Comment by ews
19 days ago
The US rarely looks into how other countries solve problems. (i.e. Universal Healthcare, High Speed Trains and so), this is the sad part of "American Exceptionalism"
19 days ago
The US rarely looks into how other countries solve problems. (i.e. Universal Healthcare, High Speed Trains and so), this is the sad part of "American Exceptionalism"
Those are two odd examples. The Affordable Care Act is similar to the Netherlands health insurance system: https://www.commonwealthfund.org/blog/2011/lessons-abroad-du... (“These similarities are not entirely coincidental. American public officials, health industry leaders, and scholars made frequent visits to the Netherlands in the run-up to the debate over U.S. health care reform, borrowing ideas and, on occasion, citing the Dutch system as a model for what the U.S. might achieve.”).
As to rail, both the first-gen and second-gen Acela is based on the French TGV.
The U.S. has a pitiful amount of high speed rail. It serves no point to mention that this pitiful amount of high speed rail is based off of TGV.
The comparison to the Dutch healthcare system is not apt. While the Heritage foundation may used ideas from the Dutch system our system is quite a bit more Byzantine and inefficient. We spend twice as much per capita on healthcare and have worse outcomes and fewer people covered. Our citizens have far more per capita medical debt than the Dutch.
We didn’t really implement the Dutch system and we didn’t really learn from the French how to build and maintain high speed rail. Saying we learned healthcare from the Dutch because we have doctors like they do makes as much sense as your argument.
The original claim was "The US rarely looks into how other countries solve problems". That claim appears to be false.
Why does the US execution not match that of the countries it looks into? I think it's because talented people in the US disproportionately go into the private sector, leading to an incompetent public sector. American distrust of their government is arguably justified.
You're also twice as fat so I think spending twice makes perfect sense
> The Affordable Care Act is similar to the Netherlands health insurance systemh
> The average Obamacare plan costs $483 monthly for a 30-year-old, $544 for a 40-year-old and $760 for a 50-year-old.
> The bronze plan covers 60% of the costs associated with care.
I feel like they missed the most important parts of the Dutch health insurance system…
The Dutch system also requires payment of monthly premiums. The US premiums reflect the cost to insure the US’s significantly less healthy population.
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I thought the ACA was based on the Swiss system of mandatory insurance? The heritage foundation copied the Swiss, Romney took that proposal to Mass, and Obama thought going with a Conservative initiated plan would make it more bipartisan (it didn’t, but mainly because republicans hated Obama).
Definitely not.
IMO the most distinct parts of the Swiss health insurance system is that (1) copay is obligatory but limited (i.e. healthcare isn’t free but it’s not expensive either), and (2) it’s individual, companies cannot pay for it, so there’s no US-like extreme benefit of having a good job.
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A less cynical framing is that the US is a much different culture from European countries, and is massively larger in scale. Depending on the problem, some of their solutions simply can't or don't apply.
The scale argument is thrown around a lot as a justification for why the US couldn't possibly implement universal healthcare. The elephant in the room that I'm always surprises at how rarely it's mentioned in these discussions is Brazil, which is a huge country of comparable size (both territory and population wise), and it manages to make UHC work even though it's also a much poorer country.
It's not perfect by any means, but it's definitely much better than nothing. So the US should absolutely be able to at the very least match that, but really most likely it should be able to do much better. That it doesn't is very much a choice.
The elephant in the room is that in every other sphere, scale is the solution, not the problem. The US should find it easier to implement UHC just because of its scale. More tax dollars, more average outcomes, more resources for outliers, more incremental money for research into rarer conditions. That 10x smaller countries like Canada do it effectively is an indictment of America's inability to do it.
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Did Brazil start with a Byzantine kluge of private and public providers and intermediaries? Genuine question, not snark.
I think the US would prefer a UHC if we were starting from a blank slate. The difficulty is mapping a path from what we have now to that.
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I got a Master's Degree in Education and spent 2 years in Educational Psychology Ph.D. program and absolutely 0 time was spent looking at how other countries do education.
It's baffling how despite numerous other countries outperforming the US in educational outcomes we do not even look at other approaches!
Maybe it's better not to look...
https://www.tiktok.com/@guinnessworldrecords/video/747057742...
ha-ha f....
cause we are the best and when you are the best you simply do not look back :)
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Which part here exactly cannot work in the US? I am talking about brushing one's teeth with toothpaste containing fluoride, which sounds as plain simple as possible to me. Is it regular brushing teeth that fails in the US for cultural reasons? Fluoride in the toothpaste? Supervising kids while brushing their teeth to make sure they do not swallow? It is an honest question.
In a word: poverty. People do not have free dental care, and poor people aren't guaranteed to have a toothbrush, toothpaste or sometimes even a sink to brush their teeth in. Fluoridated water is one of the few dental protections available to everyone regardless of their income. It's cheap, minimal and cost-effective cavity protection at scale for the entire country.
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AFAICT most US toothpaste has flouride in it already.
(For now, at least? How long until that gets cracked down on as dangerous?)
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This is exactly the framing. "What worked there can't work here", whether it's firearm control, socialized medicine or education, whatever.
We're either bigger, or denser, or less dense, or ... essentially whatever suits the argument.
The other weird thing in US discourse about other countries is that when it does enter the conversation, the "rest of the world", or at least other developed countries, are often treated as some kind of monolithic entity culturally and politically. For example, a lot of people on both left and right in US believe that the rest of the world is single payer, and generally that "single payer" is synonymous to "public healthcare". Similarly with gun control, there's no recognition of the fact that there are countries in Europe where you can own an AR-15 just fine, and countries (different ones!) where silencers are over the counter items not requiring any special registration.
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Yes, that's my point. We are literally different people with different cultures, values and problems. Case in point: the firearm control you mentioned. I won't get in a gun control debate here, I have my own complicated views on the matter, but it's an undisputed fact that Americans have a right to own guns (maybe with limitations, maybe not) and many Americans deeply cherish that right. There is no gun control solution we can take from Europe that you could apply to the US, it's simply not compatible with our culture, not to mention our own Bill of Rights. It's not a bad thing to recognize that.
A lot of people are uncomfortable having an opinion without being able to rationalize it.
I have to assume many, maybe most, people that give reasons like you mention just flat out don't want the policy and reach for a reason to justify it.
I can say I don't want gun control laws. Not because it doesn't work elsewhere or couldn't work here. I just fundamentally disagree with it and don't want to live in a place where the only ones with guns are state officials.
Scale is a scapegoat. Take the US region by region and you can find analogs around the world.
The US isn't several countries put together, region by region. It's one big ass country. I really don't see how taking it region by region somehow eliminates scale issues when you still have to apply it to the entire country.
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There shouldn't be a scale issue with regards to fluoride in the water. It is either scientifically shown to be beneficial or it isn't, scale and geography likely have nothing to do with it.
Does it not depend on the chemical composition of local water? The US is vast, geologically diverse, and water quality varies hugely across it. Denmark can likely make a decision that's good for the entire country.
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a decades long study with a gazillion of potential confounders is never "either scientifically shown to be beneficial or it isn't"...
let alone the precautionary principle in a complex system with a gazillion variables... (i.e. things we don't know we don't know)
You're not wrong in that our culture is different, but that cultural difference is chiefly a self fulfilling prophecy of "the government can't do it," promoted by billionaire owned media, so that those same billionaires can run for-profit industries like healthcare and transportation.
The cultural difference is that our rich people are too rich, our media is too centralized, and none of those in power want to enrich and empower the country, when they could enrich and empower themselves.
This is the excuse all American use about literally every single issue anytime anybody points out that other do things better. Most often without actually having thought about it beyond 'muhuhu US BIGGG! USA! USA! USA!'.
If you want to make that argument, actually make it, because if you try, 99% of the time its not actually true, its simply ignorance.
I'm not sure what point you're trying to make here except that you take a dim view of Americans.
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I feel like this always comes up in these sorts of arguments, that the US is so unique that solutions that work elsewhere can't work here. And yet this point is always hand-waved in, without and specifics discussed, and is just presented as a given.
I really don't buy it, at least not as a general statement.
This argument works fine for high-speed rail, not so well for insurance and healthcare.
If you focus only on the scale part of my argument, sure. But I think the culture part of my argument is more than enough of an answer for insurance and healthcare:
https://news.ycombinator.com/item?id=43521734
Why is it less cynical, what does the scale of the US have to do with it?
Maybe it's just me, but I find the argument that "Americans won't do X cool thing that Europeans/the rest of the world do because they [are dumb/are corrupt/love money/hate each other/believe in American exceptionalism]" to be a very cynical and lazy argument. Note that the person I was replying to was talking about policies and goals like UHC and High Speed Rail, not specifically about fluoridated water – that was the context in which I was replying.
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When I was a kid the schools taught us the metric system, telling us it was the world standard, and would become the standard is the US by the time I was an adult. That was over 40 years ago. And that pretty much sums it all up.
The US legally switched to metric when England did. It is taught in all schools and used for international trade. But, just like in England there is a mix of imperial and metric units used domestically. If you dont travel internationally, like many Americans, there is little need to use metric. Another generation and there won't be many people left in the US that didn't at least learn metric.
It's not like England in that respect at all. Yes, there is a mix of usage in the UK but it is very limited. People use metric for everything except miles in cars, pints in pubs, and height and weight of people.
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At least they were right about one thing. It definitely is the world standard.
see that proves it - the U.S can't adopt the metric system, it's too big, you don't want to have to break out the megameters! /s