First, let me say that I did get several responses suggesting that I keep this blog going. Perhaps I do have an audience greater than one, though writing for myself might justify this effort in and of itself. After all, the best conversations I have occur within the six inches or so between my ears. So, onwards … at least for the time being.

Second, I keep thinking that my next post will be light and frothy. Apparently, however, I have a lot of venting to do but the wit will not be far behind. I promise.

It is easy to be fuming these days. It remains shocking to me, and anyone with a minimal moral compass, that a major American political party has been cowed by a narcissistic sociopath who would leave the country in flames rather than face the consequences of his own actions. This reminds me of the McCarthyism of the 1950s though the country rather quickly came to its senses back then and censured that sick political pretender though much irreperable harm was done in the meantime. But I will leave Trump for another day or several days.

Today we take a peek at the topis of American Exceptionalism, the tendency for many people, and almost all Republican politicians, to claim that we are the best. We are the shining City on the Hill that stands as an exemplary beacon of hope for the world. I certainly believed that as a child growing up in the post WWII period. That youthful illusion is long gone. To be fair, let us take a look at one area where many claim that the U.S. is superior and see how we are doing.

This graph looks messy but is quite illuminating. It lays out three variables or dimensions … time (from around 1970 to just before the Covid pandemic), expected life expectancy (from less than 70 years of age to the mid 80s), and per-capita expenditures on health care adjusted for inflation and cross-country price differences (ranging from less than a thousand dollars to more than $10,000).

Now, if you got all that, here is the basic story. All the other countries depicted here spend much less per person on health than we do and yet all, every one, has a longer life expectancy … by several years. Many spend half of what we do for much better outcomes. Only Switzerland approaches us in outlays yet still spend about 70 percent as much as us. Yet, there is little outrage at this shocking performance.

Stunningly, Republicans often praise us as having the best health care system in the world. For example, we can see any doctor we would like without waiting times like they have uo in Canada with their socialist approach to care. They note that people fly in from other countries to avail themselves of our superior care. They somehow neglect to mention those that die or go without care because of costs. Very convenient.

They also don’t mention that these medical travelers often fly in from oil rich countries with bags full of money and to whom cost is not a factor. They seldom mention the migration of Americans to other countries seeking quality medical services at a fraction of the cost. And let’s look at those wait times in every other country that provides socialist care. Well, I never heard a Canadien complain nor express any freaking desire to become part of our system. Just the opposite, they manipulate their stays in the U.S. to maintain access to their own health care system. Besides, I live in Madison Wisconsin, which has great doctors and health facilities. There seems to be one such facility on every other block. And yet, try to get a non emergency appointment (e.g. a colonoscopy). My internist ordered one for me last fall and I won’t get in until the May (and I have great insurance).

I recall Paul Ryan, former Republican Speaker of the House and VP candidate who represented the district just south of me. He once proclaimed that our system was superior precisely because it was based on free market principles unlike all the other countries in the world which publicly guaranteed access and controlled prices. I guess he never looked at the data, or paid attention to the yearly 40,000 plus amenable deaths that occured when he made this claim, or the fact that two out of three U.S. bankruptcies are caused by exorbitant medical bills, the biggest reason for economic disaster by far.

Think about it for a moment. Paul enjoyed a Cadillac health insurance program as a Congessman. More to the point, buying health care is not like buying a car. It is not as easy to comparison shop. Who knows enough to sort through competing claims even if they have a decent concept of the specifics of their ailment. Nor do peope have a choice in many cases, not everyone can think about alternate providers when they have a heart attack. I recall terrible stories of my Florida neighbors whose spouses were carted off to the nearest (and profit based) cardiac care facility because that is what the emergency people do. Never, and I mean never, leave a loved one in the care of a facility whose motive is profit and not the well-being of the patient.

Despite Paul’s claim that our free markey approach leads to quality care, we have a semi-socialist system where the elderly, veterans, and the poor have publicly provided care, at least in part. It is not great coverage and Republicans would love to cut these programs back. Just imagine the suffering and dying, plus the economic hardship, that would result is they succeed. And don’t forget their franntic efforts to undo Obamacare despite public approval and the good the program did. There is one principle that dominates Republican thinking … if it doesn’t benefit the very rich, it is not a good thing.

Much more might be said but let me end with one more point … the fact that we do not view health care as a public good. Among other things, we give the markets considerable (though not always total) freedom to set prices. Guess what, they set them as high as they can get away with.

This is an easy chart to interpret. U.S. prices for drugs is much higher than in that damn Socialist country to our north. Moreover, the drugs are just as effective. Other countries offer even better prices. No wonder, so many go on drug holidays, and I don’t mean to buy a supply of weed. Many Americans must decide between food or medicine. Sometimes it is a matter of life and death.

I still laugh at the Republican claims that Obomacare would introduce death panels into our health care system. There have always been death panels and there there have always been well-paid people who act in ways that are criminally negligent with respect to human life. They are found running insurance companies, in the corporate offices of parmaceutical companies, and in the board rooms of some major medical facilities. Rick Scott, former Florida Governor and now Senator, ran a for-profit health company before entering poilitics. When he was in charge, his company was hit with the largest fines ever (to that point) for fraudulent billing of the federal government. I guess there is truth in the old British aphorism … steal a loaf of bread and go to prison, steal a railroad and go to Parliament.

There are a growing number of stories about people going to Europe for hip replacements and other more elective surgeries. Even with travel and other expenses, it is cheaper to go abroad if they don’t have great insurance. Even those with some coverage find the OOP (out of pocket) expenses in the U.S. exorbitant. This sad state of affairs will never change as long as health care is viewed as a profit center. If people have to die to sustain the bottom line so be it. Just the cost of doing business. That is an unacceptable cost to me. I am shocked that the public is not up-in-arms.

When Republicans state that it would be too expensive to provide health to all, ask them this … how does every other advanced country in the world provide health care as a public good?

American exceptionalism! You bet. We are just about the worst in the advanced world.

NOTE: Some argue that a ‘medicare for all’ approach would save money in the end fora variety of reasons including all the resources wasted on advertising and cost avoidance activities that do nothing to improve outcomes.