Rather than looking at USA as Scandinavian county, imagine living in some of the counties in the global south. The competition for good jobs is so intense that you’ll work 10 hours a day, 6 days a week. You won’t miss work if you’re sick or have a family event because then somebody else gets your job. Culturally second chances don’t exist, and you’re the only chance your children have to get through school (because you have to pay for it) and for your parents to retire in peace (because they live with you and you care for them). Heaven forbid you get sick. There’s barely a regulatory system for doctors. The doctor takes your temperature but wasn’t trained to sanitize the thermometer correctly. You are now double sick and don’t have somewhere safe to isolate because your rented home has 2 rooms and no ability to ventilate. Your family is now sick, and your children’s school has no mercy for missing class. The children have to compete in complicated exams to even have the sliver of a chance to land themselves in a good university. Otherwise, they’re just gonna live in your footsteps. Oh and don’t take out a loan, because when you do and somehow your entire contact list lands in your lenders hands, every contact on the list will hear about your debt for the next several months.

I’m just demonstrating here but this is an example of the stressful life many people around the world are living. We are blessed to be in the USA.

There are no doubt way worse places than the US.

I was under the impressions that Americans work hard too. For example, if I'm not mistaking there's no mandated minimum number of vacation days, so you might get only 11 compared to 20 in most European countries.

> Heaven forbid you get sick.

The medical act is (very) good in the US, but is it affordable?

> The children have to compete in complicated exams to even have the sliver of a chance to land themselves in a good university.

Doesn't the same apply to the US as well? You either have lots of money, or good grades or you're good athlete.

> The medical act is (very) good in the US, but is it affordable?

The answer is....it depends.

If youre at poverty levels you would qualify for federal-level Medicaid insurance. learning about these benefits takes some digging. Some states(often democrat) provide their omedical benefit coverage for people who are at or below poverty line(which is itself a locale-specific metric).

If youre upper-middle-class or work for the government, you have good medical insurance through your employer or by paying $$$$$ out of pocket.

Anything between these two -- youre probably underserved in terms of medical coverage and you probably only see the inside of hospitals via emergency rooms.

This also describes the situation in some countries of the "global south". Not sure why the original commenter thought the US was so different.

20 days? The norm is 30-40 in the U.K (9ish bank holidays plus 20 minimum but many professional jobs are 25-30). I can’t imagine mainland Europe is worse.

The required minimum is 20 days in Romania + 2 for Easter + 2 for Christmas + a couple of other holy and secular days. Though if they're during the weekend, better luck next time.

Which countries in the "global south" are you talking about? I live in South America and life is not like this. Like, nothing at all like this; you might as well be describing Narnia or Middle Earth and it would sound just as fantastical.

Just as some examples:

Doctors are quite good here, none of that untrained nonsense you mentioned.

You have safety nets.

If you work formally employed (which granted is not a minor detail, since informal employment is a big problem), you have plenty of sick days, and these are mandated by law; so not at the mercy of the company.

Vacations are mandated by law to be paid according to how long you've been at the company. Nobody can fire you for taking vacations; it's about 2 weeks vacation once you've been working for a year. This is by law, the company is of course free to sweeten the deal.

Our best university is public and free.

While life is not easy for somebody without a family to support them or a good job, the reality is nowhere close to what you imagined.

Now, this is one country and I'm aware the "global south" is large and varied. I'm sure other countries have it worse. But it makes me suspect your global description of the south.

Etc, etc.

I am referring to the "global south" as in the UN definition, which is probably a little dated and could use a revisit (https://en.wikipedia.org/wiki/Global_North_and_Global_South) Much of these observations from spending a few years living in Southeast Asia. I've been to the untrained doctors. Watched them practice with unclean tools (did not accept care...). The vast majority of people will never achieve formal employment.

> The competition for good jobs is so intense that you’ll work 10 hours a day, 6 days a week. You won’t miss work if you’re sick or have a family event because then somebody else gets your job. Culturally second chances don’t exist, and you’re the only chance your children have to get through school (because you have to pay for it) and for your parents to retire in peace (because they live with you and you care for them). Heaven forbid you get sick.

I'll be honest, as a non-American, I thought you were describing the USA in these sentences. I quite frequently read things online/see videos etc where Americans are shocked that we can take several weeks or a month off for a holiday in Europe, that if we're sick we just take time off, there's no worry about being fired for getting sick, or needing to work in order to qualify for health insurance. Education isn't free everywhere, but in most places people acquire much less debt than it seems you do in the USA.

It doesn't shock me that there's anti-US propaganda. It shocks me that people on this site routinely fall for it.

I think it’s more that we routinely see very poor and mentally ill people in the US get zero support?

It’s not a great stretch to go from there to assume they don’t have any social security at all.

If it’s available but many people cannot or do not know to make use of it, is it really social security? If they do make use of it and it’s still not enough, does that change things?

It's a nation of ~360-370 million people including undocumented.

Have you seen the horrific conditions the poorest people of Europe 'survive' in? The ghettos of Eastern Europe are every bit as bad as the worst areas of Baltimore or St Louis. The bad areas in and around Paris are hyper minority poverty with zero upward mobility and extreme unemployment problems (thus the annual large riots). People in rural Western Russia live in third world conditions on $20-$30 per month; they live like nothing has improved in a century. To say nothing of the Ukraine war, which is now part of their living condition (for Ukraine and Russia). You realize how poor Moldova or North Macedonia are? The level of education and outcomes among the bottom 20% of Europe is every bit as bad as the bottom 20% in the US.

It's exceptionally difficult to provide a median (or median+) first world outcome to so many, perhaps impossible.

Not sure how relevant it is to compare the poor in the USA to the poor in Europe.

The Poorest 20% of Americans Are Richer on Average Than Most European Nations: https://fee.org/articles/the-poorest-20-of-americans-are-ric... Although averages are a dangerous measure to use and I guess the article is wrong for other reasons (I think it is talking about consumption). The study and article are in response to the crazy OECD poverty measurements: "OECD measure assigns a higher poverty rate to the US (17.8 percent) than to Mexico (16.6 percent). Yet World Bank data show that 35 percent of Mexico’s population lives on less than $5.50 per day, compared to only 2 percent of people in the United States."

I'm in New Zealand, where we have some social support for the unfortunate. Disclaimer: I'm very ignorant of conditions for the poor in the US and Europe.

> I think it’s more that we routinely see very poor and mentally ill people in the US get zero support?

The state of California alone has spent $24,000,000,000 on homelessness in the last 5 years. The government spends about $50,000 per homeless person. See: https://www.cbsnews.com/sanfrancisco/news/california-homeles...

You can certainly argue that the support they're being given isn't working, but it's very far from zero support.

> The state of California alone has spent $24,000,000,000 on homelessness

should very probably read "paid $24 B over 5 years to third parties on programs claiming to 'fix' homelessness"

This would include urban architectures and installions that seek to deter homelessness making sidewalks unsuitable for tents, benches unusable for sleeping, removing access to water and public toilets, etc.

Such things would not count at all as "support" for the homeless.

Regardless it seems remarkably ineffective and one has to wonder, as with military spending, how much goes to end use and how much is $$$ profit! for the contracters.

What would $24 B of affordable public housing look like, employing the homeless as labour?

You believe yourself to have a proper understanding of what's what with the United States? If so, I'd be quite interested in hearing how you went about acquiring an accurate model.

Earned Income Tax Credit, Supplemental Security Income, Temporary Assistance for Needy Families, the Child Care and Development Fund, housing assistance, Low Income Home Energy Assistance Program, Medicaid and Children’s Health Insurance Program, Special Supplemental Nutrition Assistance Program, and the Supplemental Nutrition Assistance Program for Women, Infants and Children

Those safety nets have huge gaps. The government doesn't want to be accused of harboring freeloaders (or, perhaps more accurately, a significant chunk of the population would rather people be homeless than a few "welfare queens" be permitted to cheat the system), so many who are genuinely in need can't get it.

That’s true of most rich countries. The big difference between the US and most rich countries is universal healthcare.

Life and death kinda difference innit

Wikipedia suggests 0.01% of the US population dies each year (30-40,000) due to lack of health insurance. I’m sure the real number is at least double.

That is a very, very big difference.

It is, although it disproportionately affects people who are poor but not broke. If you’re truly broke, there’s Medicaid, if you’re old there’s Medicare, 4% by some form of military healthcare, many people covered by their employers, and so on. 90% of Americans are insured.

As a Britisher, obviously I’m in favour of universal healthcare, and I think the US system would benefit from it. But let’s not pretend it’s perfect there either

> 90% of Americans are insured

I'm one of those 90%. My health insurance (family of 4) costs more than my house payment, and the annual deductible is over $6000 (for one person). Either the premiums or my deductible goes up every year. In terms of total cost (monthly premiums plus annual deductible) it's also pretty much the least expensive plan that I can get.

It's not that health care here is bad, it's that it's ridiculously expensive compared to most other places in the world.

> It's not that health care here is bad, it's that it's ridiculously expensive compared to most other places in the world.

Sure, but the average American also gets paid $20k more than the average Brit, on average.

That doesn't matter for this discussion, because the average American spends way more on healthcare as a percentage of their income than the average European.

~25% of the federal budget goes to medicare and medicaid, i.e. healthcare for other people. On top of that, you're paying for your own medical insurance as an implicit deduction on your salary for your employer-sponsored healthcare plan, or you just pay for your plan directly if you're self-employed.

Those percentages add up.

Whereas in the UK, or in Sweden where I'm from, you only pay once through your taxes for healthcare for everyone, including yourself.

On top of that, copays are higher in the US, annual deductibles are much higher, procedures are much more expensive, medication is much more expensive. Healthcare in the US is simply disproportionally more expensive than in the rest of the world, as a percentage of people's income, and as a percentage of GDP. It's got nothing to do with salary levels.

The medium income is about $48k vs £38k which is much more realistic than averages when a select few make millions per year. Healthcare costs can easily exceed this difference.

We spend over $30k annually just on premiums. On top of that, we pay for most doctor visits, tests, prescriptions and procedures out of pocket.

Edit: everything we pay out of pocket we can deduct from our taxable income (it's an HSA plan), but still.

> f you’re truly broke, there’s Medicaid

Which you still might not qualify for, and may not get even if you do qualify for it (https://www.theguardian.com/tv-and-radio/2024/apr/15/john-ol...)

> 90% of Americans are insured.

Which doesn't prevent nearly 40% of americans from being forced to put off needed medical care because of the expense they're still subjected to. (https://www.cnbc.com/2023/01/20/americans-put-off-health-car...) Medical debt is the leading cause of bankruptcy.

Again, with the caveat that I much prefer the British system...

> nearly 40% of americans from being forced to put off needed medical care

Hard to interpret UK NHS waiting-time figures, especially given the political weight given to them, but these[0][1] paint a picture of 6 month to >1 year waiting times.

0: https://www.boa.ac.uk/resource/boa-statement-on-nhs-app-show...

1: https://www.rcseng.ac.uk/news-and-events/media-centre/press-...

> Medical debt is the leading cause of bankruptcy

Medical debt for non-elective treatment feels barbaric, although digging into the figures (2m personal bankruptcies a year, 60% medical) gives 0.3% of the US population declaring medical bankruptcy a year, possibly going up to 1% if you do fancier maths involving households vs people.

It might be worth stressing for US audiences that the UK NHS waiting times quoted are for elective non life threatening procedures; osteoarthritis surgeries that decrease pain for people already with a degenerative joint disease, hip and knee replacements, etc.

The long wait times, 22 weeks mean average, > 63 week in 8% of extreme waits, are regrettable but not indicitive of waiting for urgent emergency life threatening required non elective procedures which are relatively prompt and immediate for the most part.

I’ve used emergency care in the US and U.K. waiting in the U.K. was half an hour, in the US was 4 hours. The U.K. was of course free, the US was $2k

Same problem, same prescription.

I don't think your portrayal captures the reality of this well. Again, generalizing about numbers when it's such a hot political issue is difficult, and it's super-easy to cherry-pick, but take three NHS trusts in the South East, which for non-Brits is the rich part of the country -- I've chosen these three because I'm somewhat familiar with the hospitals themselves, and they're all big enough to have multiple specialties. I suspect if anything they understate rather than overstate the problem.

0: https://www.myplannedcare.nhs.uk/seast/royal-surrey/

1: https://www.myplannedcare.nhs.uk/seast/oxford/

2: https://www.myplannedcare.nhs.uk/seast/buckinghamshire/

For each specialty, there's a waiting time, which is the time between you seeing your local doctor and then seeing a specialist, and then there's a waiting time given from when the specialist refers you for a treatment -- they need to be added together. Cardiology is 17+21 weeks, 10+12 weeks, and 25+28 weeks, urology is 12+18 weeks, 18+23 weeks, and 25+20 weeks. Orthopedics (for your osteoarthritis example) is at 17+24 weeks, 22+46 weeks, and 20+25 weeks.

> not indicative of waiting for urgent emergency life threatening

Hospitals in the US can't turn you away if you show up presenting urgent, emergency, life-threatening symptoms either, and I suspect those are not the types of medical care that people in the US are generally putting off for cost reasons (although I'm sure there are a few cases where they are).

> I don't think your portrayal captures the reality of this well.

"My" portrayal is a summary of the information in the links that you provided.

Also all the non governmental safety nets. Food banks, charities, mutual aid networks, shelters and religious orgs.

The US in fact has a gigantic welfare state support system. The US spends more of its GDP on social welfare than either Canada or Australia, and we spend it poorly unfortunately (our return on investment is not great, we spend too much for too weak of results, as with healthcare).

To add to your list: housing, healthcare, food programs exist at the local + state + federal levels. The US state government system is huge unto itself, like having an entire other federal government nearly.

There are thousands of government support programs between the state + federal levels of government.

People outside of the US are almost entirely ignorant of how large the government systems in the US are. They're not as big as in France or Denmark obviously, they are still sizable compared to the median peer nation (on a GDP % basis).

Mostly because the help is provided too late.

We do some stuff (often not the right stuff) to prop up people struggling as adults. We do very little, relatively speaking, to enhance people's childhoods (or even just ensure that it's OK).