Unfortunately, too, the solution to the "problem" of high variation in standards is uniform mediocrity. I remember an incident here when Ann Richards was governor and the Texas legislation attempted to implement a "Robin Hood" system of education funding. The plan was to shunt money from so-called wealthy school districts (read districts where residents voted higher taxes on themselves to fund better schooling) to ones that had smaller budgets. There was naturally some contention and after pulling an all-nighter to try and come to a compromise, Ms. Richards emerged from the chambers a little worse for the wear and let slip an unguarded statement that the best way to equality was to bring the level of the better systems down to that of the non-performing systems. Needless to say, her political party hasn't seen anything that resembles power in this state since then.
But by actual statistic, the figure is greater than 60%. I do have one question for you Kiwis: Do all of these immigrants enjoy full rights of citizenship, voting rights for example? Or are they mostly nearer the status of guest workers?
John
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I remember my mother talking about the Great Depression, (1930's) saying "it was no problem being poor, everyone was poor. But everyone shared what they had".
Modern Society is not like that. Its more "Pull up the ladder, Jack, I'm OK" if you recognise the reference.
But uniform mediocrity is not necessarily the outcome as you suggest. You have stated already that medical professionals in USA are dedicated to providing the best possible outcome. I have found this true in all countries, regardless of funding.What has varied is the standard of expertise (because of lack of education oportunities, not of desire) and the shortage of resources, both money issues.
Poor countries tend to stay poor because of poor education, not a wish to stay poor.
Modern Society is not like that. Its more "Pull up the ladder, Jack, I'm OK" if you recognise the reference.
But uniform mediocrity is not necessarily the outcome as you suggest. You have stated already that medical professionals in USA are dedicated to providing the best possible outcome. I have found this true in all countries, regardless of funding.What has varied is the standard of expertise (because of lack of education oportunities, not of desire) and the shortage of resources, both money issues.
Poor countries tend to stay poor because of poor education, not a wish to stay poor.
In a hypothetical utopian society no it's not, but in reality, mediocrity is the unavoidable outcome. There is just no way to expect excellence from everyone since every society has an irreducible number of people who want a life of unearned leisure or who are incapable of ever achieving anything. Take away rewards for hard work and excellence, for people who have succeeded in the medical profession and draw a high salary for example, and uniform mediocrity will necessarily ensue. It always has.
John
I agree. The trick is to minimise the number of "problem" people. Its a matter of balance and opportunity. If the difference between rich and poor is too great, the perception that anyone can be rich is lost, so people simply give up, or rebel, eventually by force of arms. Look at history to see what I mean.
There must be rewards for excellence, or working hard, but also there must be encouragement to doing so. If you make the mountain too high, fewer and fewer people will climb it. I suspect in USA, this is the case for many communities.
Unfortunately, from what I have seen Federal and State aid for poor communities has been driven by political considerations and not need.
I may be wrong, but it seems to me that mistrust of the government, (at all levels) is higher in the USA than in most western countries. If I were you, I would be extremely worried by that, and would be trying to find out the reason. If you know, why don't you do something about it?
But to go back to the original discussion, the Census. I suggest the best approach is to fill it in correctly, but may sure the information is used properly. To lie is counter-productive.
There must be rewards for excellence, or working hard, but also there must be encouragement to doing so. If you make the mountain too high, fewer and fewer people will climb it. I suspect in USA, this is the case for many communities.
Unfortunately, from what I have seen Federal and State aid for poor communities has been driven by political considerations and not need.
I may be wrong, but it seems to me that mistrust of the government, (at all levels) is higher in the USA than in most western countries. If I were you, I would be extremely worried by that, and would be trying to find out the reason. If you know, why don't you do something about it?
But to go back to the original discussion, the Census. I suggest the best approach is to fill it in correctly, but may sure the information is used properly. To lie is counter-productive.
Sorry John, but your argument holds no water in terms of the subject or your approach.
As rjb saliently notes, it is not a fact that the uplifting of the lowest will only happen by the degradation of the highest. The only way that could logically follow would be if constant improvements at the top necessarily resulted in further falls at the bottom. Neither is true, hence your argument is flawed.
And in terms of the facts - the US citizen spends 300% more than a NZ citizen (in $US) and yet has poorer health outcomes (our life expectancy is 2 years longer). Even more telling, you spend twice as much as us on health (public and private) on a %GDP basis - for a lesser outcome. NationMaster - World Statistics, Country Comparisons.
Your "system" is demonstrably NOT providing the same value that ours does. And ours is far from perfect too.
In response to your question, our immigration policy allows for several classes of entry to the country including tourism, work permit, residency and citizenship. Various democratic rights fall to the different classes. A substantial number of work permitted entries later get converted to permanent residence and ultimately citizenship but I'm not sure of the stats on it.
As rjb saliently notes, it is not a fact that the uplifting of the lowest will only happen by the degradation of the highest. The only way that could logically follow would be if constant improvements at the top necessarily resulted in further falls at the bottom. Neither is true, hence your argument is flawed.
And in terms of the facts - the US citizen spends 300% more than a NZ citizen (in $US) and yet has poorer health outcomes (our life expectancy is 2 years longer). Even more telling, you spend twice as much as us on health (public and private) on a %GDP basis - for a lesser outcome. NationMaster - World Statistics, Country Comparisons.
Your "system" is demonstrably NOT providing the same value that ours does. And ours is far from perfect too.
In response to your question, our immigration policy allows for several classes of entry to the country including tourism, work permit, residency and citizenship. Various democratic rights fall to the different classes. A substantial number of work permitted entries later get converted to permanent residence and ultimately citizenship but I'm not sure of the stats on it.
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Just to clarify voting rights, all permanent citizens over the age of 18 must register on the voting roll. Voting is not compulsory, but the percentage that vote is very high for national elections, less so for local body elections.
We trust our government not to misuse the roll information, and in fact the privacy laws are strict, not just for this but for all information the government collects, eg drivers licences. Computer access is tracked, and prosecutions do result.
Just as an aside, all NZ's, like the Scots, are "agin the govt" who-ever they are. This keeps them in line, so we can trust them generally to be honest. Careful track is kept of financial matters, and even the smallest bribe would not go un-noticed. Nor would "favor for favor". Election costs are limited by law, and must be published.
Recently there has been great fuss about inappropriate purchases by a Minister on a government credit card amounting to a bottle of wine! He resigned his position.
We trust our government not to misuse the roll information, and in fact the privacy laws are strict, not just for this but for all information the government collects, eg drivers licences. Computer access is tracked, and prosecutions do result.
Just as an aside, all NZ's, like the Scots, are "agin the govt" who-ever they are. This keeps them in line, so we can trust them generally to be honest. Careful track is kept of financial matters, and even the smallest bribe would not go un-noticed. Nor would "favor for favor". Election costs are limited by law, and must be published.
Recently there has been great fuss about inappropriate purchases by a Minister on a government credit card amounting to a bottle of wine! He resigned his position.
Yes, let's try to steer clear of politics.
Can you think of alternative explanations? Demographics? Means of tabulating statistics (that's particularly an issue when comparing infant mortality)? Does the NZ per capita expenditure include public subsidies, which still come out of their citizens' pockets? Do the numbers include research and cutting edge medicine, which tends to concentrate more in the US than other places?
Can you think of alternative explanations? Demographics? Means of tabulating statistics (that's particularly an issue when comparing infant mortality)? Does the NZ per capita expenditure include public subsidies, which still come out of their citizens' pockets? Do the numbers include research and cutting edge medicine, which tends to concentrate more in the US than other places?
Good point-Sy. "There are lies, damned lies, and Statistics"
Much of the medical research carried out in NZ is funded off-shore, often by US Varsities and charitable trusts. So presumably that expenditure is not included.
Stalker- I have no problem with those that are mentally or physically incapable living off the state, or those that like a life of leisure that can afford to from their own funds. But those that simply lack opportunity, education or by misfortune may have the desire but be still be unable to help themselves without some assistance. In the past this has been provided through a religious organisation or through charitable works, both of which have fish-hooks. Neither are new laws necessarily the answer. How and to what level this is provided differs between countries, and is always a subject of debate. There is no simple answer.
Much of the medical research carried out in NZ is funded off-shore, often by US Varsities and charitable trusts. So presumably that expenditure is not included.
Stalker- I have no problem with those that are mentally or physically incapable living off the state, or those that like a life of leisure that can afford to from their own funds. But those that simply lack opportunity, education or by misfortune may have the desire but be still be unable to help themselves without some assistance. In the past this has been provided through a religious organisation or through charitable works, both of which have fish-hooks. Neither are new laws necessarily the answer. How and to what level this is provided differs between countries, and is always a subject of debate. There is no simple answer.
Poor people tend not to stay poor when they emigrate to any country.
That's because they have some get up and go, and something of use to their new country. We have some very rich wine-makers that arrived from central Europe with nothing after the second world war. Ditto Asians, that have improved the range and quality of our restaurants enormously, providing a point of difference from the saucy French and KFC that ruled previously.
That's because they have some get up and go, and something of use to their new country. We have some very rich wine-makers that arrived from central Europe with nothing after the second world war. Ditto Asians, that have improved the range and quality of our restaurants enormously, providing a point of difference from the saucy French and KFC that ruled previously.
rjb- In fact I was only joking, I have never felt the need to defend any social class nor do I care for statistics. You must understand that for an individualist this debate holds no meaning. My apologies then for interrupting this conversation with sarcasm but as you have said- there's not simple answer.
Still, I keep reading... I enjoy the clarity of your reasoning.
Still, I keep reading... I enjoy the clarity of your reasoning.
Actually, I haven't put up ANY reason for the poor service and value you collectively get from the health services in the USA so far SY - I've just suggested that health systems perform better when they have a full understanding of the populations they serve. John contends the market will fix it.
The stats are attributed- you can check their source. They are, as far as I can tell, from reputable data (OECD largely) and the definition suggests they have been limited to primary, secondary and tertiary health provision regardless of the funding source.
In any case, the facts hold for other locations too - in Europe, and even your neighbours in Canada.
Fact is, you collectively spend significantly more on direct healthcare (public and private) than ANY other country both in a per capita dollar basis and a % GDP basis.
Fact is, you don't live any longer for it, and the last years of your lives are spent in poorer health than a large number of countries that spend significantly less than you.
I guess a point could be argued that the USA can afford to be a bit wasteful and that to not get great value outcomes at a population level is a market choice that has been consciously or otherwise chosen by the population. A focus on the extreme and unusual will do this and would explain the widespread celebration in the country when expensive treatments become available to address relatively rare illnesses while 20-odd million people can't afford to get primary health care.
Interesting that you raise demographics as a possible cause, since thats where we came in. If you fill out your census forms accurately, perhaps we could find out and your tax burden could drop...
The state of the poor here has no historical equivalent. The idea that all of our lazy types would ever get up from watching TV and start a revolution is laughable. The only reason they might have given up on being wealthy is that they are already comfortable. This reminds me of a story that a friend of mind told me about a guy he met who was from India. He was a member of an upper caste there but held only an ordinary position here. When my friend asked him why he gave up privilege in India to come here and start from scratch his reply was that he had always wanted to live in a country where all of the poor people are fat. Maybe that's one of the reasons that life expectancy here is slightly lower, not to mention that when a child is born pre-maturely in this country every effort possible is made to prolong its life if only for a few days. Often, in other developed countries, the child is left to die and the event is counted as a non-birth and doesn't affect life-expectancy statistics.
How many people here do you think are willing to bet that if we spend less money on the healthcare system it will get better? New Zealand should be grateful for the billions we spend on medical technology and pharmaceutical research, much of which leads nowhere - which of course lessens our all-important bang for the buck.
John
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Thanks for your viewpoints but I think that we can safely say that we are getting into politics here.- Status
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