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.
For example, OC claims there has been an alarming rise in degradation of public infrastructure in the US. Does the hard data really support this? If so, I'd love to see it (seriously). Observations from personal travel are virtually meaningless in this context.
Meanwhile, Americans’ international peers enjoy more efficient and reliable services, and their public investment in infrastructure is on average nearly double that of the United States.....The United States generally lags behind its peers in the developed world. According to the World Economic Forum’s Global Competitiveness Report, in 2016 the United States ranked [PDF] tenth in the world in a broad measure of infrastructure quality—down from fifth place in 2002. That places it behind countries like France, Germany, Japan, and Spain.
The Interstate 35W Bridge that collapsed in Minneapolis 2007, I used that four or more times a day on average shortly before its demise. The story was similar throughout Minnesota and proved poisonous to the then-governor who wanted to starve the state.
For us, we based our decision not on infrastructure alone but rather total system health. We need to be able to adequately commit to maintenance and future-proofing our societies, not kicking the metaphorical can down the road.
We speak one of the languages, know enough of the culture and politics, etc. to be inconspicuous and blend into the crowd. More than that, the culture and people and country have grown on us tremendously. :-)
CH appeals most to rich and upper-middle class foreign tourists, but I distinguish between “visitor” from “foreigner living there”.
In terms of the latter group, I don’t think CH attempts to appeal: practically all paperwork is in local language with no attempt at furnishing anything in the language of my mother tongue. Further, your immigration status factors into contracts: subscriptions (telephony), rental agreement, etc. We were once turned down for an apartment because of it. Throughout my time abroad, a common trend is that expats (note: first use of that word) don’t bother to learn local language and are typically unhappy. Those that do attempt to are far happier. Does a host country afford and coddling for the former? I’ve never seen evidence of that no matter how rich. Is it hostile? No.
The story could be different for the super rich who live there like Tina Turner and former Yukos Mikhail Khodorkovsky, but that is not the circumstances of our family nor any other family we know by a long-measure. Citizenship cannot be bought here either. I think for a few million it is purchaseable in Austria or Hungary.
But at the end of the day, in my top-level reply, I had stated “at the moment.” We have lived elsewhere in the world, and the assessment of the overall problems the U.S. are facing would have been identical. The decline is palpable.
In Switzerland, that's no longer going to be an option. They recently implemented a change that requires you to learn at least A1 level (super basic) German in order to keep your B-permit.
As a recent arrival on a B-permit, I think it's a good idea.
- Allow time-based naturalization outside of marriage?
- Allow dual or more citizenship?
CH is on the more restrictive end, but it is one of the few European countries to allow either of the above. If you compare outcomes and hurdles, the U.S. has been more restrictive to foreigners coming in than CH (don’t believe me; tell that the the Canadians I know who moved to CH instead of working for U.S. branches due to U.S. not issuing family reunification visa).
So the question to ask: what do you want? Permit to enter, live, and work; permanent residency; citizenship? Each of these things are different.
If you're an EU citizen you have the right to live there no questions asked.
If you're not EU, you can live there to pursue gainful employment so long as your employer can show that you have skills they can't obtain from within Switzerland or the EU.
If you can get a job, you'll be given either an L permit, which is "temporary" but can be exchanged for a B permit after 2 years, which can then be renewed indefinitely. After 5 years, if you can demonstrate integration (criteria vary by canton), you can get a C permit, which is permanent (essentially a green card).
As a skilled worker, I actually found Switzerland to be substantially more friendly than the US, though a lot of the hard work was handled by my employer.
Due to bilateral treaties, immigration from EU countries is quite easy nowadays, but for citizens of non-EU countries, far less so. Almost 90% of resident foreigners are European: https://en.wikipedia.org/wiki/Demographics_of_Switzerland
It was super easy for me to get a working visa to Switzerland when I had a job there, and I’m not EU. Anecdata for sure, but I was hardly the only non-European around. There were even plenty of war and economic refugees around, far more than I ever encountered in the states.
I mostly think people with money in the US are unlikely to have much different quality of life than developed European counterparts, though. It's mostly people with fewer resources that are disproportionately worse off.
Just this week, a friend who is middle class with chronic but manageable health problems was expressing serious intent on leaving the U.S. precisely because of long-term bankruptcy from medical cost prospects.
If your friend emigrates, they may put a burden on the country they go to. Even if they are productive, the cost of their ailment (assuming its not just ridiculously ovepriced medicine in the US that is in reality really cheap everywhere else, in which case the nation he immigrates to should be overjoyed at the opportunity!) can slow economic growth over if someone with no ailment and the same qualifications emigrated instead.
So the US "sheds" a "cost center" and another country takes on the burden. American companies keep turning over record profits and stock valuations while its poor and sick suffer and die, while other nations are burdened with those America should have taken care of itself with its vast wealth if only it had any morality to care about its citizens.
Not necessarily - old or feeble doesn't mean useless. Brain drain is a real thing ...
While you probably have PTO in the US, the typical leave is 2 - 3 weeks, many companies will offer unlimited PTO to further obfuscate how much time you are expected to take and avoid PTO payouts.
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).
This is not what HN is for. It's tedious, destructive, and nothing good comes of it.
HN is for intellectual curiosity, which is not compatible with political venting. Regardless of how right your views are or you feel they are, please respect the mandate of this site when posting here.
* Frankfurt (both of them)
* Venice (even outside the touristy bits)
And yes, I know not all of those are in Europe; this is generically “nice places”. I’d name places in the UK if the UK government wasn’t currently digesting its own brain.
I’d give Budapest a miss thought. Even the street with all the embassies on is literally falling down and has barriers to keep the pedestrians safe from falling masonry.
Over half of German GDP stems from exports, which is a huge fraction and which is only possible because of the Eurozone and because of the Bretton Woods system. The Bretton Woods system was created by the US to help fight the Cold War by encouraging free trade and the US particularly since the election of Trump is not interested in supporting the system anymore. The Eurozone and the European Central Bank's monetary policy have been preventing the economies of the countries on the periphery of Europe from developing, and those countries will either withdraw from the Eurozone or at least force changes to monetary policy that will be detrimental to Germany's exports.
So it looks like Germany's exports will fall, maybe drastically. Taxes on the profit that German companies make on these exports is how Germany pays for its social programs.
When the economy gets bad in Germany, young Germans cannot find jobs. (France is the same way.) This youth unemployment has gotten so bad once or twice during the postwar period that people start worrying about riots and other kinds of social upheaval, which makes things bad for everyone, not just people needing to find a job. Youth unemployment never gets that bad in the US.
I don't see any challenges to the US similar to those 2 challenges facing Germany.
Although I concede that I probably would have been better off if I had moved to Germany 30 years ago in my 20s, let's see if you still think Germany is markedly better than the US in 15 years.
Post war Germany has never had significant youth unemployment, and worries about "riots and social upheaval" because of that unemployment? That's a pretty outrageous claim.
You cant move around in Europe if you are an average folk like you can in the US. Moving around in Europe means almost a life time commitment to the language and the country and that does not always pay off.
I think you can achieve a working level of any (European) language in around one year. And today we have Google translation in our phones, the job is 10x easier.
Nowhere is a "lifetime" commitment, but if you like a place, might just stay there.
I dont think you have even a clue about how hard european languages are and how hard it is to integrate.
So yeah, I have done that.
Its really not that hard if your study correctly and you're able to spend significant time in a country that speaks the language.
Nevertheless, when taking the whole risk and probability matrix into account, neither my spouse nor I feel confident that the U.S. will turn itself around successfully to warrant an all eggs in one basket approach. The United States would need to stop acting like a petulant family at war with itself and start taking better care of itself and its people.
You could try to converge and force others to foot the bill but sooner or later it would damage the industries that make you money.
Switzerland is an anomaly not the norm in Europe and other countries are paying dearly for Switzerland's success.
Most rich countries have some kind of USP. That isn't an argument that they shouldn't try to replicate the more successful elements of other nations.
Germany is an anomaly in Europe, France also, along with Britain, Ireland, Italy, etc, etc.
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.
This applies to health-care, funding for universities/hospitals/libraries/etc., or just making sure people have food on the table.
To exemplify this, aren't food donation campaigns sort of missing the mark. Yes they provide a valuable service, but the service it self shouldn't be required.
And in return for having you most basic needs like healtcare/education/food covered, why aren't people fine with paying some taxes for this?
I thought I've had is that the nature of having states 'compete' against each other with lower taxes plays a part in this vilification of taxes. But surely this would only explain a small part of this problem.
Because certain people in government convince people that citizens can manage their money better than the government can. Forget about the purchasing power of pooling your money (by way of taxes). Then you have people like Mitch McConnell who calls programs for the less fortunate as "entitlements". The people who need these services don't feel "entitled". Not one bit.
And this is wrong? Look at the absurd high speed rail costs, or the bloated military budget, or SLS vs SpaceX.
Then you have people like Mitch McConnell who calls programs for the less fortunate as "entitlements".
"Entitlements" is a standard term used to distinguish those programs from discretionary spending.
Very simply, there are many sectors where the market works best. Healthcare isn't one of them.
But let's compare the two systems as they are, both dictated by the government. The US is actually rather heavy handed, imposing regulations on healthcare and pharma that most of the world doesn't share. For example, in most countries medical education doesn't require a previous non-medical degree. Pharmacists are often allowed to provide basic medical advice. And medicines are often approved more quickly and less expensively in Europe. How much of the extra cost is due to over-regulation?
Also, how much of our costs are due to our unhealthy lifestyle? If we lived as healthfully as Europeans, we'd surely have lower medical costs.
We can't honestly compare the cost of medicine without controlling for factors like those.
High speed rail cost overruns are almost always due to how expensive eminent domain is more than anything. The estimations given to state officials are often an order of magnitude off how much land they would need to buy. Its also the kind of project beyond the scope of anyone but the largest companies to even attempt, so even if an investment firm could do the math to recognize the economic benefit of having high speed rail and thus they could capitalize on investing in it through other investments in other industries that would grow substantially in the presence of better transit they can't raise the capital to do it and the time frame to realize those returns is too long for any investor to consider reasonable. So we don't get public or private trains.
> the bloated military budget
Its not a money mismanagement at all though. The money allocated to the military that is squandered on hundred thousand dollar toilets and billions on fighter jets that don't even work and will never see practical application in aerial combat were all budgeted intentionally to make private defense contractors rich. Those contractors paid the bribe money to see the budget allocated to them and get a tremendous return on investment.
Something like comparing NASA and SpaceX can be reasonable, but you have to be nuanced about it. A large part of the SLS overrun, for example, was due to their contract with Boeing which was budgeted for 4B but overran time and money up to 9B. Thats "private enterprise" at work wasting tax money because they knew the oversight wasn't there to hold them accountable, as is the case with many government projects mired in corruption.
But you know what? If your government is corrupt, the solution is not to give private enterprise - those that corrupted said government - control over the functions government was supposed to fulfill. You fix your government. If NASA is unable to budget or deliver projects on time, you fire those given the responsibility of managing said projects, do independent investigations of why they failed, and if some party is culpable for the intentional sabotage or deception of the proposals arrest them. If theres a revolving door in Washington of defense contractors lining the pockets of congressmen for taxpayer money via the defense budget investigate and impeach the corrupt politicians. When you contract with a third party to budget infrastructure expansion make them culpable for failure to deliver or for budget overruns.
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.
> 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.
If these are the opinions of Americans, then I think I have found out why the "US is a Rich Country with Symptoms of a Developing Nation". Viewing taxation as direct threat of violence 10000% will result in a crumbling society that is built on democracy and taxation.
It's a frequent comment on HN and it's fucking stupid everytime.
The laws are clear, and you agree to them by living here. A taxation-related arrest will be done non-violently anyway, what on Earth are you talking about here?
Where is this threat of violence coming from?
The opposite of the monopoly on violence would be anarchy, which could be interpreted as a free market of violence.
I can't find anything in that article that has any relevance to today.
Healthcare in the us is seriously fucked up. It's highly regulated and prices are set in an incredibly corrupt fashion. Insurance is misunderstood by politicians as a magic trove of money and then gets the blame when it falls short. We get quite honestly the worst of a privatized and the worst of a public system.
That is simply false. You will not be "carted off to jail, violently, if necessary". If you refuse to obey the laws of the country of course you will be arrested. They will not be violent! If you choose to pull out a gun or something and fight them, then you have initiated the violence and they will defend themselves. This is all fucking insane anyway, why are we even talking about this? You don't have a clear understanding of how the laws or modern society works.
You're not living under a threat of violence with taxation, my god. I can't imagine what kind of misconceptions you have that result in you thinking that a result of you not paying taxes could end violently. We have looooong surpassed that, and in fact, our Constitution written hundreds of years ago, while flawed, absolutely prevents the scenario you are describing.
Are we talking about the US? Perhaps you're not a person of color, so you don't understand what it's really like here.
 actually may be an Objectivist, I guess. They argue the same.
When you buy car insurance, you’re not buying it for yourself, you’re buying it for everyone who has car insurance
And then here's the data on improved access to health care: https://www.kff.org/slideshow/public-opinion-on-single-payer...
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.
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.
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.
You're more likely to get hit by an asteroid than killed by a cop in the US - the fact that you think it's a real issue worth talking about, in a thread about 3rd world countries, shows your lack of perspective. Go tell someone in Sierra Leone about police brutality stats and poverty levels and see how you get on.
I highly recommend you get out of your internet-San Francisco bubble and go and travel off the beaten path to get a better understanding of what the rest of the world still lives like.
That a completely different problem than not being able to afford healthcare or own a home.
The sheer lack of perspective of Americans is baffling. You have no conception of just how difficult life can be and frankly, is, for the vast majority of people.
Play the tape forward on our continual lack of infrastructure investment, our slouch towards oligarchy, our fractious internal tribalism.. the root causes behind 3rd world problems are sneaking up on us.
The municipalities can't fix the sewage system, and the health authorities can't screen for intestinal worms and hand out medication worth pennies. It's shameful to see.
You'd think in the age of YouTube people would have more perspective on the rest of the world. Seriously, one stroll down the giant open air landfills (which double as housing for hundreds of people) of Dhaka should be enough to be eternally thankful for what one has.
I think you are clearly misreading both the article and people’s comments to it. No one is suggesting the US is a 3rd world country. But in certain areas it’s statistics resemble 3rd world country outcomes more than it does developed country outcomes.
The reason this is important is that the US is usually an outlier in developed countries in this area, which means solutions to these problems exist.
Even life at the lowest rungs of US culture have it way better than most in a third world country. We have law and order and pretty good public infrastructure.
Been living in India for more than 2 decades. Never had to bribe the police once.
> hope no one visits your family in the middle of the night,
Funny you mentioned that. USA has worse criminal violence than most countries in the world. Gun violence is entirely a US phenomena.
> don't have access to clean food or water.
Never faced the issue of clean food or drinking water in my entire life. And I am from lower middle class.
> Even life at the lowest rungs of US culture have it way better than most in a third world country
Really? I prefer to live in a country where I can afford healthcare atleast. Probably a great idea to visit some so called "third world" countries and see for yoursevles. If you dont have time for that read Fact-fullness.
You haven't had issue with clean water? I'd say you're pretty lucky then:
"Intentional homicide, number and rate per 100,000 population."
And related to water, we may have different standards for cleanliness. But when the whole world agrees that most of the water is not fit for consumption you have to wonder. 
Anecdata. I went with a friend to a wedding in India. And while we were warned to only drink from water bottles that we unseal ourselves (we even received refilled bottles of water in the Hilton hotel we were living in), my friend did not account for the ice cubes in his drinks. The outcome wasn't pretty.
I agree that some portion of my country is living in bad conditions. But majority are not and nobody is going to trade their spot for the lowest rungs of US culture. Don't get me wrong. I have been to US as well. I would probably trade my place with a person living in a good neighbourhoodn with his own house in California if I was offered Greencard and a job with good salary. But lowest rungs of US culture? Defintely not.
And guess what. The US is at 99 and India is at 107 which reinforces the idea that the US has developing country outcomes in certain areas. It’s not the worst (there are 98 worse countries), but it’s signficanrly worse than its wealth should indicate it should be.
I moved to Asia, to a country with much lower taxes and live a much better life.
Neither the US nor Italy are being directly compared to the developing world. The author is taking the UN's term of "in transition" and considering whether it might apply to the dynamics at play in both countries.
I remember reading an article proclaiming that the United States is the 10th(!!!) most dangerous country in the world for women.
It sure isn't. Infant mortality in Bangladesh is 27/1000 (in 2017), whereas Memphis is down from 15/1000 (in 2003) to 8/1000 (in 2015).
Comparing America to developing worlds can be done but it’s hyperbolic and can turn people off of discussing it.
EDIT: Downvotes on this comment just confirm my point.
The black teenager being bludgeoned into permanent disability by a cop should feel extra grateful the water only has iron in it and not ebola.
Humans are infinitely capable of inflicting and causing misery. Just because some are more miserable than others doesn't make some not miserable. And we are all only unto ourselves - I cannot do anything to solve the suffering of billions abroad, my influence is functionally limited to who I vote into office that has macroeconomically influential power.
And I'll keep doing my best to try getting those elected into such positions of power, using the power I have, that would work to reduce misery everywhere when they are able, but each of us is only one person usually with only the capacity to influence those immediately around us. We cannot all be changing the world at once.
If you NEVER allow yourself to be grateful for what is good in your life, you are going to INCREASE the misery you have.
And that's what is missing in our culture. We goad each other online into complaining and more complaining about things that, while problems, make us forget the good we have and which robs us of happiness.
There's kind of a perverse incentive to come up with the biggest "woe is me" story because it often confers a sort of status in today's culture.
The fact of the matter is that in the history of all humanity, suffering is the norm. Falling asleep on a soft bed with a full belly after a clean shower with an entertainment screen is what is unusual.
It really is unpopular these days to be thankful for what we have.
I mean, is promoting gratitude really something deserving of downvotes?
A few days ago a story hit HN about how ISIS is banning single-use plastics. That was very problematic because my eyes almost rolled into the back of my head.
One of the few US places that actually resembles a developing nation is San Francisco. Whatever economic policy those people employ, the nation should do the exact opposite.
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?
It’s not the right question. The reality is that you’d never be free from worry due to insurer denials, changes to laws that may affect your coverage, provider network status changes and rate increases, job loss, employer changing insurers, etc.
There is no end to your risk in the long run, even when you have “good insurance” at a particular point in time.
I would like to see us start gradually expanding the existing system of "socialized medicine" in the US: The military medical system.
I think an extremely moderate position would be to expand medical benefits for life to anyone who has served on active duty, even if they didn't stay in long enough to retire. Currently, you have to stay in twenty years -- or be the dependent of someone who has done so -- to remain in the system. This screws over a lot of veterans and is a travesty.
The American military medical system is an excellent system with a lot going for it. We have no need to look at how other countries handle "socialized medicine." We have a perfectly functional system within our own borders already run by our own government. We just need to find a politically viable and practical means to start expanding access to it.
Another possible step: If you qualify for Medicaid/Medicare, instead of the current fucked up system, we move you to having access to the military medical system.
So minimum to maximum liability spread for healthcare cost is ~$10k-$27k. If I pull down $100k in a year, 10-27% of my gross paycheck goes to healthcare.
A shoddy analysis of ACA programs countrywide for 2019  (e.g., for a 30-year-old couple with one child) lead me to the conclusion that it really doesn't get that much cheaper. Bronze, silver, gold, or platinum -- you're going to end up paying a good chunk for premiums. The metal level just is a gamble whether to front- or back-load the costs to you (roll the dice on if you think you're going to be sick next year). At absolute minimum $6400/yr, and if you get really sick, it's going to cost you $17-50k.
It's incredible and terrifying to me how small business owners -- at least those who earn too much for a subsidy -- have fallen through the cracks of the ACA. It's far better than it was, but we need universal healthcare, period.
It will lower total cost of healthcare (even though taxes will obviously increase, they should increase less than healthcare costs will decrease, since the US often pays double what other rich countries pay for healthcare ), remove the sword of Damocles of employer-subsidized healthcare hanging above the head of would-be entrepreneurs (who hope to leave and follow their own path, but many don't because if they don't make enough in your new business to offset the massive increase in healthcare costs, they're screwed), remove medically caused bankruptcies, and remove "should I get this cough/lump/etc. checked out" as an economic vs. health question (which is just a perverse calculation, but one that happens often in the US). These are just a few of the primary benefits.
 Data available here: https://www.healthcare.gov/health-and-dental-plan-datasets-f...
You can continue your exact insurance plan via COBRA and pay both your portion and your employer's portion of expenses. Having done this, I paid nearly $3k a month in premiums alone for continued individual coverage. That is not feasible for everyone who were just laid off and still have bills to pay.
To be eligible for Medi-Cal, you must make under 138% of the federal poverty line, or be disabled or elderly. A tech worker who was just laid off would not be eligible for Medi-Cal unless they were recognized as disabled by the state, and the program they'd be eligible for during that tax year would require them to spend a significant portion of medical costs out of pocket before Medi-Cal kicked in.
There are special provisions to purchase health insurance on the individual private market if you're laid off. However, anyone with a chronic condition can attest to the problems that arise when you're forced to switch health insurance plans and continue treatment at the same time.
The suggestion to leave a stable healthcare situation for a hard to secure position at one of the top employers in the world in the most expensive to live place in the world is downright bad.
Treating CD/IBD in U.S. could easily cost $250+ month.
But pre-existing condition exclusions might help to secure insurance with comparable treatment.
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.
Such high earners can cover their healthcare in any country. It's the rest of the people you have to worry about. And if your illness endangers your employment status you definitely don't want to be in the US.
But if it’s something that is controlled with the the right care and they’re a pretty good engineer, then the risk of moving here is much smaller than they realize.
I'm not sure americans understand how annoying it is the process of getting an H1B (or any other visa to be honest)
You will have so much more leverage to negotiate for your skill set. They Truly value your skills.
Kick your safety net to the side, jump the pond and make a good business decision for yourself.
Check this guy out — https://www.instagram.com/p/BuJkJILA_8I/utm_source=ig_share_...
EDIT: If you’re going to downvote, at least have the respect to state why. My post is a serious one, I’m not trolling — people have freed themselves of Crohns with carnivore diets.
I am entirely sympathetic to the idea that certain diets do really help symptoms at times. Examples that have been studied include Specific Carbohydrate Diet, Low FODMAPS, etc. These diets do NOT work for everyone and thus are highly variable.
I've spoken to many rheumatologists who openly say that they are open to patients experimenting. HOWEVER, that broken instagram link you posted is likely one of the few success stories that filters to the top. All the people who try these diets and fail you do not hear about.
The role of the gut and diet in autoimmune is being researched and further elucidated. Patients should safely experiment with the role of diet.
But for you to say "Fix your diet"?! As if you KNOW that other diets are simply BROKEN and that an all carnivore diet is fixing it?? It is not supported by the data at all. It runs contrary to most of the research done on dieting. I'll agree that plenty of research in dieting is flawed (often centered around mediterranean diet), but your tone of "Fix" is why you earned my downvote as a person who has an autoimmune but I don't think you are guilty of trolling. No hard feelings but be a bit more humble around these things when there's so much unknown and ANYONE telling you that they have a perfect FIX is not telling the truth.
Most people’s diets ARE broken though, even 50 years ago we didn’t have hardly the level of autoimmune disease that we have today. The standard medical approach to chronic/autoimmune disease is to tell people the best that can do is manage it, not heal it.
There are plenty of people who have in fact healed themselves from autoimmune diseases and there’s a very common theme — avoid all processed foods, avoid most grains, avoid most sugar, etc. Focusing primarily on animal products (which is where the nasty majority of people got the majority of their calories over until just a few thousand years ago has been shown to ameliorate autoimmune — you have to test it out for yourself, if you wait until the medical establishment comes around you’re going to be waiting your whole life, it is completely against their incentive to find a dietary method of healing Crohn’s or any other autoimmune disease).
However, look up "mcdougall starch diet autoimmune". Here's a doctor who runs a starch based clinic (Starch heavy, avoid ALL animal products). He has client testimonies, a legit clinic, and patients who cured their autoimmune disease.
I personally find that the diet you recommend (albeit with more vegetables) is best for me, but the paleo vs vegan argument has proponents on both sides claiming they've cured autoimmune diseases. I cannot find strong clinical trial data favoring one side over the other. With that said, look up "Dine-CD research study" that is trying to be the first clinical trial of specific carbohydrate diet for crohns.
Be well and enjoy the steak!
Here’s an updated link worth exploring — http://meatheals.com/category/crohns-disease/
Thing is, it doesn't stop the illness itself. You are confusing eating things (like meats, also no fibers etc) that are known to not cause bowel issues in people with crohn's disease, with curing the illness. Being on that diet does little to reverse the illness and it's effect on the digestive tract other than the proccessing in the intestine and down. And what's the point of calling it a treatment if you can never revert to normal?
I asked how much insurance was. If I wanted woo-science shoved down my throat I would return home to my parents.
Please don't make medical "recommendations" of any kind at all on the internet -- even if you are a doctor. It is a really, really bad practice that doesn't work at all and actively interferes with reasoned and serious discussion by people who are directly impacted by such conditions and in dire need of the ability to have meaty discussions about life, the universe and everything as it relates to their condition.
Signed: Someone with a serious condition.
Do you feel it’s a scientific approach to NOT test out something before concluding it doesn’t work?
I’m not a doctor and don’t play one on the Internet but everyone can think and test out things for themselves. A mostly carnivore diet is low risk to say the least considering that’s how almost all humans ate for thousands of years, the modern food supply and diet is what’s radical.
You previously said -- and I already quoted it, above:
I highly recommend you try out a therapeutic diet
That's what I'm talking about right there. That right there is a medical recommendation.
My whole point is that modern diets are broken, lots of people are healing autoimmune conditions with therapeutic diets such as carnivory (or if you want a less strict but IMO less therapeutic autoimmune diet you can check out the autoimmune protocol — see Sarah Ballantyne’s The Paleo Approach).
The OP in no way asked for alternative remedies. They asked for info on how one might adequately access conventional treatment if they moved to the US, without breaking the bank.
It is inappropriate in that context to "recommend" alternative remedies at all for any reason.
A better approach -- if you absolutely feel compelled to butt into someone else's life and just cannot restrain yourself -- is to ask if they would be interested in alternative treatments and any hard data or good info you might have about such approaches. And if they don't say "yes," drop it rather than arguing endlessly with all comers about your right to promote a carnivore diet as some kind of cure-all for autoimmune disorders.
As stated previously: I have a serious condition. I happen to manage it with diet and lifestyle, which gets me called a nutter and given all kinds of headaches. Remarks and behavior of the sort your comments are engaging in are a huge headache for me because it is part of why I am treated so shittily when I want to try to have a reasoned discussion about such topics.
I would never pursue a carnivore diet. I generally eat less meat than the typical American. My current dietary approach is basically working miracles.
And I suggested a methodology for trying to educate people that does not veer into the territory of making medical recommendations.
I don't intend to discuss this with you further. I will just leave this here as an FYI:
Please don't use Hacker News primarily for political or ideological battle. This destroys intellectual curiosity, and we ban accounts that do it.
You believe that nutrition is an "ideology"? Jesus. It's a science, and I make no claim that it's 100% clear what the science shows (in fact most of it is corrupt), but I do believe people should treat themselves as n=1 experiments (your blog clearly shows that you treat yourself as such, much to your benefit it seems) -- and there is plenty of evidence that carnivore or at the very least an AIP diet greatly reduces or completely eliminates autoimmune conditions.
If you want to claim that the way people, lived largely disease free, for hundreds of thousands of years doesn't constitute any form of evidence, then I'm not really sure what to say.
Crohns is like not an issue dude. Compared to my other issue that I linked in the same post.
And a little citation needed on people living disease free for any extended period of time ;)
Small sample sizes but the fact that most went into complete remission is worthy of consideration
Also check out some of the anecdotes here
Hope things works out for you!
The US isn't there yet, but that's where things seem to be headed.
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.
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.
But hey, at least they can ride the subway alone.
Every country has its' problems, and any country can seem great until you actually live there.
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.
Is this for real? I find it quite funny that they conceived it to require clothes to 'drop' from one section to the next.
I'm not sure why you're being downvoted. I travelled to Denver for business recently and felt similar things. Outdated fire sprinklers in my hotel (a good one at that) where very strange.
That and the absolutley shocking number of homeless people.
Indeed, and unfortunately they still aren't good. Just useful if space is a premium (e.g. apartments).
I was recently reading extensively on them, and the consensus seems to be that the washer part is roughly as good as a stand-alone unit, but the dryer is significantly worse (slow and inefficient). Often taking twice as long to dry the same loud.
This seems to be because the dryer is a condenser dryer (stand alone dryers are typically vented dryers). This means instead of pumping warm-wet air outside, they use a heat exchanger to cool the warm-wet air, causing water to be deposited which is then drained.
This results in the combo units consuming water to DRY. Since the heat exchanger has water pumped through it to keep its temperature low, and that water has to be discarded when it gets warm.
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.
> Certainly not in the Bay area.
Yeah, not so much. My first USA stint was in Michigan.
The problem is that much of the intermediate-level power distribution grid is carried on poles. With the ice freezing on the power lines, a lot of them came down. The power company had people working round-the-clock, but it was just so much of the distribution grid that had failed.
Even little backwater valleys (or even mountains) in the alps don't have those problems. For me, the power going out for 3 days after a bit of bad weather was just not something I had ever even heard of, never mind experienced.
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.
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.
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.
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.
Obviously many of them are immensely beneficial and some are not - but I think this statistic belongs as part of the equation.
I can’t tell if I’m on Facebook or hacker news.
This is germane to the topic because many of our recent immigrates are from developing countries.
Here's a PDF of the UN 2017 report - it shows America has over 49 million immigrants on page 6.
Most issues are a consequence of this inequality.
"The left hates math" = "the left hates our statistics"
Perhaps you could elaborate on your comment.
That makes it sound like being a developing country is a disease.
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.
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.