UCLA historian Peter Baldwin has written a book arguing that Europe and the United States aren't as different as commonly thought and that some of the differences that exist do not fit common stereotypes. The book, The Narcissism of Minor Differences: How America and Europe are Alike, does a variety of comparisons including health care.
Take health care. Despite the high cost of care and the high rate of uninsurance in the United States, the quantifiable outcomes of the American health care system compare favorably with Europe's, Baldwin found. Proportionately speaking, fewer Americans die of major diseases, strokes, heart attacks, hypertension and cancer than citizens of several European nations.
"If these measures were stripped of any identifying information and you were asked to choose the country which doesn't have a national health care system, you wouldn't necessarily pick the United States," Baldwin says. "In every respect, America falls more or less smack dab in the middle."
In fact, when it comes to the four major cancer killers — colorectal, breast, lung and prostate — Americans actually have better five-year survival rates than Europeans, who are covered by national health insurance systems of one form or another. And these figures include the 15 percent of Americans who don't have health insurance.
So that enormous amount of money Americans spend on health care does buy the sick among us something in the short term. I would argue that it also provides much bigger incentives for the development of new treatments and that those incentives are the biggest benefit of the American health care system. I'd like to find ways to get bigger incentives at lower cost. But I'd prefer higher incentives at higher cost to lower incentives at lower cost.
One point I do not see mentioned in the current health care spending debate: Most people who are alive are not seriously ill. Therefore for most people it is the health care treatments available in the future and not the health care system's delivery of existing treatments in the present that should be their primary concern. Everyone has some disease waiting for them in the future that is currently fatal today. Your greatest interest is in a health care system that provides big incentives for the cure of currently incurable fatal diseases and chronic debilitating and painful diseases.
Europeans waste too much energy transporting freight. While trains are the preferred form of mass transit of more affluent people the much greater American use of trains for freight counts for more than the greater European use of trains for passenger travel.
The United States also has an unexpectedly strong track record when it comes to public transportation, Baldwin found. True to reputation, Americans drive much more than Europeans — some 70 percent more than their closest peers, the Italians. And the U.S. public transportation system leaves, as Baldwin puts it, "much to be desired."
But it's not because America doesn't have a good rail system, he says. It's just that Americans rely less on rail to move passengers than do Europeans. In the United States, rail much more frequently moves goods than in Europe. In fact, well over three times as much freight is carried by rail per capita in the United States than in the closest European nation, Sweden. All European nations, meanwhile, send a higher percentage of freight by road than America. As a result, a smaller percentage of transportation-related carbon dioxide emissions is caused by road travel in the United States than anywhere in Europe other than Norway.
"It may be that Europeans virtuously ride the rails as passengers," Baldwin says. "But their refrigerators, their Corn Flakes and their mail are hauled around in trucks. From Mother Nature's point of view, it doesn't make much difference if you're sending your passengers by rail but your freight by truck rather than the other way around. Pollution is pollution."
The extent of mass transit usage in Europe is exaggerated anyway. Check out table 3 at this link which shows percentages of distances traveled in Europe by car, rail, tram & metro, and bus & coach. What you'll see is that cars account for over 80% of distance traveled in 11 western European countries and only gets below 80% in Denmark, Austria, and Ireland. If that's the best European countries can do with mass transit given their high gasoline prices, denser populations, and public subsidies then the idea that Americans could shift to mass transit is absurd.
Americans engage in more sexual antics than Europeans. Though I wonder on this one whether white Americans are all that risque.
While Europeans may have a reputation for being far more indulgent of the sexual antics of their leaders than Americans, they actually come off as relatively prudish in Baldwin's book. America ranks behind only one country — Iceland — when it comes to the percentage of respondents who claim to have had "three in a bed during sex" and ranks first in respondents claiming to have had at least one homosexual experience.
Iceland probably represents an opportunity for pick-up artists. The place is in a huge economic contraction. Sexually adventurous Icelandic women are probably attracted to affluent foreigners.
Americans score above most European countries by various measures of charity and helping of others.
And although Americans have a reputation for displaying less solidarity than their European brethren, the figures don't reflect that either. When compared to a range of European countries, America ranks first in blood and organ donation and individual charitable giving and second in volunteer work and participation in civic groups.
Again I'd like to see the numbers broken out by race.
America is a large enough and varied country that what's really needed is a comparison of America's regions and races against assorted European countries.
Update: The UK government report on transportation referred to above contains a chart in chapter 2, "Figure 3: Overall mode share of distance travelled (%) in 2003", that speaks volumes about mass transit in Europe:
|Share |||By Randall Parker at 2009 November 15 04:25 PM Culture Compared|