Does America Have Exceptional Healthcare?
No. America does not have Exceptional Healthcare
FAR FROM IT — With no supporting evidence, we tend to believe we have exceptional healthcare, and that myth extends to American Exceptionalism. We need to wake to the fact that we are far from having the best healthcare in the world, as we keep being told. We spend twice as much as other rich nations on average, but we live sicker and die younger and leave millions without care. This was made clear in an excellent article questioning Why Are Americans So Unhealthy? Here’s a quick summary, followed by my reaction:
“When you find out that every other rich country in the world — without better technology, without more spending on biomedical research — is healthier, it undermines your case that what you are doing is right.”
“Compared to 16 other nations, the U.S. ranked dead last in life expectancy for males and second-to-last for females. Beyond that, the nation ranked at or near the bottom in nine broad areas, including injuries and homicides, drug-related deaths, heart disease, and diabetes. Lung disease was both more common and more deadly in the U.S. than in most of the comparison countries, while older adults were more likely to have arthritis than people in the United Kingdom, Europe, and Japan. The U.S. surpassed all other nations in its rate of infant death. It had the highest rate of new AIDS cases. American young people were more likely than their international peers to die in traffic accidents.”
THINK UNIVERSAL HEALTHCARE WOULD BE A NIGHTMARE? IT ISN’T FOR JAPAN.
- 100% of Japanese people have health coverage, regardless of their income.
- They spend half of what the USA does.
- They get to choose their own doctors, and see them twice as often as we do.
- They have the world’s longest life expectancy, and second lowest infant mortality rate in the world.
- 95% of Japan’s healthcare is non-profit.
- The Japanese government caps fees for medical services and pharmaceuticals.
We could do this in the USA too!
Those rankings and stats are from a 2013 study, but since then it’s only gotten worse in the USA, even for rich white people. WHY?
“Common explanations — obesity, lack of access to health care, health disparities between White and Black people — were all at play, but the exact cause, or combination of causes, was not clear.”
There must be some underlying “cause of causes,” the new study explored. “Recent work points to a surprising culprit: conservative policies.” That’s not going to go over well among Republicans who have politicized mask wearing even during the COVID pandemic.
“On the surface, it may seem absurd to claim that an illness like heart disease might stem from individual freedom, free enterprise, self-reliance, the role of religion, and federalism.” But there are explanations.
“For example, the constitutional right to bear arms reflects the American value of personal freedom. Firearms are more available in the U.S. than in peer countries, and homicide rates are … 19.5 times higher than the average for the other countries.
“Similarly, Americans prize self-reliance, prompting many to believe individuals should solve their personal problems without ‘handouts,’ so raising taxes for state-financed health programs is often unpopular. Six years after the Affordable Care Act went into effect, 12 states have not expanded Medicaid, despite the federal funding that would cover at least 90 percent of the cost.”
My Reaction to the “Exceptional Healthcare” claim:
Another excuse for our nation’s high healthcare costs is the shortage of doctors, but medical school is expensive, and it’s hard to get in. ‘Not so elsewhere.
- Germany: All college is tuition-free.
- Finland: They welcome anyone in the world to get any level of education at no charge.
- Denmark: Don’t be silly, college won’t cost you anything. And they provide students $900/month for living expenses for 6 years.
- United States: This is self-reliant America, so pull yourself up by your bootstraps. We’ll provide loans at 10x the interest rate we charge banks. If you don’t pay, we’ll garnish your paycheck. And even if you file bankruptcy, you still owe us. Also, textbooks aren’t included.
The article’s mention of conservative values such as individual freedom and self-reliance reminds me of this satirical video of American mountain man Gus Porter. He gets mauled by a bear but won’t let the socialist Canadian health care fix him up. He’d rather hike back to America because of his misguided ideology. That thinking eventually costs him his life.
Here at Modern Health Talk, I’ve long seen our broken political system as a cause of our nation’s health disparity, and I’ve published articles asking Why American Healthcare So Expensive, critiques of uncontrolled capitalism, the role of poverty, and extreme inequality as the likely cause of causes.
As a result, my writing here and elsewhere has gotten increasingly political in nature, and increasingly progressive. I’ve concluded that fixing our broken healthcare (i.e. sick care) system requires fixing our broken political system while addressing inequality and corruption.
But any real and lasting fix must also realize that our problems are systemic and deeply rooted. We must abandon the Exceptional Healthcare myth, and the American Exceptionalism myth too. For any hope of becoming exceptional again, we must accept the reality that we need new goals with an eye on the future. Simply matching the average spending and health outcomes of our peer nations would save us $2 trillion/ year in healthcare costs. But when is being average enough for proud Americans?
Strategic investments in a healthy, skilled, productive, and well paid workforce would help grow our economy, corporate profits, and global competitiveness, generating trillions more. Together, addressing these underlying “causes of causes” offers huge economic benefits beyond the social ones.
“What makes America the greatest country in the world?“
This clip is from a 2016 episode of HBO’s “The Newsroom,” where Will McAvoy (Jeff Daniels) is asked a simple question by a college student during a campus debate.
McAvoy initially goes with a politically correct answer, but when pressed, he offers this honest, bold, straight forward response that sums up a lot of the problems we seem afraid to accept today. We want to believe in American Exceptionalism. But in reality, we no longer lead in many ways. We’re just pretending and believing what we see in news and social media.
THE MESSAGE: The first step to solving a problem is to admit there is one. That is exactly what I tried to address in this article about American Healthcare.
TODAY’S POLITICS: The problem I now see is that Trump-supporting MAGA folks have the wrong idea of why America was once exceptional. The Newsroom video gives us a hint, and it’s not that we were mostly white Christians, or have freedom to carry guns, or any of their other misconceptions. It’s because we refuse to even have an honest debate, as Bernie Sanders claims in this next video (1:23).
I have never read a more brutally honest assessment of who we are as a nation and what we’ve become.
By OLIVER KORNETZKE, during Donald Trump’s second administration as he prepares for the 250th anniversary of the Declaration of Independence by hosting an Ultimate Fighting Championship (UFC) event on the South Lawn of the White House. [emphasis added to highlight healthcare issues]
250 years. Two hundred and fifty fucking years of the most powerful, most resourced, most theoretically capable nation in the history of human civilization and here is what we have to show for it.
Forty million people on food stamps, thirty million without health insurance, the highest maternal mortality rate in the developed world, the highest incarceration rate on earth, an opioid crisis that has killed over half a million people and counting, a housing market so broken that working people cannot afford to live in the cities they work in, an education system that buries young people in debt before they earn their first dollar, infrastructure that is (quite literally) collapsing, a life expectancy that is going backwards, a political system so thoroughly purchased by concentrated wealth that the laws it produces bear almost no relationship to what the public actually wants or needs, a working class that has not seen meaningful real wage growth in thirty years, a mental health crisis so severe we normalized it, a gun violence epidemic so routine we don’t even act much anymore when preschoolers are slaughtered, and a climate hurtling toward catastrophe while the people paid to address it collect checks from the industry causing it.
Two hundred and fifty years of that. And to celebrate, we built a wrestling arena on the White House lawn.
Not a hospital, or a school, or a housing development. Not a single fucking thing that addresses a single goddamn item on the list above. A wrestling arena. With cranes and pyrotechnics and a steel arch that probably cost more than the annual budget of three rural counties combined, erected in front of the building where Lincoln and Roosevelt and every president who ever tried to make any of this mean something once lived and worked and in some cases died trying.
Truthfully, this is not a departure from American values. This is the fullest possible expression of them. Because this is what we chose. Every single time the choice was presented.
We built a culture where a football coach makes forty times what a physics professor makes and then express genuine bewilderment at the outcomes. Where a reality television star becomes president and a school district cuts its art program in the same fiscal year. Where children know every statistic of every player on their favorite sport team and cannot locate their own country on a map. Where scientific consensus on vaccines, climate, evolution, and basic nutrition gets weighed against a Facebook post and the Facebook post wins at the dinner table. Where the school that wins the state championship gets a parade and the school that produces a Nobel laureate gets a budget cut.
We chose the bomber over the teacher. The tank over the clinic. The aircraft carrier over the water treatment plant. We spend more on military than the next ten countries combined, including our allies, while veterans sleep on the streets of the cities they came back to. We built the most expensive killing apparatus in human history and then told the nurse she made too much money. We sent young men to die in wars that made defense contractors rich and called it freedom and put a yellow ribbon magnet on the back of the car and called that support. We made the soldier and the police officer into sacred untouchable symbols of national identity and then cut their benefits, denied their PTSD claims, let them die waiting for VA appointments, and sent them back for third and fourth tours because it was cheaper than taking care of them when they came home. We worshipped the uniform and neglected the human inside it because the uniform is a symbol and symbols are cheaper than healthcare and housing and the therapy that would actually help. We built bases in a hundred and fifty countries and could not build enough affordable housing in fifty states. We funded a military budget that could have ended homelessness and medical debt and student debt several times over and we did it with bipartisan enthusiasm and called the people who questioned it unserious.
We chose entertainment over education so many times and for so long and at every available level of society that we forgot there was a distinction worth making. Spectacle over substance, performance over policy, the aesthetics of greatness in place of the actual thing, and the feeling of winning instead of asking what was being won and who was paying for it and what it would cost the people who came next.
Rome had bread and circuses. We Americans have food stamps and a wrestling ring outside the Oval Office.
250 years. This is what we built. This is what we chose. This is what we are celebrating. And the most perfectly, catastrophically, irreducibly American thing about all of it is that anyone pointing at this image and asking what it means will be called unpatriotic by people watching it on a television they bought on credit they cannot afford to pay back, rooting for a sport they cannot explain, in a country they cannot describe, celebrating a birthday they cannot contextualize, for a nation that has spent two and a half centuries confusing the noise it makes with the work it never did, all while claiming to be the greatest country on Earth.
Happy Birthday America! You have never looked more like yourself!
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Waaay ahead of you, Wayne. But it’s encouraging when one more joins the fold. I am a retired health economist now 95 years old; have build health systems in various countries – and was asked a year ago (by Physicians for a National Health plan) to present a lecture that was cancelled by Covid; so now I’m writing it up for publication. Couple of details need refinement first. But hang in there; as we have no reasonable alternative.
Thanks for commenting. Hearing of your vast experience, I’m glad you enjoyed my article and happy to hear about the paper you’re working on. If completed, I’d love to have a look if you can provide a link.