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Europe is densely populated in general but there are villages all over the place where you can have a large house like in an American suburb. I think cultural

by mrtksn 3y ago

Europe is densely populated in general but there are villages all over the place where you can have a large house like in an American suburb. I think cultural expectations are more defining, for example Turks are frustrated with the healthcare in Europe because they expect to see a specialist ASAP even for the smallest thing and they want antibiotics for it. In Germany you won’t get all the antibiotics you want unless you actually need it and you won’t be seen by a professor just because you feel like. Germany will try to make you live healthier life through preventative medicine, Turkey will try to give you a 5 minutes access to a doctor and infrastructure quickly. I’m hearing about Americans complaining on similar stuff. IIRC Americans feel neglected during pregnancy in Germany despite that the US infant mortality rate is almost twice the German one.

legitster 3y ago
I think as much as Americans like the idea of European healthcare systems, I think most of them would be appalled in practice. Not that it's inherently inferior, but part of the reason healthcare is so expensive in America is that Americans (perhaps a bit spoiled by our own prosperity) demand lots of care. My wife's sister saw specialists 11 different times last year because she was not happy with the advice. And I would not say this is an entirely unheard of extreme. In the US, if someone gets denied anything from their doctor, it is somewhat of a scandal.
- mrtksn 3y ago
  Different expectation and I respect both approaches. I'm accustomed to the EU version of it and I expect the doctor to tell me what to do and my defence against bad advice is getting a second opinion. In Turkey, where I lived for quite a while, the modus operandi is that you go to the hospital to demand something. If the government ones don't make you happy you go to the private one and they will pour all the tests you can handle. Once I thought I'm having a heart attack and rushed to the ER in a private hospital. Turns out I'm just a bit dehydrated, so drinking water would do it but the doctor asked me if I would like an IV. I was appalled because my expectation is that if I need an IV the doc should just do it, he should't ask me. I asked if I need it, he said it's not necessary but can speed up the recovery. It turns out, Turks like to go to the hospital to get an IV when they don't feel very well, they just like that a professional is taking care of them even if they don't actually need a medical intervention and they will get better spontaneously as they rest and the private hospitals provide this service. I like the European way better.
rootusrootus 3y ago
> I’m hearing about Americans complaining on similar stuff. IIRC Americans feel neglected during pregnancy in Germany despite that the US infant mortality rate is almost twice the German one. To my understanding, infant mortality has less to do with quality of care, and a lot more to do with environmental and genetic factors. The biggest causes of infant mortality in the US are congenital defects and complications due to premature birth. There seem to be enough confounding factors that I'd question comparing infant mortality rates across borders to begin with.
- areoform 3y ago
  To my understanding, infant mortality has less to do with quality of care, and a lot more to do with environmental and genetic factors. The biggest causes of infant mortality in the US are congenital defects and complications due to premature birth. This statement is a commonly held sentiment that can be trivially shown to be invalid. Consider California, the state has seen a decline in maternal mortality by 65% while the rest of the US, especially states like Alabama have seen consistent increases of 700%+ in the same time period, CMQCC was founded in 2006 at Stanford University School of Medicine together with the State of California in response to rising maternal mortality and morbidity rates. Since CMQCC’s inception, California has seen maternal mortality decline by 65 percent between 2006 to 2016, while the national maternal mortality rate continued to rise. https://www.cmqcc.org/who-we-are https://www.cmqcc.org/who-we-are Alabama's maternal mortality rate in 2012 was 6.9 per 100,000, 49.1 per 100,000 in 2016, and is now likely excess of that from 2023 onwards. The state suffers from what's now being called a, Maternity Care Desert, https://www.montgomeryadvertiser.com/story/news/local/alabama/2022/11/23/maternal-infant-health-at-risk-alabama-health-care-deserts-worsen/69618003007/ https://www.montgomeryadvertiser.com/story/news/local/alabam... https://www.alreporter.com/2020/11/22/nearly-70-percent-of-alabamas-pregnancy-related-deaths-in-2016-were-preventable-report/ https://www.alreporter.com/2020/11/22/nearly-70-percent-of-a... Actions matter. Even if there's a genetic factor that leads to a predisposition to an event, how that event is handled and, indeed, how prevention is addressed — a genetic predisposition is a probability that something will occur not a certainty — makes all the difference. Just because someone was genetically predisposed to get a heart attack doesn't mean that their death from a heart attack was due to their "genetics." Suppose the ambulance took 3 hours to arrive, only to deliver poorly trained paramedics that failed to administer care leading to the patient's death on a gurney en route to the hospital. In that case, the patient hasn't died due to genetics. They've been killed because of catastrophic, systemic failure. A systematic failure to address their elevated risk, a failure to prevent or mitigate said risk, and then a catastrophic failure in handling the event precipitated from this unmitigated risk. There seem to be enough confounding factors that I'd question comparing infant mortality rates across borders to begin with. These rates have been successfully reduced across the world and have gone up in certain parts of the US while declining in others. The fact that these rates are so sensitive to infrastructure, practises and care leads to an entirely different conclusion than the one implied here.
bpodgursky 3y ago
I get that this is true in principle, but the fact is that Americans have significantly more children per-capita than Germans, and this is at least in part driven by economic limitations (including housing).
- crote 3y ago
  A significant part of it is driven by religious practices promoting large families, restrictions on contraceptives and abortions, and a lack of proper sex education leading to unintended pregnancies. Economic limitations have never stopped people from having kids and it is often the poorer people who have more kids.

by mrtksn 3y ago

legitster 3y ago

I think as much as Americans like the idea of European healthcare systems, I think most of them would be appalled in practice. Not that it's inherently inferior, but part of the reason healthcare is so expensive in America is that Americans (perhaps a bit spoiled by our own prosperity) demand lots of care. My wife's sister saw specialists 11 different times last year because she was not happy with the advice. And I would not say this is an entirely unheard of extreme. In the US, if someone gets denied anything from their doctor, it is somewhat of a scandal.

mrtksn 3y ago
Different expectation and I respect both approaches. I'm accustomed to the EU version of it and I expect the doctor to tell me what to do and my defence against bad advice is getting a second opinion. In Turkey, where I lived for quite a while, the modus operandi is that you go to the hospital to demand something. If the government ones don't make you happy you go to the private one and they will pour all the tests you can handle. Once I thought I'm having a heart attack and rushed to the ER in a private hospital. Turns out I'm just a bit dehydrated, so drinking water would do it but the doctor asked me if I would like an IV. I was appalled because my expectation is that if I need an IV the doc should just do it, he should't ask me. I asked if I need it, he said it's not necessary but can speed up the recovery. It turns out, Turks like to go to the hospital to get an IV when they don't feel very well, they just like that a professional is taking care of them even if they don't actually need a medical intervention and they will get better spontaneously as they rest and the private hospitals provide this service. I like the European way better.

rootusrootus 3y ago

> I’m hearing about Americans complaining on similar stuff. IIRC Americans feel neglected during pregnancy in Germany despite that the US infant mortality rate is almost twice the German one. To my understanding, infant mortality has less to do with quality of care, and a lot more to do with environmental and genetic factors. The biggest causes of infant mortality in the US are congenital defects and complications due to premature birth. There seem to be enough confounding factors that I'd question comparing infant mortality rates across borders to begin with.

areoform 3y ago
To my understanding, infant mortality has less to do with quality of care, and a lot more to do with environmental and genetic factors. The biggest causes of infant mortality in the US are congenital defects and complications due to premature birth. This statement is a commonly held sentiment that can be trivially shown to be invalid. Consider California, the state has seen a decline in maternal mortality by 65% while the rest of the US, especially states like Alabama have seen consistent increases of 700%+ in the same time period, CMQCC was founded in 2006 at Stanford University School of Medicine together with the State of California in response to rising maternal mortality and morbidity rates. Since CMQCC’s inception, California has seen maternal mortality decline by 65 percent between 2006 to 2016, while the national maternal mortality rate continued to rise. https://www.cmqcc.org/who-we-are https://www.cmqcc.org/who-we-are Alabama's maternal mortality rate in 2012 was 6.9 per 100,000, 49.1 per 100,000 in 2016, and is now likely excess of that from 2023 onwards. The state suffers from what's now being called a, Maternity Care Desert, https://www.montgomeryadvertiser.com/story/news/local/alabama/2022/11/23/maternal-infant-health-at-risk-alabama-health-care-deserts-worsen/69618003007/ https://www.montgomeryadvertiser.com/story/news/local/alabam... https://www.alreporter.com/2020/11/22/nearly-70-percent-of-alabamas-pregnancy-related-deaths-in-2016-were-preventable-report/ https://www.alreporter.com/2020/11/22/nearly-70-percent-of-a... Actions matter. Even if there's a genetic factor that leads to a predisposition to an event, how that event is handled and, indeed, how prevention is addressed — a genetic predisposition is a probability that something will occur not a certainty — makes all the difference. Just because someone was genetically predisposed to get a heart attack doesn't mean that their death from a heart attack was due to their "genetics." Suppose the ambulance took 3 hours to arrive, only to deliver poorly trained paramedics that failed to administer care leading to the patient's death on a gurney en route to the hospital. In that case, the patient hasn't died due to genetics. They've been killed because of catastrophic, systemic failure. A systematic failure to address their elevated risk, a failure to prevent or mitigate said risk, and then a catastrophic failure in handling the event precipitated from this unmitigated risk. There seem to be enough confounding factors that I'd question comparing infant mortality rates across borders to begin with. These rates have been successfully reduced across the world and have gone up in certain parts of the US while declining in others. The fact that these rates are so sensitive to infrastructure, practises and care leads to an entirely different conclusion than the one implied here.

bpodgursky 3y ago

I get that this is true in principle, but the fact is that Americans have significantly more children per-capita than Germans, and this is at least in part driven by economic limitations (including housing).

crote 3y ago
A significant part of it is driven by religious practices promoting large families, restrictions on contraceptives and abortions, and a lack of proper sex education leading to unintended pregnancies. Economic limitations have never stopped people from having kids and it is often the poorer people who have more kids.