6 ms·

I’ve been to the US a couple times for work (all over), always travelled around a bit. I found the people to very, very warm and kind everywhere. Racial segrega

I’ve been to the US a couple times for work (all over), always travelled around a bit. I found the people to very, very warm and kind everywhere. Racial segregation is sometimes too real in some places but the black people there seem so positively surprised and very kind when you ask them something as a white dude, it’s easy and rewarding to just be the change you want to see in that respect. The only reservation I’d have is about the healthcare system especially as you grow older. Maybe get well informed about good insurance.

diognesofsinope 4y ago
Federal government literally spends over $1T on healthcare for the elderly. The healthcare issues in the country have never been about the old.
- teekert 4y ago
  Oh that’s good to hear, I got the impression it was only good as a veteran.
- guerrilla 4y ago
  What are you talking about, health care for the elderly is terrible! I guess you've never had to take care of an old person in the US? And never been exposed to northern European healthcare?
  - feet 4y ago
    You bring up a good point, even though the US spends the most per capita on health care we actually have the worst outcomes https://www.pgpf.org/chart-archive/0252_health_outcomes_spending https://www.pgpf.org/chart-archive/0252_health_outcomes_spen...
    - kongolongo 4y ago
      Every time this stat is brought up I always think it doesn't convey the full context. Even though its in terms of per capita, it's still an absolute amount, I think a better data point to illustrate if the US was overspending compared to outcomes would be what % of disposable income is spent on healthcare vs outcomes. For example, let's say the US spent 2x on healthcare as some country, but had 4x the disposable income, would this still be overspending or would it be more efficient given the amount relative to income? The closest I can find is health spending as % of GDP but that doesn't capture what a person's income, since it includes government spending too, so it obfuscates whether or not the inefficiency (if any) lies in private or public healthcare in the US.
      - feet 4y ago
        Why would that even matter?
        ipaddr 4y ago
        Things cost more in some places so you need to account for that variation. A million could pay for 3 / 4 doctors in the US or 30 / 40 in Africa.
        feet 4y ago
        You say this like the profit seeking in the US is some sort of natural phenomenon that we can't avoid. We can adjust costs based in cost of living and local currency, profiteering is what sucks resources out of the system Physicians in the US are protected, there's only a limited number of slots every year in med schools. This is fake scarcity
        kongolongo 4y ago
        Let's say the US spent 2x on healthcare as some country, but had 4x the disposable income, would this still be overspending or would it be more efficient given the amount relative to income? Healthcare spending in $ per capita doesn't capture how much people earn in that country or how much of a burden it is relative to their income so its kinda meaningless without more context. It's like saying the US economy is better than 85% of the OECD because its in the top 5 gdp per capita.
    - mensetmanusman 4y ago
      I bet sugar has a lot to do with it
  - lazide 4y ago
    I think the issue isn’t the wilingness to spend. It’s the lack of willingness to make it effective.
    - feet 4y ago
      The reason its not effective is because most of the money doesn't actually do anything, that's literally what profit is Profiteering leeches resources from a system to benefit a small number of people at the expense of the rest of the healthcare system In my opinion, please excuse my language, but it's fucking insane
      - guerrilla 4y ago
        Unfortunately it's starting to happen here too. I'm not sure how much longer I'll be able to make these arguments at the rate we're privatizing and contracting out things... Might end up just as bad here in the long term.
        feet 4y ago
        It's the whole reason for the UK tube strikes right now too, and the media is trying to paint the union guy as some Marxist villain when they just want decent wages The whole thing is totally absurd and short sighted, it's damaging to society. This is why there's more stability in some EU countries. We shouldn't be sacrificing stability for profits, that's a terrible idea. We need a stable populace to make stable progress and have a robust system that lasts for generations
      - lazide 4y ago
        In my experience, it’s often even worse - there often isn’t even any significant profit, at least not in any coherent, centralized way. There are a lot of individual players who can be pointed out, but none of them individually is ‘the problem’. Absolutely massive amounts of value is destroyed (and patients harmed) just doing super inefficient shitty processes because no one has the ability or incentive to do any better at a systemic level. Everyone in the system who has a degree of control gets paid very well keeping the wheels turning and consuming cash.
- heavyset_go 4y ago
  Medicare still has costs to the policyholder and it also requires supplemental insurance for coverage of things like eyes, teeth, hearing aids, long term care, etc.
- birdyrooster 4y ago
  They will just send you home to die when you become a burden to them. Happens all the time, old folks just get told to pound sand and die and no one does shit about it.
  - deleted 4y ago
    [deleted]
christophilus 4y ago
> the black people there seem so positively surprised and very kind when you ask them something as a white dude Where were you? I live and grew up in the south east, and have always chatted with my black neighbors / clerks / coworkers / etc when out and about. It’s so normal that I can’t imagine a response of surprise.
- the_only_law 4y ago
  I'm here in the south too, and the way my friends up north and out west talk, they seem almost more segregated than the south.
  - daniel-cussen 4y ago
    Private schools--or neighborhoods with a good school system--are basically about segregation. Every single black child I've ever seen--with one notable exception--had a super arrogant streak, in one case it was a one-time thing, in every other case like holy shit (though another one I sometimes had good conversations with, it just varied). Like out of nowhere, spitting in my path in US--that's racial bullying on their part, they're trying to impress white boys--literal white boys, white males under the age of 18--that they can even intimidate white men. So then what? What's the endgame of those underage black boys? What are they trying to accomplish? Whom else are they trying to impress? And so then you just want to avoid them, because nobody can punish them without undergoing that which Americans and especially Californians are most afraid of--being accused of racism. California is built with this form of segregation in mind--highways, no sidewalks, no public bathrooms, extortionate rent (huge percentage of income, 40% is common) with the homelessness that is its direct consequence, crazy zoning (you could economically build 60-story skyscrapers anywhere in Palo Alto), concrete everywhere with many places inaccessible except by car, hospitals out to fuck you, firmatage, terrible public transport--all out of fear of harm from minorities which can believe it or not be out to get whites--have that specific intent of harming whites, and they get convicted for hate crimes but those crimes never make the news--which they never punish, only prevent.
  - nextos 4y ago
    I am European, I have stayed in the US many times and I think some parts of Europe have more racial problems than the US. For example, I have some Asian friends who used to work with me in Scandinavia and moved to the East Coast as they felt like second class citizens. Another big problem in Europe is the way talent is valued. It is much more important to have good connections and to belong to the upper class. Simply compare the salaries between engineers here and there. Only management gets a good compensation. This explains why innovation is somewhat stifled. Things are changing and there are some exceptions. For example, Switzerland shares many of the desirable traits of EU and US, but few of their issues. Stockholm and Berlin have nice startup scenes, and so on. However, the rate of change has slowed down dramatically due to COVID, the housing bubble and inflation rates.
the_third_wave 4y ago
> the black people there seem so positively surprised and very kind when you ask them something as a white dude In ~1999 I was in New York, walking around with a sizeable backpack and asked around in Harlem where to find the Sugar Hill hostel. I'd asked two men about where to find it when I was approached by two young women who advised me not to ask these questions here as that would not be safe. I was rather surprised by this since I thought that time was past. Maybe it was the location, maybe it was the backpack but it was not what I'd expected. I found the hostel by myself and came to no harm in any way or shape. I'm "white" (more of a shade of tan, really), everyone else in this narrative is "black" (more of a shade of brown, really).
- armitron 4y ago
  I wouldn't try the same thing today.
  - nemothekid 4y ago
    Odd comment given how that area of Harlem is much much safer today than it was in the 90s
- guenthert 4y ago
  Funny, I (as white as it gets, melanin deficit disorder) stayed at the Sugar Hill Hostel for a couple of days (around labour day -- found it difficult then to leave the city on bus or train) in '98. An African American man walked me to the hostel in an apparent effort to ensure my safety. He pointed out that there are different shades of black skin, which I found a bit sad (the pointing out part). The area seemed actually fairly safe, but the fellow was nice enough to chat with. The Hostel itself was not all that remarkable (other than the lack of air conditioning at that time of the year), but the crowd there was interesting, quite an experience. Thanks for jogging my memories ;-)
  - the_third_wave 4y ago
    After my stay in the hostel I went for a long hike in the Catskills - where a porcupine ate my candles during a night in a lean-to - after which I returned there to pick up a friend from JFK with whom I proceeded to hike around and over Mt. Washington - where a squirrel found the bag of food which I hung in a tree to keep it from the bears, it ripped my sleeping bag stuffing bag to shreds - to return to NYC. From the long night conversations with an 19yo Israeli girl who I managed to talk out of hitch-hiking solo through the US through staying in a rather rickety apartment in the Bronx (large cockroaches in the sink in the morning, etc) with a Brazilian, an Irishman, an American woman and (another) Dutchman, it was an interesting trip. I've staid there on other trips as well, it being (at least back then) an affordable and relatively central location. Never missed the AC, maybe 'cause I'm not used to it being present?
demygale 4y ago
We have really good insurance and now that my partner needs treatment for a chronic illness, they are denying the treatment. It’s lowering her quality of life, may lead to her death, and it’s absolutely standard operating procedure for insurance companies. It’s a delaying tactic. Healthcare is hard here.
- lotsofpulp 4y ago
  The only reason insurance would (legally) be able to deny treatment is if there is no good efficacy data. If your doctors say there is supporting data for the treatment they are recommending, then filing and appeal is an option. https://www.healthcare.gov/appeal-insurance-company-decision/appeals/ https://www.healthcare.gov/appeal-insurance-company-decision... I believe it works similarly in countries with taxpayer funded healthcare. Some group of people at some point in the process decide what is eligible to be paid for by the government.

diognesofsinope 4y ago

Federal government literally spends over $1T on healthcare for the elderly. The healthcare issues in the country have never been about the old.

teekert 4y ago
Oh that’s good to hear, I got the impression it was only good as a veteran.
guerrilla 4y ago
What are you talking about, health care for the elderly is terrible! I guess you've never had to take care of an old person in the US? And never been exposed to northern European healthcare?
- feet 4y ago
  You bring up a good point, even though the US spends the most per capita on health care we actually have the worst outcomes https://www.pgpf.org/chart-archive/0252_health_outcomes_spending https://www.pgpf.org/chart-archive/0252_health_outcomes_spen...
  - kongolongo 4y ago
    Every time this stat is brought up I always think it doesn't convey the full context. Even though its in terms of per capita, it's still an absolute amount, I think a better data point to illustrate if the US was overspending compared to outcomes would be what % of disposable income is spent on healthcare vs outcomes. For example, let's say the US spent 2x on healthcare as some country, but had 4x the disposable income, would this still be overspending or would it be more efficient given the amount relative to income? The closest I can find is health spending as % of GDP but that doesn't capture what a person's income, since it includes government spending too, so it obfuscates whether or not the inefficiency (if any) lies in private or public healthcare in the US.
    - feet 4y ago
      Why would that even matter?
      - ipaddr 4y ago
        Things cost more in some places so you need to account for that variation. A million could pay for 3 / 4 doctors in the US or 30 / 40 in Africa.
        feet 4y ago
        You say this like the profit seeking in the US is some sort of natural phenomenon that we can't avoid. We can adjust costs based in cost of living and local currency, profiteering is what sucks resources out of the system Physicians in the US are protected, there's only a limited number of slots every year in med schools. This is fake scarcity
      - kongolongo 4y ago
        Let's say the US spent 2x on healthcare as some country, but had 4x the disposable income, would this still be overspending or would it be more efficient given the amount relative to income? Healthcare spending in $ per capita doesn't capture how much people earn in that country or how much of a burden it is relative to their income so its kinda meaningless without more context. It's like saying the US economy is better than 85% of the OECD because its in the top 5 gdp per capita.
  - mensetmanusman 4y ago
    I bet sugar has a lot to do with it
- lazide 4y ago
  I think the issue isn’t the wilingness to spend. It’s the lack of willingness to make it effective.
  - feet 4y ago
    The reason its not effective is because most of the money doesn't actually do anything, that's literally what profit is Profiteering leeches resources from a system to benefit a small number of people at the expense of the rest of the healthcare system In my opinion, please excuse my language, but it's fucking insane
    - guerrilla 4y ago
      Unfortunately it's starting to happen here too. I'm not sure how much longer I'll be able to make these arguments at the rate we're privatizing and contracting out things... Might end up just as bad here in the long term.
      - feet 4y ago
        It's the whole reason for the UK tube strikes right now too, and the media is trying to paint the union guy as some Marxist villain when they just want decent wages The whole thing is totally absurd and short sighted, it's damaging to society. This is why there's more stability in some EU countries. We shouldn't be sacrificing stability for profits, that's a terrible idea. We need a stable populace to make stable progress and have a robust system that lasts for generations
    - lazide 4y ago
      In my experience, it’s often even worse - there often isn’t even any significant profit, at least not in any coherent, centralized way. There are a lot of individual players who can be pointed out, but none of them individually is ‘the problem’. Absolutely massive amounts of value is destroyed (and patients harmed) just doing super inefficient shitty processes because no one has the ability or incentive to do any better at a systemic level. Everyone in the system who has a degree of control gets paid very well keeping the wheels turning and consuming cash.
heavyset_go 4y ago
Medicare still has costs to the policyholder and it also requires supplemental insurance for coverage of things like eyes, teeth, hearing aids, long term care, etc.
birdyrooster 4y ago
They will just send you home to die when you become a burden to them. Happens all the time, old folks just get told to pound sand and die and no one does shit about it.
- deleted 4y ago
  [deleted]

christophilus 4y ago

> the black people there seem so positively surprised and very kind when you ask them something as a white dude Where were you? I live and grew up in the south east, and have always chatted with my black neighbors / clerks / coworkers / etc when out and about. It’s so normal that I can’t imagine a response of surprise.

the_only_law 4y ago
I'm here in the south too, and the way my friends up north and out west talk, they seem almost more segregated than the south.
- daniel-cussen 4y ago
  Private schools--or neighborhoods with a good school system--are basically about segregation. Every single black child I've ever seen--with one notable exception--had a super arrogant streak, in one case it was a one-time thing, in every other case like holy shit (though another one I sometimes had good conversations with, it just varied). Like out of nowhere, spitting in my path in US--that's racial bullying on their part, they're trying to impress white boys--literal white boys, white males under the age of 18--that they can even intimidate white men. So then what? What's the endgame of those underage black boys? What are they trying to accomplish? Whom else are they trying to impress? And so then you just want to avoid them, because nobody can punish them without undergoing that which Americans and especially Californians are most afraid of--being accused of racism. California is built with this form of segregation in mind--highways, no sidewalks, no public bathrooms, extortionate rent (huge percentage of income, 40% is common) with the homelessness that is its direct consequence, crazy zoning (you could economically build 60-story skyscrapers anywhere in Palo Alto), concrete everywhere with many places inaccessible except by car, hospitals out to fuck you, firmatage, terrible public transport--all out of fear of harm from minorities which can believe it or not be out to get whites--have that specific intent of harming whites, and they get convicted for hate crimes but those crimes never make the news--which they never punish, only prevent.
- nextos 4y ago
  I am European, I have stayed in the US many times and I think some parts of Europe have more racial problems than the US. For example, I have some Asian friends who used to work with me in Scandinavia and moved to the East Coast as they felt like second class citizens. Another big problem in Europe is the way talent is valued. It is much more important to have good connections and to belong to the upper class. Simply compare the salaries between engineers here and there. Only management gets a good compensation. This explains why innovation is somewhat stifled. Things are changing and there are some exceptions. For example, Switzerland shares many of the desirable traits of EU and US, but few of their issues. Stockholm and Berlin have nice startup scenes, and so on. However, the rate of change has slowed down dramatically due to COVID, the housing bubble and inflation rates.

the_third_wave 4y ago

> the black people there seem so positively surprised and very kind when you ask them something as a white dude In ~1999 I was in New York, walking around with a sizeable backpack and asked around in Harlem where to find the Sugar Hill hostel. I'd asked two men about where to find it when I was approached by two young women who advised me not to ask these questions here as that would not be safe. I was rather surprised by this since I thought that time was past. Maybe it was the location, maybe it was the backpack but it was not what I'd expected. I found the hostel by myself and came to no harm in any way or shape. I'm "white" (more of a shade of tan, really), everyone else in this narrative is "black" (more of a shade of brown, really).

armitron 4y ago
I wouldn't try the same thing today.
- nemothekid 4y ago
  Odd comment given how that area of Harlem is much much safer today than it was in the 90s
guenthert 4y ago
Funny, I (as white as it gets, melanin deficit disorder) stayed at the Sugar Hill Hostel for a couple of days (around labour day -- found it difficult then to leave the city on bus or train) in '98. An African American man walked me to the hostel in an apparent effort to ensure my safety. He pointed out that there are different shades of black skin, which I found a bit sad (the pointing out part). The area seemed actually fairly safe, but the fellow was nice enough to chat with. The Hostel itself was not all that remarkable (other than the lack of air conditioning at that time of the year), but the crowd there was interesting, quite an experience. Thanks for jogging my memories ;-)
- the_third_wave 4y ago
  After my stay in the hostel I went for a long hike in the Catskills - where a porcupine ate my candles during a night in a lean-to - after which I returned there to pick up a friend from JFK with whom I proceeded to hike around and over Mt. Washington - where a squirrel found the bag of food which I hung in a tree to keep it from the bears, it ripped my sleeping bag stuffing bag to shreds - to return to NYC. From the long night conversations with an 19yo Israeli girl who I managed to talk out of hitch-hiking solo through the US through staying in a rather rickety apartment in the Bronx (large cockroaches in the sink in the morning, etc) with a Brazilian, an Irishman, an American woman and (another) Dutchman, it was an interesting trip. I've staid there on other trips as well, it being (at least back then) an affordable and relatively central location. Never missed the AC, maybe 'cause I'm not used to it being present?

demygale 4y ago

We have really good insurance and now that my partner needs treatment for a chronic illness, they are denying the treatment. It’s lowering her quality of life, may lead to her death, and it’s absolutely standard operating procedure for insurance companies. It’s a delaying tactic. Healthcare is hard here.

lotsofpulp 4y ago
The only reason insurance would (legally) be able to deny treatment is if there is no good efficacy data. If your doctors say there is supporting data for the treatment they are recommending, then filing and appeal is an option. https://www.healthcare.gov/appeal-insurance-company-decision/appeals/ https://www.healthcare.gov/appeal-insurance-company-decision... I believe it works similarly in countries with taxpayer funded healthcare. Some group of people at some point in the process decide what is eligible to be paid for by the government.