
U.S. Is a Rich Country with Symptoms of a Developing Nation - ForHackernews
https://www.bloomberg.com/opinion/articles/2019-02-21/u-s-is-a-rich-country-with-symptoms-of-a-developing-nation
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matttproud
I am inclined to agree with the article.

As an American who has lived abroad for a sizable fraction of adulthood while
frequently traveling back, the rising level of degradation — the people,
public and private goods — in the U.S. simply can’t be ignored or smugly
explained away. The country is rotting.

Life looks so hard, the conditions and future tenuous, that my family is
making the conscious choice to raise our child abroad. While our American
friends miss us to be sure, not a single one has recommended we return — esp.
those with children.

~~~
briandear
Comparing San Francisco to similarly sized Marseille; I would suggest that
Europe doesn’t necessarily have to answers either. I lived near Avignon and
half of the storefronts in that town are boarded up. You’ll find a similar
story across much of France. Paris, Marseille and Lyon suburbs often look like
war zones and while the US has some similar areas, there are still plenty of
places that don’t. Those that like to compare Europe to the US often look at
the capital cities such as Paris as examples, but fail to look beyond the
surface. France has considerable decay and economic malaise. Two of my kids
were born in France and while it’s a nice place, the opportunity there doesn’t
even come close to the US.

~~~
toweringgoat
Using France as a representaiton of Europe isn't really sensible. And Europe
as a representation of life outside the US even more so.

Travelling to France feels similar to travelling to the US to me. Horrible
infrastructure (especially Paris IMHO). Similar feelings for some other
European countries, Italy at the forefront.

Better models are places like the Nordics, New Zealand, Singapore. But more
middlingly, Canada, Germany, Taiwan, all outclass life in the US or France.
Heck, I'd even say China are doing a lot better in many regards (they have
their own issues of course, but many aspects are strong).

~~~
dmode
Having spent 10 days in France and driving from Paris to Lyon to Nice, this
doesn’t jive with my experience at all. French cities were clean and nice.
French villages look pristine and well managed. Unlike some of the broken
rural areas in the US.

~~~
microtherion
I've spent my vacations in rural France every year for the last 10 years or
so. There are certainly some problems — smaller places just don't feel very
dynamic economically. On the other hand, the French seem to have a vastly
better life/work balance, and I really enjoy their unhurried way of life, even
though as a customer, it's not always to my benefit. The one place in the US
that reminds me most of this is the Big Island of Hawaii.

------
jccalhoun
I'm reminded of the Breaking Bad Canada comic. "You have cancer. Treatment
starts next week. The End."

When I see "heartwarming" stories on tv about people donating to people that
need help I can't help but think it would be more "heartwarming" to have a
government that tried to make sure people wouldn't need to depend on the
kindness of strangers for health care.

~~~
mikeq101101
People being forced to pay for someone's healthcare is more heartwarming to
you than people voluntarily paying for someone's healthcare?

~~~
pcbro141
I would say so. It's very sad to think of someone dying from a treatable
condition because their GoFundMe campaign wasn't popular enough.

~~~
dnautics
The thing is that government doesn't reach everyone either. Often homeless
vets don't seek VA help because why would you trust the government, which
injured you and put you in the place you're in now (not to mention that the VA
has a terrible track record of actually helping). The government also has a
very terrifying incidents in it's history relative to providing healthcare,
from the Tuskegee siphilis experiments, to offering healthcare in exchange for
sterilization, and more recently, using a polio vaccination program as a cover
to spy on bin laden.

~~~
yardie
> VA has a terrible track record of actually helping

Is this a fact? Would private industry do it better?

I ask because the VA is the closest thing we have to a single-payer experience
in the US. Active or inactive, the VA is willing to treat you the only
requirement being that you served.

Yet, when people bring up the failing VA they always pass along the Walter
Reed VA hospital horror stories. I looked into it and you know what, Walter
Reed is a huge military hospital base. It's so big there are multiple
hospitals on site. And that site has government run VA hospitals and
contractor run VA hospitals. And they are all called Walter Reed. But guess
what? All the VA horror stories from Walter Reed come from the same contractor
ran hospitals.

~~~
dnautics
My dad was a hospital administrator at the VA. He complained about several
issues and was rubber-roomed (dad was in the Navy, used to delivering products
on time and in budget and was appalled at the treatment of his fellow vets).
This was not at Walter Reed. The organization simply doesn't have a culture of
taking care of veterans, or anything really, beyond CYA and job security for
career bureaucrats.

> the VA is willing to treat you the only requirement being that you served.

They will make it very hard for you to qualify for VA disability by throwing
bureaucracy at you.

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zeropnc
What's with Americans constantly attempting to paint their situation as more
dire than it actually is? Is it just a blatant lack of perspective on the rest
of the world? Reminds me of an article I read attempting to claim that child
mortality in Memphis was worse than in Bangladesh.

No, the United States isn't like the "developing world" if you're poor (and
since when is Italy, the comparison country, considered "developing world"?)

Comparisons like these (which are rather frequent, I've found) are obnoxiously
disrespectful to the millions of people actually living in developing world
countries. The same millions who would give up their first kid (and often, in
many ways, do) to be allowed into the US.

We can discuss improving the US while also still acknowledging that, on a
global scale, their problems are fundamentally "first world problems". You
don't need to spend hours crunching numbers finding some favourable metric to
the South Sudan to make your damn point.

~~~
blitmap
I guess this depends on what your definition of a first-world problem is.

People die here because they can't afford care. People avoiding the larger
milestones in life like owning a home and having children because it's
untenable. This will cause larger, show-stopping problems.

~~~
zeropnc
People in the rest of the world die because there literally isn't good care
available, regardless of whether they can afford it. As a kid, I once got a
big cut and my doctor's only solution was to dump an old vial of iodine on it
because they didn't have bandaids.

All you (and a few other comments here) are doing is proving my point.
Complain all you want, but don't for a second think your problems are even
remotely close to what the majority of the rest of the world endures.

I suspect the West as a whole hasn't had real problems in a very long time, so
a generation is growing up magnifying their own to victimize themselves.
Americans are particularly bad about this.

~~~
ericd
I think I agree with your summary of what's happening in the US re: magnifying
problems - our range of experiences has become much narrower as things have
become safer and more controlled, so it takes less and less extreme
experiences to reach the extremes of our personal experience.

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tapland
Always wanted to move to the US, but having:

Crohn's disease

MEN-1 [0]

and medications for them, and bi-yearly MRIs and CTs as well as expected
surguries to remove tumours now and then

I have just dismissed the possibility of ever moving there.

Here in Sweden I pay less per earned dollar in taxes towards healthcare, and
my total healthcare costs (all inclusive) are <$270/year (~half for maxing out
pharmacy costs, other half for maxing out medical treatments/doctor's visits
etc).

How much would insurance cost me per month in the US to make me covered so
that I never had to worry about not being able to afford medications or a
surgury?

[0]
[https://en.wikipedia.org/wiki/Multiple_endocrine_neoplasia_t...](https://en.wikipedia.org/wiki/Multiple_endocrine_neoplasia_type_1)

~~~
aantix
Assuming you're an engineer and a decent one at that?

Move to SV, get a job with Google/FB/etc.

If you're single, you'll have a max-out-of-pocket of a few thousand dollars,
but that will more than be made up for by the increase in salary. And you will
have good insurance subsidized by your employer.

~~~
robjan
Do insurance companies in the US pay out for preexisting conditions?

~~~
ianai
Not if they can help it. Iirc, that portion of the ACA was just repealed in
the courts. Group insurance for a large employer will though.

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johan_larson
I'd say the obvious comparison is to Brazil. The upper end of Brazilian
society lives in first-world conditions. Some of them a really rich. But the
bottom end lives in the third world, in gang-run unregulated slums that have
dodgy water and power.

The US isn't there yet, but that's where things seem to be headed.

------
buf
I grew up in the USA but have lived abroad for many years. After seeing life
in Europe and Asia, I agree with this article. Generalization below:

Americans are isolated from other countries and from each other. It creates
fear insofar as that we don't even let our children play in the front yards
anymore, all the while kids in Tokyo ride the metro unattended by an adult.

My life is much better outside of America, but yet I remain for now, because
of the money I make here. Few more years to go and I'm done.

~~~
malvosenior
It depends on how you define better. I happen to love Tokyo but let's not
pretend like it's universally better than the US in all regards. In fact a lot
of the countries people would think of as having better quality of life than
the US have a _higher_ per capita suicide rate:

[https://en.wikipedia.org/wiki/Suicide_in_Japan#/media/File:S...](https://en.wikipedia.org/wiki/Suicide_in_Japan#/media/File:Suicide-
deaths-per-100000-trend.jpg)

~~~
buf
I regret bringing up any country by name, because every country has at least
one issue that is easily searchable on the internet.

~~~
tzs
That's a favorite trick of politicians for criticizing health care proposals.

There are hundreds of different factors that you could use to compare the
health care systems of any two countries.

When someone proposes some change, and offers country X as an example of a
place that works that way, opponents can always find among those hundreds of
factors some particular things where we have better care than X, and then
that's all they talk about.

And of course if you propose a change and do NOT cite places that already work
that way, then the opponents say you are trying something that is just
theoretical and it would be irresponsible to risk our health on such
experiments.

------
mpweiher
The first time I moved to the US was in 1981. Coming from Germany, a lot of it
was quite shocking and seemed like a developing nation even back then,
relatively speaking. Infrastructure crumbling. Highways made of concrete slabs
that go badum-badum at the seams. Can tell if you're going too fast just by
following the rhythm. The cars (rigid axle? seriously?). The appliances. The
furniture. Windows that don't really close. Power lines on poles.

We had an ice-storm once that knocked out power in a 500 mi radius. For at
least three days. This was, at the time, one of the wealthiest communities in
the country.

All that despite a _significantly_ higher GDP/person.

Came back in 2007 to the Bay Area. A lot still the same, though the highways
are nice and most people drive foreign cars. You have to be really quite well
off in order to get things that don't suck, and I determined I could maintain
the same standard of living for a lot less income if I moved back to Berlin,
which I eventually did. On the other hand you can learn to fly for
(comparatively) cheap. ¯\\_(ツ)_/¯

Oh, some of my colleagues at <super-wealthy-top-bay-area-tech-firm> had this
idea for an automatic washer-dryer combo: you put the washer on top, then when
it's done the clothes drop into the dryer on the bottom. They had a hard time
believing that single-unit washer-dryer units have existed for quite some
time.

~~~
bluedino
>>The first time I moved to the US was in 1981. Coming from Germany, a lot of
it was quite shocking and seemed like a developing nation even back then

Actually, the USA has been improved much since the 70's and 80's it's not even
funny.

Large cities like NYC and SF were hell holes with tons of crimes and murders
and poor people. They've really gotten rid of most of the crime and cleaned up
the streets and neighborhoods. Watch a movie set in either city from 40 years
ago compared to now. The pollution has improved drastically as well.

------
aquova
I've studied abroad for some brief periods, but I've lived almost all of my
life in the US, particularly in some of the more rural states. I'm at this
weird place mentally where I'm sometimes both exasperated by the economic
situation here, while still annoyed by 'outsiders' who draw attention to it.
Sometimes I feel that the faults of the US get more negative international
publicity than other countries, leading people who don't really know the
situation here to constantly try to bring up our issues. At the same time,
there is still a Cold War-esque "We're number 1" attitude that makes some
people here unwilling to see the faults.

In the end, I wish I had an answer. Even more so, I wish I knew what the
problem is. As the article says: I'm not surprised that bridges and roads
built primarily from the 50s-70s are crumbling and need to be repaired. I'm
just surprised that it costs so much to do so, and no one is sure why.

------
mindfulplay
People have gotten too comfortable. We no longer have the will to care for the
things we are surrounded by.

We wait for government regulations and lawsuits to make things happen. That
was not how this country was built.

Once you concentrate power in corporations or in politics, people just don't
have the will or say anymore to do anything.

It takes too much time to build a bridge, and too many players involved and
everyone seems to need more checklists and committees and regulations and
vendors and contractors just to build a damn bridge. Private construction/
builders are only slightly more efficient because they don't run for election
but due to monopolies or regulations they are ever more inefficient than
before.

And everything gets amplified a million times through Twitter with not much
substance but just generally shouting about things and not actually doing
shit.

------
PaulHoule
I remember when it took almost a year to refurbish a small bridge in downtown
Ithaca.

There used to people who said the Egyptian Pyramids were built by aliens, but
the experience with that bridge made me wonder if the Tappan Zee bridge was
built by aliens.

------
sershe
From a very long article on healthcare, "High US health care spending is quite
well explained by its high material standard of living", I got an idea that
neatly explains my experience in the USA and the perception of various groups
from outside in (I'm from Moscow, that some people jokingly claim is a
separate country from the rest of Russia). It's still not a well-formed idea,
just a gist of it.

US to me looks like a first world country with a 3rd world country attached to
it; with the bleed of culture both ways (making urban-rural divide worse, sort
of), and obviously economic effects both ways. It's sort of like if Russia
joined the EU as far as people and economics are concerned - it'd still be a
hellhole outside few major cities, but overall richer and with lots of angry
anti-EU people. The US is like that, and the states are much more integrated
than the EU is.

The strongest case for this can probably be built by analyzing human capital
as well as metrics such as healthcare (like the original article did), crime,
etc by county. The weaker case for me personally is that the "feel" (and the
norms if online sources are any indication) of rural/small-town places in the
US vs urban/rich places in the US, is much more like small-town Russia vs
Moscow (except more pissed instead of resigned to their fate), or other semi
3rd world countries, than the same in Europe.

I don't actually think that Civil War was a war between those countries, but
its interpretation these days by many people seems to cast it as such... and
the present-day GOP leadership looks to me basically like United Russia in
Russia - it's a party of power, plain and simple, that aspires to unleash the
freedom to shear the great unwashed.. a typical 3rd world party of which there
are few or no European equivalents. The Dems (and centrist GOP, I guess) are
such a bizarre party these days because they, in turn, have to represent
almost the entire spectrum of the first-world parties - from Bill Clinton
liberal and Christian centrists, to Greens and Socialists.

------
dgudkov
My rule of thumb: if an article has a line chart with non 0-based Y axis it
most probably tries to manipulate the reader's opinion by trying to present an
increasing/decreasing trend as more significant than it actually is.

------
rb808
Surely this is just normal for a big country. USA, China, Brazil, Indonesia,
Russia. There are some outliers - Germany, Japan, France, but they're stagnant
with falling populations as people want to leave them. There are also some
smaller countries Australia, Sweden, South Korea that have done well the last
few decades, but we'll see how much longer for.

------
devoply
When you have a sizable underclass because the upper classes want that sort of
thing, then you have these sorts of issues.

~~~
benjohnson
I think we should acknowledge that we accept over a million legal immigrants
every year - comprising over 12% of our population.

Obviously many of them are immensely beneficial and some are not - but I think
this statistic belongs as part of the equation.

~~~
tracer4201
1 million legal immigrants comprises over 12% of our population? What exactly
do you believe the US population is?

I can’t tell if I’m on Facebook or hacker news.

~~~
benjohnson
Year over year a million immigrants adds up to 14.2% of our population as
stated in this UN report:

[http://www.un.org/en/development/desa/population/migration/d...](http://www.un.org/en/development/desa/population/migration/data/estimates2/estimates15.shtml)

This is germane to the topic because many of our recent immigrates are from
developing countries.

~~~
tracer4201
Broken link

~~~
benjohnson
Looks like they're having some server issues.

Here's a PDF of the UN 2017 report - it shows America has over 49 million
immigrants on page 6.

[http://www.un.org/en/development/desa/population/migration/p...](http://www.un.org/en/development/desa/population/migration/publications/migrationreport/docs/MigrationReport2017_Highlights.pdf)

------
burlesona
Strong Towns has the best explanation of this phenomenon that I’ve seen:
[https://www.strongtowns.org/the-growth-ponzi-
scheme](https://www.strongtowns.org/the-growth-ponzi-scheme)

------
pjc50
I recently started to understand US politics a lot better by realising that
it's a global moon-landing superpower _and_ a Latin American banana republic
that occupy the same physical space.

------
Shorel
It seems it is both the richest and the most unequal among the developed
countries.

Most issues are a consequence of this inequality.

------
theredbox
Sigh I am sad we cant have a productive discussion without going into "grass
is greener on the other side".

------
crubier
From a European point of view, the growing use of GoFundMe campaigns to pay
for health care bills in the US feels like a wild capitalist dystopia. Your
Facebook friends decide if you'll live or die.

------
adrianhel
You guys need a good dose of socialism!

------
ouid
The US is a rich country with the symptoms of a rich country.

------
DoreenMichele
_Symptoms?_

That makes it sound like being a developing country is a disease.

------
Shivetya
Welcome to the effect of too much government, between Federal, State, and
Local, there is so many layers of inefficiency, graft, and corruption, it has
become incredibly expensive to get a lot done. Corruption isn't simply down to
giving and taking of bribes but the outright placing campaign officials in
places of authority and nepotism.

County level in many states works out just fine but even they are subject to
harassment if not extortion by higher levels of government.

We have a government too big it fails. Worse it costs the poorest of our
country an inordinate amount due to taxes, fees, and penalties.

~~~
okintheory
And yet there are countries with more government and much better outcomes
along many axes, e.g. Denmark. So maybe there's a difference between a big
government and corrupt one?

~~~
seabrookmx
This.

Also it's hard to define "too much government."

Too many/too steep of taxes?

Too many Government employees?

Too much regulation of industry?

There's definitely some correlation, but I don't think these are strictly
coupled.

It would be possible to have France-like tax rates but not employ many
government workers by paying private industry to handle tasks like health and
education.

I'm of the belief that practices like this might be part of the reason the US
has so many healthcare inefficiencies though. Corporations are solely focused
on making profit and there just isn't enough competition in areas like
telecom, healthcare, etc. to keep prices down.

I'm Canadian and our healthcare isn't perfect, but it's also not the kind of
political talking point it is in the US for a reason.

