> We also lag behind those comparison countries in hundreds of other metrics--food security, housing, segregation, relative public spending on healthcare, education, services, etc.

Most of this is simply not true, even though it feels good to say. For example, US public spending on healthcare is greater than all of these countries: https://www.statista.com/statistics/283221/per-capita-health...

Spending != Quality/effectiveness of care

I’m not sure what the point of this particular goalpost movement is, but the US ranks quite highly on measures of treatment quality as well. Those are of course much vaguer than the relatively easy-to-measure dollar amount.

What is your definition of “ranks quite highly?” The US ranks near or dead last among developed countries on access to care, outcomes, efficiency, equity, etc.

> access to care, outcomes, efficiency, equity

Of these, only "outcomes" could reasonably be described by "quality," the rest are a further goalpost pushing. And the US ranks highly on those, (e.g. https://worldpopulationreview.com/country-rankings/cancer-su...). The only way to get US outcomes to look bad is to compare things that also include non-health-care inputs, like mortality, which is like comparing a sports medicine clinic to an ER room and concluding the ER room loses more patients.

This is just patently false. How are you extrapolating a high ranking for healthcare quality from the survival rate of a single disease? The US spends exponentially money per capita yet has lower life expectancy, infant mortality, childbirth safety, etc. than countries like China, Estonia, and Poland.

I don’t know where you could possibly be getting your information from but here is some reading for you.

https://www.commonwealthfund.org/publications/fund-reports/2...

https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more...

https://jamanetwork.com/journals/jamainternalmedicine/fullar...

> spends exponentially money per capita

It's funny, this entire chain started because someone claimed the US spent less than all those other countries and I corrected them.

> has lower life expectancy, infant mortality, childbirth safety

You completely misread my post, because I specifically addressed this point. The reason you look at treatments of specific diseases to judge quality of health care rather than something like life expectancy is that life expectancy depends more on things outside the health care system's control than in it. If you get shot or die in a car accident, that wasn't the doctor's fault, a population with much higher rates of obesity will die at a faster clip than one without, even with the exact same care, etc.

Woulnd't life expectancy reflect pretty much all major factors related to health? (outcomes, access, etc) For that, US currently ranks about number ~50 in the world, which is not that bad, but also not so great for a rich country.

Sorry, by relative I meant basically what effects to an investment in healthcare (with regards to systemic change as was my point), not total spending which is obfuscated by recent COVID-19 response spending and Medicare's inability to negotiate prescription and treatment prices historically. For instance, American hospitals being overwhelmed/at capacity and rural areas turning to telehealth due to lack of healthcare services.

And because of all the privatization we favor in the US because of "efficiency," many people efficiently extract profit from that US spending. Whether on prisons or health care.

I sleep easily, knowing it's for profitable efficiency and not merely corruption.

Crime isn’t caused by the lack of social services. Villages in Bangladesh have less crime than many parts of America. Indeed, America itself has higher crime than it did in the 1950s, even though most modern social programs didn’t exist back then.

In modern economies, social services reduce crime. That doesn't mean that crime is caused by a lack of social services.

Part of the reason that social services are necessary is that modern society does not support traditional support networks such as those you might find in a village in Bangladesh. Many people today don't even have families they can turn to for help.

Increased crime rates today compared to the 50s are largely due to higher rates of reporting. In the 50s, crime in low income neighborhoods wasn't reported. It's much safer today, and continues to get safer every year.

Countries with excellent social safety nets, such as Finland, Japan and Germany have much lower crime than the US.

> Increased crime rates today compared to the 50s are largely due to higher rates of reporting. In the 50s, crime in low income neighborhoods wasn't reported. It's much safer today, and continues to get safer every year.

Source? Homicide rates have been well reported since the 19th century, and they track the same general pattern as violent crime rates: https://en.wikipedia.org/wiki/Crime_in_the_United_States. Also, I’m not sure how underreporting is an explanation since crime was higher at the turn of the 20th century and decreased after that.

> Countries with excellent social safety nets, such as Finland, Japan and Germany have much lower crime than the US.

Those countries are also homogenous and socially rigid compared to the US. Homicide rates in Germany and Scandinavia fell below the 5 per 100k (the current US level) way back in the early 1800s, long before the modern welfare state: https://ourworldindata.org/exports/homicide-rates-across-wes...

You picked Japan, Germany, and Finland, three countries that happen to have high social spending and low crime. But Korea also has low crime and has lower social spending than the US: https://mobile.twitter.com/oecd_social/status/98735230257827.... By contrast, Brazil has a very high crime rate with similar levels of social spending as the US.

The data just doesn’t tell the story about the root causes of crime that you want to tell.

> Homicide rates have been well reported since the 19th century, and they track the same general pattern as violent crime rates:

There is one confounder here which makes the tracking progressively less and less good for past 50 years, and makes it seem like the current crime rate look better than it actually is, relative to the past crime rates: improvements in trauma medicine.

Basically, what would be a homicide 50 years ago, today increasingly is “only” an aggravated assault, because of advanced treatments. If you adjust for that, if you assume that the standard of care today is unchanged for past 50 years, today’s homicide rate would likely double.

In addition, the 50s were a period of high wealth equality even though there were less social programs. After the Great Compression ended crime began to increase.

Racial homogeneity is proven to also contribute to lower crime rates. A very under looked reason.

This is misleading, crime massively increased from 1960 to 1980 and has been steadily decreasing ever since.

It correlates with access to abortion interestingly. Of which blacks use it the most.

I know this was made popular by freakonomics but it has since been disproven. Crime rates dropped in other countries that didn't have Roe v Wade and the data better fits the hypothesis that the drop in crime was caused by the banning of leaded gasoline.

Interesting! Thanks for this comment and update.

The authors are libertarians, not the people we'd expect to be pushing social services.