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mikepurvis 5 hours ago

Given that reality, I wonder why it is that spending in this category seems to be so much less effective in the US relative to other nations? Why is the US #22 in general quality of life [1], and the bottom of many rankings of health system performance [2]?

Speaking as a Canadian, I wonder if at least part of it is the attitude that investments in these areas are "welfare" and not simply a part of the portfolio of essential services that are delivered by the state to citizens?

[1]: https://www.usnews.com/news/best-countries/rankings/quality-...

[2]: https://www.commonwealthfund.org/publications/fund-reports/2...

fhdkweig 5 hours ago | parent | next [-]

It may just be my cynicism talking, but it seems that it comes down to the power of lobbyists. In the US, the healthcare companies control the government. Elsewhere, the government controls the healthcare companies.

mikepurvis 4 hours ago | parent [-]

The media narrative is a factor too. Like I have extended family, friends, and work colleagues in the US, many of whom are wealthy and well-traveled and even a lot of them will still loudly assert obviously disprovable untruths like "well at least we don't die in waiting rooms like in Canada" or "at least we don't have death panels deciding who gets to have life-saving treatment" or worst of all "ehh I mean I have good insurance, and outcomes are much better here for top-5%ers, so I don't really care about the rest of the system." All while decades of TV hospital dramas depict a well-oiled medical system delivering effective and efficient care to people with nary a whisper about how it's getting paid for.

It's got to be desperately frustrating trying to fight this kind of thinking when you've got whole communities who have never even thought to question it.

My main hope at this point is with bottom-up type efforts. Let Mamdani show people that an effective city government can fill potholes and operate a few at-cost supermarkets. Let that be the start of citizens expecting more than chainsaw-waving and twitter meltdowns for their tax dollars.

zahlman 3 hours ago | parent | prev [-]

> Speaking as a Canadian, I wonder if at least part of it is the attitude that investments in these areas are "welfare" and not simply a part of the portfolio of essential services that are delivered by the state to citizens?

Also speaking as a Canadian, I don't understand the distinction you're drawing.

mikepurvis 3 hours ago | parent [-]

The distinction is in whether there's a value judgment. Is healthcare and welfare something we assume is part of the package living in a developed nation, or is it an indulgent extra, subject to suspicion and scrutiny above and beyond what essentials like military spending get?

I would say that the mainstream Canadian view is the opposite of this. We expect healthcare funding and many are supportive of the strikes when it gets cut, but we are much more likely to treat military budget as the purchase of a lot of unnecessary toys.