4 ms·

More that the government understands they have a vested interest in caring for (as opposed to exploiting) its population. That's why the US is always at the ve

More that the government understands they have a vested interest in caring for (as opposed to exploiting) its population. That's why the US is always at the very bottom of rankings like this.

rwmj 1y ago
Yes it's very obvious having spent much time in Japan that the government actually works for the people instead of regarding them as an inconvenience.
- FirmwareBurner 1y ago
  If the Japanese gov actually cared about its people, they would enforce some overtime regulations on companies.
- Muromec 1y ago
  That's like most rich countries with more or less democratic government. US is just corrupt to the levels only achievable by Eastern Europe.
rayiner 1y ago
The U.S. has beginning to end health care for pregnancy and child birth. Its infant mortality rate (5.4) isn’t really much higher than Canada (4.7), which has a socialized healthcare system.
- const_cast 1y ago
  Which seems kind of okay, except when you consider that we pay significantly more per-capita for healthcare as opposed to Canada. Yes, that includes if you take into account taxes, and it's not even close. Sure, we're not the absolute worst, but we are the most expensive. And, for that, we get close to the worst results. Clearly, our healthcare system is broken in a variety of complex ways.
  - rayiner 1y ago
    As far as I can tell, we pay more for healthcare for the same reason we pay more for schools and more for subways. We’re a low competence, low trust society, and have to compensate for it by making everything subject to litigation to the point where the country is effectively run by lawyers. My six year old boy ran into a table and got a black eye. Took him to the doctor (because my wife made me), who physically examined him and saw he was fine. But ordered a CT scan anyway (which we got the same morning because this is America). No sane healthcare system would order a CT scan for this! But in our litigation-driven system, the doctor has to do it, because in the extremely unlikely situation that there was an undetected internal bleed, he’d get sued. And some expert would get on the stand and say the standard of care is to order a CT scan every time a six year old boy does a six year old boy thing.
    - const_cast 1y ago
      I don't think this is the sole reason why, I think private sector inefficiency is a big reason why, too. We have an extremely fragmented system that breeds inefficiency. Thousands of insurers, so hospitals have hundreds of billing specialists. Thousands of plans, so the complexity of what is and isn't covered explodes beyond belief. There's no streamlining, no centralization, no authority. Just bickering and "erm, ackshually" from every party. Every interaction has extremely high friction that comes with a massive, fragmented system. It's like a microservice architecture with thousands and thousands of microservices. Except their contracts aren't always published, sometimes you need to call them on the telephone. And sometimes you just have to try requests and see if they get denied. Also, I think a CT for head injury is fairly standard practice. I think they do that in Europe. Anyway I had some pain somewhere inconspicuous once and it was cancer, so. I don't think the issue is we image too much.
      - tptacek 1y ago
        We very definitely image too much. There are apparently as many MRI machines in Massachusetts as there are in all of Canada. "We image too much" is a pretty common complaint in health policy discussions; Rayiner is not just making that up himself.

More that the government understands they have a vested interest in caring for (as opposed to exploiting) its population. That's why the US is always at the very bottom of rankings like this.

rwmj 1y ago

Yes it's very obvious having spent much time in Japan that the government actually works for the people instead of regarding them as an inconvenience.

FirmwareBurner 1y ago
If the Japanese gov actually cared about its people, they would enforce some overtime regulations on companies.
Muromec 1y ago
That's like most rich countries with more or less democratic government. US is just corrupt to the levels only achievable by Eastern Europe.

rayiner 1y ago

The U.S. has beginning to end health care for pregnancy and child birth. Its infant mortality rate (5.4) isn’t really much higher than Canada (4.7), which has a socialized healthcare system.

const_cast 1y ago
Which seems kind of okay, except when you consider that we pay significantly more per-capita for healthcare as opposed to Canada. Yes, that includes if you take into account taxes, and it's not even close. Sure, we're not the absolute worst, but we are the most expensive. And, for that, we get close to the worst results. Clearly, our healthcare system is broken in a variety of complex ways.
- rayiner 1y ago
  As far as I can tell, we pay more for healthcare for the same reason we pay more for schools and more for subways. We’re a low competence, low trust society, and have to compensate for it by making everything subject to litigation to the point where the country is effectively run by lawyers. My six year old boy ran into a table and got a black eye. Took him to the doctor (because my wife made me), who physically examined him and saw he was fine. But ordered a CT scan anyway (which we got the same morning because this is America). No sane healthcare system would order a CT scan for this! But in our litigation-driven system, the doctor has to do it, because in the extremely unlikely situation that there was an undetected internal bleed, he’d get sued. And some expert would get on the stand and say the standard of care is to order a CT scan every time a six year old boy does a six year old boy thing.
  - const_cast 1y ago
    I don't think this is the sole reason why, I think private sector inefficiency is a big reason why, too. We have an extremely fragmented system that breeds inefficiency. Thousands of insurers, so hospitals have hundreds of billing specialists. Thousands of plans, so the complexity of what is and isn't covered explodes beyond belief. There's no streamlining, no centralization, no authority. Just bickering and "erm, ackshually" from every party. Every interaction has extremely high friction that comes with a massive, fragmented system. It's like a microservice architecture with thousands and thousands of microservices. Except their contracts aren't always published, sometimes you need to call them on the telephone. And sometimes you just have to try requests and see if they get denied. Also, I think a CT for head injury is fairly standard practice. I think they do that in Europe. Anyway I had some pain somewhere inconspicuous once and it was cancer, so. I don't think the issue is we image too much.
    - tptacek 1y ago
      We very definitely image too much. There are apparently as many MRI machines in Massachusetts as there are in all of Canada. "We image too much" is a pretty common complaint in health policy discussions; Rayiner is not just making that up himself.