Workaholism in America Is Hurting the Economy • Hacker News Board

Re: Workaholism in America Is Hurting the Economy

#241

Post by Dewie » Tue, Jun 24, 2014, 6:28 PM UTC

adventured wrote: post #227

Dewie wrote: post #200

Earlier quoted context omitted.

> Other comments posted before mine have already pointed out that overall prosperity in the United States is quite high, I've seen more that people have pointed out that America is prosperous, not necessarily that America is overall prosperous. The US seems to have one of the highest gini coefficients out of the OECD countries. > For me, the crucial fact to keep in mind in any of these decry-America threads on Hacker…

Part of the problem is a double standard with regards to America. The other part of the problem, is that America bashers know a lot more about America, than the average person is likely to know about their country, so the basher feels free to attack and never fears their country will be put under a spotlight for its terrible qualities. It's a game of bash and hope for ignorance. For example, if America doesn't have p…

> Part of the problem is a double standard with regards to America.

I don't know what that means.

> The other part of the problem, is that America bashers know a lot more about America, than the average person is likely to know about their country, so the basher feels free to attack and never fears their country will be put under a spotlight for its terrible qualities. It's a game of bash and hope for ignorance.

I don't know if that is intentional, but it might be what happens.

But this could easily swing the other way - a lot of non-Americans know about America, so they can discuss it and amplify anything that they think is positive about it.

> For example, if America doesn't have paid maternity leave, that's considered very backwards, and America frequently gets bashed for such things. If Spain has 34% real unemployment, somehow that isn't considered wildly backwards by comparison, because hey they have paid maternity leave and six weeks of vacation.

What? The ridiculous unemployment of young people in Spain is seen as a big problem. Certainly a bigger problem than a small amount of maternity leave.

If it is viewed as barbaric by comparison, then it might be because maternity leave is a matter of social policy, while unemployment is obviously not. It might be a symptom of mismanagement by the government, but no a matter of social policy.

I think Spaniards are more busy with protesting the government than with feeling smug about being better than Americans. On the other hand, a lot of them have a lot of 'free time', so who knows. :)

> Or if Albania (or Nigeria or Congo or Vietnam) has a drastically better gini number than the US, somehow that's considered amazing. Except it's ignorant analysis.

Oh come on. I have never seen America been compared to countries like Congo over stuff like this, except perhaps hyperbolically.

> I see this all the time in regards to Europeans bashing the US. They're counting on Americans not knowing enough about most of Europe to lodge a counter response.

Thankfully for America, there are plenty of prideful Americans willing to take a stand, it seems.

Keep in mind, though, that not all America bashing is from Europeans. Americans can do it, too. And even if a European (or whatever) country is being hailed as better than the US, it might not be people from that country who are saying it.

Re: Workaholism in America Is Hurting the Economy

#242

Post by refurb » Tue, Jun 24, 2014, 6:28 PM UTC

yequalsx wrote: post #239

refurb wrote: post #199

Earlier quoted context omitted.

You've made several erroneous claims, so I'll comment on a few of them: Hospitals are not required to treat, but most do. It is general knowledge in the industry that if you can't afford treatment for your cancer you go to a local hospital where you will be treated regardless of ability to pay. Yes the US spends more than any other industrialized nation, but no, health outcomes are not the worst. If you use blunt too…

Your last sentence is not warranted and has no place on this site. The Medicaid bump only applies to states that enacted it. It is also a recent thing. People without healthcare insurance often find out they have cancer far too late. While they may find treatment for free often times it is too late. If the free healthcare that hospitals provide was anywhere near adequate then people with insurance would dump it and s…

Sorry for the last comment, but you're repeating several claims that are untrue and have no basis in fact.

Another example: "Medical bills are the number one reason for bankruptcy in the u.s.", again, not true. The correct statistic is "Unpaid medical bills are the most common debt owed during bankruptcy filings", someone could have a medical debt of $10 and that doesn't mean it caused their bankruptcy.

"Interestingly, it turns out that research commissioned by the Canadian government shows that 15% of people over the age of 55 who declare bankruptcy cite a medical problem as the primary reason. Medical bankruptcies can, as I've been saying for a while, be driven by something other than the lack of free government provided medical care."[1]

http://www.theatlantic.com/business/archive/2009/09/bankrupt...

Re: Workaholism in America Is Hurting the Economy

#243

Post by jmct » Tue, Jun 24, 2014, 6:58 PM UTC

brightsize wrote: post #116

jmct wrote: post #43

Earlier quoted context omitted.

Would you mind naming the generic drug? It seems like this is a powerful argument against having (only) for-profit healthcare. I'd like to be able to point to a specific case of what you're describing.

A data point from the USA: I take a very low dose of lamotrigene extended-release (mild epilepsy). The brand-name cost of this was $1200-$1400 per month. The recently available generic version of this costs nearly $400/mo. And this is, again, for a very low dose. For someone with a moderate or severe seizure (or bipolor - it's used for that too) disorder, the cost might be 4-5x this. While one might argue that the na…

While your point is also good, I really wanted to know the case where the a generic equivalent isn't even available (despite being more effective).

The OP's anecdote seems to imply that there are situations where only inferior proprietary drugs are available. Which, in my opinion, would be impossible to defend, no matter how much of a fan of the free market one might be.

Re: Workaholism in America Is Hurting the Economy

#244

Post by yequalsx » Tue, Jun 24, 2014, 6:58 PM UTC

refurb wrote: post #242

yequalsx wrote: post #239

Earlier quoted context omitted.

Your last sentence is not warranted and has no place on this site. The Medicaid bump only applies to states that enacted it. It is also a recent thing. People without healthcare insurance often find out they have cancer far too late. While they may find treatment for free often times it is too late. If the free healthcare that hospitals provide was anywhere near adequate then people with insurance would dump it and s…

Sorry for the last comment, but you're repeating several claims that are untrue and have no basis in fact. Another example: "Medical bills are the number one reason for bankruptcy in the u.s.", again, not true. The correct statistic is "Unpaid medical bills are the most common debt owed during bankruptcy filings", someone could have a medical debt of $10 and that doesn't mean it caused their bankruptcy. "Interestingl…

Instead of reading Megan read the report she cites. The Canada number is self reported by those surveyed and it isn't known if this is from the bills themselves or from loss of income due to illness or a combination of both. If it is from medical bills this would be for care above and beyond what the Medicare system provides. I don't know exactly what Medicare refers to when talking about Canada. I'm quoting the paper that Megan cited. interestingly the paper cites work by Warren and Megan is quite critical of her work in the article you linked too. I've found Megan to be unreliable when interpreting studies.

The fact remains that people in the US do go bankrupt as a result of medical bills. People in Germany, France, etc. don't. As a general matter of affairs. We spend far more per capita than anyone else on care. We don't live longer, aren't more happy, or in better health than people in other countries. Our health outcomes are worse than many industrialized nations. The free care that hospitals provide is not adequate care evidenced by the market.

Re: Workaholism in America Is Hurting the Economy

#245

Post by whybroke » Tue, Jun 24, 2014, 7:01 PM UTC

refurb wrote: post #240

whybroke wrote: post #216

Earlier quoted context omitted.

> In addition, if you are sick and you go to a hospital, you must be treated regardless of your ability to pay. If you'll pardon a second response, I must point out this is only true of emergencies like car accidents and the ever abundance of shootings. In most states, if you get cancer without insurance you just die. Period. And not by euthanasia, by the way, because apparently that is mortal sin / slippery-slope to…

"In most states, if you get cancer without insurance you just die. Period. And not by euthanasia, by the way, because apparently that is mortal sin / slippery-slope to mass murder." This is patently untrue. Do a google search for "disproportionate share hospitals" and "charity care". In my line of work I've spoken with numerous oncologists and I've asked them "what do you do if your patient can't afford cancer treatm…

If you have a fashionable cancer then yes there are special programs.

If you do not have the right kind of cancer then there are not.

Which is pretty strange in and of itself.

And if you are utterly indigent then yes there programs in many counties. County or city run hospitals which is of course the exact definition of socialist which I understand is completely objectionable on principle and so something to be zealously eradicated.

But if you are one of the working poor the options evaporate. Especially if you are in the wrong county/state.

If you glance through this pdf

http://action.acscan.org/site/DocServer/cancer-disparities-c...

I think you'll find there is an enormous difference in the fatality rate for uninsured vs insured patients exactly because of the lack of treatment.

But perhaps I'm wrong: what is the name of this hospital run entirely by donation that takes every cancer patient that shows up free of charge?

Re: Workaholism in America Is Hurting the Economy

#246

Post by Dewie » Tue, Jun 24, 2014, 7:18 PM UTC

rayiner wrote: post #187

resu_nimda wrote: post #137

Earlier quoted context omitted.

I like how you edited "Self Entitled" into the generational title, just to really drive home the disgust. ;) I partially disagree, though. I do think Americans are exceptional, even if I haven't settled on exactly how, and I definitely don't think of it as a wholly positive trait. But this juxtaposition from your post is interesting: Americans aren't exceptional in any way. Americans love to believe that the individu…

I think Americans are exceptional, which doesn't need to mean "the best at everything." 1) Americans are, historically, exceptionally willing to let immigrants integrate. My family is from Bangladesh, my wife's from Oregon, both going back many generations. She could never integrate into Bengali society the way I have been allowed to integrate into American society. She could live there her whole life, and she'd alwa…

> Now, we're not as exceptional as we used to be. But in large part because Europe spent the last couple of decades becoming more like us.

Or perhaps things were set up really good for the US after WWII? Then eventually a lot of Europe started to catch up to that initial advantage.

In the case of the old Soviet Block, given their past, basically anything that they could have done w.r.t. their markets and governments would have made them more like the US, if they aspired to some kind of democracy and some kind of free market. So I'm not so sure if 'More like the US' is very descriptive.

Re: Workaholism in America Is Hurting the Economy

#247

Post by michaelfdeberry » Tue, Jun 24, 2014, 7:33 PM UTC

refurb wrote: post #199

yequalsx wrote: post #173

Earlier quoted context omitted.

Hospitals are not required to treat people regardless of ability to pay. Hospitals are merely required to stabilize a patient before dumping them. The U.S. spends around 16% GDP on healthcare. This is by far the most of any industrialized nations. Americans have among the worst health care outcomes of the industrialized nations. Americans spend far more for procedures than citizens of other countries. Medicaid only k…

You've made several erroneous claims, so I'll comment on a few of them: Hospitals are not required to treat, but most do. It is general knowledge in the industry that if you can't afford treatment for your cancer you go to a local hospital where you will be treated regardless of ability to pay. Yes the US spends more than any other industrialized nation, but no, health outcomes are not the worst. If you use blunt too…

>Hospitals are not required to treat, but most do. It is general knowledge in the industry that if you can't afford treatment for your cancer you go to a local hospital where you will be treated regardless of ability to pay.

Do you have a source for this? I can only speak from personal experience, but when I was sick and didn't have insurance I had to come up with a pretty significant upfront payment to see a specialist.

You may get to see a doctor, but try seeing a true specialist with insurance. So yeah, I agree with yequalsx, you will be stabilized, and that's pretty much it.

Re: Workaholism in America Is Hurting the Economy

#248

Post by whybroke » Tue, Jun 24, 2014, 7:51 PM UTC

refurb wrote: post #238

whybroke wrote: post #207

Earlier quoted context omitted.

Quite correct: I have no idea what the price is in Lichtenstein. Nor have I compared the price of every drug manufactured. Nor even a majority of those thousands. I have, however bought a dozen or so different drugs and have done so in France, Italy, Croatia, Spain, Portugal and the Netherlands. All of which were tiny fraction of the price in the US. So given two hypothesis: the US is cheaper vs the EU is cheaper, an…

I'd take a Commonwealth Fund analysis over your "Bayesian statistical analysis". http://managinghealthcarecosts.blogspot.com/2012/03/united-s...

Ah yes that is obviously much better than extrapolating from anecdotes.

But of the few European countries compared, at least two have deregulated pricing for generics which is exactly the point we're talking about isn't it? The others may or may not (I don't know). But why were Norway, Sweden and Denmark omitted from that comparison when they are in every other comparison on the original page? It's a strange omission because generics in Scandinavia are lower than western Europe. Inside of Europe, countries that have deregulated their generics simply have higher prices.

Re: Workaholism in America Is Hurting the Economy

#249

Post by jefurii » Tue, Jun 24, 2014, 8:01 PM UTC

jasonkester wrote: post #83

That Cadillac ad is awesome. I'd never seen it before. It watches like a parody, but at the end you're hit by the reality that yes, this guy is being completely serious. The message really is "sure, I traded away my quality of life, but look at all this stuff! " That's actually the notion that Cadillac is trying to sell. Amazing that they're doing such a good job of it. Fortunately, there's no real trick to getting b…

> That Cadillac ad is awesome. I'd never seen it before.

Watching that commercial filled me with rage and made me want to punch that rich asshole in the face.

Re: Workaholism in America Is Hurting the Economy

#250

Post by TylerE » Tue, Jun 24, 2014, 8:23 PM UTC

wtbob wrote: post #235

dasil003 wrote: post #23

Earlier quoted context omitted.

Vacation policies are the least of it. How about the lack of a safety net? Take health care. Civilized people should agree that medical care in a rich country should be available to everyone. The thought of people dying in the streets from preventable disease and injury sounds pretty horrendous. But for the past 20 years we've been fed the same fabricated FUD about socialized medicine that has no basis in reality. Pe…

> The thought of people dying in the streets from preventable disease and injury sounds pretty horrendous. Funny that you raise FUD in your very next sentence, because that is itself FUD. Since the 1980s hospitals have been obliged to treat anyone who shows up. > And it turns out that this medication is not as effective as the generic that would cost $2 per pill. But because there is no profitability this medication…

In theory.

In practice, the active ingredient(s) are required to be the same, but there can be some variation in e.g. binders that can make differences. The characteristics of the generic (bioavailbility, onset time, etc) are only required to be within a certain range compared to the original, not be identical.

See this, for example: http://en.wikipedia.org/wiki/Generic_drug#Efficacy