The first suggests that the belief that hard work pays off remains strong in only a few countries: Pakistan (81%), the U.S. (77%), Tunisia (73%), Brazil (69%), India (67%) and Mexico (65%). The low scores in China, Germany, and Japan are worth noting. This is not to say that people everywhere are not working hard, just that many no longer believe there is a strong connection between their effort and outcome.
The second chart highlights the fact that growing numbers of people are losing faith in free market capitalism. Despite mainstream claims that “there is no alternative,” a high percentage of people in many countries do not believe that the free market system makes people better off.
GlobeScan polled more than 12,000 adults across 23 countries about their attitudes towards economic inequality and, as the chart below reveals, the results were remarkably similar to those highlighted above. In fact, as GlobeScan noted, “In 12 countries over 50% of people said they did not believe that the rich deserved their wealth.
It certainly seems that large numbers of people in many different countries are open to new ways of organizing economic activity.
The Supreme Court has ruled favorably on the legality of the Affordable Care Act. Actually, despite its name, the Act has more to do with extending and attempting to improve private health insurance coverage than it does with improving care or reducing its cost.
Unfortunately for us, the effort to improve our health care system has remained within bounds set by the needs of private health care providers and insurers. As President Obama made clear from the start of his push for health care reform, there would be no consideration of a universal system.
Critics of such a universal system are always quick to argue that only market forces driven by the private pursuit of profit can ensure an efficient health care system. Of course, in determining whether this is true, we need to recognize that efficiency is a complex term and that our health care system, like all systems, produces multiple outcomes. The most obvious ones are private profit as well as the quality and cost of the relevant health care.
In terms of private profit there can be no doubt that our health care system functions well. However, the story is quite different if we evaluate it in terms of quality and cost. The fact that we continue to embrace a private health care system makes clear which measures of efficiency are considered most important and by whom.
The following map shows the countries, colored green, that have adopted a universal health care system.
What’s astonishing is how cleanly the green and grey separate the developed nations from the developing, almost categorically. Nearly the entire developed world is colored, from Europe to the Asian powerhouses to South America’s southern cone to the Anglophone states of Australia, New Zealand, and Canada. The only developed outliers are a few still-troubled Balkan states, the Soviet-style autocracy of Belarus, and the U.S. of A., the richest nation in the world.
The handful of developing countries that provide universal access to health care include oil-rich Saudi Arabia and Oman, Latin success story Costa Rica, Kyrgyzstan, and, famously, Cuba, among a few others. A number of countries have attempted universal health care but failed, such as South Africa, which maintains a notoriously inefficient and troubled public plan to complement the private plans popular among middle- and upper-class citizens…
That brings us to another way that America is a big outlier on health care. The grey countries on this map tend to spend significantly less per capita on health care than do the green countries — except for the U.S., where the government spends way more on health care per person than do most countries with free, universal health care. This is also true of health care costs as a share of national GDP — in other words, how much of a country’s money goes into health care.
The OECD just published a major study on the health care systems of its 34 member nations. It found that:
Health spending accounted for 17.6% of GDP in the United States in 2010, down slightly from 2009 (17.7%) and by far the highest share in the OECD, and a full eight percentage points higher than the OECD average of 9.5%. Following the United States were the Netherlands (at 12.0% of GDP), and France and Germany (both at 11.6% of GDP).
The United States spent 8,233 USD on health per capita in 2010, two-and-a-half times more than the OECD average of 3,268 USD (adjusted for purchasing power parity). Following the United States were Norway and Switzerland which spent over 5,250 USD per capita. Americans spent more than twice as much as relatively rich European countries such as France, Sweden and the United Kingdom.
What does all of this mean in terms of health outcomes? According to the OECD report:
Most OECD countries have enjoyed large gains in life expectancy over the past decades. In the United States, life expectancy at birth increased by almost 9 years between 1960 and 2010, but this is less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. As a result, while life expectancy in the United States used to be 1½ year above the OECD average in 1960, it is now, at 78.7 years in 2010, more than one year below the average of 79.8 years. Japan, Switzerland, Italy and Spain are the OECD countries with the highest life expectancy, exceeding 82 years.
One possible explanation for this lagging performance, highlighted in an earlier OECD report, is that the U.S. ranked 26th in terms of the number of practicing physicians relative to its population, 29th in terms of the number of doctor consultations per capita, 29th in terms of the number of hospital beds per capita, and 29th in terms of the average length of hospital stay. At the same time, the “U.S. health system does do a lot of interventions… it has a lot of expensive diagnostic equipment, which it uses a lot. And it does a lot of elective surgery — the sort of activities where it is not always clear cut about whether a particular intervention is necessary or not.”
Private health care providers and insurers are clear about how they measure health care efficiency. And as long as we rely on them to set the terms of the debate we will continue to suffer the consequences.
Earlier this month NPR profiled Alex Hernandez, a member of a Mexican third gender. This prompted me to re-post our discussion of muxes from 2008. Images of Hernandez, taken by photographer Neil Rivas, are added at the end.
A New York Timesarticle this week briefly profiles muxes, a third “gender” widely accepted in Oaxaca, Mexico. According to the article, this part of Mexico has retained many of the pre-colonial traditions. One of these included flexibility around gender and sexual orientation. From the article:
There, in the indigenous communities around the town of Juchitán, the world is not divided simply into gay and straight. The local Zapotec people have made room for a third category, which they call “muxes” (pronounced MOO-shays) — men who consider themselves women and live in a socially sanctioned netherworld between the two genders.
“Muxe” is a Zapotec word derived from the Spanish “mujer,” or woman; it is reserved for males who, from boyhood, have felt themselves drawn to living as a woman, anticipating roles set out for them by the community.
Not all muxes express their identities the same way. Some dress as women and take hormones to change their bodies. Others favor male clothes. What they share is that the community accepts them; many in it believe that muxes have special intellectual and artistic gifts.
Robin B. pointed us to a slide show. Here are some select images and info from the Times.
Alex with her mother, Rosa Taledo Vicente, and her father, Victor Martinez Jimenez:
Ninel with her boyfriend, Sebastian Sarmienta, 18 years old, have a laugh outside of Ninel’s home:
Carmelo with his grandmother at their home in Unión Hidalgo:
“Thalía,” who was named princess the night before at a vela, or community celebration, for the muxes, waits for a parade to begin:
Beth-Sua enjoys a smoke at a vela in Oaxaca City. She traveled there from the Isthmus to represent her city’s muxes:
Alex Hernandez at the Vela de Las Intrepidas, a festival in “celebration of ambiguity and mixed gender identities” (photos by Neil Rivas):More images at NPR.
Dolores R. sent in a flubbed opportunity to represent Mexicans positively and reach out to the expanding Mexican market in the U.S. In “honor” of Cinco de Mayo, Mike’s Hard Lemonade hired five men — in fake mustaches and sombreros – to pretend to be a Mariachi band. They then improvised songs in response to submissions from viewers. The stunt is self-conscious, along the lines of the “ironic” “hipster racism” we now see so much of. Notice them making fun of themselves in this promo:
The fake band may have been making fun of themselves, but they did so by engaging in something that they had already decided was ridiculous, Mariachi music. Happy Cinco de Mayo, everyone.
A better approach, Latino Rebels suggests, would have been to spotlight some of the actual awesome Mariachi music out there. They wouldn’t have even had to be traditional. They could have hired a real band to improvise, or they could have drawn on the existing Mariachi cover bands, bands that do really neat stuff! Here’s, for example, is a band covering Hotel California:
This is a notable change, as Mexican immigration has been the single largest immigrant flow to the U.S. form a single country, in overall numbers (though in the late 1800s, German and Irish immigrants made up a larger percent of all immigrants annually than Mexicans make up today). The report attributes this change to a range of factors, from changing economic conditions in Mexico, the recession’s effects on the U.S. economy, border enforcement, and the dangers of border crossings.
Indeed, we may now be seeing more people moving from the U.S. to Mexico than vice versa:
The change is due primarily to a drop in undocumented immigration, which peaked around 2007 and has dropped off significantly since:
There’s a lot more information available on changes in border enforcement and socio-economic changes in Mexico, so check out the full report.
You can see a few other notable trends here that illustrate various national trajectories, as Phil McDermott at Cities Matter points out. For instance, notice that while Russia underwent rapid urbanization between 1950 and 1980, it has leveled off since then. Similarly, Indonesia’s urbanization slowed significantly in the late ’90s and has continued at a much slower pace since then. We also see quite different patterns between the world’s two most populous nations: While China’s urbanization rate sped up in the early ’90s (after urbanization actually dipped in the ’70s), India has experienced fairly slow urbanization.
Credit Suisse released a report on urbanization and emerging markets, if you’re interested in the impacts of urbanization on a wide array of economic development indicators, from electricity and steel consumption to projections of future housing needs to incomes and standards of living.
Norton Sociology recently posted an image that illustrate differences in rates of imprisonment in a number of countries. Imprisonment rates are influenced by a number of factors — what is made illegal, how intense law enforcement efforts are, preference for prison time over other options, etc. The U.S. does not compare favorably, with 74.3 per 100,000 10,000 of our population behind bars (click here for a version you can zoom in on, and sorry for the earlier typo!):
Here’s a close-up of the breakdown of the U.S. prison population:
UPDATE: Since posting this, I’ve discovered that the numbers do not accurately reflect the ratio of CEO vs. worker pay. Writes PolitiFact:
We don’t doubt the chart’s underlying point that the ratio of CEO pay to worker pay is high in the United States, and is likely higher in our free-wheeling economy than it is in the historically more egalitarian nations of Europe.
But in its claim that the U.S. ratio is 475 to 1, the chart conveys a sense of certitude and statistical precision that simply isn’t warranted — and which is contradicted by the facts. The latest number for the U.S. is 185 to 1 in one study and 325 to 1 in another [though in previous years, those ratios have reached as high as 525 to 1] — and those numbers were not generated by groups that might have an ideological interest in downplaying the gaps between rich and poor. We rate the claim on the U.S. ratio False.