Tag Archives: international comparisons

Medicare vs. National Health Care: How U.S. Seniors Do in Cross-National Perspective

“We need to get rid of Obamacare,” says Ed Gillispie in a NYT op-ed. The reason: Obamacare’s “gravitational pull toward a single-payer system that would essentially supplant private insurance with a government program.”

Gillespie, who lays out his credentials at the start of the article – he ran for Senate in Virginia and lost – notes that Obamacare is unpopular. But he omits all mention of a government-run single-payer system that happens to be very popular – Medicare. No Republican dare run on a platform of doing away with it. Gillespie himself accused Obamacare of cutting Medicare, a statement that Politifact found “Mostly False.”

So how are seniors doing? Compared to their pre-Medicare counterparts, they are  probably healthier, and they’re probably shelling out less for health care. But compared to seniors in other countries, not so well. A Commonwealth Fund survey of eleven countries finds that seniors (age 65 and older) in the U.S. are the least healthy – the most likely to suffer from chronic illnesses.* 

Over half the U.S. seniors say that they are taking four or more prescription drugs; all the other countries were below 50%:

And despite Medicare, money was a problem. Nearly one in five said that in the past year they “did not visit a doctor, skipped a medical test or treatment that a doctor recommended, or did not fill a prescription or skipped doses because of cost.” A slightly higher percent had been hit with $2,000 or more in out-of-pocket expenses. 

In those other countries, with their more socialistic health care systems, seniors seem to be doing better, physically and financially.  One reason that American seniors are less healthy is that our universal, socialized medical care doesn’t kick in until age 65. People in those other countries have affordable health care starting in the womb. 

Critics of more socialized systems claim that patients must wait longer to see a doctor. The survey found some support for that. Does it take more than four weeks to get to see a specialist? U.S. seniors had the highest percentage of those who waited less than that. But when it came to getting an ordinary doctor’s appointment, the U.S. lagged behind seven of the other ten countries.

There was one bright spot for U.S. seniors. They were the most likely to have developed a treatment plan that they could carry out in daily life. And their doctors  “discussed their main goals and gave instructions on symptoms to watch for” and talked with them about diet and exercise.

Gillespie and many other Republicans want to scrap Obamacare and substitute something else. That’s progress I suppose. Not too long ago, they were quite happy with the pre-Obamacare status quo. Throughout his years in the White House, George Bush insisted that “America has the best health care system in the world.” Their Republican ideology precludes them from learning from other countries. As Marco Rubio put it, we must avoid “ideas that threaten to make America more like the rest of the world, instead of helping the world become more like America.”

But you’d think that they might take a second look at Medicare, a program many of them publicly support.

* Includes hypertension or high blood pressure, heart disease, diabetes, lung problems, mental health problems, cancer, and joint pain/arthritis.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Chart of the Week: Do U.S. Efforts to Reduce Income Inequality Work?

Below are two figures. The first ranks the U.S. and other countries by income inequality before taxes and government interventions to reduce it. The second ranks the same countries after taxes and intervention.

What we see is that, whatever we’re doing to reduce inequality, it’s not working nearly as well as what other countries with high levels of income inequality are doing, with the sole exception of Chile.

1 (3) 1 (4)

Thanks to Christian Science Monitor for the images and Martin Hart-Landsberg for the tip.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Length of the Workweek in International Perspective

Iceland continues to experiment with new ways to promote majority living standards. According to the Icelandic Grapevine, a bill has been submitted to the Icelandic parliament that would shorten the workweek.  More specifically, it would change the definition of a full time workweek to 35 hours instead of the current 40 and the full workday to 7 hours rather than the current 8.

As the Grapevine reports:

The bill points out that other countries which have shorter full time work weeks, such as Denmark, Spain, Belgium, Holland and Norway, actually experience higher levels of productivity. At the same time, Iceland ranked poorly in a recent OECD report on the balance between work and rest, with Iceland coming out in 27th place out of 36 countries.

The bill also points out that a recent Swedish initiative to shorten the full time work day to six hours has been going well, with some Icelanders calling for the idea to be taken up here. In addition, the bill also cites gender studies expert Thomas Brorsen Smidt’s proposal to shorten it even further, to four hours.

There is certainly significant variation among countries in the length of the workweek, as the following information from the U.S. Bureau of Labor Statistics shows:

2

In 2011 the average annual hours worked per employed person in the U.S. was 1758.  The number for French workers was 1476.  It was 1411 for German workers.  Assuming a 40 hour workweek, the average U.S. worker had a work year more than two months longer than the average German worker.  It is also worth noting that while all the countries that reported data for the entire period 1979 to 2011 showed reductions in work time, the reduction was the smallest in the U.S.

Although it is not easy to establish a clear relationship between work hours and productivity, there is reason to believe that the relationship may be inverse.  In other words, the shorter the workweek the more productive we are. It would certainly be nice, for many reasons, if someone in the U.S. Congress followed the lead of Iceland and introduced  a bill to reduce work time in the U.S.

Cross-posted at Pacific Standard.

Martin Hart-Landsberg is a professor of economics at Lewis and Clark College. You can follow him at Reports from the Economic Front.

School Shootings: What’s Different About Europe?

Yesterday’s killing was the 39th school shooting in the U.S. this year.  Most of those got little press coverage. Unless someone is actually killed, a shooting might not even get coverage in the local news.

Yesterday’s did.

Why would an apparently happy kid shoot several classmates? That seems to be the question that’s getting the attention of the press and perhaps the public. “Struggling to Find Motive,” said one typical headline. That’s the way we think about school shootings these days.

It’s unlikely that any of the motives that turn up will be all that strange. Fryberg may have been upset by a racial comment someone had made the day before or by a break-up with a girl. He may have had other conflicts with other kids. Nothing unusual there.

But “why” is not the question that first occurs to me. What I always ask is how a 14-year old kid can get his hands on a .40 Beretta handgun (or whatever the weaponry in the shooting of the week is).  For Fryberg it  was easy. The pistol belonged to his father. Nothing strange there either.  Thirty million homes in the US, maybe forty million, are stocked with guns.

Do European countries have school shootings like this? Surely kids in Europe get upset about break-ups; surely they must have conflicts with their classmates; and surely, some of them may become irrationally upset by these setbacks.  So surely there must have been school shootings in Europe too.

I went to Wikipedia and looked for school shootings since 1980 (here and here).  I eliminated shootings by adults (e.g., Lanza in Sandy Hook, Brevik in Norway). I also deleted in-school suicides even though these were done with guns and were terrifying to the other students. I’m sure my numbers are not perfectly accurate, and the population estimate in the graph below  is based on current numbers; I didn’t bother to find an average over the last 35 years. Still the differences are so large that I’m sure they are not due to technical problems in the data.

1 (3) - Copy
Does the U.S. have a much greater proportion of kids who are mentally unstable? Do our schools have more bullying? Are European kids more capable in dealing with conflicts? Are they more stable after break-ups? Do they spend less time with violent video games? Do their schools have more programs to identify and counsel the potentially violent?  I’m not familiar with the data on these, but I would guess that the answer is no and that our kids are no more screwed up than kids in Europe. Or if there are differences, they are not large enough to explain the difference in the body count.

No, the important difference seems to be the guns.  But guns have become the elephant in the room that nobody talks about.  Even asking about access to guns seems unAmerican these days.  Thanks to the successful efforts of the NRA and their representatives in government, guns have become a taken-for-granted part of the landscape. Asking how a 14-year old got a handgun is like asking how he got a bicycle to ride to school.

When the elephant’s presence is too massive not be noticed – for example, when the elephant kills several people –  the elephant’s spokesmen rush in to tell us that “No, this is not the time to talk about the elephant.”  And so we talk about video games and psychological screening and parents and everything else, until the next multiple killing. But of course that too is not the time to talk about elephants.

Cross-posted at Pacific Standard.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Map of the Week: 57% of Languages Do Not Have Gendered Pronouns

The map below is an interactive available at the World Atlas of Language Structures.  It represents an extensive, but not quite comprehensive collection of world languages. Each dot represents one. White dots are languages that do not include gendered pronouns. No “he” or “she.” Just a gender neutral word that means person.

2

The colored dots refer to languages with gendered pronouns, but there are more than one kind, as indicated by the Values key. The number on the right, further, indicates how many languages fit into each group. Notice that the majority of languages represented here (57%) DO NOT have gendered pronouns.

3The map at the site is interactive. Go there to click on those dots and explore.

Lisa Wade is a professor of sociology at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. You can follow her on Twitter and Facebook.

Watch London Cops Subdue, Not Kill, a Man Yelling and Swinging a Machete

Despite the cellphone video of two police officers killing Kajieme Powell, there is some dispute as to what happened (see this account in The Atlantic). Was Powell threatening them; did he hold the knife high; was he only three or four feet away? 

The video is all over the Internet, including the link above. I’m not going to include it here.  The officers get out of the car, immediately draw their guns, and walk towards Powell. Is this the best way to deal with a disturbed or possibly deranged individual – to confront him and then shoot him several times if he does something that might be threatening?

Watch the video, then watch London police confronting a truly deranged and dangerous man in 2011.  In St. Louis, Powell had a steak knife and it’s not clear whether he raised it or swung it at all.  The man in London has a machete and is swinging it about.


Unfortunately, the London video does not show us how the incident got started. By the time the recording begins, at least ten officers were already on the scene. They do not have guns. They have shields and truncheons. The London police tactic used more officers, and the incident took more time. But nobody died.  According to The Economist:

The police in and around Ferguson have shot and killed twice as many people in the past two weeks (Mr Brown plus one other) as the police in Japan, a nation of 127m, have shot and killed in the past six years. Nationwide, America’s police kill roughly one person a day.

The article includes this graphic:

1 (2)

I’m sure that the Powell killing will elicit not just sympathy for the St. Louis police but in some quarters high praise – something to the effect that what they did was a good deed and that the victims got what they deserved. But righteous slaughter is slaughter nevertheless. A life has been taken.<

You would think that other recent videos of righteous slaughter elsewhere in the world would get us to reconsider this response to killing. But instead, these seem only to strengthen tribal Us/Them ways of thinking. If one of Us who kills one of Them, then the killing must have been necessary and even virtuous.

Originally posted at Montclair SocioBlog.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Saturday Stat: World’s Top Military Spender

According to the Stockholm International Peace Institute, the United States remains the world’s top military spender. In fact, U.S. military spending equals the combined military spending of the next ten countries.  And most of those are U.S. allies.

1 (2) - Copy

Although declining in real terms, the U.S. military budget remains substantial and a huge drain on our public resources.  As the following chart shows, military spending absorbs 57% of our federal discretionary budget.

1 (2)

 Notice that many so-called non-military discretionary budget categories also include military related spending. For example: Veteran’s Benefits, International Affairs, Energy and the Environment, and Science.   We certainly seem focused on a certain kind of security.

Martin Hart-Landsberg is a professor of economics at Lewis and Clark College. You can follow him at Reports from the Economic Front.

Saturday Stat: Main, Mean, and Median Street

Mean and median are two measures of “average.”  The mean is the average as we typically think of it: the sum of things divided by the total number of things.  The median, in contrast, is literally the number in the middle if we align all the quantities in order.  People often use median instead of mean because it is insensitive to extreme outliers which may skew the mean in one direction or another.

For a quick illustration of the difference, I often use the example of income. I choose a plausible average (mean) for the classroom population and review the math. “If Bill Gates walks into the room,” I say, “the average income is now in the billions. The median hasn’t moved, but the mean has gone way up.” So has the Gini coefficient.

Here’s a more realistic and global illustration – the net worth of people in the wealthier countries.  The U.S. ranks fourth in mean worth – $301,000 per person…

1 (2) - Copy

…but the median is far lower – $45,000, 19th out of the twenty nations shown.  (The graph is from Credit Suisse via CNN.)

The U.S. is a wealthy nation compared with others, but  “average” Americans, in the way that term is generally understood, are poorer than their counterparts in other countries. 

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.