4 ms·

Do the countries you're referring to have the geographic size, population size, diversity, polarization, and the military responsibilities that the US has?

gspr 6y ago
I've long been puzzled by this argument! Can you please elaborate? > geographic size That might matter for things like transportation infrastructure, but surely being graphically large doesn't make healthcare, schooling or housing harder? At worst, it's surely irrelevant, and at best it might even be an advantage for some of those? > population size I ask another commenter about this here: https://news.ycombinator.com/item?id=23518452 https://news.ycombinator.com/item?id=23518452 > diversity How does this matter? > military responsibilities Arguably, the US is spending far more on the military than her responsibilities necessitate.
- kongolongo 6y ago
  Population distribution in conjunction with geography is what makes it difficult. Even though most of the US population lives in cities, it is necessary to serve the health needs of sparsely populated areas as well. The cost to serve those areas is significantly higher and the distribution of those areas around the U.S. geographically is much different challenge than in Europe. In general, the EU is much more densely populated than the U.S. [1]. Shortages of specialists and emergency services are common examples of challenges with serving rural U.S. areas. The diversity of the population matters because, for example, different cultural practices result in many different health impacts that result in a more diverse set of healthcare challenges aside from the technical ones. Even something as seemingly simple as patients being able to effectively communicate their health issues and healthcare providers being able to understand these needs is a challenge due to cultural barriers. We can make specific comparisons, but in general EU countries populations are more homogeneous than the U.S. [2]. There is significant challenge to be able to train and maintain a healthcare work force that can understand needs of a diverse population. I'm not sure how spending on military affects healthcare directly either, but the VA program is definitely a factor in how the US spends on healthcare. [1] https://en.wikipedia.org/wiki/Population_density#/media/File:World_population_density_1994_-_with_equator.png https://en.wikipedia.org/wiki/Population_density#/media/File... [2] https://www.washingtonpost.com/news/worldviews/wp/2013/05/16/a-revealing-map-of-the-worlds-most-and-least-ethnically-diverse-countries/ https://www.washingtonpost.com/news/worldviews/wp/2013/05/16...
  - gspr 6y ago
    > Even though most of the US population lives in cities, it is necessary to serve the health needs of sparsely populated areas as well. That would perhaps be a valid starting point for further discussions if the urban parts of the US had a good healthcare system. > The diversity of the population matters because, for example, different cultural practices result in many different health impacts that result in a more diverse set of healthcare challenges aside from the technical ones. Citation needed! This is just armchairing.
    - kongolongo 6y ago
      >What would perhaps be a valid starting point for further discussions if the urban parts of the US had a good healthcare system. They aren't disjoint systems. The increased cost of serving rural areas directly impacts urban areas as well. They share Federal funding. Actually comparing whether or not cities have have better healthcare systems than rural areas is much better than trying to define whatever "good" means. And yes in terms of access to specialists and emergency care, they definitely do. >Citation needed! This is just armchairing. Sure. https://patientengagementhit.com/news/cultural-barriers-limit-immigrant-patient-provider-interactions https://patientengagementhit.com/news/cultural-barriers-limi... https://patientengagementhit.com/news/understanding-national-patient-language-proficiency-barriers https://patientengagementhit.com/news/understanding-national...
      - gspr 6y ago
        These are still tiny numbers. If you completely abandoned these groups (you definitely shouldn't), the US healthcare system would still be entirely broken.
        kongolongo 6y ago
        Yes but the point is the solution to "copy EU" countries is extremely naive and doesn't address these significant differences in needs.
        kongolongo 6y ago

gspr 6y ago

I've long been puzzled by this argument! Can you please elaborate? > geographic size That might matter for things like transportation infrastructure, but surely being graphically large doesn't make healthcare, schooling or housing harder? At worst, it's surely irrelevant, and at best it might even be an advantage for some of those? > population size I ask another commenter about this here: https://news.ycombinator.com/item?id=23518452 https://news.ycombinator.com/item?id=23518452 > diversity How does this matter? > military responsibilities Arguably, the US is spending far more on the military than her responsibilities necessitate.

kongolongo 6y ago
Population distribution in conjunction with geography is what makes it difficult. Even though most of the US population lives in cities, it is necessary to serve the health needs of sparsely populated areas as well. The cost to serve those areas is significantly higher and the distribution of those areas around the U.S. geographically is much different challenge than in Europe. In general, the EU is much more densely populated than the U.S. [1]. Shortages of specialists and emergency services are common examples of challenges with serving rural U.S. areas. The diversity of the population matters because, for example, different cultural practices result in many different health impacts that result in a more diverse set of healthcare challenges aside from the technical ones. Even something as seemingly simple as patients being able to effectively communicate their health issues and healthcare providers being able to understand these needs is a challenge due to cultural barriers. We can make specific comparisons, but in general EU countries populations are more homogeneous than the U.S. [2]. There is significant challenge to be able to train and maintain a healthcare work force that can understand needs of a diverse population. I'm not sure how spending on military affects healthcare directly either, but the VA program is definitely a factor in how the US spends on healthcare. [1] https://en.wikipedia.org/wiki/Population_density#/media/File:World_population_density_1994_-_with_equator.png https://en.wikipedia.org/wiki/Population_density#/media/File... [2] https://www.washingtonpost.com/news/worldviews/wp/2013/05/16/a-revealing-map-of-the-worlds-most-and-least-ethnically-diverse-countries/ https://www.washingtonpost.com/news/worldviews/wp/2013/05/16...
- gspr 6y ago
  > Even though most of the US population lives in cities, it is necessary to serve the health needs of sparsely populated areas as well. That would perhaps be a valid starting point for further discussions if the urban parts of the US had a good healthcare system. > The diversity of the population matters because, for example, different cultural practices result in many different health impacts that result in a more diverse set of healthcare challenges aside from the technical ones. Citation needed! This is just armchairing.
  - kongolongo 6y ago
    >What would perhaps be a valid starting point for further discussions if the urban parts of the US had a good healthcare system. They aren't disjoint systems. The increased cost of serving rural areas directly impacts urban areas as well. They share Federal funding. Actually comparing whether or not cities have have better healthcare systems than rural areas is much better than trying to define whatever "good" means. And yes in terms of access to specialists and emergency care, they definitely do. >Citation needed! This is just armchairing. Sure. https://patientengagementhit.com/news/cultural-barriers-limit-immigrant-patient-provider-interactions https://patientengagementhit.com/news/cultural-barriers-limi... https://patientengagementhit.com/news/understanding-national-patient-language-proficiency-barriers https://patientengagementhit.com/news/understanding-national...
    - gspr 6y ago
      These are still tiny numbers. If you completely abandoned these groups (you definitely shouldn't), the US healthcare system would still be entirely broken.
      - kongolongo 6y ago
        Yes but the point is the solution to "copy EU" countries is extremely naive and doesn't address these significant differences in needs.
      - kongolongo 6y ago