How does the US health care system measure up to others?

My wife, my daughter, and I have been in Canada now for twelve years, but I can no longer imagine life without Medicare.  I have become a Canadian, through and through.  Or, just maybe, I always was but didn't realize it until I was 48 years old.

Here's what I believe:  Access to essential medical care is a basic human need and I believe it is a human right.

And, I might add, I have absolutely nothing but the highest praise for the medical care we've received here in New Brunswick.  We've had excellent and prompt care from specialists (oncology, radiology, dermatology, and neurology), from our family doctor, and from blood clinics and emergency services.  Our experience may not be typical, but it is my first-hand experience.  It's what I know to be true.  New Brunswick's Medicare system is far from perfect, I know that, but flaws in the Canadian system do not "prove" that the American medical system is better.  

Canada's health care system is truly excellent.  But eight years ago, during the debate on the Affordable Care Act, Senate Minority Leader Mitch McConnell (R-KY) made in a speech on the Senate floor in which he insisted that Americans will not accept a health care system like those of Great Britain, Canada, and New Zealand.  Really?  I think he's wrong about the American people.   I know he's wrong about the "terrible" health care systems of the three countries he picked to compare with that of the US.  Actually, though, it wouldn't matter what three countries he picked, since in every other developed country in the world, health care spending is lower than it is in the United States, and results are better than those of the United States.

But Mitch McConnell chose Canada, New Zealand, and the United Kingdom to make his point.  That wasn't an "error of judgment."  It was a display of ignorance.  It was a very stupid thing to say.  But he did it and, so, let's look at some measures of the quality of health care in those three countries, and compare them to the same results for the United States.  
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Let's start with per capita health care spending, how does the US stack up against the other three?

United States: $9,451

Canada: $4,608

United Kingdom: $4,003

New Zealand: $3,590

Source: http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_%28PPP%29_per_capita

And total health care spending as a percent of each nation's GDP:

United States: 17.1%

New Zealand: 11.0%

Canada: 10.4%

United Kingdom: 9.1%

Source:  https://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?locations=US-CA-GB-NZ

Infant mortality rates (the number of children, per thousand who were born live, who die within their first year of life)

United States: 6.5

New Zealand: 5.7

Canada: 4.9

United Kingdom: 4.2

Source:  https://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate#Under-five_mortality_from_the_World_Health_Organization

The probability of a newborn making it to age 65:

Canada: 82.3%

United Kingdom: 81.5%

New Zealand: 80.9%

United States: 77.4%

Source:  http://www.nationmaster.com/graph/hea_pro_of_rea_65_mal-health-probability-reaching-65-male

Life expectancy at birth for the total population (male and female), considered a good indicator of overall health.  The gap in life expectancy between Canada and the U.S.  continues to widen.

Canada: 82.2 years

New Zealand: 81.6 years

United Kingdom: 81.2 years

United States: 79.3 years

Source:  http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

And, my own favourite statistic, expected number of healthy years of life?

Canada: 72.3 years

New Zealand: 71.6 years

United Kingdom: 71.4 years

United States: 69.1 years

Source:  https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

"the Truth shall make you free"

For the first 48 years of my life, I paid almost no attention to current events or politics. Like sports, those were things I didn't discuss with others.  I didn't feel I knew enough about any of those to have a strong opinion, and I didn't have the time or the inclination to learn more than I already knew.  I was happy living like that.

I voted, of course, that was expected of me.  For for 30 of those years, I voted Republican in two different Deep South states (Tennessee and Alabama) ... as a conservative Protestant Christian, I really didn't have to consider how I'd vote or even really care.  I just did as I was expected to.

And then ... ok, what the hell happened to my America when I wasn't watching?  It seemed to turn to shit overnight.

And I suddenly found myself struggling to understand things I never cared about before ... and what I learned turned my comfortable world upside down.  The list of things I was absolutely wrong about was long.  Every day, it seemed, I discovered some new fallacy in my understanding of the world.  Cold War propaganda had worked like magic on me.

I learned this: if you are interested only in the truth, you have to avoid the US mainstream media almost completely. Not that the truth doesn't surface in the US media; it's just much harder to discern. What's truth, and what is "spin"?  You can't tell anymore.

A good rule of thumb is this; if it's a mainstream news outlet based in the US, it almost certainly slants the truth ... to the right, to the left; does it matter which? The US news media plays to an audience that believes that the truth is whatever they want to hear. Americans tend to search out "news" sources that tell them the most comfortable lies.

The fact is, though, most people don't care to know the truth anymore. They think (like I once did) that they already know it. That's a "willful ignorance" and its societal suicide. Head–>Sand.

One good way to verify which are good news sites is to find a significant news item and see who carried it; and, if you're not sure it's true, watch it to see if it is revealed as factual ... or as a fabrication.

And be sure to read non-US news sites. Trust me on this: if you had been paying attention to non-US news sources in January, 2003, you would not believe that "before the invasion of Iraq, everyone thought it was the right thing to do." There was a serious debate about it, then, though most Americans (including myself, living in rural Alabama) were not even remotely aware of it. 

For what it's worth:  those who questioned the Bush Administration and the "evidence" they presented to justify the invasion of Iraq were right to do so. 100% right.  One month before the US invaded Iraq (a tiny defenceless country that posed no threat the US), a future presidential candidate spoke these words in a speech at Drake University in Des Moines, Iowa:

"I firmly believe that the president is focusing our diplomats, our

 military, our intelligence agencies, and even our people on the wrong

 war, at the wrong time.  Iraq is a divided country, with Sunni, Shia 

 and Kurdish factions that share both bitter rivalries and access

 to large quantities of arms."

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 http://www.gwu.edu/~action/2004/dean/dean021703sp.html

Yes, there were Americans saying the right thing, the problem was that too many Americans weren't listening ... they were caught up in a lynch mob mentality.  Were those who predicted America's failures in its foreign invasions able to see into the future?  Of course not.  Did they know something the rest of us couldn't know?  Nope ... they were only stating truths that were evident to those who hadn't already made up their minds, and were willingly blind to reason or truth.

Those leaders were right.  100% right. And so was Scott Ritter.

Stop the War! (1968)

Watching the 10-part (18 hour) documentary The Vietnam War on PBS, I was struck by what a large contingent of delegates at the 1968 Democratic nominating convention in Chicago raised signs in protest of the war ... and these were political party delegates ... mainstream Americans ... part of the system.

Vietnam, don't forget, was also a Democratic Party war.

What struck me was that, 50 years ago, the opposition to America's immoral (and illegal) war had definitely gone mainstream.  

And that is something that has changed dramatically in the half-century that has passed.

Americans today are far more passive in accepting an endless series of wars, known to be based largely on outright lies (as was Vietnam, which was the salient fact that was exposed in The Pentagon Pagers).  Americans are more than happy to yield their American value system (supposedly something for which they'd die) and all their civil liberties for empty promises of relief from fear.  Cowardly?  In the extreme.

Mainstream Americans today, regardless of which side of the political divide they stand, act like sheep; and neither political party has a monopoly on cowardice.  That's the one thing Americans share.

A tightly-controlled US press ensures that.

The uniformity of opinion molded by the media is reinforced through the skillfully orchestrated mass emotions of nationalism and patriotism, which paint all dissidents as “soft” or “unpatriotic.” The “patriotic” citizen, plagued by fear of job losses and possible terrorist attacks, unfailingly supports widespread surveillance and the militarized state. There is no questioning of the $1 trillion spent each year on defense. Military and intelligence agencies are held above government, as if somehow they are not part of the government. The most powerful instruments of state control effectively have no public oversight. We, as imperial citizens, are taught to be contemptuous of government bureaucracy, yet we stand like sheep before Homeland Security agents in airports and are mute when Congress permits our private correspondence and conversations to be monitored and archived. We endure more state control than at any time in U.S. history.

 

And yet the civic, patriotic, and political language we use to describe ourselves remains unchanged. We pay fealty to the same national symbols and iconography. We find our collective identity in the same national myths. We continue to deify the founding fathers. But the America we celebrate is an illusion. It does not exist.

– Chris Hedges

      Chicago, 1968

The staggering cost of empire

How much does it cost the United States to maintain its global empire and domestic security state? The following table summarizes defense-related costs in the US federal budget since 2003 plus supplemental spending (OCO=Overseas Contingency Operations, basically a un-allocated "slush fund). These numbers do not include other costs (such as the Department of Homeland Security, veteran's care and interest payments). The actual amount that Americans spend on their endless wars exceeds $1.2 trillion every single year.

The real costs of these wars, though (and the US is now involved in seven), are the "opportunity costs" ... what could have been done with that money?  What good could been done with that money?

Look what a sorry return Americans got for all those lives (over 6,251 American soldiers) and dollars spent (between US$4 and $6 trillion in Iraq and Afghanistan alone).  Fifteen years ago, I believe Americans chose a truly pathetic way to think and to live.  And now they're stuck with their wrong choice; the nation in involved in seven long-term wars it cannot win. Who can accept the astonishing stupidity of it, the utter mediocrity of a society that aspires to do nothing more, nothing better, with its tremendous wealth?

Maybe roads, schools, bridges, railroads, and dams don't matter as much as conquest and empire.  Maybe child development, education, old age security, unemployment benefits and health care don't matter as much as tax breaks for the ultra-rich.  But I choose to believe otherwise.  And my choice is one I can easily live with.

US Military Spending History since 2003:

FY	DoD Base  Budget	DoD OCO	Support Base	Support OCO	Total Spending
2003	$364.9	$72.5			$437.4
2004	$376.5	$91.1			$467.6
2005	$400.1	$78.8			$478.9
2006	$410.6	$124.0	$109.7		$644.3
2007	$431.5	$169.4	$120.6		$721.5
2008	$479.0	$186.9	$127.0		$792.9
2009	$513.2	$153.1	$149.4		$815.7
2010	$527.2	$163.1	$160.3	$0.3	$851.6
2011	$528.2	$158.8	$167.4	$0.7	$855.1
2012	$530.4	$115.1	$159.3	$11.5	$816.3
2013	$495.5	$82.1	$157.8	$11.0	$746.4
2014	$496.3	$85.2	$165.4	$6.7	$753.6
2015	$496.1	$64.2	$165.6	$10.5	$736.4
2016 Actual	$521.7	$58.6	$171.9	$15.1	$767.3
2017 Enacted	$516.1	$82.4	$175.8	$19.4	$793.7
2018 Budget	$574.5	$64.6	$173.5	$12.0	$824.6

They took an oath to serve

A good soldier follows orders, and does not question those orders, even when those orders are immoral or illegal. They "took an oath to serve." My country, right or wrong.

A good soldier always has the excuse that "I was just following orders." That absolves a good soldier for responsibility for his or her actions.

"Just following orders." That's the excuse that was used by the defendants at the Nuremberg trials ... that their oath of allegiance to the State, and to serve as an instrument of that state, absolved them of responsibility for their own actions.  They were hanged anyway ... the judgement of the court being that we are all, individually, responsible for our own actions.  Not the State, not the Marine Corps, the First Baptist Church, or the Boy Scouts of America.  

Moral autonomy is having the freedom and possessing the courage, and the will, to make moral decisions on one's own, individually.  It's standing on one's own two feet; and sometimes that requires sacrifice. There is no freedom without the exercise of autonomy. It is not a free nation that prohibits dissent.

Moral autonomy is at the root of what is termed "character."  Character is always individual.  You don't display character by joining a group.  Moral autonomy is the ability to choose the right course of action, by oneself, without any outside pressure or influence.

Our first allegiances, as men and women of characters, should always be to our principles, and to our families, those who depend on us, not to some oath of allegiance to a State.   To put allegiance to country above our principles is to act as a tool of an authority that seeks only to enrich and empower itself at our expense; in other words, to act as a slave, rather than a man. It is not merely a choice to act amorally, without conscience, giving over our moral choice to another; it is moral cowardice to refuse to do what we believe is right, using our "oath of allegiance" to excuse that choice.

Oath Keepers and Patriots, May 1941

Tommy Douglas, born October 20, 1904

Three years ago, in preparation for Canada's 150th birthday (which is this year), an online survey was conducted by the Canadian government, in which 12,000 Canadians participated.  They produced a list of the ten Canadians who are most esteemed by the Canadian public.   Only one of the 10 is a military leader.

When Canadians were given the chance to name the greatest Canadians ever, near the top of the list (which was headed by Pierre Elliot Trudeau, the prime minister who gave this country its Charter of Rights and Freedoms), they chose a diminutive rural minister from the prairie province of Saskatchewan, a man who espoused a philosophy of collective compassion, equal access to health treatment for all, and fairness in hiring, among other things.

Tommy Douglas, the Canadian social reform politician and Baptist minister, is honoured by Canadians for one thing ... he gave Canadians universal health care.  But it is not just Canada's health care system for which Canadians honour Douglas, it is his belief that every Canadian deserves the right to have quality health care, regardless of their economic or social situation.  That has become a core Canadian principle.

Tommy Douglas was born on October 20, 1904 in Falkirk, Scotland.  If you're Canadian, please take a minute to think about how we want to perceive ourselves, and be proud of a Canada in which a man like Tommy Douglas easily ranks among the greatest and most noble citizens.

Tommy Douglas

Top Canadian Heroes

1. Pierre Elliot Trudeau
2. Terry Fox
3. Tommy Douglas
4. Lester B. Pearson
5. Chris Hadfield
6. David Suzuki
7. Jack Layton
8. Sir John A. Macdonald
9. Wayne Gretzky
10. Romeo Dallaire

http://www.cbc.ca/news/canada/top-10-canadian-heroes-list-includes-pierre-trudeau-jack-layton-1.2676398

Howard Zinn called it "the unreported resistance"

Howard Zinn claimed that there has always been a very large group of Americans, probably tens of millions he said, who refuse, either actively or silently, to support the actions of the government.  The American electoral system is a total sham, he said, offering Americans no real choice in elections but acting together to ensure that wealth and power remain in the hands of a small group; and that Americans remain bitterly divided by narrow ideologies.

If Americans ever chose to cast aside those ideological differences and realize that they have one common enemy, the game would be up.

Zinn said that in nearly every one of America's wars, there has been a resistance that you largely never hear about. It goes unreported by the press, which acts to sustain an atmosphere of fear and hate and the official narrative that "our national security is under threat!"

Consider the first Gulf War in 1990/1991.  I remember it quite well.  My wife and I had our first (and only) child in February, 1991.  I remember sitting in bed, every night next to a very pregnant woman, watching the early weeks of the build-up to the ground war in Kuwait on TV.  I was following the whole thing very closely.  I thought I knew all the reasons for the US involvement in the war, and the strategy as it unfolded.  I was actually following the nightly news for the first time in more than 10 years and I think I knew more about what was going on in January, 1991 than most Americans did.

But you know what?  I cannot remember seeing images of the global resistance to that war, which was quite widespread.  Was that even shown on American television?  Perhaps.  I don't think so.  It was left "unreported," I believe.

Do you remember this?

On Saturday, January 14, 1991, the weekend before the US began its aerial (and naval) bombardment (on Thursday, January 17), 100,000 people marched against the war in London, 15,000 in Manchester, 10,000 in Glasgow, 3,000 in Bristol. There were also protests in many smaller cities.  250,000 people marched in 120 German cities. Over 200,000 marched in 150 towns and cities across France. 100,000 marched in Rome, 40,000 in Brussels and 60,000 in Istanbul. More than 75,000 attended rallies in Madrid and Barcelona, which ended in violent clashes with police. There were demonstrations in Switzerland, Norway, Sweden, in over 30 cities and towns in Canada, and all across the United States.

Do you remember that?  I don't.

Do you remember that, on the weekend that followed those protests, Saturday, January 18, 1991, there were two large antiwar demonstrations in Washington and San Francisco.  The size of the protest in Washington was estimated at 200,000 people (source).  

Remember that?  I don't.

And on January 26, 1991, which was nine days after the beginning of the war, over 150,000 people marched through the streets of Washington, and they listened all day to speakers denounce the war, including actors Susan Sarandon and Tim Robbins who were arrested. They heard from an Oakland, California woman who held up the folded American flag that was given to her when her husband was killed in Vietnam, and said, "I learned the hard way there is no glory in a folded flag."

Do you remember that huge anti-war demonstration?  I don't.

Most Americans were pretty complacent during "Operation Desert Storm", as always, but don't kid yourself ... there was a large (and, as Howard Zinn called it, unreported) resistance to that war.

And that resistance was always growing ... it was just getting started.  Considering that the protests were coordinated and organized largely with fax machines (there was no  Internet or "social media") and the entire war only lasted six weeks, I think the resistance was huge.  I think the size of the complacent, silent, but unreported, American resistance was massive.  

I'd have been part of it, if I had known it existed.  I did not.  Because my only source of information, in rural Alabama, was the news media, and they weren't reporting it.  

One more incident I'd like to ask if you remember:

Latinos have always been more conscious than other Americans of the imperial role the United States, because of US involvement in Latin and South American and the Caribbean (especially the US actions in Nicaragua, El Salvador, and Cuba).  During the Vietnam War, In 1970 there was a sizeable march in Los Angeles of Latinos protesting the war.  Those marchers were attacked by police, three Chicanos were killed.  In the summer of 1990, well before most Americans had Kuwait on their radar screens, when the Bush administration was preparing for war against Iraq, thousands of people in Los Angeles marched along the same route they had taken twenty years before. when protesting the Vietnam war. They were among the first to mobilize against a war they knew was coming.  They tried to stop it.  But you know what?  That protest went largely unreported.

Do you remember that?  I don't. 

The unreported resistance.  I'm part of it.