Seriously thoughtful US/Europe Cultural Divide -- Musings

[Xenophon]

Lots of interesting responses, folks -- and all polite about it, too! Keep up the good work!

(And since there's so much above, I won't try to quote individuals, but will try to say what I'm responding to)

@Someone(?tirsales?) wrote that government funding is superior because it doesn't differentiate, is guaranteed, etc.

History in the use suggests otherwise. For example, throughout the Jim Crow era in the US, government funding most certainly did differentiate on the basis of (ethnic) group membership. During the same period, much private philanthropy did too... but quite a bit did not. In fact, the private philanthropists were waaaaaay out in front in terms of supporting causes that served people the government left behind.

On the front of governments providing "guaranteed funding," I observe (anecdotally) that government funding is by no means guaranteed. Two examples:

• My mother-in-law was the director of the Central Pennsylvania Blind Association, a charity providing support and services for the visually handicapped in the center of the state. They were funded partly through private donations and partly via the state budget (for services provided on a contract basis). One year the newly-elected Governor (a Democrat, not that it really matters) who face a small budget short-fall simply zeroed out the budget for all support services for the disabled. Statewide. Across all kinds of disabilities. My MiL's group (and other Blind Associations around the state) survived only because they could turn to private philanthropy to help close their budget gap.
• Research funding from NASA: Hurricane Katrina -- in addition to the damage to New Orleans -- also did $4Billion in damage to various NASA facilities. Their budget did not include money for repairs (it's rather hard to budget for a hurricane a year in advance!). So they asked Congress for a solution. Congress passed a bill allowing NASA to redirect their previously allocated budget to effect repairs, but provided no additional money. So the NASA administration unilaterally cancelled all outside research contracts. No warning. No payment for any bills not yet presented at the time of cancellation, even if the work had been conducted under a valid contract. [NOTE: This would be blatantly illegal if done by any entity other than the gov't. Even for a gov't agency it would be questionable -- except for the aforementioned bill.]
  
  Now let's consider the research funding cycle: you submit proposals now for funding next fiscal year. If you yank current funding, there's no way for the researchers to get new funding until next fiscal year. Unilateral instant cut-off destroys entire research groups who depended on the funding allocated for this year. Further, signing the official contract often doesn't happen until 6 months into the 1-year contract -- but work begins on day 1 under a memorandum of understanding. Funding regulations put the project PIs at individual financial risk for non-payment under a MoU (but not under contract). But it's not a problem, after all. The Gov't always pays. Right? So we wound up with a bunch of mid-career professors who were personally liable to repay their Universities for the expenses incurred under cover of an MoU -- often 20x-50x their annual salaries! When the dust settled, a pile of Congress-critters sent a letter to NASA saying that this particular redirection was clearly outside their intent and directed them to continue funding both existing contracts and MoU work through the end of the fiscal year, so none of the PIs wound up on the hook. But a whole bunch of multi-year research contracts were abruptly terminated at the end of that fiscal year.

Continued in next post, clicked submit too soon.

[Xenophon]

Neither of the examples I give above turned into a total disaster. But government funding in the US turns out to be less reliable than private philanthropy -- as long as you have a sufficiently broad base of donors. Sure, donations go up and down. Individual donors drop out. But the private sector turns out to be more reliable than the gov't.

Xenophon

[Xenophon]

Originally Posted by pilotbob

If only that were true. Celebrity here also seems to be worshiped. So many people "wanna be" Paris Hilton. What has she achieved? Certainly she was lucky by birth... but that isn't an achievement. Yet so many people seem to value here and follow here every move.

Also, as someone else many in the US equate popularity and riches with achievement. It really is a "beauty is in the eye of the beholder" type issue here isn't it?

BOb

Well... we also lionize Nobel Prize winners. And Turing Award winners. And leading academics. And successful business people. And authors, musicians, painters, preachers, soldiers (sometimes)...

So a large fraction of the US reads the scandal rags and "wanna be" Paris Hilton. This differs from the Royals.... how? (I'm talking about your "lucky by birth" comment, and not about sovereignty issues, b.t.w.)

I think that the popularity-and-riches thing is a relatively widespread issue that is not unique to either side of the pond.

Xenophon

[Greg Anos]

Originally Posted by Sparrow

But how do you measure achievement?
It seems that material possessions are the indicator of success in the US; or is that unfair?

I think in Europe we see many ways to achieve. It isn't just about winning or losing.

It is one way of measuring achievement, there are others in the US. Achievement is a personal evaluation, depending on personal goals and beliefs. For some it may be a 100 room mansion with all the trimmings, for others it may be a travel trailer wandering around the countryside. Still others may want a huge library. There are as many different definitions of achievement as there are people. And that it doesn't mean that you will achieve your goals. A person with only a 20 room mansion whose goal was a 100 room mansion will feel a failure, by his standards. The person driving around with his travel trailer will laugh at both the 20 and the 100 room mansion.

The culture here has been geared to letting any person try to achieve any goal, with a minimum of interference. But to do that, you have to acknowledge that some people will fail badly. It is not the duty of the culture to "cut down the tall poppies" to make up for the failures. Both are the Yin and Yang of achievement...

[HarryT]

I assure you that the "cult of celebrity" is just as widespread on our side of the pond as it is on yours.

[pilotbob]

Originally Posted by Xenophon

So a large fraction of the US reads the scandal rags and "wanna be" Paris Hilton. This differs from the Royals.... how? (I'm talking about your "lucky by birth" comment, and not about sovereignty issues, b.t.w.)

No it doesn't differ. That is my point that there is exactly NO difference. Someone above pointed out that in the US we value "achievement" over "position" which is why we prefer American football over football. My point is that we are just as start struck with "royalty" and position here as are folks in the UK.

BOb

[Xenophon]

partly , partly on

Originally Posted by DixieGal

[SNIP down to the part I want to comment on...]
Pay attention now, this is what I've been getting to: Those pts who are poor and don't have insurance are covered under a govt program called Medicaid. Medicaid only pays us a fraction of the cost of the medical care, and we are forbidden to try to collect the remainder. This is a contractually binding agreement. We take a large loss on these pts versus pts who have insurance. Nobody makes up the difference. It is mutually agreed upon by us and Medicaid that we will take whatever pittance they give us and be satisfied. We understand that we can not count on our majority population of poor urban pts to support us and that the excellent care they receive from us will be free to them.
[and SNIP some more]

This part of DixieGal's post is very important! It indirectly explains much of the reason why healthcare in the US is more expensive than in many other countries -- and it's our own darn fault, too!

There's an economist -- I'm blanking on his name, darn it! -- who got his Nobel prize for explaining the effect you get on prices when a market is partly price-controlled and partly not. Especially when the price-controlled portion is both (a) large relative to the total, and (b) pays below market-equilibrium prices for what it consumes. I'll skip over lots of economic theory that I probably didn't understand correctly anyway, and jump to the bottom line:

First the obvious part -- providers in the market shift costs from the controlled portion to the uncontrolled portion. They must recover their costs somewhere, after all, and they're not allowed to charge more in the controlled part so... But the NONobvious part is this: the upwards pressure on prices in the uncontrolled part of the market is much worse than you would expect. It turns out to be seriously non-linear. And the larger the controlled fraction of the market is, the more non-linear the pressure becomes on the uncontrolled part -- up until the whole edifice collapses because the few remaining players in the non-controlled part of the market can't afford to subsidize the below-cost controlled part any longer. <Whoeveritwas> quantified the non-linearity... but I don't remember the numbers <sigh>

The work cited for the Nobel prize was done on rent control, but he and others have since taken a close look at the US health-care market.

I'm about to get a bunch of numbers wrong here (I'll mark them with a *), so someone more expert than I should correct me. That said, the general sense of what follows is correct, even though the specific percentages are wrong...

Medicaid (for the poor) and Medicare (for the elderly) pay below-market rates by statute. A government agency computes the "reasonable and customary" charge for each procedure in various parts of the country. These programs then reimburse providers (doctors/hospitals/etc.) at a standard rate and on a standard time-to-payment (much more delay than private payers, and usually later than that, too!). The rate is 60%* of the reasonable and customary charge. The agencies also take advantage of a very interesting law affecting government procurement, to wit: when the government buys something or pays for something that is a standard procedure with a price-list (rather than via competitive bid), they must always be given the lowest price ever given to any other buyer. (Yes, this means that when they buy one widget, they must be given the quantity-one-million-widgets price!). But this rule is applied to the r&c charge for procedures, before the 60&* of r&c payment rate.

One might think, for example, that a customer who walks in with a suitcase full of $20 bills should get the very best price. After all, there's no question of credit or time until payment -- he's offering cash on the barrel head. But Uncle Sam will pay no more than 60%* of either the r&c price or the lowest price given to any other purchaser.

Needless to say, the cost-shifting results I almost cited above (would have cited if I was less lazy) tell us that the costs not covered in the controlled market get shifted to the uncontrolled part of the market, while being non-linearly inflated on the way. Various studies have suggested that most (although not all) of the "higher cost of health-care" in the US is due to this cost-shifting problem. Having Uncle Sam pay full freight would remove that part of the problem. But it would require Uncle Sam (which is to say the Congress, and so in the end the voters) to admit to the true cost of the health-care provided at taxpayer expense. And that, in turn, would affect the budget, and...

It's a mess.

Xenophon

[Xenophon]

Originally Posted by Ralph Sir Edward

[SNIP]
The US is an achievement based culture. It always has been. It's an artifact of having an open frontier for 200+ years (circa 1650 - 1890). If you failed, you simply moved out to the edge and started over.

[SNIP]

This leads to a view of government as referee. Government should try to see the "rules of the game" are enforced evenly, and let the best man win. Of course, in areas that are many generations away from the "frontier ethos", there has been a slow change to a more European government world view, as more and more people try to "lock in" their social position and reduce social mobility. This has led to continual friction inside the US itself between the followers of the old "frontier ethos" and the newer (to the US) "social lock-in ethos".
[SNIP]

Interesting that no one has yet commented on RSE's government as referee observation. He's absolutely nailed an important part of the American attitude towards government, IMHO. Another part of the American attitude on government -- that permeates the writings of our Founding Fathers, by the way -- is that government is a necessary evil. We need it both to secure "certain inalienable rights" (to quote one of those FFs) and also to be the hopefully-impartial-referee that RSE described. But there's a strong strain of American thought that views government beyond a certain minimum level as a problem, not a solution. (I would argue that this meme is not nearly strong enough in contemporary America. Your mileage may vary.) I suspect that most of our European members don't see things that way. Am I right?

Xenophon
(Who was radicalized by extensive readings from the FFs during high-school. Those guys were fire-eating revolutionaries! We tend to forget that these days...)

[Ea]

Originally Posted by HarryT

And therein lies the difference, Nate. You consider a government-run healthcare system to be a "nanny"; we perceive it as a basic duty of government to provide such a service, and free access to healthcare to be a fundamental human right.

Not only that, but healthy, well-educated people also work better and creates greater value for the nation as a whole. The welfare system certainly hasn't hurt Denmark at all - I'd say it's the opposite.

[Greg Anos]

Originally Posted by Xenophon

Interesting that no one has yet commented on RSE's government as referee observation. He's absolutely nailed an important part of the American attitude towards government, IMHO. Another part of the American attitude on government -- that permeates the writings of our Founding Fathers, by the way -- is that government is a necessary evil. We need it both to secure "certain inalienable rights" (to quote one of those FFs) and also to be the hopefully-impartial-referee that RSE described. But there's a strong strain of American thought that views government beyond a certain minimum level as a problem, not a solution. (I would argue that this meme is not nearly strong enough in contemporary America. Your mileage may vary.) I suspect that most of our European members don't see things that way. Am I right?

Xenophon
(Who was radicalized by extensive readings from the FFs during high-school. Those guys were fire-eating revolutionaries! We tend to forget that these days...)

I hope this don't trigger our European brethren, but Europe never had a frontier to develope the ethos. There has always been somebody on top running things. So culturally, it's always been a battle for who's on top, and the position relative to each other in the power structure is the main point. The more you deny the people below you, the less resources/abilities they have to supplant you. It should be no suprise that literacy and education was not a high prioirty to be given to peasants. They might become competitors.

[Nate the great]

Originally Posted by Ea

Not only that, but healthy, well-educated people also work better and creates greater value for the nation as a whole. The welfare system certainly hasn't hurt Denmark at all - I'd say it's the opposite.

And yet the US has a higher per capita GDP than any country in Europe except Norway, Luxembourg, and Lichtenstein without having your healthcare system.

[Jellby]

Would you leave the army under the control of private corporations and individuals? Well, that's most Europeans' view with healthcare and education (and other subjects)

(I fear someone will tell me the army already is under the control of private corporations)

[DixieGal]

I'm curious about something. What do Europeans do if they believe they are not receiving the best care available? Over here, we fuss and grumble and write letters to clinic managers until a problem is solved.

This is a great thread, BTW. I don't think any minds will be changed, but I'm happy to be learning more about the subject.

[pilotbob]

I think the FF drafted the constitution with "necessary evil" in mind and as a reaction to the monarchy heritage of the "old world" they left behind. I think the monarchy is viewed as "taking care" of the people which comes with oppressive non-representative taxation.

I am one that think the US government has grown much to big and has it's hand in much to much. I am somewhat of a consitutionalist/libertarian views there. But, I also do see that there is alot which the founding fathers didn't anticipate.

The problem is that the interpretation of "promote the the general welfare" can be drastically different when viewed by many people.

BOb

[nekokami]

I am hesitant to get into this topic, but things have been civil for 4 pages, now, so I'll dip in a toe.

The most effective predictor of academic success in the US is socio-economic status, i.e. the financial status of the family of the student. This is a very uncomfortable fact for American educational researchers. The proposed explanations vary from nutritional support (which affects brain development at an early age) to lack of safe environments in which to study to working-class parents not having enough time to read to their young children (the second most significant predictor of academic success). People will toss around ideas about cultural values of different groups in the US, too. I don't think the explanation is simple, and research has not supported any single explanation so far.

But the implication is that people don't really get an equal start here in the U.S., and although we certainly have "rags to riches" stories about people who made it big despite humble beginnings, if we look at the statistics, the children of the poor tend to remain poor (or get poorer).

Let us hypothesize that an education of equal quality for all children could minimize this difference between the starting points of individuals, to somehow create a perfect meritocracy (or at least a closer approximation of it). What I often hear people say is that they don't want to have to pay for the education of other people's children. They want the best for their own children, to make them "able to compete," and though they rarely say so out loud, one gets the sense that if the "other" children don't have as many educational opportunities, so much the better for the kids lucky enough to be born into "good" families.

I don't feel comfortable with this social setup, but I don't have the answers, either. To me, this seems like the sort of thing government exists to deal with. But I expect others will feel differently.