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America is the greatest country on Earth!
The strongest,
the richest,
the most powerful country on Earth.
As an American, I'm sure you've heard that
roughly 135 times a year.
235 if you go to public school
335 if you go to a christian academy
We're told that Americans have the best lives
of any people in the world.
That we have low taxes,
small government,
and the highest living standards on Earth.
And, most inaccurately, that we're the freest.
Well it is partly true,
America is the richest country,
not just in the world, but in the history of the world.
It's really hard to comprehend just how rich we are.
We have 18 million people who are millionaires.
American households own about 100 trillion dollars
in wealth, an almost unthinkable amount of money
Okay, so America is the richest country ever
but there's a curious paradox.
most Americans actually have a much worse
standard of living than people who live
in poorer countries like
Germany, or Finland, or Britain.
But how can that be?
That shouldn't make any sense.
Well, here's the shitty deal.
Americans get significantly worse services
because our tax dollars don't fund them.
So of course our services are worse
and thus, we enjoy less happy lives than
people who live in the aforementioned countries.
Not that difficult a concept to conceive, really.
"You get what you pay for!" said the cartoon dog
to the other cartoon dog.
And while you might think the reason American
tax dollars don't fund as many services
is because we pay lower taxes than other countries
that's not even true!
When you add federal, state, local, and sales taxes and
include other costs and services that our taxes don't cover
but other countries taxes do,
like our uniquely high health insurance premiums,
you'll find that Americans actually give away
MORE of their wages than most of the developed world.
For example,
in Canada, for a married worker with two kids,
all the previously mentioned costs combined,
from taxes to health insurance premiums,
make up only 11 of the average wage
in the uk it's just about 26%.
Meanwhile, once you tack on the cost of
our outlandish health insurance premiums,
you're spending a whopping 43% of your paycheck
that's more than France Finland Sweden and Norway.
In real reality, Americans keep much less of
what we own than in other countries.
In other countries,
their government takes a bit more tax
but then gives that money back to their citizens
in the form of health care,
or job support,
or a general safety net for
all vulnerable citizens,
no matter how dusky they are.
So what do Americans get for the money we pay in?
Well sure, we get
a crumbling infrastructure,
shameful homelessness,
and millions of hungry, neglected children
BUT we also get some of the worst services in
the developed world.
Again, our healthcare.
American healthcare is simultaneously the most expensive,
the least efficient,
and the least effective healthcare system in
the developed world.
He-hey! The devil's trifecta.
and in exchange for this extremely expensive,
inefficient healthcare system, what do we get?
Well we get some of the worst health outcomes
in the developed world.
We have fewer hospital beds per capita
than people in Turkey or Brunei
americans have a lower life expectancy than
people in Lebanon or Cuba
and in the Mississippi Delta, and much of Appalachia?
Life expectancy is lower than in Bangladesh.
In fact, in 2017, the United Nations sent
a commissioner to West Virginia to document
what he saw and he described
"third world conditions of absolute poverty."
We even have a higher infant mortality rate
than people in Russia and Serbia.
In every single metric, America does worse
across the board.
So why is healthcare so expensive?
Because it's so complicated.
You have to look for in-network physicians,
schedule an established care appointment,
beg for coverage from your insurance company
that couldn't care less about you,
and that's if you're lucky enough to have good insurance!
Compare that to Britain, and all of those other
evil socialist-like countries
where it's simple:
public hospitals provide free treatment to people who need it.
That's it
I'll repeat that.
Public hospitals provide free treatment to people who need it.
And here's the best part:
even though britain offers health care for free
their system is actually a lot cheaper to run
than ours.
Per capita healthcare spending in the U.S. is almost
three times what it is in Britain,
and almost five times what Canadians spend.
In fact Americans spend the most per person
of any country in the world for health care.
"But the free market is more efficient" you screech.
But in America, private systems often aren't efficient at all
private drug companies have an incentive to
charge whatever they can get away with for pharmaceuticals.
In Canada, a carton of insulin costs about 20 bucks.
In the U.S. it costs 300 bucks.
And with private insurance companies footing the bill,
hospitals have an incentive to get as much money
out of patients as possible too.
In 2015 the average cost of an mri scan
in the U.S. was $1119.
But it was only $215 in Australia.
Spain? About 181 bucks.
And our health care system is so inefficient
that we spend over a third of our costs on-
administration.
The United States spends significantly more
on administration than we spend on preventative
or long-term health care.
That's just not smart
"Okay, we get it. We all know that American health care
is so much more expensive," you say.
"But that's the cost of having the freest freedom
in God's favorite country!"
Well... guess what?
Medical procedures that are totally free in Britain,
like giving birth,
cost tens of thousands of dollars in the United States.
I mean you want to talk about the cost of freedom.
Sadly, because of these high costs,
Americans often avoid going to the doctor,
something almost half the population say they do.
with shoddy or non-existent health insurance,
Americans will wait until their conditions force them into
the emergency room, where treatment is
far more expensive.
Again, not a smart system.
Quite often, they end up putting off medical visits and dying.
Susan Finley, a 53 year old Walmart employee in Colorado,
got pneumonia and took one day off of work
beyond what Walmart's policy allows.
So of course, Walmart's going to Walmart
which they did, by firing her.
Without her job she lost her nominal health care coverage,
she struggled to find new work,
and after avoiding a visit to the doctor for
flu-like symptoms, she was found dead in her apartment.
When Americans do manage to get treated,
they frequently can't afford it.
Simple, life-saving treatments can cost
tens or hundreds of thousands of dollars and
if they don't have really good insurance
they're forced to take on medical debt.
Tens of millions of Americans owe medical debt,
often into the tens of thousands of dollars.
Meanwhile in a country like Britain or Norway,
Medical debt is almost unheard of.
But hey, that's why GoFundMe is such a critical
component of American health care.
One in three GoFundMe campaigns is now for medical bills.
I'll repeat that,
one in three GoFundMe campaigns is now for medical bills.
America is such a strong, powerful, rich, and great country
that its citizens have to beg strangers on the internet
for money so they can get life-saving treatments
that are FREE in the rest of the developed world.
But hey, that's just healthcare.
Americans get terrible deals wherever you look.
Let's take work, for example.
Americans work longer hours than people in
any other rich country in the world,
and that's not because they enjoy sleep deprivation
and not seeing their families for days at a time.
It's because they don't want to starve, or freeze, or die.
See, America has the least generous job support programs,
the least generous family benefits,
and the least generous unemployment benefits
of any wealthy country.
It's one of the only countries on Earth
that doesn't guarantee paid time off for vacations.
It doesn't even help provide paid time off for parents
who JUST had a child.
And it's not coincidental that we're also
one of the most hostile countries to workers rights.
America has one of the lowest unionization rates
in the entire world.
Maybe this deprivation, our refusal to give people
the means to lead a good, dignified life, commensurate
with how rich our country is,
can explain a bit of what we've seen in the United States
over the last few decades.
Fraying communities,
rising rates of depression and suicide,
huge numbers of deaths from drug overdoses.
These so-called "deaths of despair,"
suicide,
drug overdoses,
alcoholic liver disease,
they're one big reason why American life expectancy
has actually started to decline over the last few years.
And with such poor conditions, it's not a surprise
that poverty is so rampant in the United States.
America devotes a smaller percentage of
spending on social welfare than any other
industrialized economy because,
say it with me,
socialism is evil.
It's evil!
Go to Denmark and try telling those
happy, healthy families enjoying their paid vacation
that their system of government is evil.
Guess what?
I guarantee they'll know you're an American
But I digress,
America also has the highest rate of child poverty
of any developed country, and the highest percentage
of workers earning significantly less than
the national median income.
THAT seems pretty evil to me.
Especially since such a tiny fraction
take as much of your money from themselves
and their families as you will let them.
All the while both parties smile
and shake hands.
Across every single metric,
no people accept a worse deal than Americans today.
high taxes,
high costs of living,
for next to nothing in return from the government.
The most expensive health care system,
for the worst health outcomes.
More money taken from workers,
for the highest rate of child poverty.
We are the richest country in the history of the world,
but we have fewer miles of high-speed rail than Uzbekistan.
We are the greatest country in the world,
yet we have the most people in prison of any country
and the highest incarceration rate as well.
And a higher rate of police killings than in Angola, and Sudan.
America is bad at everything because
instead of choosing to make life better
for people,
through a public health care system or
more generous child care policies,
or better public transit,
or programs that allow people to
spend more time with their families,
American law is designed and crafted
to protect a class of parasitical middleman industries.
Instead of using a proportionally tiny piece
of the massive amount of the wealth in this country
to make people's lives healthier and happier.
Most of our elected leaders are,
and have been for generations,
engaged in a massive project of
looting.
Gently and lovingly guiding as much money as possible
from working people into the
pockets of the well-connected and the ultra-rich.
Think about that as we start hearing about
the inevitable rise in
homelessness,
poverty,
starvation,
and sickness that will occur during
these coming months and years
in the greatest,
strongest,
richest,
most powerful country
on the face of the Earth
I'm David Cross, for the Gravel Institute.
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