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In health care, America is falling further behind its economic peers


As we continue to get wrapped around the axle of intricate detail in the Affordable Care Act (ACA) now before the U.S. Supreme Court, we are experiencing a classic case of not seeing the forest for the trees.

While we debate the minutia of a several-thousand-page document, and critics such as Rep. Michele Bachmann claim it will “infringe on personal liberty,” what we really ought to be discussing is assuring that all of our citizens will have affordable and universal health care – just as every developed nation in the world, except one, now provides its citizens!  The one developed nation without universal health care: the United States of America.

The arguments against the insurance mandate are so spurious and weak (when viewed globally), it is surprising they are even being challenged. Indeed, that is precisely how the rest of the world is getting healthier, while we lag behind.

The United Nations has long had criteria as to what constitutes an “industrialized, developed nation.” There are currently 33 on that list. Of that number, 32 have universal health care — all except the United States of America. Furthermore, without exception, all pay through some sort of mandatory fee, tax or other compensation from all its citizens.

The three basic methods

There are three basic methods of collecting needed funds so that all citizens get full health care: both preventive and treatment. And all three methods have been longstanding and successful. One is the insurance mandate, now being challenged in the Supreme Court. Among the nations that have such a plan, the most successful are several European countries (notably Germany with a highly regarded health-care system). Very simply, the government mandates that all citizens purchase insurance, whether from private, public or nonprofit insurers; and if from private sources, no one can be rejected.

Some countries have what is called a “two tiered plan.” The government provides or mandates catastrophic or minimum insurance coverage for everyone.  Additional voluntary insurance or fee-for service care can be purchased if desired.  Thus, the government provides a core policy which can be supplemented with private insurance. But everyone is covered. We attempted to employ a variation of that idea with the “public option” in our legislative health care debates, but that was quickly rejected by conservatives in Congress.

Then there is the single payer plan, which about half the developed nations utilize. Again, rejected by conservatives, and badly mischaracterized as some sort of socialized medicine. The fact is, the actual medical care (with the exception of a couple of countries) is carried out by private providers. In short: your doctor. This is not unlike our highly successful and highly regarded Medicare system. Also, already government run, and widely accepted are the military Tricare and VA programs. And few complain about “infringement on personal liberty.”

The effects on health outcomes

So, while we clearly are out of step with the rest of the developed world on universal health-care programs, what is often lost in this debate are the effects this has in the overall health of our nation. There are a number of ways to determine the “health” of a country, but perhaps the simplest one, and most easily defined, is life expectancy. Notably, virtually every country (of the 32 countries referred to above) with universal health care is in the top tier of longevity. The United States now ranks 34th on that list, according to the World Health Organization.

Another measure is infant mortality. According the 2009 CIA World Factbook, which tracks such things, the United States is now 49th in the world in that statistic. But that is not the worst of it, because as far back as 1950, we ranked among the best in the world; now dozens of countries have passed us by.  Even more distressing, with our continuing slide down the slippery slope of declining health-care results, is the fact that we now have the most expensive health-care system in the world.

Critics (and those who commenced the SCOTUS lawsuit), are now trying to find cover for scuttling the ACA under “constitutional” grounds. While they may find success, it is widely acknowleged that such a decision will almost certainly be made by the court on political leanings rather than legal, as many of our previous 5-to-4 decisions have been in recent years. And that would be a significant loss for health care in America.

A pragmatic premise

The Affordable Care Act is an attempt to redress the weaknesses that have existed in our nation’s health-care system. It provides a mechanism whereby the 45 million uninsured (about 15 percent of our population) are afforded essential availability to health care. It employs a payment plan that has been successfully adopted by every other developed nation in the world – and no nation has ever reversed the plan or characterized it as unfair or unreasonable.

It is based on the pragmatic premise that if each of us sacrifices modestly, there will be a greater good for the whole – and from that we too will end up being enriched.  And that means we all will be living in a healthier, more vibrant, more robust America. 

Myles Spicer of Minnetonka has spent his business career as a professional writer and owned several successful ad agencies over the past 45 years.


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Comments (10)

  1. Submitted by Greg Kapphahn on 04/13/2012 - 10:46 am.

    Our Rejection of Universal Health Care is a Symptom of Illness

    As long as a substantial portion of our nation’s population continues to listen to those who seek to manipulate them by playing on their insecurities, their lack of compassion and empathy, and their selfishness,…

    as long as so many of us cling to faith in religious institutions and religious leaders that are earnestly seeking after, and leading us to seek after the same temptations to glory, wealth, and turning God into our own personal concierge that Jesus of Nazareth rejected in the wilderness when He was tempted by Satan,…

    and as long as “conservatives” continue to believe that “every man (and I DO mean men) for himself,” leads to something other than chaos where the biggest bully (the person willing to inflict the most damage on those around them) in each neighborhood or location rules over everyone else,…

    the exact attitudes upon which the opposition to universal health care are based (despite the pretty-sounding lipstick that the most dysfunctionally miserly among those people with the MOST insist on attempting to apply to that dangerous and destructive attitude),…

    that attitude will act like a dose of radioactive poison surreptitiously added to our food to gradually melt this nation from within, destroying everything that once made us strong, and fantastically successful.

    The underlying question is this: will we continue to let these very-well-financed sociopaths play on our pathetic insecurities, and play us off as enemies to each other, and thereby allow them to continue to poison our hearts and minds and souls?

    If we don’t learn to identify and resist their poison(s), they will successfully manage to get us to destroy each other and our nation for no other reason but that they believe they will gain financially from our doing so.

  2. Submitted by rolf westgard on 04/13/2012 - 11:31 am.

    Right on, Myles. But don’t count on any large share of elected representatives in St Paul or DC to get the point. It’s not like we have to invent a system. We can see how it works in other developed nations.

  3. Submitted by Karen Sandness on 04/13/2012 - 12:47 pm.

    One thing about the German plan with private insurance

    is that the insurance companies are much more regulated than they are here.

    There are limits on executive compensation and premiums, and the companies are required to pay claims within a certain time frame without question unless they can *prove* fraud. There are also strong limits on out-of-pocket costs.

    Under Japan’s system, most people receive health insurance from their employers, but there’s also a public option, with largely identical costs and benefits, for those who do not. Premiums are based on income, not on age or state of health. There are co-pays but no deductibles, and if your out-of-pocket expenses exceed a certain maximum, you can apply for compensation from the government. If you have one of about twenty chronic or catastrophic conditions, the government plan picks up the full tab with no deductible.

    I’d also like to add that there are really four models for health care, because models like Canada’s single-payer system and Britain’s National Health Service are quite different.

    Canada does not allow private insurance except for extras not covered by the national plan, but most of its health care workers are in private practice.

    In the UK, most health care workers are government employees and most health care facilities are government-owned, and health care is free at the point of service, being paid for by tax revenues, but individuals can buy private insurance and patronize private doctors if they so choose.

  4. Submitted by myles spicer on 04/13/2012 - 02:48 pm.


    As an FYI, I did say “a couple of countries” did have socialized medicine. these being UK (as you noted) Finland, Spain, Israel, and Cuba. I have not even suggested that we adopt such a system, others work just as welI and are more tenable and possible in America. I have lots of Canadian friends, and without exception they would not trade their system for ours (as would most other countries). In short, we are hamstrung and damaged by irrelevant idealogical forces rather than rational, effective, proven solutions all other similar countries now enjoy.

  5. Submitted by Solly Johnson on 04/13/2012 - 04:04 pm.

    socialized medicine

    I lived and worked abroad in socialist nations for fifteen years, and the medical care in some of those nations is superior in quality and much more inexpensive than in the USA. Many of us who have had experiences living abroad travel back to those nations for medical care, since the savings in medical bills allows us to incorporate a personal trip at the same time. Rarely does one see any news coverage regarding medical tourism in the mainstream media, since it is controlled by the corporate plutocracy.

  6. Submitted by Jon Kingstad on 04/13/2012 - 08:15 pm.

    “Socialized” medicine

    is the name the right like to give to things they don’t like, as if “socialist” was equivalent to “communist” which as we all know is “un-American” whatever that is. “Socialized” in this instance is merely a corruption of the phrase “social insurance” which is what Social Security is and what countries like Germany have enjoyed since Bismarck was Chancellor in the 1870’s. Unemployment insurance and worker compensation insurance are other forms of social insurance that have long been accepted in this country.

    Calling something you don;t like is way of ending discussion or exchange of information which is what the right is all about. Like “Class warfare” which is another corruption of the phrase “class legislation” and a confusion of that concept with Marx’s idea of struggle of the classes. So much energy is wasted on defining terms and misusing language and ideas so nothing ever gets done.

  7. Submitted by myles spicer on 04/14/2012 - 10:41 am.


    I am 79 years old and like most of my peer group served in either WWII or Korea, or both. thus, I have many friends with military service. Several enjoy Tricare, and we all have the VA medical plan. Both are totally “socialized” medical plans with government owned facilities and doctors. Yet, my friends are the loudest ones to complain about too much government etc. When I point out this hypocrisy, they seem to have some weak excuse why THEY should have such benefits while others should not.

    It is the height of irony, but I have long given up trying to open their closed minds…I am apparently tilting at windmills

  8. Submitted by Joe Musich on 04/15/2012 - 11:37 am.

    the land of the lazy

    More and more the discussion of healthcare seems like a story line out of Boardwalk Empire. The question is will my health allow me to outlive the corruption ? Maybe that is what broadkorp suddenly out of work with no healthcare.

  9. Submitted by Dennis Tester on 04/15/2012 - 03:30 pm.

    THEY should have such benefits

    Because they earned them by risking their life for their country. If everyone who wants free health care had risked their life for their country than everyone would deserve free health care.

    We became the freeist, wealthiest, most powerful nation in the history of the world for a reason. And it wasn’t by adopting the socialist policies of Europe.

  10. Submitted by myles spicer on 04/16/2012 - 08:35 am.

    I speak from experience…

    OK Dennis, actually, I TOO am a service disabled vet from the Korean era. Sure I earned having some VA benefits — but as a vet, I KNOW it is a system that works. And with that knowledge, why should other Americans enjoy a government run system that works?

    The short answer is…they should, just like me. The only reason they don’t is because people like you say its OK for vets to have excellent government care but not others — only for ideological reasons (not logical ones). In a sense all older people have “earned” the right for government care (Medicare) too — they paid for it with fees and taxes, and Medicare is a well run program with minimal adminstration costs. Now it is time for the rest of our citizens to have universal health care as well — and with some public/private cooperation, they can!

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