I limit my social media engagement to three sites at this point. I am a viewer of Instagram (I never have posted) and I find it a nice and easy way to follow the whereabouts and doings of my children and nieces/nephews. I started on Instagram specifically because I found that my kids were posting away from me when I was on Facebook and I decided to get sneaky and sign up for Instagram to find out what they were up to. Now I clear out my Instagram inbox every couple of days and basically give them all a heart when I see them posting so that they know I’m paying attention and that I love them all. I also use Snapchat, which is sort of the official site of Marin Madness, out family site where we post pictures and videos and commentary amongst all my kids and their significant others. I regularly post on Snapchat as a way to keep them informed of what we are up to. When Snapchat sends me suggestions of new friends to follow, I generally ignore them because I want this to be exclusively about my nuclear family. The last of the social media sites that I subscribe to is LinkedIn. I find LinkedIn very useful to keep in lose touch with a broad array of acquaintances rather than close friends (though I do occasionally cross paths with close friends on LinkedIn). I also find that the content that people I know post is sometimes especially interesting and useful as grist for the writing mill.
Yesterday I happened upon a post from someone I vaguely know, but it caught my eye because it was an animated post that was actually a visualization of a graph with a time sequence element of it. Specifically, it was about the American healthcare system and it combined two datapoints that I have tended to track independently. For all the major countries of the world, it showed a chart that plotted healthcare costs per capita versus life expectancy. That is an interesting and very logical juxtapositioning when you think about it. I’m sure people will say that the two are not directly correlated and they are probably right if taken on a person by person basis, but in aggregate it probably is more meaningful. We have all noticed that the life expectancy of Americans have generally been lower than most of Europe and Japan. We attribute that to everything from the Mediterranean diet to the Japanese fish diet versus the American high fat and junk food diet. I have also assumed that our life expectancy numbers are lower because of our higher level of immigration wherein it takes a generation or two of American nutrition for immigrants to pick up lifespan improvement (as much as that seems counterintuitive given the high fat and junk food nature of it). Actually, I suspect it is all about early life nutrition for babies that tends to strengthen the vitality and lifespan prospects of Americanizing immigrant children.
Today I also noticed that the young man apprehended in Altoona, PA and indicted for the murder of United Healthcare CEO, Brian Thompson, a man named Luigi Mangione, had in his possession some admissions including an exhortation of the American healthcare system, saying that it was the highest cost system in the world and that American longevity ranked 42nd in the world, thereby decrying the systems ineffectiveness and antisocial corruption.
I am not in the habit of reviewing the exact same factual evidence as a convicted assassin and coming to the same conclusion, but I have to say that that chart was an eye popper. It was so stark that I brought it to Kim’s attention, which I would not usually do with a piece of demographic data. The story it told visually was that the U.S. healthcare system is a dramatic outlier in that its cost on a per capita basis is vastly higher than any other country. This was a scatter diagram with a cloud of datapoints representing all the other countries in one large grouping and then the U.S. totally separate by virtue of its far excessive costs per capita. But wait, there is more. In addition to being an outlier on the cost axis, it was also an outlier on the longevity axis. This other cloud of country datapoints were also clustered at a much higher life expectancy level than the U.S. Once again, this was not just a case of the U.S. being at the outer downward extreme, but rather that it was WAY below the norm for all the other countries. And then there was the time sequence portion of the dynamic chart. As time passed over the fifty years captured, the extreme outlier level in terms of costs kept increasing and shows no signs of slowing down its distancing against other country’s norms. Additionally, and perhaps most upsetting, the U.S. life expectancy has not even kept pace with the growth of life expectancy by the other countries. In other words, we seem to be falling behind on both dimensions in a way that cannot be considered random or insignificant.
When I lived in Toronto Canada for two years, thirty-four years ago, I used to note that the socialized medicine (what we would call Universal Healthcare these days) system was able to work so well because Canada was fortunate enough to be situated within easy reach of the American healthcare system. That way, if the best doctors flee Canada for a more prosperous career in the U.S., they could be accessed by Canadians through a voucher system which seemed to be very efficient and cost-effective. I’m not sure the same could be suggested today. I hear more about Americans going to Mexico for cost-effective and highly competent surgical treatment or to get drugs at fair prices. I recall that when we were in Italy during COVID, we needed to get tested in Rome before being allowed on the flight to come home. I can say without hesitation that it was far easier and without cost to do that in Rome than it ever would have been in New York.
So what is at the heart of all of this? Is this about American students falling behind in their math/science scores and thus a system staffed by less qualified people? That may be a small part of the problem, but the largest part of the problem is our national trending tendency to be transactional about everything. Staunch American independence has translated into the belief that free enterprise allows anyone to charge whatever they want for their goods and services because to do otherwise would be anti-capitalistic. That, combined with a growing sense of caveat emptor through deregulation is thought to somehow be a healthy thing for American prosperity. I understand that the world moves in cycles and that at time personal liberty is more valued than concern for the common good, but when the U.S. is out of step altogether with the rest of humanity, there is simply something not right. We have allowed greed to overtake common sense and short term transactional thinking to take precedence over longer term ethical thinking.
We only get clear signals of turning points every so often, but the assassination of Brian Thompson, tragic though it certainly is, is hard to deny as a clear signal of a turning point. This is so much so that we need to step back and think about how well we are balancing this individual liberty and extreme capitalism against the sense of common good. What America needs to do to stay long term competitive and the best place to live in the world requires a better healthcare system.