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> Alaska is substantially larger than any of the European countries you listed, and is not very urban. Sure, but hospital requirements don't scale with area. I

by gspr 6y ago

> Alaska is substantially larger than any of the European countries you listed, and is not very urban. Sure, but hospital requirements don't scale with area. If the US had a horrible healthcare system in Alaska, and a great one in urban areas, maybe we wouldn't have this debate. > Given how badly the US has mucked it up? Is the mucking up due to size though? That is the crux of the matter, and I can see no evidence that that is the case. > Pretty solid evidence that it can't be done. This sounds like insanity to me. It's literally one datapoint! Isn't that a bit like saying "China hasn't gone to the moon, so that's pretty solid evidence that the preference of rice over potatoes as main starchy staple makes moon landings impossible". > Healthcare is similar to housing. Sickness is location-specific and population-specific. For education the arguments take a slightly different flavour; but boil down to different industries have different educational needs and a one-size-fits-all educational system will either systematically under- or over- educate students in different cities with different industry needs/opportunities. There's nothing of substance in what you're saying here. You made a very bold claim, and all your evidence for it seems to be "oh it could be that, it could be this, maybe that".

kongolongo 6y ago
> Sure, but hospital requirements don't scale with area. They absolutely do. How can you say the requirements of getting emergency response to a sparsely populated area is the same as a much smaller and more densely populated area? Getting a appropriate response times to cover the larger and more sparsely populated area is definitely going to be more costly and difficult. >If the US had a horrible healthcare system in Alaska, and a great one in urban areas, maybe we wouldn't have this debate. Actually yes healthcare in rural areas is significantly worse. Urban is not great, but that is not relevant to the point, also they are not disjoint systems they share significant funding. Saying urban US doesn't have great healthcare doesn't disprove the point that rural areas have higher healthcare costs and worse outcomes. https://hpi.georgetown.edu/rural/#:~:text=The%20rural%20population%20is%20consistently,population%20with%20respect%20to%20health.&text=Rural%20residents%20are%20also%20more,tests%20for%20various%20chronic%20conditions https://hpi.georgetown.edu/rural/#:~:text=The%20rural%20popu....
- gspr 6y ago
  > They absolutely do. How can you say the requirements of getting emergency response to a sparsely populated area over a much larger area is the same as a much smaller and more densely populated area? Getting a appropriate response times to cover the larger and more sparsely populated area is definitely going to be more costly and difficult. You are describing density. > Saying urban US doesn't have great healthcare doesn't disprove the point that rural areas have higher healthcare costs and worse outcomes. Nor does rural areas having higher costs prove that European-style public healthcare won't scale to the US.
  - kongolongo 6y ago
    >Nor does rural areas having higher costs prove that European-style public healthcare won't scale to the US. No but now the burden of proof is to show how it does scale when the requirements and characteristics of the users are clearly very different. European population density is in general higher than US, and in general European countries are more homogeneous.
    - gspr 6y ago
      They're not "very different". And I gave numbers that show that Europe and the US are roughly equally urban. As for homogeneity, what kind of homogeneity are you thinking about? Europe is in general ridiculously far from homogeneous in most measures!
    - kongolongo 6y ago
      Having similar rates of urbanization does not address the fact that the population density is still significantly different. Even if the urban rates are exactly the same there may still be many more pockets of rural areas in the U.S. that also require access to healthcare, which incurs significant costs. You're completely not addressing this point at all.

by gspr 6y ago

kongolongo 6y ago

> Sure, but hospital requirements don't scale with area. They absolutely do. How can you say the requirements of getting emergency response to a sparsely populated area is the same as a much smaller and more densely populated area? Getting a appropriate response times to cover the larger and more sparsely populated area is definitely going to be more costly and difficult. >If the US had a horrible healthcare system in Alaska, and a great one in urban areas, maybe we wouldn't have this debate. Actually yes healthcare in rural areas is significantly worse. Urban is not great, but that is not relevant to the point, also they are not disjoint systems they share significant funding. Saying urban US doesn't have great healthcare doesn't disprove the point that rural areas have higher healthcare costs and worse outcomes. https://hpi.georgetown.edu/rural/#:~:text=The%20rural%20population%20is%20consistently,population%20with%20respect%20to%20health.&text=Rural%20residents%20are%20also%20more,tests%20for%20various%20chronic%20conditions https://hpi.georgetown.edu/rural/#:~:text=The%20rural%20popu....

gspr 6y ago
> They absolutely do. How can you say the requirements of getting emergency response to a sparsely populated area over a much larger area is the same as a much smaller and more densely populated area? Getting a appropriate response times to cover the larger and more sparsely populated area is definitely going to be more costly and difficult. You are describing density. > Saying urban US doesn't have great healthcare doesn't disprove the point that rural areas have higher healthcare costs and worse outcomes. Nor does rural areas having higher costs prove that European-style public healthcare won't scale to the US.
- kongolongo 6y ago
  >Nor does rural areas having higher costs prove that European-style public healthcare won't scale to the US. No but now the burden of proof is to show how it does scale when the requirements and characteristics of the users are clearly very different. European population density is in general higher than US, and in general European countries are more homogeneous.
  - gspr 6y ago
    They're not "very different". And I gave numbers that show that Europe and the US are roughly equally urban. As for homogeneity, what kind of homogeneity are you thinking about? Europe is in general ridiculously far from homogeneous in most measures!
  - kongolongo 6y ago
    Having similar rates of urbanization does not address the fact that the population density is still significantly different. Even if the urban rates are exactly the same there may still be many more pockets of rural areas in the U.S. that also require access to healthcare, which incurs significant costs. You're completely not addressing this point at all.