Each time anyone voices support for universal healthcare or any other social benefit, another person will immediately jump in to say this: “Free stuff isn’t free!”
You know when we never hear that?
When we talk about things like public roadways, the national defense or even local things like police and fire.
We understand that some things benefit all of us and so all of us need to pay into them. It’s not very controversial to say that a city on a river requires a bridge. Nobody screams, “If you people want to cross that river so bad, you just need to get your ass into the water and swim!”
Even in the case of public schools, which do come with plenty of controversy, very few people call for outright closure. They might grumble about free school lunches or a curriculum they don’t like, but almost nobody thinks we should stop educating the public.
So it’s a matter of hashing out what stuff we think society as a whole should make sure is available for all, and what things we think individuals should pay for if they want them.
We’re No. 1!
American Exceptionalism tells us that we’re the best. We aren’t. Some things are better here and some things are better in other countries.
But people, in general, are gullible. I know some folks who will only buy a certain brand of canned green beans because they are “better,” when all canned green beans are awful. If you truly want quality green beans, you’ll have to start with fresh or frozen.
Others will pay twice as much for a certain brand of peanut butter or whatnot, just because they swallow the advertising. I’ve never understood such brand loyalty: How logical is it to believe the brand that spends more on advertising is actually of higher quality?
My dad worked in a food factory. Sometimes, a friend would claim Name Brand A was better than Store Brand B, and my dad would chuckle. He’d inform them the two items were packaged on the same line using the same ingredients. Literally nothing was different but the labels. They’d stop in the middle of a production run and switch the label and then proceed.
Yet I recall people arguing with him about it. I’m not saying one brand is never better than another, but I’m saying you should pay no mind to the advertising.
In a related matter, when I’m on hold with some company and a voice keeps breaking through the stale music to tell me how much they value me as a customer, I roll my eyes. If we were actually valued, of course, they’d hire more actual humans to take our calls.
But it’s way cheaper and easier to spend a little money telling the public how good your product or service is and how much you value them for being your customer than it is to simply improve what you’re offering.
And so it is with the U.S.
We could address our problems, but instead we push American Exceptionalism as a belief. Shockingly, billions of Americans swallow this, and that’s why we can’t fix anything.
Why change things when you’re already the best?
But I married a European
So I know better.
Because I have many European in-laws and friends, I’m more familiar than most Americans are about how differently things work in other countries.
Each time I visit the Netherlands, where my husband is a citizen, I have the same exact thought: “Why can’t Americans have nice things like this?”
It’s like stepping into an alternate reality — one in which the far-right did not squash all progressive ideas.
Things that seem like pipe dreams in the U.S. — affordable or free medical care for all, a comfortable work-life balance, unions that look out for workers, generous paid parental leave, free or subsidized daycare, smarter energy programs, solid social safety nets, free or affordable education, compassionate care for the elderly, healthier food, convenient public transportation and a million other things — are taken for granted in places like the Netherlands.
Systems and individuals
It isn’t that the Dutch don’t have any problems. Of course they do. But they seem to assume that one role of government is to set up systems in such a way that citizens’ lives are better. The same is true of many other countries.
In the U.S., there is no such assumption. It’s every man for himself here. Do several million of you think the system isn’t working well for you? Well, several million of you will need to figure out individually how to get by as best you can. We will not change the system.
The Dutch have multiple right-wing, central and far-left parties. After every election, the winning candidates have to form a coalition and work together.
The U.S. has two main parties: The far-right Republican party and the center-right Democrat party. By international standards, the Democrats are not liberal at all, let alone socialist or communist as some ill-informed far-right Americans claim. There’s little hashing things out. It’s more of a winner-take-all. Never mind what 49.9 percent of the population wants — they get nothing. The spoils go to the 50.1 percent who won.
Or, in the case of the presidency, the minority will repeatedly be able to grasp power over the wishes of the majority via the Electoral College.
Healthcare is a great example of what this has led to
I’ve made it a point to ask many Europeans how they feel about their healthcare. So far, every single person I’ve asked has had good things to say about the quality of their care and the cost.
Can you name even one American who can say the same?
Americans don’t agree about very much, but we do come together on this. Bring up this subject at any gathering and everyone is eager to tell their story about waiting forever to see a specialist, about being billed a fortune for something simple or about someone they know who went bankrupt after a serious illness.
There’s a but
But, they’ll add, other countries pay so much higher taxes.
This is true.
The U.S. has generally lower taxes than other well-off countries. According to the Tax Policy Center of the Urban Institute and the Brookings Institution, citizens of Denmark pay the highest taxes. The French are in second place. The U.S. is way down in 32nd place.
However, when you take into consideration what Americans pay annually in health insurance — and what their employer pays — plus what they pay out of pocket because their health insurance doesn’t cover everything, plus all the other things they get that Americans don’t even know about — it’s certain that most of us would be money ahead even if we did pay higher taxes.
Because everyone’s situation is different and the cost of health insurance, healthcare and taxes vary considerably by countless factors, it’s impossible to nail down an exact number. My health insurance costs and medical bills are no doubt quite different from yours, and so is my tax bill.
Of course, different countries use tax dollars in different ways. Many countries provide lengthy paid maternity and paternity leaves, plus free or heavily subsidized healthcare, daycare and college, for example, plus of course all the usual costs of running a country that you’d expect taxes to cover.
How much more money would be in the average family’s pockets if a university education, daycare and healthcare were free or nearly so?
American healthcare is generally inferior yet more expensive
You’ve probably heard people claim that in other countries, you have to wait to see a specialist. That’s hardly limited to other countries.
An older American I know just waited six months to see a cardiologist!
The U.S. pays more for its healthcare than any other country. Per capita, we pay $12,318. In second place is Germany, at $7,383, according to the World Economic Forum.
This might be somewhat acceptable if we at least had the best healthcare in the world for this high cost.
We do not.
The University of Michigan School of Public Health notes that even though we’re paying a lot, our outcomes are worse.
We have the lowest life expectancy at birth
We also have the highest maternal and infant mortality, according to The Commonwealth Fund. These are well-accepted measures of how well a country’s healthcare system is functioning, and we’re failing.
The Lancet is one of our most reputable medical journals. In Improving the prognosis of health care in the USA, the authors calculate that “a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than U.S $450 billion annually….”
That study notes that the entire system would cost less than employers, households and governments spend now, and would save 1.73 million human life-years every year compared with what we’re doing now.
World Health Systems Facts, a project of the Real Reporting Foundation, provides a nice comparison of costs and life expectancy by country, along with plenty of useful information.
Why would we not choose to implement a system that saves us money and keeps us healthier?
There’s a simple explanation: Americans are always afraid that somebody somewhere might get a benefit they did not work hard enough for. Many Americans would prefer to keep a wasteful and costly system that results in worse outcomes to avoid that.
Better that people go bankrupt and die prematurely than implement a system that will just give away free goodies like birth, knee replacements, chemotherapy and appendectomies. Or even yearly checkups, for that matter. I mean, can you imagine all the people lining up to have their healthy gallbladders removed if you could just have it done for free anytime you wanted?
It’s easy to make the case for providing universal health care. All the numbers speak for themselves. I think the same arguments apply to an awful lot of things that all of society benefits from but that not everyone can afford to access.
That’s not socialism or communism. It’s just setting up systems that work so people can thrive.
About Michelle Teheux
I’m a writer in central Illinois. If you like my work, subscribe to me here or on Medium. My new book is Strapped: Fighting for the soul of the American working class.
From the author of The Trailer Park Rules comes this enraging and engaging collection about all the ways our broken system sets us up to fail and whether there’s anything you can do about it.
Did you know that originally the term “bootstrapping” was used sarcastically to describe an impossible task? Yet now, the meaning has morphed into the opposite.
I invite you to give it a try. Reach back, grab your bootstraps and pull with all your might. How did that work out for you?
There’s a reason we tell people to pull themselves up by their own bootstraps even though we know it can’t be done. It’s one of the ways people in power keep the rest of us from complaining that we’re being screwed. We keep trying and trying and blaming ourselves when we have trouble. Of course we blame ourselves. Who else can we blame?
This is not a self-help book because you cannot single-handedly fix what’s wrong with the system by working harder or working smarter. There’s a good possibility that some of your problems are out of your hands.
This book was not written for the top 10 percent or for anyone who had life handed to them on a silver platter.
Instead, this book is for every working-class, lower-class and even middle-class person who has done everything right but still feels strapped.
Michelle, I agree that America can well afford to provide everyone with healthcare provided we had the will to raise taxes. Healthcare should be a right not a privilege. I didn't always believe this. But I do now.
My sister married an American 35 yrs ago and lives in the US. I love to visit her, like to be there, but no way move there. Too many people incarcerated, too many gun related crime, capital punishment...