nation: Japan

Cross-posted at Reports from the Economic Front.

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.

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As Max Fisher explains:

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.

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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.

In a previous post I discussed how the U.S. became more religious in the 1950s, in part in response to its the Cold War enemies (atheist communists).  In fact, the U.S. is among the most religious countries in the world.  Using data from the International Social Survey Programme, Sociologist Tom Smith paints wildly different religious portraits of 28 nations (full text).

When asked whether they “know that God really exists and… have no doubt about it,” 61% of Americans say “yes.”  Of the 28 nations studied, only four were more likely to say “yes” to this question: Poland, Israel, Chile, and the Philippines. Here’s how we look compared to similar countries:

Here’s all 28 in rank order (borrowed from LiveScience).  Notice how wide the divergence is.  In Japan, the least religious country according to this measure, only 4% say they have no doubt God exists.  In The Philippines, 84% have no doubt.

% Have No Doubt God Exists:

  • Japan: 4.3 percent
  • East Germany: 7.8 percent
  • Sweden: 10.2
  • Czech Republic: 11.1
  • Denmark: 13.0
  • Norway: 14.8
  • France: 15.5
  • Great Britain: 16.8
  • The Netherlands: 21.2
  • Austria: 21.4
  • Latvia: 21.7
  • Hungary: 23.5
  • Slovenia: 23.6
  • Australia: 24.9
  • Switzerland: 25.0
  • New Zealand: 26.4
  • West Germany: 26.7
  • Russia: 30.5
  • Spain: 38.4
  • Slovakia: 39.2
  • Italy: 41.0
  • Ireland: 43.2
  • Northern Ireland: 45.6
  • Portugal: 50.9
  • Cyprus: 59.0
  • United States: 60.6
  • Poland: 62.0
  • Israel: 65.5
  • Chile: 79.4
  • The Philippines: 83.6

Americans are also particularly likely to believe in a “personal God,” one who is closely attentive to the lives of each and every person.

Quite interestingly, the U.S. is in the minority in that Americans tend to become increasingly religious as they age.  In most countries, people become less religious over time.  This graph (confusingly labeled), shows changes in DISbelief over the life course.  The U.S. is the only country among these in which disbelief declines:

Lifetime Change in Religiosity (from increase in disbelief to increase in belief):

  • The Netherlands: -14.0
  • Spain: -12.4
  • Australia: -12.0
  • France: -11.3
  • Norway: -11.0
  • Great Britain: -10.1
  • Switzerland: -8.2
  • Germany (East): -6.9
  • Denmark: -6.1
  • Czech Republic: -5.5
  • Sweden: -5.5
  • Germany (West): -5.4
  • New Zealand: -4.0
  • Italy: -2.7
  • Poland: -1.8
  • Japan: -1.5
  • Ireland: -0.9
  • Chile: +0.1
  • Cyprus: +0.2
  • Portugal: +0.6
  • The Philippines: +0.8
  • Hungary: +1.0
  • Northern Ireland: +1.0
  • United States: +1.4
  • Israel: +2.6
  • Slovakia: +5.6
  • Slovenia: +8.5
  • Latvia: +11.9
  • Russia: +16.0

Rates of atheism — a strong disbelief in God — also vary tremendously.  East Germany is the most atheist, with more than half of citizens claiming disbelief.  The country is a stark contrast to the atheist among them, Poland and the U.S. (only 3% atheist), Chile and Cyprus (2%), and The Phillipines (1%).

% Atheist:

  • East Germany: 52.1
  • Czech Republic: 39.9
  • France: 23.3
  • The Netherlands: 19.7
  • Sweden: 19.3
  • Latvia: 18.3
  • Great Britain: 18.0
  • Denmark: 17.9
  • Norway: 17.4
  • Australia: 15.9
  • Hungary: 15.2
  • Slovenia: 13.2
  • New Zealand: 12.6
  • Slovakia: 11.7
  • West Germany: 10.3
  • Spain: 9.7
  • Switzerland: 9.3
  • Austria: 9.2
  • Japan: 8.7
  • Russia: 6.8
  • Northern Ireland: 6.6
  • Israel: 6.0
  • Italy: 5.9
  • Portugal: 5.1
  • Ireland: 5.0
  • Poland: 3.3
  • United States: 3.0
  • Chile: 1.9
  • Cyprus: 1.9
  • The Philippines: 0.7

As a post-9/11 American watching another election cycle, I can’t help but notice how so much of our rhetoric revolves — sometimes overtly and sometimes not — around people who are the wrong religion.  Notably, Muslims.  And yet, the U.S. and many Muslim countries are alike in being strongly religious, at least in comparison to the many strongly secular countries.

This is odd because stands in contrast to recent data on American attitudes.  Within the U.S., people express much less tolerance for atheists than they do Muslims (homosexuals, African Americans, and immigrants). Weirdly, we think we have more in common with more secular nations like Great Britain than we do with countries like Pakistan or Saudi Arabia. In certain ways, the opposite might be true.

Thanks to Claude Fischer for the graphs.  Fischer, a sociologist at UC Berkeley, is the author of Made in America: A Social History of American Culture and Character.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

It is Easter Sunday. How about other places on the globe such as Japan? Christians are less than 1% of the population of Japan.  Yet, because of globalization, geographic locations plays less and less of a role in defining culture.  Many people around the world now consume the same food, clothing, music, movies, and technology.

Global corporations play a role in transmitting culture from place to place.  Recently, American corporations in Japan have been trying to popularize and commercialize Easter.  Disney’s theme park in Tokyo, for example, has promoted Easter with the Disney Easter Wonderland since 2010:

Likewise, beginning last year, Baskin Robbins has been promoting the holiday.  This year they have a month-long Wonderful Easter Campaign:

It will be very interesting to see how Easter becomes part of Japanese culture.  When the Japanese adopted Valentine’s day, for example, they added their own twist.  Women are expected to give chocolate to men; men are supposed to return the favor by giving candy to women on March 14th, White Day.  I would not be surprised to find that Easter becomes popular in Japan, but celebrated with a twist – a Japanese flavor.

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Sangyoub Park is an assistant professor of sociology at Washburn University, where he teaches Social Demography, Generations in the U.S. and Sociology of East Asia. His research interests include social capital, demographic trends, and post-Generation Y.

The Paris School of Economics has posted a database, compiled by Facundo Alvaredo, Tony Atkinson, Thomas Piketty, and Emmanuel Saez, of the distribution of top incomes in a number of nations, with more on the way. Using income tax records, they provide a quick glance at concentration of income among the wealthy over decades (and in some cases, data extends back over a century). As the authors point out, there are limitations to using tax info to measure inequality, so it’s important to be aware of the limitations of this data series. Most obviously, individuals may take steps to hide their income to evade taxes, and the very wealthy may be particularly able to do so through the use of tax havens, etc. Also, tax policies change, so what counts as “income” at one point might not at another. The authors also had to contend with differences in the taxation unit (households vs. individuals) in different countries to provide some level of comparability.

The database allows you to select a country, a time period, and a variable (top 5% income share, etc.), and get a table showing the results for all years in which data were available. Here, for instance, is part of the table for the share of income earned by the top 1% in Singapore:

Of course, this includes only data on income. In many countries, including the U.S., wealth (value of all assets) is significantly more concentrated than income.

Looking at the dataset, you can see patterns over time. For instance, here’s part of the data from the U.S. (notice there are time gaps between the end of each column and the beginning of the next–I was just grabbing some illustrative screencaps), showing how the percent of income earned by the top 0.1% decreased significantly starting in the 1940s, but began creeping up again by the late 1980s and has grown since then:

The site also allows you to create graphs. They provide a comparison of the share of income earned by the top 1% in 2005 in the U.S., Japan, Australia, and France, but you can look at data for individual nations:

It’s worth playing around a bit, but keeping in mind the caveats about what these data do and don’t tell us. Thanks to Shamus Khan for the tip!

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.

I apologize for not vetting this more carefully.

H/T KeepYourHopesUpHigh via GlobalSociologyBlog.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Cross-posted at Reports from the Economic Front.

There is big trouble brewing in Europe.  John Ross, in his blog Key Trends in the World Economy, highlights this brewing crisis in a series of charts, some of which I repost below.

This first chart shows the extent of the recovery from the recent economic crisis in the U.S., the EU, and Japan.  While the U.S. GDP has finally regained its past business cycle peak, the same cannot be said for Europe (or Japan).  As of the 3rd quarter 2011, EU GDP was still 1.7% below its previous business cycle peak.  The Eurozone was 1.9% below.

Recent GDP estimates for the 4th quarter show European GDP once again contracting, which strongly suggests that the region is headed back into recession without having regained its previous business cycle peak.  This development implies that Europe faces serious stagnationist pressures.

gdp1.jpg

This chart looks at the growth record for the 5 largest European economies.  Germany has regained its previous GDP peak.  France is making progress toward that end.  These two countries account for 36.2% of European GDP.  However, things are quite different for the UK, Italy, and Spain.  These three countries account for 34.7% of European GDP and not only do they each remain far below their respective previous GDP peaks, their economies are once again heading downward.

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The third chart highlights the economic performance of the three countries which have received the most media attention because of fears that their governments will be unable to repay their respective debts.  They are clearly in trouble, adding to the downward pressure on European GDP.  However, despite all the attention paid to them, their combined economies are only one-eighth the size of the combined economies of the UK, Italy and Spain.

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The next two charts highlight the fact that economic trends are also dire throughout much of Eastern Europe.

gdp4.jpg

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The take-away is that European economic problems are not limited to a few smaller countries.  Some of the largest are also performing poorly and apparently headed back into recession without ever having regained their past business cycle peaks.  It is hard to see Europe escaping recession.  And it is hard to see the U.S., Asia, and Africa escaping the consequences.

Here’s a fun one for our series on the social construction of flavor!

See also:

And the list wouldn’t be complete without our Jell-O posts:

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

How does the U.S. compare to other developed countries on measures of social justice? According to the New York Times, not very well.  The visual below compares countries’ poverty rates, poverty prevention measures, income inequality, spending on pre-primary education, and citizen health.  The “overall” rating is on the far left and the U.S. ranks 27th out of 31.


Via Feministing.  See also how the U.S. ranks on measures of equality and prosperity(33 out of 33, for what it’s worth). Thanks to Dolores R. for the link!

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.