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> Yet another example of the surprisingly poor living quality in the USA in aggregate terms relative to GDP. If your friend grows up in a rich neighborhood and

> Yet another example of the surprisingly poor living quality in the USA in aggregate terms relative to GDP. If your friend grows up in a rich neighborhood and all of his friends drive BMWs, and he's upset because he's driving a brand new Accord, would you feel bad for him? Probably not, but this is how people criticize the USA's relative poverty and income inequality. If you disregard absolute terms and only look things relative to the mean, then of course that means countries with low populations and high in homogeniety (e.g. scandinavian countries) will look superior in comparison.

forapurpose 8y ago
> If your friend grows up in a rich neighborhood and all of his friends drive BMWs, and he's upset because he's driving a brand new Accord, would you feel bad for him? Probably not, but this is how people criticize the USA's relative poverty and income inequality. The US has higher income per capita than almost any country in the world, yet living standards are relatively low for a wealthy country. For example, many US citizens don't have access to health care or decent education. Alone among wealthy countries, US life expectancy is dropping. That's not the difference between an Accord and a BMW, but between life and death. https://www.washingtonpost.com/news/wonk/wp/2017/12/27/americans-are-dying-younger-than-people-in-other-rich-nations/?utm_term=.96ad041fff54 https://www.washingtonpost.com/news/wonk/wp/2017/12/27/ameri... And also, why should Americans, with all that wealth, want to live like a poorer country? > countries with low populations and high in homogeniety (e.g. scandinavian countries) will look superior in comparison Most wealthy countries look superior to the US, and only a few of the very poorest countries in the world are losing life expectancy. > homogeniety Who says that this has a negative impact? I'm not even sure what it means. In many cases, research shows heterogeneity is a strength, not a weakness. If it's the old racist complaint, I don't see how having many skin colors prevents the US from providing health care for its citizens. A health care system that costs 2-3 times as much seems a more substantial cause.
- defertoreptar 8y ago
  > yet living standards are relatively low for a wealthy country. > Most wealthy countries look superior to the US And yet more people choose to immigrate there than anywhere else in the world: https://businessinsider.com/top-15-countries-migrants-2017-12 https://businessinsider.com/top-15-countries-migrants-2017-1... > Who says that this has a negative impact? Cultural conflict theorists. Undeniably it's a good thing, I agree, but there is an argument for how linguistic/ethnic/religious heterogeneity can create economic friction. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0000929 http://journals.plos.org/plosone/article?id=10.1371/journal....
- sonnyblarney 8y ago
  "US life expectancy is dropping" there are so many things that affect this that it's not a very good measure of healthcare. US has great healthcare for those who have coverage. The issue is non-full coverage and how bonkers costly it is. Not quality in general.
  - forapurpose 8y ago
    > US has great healthcare for those who have coverage While I agree it seems pretty good, I'd be interested in a more detailed breakdown of its strengths and weaknesses (for those who have coverage, and ignoring costs). I realize that nothing tells me that it's "great" other than somewhat boastful repetition by Americans.
    - sonnyblarney 8y ago
      It's great because it's highly professional and responsive, and the opportunities for specialized, high-end care are renowned. When you need something, they do it. In most socialized systems, you wait, and, you may get the commodity version. When you're a special case, there's a specialist there, and often they are on the real cutting edge. Socialized systems tend to get stuff later. If you have something weird and chronic, doctors can look into it. Here in Canada, in Waterloo, I literally could not get a doctor - not as some kind of 'shortage' thing, but by policy: you don't get a doctor - you go to a clinic. They mostly do kids with the flu in there, not weird stuff and it's really difficult to get someone to take you seriously. And it's illegal to pay someone to have a close look at you. The richest people in the world generally go to America for tricky or specialized things. America has the best for those who are covered, it's just to easy to lose coverage, moreover, the costs in the system are byzantine and crazy.
      - forapurpose 8y ago
        I've heard the same things, but they don't match the facts I've observed and read about: > it's highly professional ... I disagree. Hospital errors are a leading cause of death in the U.S., and outcomes vary significantly by zip code - in large part, AFAIK, because doctors don't follow standards of care. Getting them to wash their hands between patients to prevent the spread of infection was (is?) a problem. The opiod epidemic is partly due to doctors over-prescribing the drugs, even when everyone knew about the problems. AFAIK they still overprescribe anti-biotics, even though everyone knows it's creating more drug-resistant threats. The experiences of myself and people I know in U.S. hospitals and is horrible; it's a punchline. People are forgotten and wait for hours in ERs and hospitals. Nurses bring the wrong drugs, and wake people up all night. Doctors and nurses treat patients with utter disrespect. They don't listen at all, they are condescending and rude, and treat patients like their enemies. One person I know showed up for his doctor appointment and could barely find a seat in the waiting room. The doctor had scheduled the whole day's appointments at the same time and expected everyone to just wait - their SOP - including a woman in a wheelchair with a respirator who sat their for hours. And let's not forget doctors like Larry Nasser, the one who sexually abused all those teen girl athletes. His boss at Michigan State University, a dean, gave a speech defending Nasser to other professionals: He said 'you forgot the first rule, never trust patients'. I can't tell you how many Nassers there are, but the dean seems to think that's a widely accepted belief and it matches my observations. > responsive > When you need something, they do it. In most socialized systems, you wait, and, you may get the commodity version. That doesn't describe the experience of anyone I know, even very wealthy, connected people that I know. Everyone waits; specialists schedule people months ahead of time. Then that doctor tells you to see someone else, and you wait a month or more, then the test, then another wait, then another test ... One person I know had crippling back pain, to the point they were talking about death. They contacted the hospital for an appointment and were told to wait a week. They begged and pleaded, daily, for someone to prescribe just painkillers so the patient could make it through the week; the hospital simply didn't care and refused - no painkillers because it would interfere with the examination in a week. I can't imagine what the patient went through. Another person, a 60ish woman, broker her wrist with partial displacement. She had to go to several doctors to find someone to set it - they all told her, 'you don't use it much anyway'.

forapurpose 8y ago

> If your friend grows up in a rich neighborhood and all of his friends drive BMWs, and he's upset because he's driving a brand new Accord, would you feel bad for him? Probably not, but this is how people criticize the USA's relative poverty and income inequality. The US has higher income per capita than almost any country in the world, yet living standards are relatively low for a wealthy country. For example, many US citizens don't have access to health care or decent education. Alone among wealthy countries, US life expectancy is dropping. That's not the difference between an Accord and a BMW, but between life and death. https://www.washingtonpost.com/news/wonk/wp/2017/12/27/americans-are-dying-younger-than-people-in-other-rich-nations/?utm_term=.96ad041fff54 https://www.washingtonpost.com/news/wonk/wp/2017/12/27/ameri... And also, why should Americans, with all that wealth, want to live like a poorer country? > countries with low populations and high in homogeniety (e.g. scandinavian countries) will look superior in comparison Most wealthy countries look superior to the US, and only a few of the very poorest countries in the world are losing life expectancy. > homogeniety Who says that this has a negative impact? I'm not even sure what it means. In many cases, research shows heterogeneity is a strength, not a weakness. If it's the old racist complaint, I don't see how having many skin colors prevents the US from providing health care for its citizens. A health care system that costs 2-3 times as much seems a more substantial cause.

defertoreptar 8y ago
> yet living standards are relatively low for a wealthy country. > Most wealthy countries look superior to the US And yet more people choose to immigrate there than anywhere else in the world: https://businessinsider.com/top-15-countries-migrants-2017-12 https://businessinsider.com/top-15-countries-migrants-2017-1... > Who says that this has a negative impact? Cultural conflict theorists. Undeniably it's a good thing, I agree, but there is an argument for how linguistic/ethnic/religious heterogeneity can create economic friction. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0000929 http://journals.plos.org/plosone/article?id=10.1371/journal....
sonnyblarney 8y ago
"US life expectancy is dropping" there are so many things that affect this that it's not a very good measure of healthcare. US has great healthcare for those who have coverage. The issue is non-full coverage and how bonkers costly it is. Not quality in general.
- forapurpose 8y ago
  > US has great healthcare for those who have coverage While I agree it seems pretty good, I'd be interested in a more detailed breakdown of its strengths and weaknesses (for those who have coverage, and ignoring costs). I realize that nothing tells me that it's "great" other than somewhat boastful repetition by Americans.
  - sonnyblarney 8y ago
    It's great because it's highly professional and responsive, and the opportunities for specialized, high-end care are renowned. When you need something, they do it. In most socialized systems, you wait, and, you may get the commodity version. When you're a special case, there's a specialist there, and often they are on the real cutting edge. Socialized systems tend to get stuff later. If you have something weird and chronic, doctors can look into it. Here in Canada, in Waterloo, I literally could not get a doctor - not as some kind of 'shortage' thing, but by policy: you don't get a doctor - you go to a clinic. They mostly do kids with the flu in there, not weird stuff and it's really difficult to get someone to take you seriously. And it's illegal to pay someone to have a close look at you. The richest people in the world generally go to America for tricky or specialized things. America has the best for those who are covered, it's just to easy to lose coverage, moreover, the costs in the system are byzantine and crazy.
    - forapurpose 8y ago
      I've heard the same things, but they don't match the facts I've observed and read about: > it's highly professional ... I disagree. Hospital errors are a leading cause of death in the U.S., and outcomes vary significantly by zip code - in large part, AFAIK, because doctors don't follow standards of care. Getting them to wash their hands between patients to prevent the spread of infection was (is?) a problem. The opiod epidemic is partly due to doctors over-prescribing the drugs, even when everyone knew about the problems. AFAIK they still overprescribe anti-biotics, even though everyone knows it's creating more drug-resistant threats. The experiences of myself and people I know in U.S. hospitals and is horrible; it's a punchline. People are forgotten and wait for hours in ERs and hospitals. Nurses bring the wrong drugs, and wake people up all night. Doctors and nurses treat patients with utter disrespect. They don't listen at all, they are condescending and rude, and treat patients like their enemies. One person I know showed up for his doctor appointment and could barely find a seat in the waiting room. The doctor had scheduled the whole day's appointments at the same time and expected everyone to just wait - their SOP - including a woman in a wheelchair with a respirator who sat their for hours. And let's not forget doctors like Larry Nasser, the one who sexually abused all those teen girl athletes. His boss at Michigan State University, a dean, gave a speech defending Nasser to other professionals: He said 'you forgot the first rule, never trust patients'. I can't tell you how many Nassers there are, but the dean seems to think that's a widely accepted belief and it matches my observations. > responsive > When you need something, they do it. In most socialized systems, you wait, and, you may get the commodity version. That doesn't describe the experience of anyone I know, even very wealthy, connected people that I know. Everyone waits; specialists schedule people months ahead of time. Then that doctor tells you to see someone else, and you wait a month or more, then the test, then another wait, then another test ... One person I know had crippling back pain, to the point they were talking about death. They contacted the hospital for an appointment and were told to wait a week. They begged and pleaded, daily, for someone to prescribe just painkillers so the patient could make it through the week; the hospital simply didn't care and refused - no painkillers because it would interfere with the examination in a week. I can't imagine what the patient went through. Another person, a 60ish woman, broker her wrist with partial displacement. She had to go to several doctors to find someone to set it - they all told her, 'you don't use it much anyway'.