I think the issue is US _culture_, not education (although the two are intertwined). We had too many easy years where you could take a Jack Kerouac road trip for 5 years to find yourself and then settle down to the equivalent of a cushy 6 figure job just for being a man with a pulse. Now if you do that, you will come back to find all the cushy jobs filled, and you are unqualified for anything except bottom of barrel service industry jobs.

Today there is a lot more prerequisite grind to become a doctor that parents don't feel good about forcing on their kids. Five decades of movies villifying parents for pushing their kids too hard will do that.

Meanwhile, parents in/from China and India and Nigeria and many other places are more than willing to force their kids to grind to move up the economic ladder.

Getting into the medical school and staying there for so many years until you can support yourself means also a huge investment from the family. Now, what is the culture saying about this? Would you keep your kids on your paycheck until they're almost 30, or you throw them out to get a job as soon they're 16? And of course, can the kids already afford to be independent and support themselves when they're 16 (aah sweet liberty fuck those geezers)? These are I believe other major contributing factors in western societies.

I know this is a rhetorical question, but... yes? As a parent I absolutely am going to make sacrifices to help my kids get through college, and one is planning for med school. I feel like many immigrant parents have this mentality. It is the native born who do not. (Native born white guy here looking at all my family and acquaintances)

At our current level of technological advancement, we should be able to get far more than a 5y Kerouac road trip before joining the grind. Where are all those supposed productivity gains going? Why are we becoming less free?

(This is sort of an aside. Yes, bring all the hardworking immigrants here, please. And maybe let them have those road trips, too.)

It's obvious to me the gains of our productivity is being siphoned up. The US economy is... very weird right now, and has been getting weird for a few decades. I wouldn't even consider the US a capitalist nation, what we have is something new.

Most companies don't do anything, most investors make money without putting in any labor, and money just... poof, appears. But not for us. Nothing really seems to make sense anymore.

Things that were trivial before, like having a receptionist to answer your phone, now seems economically impossible. And yet, our GDP continues to rise. We run companies with a tenth of the people we did before - everything is computerized, automated. But the wages are lower.

The productivity gains go to:

- an ever increasing standard of living

- stonks go up to prevent a pensioner revolt and to inflate egos of billionaires

We are kind of equivocating about "the grind" though. There is the grind of a student keeping their heads in books and activities while friends play video games or party or whatever. This grind has a light at the end of the tunnel in the form of obvious graduation dates and similar rites of passage.

Then there is the grind of working at McDonalds or Walmart because that is the only opportunity left to you, and that is a grind that might easily go on forever unless you win the hunger games and get into a management track rat race.

US health care continues to fall behind other Industrial Countries.

Can you provide evidence of this? The services are top notch, and over 90% of people have health insurance. Moreover, in other single payer systems (Canada, Poland) I keep hearing about months long wait for procedures until you go private/out-of-pocket.

The unique thing about the US healthcare system is that care is directly proportional to how much money you can spend on it. So as a top spender, yes the care is great. Though realistically we should look at the system as a whole for all people it "covers". Looking at infant mortality rate, life expectancy, etc, for the average person, the picture is bleak; the US is shockingly bad.

Exactly. The data tells the story, and the results data of healthcare in America is abysmal. I used to workout at a gym that was near a major hospital. I will never forget a conversation I overheard between two doctors in the steam room many, many years ago where they were talking about this issue and the one doctor quipped to the other "the United States has the best healthcare nobody can afford."

Sorry, but as an outsider from one of those other countries you mention, I don't get what you mean by top notch? Top notch for whom? The people who can afford to pay out of pocket? Or those willing to do into debt to just get treatment? Whenever I see news from places like PBS News Hour, it's about some low wage or senior person struggling to just care for their medical needs or prescriptions.

I don't know my guy, your system isn't exactly top notch for most people - I don't think you need to look very hard to see that if you try.

Random examples:

- https://upload.wikimedia.org/wikipedia/commons/0/0b/OECD_hea... - https://upload.wikimedia.org/wikipedia/commons/d/d6/Life_exp...

There's something very very wrong here when your paying that much per capita and a lot of people are still struggling.

Having insurance in the US doesn't mean anything, as the insurance itself does not provide any health care.

In fact they actively try to provide as little care as possible. It's a negative signal, not a positive one as you seem to think.

> The services are top notch

Healthcare is a plethora of services, ranging from something as simple as a blood draw to open-heart surgery. I can tell you from experience that many diagnostic services are definitely NOT top notch, and the service of getting billed after is an absolute nightmare.

Examine your priors.

New International Study: U.S. Health System Fails Many Americans; Ranks Lowest on Health Equity, Access, and Outcomes https://www.commonwealthfund.org/press-release/2024/new-inte...

> months long wait for procedures

The demand for healthcare procedures is unlimited.

Instead queues are used to limit access to expensive procedures, because waiting lists are the only solution that is palatable to voters.

Although in theory queues shouldn't actually reduce total costs (just delay the costs?)

WTF are you on about? There's a cap on the number of funded residencies (the federal government pays those salaries). Nothing to do with education. Everything to do with the AMA begging Congress to cap those positions ~20 years ago to protect their incomes.