Comment by pedrocr | Hacker News Reader

Comment by pedrocr | Hacker News Reader

Parent Full thread

The statistics are misleading and muddy:

- Comparing adjusted disposable income between Scandinavia and the US is highly misleading. The disposable income in Scandinavia doesn't need to cover any healthcare, education and other public services. I wonder how much, if any, the difference is once you adjust for that.

- The argument mistakes distribution of wealth with average output per capita. Portugal is in the bottom of the list in the GDP per capita comparison between US states and EU countries. In Portugal there is a somewhat high wage disparity which means that those with high wages can afford to pay those with low wages to get cheap pizza (the example given). The same disparity exists in the US and pizza is cheap too, even though the US GDP per capita is at the other extreme of the comparison. Scandinavian countries have low wage disparity so things are more expensive by comparison. It has nothing to do with the output of the economy.

Basically it is trying to draw conclusions about the strength of the economies based on statistics that don't properly control for very relevant factors. The only good argument is the 2.2% vs 3% GDP growth rates. Considering the article is from 2005, recent events may throw some doubt into that picture. The latest estimates on Wikipedia were 2.6% in Norway and 1.1% in the US.

> The disposable income in Scandinavia doesn't need to cover any healthcare, education and other public services.

If the study's honest, those should already be factored into "cost of living", not "disposable income".

The study that compares the US to Europe (linked in another commend) does these comparisons:

- Compare GDP between US and Europe and show that US is higher per capita on average. No debate there.

- Compare private consumption between the US and Europe, specifically stating that it does not control for healthcare and education. From page 14:

Different countries’ choices of public commitment influence, through taxation policy, the scope available for private consumption, at the same time as high taxation countries, through their public sectors, offer some of the things recorded in low taxation countries as private consumption. There is no easy way of getting round this, but it is an important point to bear in mind when comparing private consumption.

- It does then compare retail consumption which shouldn't include any of these things and thus be more objective. That one still shows the US as higher than Sweden. Another table shows that US households have more home appliances. So on that count Americans do appear to be richer, assuming of course they are getting equal average amounts of education and healthcare on their private purchases as the Europeans are getting on their tax dollars. Otherwise you'd just be displacing money from healthcare and education into buying retail goods. An argument can surely be bade that this is in fact the case and that although the higher end healthcare and education in the US is top notch the average over the whole population is not as good as the average in Sweden. Anyone know of any good data on this?

I did notice however that the disposable income argument was made about countries within the EU based on another study. So it is possible that the public/private mix in the several EU nations actually doesn't favor Scandinavia in terms of efficiency. All these things are hard to argue because there is no comparable definition of the extent of public services in the economies and how those are replaced or not by private spending.

> So on that count Americans do appear to be richer, assuming of course they are getting equal average amounts of education and healthcare on their private purchases as the Europeans are getting on their tax dollars.

That assumption is rather dodgy on a couple of points.

One is that a lot of healthcare and education in the US is tax-supported. Another is that a rational person may choose to spend money on things other than healthcare and education. Forcing them to spend it on healthcare and education can make them poorer, aka "less bang for same bucks".

> the average over the whole population is not as good as the average in Sweden.

How about we compare average cancer survival rates?

Relevant fact: a huge fraction of the "uninsured" in the US are eligible for free govt healthcare but simply haven't signed up. (When they run into problems, they typically, but not always, sign up.)

>That assumption is rather dodgy on a couple of points.

I thought so too, that is why I pointed it out.

>One is that a lot of healthcare and education in the US is tax-supported.

It may very well be but less of it is compared to Scandinavia so the point is the same.

>Another is that a rational person may choose to spend money on things other than healthcare and education. Forcing them to spend it on healthcare and education can make them poorer, aka "less bang for same bucks".

Very true of course, but then you can't really argue that the Scandinavians are worse off because they can buy less retail goods because they put more money into their government to get healthcare and education. Choice need not be only about how to allocate private spending, you can also influence the tax/welfare situation.

>How about we compare average cancer survival rates?

I could only find cancer deaths not survival rates once you do have cancer. In a lot of ways that is what matters and can mean better preventive care. On the other hand it adds a bunch of environmental factors. Anyway, according to this:

http://www.nationmaster.com/graph/hea_dea_fro_can-health-dea...

The US is middle of the board. Sweden, Finland and Norway all beat the US. The only surprising one on that board for me was the Netherlands, with such high rates.

Very true of course, but then you can't really argue that the Scandinavians are worse off because they can buy less retail goods because they put more money into their government to get healthcare and education.

Actually you can. That's part of the deadweight loss of taxation: you are forced to spend money on stuff you don't want and are unable to spend on stuff you do want.

If person X would choose to spend $100 on an ipod, but is instead forced to spend $100 on education which they only value at $80, they have lost $20 of value.

Now, in a democracy, people in the situation of person X may only make up 50% - 1 of the population, but that doesn't change the fact that they lose.

Actually you can. That's part of the deadweight loss of taxation: you are forced to spend money on stuff you don't want and are unable to spend on stuff you do want.
(...)

Now, in a democracy, people in the situation of person X may only make up 50% - 1 of the population, but that doesn't change the fact that they lose.

That is all true of course. What I was pointing out is that the democratic group decision to spend more on healthcare is also a spending decision. The counterpoint is what you mentioned, that 50% - 1 could be against it. In Scandinavia however you will find that support for the welfare state is very high. Another important consideration is that the public healthcare in these countries tends to be much more efficient per person than the one you get for you private dollars otherwise. You could of course argue that that is just the market currently being inefficient.

Support for "the welfare state" in the abstract is irrelevant. The relevant question is "would person X purchase retail goods or health care if given the choice?"

People might support the welfare state for various other reasons, including signaling [1], compromise and ignorance [2]. Regarding more efficient public health care (assuming it to be true for the moment, I've seen no compelling evidence for this), all this does is reduces the deadweight loss by lowering the price of the unwanted goods.

[1] I voted for X because I'm {religious/moral/not racist/hard working/$OTHER_TRIBAL_IDENTITY}.

[2] This is due both to politicians lying ("I won't force people to buy health insurance they can't afford") as well as to people not having a clue ("death panels").

> >One is that a lot of healthcare and education in the US is tax-supported.

> It may very well be but less of it is compared to Scandinavia so the point is the same.

Not so fast. You wrote "It does then compare retail consumption which shouldn't include any of these things and thus be more objective." You otherwise assumed that health care is largely private in the US. It's not - it's about half public. Moreover, the public spending is concentrated on the poor. So, they're getting govt healthcare and buying big screen TVs.

> I could only find cancer deaths not survival rates once you do have cancer. In a lot of ways that is what matters and can mean better preventive care. On the other hand it adds a bunch of environmental factors.

As someone else has posted, the "not get cancer" stuff, which isn't due to health care, overmatches what happens when you get cancer, which is when health care matters.

Not so fast. You wrote "It does then compare retail consumption which shouldn't include any of these things and thus be more objective." You otherwise assumed that health care is largely private in the US. It's not - it's about half public. Moreover, the public spending is concentrated on the poor. So, they're getting govt healthcare and buying big screen TVs.

What I assumed and is true is that healthcare is more private in the US than in Scandinavia, which it is. So the argument still holds that if you are comparing private spending in the US that will include more healthcare than in Scandinavia. Retail spending however will not as you don't buy healthcare as a retail good.

>As someone else has posted, the "not get cancer" stuff, which isn't due to health care, overmatches what happens when you get cancer, which is when health care matters.

What makes you think "not get cancer" has nothing to do with healthcare? Two very large healthcare factors come to mind. If you die sooner from another illness you won't get cancer and if you get continuous preventive medicine you won't get as much cancer. Diet and other unrelated factors will be important as well but "not getting cancer" has a lot to do with health care.

The other flaw in the whole "cancer survival is higher so healthcare must be better" argument is that although cancer is a very important illness it is far from the only important one and not even the major cause of death. Having very good cancer survival rates could just mean that the US healthcare spends an irrational amount of resources on it, neglecting other diseases. But I don't really know.

> What I assumed and is true is that healthcare is more private in the US than in Scandinavia, which it is.

You're ignoring the fact that US poor get govt healthcare. Unless you want to argue that said govt healthcare is better than the private healthcare that the rest of us get, the US has "govt healthcare or better" and more stuff. By cohort, our poor people have govt healthcare and more stuff than yours and our richer people have better than govt healthcare and even more stuff.

Which gets us to the question of how our govt and private healthcare compares to yours, because the "more stuff" conclusion seems pretty solid.

> Retail spending however will not as you don't buy healthcare as a retail good.

What is the basis for your claim that healthcare can not be a retail good? You may not think of healthcare as being available as a retail good, but I see it in stores and the like. I happen to received an advertisement for a "get an MRI to see anything interesting is happening inside you" service in the mail today, and that sort of thing is reasonably common.

Surely you're not going to argue "necessity", as food, clothing, and shelter are both necessities and retail goods.

> if you get continuous preventive medicine you won't get as much cancer

Oh really? We just started to see vaccines for a common form of cervical cancer, and that was a first. How about some supporting evidence. Be precise - what types of cancer and what kind of healthcare. (Note - precancerous growths are not really pre-cancerous - they're early stage, as evidenced by the fact that the success in treating them is evaluated the same way that we evaluate other cancer treatments.)

> The other flaw in the whole "cancer survival is higher so healthcare must be better" argument is that although cancer is a very important illness it is far from the only important one and not even the major cause of death.

I didn't say that cancer survival rates were a decisive argument. I said that they were more relevant to the healthcare quality argument. I'd be happy to see more and better data, but see no reason to assume anything about that data before it shows up.

The author of that so-called "cancer survival rates" BS is Betsy McCaughey, the woman who invented the "death panels" nonsense.

Here's link to webpage with video of John Stewart unloading on Betsy McCaughey for 2 entire segments of the Daily Show because of the "death panels"

http://www.mediaite.com/tv/finally-jon-stewart-gives-betsy-m...

OK, we heard you already - you don't need to spam the comments with the same thing quite so many times.

I'm in the UK and this is the first I heard about "death panels". I looked at the top listing in the NYT and on ABC, as returned by Google, in order to get a definition.

Surely any country with limited healthcare resources requires someone (maybe a panel) to decide where to restrict application of resources. In many cases this failure to provide infinite resources to any health problem will result in premature death. So you could call the panels deciding on restricting care "death panels".

There's nothing controversial about that, is there. We have such panels in the UK, the only controversial part is that location within the UK gets factored in ("postcode lottery") when we are supposed to have a "national health service".

Some drugs and treatments are too expensive for the public purse.

If you are so out of the loop of American politics that you were not aware about the whole "death panels" uproar, you really aren't aren't in the loop enough to be discussing the rest of this subject matter on this thread either

"Palin: Obama's "Death Panel" Could Kill My Down Syndrome Baby

In a new posting on her Facebook account, former Gov. Sarah Palin (R-AK) made a dire statement about health care reform -- that it could result in an Obama-created "death panel" killing her infant son with Down Syndrome:

    The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil...."

http://tinyurl.com/lujt9h

pbhjpbhj, the UK most certainly DOES NOT have what Betsy McCaughey and Sarah Palin defined as a "death panel"

Not so fast. She was quoting Lancet. Moreover, she's not the only source.

http://papers.nber.org/papers/w15213#fromrss

Here's the link with the original "cancer rates" article

"U.S. Cancer Care Is Number One No. 596

Thursday, October 11, 2007

by Betsy McCaughey

During this presidential election season, candidates are urging Americans to radically overhaul our “broken” health care system. Before accepting the premise that the system is broken, consider the impressive evidence from the largest ever international study of cancer survival rates..."

More lies from proven liar Betsy McCaughey

http://www.ncpa.org/pub/ba596

You cite %change in GDP as a measure of economic growth in your third point, after claiming in your first and second points that GDP itself is not a good measure for quality of life/economic well being/etc, in points one and two. Does that make sense?

I think you're letting your terminology run away from you in your first point. It's true that "Disposable income" doesn't need to cover educational, medical, and other social expenses in Scandinavian welfare states, but those expenses still have to be paid out of tax receipts.

I don't see how the Scandinavian governments can get $35000 per person in value out of $25000 per person in income.

>You cite %change in GDP as a measure of economic growth in your third point, after claiming in your first and second points that GDP itself is not a good measure for quality of life/economic well being/etc, in points one and two. Does that make sense?

My first point was about disposable income which is a subset of GDP. My second one only said that high relative costs can just mean flat income structures independent of GDP (hence the two extreme cases of Portugal and the US with high and low GDPs both having low costs for pizza compared to Sweden. I never really argue that high GDP doesn't make you richer.

> I think you're letting your terminology run away from you in your first point. It's true that "Disposable income" doesn't need to cover educational, medical, and other social expenses in Scandinavian welfare states, but those expenses still have to be paid out of tax receipts. I don't see how the Scandinavian governments can get $35000 per person in value out of $25000 per person in income.

I agree with you that the pure GDP comparison makes the disposable income point less important. But GDP by itself doesn't seem comparable either. If the Scandinavian population consumes on average more healthcare and education on a per-service not per-dollar basis than the US one, you can have a higher purchasing power just because you buy a higher percentage of Chinese goods produced with low wage costs instead of locally supplied healthcare and education delivered by higher-earning local wages (ever increasing since you are getting richer). But now I am way out of my league. IANAEconomist

All this discussion naturally forgets the next point of how much this added GDP/wealth actually drives happiness. From what I saw from Happiness research Europe has actually been obtaining gains in overall happiness while the US has stagnated. One theory was that productivity gains in Europe were used to reduce number of work hours while in the US they were used to increase GDP. Europe would be doing the better tradeoff as both were already at diminishing returns for money but time off had a good return. An interesting theory at least.

What's murky about purchasing power? Go live in Copenhagen - shits expensive! Plus a 25% sales tax on top and don't even get me started on alcohol...

you're taking a middle class perspective

poor people in the US can't afford pizza. poor people in scandinavia don't really exist.

Lets not take it out of perspective - no one will starve here, this isn't Uganda, and Domino's has $5 Pizzas.

Then I guess this story from ABC Chicago is a big lie, and the food bank is really just gonna buy $5 Dominos pizzas for everyone?

"CHICAGO (WLS) -- A food pantry on Chicago's far South Side says it has run out of food to help the needy.

The Greater Chicago Food Depository says food banks throughout the city are in desperate need of donations.

The economic downturn is making it harder for many to feed their families.

The food depository says there has been a big jump in demand for help at area food banks. That's expected to go up as the holiday season approaches. And they need more supplies to meet the demand."..."

http://abclocal.go.com/wls/story?section=news/local&id=6...

What does a failing charity have to do with the cost of living in Chicago, or the US as a whole?

The point is not a failing charity, it's that demand for food assistance is going up. It's going up all over the nation, not just Chicago.

Actually, people do in fact starve in the united states every year.

Edit: http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf

Page 33 says roughly 2500 people die of malnutrition and nutritional deficiencies.

1) Malnutrition is not starvation due to not affording food.

2) Thats a whooping 0.0009 of all deaths.

3) If you are poor in America, you are most likely to die from heart disease from eating to many $5 Pizzas and other high caloric food because it's so cheap!

My sister in law's family (parents and siblings) are all on welfare and receive food stamps. They find clever ways of using their food stamps to get cigarettes, drugs and alcohol (such as "selling" them to family and friends for cash), and more often then not they run out of food by the end of the month. Her teenage sister just had a baby and they were asking around for money for formula, even though they get hundreds of dollars a month in food stamps (more money per family member then my own family spends each month on food). I wouldn't be surprised if at least a few of her family members are malnourished, but you can't force feed people.

You need to present evidence people are starving due to poverty.

There are all sorts of reasons one might die of malnutrition. Bulimia, for instance, is said to affect about 0.2% of men and 1.3% of women. Anorexia affects another 0.3% of people, mostly women.

http://en.wikipedia.org/wiki/Bulimia_nervosa

http://en.wikipedia.org/wiki/Anorexia_nervosa

HIV and many geriatric conditions also can cause malnutrition.

Any links to back this up?

Which with 350 Million people comes out roughly to 7 in every million people.

Meanwhile 1 out of 218 die from falling, 1 in 63,000 from legal execution, and 1 in 350,000 from a fireworks discharge.

So you've got a 30,000 times greater chance of dying from falling down than from hunger in the United States.

Hardly a statistically significant problem, especially since in every community I know of, multiple sources of free food are available. Sometimes dozens of sources. You could argue at these rates these are "accidental" starvations and not due to prevailing societal conditions -- perhaps due to mental illness, bad weather, age, etc.

http://athletesheart.blogspot.com/2009/10/interesting-facts-...

That doesn't mean that any death is okay, just that context is important.

While poor people in Scandinavia (and drugs will ensure that some people are poor) can't afford $30 pizza.

In Scandinavia, drugs don't ensure that some people are poor.

Some people choose to spend the $30 on drugs instead of pizza, of course-- but there really is no poverty here.

Let me ask again.

Are you guys saying this video ABC report from Chicago about A food bank Chicago emptied of food is a lie?

Do know that unemployment runs 70% among people with partial disabilities trying to find work? What do you think these perpetually unemployed partially disabled people are doing, living off their trust funds?

I think you misread me. When I said "there's no poverty here", I was speaking of Scandinavia.

Here in Norway, the perpetually unemployed partially disabled people are well looked after, and can afford the $30 pizzas as well as anybody else.

Just because this food bank doesn't have food doesn't mean there are millions of people starving in Chicago. There are a myriad of reasons for why the food bank might not have food, chief among them is that in a major recession like we have been experiencing, fewer people donate.

Do people exist in the US who are consistently hungry? Yes. Do they starve on a regular basis? No. It has nothing to do with whether your link is a lie or not.

Does unemployment run 70% among people with partial disabilities? I wouldn't be surprised at all to hear that 70% of people with partial disabilities who are trying to find work are unemployed. It doesn't sound like a particularly useful stat. I wouldn't be surprised to hear that 70% of all people who are trying to find work are unemployed. They are looking for work after all.

The permanently disenfranchised immigrant underclass that the American economy relies on doesn't exist in Norway.

pizza isn't an issue of starvation, it's a luxury good

norweigian pizza is expensive but everyone can afford it once in awhile

american pizza is cheap but many cannot afford it at all

> poor people in scandinavia don't really exist.

Poor Scandinavian-Americans don't exist either. (Poverty is not equally distributed.)

So all those blonde homeless guys I see lining up for free meals at the Mission downtown, I guess those guys would all be of German-American descent, huh?

This could be a reference to the (possibly apocryphal) anecdote that Milton Friedman was told that "we have no poverty in Sweden."

To which he responded "that's interesting. We have no poverty among Swedish-Americans either."

Exactly. Watermelon cost like 50 cents in China, doesn't mean people are wealthier there.

Although for some reason the iPhone costs several hundred dollars more... But I'm sure they'll come to their senses soon and lower it.

Domestic goods are cheap, imports are expensive. Import taxes are lower in Hong Kong, but then service expensive.

Domestic goods are cheap because the labor is cheap, and because the cost of living is lower.

iPhones are expensive because China Unicom is stupid. Plus, iPhones are made in China, so they're not imported. And the irony is that the imported phones, which originated from China too, actually cost less.

Reply on news.ycombinator.com