Want to get rich? Try socialism.

[snousle]

Interesting graph of inter-generational social mobility as compared to the US:



More here

Not to put too much into one study, but the higher class mobility index for Canada matches my personal experience. My cousin, for example, is basically a lug - nice guy, moderately smart, middle class. But he's a VERY hard worker, and he is making a LOT of money in construction - i.e. going from basically nothing to buying a second house by age 50 (I think his first is paid off). Of course the strong Canadian real estate market and stable banking system doesn't hurt. But his story is not so unusual, and he's doing better at the American dream than almost any American I know.

Canada knows how to help people help themselves. By and large their social welfare programs don't create a lot of intractable dependency, not like here. In the US, where "welfare" is disguised in all sorts of bureaucratic forms that make it not look like welfare, people end up getting trapped in permanent poverty by programs whose real goal is not to help them, but to disempower them. This is in part because of people like Reagan, who instilled such a passionate hatred of mythical "welfare queens" that actual recipients of social programs are actively blocked from succeeding lest they become undeserving of their assistance.

The elephant in the room is still health care. It's hard to be an entrepreneur here when it's so hard to control the risk of medical bankruptcy. The US, for all it's blather about "freedom", presents huge barriers to doing business and achieving cooperation between ordinary people. I don't mean to sound like a broken record, but I'll say it again: when the uber-conservative Heritage foundation ranks social democracies like Denmark and New Zealand higher than the US in its index of economic freedom, the US is obviously doing something very, very wrong. (The US has actually slipped from #5 to #9 in just a few years.)

In this context, all the right-wing hysteria about "socialism" seems intended to divert attention from an increasing number of not-actually-socialist countries that are basically walking all over the US when it comes to opportunity and quality of life.

Comments

[equinas.livejournal.com]

I disagree with just about everything in this post, but I'll grant you this: in all my world travels, the only place I've seen socialized medicine really work - quality care, no life-threatening waiting lists, etc. - is Scandinavia. But keep in mind the the Norwegians pay 50% income tax and 21% national sales tax (VAT). On the other hand, their minimum wage is $22/hour ($16/hour for under-18's).

The problem with those who want socialism in America is that they refuse - either out of fear of backlash or a desire to protect their own wealth - to take the pain with the gain. Obama had some great ideas, but he and the liberals weren't willing to take it all the way - raise taxes to a phenomenal level - in order to be able to pay for them. So instead, we end up with some horrible mutant hybrid that is the worst of both worlds. And, with all the waste, fraud and abuse in our bloated federal government, we have no way to even use such a boost in tax revenue efficiently in order to offset the new tax burden with reduced costs to health care and education. And if people can't see an immediate benefit to that type of massive tax increase, that's fodder for civil war.

As a Libertarian, socialism is pretty much anathema to me. I see it and communism as a demonstrably failed system, with a few exceptions. But if we're going to do it, we have to do it right, and this country would never tolerate that.

[snousle.livejournal.com]

By actual health outcomes it's very hard to find any measure by which the US is demonstrably better than any other industrialized country. And I don't mean the availability of MRIs on short notice, I mean life expectancy, infant mortality, and levels of disability. Feel free to prove me wrong on that, I'm very amenable to being persuaded by quantitative data.

The really damning thing is that the in the US this low-performing care costs around 2x as much as a percentage of GDP, never mind in absolute terms, as most other countries.

This gapminder chart based on this visualization, which I adjusted to include the US in view, compares life expectancy vs. (absolute) spending per person on health care. (Didn't have it available as fraction of GDP on short notice).

This business about socialized medicine "failing" is rubbish, the data deny it at every level. I could cite primary sources supporting this fact literally all day long.

Anyway, count me as not unhappy with a 60% tax rate if I can live in a country like Sweden. And no, I don't think it's plausible in the US either.

[equinas.livejournal.com]

I'll find the data you want when I have a faster connection (maybe we can discuss it at Thanksgiving), but until then, answer me this: If socialized medicine is so good, why do you think so many rich people from socialized countries (including Canada's prime minister) pay to get their care in the U.S.?

[equinas.livejournal.com]

And as for socialized medicine's shortcomings, you can count me as a primary source. I've seen it, worked in it, and been a part of it, in Ireland and the UK. It fails its citizens daily (and is getting worse, not better with the current economic climate).

[snousle.livejournal.com]

I don't see how you can say socialized medicine is failing based on personal experience when the aggregate data contradict that. I don't consider dramatic anecdotes to be relevant, medicine is full of them. The real difference, I think, is that in the US you don't actually see the failures, because they aren't admitted to the hospital in the first place. They die with relatively little attention.

[snousle.livejournal.com]

OK, I don't mean to dismiss tales of problems with socialized medicine from within the system; there are terrible incentives in poorly-managed government programs that can make life a living hell for people working and served by it. In fact I was about willing to concede that "personal satisfaction' with these systems might indeed be very low and that this would be a problem; one would have to decide if measurable health outcomes mattered more than perception, and what that implied for democracy in those situations.

But I needn't have worried, as the very first page I pulled up on measures of health care satisfaction, this Gallup poll, put Ireland at #1, the UK at about #10, and the US a fair ways down the chart from that.

Lest anyone confuse this with "left wing media bias", it is worth nothing that Fox News concurs.

Plenty to discuss about all of this, I agree!

[Update: Typing too fast, the Gallup survey I cited was "health satisfaction", not "health CARE satisfaction, which is more directly addressed by the other Gallup survey I was looking at, albeit for fewer countries.]

[equinas.livejournal.com]

Heh, I love the Irish, but having lived there I can tell you that the general population is not too savvy on what constitutes good health care and in general they are not aware of what a properly run system (public OR private) could do for them. The fact that their satisfaction with their personal health is so high when they are consistently in the top 3 worldwide for per-capita cardiovascular disease* shows me that they're still not completely in touch with modern medicine. As they say, "ignorance is bliss". Over the past few years a massive campaign on heart health has made significant inroads into getting the Irish to stop smoking and improve their diets (gotta love that fried bread every morning) but they still have a long way to go, as does their failing health system. The Regional Health Boards were recently dissolved and reformed and I hope this will make a difference, but I can tell you that my parents have lived in Ireland for decades and are on the free system, and there have been several times I have paid out of pocket to move my mother to the front of the line so she could get the tests she needed. I will say, however, that the price to go the "private" route in Ireland was significantly less than it would have been in the U.S.

*Source: World Health Organization CVD ranking by country 2004-2011.

[snousle.livejournal.com]

The fact that their satisfaction with their personal health is so high when they are consistently in the top 3 worldwide for per-capita cardiovascular disease* shows me that they're still not completely in touch with modern medicine

You've taken a more general measure and tried to refute it with a more specific one. I think you could take any two countries and find particular health statistics where A looks better than B in aggregate, but B looks better than A on several specifics.

To turn it around: if the Irish can smoke and eat massive amounts of fatty foods and suffer high rates of heart disease, while their overall life expectancy remains neck-and-neck with the US, they must also have some advantage which counterbalances that particular problem. It may be true that genetic risk factors are involved (African ancestry in the US contributes to heart disease), but there's probably more to it than that.

I read some recent news items about the drama in the Irish healthcare system. It is possible this will have effects on health outcomes; maybe a lot of it is the unions exaggerating it for political effect. It will always be the case that a little more money would have saved so-and-so from death. The difference is that state-run single-payer systems are publicly accountable for that decision, while private practitioners can simply close the door and not have to explain themselves. So its' not surprising that socialized medicine ends up being more melodramatic.

[snousle.livejournal.com]

There is no question that the US is the place to go if you have six-figure budgets for your own health care. I don't deny its technical superiority. I would say that the relevance of that capability to the average citizen is very low. It doesn't matter how many fancy tools and drugs you have if basic services are 2x more expensive, large numbers of people cannot get insurance, and too many people forgo preventative care entirely.

[equinas.livejournal.com]

That's a good point. We should discuss this more in person, and look at some data together.

[snousle.livejournal.com]

Another point really worth considering is that the US already pays more in tax dollars to support the medical system than other countries with socialized plans do - and on top of that, Americans STILL have to pay much more in private funds to get their care. Really, even after years of being obsessed with this subject, I still find things to be shocked about:



From this article, which I think appropriately paints the idea that socialized medicine has failed as "denialism".