Even our Noem-dodging Regents couldn’t avoid some exceptionalist hyperbole in their curious curriculum statement Thursday, claiming in Point #2 that America is “the nation most responsible for expanding liberty, prosperity, and equality across the globe.”
Yeah, well if America’s so great at liberty, prosperity, and equality, why are we still so exceptionally bad at delivering a fundamental prerequisite to liberty, prosperity, and equality—affordable health care for everyone?
Once again, research shows Americans spend more on health care (actually, as a Twitter friend reminds me, on health insurance, not actual care) and get worse service than citizens of other wealthy nations:
The U.S. health care system ranked last among 11 wealthy countries despite spending the highest percentage of its gross domestic product on health care, according to an analysis by the Commonwealth Fund.
…Norway, the Netherlands and Australia were the top-performing countries overall, with the U.S. coming in dead last.
The U.S. ranked last on access to care, administrative efficiency, equity and health care outcomes despite spending 17 percent of GDP on health care, but came in second on the measures of care process metric. The nation performed well in rates of mammography screening and influenza vaccination for older Americans, as well as the percentage of adults who talked with their physician about nutrition, smoking and alcohol use.
Half of lower-income U.S. adults in the report said costs prevented them from receiving care while just more than a quarter of high-income Americans said the same. In comparison, just 12 percent of lower-income residents in the U.K. and 7 percent with higher incomes said costs stopped them from getting care.
The U.S. also had the highest infant mortality rate and lowest life expectancy at age 60 compared with other countries [Joseph Guzman, “Stunning New Report Ranks US Dead Last in Health Care Among Richest Countries—Despite Spending the Most,” The Hill, 2021.08.06].
What’s really stunning is not that this newest report ranks America last in health care; it’s that, as The Hill notes, we’ve ranked last in all seven of the Commonwealth Fund’s health care surveys since 2004.
The American health care system is an outlier in poor performance and high spending:
We can’t claim to be leading the world in equality when high costs get in the way of 50% of lower-income Americans getting health care. But costs are out of hand even for many higher-income Americans: the percentage of higher-income Americans reporting cost-related access problems, 27%, is greater than the percentage of lower-income residents reporting cost-related access problems in any other wealthy country surveyed:
Translation: it’s harder for rich people to get health care in America than it is for poor people to get health care in other wealthy nations.
For all of our “pro-life” puffery, we have made less progress in reducing preventable deaths than any other country in the Commonwealth Fund survey:
The Commonwealth Fund lists the real pro-life policies that allow Switzerland, Austria, Sweden, the Netherlands, Norway, France, New Zealand, Canada, Germany, and the United Kingdom to keep their people living healthier and longer than we do:
The striking contrast in performance between the U.S. and other high-income countries on avoidable mortality measures points to several intervention or policy targets. How have top-performing countries reduced avoidable mortality? A comparison of the features of top-performing countries and poorer-performing countries suggests that top-performing countries rely on four features to attain better and more equitable health outcomes:
- They provide for universal coverage and remove cost barriers so people can get care when they need it and in a manner that works for them.
- They invest in primary care systems to ensure that high-value services are equitably available locally in all communities to all people, reducing the risk of discrimination and unequal treatment.
- They reduce the administrative burdens on patients and clinicians that cost them time and effort and can discourage access to care, especially for marginalized groups.
- They invest in social services that increase equitable access to nutrition, education, child care, community safety, housing, transportation, and worker benefits that lead to a healthier population and fewer avoidable demands on health care [Eric C. Schneider, Arnav Shah, et al., “Mirror, Mirror 2021: Reflecting Poorly: Health Care in the U.S. Compared to Other High-Income Countries,” The Commonwealth Fund, 2021.08.04].
The Commonwealth Fund also notes that our healthier counterparts also support moms more by removing cost sharing for maternal care and providing more parental leave. They lower suicide (a growing cause of death in the U.S.) by offering better access to mental health services. And they all offer universal health insurance coverage:
The U.S. remains the only high-income country lacking universal health insurance coverage. With nearly 30 million people still uninsured and some 40 million with health plans that leave them potentially underinsured, out-of-pocket health care costs continue to mar U.S. health care performance.
Top-performing countries achieve near-universal coverage and much higher levels of protection against medical costs in the form of annual out-of-pocket caps on covered benefits and full coverage for highly beneficial preventive services, primary care, and effective treatments for chronic conditions. Germany abolished copayments for physician visits in 2013, while several countries have fixed annual out-of-pocket maximums for health expenditures (ranging from about USD 300 per year in Norway to USD 2,645 in Switzerland).
Australia addresses income-related equity through a mix of annual spending caps that are lower for low-income individuals as well as incentives for people to seek primary care. In 2019, 86 percent of Australians faced no out-of-pocket costs for primary care visits [Schneider, Shah, et al., 2021.08.04].
America’s chronic overspending and underperformance in health care has obvious policy fixes, modeled by all of our wealthy counterparts. How long will it take us to get over our inflated sense of exceptionalism and follow the lead of Norway, France, and other civilized countries to give all Americans better health care?
I think the key to healthcare is good food and water. Garbage in, garbage out.
I’d like to see our team take the Treasury and Fed back .. then divert all that stolen money back into restoration of the American Family Farm, but infused with technology assisted modern farming know-how to distribute the food system to every yard and window in America.
I was fortunate to have a diet growing-up consisting of hearty, nutrient dense food 75% of the time.
For many doctors, food is an afterthought since the pretty heaving bosomed pharma reps maintain an inventory of therapies meant to combat the symptoms of poor dietary choices. The more unhealthy eating in their market, the more therapies they sell and call it “healthcare”.
The costs of healthcare generally belie these facts while super stressful “jobs” and political shenanigans soak a person with cortisol.
Green spaces, bike paths, recreation centers, and hiking opportunities don’t seem to factor into healthcare costs, but should.
Do we have a pandemic of poor leadership in this regard?
Well Cory, just look at the trumpies in Sturgis today. They are the healthy face of the Republican party and soon they can spread it across the country. At least they will make America great again.
Green spaces, bike paths, recreation centers, and hiking opportunities, sounds like you like the Democrats infrastructure. Keep pushing it John.
I guess if there is an up side to the rally, is that they catch it here , but take it home with them, so not to many locals get sick and die. This is typical of this state, we do all the wrong things until we run out of wrong things to do and finally do the right thing. People have died, more will die and no one cares until it affects them personally and even then if they garner an inheritance, well OK with that.
**EXCEPTIONALISM** Throughout my entire life living in the United States of America, I’ve had an issue with this word and the arrogance it generates. I view exceptionalism as believing one is superior to others. I have never agreed, that in America, we should teach our children to believe they are “exceptional”. It’s certainly NOT a principle Jesus Christ tought his followers as many keep telling us we are a “Christian Nation”. Jesus never taught to view yourself better than your neighbor. Cory, this is the same view our high and mighty Governor expressed the other day in affirming that “America Exceptionalism” should remain in our social & historical curriculum taught to our children. “American Exceptionalism” is what George W. Bush & Dick Cheney pushed through the media in their justification for destroying Iraq and destabilizing the Middle East. They believed our “American Exceptionalism” could save the Iraqis from themselves. “American Exceptionalism” is what breeds our “ugly American” attitude toward others in the world as if we know what’s best for everyone else. We need to STOP teaching American Exceptionalism and START living up to the values of helping our neighbors we so much like to profess as Americans and some of us, “Christians.”
Cory, I digressed a bit when you ended your latest article with the term “exceptionalism”. It had to be said. Your analysis of our CORRUPT medical care system is spot on. The studies you sight are wide eye-opening! The most powerful and wealthy nation on earth comes in dead last among all industrialized nations for healthcare. Very sad to see this and it goes with all the other corruption bred by extreme greed and selfishness in our nation.
https://www.wonkette.com/usa-celebrates-amazing-17-year-streak-of-having-worst-most-expensive-health-care-in-the-world
17 years ago I was 17 years younger.
Commonwealth finds U.S last again in healthcare for citizens–as profits abound for U.S. health insurers.
https://www.commondreams.org/news/2021/08/06/aint-right-top-us-insurers-made-11-billion-2nd-quarter
Every now and then John Dale has something intelligent to say. I agree. Nutritious food, good quality water, clean air, substantial physical activity and a minimal amount of stress are the building blocks of good health.
I agree with Guy’s take on “exceptionalism” only I believe it to be a by-product of white supremacy declaring that America is the greatest and it is pretty good, especially for white people. This attitude has absorbed itself into all disciplines of life only to make America lax and lazy while other developed countries have left us sucking wind and that includes the medical fields. If one can not provide good service, just keep charging more and make people think that high prices provides better results.
Growing up we had little but healthy foods, clean air and water and plenty of exercise. Once my career kicked in, too much work and big financial bills, less exercise and more over eating or poor food choices. I dont know what to blame. Our environment promotes too much non nutritious food & unnecessary spending, i guess. Then our health suffers thus the cycle continues.
You know, I’m on a Medicare plan. My wife and I check it every year to make sure it’s the best in our zip code. The Medicare plan people have simply opened up to the market and let people pick. This year we got some dental also. All at no cost to us other than what everyone pays for Medicare. So conservatives don’t know what they are talking about when they talk about government control. We currently have Aetna and I’ve had no problem with them on anything. Some of my wife’s friends laugh at us and pay extra for plans that are basically useless, now thats just stealing, but it’s all legal. All the plans vary somewhat but if you have a particular issue say a medication that costs more you can balance your plan, say give something up to lower the cost of your medication. It takes some time checking but it works. To me it’s the best. A combination of government paying with your 150 thrown in, and the consumer picking the plan that best fits them. A win, win in other words. Aetna takes care of you too, they send a nurse every year that gives you tests checks for meds, contacts your doctor.he spend money doing that but it keeps you out of the emergency room. Savings for them and a better quality of life for you. I wish all Americans could do this. Just don’t trust former quarterbacks on TV. We started checking when I retired. Some books from triple AAA helped. At first I was ready to spend an additional 200 or more a month on insurance, but you don’t need it, those are the most rip off plans in the world.
Mark Anderson, is that a Medigap Plan? Are you in S.D.? We don’t get Aetna here. Bummer
I’m in Florida and they have three or four Aetna plans to choose from along with many others. Its a chore but for now we’re sticking with Aetna. It’s a Medicare Value HMO. It’s just nice that you could stick with the basics from Medicare or have a private insurer that covers more at no extra cost. Their advantage is keeping you healthy, they win, you win.
“We don’t get Aetna here. Bummer.”
You know why, don’t you.
https://www.fischerrounds.com/
The original meaning/use of the term American Exceptionalism had nothing to do with superiority or goodness – but rather referred to its form of government being the EXCEPTION to the rule. I.E. a different or unique form of government to the typical – at the time.
Perhaps you are right ,Richard, but those same people considered blacks only 3/5ths of a person and the natives of America less than human and subjected them to genocide.
cibvet, The term was first used by deTocqueville – a French tourist – not the Americans themselves.
Guy, I agree that exceptionalism as interpreted by my racist neighbors translates as, “white Christians here in the promised land are better than all those brown savages and limp-wristed Frenchies!” I agree that we need to abandon the empty rhetoric of American superiority when facts make clear we are failing to craft effective policy and institutions. We are obviously knuckleheads when we pour loads of GDP into private insurance profits (as Marie helpfully points out) instead of actual health care.
But could exceptionalism be a positive force if we took it as not a description of our superiority but a commitment to be the best? I see nothing wrong with saying, “We’re #1!” if we are actually #1. I see nothing wrong with working as a legislator, governor, or President to craft the best policies in the world, to set goals to show the biggest decrease in preventable mortality, the lowest number of uninsured citizens, the lowest infant and maternal mortality rates, the most affordable hospitals (and universities, and public transit, and groceries…).
How to trick magats into masking up.
https://pbs.twimg.com/media/E8UHsTVVkAYcEGw?format=jpg&name=medium