Tuesday, July 10, 2007

More on Sicko Two

And another thing ...

Just because Germany, France, Australia are countries, we tend to think the US, being a country, could do what they do. But they are all much much smaller, in population and geography, than the US. And size can complicate matters.

The population of France is 61m, or one-fifth the size of the US, of Germany 82.5m, just over a quarter the size of the US, of Australia 20.5m or one fifteenth that of the US.

In area, France is slightly less than twice the size of one state, Colorado. Germany is slightly smaller than the state of Montana.

When green Americans (among whom I count myself) blithely complain how we don't use public transport like the Europeans, I can hardly get them to understand the differences of scale and distance between people here as opposed to Europe.

I can not imagine these things would not also play in medical care and development. In Germany and France, for example, you need far fewer pieces of expensive equipment to serve the whole population ... in America with that few pieces of equipment some of the population could easily be 800 miles from the machine needed to treat them.

Or to put it another way, on our journey from New Mexico to northern California to see family, then on to Portland for GA, and straight home the shortest route to New Mexico again, we drove from London to Beirut, Lebanon and back again. See what I mean?

All that said, our system is certainly hundreds of per cent more brutal than it needs to be. But being hard-headedly realistic about the systems we admire even as we work to change things is still not a bad idea.

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