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American state universities are free or cheap for in-state residence and many state flagships are superior to their German counterparts.
Maybe. I'm skeptical and haven't seen evidence. White Americans and Germans are almost exactly even when we look at PISA scores.
Germans seem to kill themselves about as often as Americans, so I'm more than a little skeptical of the mental health benefits there. American incomes suffice to allow substantial maternity leave (including a full stay-at-home parent) if this is a priority. The tradeoff here doesn't seem to have actually led to Germans wanting to have children, for whatever that's worth.
I like these things and have elected to live in one of the most bike-friendly, park-heavy cities in the United States. I wish more places in the United States were like that and I'm genuinely disappointed that people don't seem to have the same revealed preferences. This is probably my least favorite part of being an American.
Yeah, this is why they're comparatively poor.
The United States spends a staggering amount of money on mental healthcare. I don't think it actually works all that well in the United States or Germany, at least judging by the intractability of Americans and Germans both killing themselves fairly often. My opinion of mental healthcare professions is sufficiently low that I regard marginal dollars spent here as a net negative, although I certainly wish the United States would return to spending on institutionalizing the severely mentally ill rather than medicating the moderately neurotic.
16.6% of Americans are on antidepressants whereas only about 1.5% of Germans are. 12.5% of Americans are on benzodiazepines, only 2% of Germans are
German suicide rate is 12 per 100k. White American suicide rate is 18 per 100k. This white American number is significantly underestimated because of the fentanyl crisis, leading to some suicides labeled overdose, and killing those who have a high chance of killings themselves.
Terrifying numbers for benzodiazepines. Even 2% seems too much but 12.5% is total crisis.
And the fact that Germans are more likely to use benzodiazepines than antidepresants (even though low in absolute numbers) is also not a good sign of their healthcare system.
I don't care about antidepresant use rates. They are not addictive and side-effects are generally mild and if people are fine with those side-effects then why should we care.
Not checked, 2022 study claims tricyclics are the most common antidepressant class in germany. Tricyclics have worse side-effect profiles than SSRIs, and have mostly been phased out in the US, so idk what's up with that.
Tricyclics are worse for elderly but still not as bad as benzodiazepines (they can cause memory problems, also falls leading to hip fractures etc.) which are now licenced only for 2-4 weeks max. Maybe those 2% are mostly people on short term regiment but then again that would mean that if the licenced use is on average once per year, it is 24% of population.
Probably most people are not on short term use though. Many doctors in Latvia didn't even know that benzodiazepines licence was changed to short term use only. Judging from reddit posts, American doctors know it very well but struggle with patients who are addicted.
Vinay Prasad should add a chapter in his book Medical Reversals about change in benzodiazepine licencing and how they used to be prescribed so widely and only then we realized their harms.
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