Work life balance in the USA

OEP

JustAThought wrote: »

i wonder how much of that is due to abysmal poverty, drugs and guncrime thou? As for mid teens versus thirties rakings the life expectancy is still somewhere in the mid 80’s .. not sure Inwant to live til I’m that old and decrepit - at least not in the Irish ‘healthcare’ system where you can work and pay 50% tax your entire life and still be left to die in a public corridor without treatment for 14 or 24 hours while junkies and drunk itinerants are prioritised and treated before you because of their ‘human rights’ status.

A family member of mine was in an accident in the US & had a serious enough head and facial injury - he had an option of a range of hospitals and plastic surgeons to treat him - try getting an appointment for a plastic surgeon or neurosurgeon in Ireland on the VHI let alone, God forbid, on a medical card.

It would be interesting to see the stastics on private maternity care in the US & how many mothers and babies are severly damaged or left brain damaged from birth over there - not as many as in Ireland where the mutilations arn’t even a stastitic and the national maternity hospital refuses to accept liability and fights every case to the steps of the high court - on the taxpayers dollar of course - to protect their often totally overwhelmed, undersupervised, exhausted often disinterested staff .

Look at the 2 major HSE recent scandals - our national hospital system - cervical smears misread, their results reported as incorrect, this ignored by the patients own (HSE employed) consultants, left to die, and the ones that did find out left to fight the HSE system and despite government (worthless) ‘ promises’ again made sue the government and HSE and fight through their dying breaths for compensation for the medical failures AND COVER UPS by the Irish medical system and their employees.

I could go on.

I listen to Dr. Death podcasts (series 1 & 2) and horrifying as their focus on the 2 doctors and their patients in the US is, in many many ways out own system is a lot worse - as are particularly the protections in place here for sub par, dysfunctional, incompetent, disinterested and incompletely trained (& often imported) HSE doctors.

At least the fear of litigation in the US and actually going to prison or losing their license to practice keeps them controlled. Here - the HSE - remember the radiology scandals - Norweigan consultant not reference checked, list of red flags behind him across europe - no consequences, Nigerian doctor working for the HSE who tore out and tossed a womans kidney into a medical waste sluice bucket because he disn’t have basic surgical training - bought his qualification/exams, not competent to practice, not checked or supervised, multiple red flags, allowed leave the country, no consequences - apart from the patients lives destroyed. The list goes on and on - and they are only the ones we happen to hear about through rare media reporting or national scandals - many of which involve thousands of women and thousands of lives destroyed.

There isn’t that level of casual clinical corruption, incompetence and a ovoidance orchestration in the US medical system.

When is the last time a doctor, administrator or nurse was arrested and tried for 2nd degree murder here, or derieiction of duty, or elder abuse or torture or manslaughter - as in the care home scandals that arn’t even a blip on the radar of the HIQUA - it wouodn’t happen in the US and for good reason. There are consequences for corruption and medical malpractice there. It might cost a lot but at least it win’t kill you. And if something goes wrong you are covered. Unlike here.

And you are paid and not taxed into a coffin. That would be nice for a change too.

I'm assuming your family member had insurance? I have insurance here and I had A minor issue recently. Went to the GP saw the consultant a few days later and he said pick a date for him to do it, as soon as I like.

AndrewJRenko

JustAThought wrote: »

It would be interesting to see the stastics on private maternity care in the US & how many mothers and babies are severly damaged or left brain damaged from birth over there - not as many as in Ireland where the mutilations arn’t even a stastitic and the national maternity hospital refuses to accept liability and fights every case to the steps of the high court - on the taxpayers dollar of course - to protect their often totally overwhelmed, undersupervised, exhausted often disinterested staff .

Look at the 2 major HSE recent scandals - our national hospital system - cervical smears misread, their results reported as incorrect, this ignored by the patients own (HSE employed) consultants, left to die, and the ones that did find out left to fight the HSE system and despite government (worthless) ‘ promises’ again made sue the government and HSE and fight through their dying breaths for compensation for the medical failures AND COVER UPS by the Irish medical system and their employees.

Ireland's maternal death rate seems to be about 1/4 of the rate in the USA.

https://www.macrotrends.net/countries/IRL/ireland/maternal-mortality-rate

Weren't the cervical smear misreads done by labs in the USA?

NSAman

One thing I do like about the health system in the states, lack of wait times.

Doctor is a phone call. Scans like mri/ct are almost immediate where I am. Surgery for most items are pretty quick too. Choice of hospitals and surgeons are available.

Lots of crap about access I understand. In Ireland I have to say, the “quality” of some of the people I experienced there was horrific.

A&e here is not a 9 hour wait. Either you are seen in 15 minutes or you are not charged.compare that to a 15 hour wait in a&e in Ireland with a mother in agony who spends 6 weeks recuperating. Then during that to A&E you get thrown out of the hospital when you ask for the doctors letter back after 14 and a half hours, only to find out they have actually lost your mothers file and the peoples files who have been sitting there with you (including and kid with a broken leg) for 15 hours, then being screamed at “you will be seen when you are f***ing seen” by a nurse...it doesn’t happen here.

Wibbs

AndrewJRenko wrote: »

Ireland's maternal death rate seems to be about 1/4 of the rate in the USA.

https://www.macrotrends.net/countries/IRL/ireland/maternal-mortality-rate

Weren't the cervical smear misreads done by labs in the USA?

Pointless exercise AJ, that poster thinks USA is Great! doesn't want to pay tax and Ireland is too leftie for its own good. Their perceptions are almost entirely predicated on that position. QV

the Irish ‘healthcare’ system where you can work and pay 50% tax your entire life and still be left to die in a public corridor without treatment for 14 or 24 hours while junkies and drunk itinerants are prioritised and treated before you because of their ‘human rights’ status.

Having had quite the number of experiences of Irish casualty depts that simply doesn't happen. It's up there with "They get free prams y'know". And we're apparently up to our oxsters in "mutilated" babies.

Like I said our system is not perfect by any means, but I'd be looking to better systems in Europe than the system in the US which is all about profits and pushing treatments that increase them. It's hardly cost effective as healthcare in the US is nigh on one fifth of GDP From wiki on the matter of how good the US healthcare system is:

The United States life expectancy is 78.6 years at birth, up from 75.2 years in 1990; this ranks 42nd among 224 nations, and 22nd out of the 35 industrialized OECD countries, down from 20th in 1990.[8][9] In 2016 and 2017 life expectancy in the United States dropped for the first time since 1993.[10] Of 17 high-income countries studied by the National Institutes of Health, the United States in 2013 had the highest or near-highest prevalence of obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides.[11] A 2017 survey of the healthcare systems of 11 developed countries found the US healthcare system to be the most expensive and worst-performing in terms of health access, efficiency, and equity.[12] In a 2018 study, the USA ranked 29th in healthcare access and quality.[13]

In poorer states volunteer medical staff set up field hospitals for the poor that wouldn't look out of place in a developing country at a time of conflict. All this in the richest nation on earth apparently.

As I said Ireland's health service needs a major overhaul and no mistake, but while the US has many advantages to well educated and qualified White people one thing that is not worthy of emulating is how they operate a health service.

IAMAMORON

Unless you are nicely minted the US is an overrated kip OP.

If holidays is what you want I suggest you fly to New York for 3 -4 days and then rent a car and drive to Los Angeles, or get the bus or the train. Enjoy.

This is a great country, don't mind the cranks.

AndrewJRenko

NSAman wrote: »

One thing I do like about the health system in the states, lack of wait times.

Doctor is a phone call. Scans like mri/ct are almost immediate where I am. Surgery for most items are pretty quick too. Choice of hospitals and surgeons are available.

Lots of crap about access I understand. In Ireland I have to say, the “quality” of some of the people I experienced there was horrific.

A&e here is not a 9 hour wait. Either you are seen in 15 minutes or you are not charged.compare that to a 15 hour wait in a&e in Ireland with a mother in agony who spends 6 weeks recuperating. Then during that to A&E you get thrown out of the hospital when you ask for the doctors letter back after 14 and a half hours, only to find out they have actually lost your mothers file and the peoples files who have been sitting there with you (including and kid with a broken leg) for 15 hours, then being screamed at “you will be seen when you are f***ing seen” by a nurse...it doesn’t happen here.

You can get fast A&E services here in Laya or VHI clinics if you have insurance. It's not hard to run great A&E services when you can cherry-pick the clients you want to service.

NSAman

Wibbs wrote: »

In poorer states volunteer medical staff set up field hospitals for the poor that wouldn't look out of place in a developing country at a time of conflict. All this in the richest nation on earth apparently.

As I said Ireland's health service needs a major overhaul and no mistake, but while the US has many advantages to well educated and qualified White people one thing that is not worthy of emulating is how they operate a health service.

Absolutely agree Wibbs. The Irish system is a joke at this stage and needs a complete overhaul. The fact that each person is contributing 6000 a year to the mess says so much is wasted money.

What Ireland does well, it does well. Cancer treatment being excellent for one. Where it falls down, it is terrible. I have worked for a number of years in developing countries, I can honestly say, A&E in Ireland is very much the same if not worse.

It worries me that vested interests in Ireland halt progress within the health system, just as much as vested interests in the US continue to make it more expensive.

Why not take the positives from many systems and implement those into the Irish system? Then a radical top down culling is needed in personnel.. too many managers in Ireland wasting the front line staffs time and wasting too much money. Problem with Ireland in my opinion, no one wants to take charge and be the “bad” guy.

The American systems favour those that can afford it, no doubt. But, there are places here e.g. St. Judes which do the best possible work anywhere in the world for any patient, with means or without!

Stateofyou

Wibbs wrote: »

Pointless exercise AJ, that poster thinks USA is Great! doesn't want to pay tax and Ireland is too leftie for its own good. Their perceptions are almost entirely predicated on that position. QV

Having had quite the number of experiences of Irish casualty depts that simply doesn't happen. It's up there with "They get free prams y'know". And we're apparently up to our oxsters in "mutilated" babies.

Like I said our system is not perfect by any means, but I'd be looking to better systems in Europe than the system in the US which is all about profits and pushing treatments that increase them. It's hardly cost effective as healthcare in the US is nigh on one fifth of GDP From wiki on the matter of how good the US healthcare system is:

The United States life expectancy is 78.6 years at birth, up from 75.2 years in 1990; this ranks 42nd among 224 nations, and 22nd out of the 35 industrialized OECD countries, down from 20th in 1990.[8][9] In 2016 and 2017 life expectancy in the United States dropped for the first time since 1993.[10] Of 17 high-income countries studied by the National Institutes of Health, the United States in 2013 had the highest or near-highest prevalence of obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides.[11] A 2017 survey of the healthcare systems of 11 developed countries found the US healthcare system to be the most expensive and worst-performing in terms of health access, efficiency, and equity.[12] In a 2018 study, the USA ranked 29th in healthcare access and quality.[13]

In poorer states volunteer medical staff set up field hospitals for the poor that wouldn't look out of place in a developing country at a time of conflict. All this in the richest nation on earth apparently.

As I said Ireland's health service needs a major overhaul and no mistake, but while the US has many advantages to well educated and qualified White people one thing that is not worthy of emulating is how they operate a health service.

And what are your perceptions predicated on, Wibbs? Have you lived in the US or are you pulling all your information from Google? You've already mentioned Wikipedia, so I'm going to guess you haven't any first hand experience at all. You can't just quote old Wikipedia data as if they're facts and pretend to be an expert in comparison.

Wibbs

NSAman wrote: »

It worries me that vested interests in Ireland halt progress within the health system, just as much as vested interests in the US continue to make it more expensive.

Why not take the positives from many systems and implement those into the Irish system? Then a radical top down culling is needed in personnel.. too many managers in Ireland wasting the front line staffs time and wasting too much money. Problem with Ireland in my opinion, no one wants to take charge and be the “bad” guy.

Oh I agree 100%. The HSE needs an enema in a big way and like I say I'd be looking to some of our EU neighbours as templates. No way in hell would I look to the American system for inspiration.

As for Ireland's A&E being third world. I've had enough experience over the last ten years with it(in Dublin to be fair) and found it bloody good and quick. That said in each case it was in very serious life or death type circumstances, 999, ambulances and all that. So no triage in the waiting room stuff and that does make a difference alright. I would not like to be "walking wounded" on the weekend in A&E. I'd agree there.

The American systems favour those that can afford it, no doubt. But, there are places here e.g. St. Judes which do the best possible work anywhere in the world for any patient, with means or without!

Oh sure quite a few hospitals do pro bono clinics and treatments, but it's highly variable.

Stateofyou wrote: »

And what are your perceptions predicated on, Wibbs? Have you lived in the US or are you pulling all your information from Google? You've already mentioned Wikipedia, so I'm going to guess you haven't any first hand experience at all. You can't just quote old Wikipedia data as if they're facts and pretend to be an expert in comparison.

I don't need first hand experience of living in Afghanistan to know it's a shitshow in many regards. The WHO who* have noted the same thing and agree with what I posted, as have many august medical authorities and statisticians across the planet, including America's own CIA statisticians. American healthcare is the most expensive on the planet and in thrall to more vested interests and access and treatments and treatment outcomes and is very much dependant on who you are, what you earn and what colour you are. Healthcare in America is a majorly contentious and debated issue as far as its shortcomings to Americans themselves. Look at how it has dealt with Covid alone. Utter mess.

Like I said America is a great place if you're an educated White Irish person who wants to make a mark and is a great place if you're a White middle class American for the most part. It has its good and bad points like anywhere in the West, but their health service of all things is hardly one to look up to or emulate.





*owl impression.

Drewgerger

You have to get a visa to work in usa
And australia
If you go to america you have some chance of going back to Ireland 6-12 hour flights
Australia it's about 20 hours

Stateofyou

Wibbs wrote: »

Oh I agree 100%. The HSE needs an enema in a big way and like I say I'd be looking to some of our EU neighbours as templates. No way in hell would I look to the American system for inspiration.

As for Ireland's A&E being third world. I've had enough experience over the last ten years with it(in Dublin to be fair) and found it bloody good and quick. That said in each case it was in very serious life or death type circumstances, 999, ambulances and all that. So no triage in the waiting room stuff and that does make a difference alright. I would not like to be "walking wounded" on the weekend in A&E. I'd agree there.

Oh sure quite a few hospitals do pro bono clinics and treatments, but it's highly variable.

I don't need first hand experience of living in Afghanistan to know it's a shitshow in many regards. The WHO who* have noted the same thing and agree with what I posted, as have many august medical authorities and statisticians across the planet, including America's own CIA statisticians. American healthcare is the most expensive on the planet and in thrall to more vested interests and access and treatments and treatment outcomes and is very much dependant on who you are, what you earn and what colour you are. Healthcare in America is a majorly contentious and debated issue as far as its shortcomings to Americans themselves. Look at how it has dealt with Covid alone. Utter mess.

Like I said America is a great place if you're an educated White Irish person who wants to make a mark and is a great place if you're a White middle class American for the most part. It has its good and bad points like anywhere in the West, but their health service of all things is hardly one to look up to or emulate.

*owl impression.

But no one is talking about Afghanistan. And I would say, yes, you need first hand experience to speak to what goes on in a country in a real sense. We all have notions about what Syria is like, yeah? Well so did I, until I worked along side a Syrian national who taught me a lot about their culture and their country. I learned a lot, more than what you would pick up from news headlines or stats. And it changed my perspective and assumptions, too.

You don't look to America for inspiration because you've never lived there. There's a lot wrong, I'll be the first to say it. But there's an awful lot that is right, too. Same goes for Ireland.

I've had first hand experience of A&E/hospital services in the US and Ireland. It's not even a contest or a slightest hesitation that I would choose the US every time. And I'll be upfront and say those services differ from place to place in the US (as I'm aware) as they do here. Where I live here now in Ireland, I wouldn't ever step foot in the local dentist or primary care. They're so desperate that my family and I were forced to look elsewhere further out for better care. I will never forget the front page headlines in the newspapers the month we moved back home from the US. It was all about the trolley crises and also the cervical check scandal. I will tell you one thing for sure-it was a shock to the system going through the health care system here after coming to the US. For the whole family. From ED, primary gp care, gynaecology, other testing/health care needs to routine dentist cleaning. Total sub par care, runaround, and wait times were all horrible compared to our experience in the US (and indeed Canada). Traveller outcomes here are worse as well, in many regards. Experience you can't learn from Wikipedia, Wibbs.

Wibbs

Wibbs wrote: »

The WHO who* have noted the same thing and agree with what I posted, as have many august medical authorities and statisticians across the planet, including America's own CIA statisticians. American healthcare is the most expensive on the planet and in thrall to more vested interests and access and treatments and treatment outcomes and is very much dependant on who you are, what you earn and what colour you are. Healthcare in America is a majorly contentious and debated issue as far as its shortcomings to Americans themselves. Look at how it has dealt with Covid alone. Utter mess.

Please feel free to point out what I typed there is incorrect. Not your personal experiences. Personal experiences are subjective and differ wildly depending on many factors. For example I knew an American living here, who had chronic health problems and went through the American health system, passed from pillar to post racking up bills and painkillers who couldn't believe how their condition was essentially treated and "fixed" in the Irish health system and how cost was not a factor. Now if I were to just go on them I'd have thought the US system was pretty appalling, but it clearly isn't. It is very good depending on where you look. World class in many respects. However in other respects it's seriously lacking and the objective view demonstrates that.

Take your second hand Syrian viewpoint. I know two Syrians, one here, the other in the UK and one gave quite the positive take on the place in many respects, the other quite the opposite, so my second hand viewpoint was kinda up in the air. Of the aforementioned Afghanistan I've known a few lads from there too and that was a mixed bag. Hell, ask five Irish people about Ireland and you'll get quite the range of opinions on the place depending on who they are as people and their experiences. Look at any thread here concerning the place. Opinions that could have me in agreement or thinking WTF and I live here.

And in case you're still labouring under the misconception that I'm "anti American" and missed this part:

Like I said America is a great place if you're an educated White Irish person who wants to make a mark and is a great place if you're a White middle class American for the most part. It has its good and bad points like anywhere in the West, but their health service of all things is hardly one to look up to or emulate.

I would also add a greater can do attitude built into the society, a fantastically varied landscape full of contradictions in places and people, a singular lack of the tall poppy syndrome that is all to common here, a history of incredible advancements in the sciences and the arts in the 20th century and so on. It would be a very long list and many attitudes we would and should emulate here.

However, looking at of all things health services, given a choice between many places in Europe, places that are most certainly better than ours in many regards and the US, I'd still look to Western Europe way before I'd look to the American model as far as a service that is the most benefit for society overall. Actually Canada that you mention would be well up in the list too as a template.

Wibbs

Missed your edit:

Stateofyou wrote: »

Traveller outcomes here are worse as well, in many regards.

Traveller outcomes are indeed worse here, but Traveller culture has a huge part to play in it and that needs to be acknowledged, but almost never is by the usual Traveller representatives. The responsibility is always in one direction. Then again if one runs with the oppressed/oppressor narrative that's all too common now it's an uncomfortable pill to swallow. Until someone has the stones to swallow it nothing will change and divisions will remain or get deeper. Divisions have certainly gotten deeper even in my lifetime. And unlike personal stories often seen here on Boards, my personal experiences with Travellers have for the most part been either neutral or positive enough, so I've no personal axe to grind there, though many people, particularly in rural Ireland do.

beggars_bush

We could start by paying our student nurses when they do actual work

Consultants are milking the public system while still being in the private system

If all the private health insurance policy money was put into the public system we would have a very good health system. Raise taxes?

ILoveYourVibes

Wibbs wrote: »

Missed your edit:Traveller outcomes are indeed worse here, but Traveller culture has a huge part to play in it and that needs to be acknowledged, but almost never is by the usual Traveller representatives. The responsibility is always in one direction. Then again if one runs with the oppressed/oppressor narrative that's all too common now it's an uncomfortable pill to swallow. Until someone has the stones to swallow it nothing will change and divisions will remain or get deeper. Divisions have certainly gotten deeper even in my lifetime. And unlike personal stories often seen here on Boards, my personal experiences with Travellers have for the most part been either neutral or positive enough, so I've no personal axe to grind there, though many people, particularly in rural Ireland do.

But how many travellers actually live traveller culture?

Most have no horses and live in houses.

Settled people simultaneously point out travelers live just like most Irish people ...but point out their culture is why they suffer in ways different to us.

You can't have it both ways.

Either they live exactly like us ..or they have a distinct culture.

Are they different from other Irish people or not?

Stateofyou

I will agree on the Canadian model, it's wonderful. Now there's something to aspire to. If the American social democrats ever get to achieve what they want to achieve in regards to healthcare for the US, to make it more affordable and more equitable, then that would really be something.

From my perspective, if you want better health outcomes either in the US or Ireland, you either need money or healthcare insurance in both countries. I think it's completely disgraceful that here we pay for the HSE from our taxes and also on top of that, health care insurance so as to have a better standard of care. Facilities here are run down and you're bounced from pillar to post, having procedures chopped and changed because no one place seems to be equipped to handle a single issue. The primary care/hospital offices in the US look and feel miles ahead from what I've seen here in Ireland. We could also access our records online in two different states we lived in there. If you've ever seen Grey's Anatomy, that was seriously pretty much what it was like there. Very reassuring and efficient (my experience anyway). Have never seen that here even in Dublin. My family have a few shockingly horrible experiences in health care sectors here in the last 1.5 years. The other half is now grumbling about flying back to the US for future holidays and having certain routine procedures done whilst there. It's embarrassing, our HSE system. Don't get me started on how the school contract tracing is handled...

Wibbs

ILoveYourVibes wrote: »

But how many travellers actually live traveller culture?

Most have no horses and live in houses.

Settled people simultaneously point out travelers live just like most Irish people ...but point out their culture is why they suffer in ways different to us.

You can't have it both ways.

Either they live exactly like us ..or they have a distinct culture.

Are they different from other Irish people or not?

And your point is? For a start I never said they live like most Irish people* They clearly don't. Their health stats are out of step, their levels of criminality ditto, their attitudes to education and women are out of step too. If that's a "distinct culture" it's not a very good one in the 21st century. Not as it stands today. Least of all for those stuck in it. And yeah, some cultures are better than others overall. I know that can freak some out who buy into the cultural equivalence stuff, but it's pretty obvious if the social studies blinkers come off.




*I know a couple of people whose great grandparents were old style Travellers who settled down and they are the same as anyone else really. Educated, employed, some good eggs, some bad, mostly meh like the rest of us. They keep some traces of the old Traveller culture about the place which is a good thing.

Wibbs

Stateofyou wrote: »

I will agree on the Canadian model, it's wonderful. Now there's something to aspire to. If the American social democrats ever get to achieve what they want to achieve in regards to healthcare for the US, to make it more affordable and more equitable, then that would really be something.

It really would, but I fear America has an uphill struggle there with too many vested interests involved with the ears of politicians on both sides who will fight tooth and nail to keep the extremely lucrative tills ringing.

I would say in some ways the nature of the American Dream(c) and that sense of American individualism(which can have great results in many areas and bad in others) will also be a major block. The very idea of socialised medicine seems a bit too close to socialism for some. Remember the debate between Sanders and Clinton when he suggested America should be a little more like Denmark as far as looking after working people and she came back with we are not Denmark and her job was to curb excesses of capitalism. And they're the "progressive" Democrats. Though to be fair that conversation wouldn't even occur to Republicans.

Though god be with the days of a different American dream...

https://www.youtube.com/watch?v=3EZ5bx9AyI4

If an American president read that out today...


And yes the HSE needs someone to go through it with a flame thrower. I'd happily pay more tax for an efficient system for all. If insurance companies want a second tier service for their members, fine, but they can build their own hospitals. The fact they currently share them is more than a bit mad. The second the insurance industry gets involved costs go up. Look at vet expenses now. Before pet insurance prices were significantly lower for the same procedures and it's not or rarely the vets making bank on the back of it.

Stateofyou

Couldn't agree more, Wibbs.

Dyr

beggars_bush wrote: »

We could start by paying our student nurses when they do actual work

Consultants are milking the public system while still being in the private system

If all the private health insurance policy money was put into the public system we would have a very good health system. Raise taxes?

We could start by accepting that student nurses are on placement to gain their qualification as is practice with most qualified professionals

The largest employer in this country is the HSE, 200,000 staff. We pay six grand a head per year for a public health system that isnt worth a tupenny curse and people try to convince us the problem is that we're not pissing enough money against the wall on it and we should cut the legs out under a private system that shows the public one up as a disgrace.

ILoveYourVibes

Wibbs wrote: »

And your point is? For a start I never said they live like most Irish people* They clearly don't. Their health stats are out of step, their levels of criminality ditto, their attitudes to education and women are out of step too. If that's a "distinct culture" it's not a very good one in the 21st century.

You seem to think on the one hand there is no distinct culture. But on the other hand all of these issues are because of their culture.


Could it be that their issues are to do with being lower income and slightly displaced and ostracized from the education system?



There is no denying that social issues can be ..generational ....they are repeated.

Once your parents fall into the ' gap ' its harder for you not to fall in.

Generational criminality is a thing.

I would not call generational criminality or poverty a culture. Therefore i wouldn't say that traveller culture actually promotes criminality.

Quite the opposite i would say that Traveller culture true culture prevents those falling into the dark gap.It helps them escape from generational criminality.

ILoveYourVibes

Bambi wrote: »

We could start by accepting that student nurses are on placement to gain their qualification as is practice with most qualified professionals

The largest employer in this country is the HSE, 200,000 staff. We pay six grand a head per year for a public health system that isnt worth a tupenny curse and people try to convince us the problem is that we're not pissing enough money against the wall on it and we should cut the legs out under a private system that shows the public one up as a disgrace.

The HSE is incredibly inefficient and wasteful though.

Not all of that is solely due to HSE staff though.

Govt after Govt have failed to address this ..mostly because half of their cronies get govt procurement contracts through this system. For instance we don't have procurement SPECIALISTS ..because of this. Very few supply chain experts whose job is to lower the cost. We don't negotiate as a single entry with other countries or companies. Or at least we were not until very recently.

Too many smaller hospitals and clinics. Each with their own HR dept ..IT dept senior management etc.

Too many health boards.

Too much of the budget spent from the HSE on private companies.

Ministers and Councillors feel they will lose their seats if they close the smaller clinics and hospitals in their constituencies even if it would shorten waiting lists and save money. And they right they would.

You said the HSE has like 200,000 staff.. ..the truth is NO ONE even KNOWS who works for the HSE or how many that is how disorganized it is. It could be more.

How many votes did FG actually get? 500k votes?? Note sure.

The HSE was designed to be wasteful. It was designed to placate unions.

That isnt to speak ill of HSE workers many of whom decry the system themselves.

Also the private public partnership is a mess. The HSE ends up paying private companies a lot ..but in return for very little to the health of the nation.

AndrewJRenko

ILoveYourVibes wrote: »

The HSE is incredibly inefficient and wasteful though.

Not all of that is solely due to HSE staff though.

Govt after Govt have failed to address this ..mostly because half of their cronies get govt procurement contracts through this system. For instance we don't have procurement SPECIALISTS ..because of this. Very few supply chain experts whose job is to lower the cost. We don't negotiate as a single entry with other countries or companies. Or at least we were not until very recently.

Too many smaller hospitals and clinics. Each with their own HR dept ..IT dept senior management etc.

Too many health boards.

Too much of the budget spent from the HSE on private companies.

Ministers and Councillors feel they will lose their seats if they close the smaller clinics and hospitals in their constituencies even if it would shorten waiting lists and save money. And they right they would.

You said the HSE has like 200,000 staff.. ..the truth is NO ONE even KNOWS who works for the HSE or how many that is how disorganized it is. It could be more.

How many votes did FG actually get? 500k votes?? Note sure.

The HSE was designed to be wasteful. It was designed to placate unions.

That isnt to speak ill of HSE workers many of whom decry the system themselves.

Also the private public partnership is a mess. The HSE ends up paying private companies a lot ..but in return for very little to the health of the nation.

No procurement specialists eh?

https://www.hse.ie/eng/about/who/healthbusinessservices/procurement/

We haven't had any health boards for about 15 years now.

FGR

AndrewJRenko wrote: »

No procurement specialists eh?

Why has procurement for public bodies not been suggested as being done on a pan EU level? Surely the bargaining power there would be huge for medical supplies, emergency service equipment and the like?

ShatterAlan

Stateofyou wrote: »

You must be a right weirdo to have that kind of experience there that colours your view that negatively. I lived there years, have many friends and family living there and not any one of us would say anything close to what you've just described. You frequently make seething posts about the US, it's very strange. Some of it is so bizarre that I question whether you actually lived there at all. Especially the bit where you said you've been to 20 states and they all looked the same. There's no way you lived there, I'm calling it out.

What do you want? Photographs, my W-2's, a copy of my driver's license. utility bills?

AndrewJRenko

FGR wrote: »

Why has procurement for public bodies not been suggested as being done on a pan EU level? Surely the bargaining power there would be huge for medical supplies, emergency service equipment and the like?

Like they're doing for the Covid vaccine?

FGR

AndrewJRenko wrote: »

Like they're doing for the Covid vaccine?

If that's how it's being done then I definitely approve. It should be expanded for all sorts be it clothing, equipment, vehicles for the public service.

Stateofyou

ShatterAlan wrote: »

What do you want? Photographs, my W-2's, a copy of my driver's license. utility bills?

Easy to say when we all know you would do no such thing. :rolleyes:

AndrewJRenko

FGR wrote: »

If that's how it's being done then I definitely approve. It should be expanded for all sorts be it clothing, equipment, vehicles for the public service.

Something like this scheme, you mean?

https://www.theguardian.com/world/2020/apr/22/coronavirus-what-is-eu-medical-equipment-scheme-why-did-uk-opt-out

SHOVELLER

ShatterAlan wrote: »

I always hear the "America's not perfect but no country is..." trope when you point out the glaringly obvious shortcomings of the place.


Never any acknowledgement or attempt to address the very addressable shortcomings. This bollocks of you work 9 to 5 but god forbid you stick to that and don't devote your every waking hour to the poxy job is pathetic.


And 10 days holiday a year is Dickensian. The French with their shorter work week and generous holiday allowance are actually 16% more productive than American workers.

You are generalising and while my personal working experience here disproves your theory you cant paint all firms with the same brush.

ShatterAlan wrote: »

You're looking at the place through rose-tinted spectacles and cherry picking the good. There are countless areas in the US that would make O'Connell Street look like the finest thoroughfare in Singapore. I lived there for 7 years. Worked in Manhattan. Some parts of the city looked and smelt like Calcutta. I've also visited sterile, cookie-cutter Stepford Wives cities like Reston, Virginia where everyone looks the same. All government type employees with Polo shirts and Chinos and identical non-descript haircuts. Even the dive bar lacked character. A testament to blandness.


And this thread isn't really about comparing the US to Ireland. But I suppose that can be unavoidable. Take public transport in the US. It's the pits. Uncomfortable, unreliable and in some cases dangerous due to bus or train drivers being so overworked that they fall asleep at the wheel. People would harp on about how the Long Island Rail Road was the epitome of luxury because the seat had cushions rather than the McDonald's style plastic seating that you get on the New York subway. The usual response to this is that "America is so rich that everyone has a fancy car and doesn't need public transport". What bollocks. You could be a wealthy commuter in New York and still have to endure appalling public transport compared to your counterparts in Berlin or Stockholm or Tokyo.

I had to read this a few times and am wondering where you ever here?? Manhattan looks like Calcutta?? I have never been to the latter and have no desire to but I have never seen any natives defecating in the streets or abject poverty there. I'm sitting now 20 miles now from Reston and have been there and what you describe is just not true on any level. You are just loading cliche after cliche to prove how unhappy you were if you were here at all.

You can change location but if you are unhappy it wont mean anything.

As far your comments on public transport it is embarrassing how wrong you are. I lived on Long Island and was a regular on the LI Railroad. It came on time and was no worse or better than any regular suburban transport in Europe.

In fact the subway in New York is one of the best as some lines run 24 hours. The Amtrak I use to go to NY is superb.

You are comparing cities like Berlin, Stockholm and Tokyo to a system that is not comparable. I have been to those three cities and yes they are superb but again not comparable.

ShatterAlan wrote: »

Can they though?


We're talking about work life balance here. This notion of if you work hard you'll have a great life in America is just not true. US workers work longer hours with less free time than practically all other OECD countries. Wages are stagnant and have been so since the 1970's.

And if you lose your job what kind of safety net is there? Do you get paid maternity / paternity leave in the US? Maybe some companies throw their employees a bone of a paltry few weeks but they are the exception. You get paid to go to college in Denmark. You are charged tens of thousands of dollars for a college education in America that is probably on a par with the Leaving Cert...ORDINARY LEVEL.


I had friends in the US who I had to help with the Mathematics module of their degrees. I was teaching them simultaneous equations for fcuks sake. You know, the sh1t you do for the Junior Cert in Ireland. What the hell were they learning at the age of 15 in high school? Their times tables?


Forget about the 1%. If you can make $20 million a year in New York whereas only £13 million in London what's the difference. Either party has it made and won't ever have to worry about money. But if you drop down to the middle class or working class that's where you see the differences. A waitress or barmaid in say Amsterdam can have a decent life whilst just working the one job. Paid holidays, health coverage, affordable rent, good amenities and infrastructure. In the US that is beyond reach. She would have to work 2 or maybe 3 jobs to make ends meet. If the bar/restaurant in Amsterdam is having a slow night the waitress is bored. In America she suffers financially and might not even have enough to cover the week's bills.


Do you think that American manufacturing workers have it better than their German counterparts? Not a chance. And teachers in America get the royal shaft. They're treated like shit by government and parents alike. I've read stories of them having to donate blood for extra money.



I know I bemoan anecdotal evidence and isolated case but I'll break my own rule and accept the consequences. I was working in IT in New York and earning $70k 20 years ago. Not bad for a 20 something. So after tax I was taking home about $3800/3900 a month. My rent was low so after bills like rent, car insturance, commuter rail ticket were paid I was down to about $2600 per month disposable income. I had health coverage with the job but it was a fairly meagre plan with no dental. I was then offered a job in the Netherlands. Same type of job except a lot less hours, twice the amount of holidays. I had a fully furnished all inclusive apartment on a canal, no need for that car...exceptional transport network to get to work. After bills were paid I had nearly 5500 euros disposable income each month.

My cousin is a teacher in NY and while acknowledging she is not well paid she has never had to sell her own blood.

I was also in NY 20 years ago and was getting paid by the hour and had a great time being virtually broke. You had $2600 a month disposable income and you were miserable?? In New York???? Come on.

Schindlers Pissed wrote: »

*Disclaimer* I've never lived in the US but I've been to New York many times, more than 25 times for a holiday.

The one thing that struck me with NYC is the rat race, I normally drank in Connollys, or The Perfect Pint, or the Pig and Whistle just off Times Square. What struck me was as other posters have said, office workers might come in for a couple of beers after work but then they scurry away onto the Subway and home to one of the boroughs. I would think it's difficult to make true friends and build true relationships over there.

The hardship of getting around too, it's so impersonal. We often went out to Hoboken for a few pints with my extended family, so get to the PATH station in Manhattan, out to NJ, have the pints, then checking a timetable to get the PATH back. Nobody talking to each other...etc etc....

I really enjoy NYC and I would say to the OP to take the chance, don't have that "what if" feeling in a few years time.

My cousin over there has a really good job with unlimited leave, but as she says herself, you don't get time to take it! She leads a team so when she gets back there's a mountain of work so it's just not worth it....

Also, in the last few years it's gone really expensive with the exchange rate....I used to buy lots of electronics because I like tech but the last couple of trips I didn't bother....there's no value in New York anymore in my opinion.

You go to a great city 3,000 miles from home and drink in oirish bars and the public transport is "impersonal"???? You should contact shatter.

L1011 wrote: »

With the medical debt over you, you aren't going to get a credit card, a car loan, a mortgage, a hire purchase agreement, etc etc - you won't even get a bill pay phone.

Yes but you can still live. Its all about the personal connections. I live in a lovely apartment and dont worry about my debt at all.

JimmyVik wrote: »

I rememeber working in the Dublin office of an American company when 911 happened.
All American companies were given a day off in mourning the victims.
Offices abroad, like ours though, no day off.
Then on that day, not expecting anybody to be in the American office I was surprised that all of them came in to the American office that day.
I asked one of them why they came in and they said that if you didnt turn up for work that day it would be noted. When they tell you you can have a day off over there you have to refuse it, reason being that you should be too busy to take the day off and use it to catch up or get ahead.

You are generalising. Not ALL companies are like this here. You have to qualify these statements. I was off the day after Thanksgiving. If I want to leave the office on personal business no problem. Depends where you work.

There is a lot of back and forth here on the differences which is fair but working and living in Ireland and the U.S. are not really comparable for multiple reasons. Also if you havent done both you cant really comment.

Remember some of the natives here might look like us and speak the same language but the real differences are vast. There are pros and cons living in both countries just as there are anywhere. It depends what you want and how happy you are as a person.