Comparing the whole of the United States to England isn't as informative as one would think, given the wide variety of racial and cultural groups in the United States.
Comparing health outcomes of white Americans of Anglo descent to health outcomes in England would be much more informative. Even more informative would be data that look at white people (and other groups such as Chinese, Indians, etc.) in the US on a county-by-county basis.
The truth is that there are certain groups in the United States whose outcomes are much worse on many statistical bases, and those groups skew the data dramatically downwards. Black people in the US, for example, commit a majority of murders every year [1], despite being only about 13% of the population - almost 4x what the rate would be, if they committed murder at the same rate as white people.
Other disparities are present as well, which mean that there are many communities in the United States where you will live a life just as long and healthy, or even longer and healthier, than in European countries. For example, this article [2] shows a county-by-county breakdown, and many counties in America where life expectancy is over 80.
Thank you, I could not have stated it better myself. When there are many real-life examples that contradict an idea, and only theories and logic that stem from certain questionable assumptions to support that idea, then at very least it is a very poor idea on which to base public policy
"at some point growing population is unsustainable"
This is a logical fallacy that has been bounced around, in catastrophic terms, for centuries. (see Thomas Malthus [1], "The Population Bomb" by Ehrlich [2], etc.) Ehrlich went as far to say that in the 1970s, HUNDREDS of millions of people would starve. Did that happen? No. These ideas about some theoretical limit on food or resources of the Earth are alarmist and do not benefit the public discourse.
Sure, maybe the Earth has a limit to how much population it can support, but it could easily be 100 billion. Who knows? Do you know that the entire population of the Earth can fit in an area the size of the state of Texas, in single family homes? [3]
In contrast to the disproven "unsustainable growing population" idea, depopulation and the aging of the population will have severe consequences within the next few decades, and already has had negative consequences in places like Japan [4], Italy [5], and many others.
We definitely need to deploy policies to increase the number of births to address these issues.
This idea - fixing systems that amplify mistakes into large, irreversible impacts-- is why I am against alcohol, marijuana and other mental-state altering drugs for recreational purposes. (I'm not talking about people who really need pain relief from cancer, amphetamines for ADHD, etc.)
If no one in the world drank, smoked pot, or did drugs, how much better off would we all be? 100,000 deaths come from alcohol use every year in the United States alone[1]. That doesn't even account for countless cases of abuse, broken families, crime, and other negative effects of alcohol and drugs.
So many people say "oh well it's fine if I do it, I'm responsible" but then at some point someone isn't fine and isn't as responsible as they think they are.
I think this is an interesting point to add to the discussion about tax rates by state. For example, Hawaii has high income taxes - but very low property taxes. Something else to consider when deciding which state is the best to live in.
Also worth considering that $200k in income in California with a couple kids probably doesn't pay the full 10% income tax, because the rates are progressive; but will pay the full 1.2-1.7% property tax on a new 750k-1 million dollar home.
A better comparison would be median single family home size in US, which is around 2,300 sq ft [1]. Over 60% of housing units in US are single family homes [2].
Another thing the US could do to reduce prices is to give people the option for certain expensive procedures (hip transplants, knee replacements, etc.) to be done outside the US by qualified doctors. Then the patient could get a discount on their insurance every month or get an incentive from medicare that splits the savings with the patient.
One interesting thing to note is that Medicare (US gov't paid healthcare for the elderly) pays hospitals DOUBLE the price for the same procedures that an MD can do in her own clinic. They pay this supposedly so that hospitals can take in patients who can't afford to pay in the emergency room, etc.
But to me this is another one of those cases where poor government policy boosts prices. Hospitals already have an incentive to buy up small practices to reduce competition, but if hospitals are paid double the price for the same procedure compared to an ambulatory clinic, the government is just incentivizing concentration in the market.
I feel you. Father of 3 here. My two year old always just runs as far as fast as he can pretty much whenever he gets a chance. Won't stay in the stroller either. Putting him in a carseat is much easier. Just went on a flight the other day with the kids and chasing him around the airport wasn't easy, although in the end it was somewhat manageable.
Car travel with kids is way easier compared to other methods.
We took the kids to Paris a while back and carting the stroller up and down the stairs to the metro was a huge pain.
You should read "Atomic Habits", by James Clear. Basically if you want to build new habits, you need to set realistic goals that you will actually do (and also have self-love, that if you don't get it done, you aren't a failure, every day and even every hour is a new hour you can do better) and then do those goals; then after you meet those goals and establish those habits, then you can move on and make that goal a little harder; or you can set goals in a different area.
Another element of this is that you need to establish when the habit will happen, and where. If you pick the same place every day, with time it becomes automatic.
Also important here is the aggregation of marginal gains - each little thing you improve in your life adds up over time to make a big difference. See this article from James Clear about this concept: https://jamesclear.com/marginal-gains.
Remember as well - as Atomic Habits mentions - the goal isn't just to do whatever your goal is; the goal isn't just the outcome; the goal is to change your very identity. A person who wants to read every day, the goal isn't just the reading itself, it is to BECOME a reader. For the person who wants to eat well and exercise, the goal isn't just to lose weight; it is to BECOME a fit, healthy person. As you form new habits every day, what you do on a daily basis becomes part of you, and those actions you take are the evidence of your new identity.
But here’s the thing: if you haven’t had kids yet you don’t know what you’re missing out on. Yes sometimes having kids is hard. But it also enables you to experience happiness and joy in ways that you previously haven’t been able to.
Well actually… Thomas Sowell (who is black) talks about how he felt safe going around on his own in Harlem in the 40s and 50s, and never heard a gunshot. So there actually was a fair amount of social trust / actual safety in black communities even then. With the obvious caveat of course that interracial violence was still a risk. But at least within black communities then, yes there was more social trust.
I would argue the best way to do things that will surpass your life is to have kids, love them and teach and train them in what is good and true and right and with all of the knowledge and wisdom you have, and then see them surpass you.
How do you do that? I tried to get Kaiser to tell me how much my wife's delivery would be and what they told us was much less than the actual bill, even though there weren't any complications
Reading through this list reminded me why I actually don’t want to use TS in the first place.
I think we need to have a discussion about the benefits of dynamically typed languages and why many people purposely choose them over statically typed ones.
In my experience, 95% of the time TS would not have helped anything. And the other 5% where it would have is not worth the constant work required to type the whole application. And sure you can use ts just a little bit... but everyone knows that organizationally the pressure then begins to use TS for the whole app.
Types are nice in some circumstances but are they really worth it? I feel like the answer is no for the majority of applications.
100% with you on the idea of increasing the supply of doctors and shortening medical education.
My dad is an ophthalmologist and he does basically 3 surgeries that take up most of his work time: LASIK, cataract surgery, and cornea transplants.
Was it really necessary for him to do 13 years of schooling to learn how to do those 3 surgeries? I really don’t think so. I feel like we could train doctors in about 6 years (2 years of focused medical training + 4 years of residency / apprenticeship with a practicing doctor). If we’re honest about what doctors are learning, they would have about the same amount of time learning about their actual specialty compared to now, without so many hoops to jump through.
The current system is a cartel that must be reformed.
We also should consider international competition. There are competent doctors in India who could do expensive surgeries like hip replacements for 1/10 the cost AND get better results than the average hospital in the US.
At least we could sell health insurance across state lines...
It's mostly the food. It's not like people in other countries get that much more exercise than we do. (Source: lived in Ecuador for two years).
I watched this youtube video recently about recipes for cutting (weightlifting term for a diet that makes you lose weight) and eating some of the food has helped me lose some weight.
One reason for this is the artificially limited supply of doctors. The AMA combined with the government keeps the number of doctors down by keeping the number of medical schools and medical residencies low, driving up prices.
Comparing health outcomes of white Americans of Anglo descent to health outcomes in England would be much more informative. Even more informative would be data that look at white people (and other groups such as Chinese, Indians, etc.) in the US on a county-by-county basis.
The truth is that there are certain groups in the United States whose outcomes are much worse on many statistical bases, and those groups skew the data dramatically downwards. Black people in the US, for example, commit a majority of murders every year [1], despite being only about 13% of the population - almost 4x what the rate would be, if they committed murder at the same rate as white people.
Other disparities are present as well, which mean that there are many communities in the United States where you will live a life just as long and healthy, or even longer and healthier, than in European countries. For example, this article [2] shows a county-by-county breakdown, and many counties in America where life expectancy is over 80.
[1] https://www.wsj.com/articles/jason-riley-the-other-ferguson-... [2] https://www.deseret.com/utah/2020/3/13/21177268/utah-citizen...