conservative media does a very good job at keeping at least 50% of the country comically uninformed This is just silly. Fox News is 95% of "conservative media," and viewership on any given night is 2.6 million people, ~0.8% of the population. Multiply by whatever fudge factor you want to get to total viewership. You've got a ways to go to get to half the country. > The billionare .0001% will probably do their utmost to keep the status quo Paranoid, conspiracy-minded nonsense. > The "American Dream" gives people the impression that working hard solves everything and that their country is the best in the world period. This is very true, conditional on you being capable. The USA has an immensely deep bench of talent and does an excellent job assimilating talent from around the world. All of these talented people are immensely incentivized to deliver, and they deliver in spades! Their contributions pull the rest of the world up with them, despite all the inequality belly-aching from collectivist types. If you are a person of intelligence and ambition, there is no better place than the US to maximize your gifts. > The US is doing very good in a lot of areas You're damn right it is! Most curiously to me, many Europeans bemoan the state of our lower and middle classes, despite those same people doing _better_ than their European counterparts on almost every material measure at almost every decile! [try to play with e.g. EDHI by DECILE at http://www.lisdatacenter.org/data-access/ http://www.lisdatacenter.org/data-access/ > but I think collective egotism is preventing it from reaching its true potential. Perhaps. It certainly makes it more difficult to solve certain collective action problems, but it also encourages citizens to tackle problems others find trivial. I doubt, for example, that Twitter could have been built outside the US: the a priori use is to selfishly broadcast thoughts about me, me, me; the vast social utility is an emergent property.

thescribe 9y ago

I am probably what you would consider an extreme conservative, but I wanted to thank you for sharing your perspective. What do you mean by: > The US is philosophically much more egotistical than other developed countries. It isn't a criticism that I had heard before.

deaddodo 9y ago

> Conservative media does a very good job at keeping at least 50% of the country comically uninformed A bit of an oversimplification. More like it keeps about 25-30% convinced they'll someday be a CEO of a corporation, so to vote in the interest of businesses. There's another 5-10% that have zero issues taking advantage of that naiveté for their own end goals. But, on the other side, you have a highly apathetic and disillusioned crowd who hardly show up to vote. And, who can blame them? The system seems built against their own interests. But it's a self-destructive thought process.