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Tilting at Windmills

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October 14, 2009

BEST CARE ANYWHERE?.... With some regularity, Republican opponents of health care reform will defend the existing system, not only as adequate, but as superior to the rest of the planet. Senate Minority Leader Mitch McConnell (R-Ken.) was recently on "Meet the Press" and argued, "[W]e have the finest health care in the world now."

Around the same time, Sen. Richard Shelby's (R) of Alabama argued that the existing U.S. system is "the best ... the world has ever known."

Silly hyperbole notwithstanding, the strategy seems premised on appealing to Americans' civic pride -- the American system couldn't possibly be a dysfunctional mess, because it's the American system.

A new report from the Pew Research Center found that Americans aren't buying into the rhetoric.

According to Americans the United States does not have the best health care in the world. Most see our health care as average (32%) or below average (27%) when compared with health care in other industrialized countries. Only 15% support the often-used political talking point that America has the best health care in the world; 23% say it is above average.

Adam Serwer highlights a key observation from the report: "The survey also notes that the more money you make, the more likely you are to believe that America does have the best health care system in the world. That, I think, says a great deal about the inherent class bias present in our national debate on health care -- those most likely to give you the evening news are also those most likely to think there's nothing wrong with the health care system at all."

I'd just add that there's been a fairly aggressive effort underway for years to characterize health care systems outside the United States as dystopian nightmares. While some Americans are able to enjoy "the best health care system the world has ever known," the right has argued, non-Americans are forced to endure rationing, life-threatening wait times, soul-crushing bureaucracies, and sub-standard medical care. (That many of these problems already plague the U.S. system is an inconvenient detail, usually ignored.)

In reality, all other industrialized democracies spend less and get more. They have systems marked by "convenience, quality, and affordability." None of these countries wants their system to resemble the U.S. system in the slightest.

I don't imagine the typical American can speak in detail about the advantages of health care in France or the Netherlands, but there nevertheless seems to be a widespread understanding that our way of doing things is badly broken. The right's pitch -- trying to convince the public we have the best care anywhere -- hasn't worked.

Steve Benen 2:05 PM Permalink | Trackbacks | Comments (32)

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I think that it could be useful to respond with "it's true that some of the most technologically advanced treatments in the world can be purchased in the US." The problematic phrases are "we have" (we don't have, as a matter of fact) and "best," which is a completely uninformative term that does not refer to quality or effectiveness so much as newness (which is also restricted under private insurance in most cases).

Posted by: latts on October 14, 2009 at 2:10 PM | PERMALINK

the more money you make...

the vulgarity of this country is not so well hidden in that phrase, as is the deterioration of its democracy.

Posted by: neill on October 14, 2009 at 2:11 PM | PERMALINK

The survey also notes that the more money you make, the more likely you are to believe that America does have the best health care system in the world. That, I think, says a great deal about the inherent class bias present in our national debate on...

Nearly everything.

As distasteful as the "populist" rhetoric about class warfare might be to the formally insulated and fairly robust middle class, many of us are finally forced to admit the facts when "we" of all people are living in a climate of fear because of healthcare, education and housing costs in the face of stagnant wages and volatile employment.

First they came for the working poor...
Then they came for the skilled laborer...
Then they came for the professional...

You get the picture.

The problems is that most Americans imagine themselves as in an economic class higher and more secure than the actually are AND aspire to be "rich." Part of that is rampant consumerism, part of that is the arms race for housing in "good" school districts, and part is our national mythology about giving our children a better material standard of living than we enjoyed.

All of that is no longer operative.

Time to smell the generic, non-French roasted coffee.

Posted by: lobbygow on October 14, 2009 at 2:12 PM | PERMALINK

I think the propaganda has stuck pretty well, when the most likely response of people at ALL income
levels is that the US has above average healthcare.

Or, it is stupid for Steve B. to use this poll to counter the 'best healthcare in the world'
meme, since it does not address it.

It does _suggest_ that a poll on 'best healthcare in the world?' stratified by income would be revealing. But it is not one of those.

Posted by: catclub on October 14, 2009 at 2:15 PM | PERMALINK

i think this angle on this issue highlights the key difference between liberals and conservatives pretty well, distilling the party choice down to a single survey question: "do you give a rats ass about anyone other than yourself or your immediate family?" (or, perhaps, "which is more important to you, other human beings or one red cent of your money?") For conservatives, whether it is health care, education, or the environment what becomes of anyone else only matters if it doesn't cost them one thin dime that they think is theirs or could be theirs.

Specifically to health care, it is likely that both views are true, that the US health care system is the best in the world and that it is middling in outcomes for the cost -- depending on your viewing angle. I have one of the top Blue Cross plans, 95% employer paid. Sure I forego salary, but that difference doesn't threaten my lifestyle. I am in a mid-market -- fully equipped but no overcrowding. I've had the same family doctor - a former clinical instructor - most of my life. So for me, is probably the best care in the world.

Unlike Republicans, however, I am not so egocentric to think everyone is that fortunate. I understand that for many, they would be better off under another country's system. I'd be fine having my taxes raised, having new regulations enacted, etc. if it meant everyone could have care comparable to mine. I consider it patriotic to reject the notion that certain Americans would be better off in another country - a proud American should consider having the best system for every American to be aspirational, not just smoke to blow in the heat of political battle.

The Democrats in Congress are just as rich as the Republicans in Congress. The difference in how they vote on issues that help those less fortunate is entirely a matter of who is driven by greed and who has a sense of humanity.

Posted by: zeitgeist on October 14, 2009 at 2:21 PM | PERMALINK

Mitch McConnell and his 'superior' goons should be forced to clean out the latrines in all the FREE CLINICS in this country ...... after a few weeks of this then let's ask him about the 'best healthcare in the world' ..........

Posted by: stormskies on October 14, 2009 at 2:23 PM | PERMALINK

Well, certainly Mitch McChinless and Senator Shelby enjoy the best health care in the world.

Posted by: g on October 14, 2009 at 2:27 PM | PERMALINK

One of the more bizarre aspects of the health care situation is how the Republicans are dumping on our allies. Countries like the UK and Israel are being pointed to as socialist hellholes. Even countries whose whole existence is based on not being Communist like Taiwan and South Korea have apparently been subverted by the Red menace.

Posted by: ArkPanda on October 14, 2009 at 2:27 PM | PERMALINK

I'd like to see the entire senate take a field trip to one of those huge mobile health care clinics.

All of them. Make them sit there all day and listen to the people who can't afford care, or can't get insurance or have insurance and can't get the company to pay their benefits.

I'm sick of their nonsense. Sick of it.

Posted by: fourlegsgood on October 14, 2009 at 2:28 PM | PERMALINK

Senators and congresscritters arguably have some of the best healthcare in the world, and other than that it looks as if they don't know and they don't care.

Posted by: N.Wells on October 14, 2009 at 2:32 PM | PERMALINK

We may very well have the best health care in the world. But the access to it/distribution sure sucks.

Posted by: exlibra on October 14, 2009 at 2:33 PM | PERMALINK

I think the US has the best care that money can buy, and that's why rich people approve of it.

Posted by: Christopher on October 14, 2009 at 2:35 PM | PERMALINK

Over 95,000 people in the country die every where because of doctors mistakes. Another 300,000 go into hospitals and end up with something they did not have before they entered the hospital, and many of these die. Of all the countries in the world the U.S. is number 54 for infant mortality rates. Just for starters. Best health care in the world: nope, don't think so.

Posted by: stormskies on October 14, 2009 at 2:37 PM | PERMALINK

I don't know anybody currently employed who's crazy about the health care system. My father is the only one I know happy about it, and he's retired. He has good teacher union-provided health insurance, plus I guess Medicaid and the VA as backups. Even union members who currently have good insurance know their company is gunning for it in the next or on-going contract negotiations. Salaried workers without negotiating power are seeing their benefits being cut. A self-insured friend, who's previous job was a Republican political appointee civil service job, would love to sign up for the public option. So, just like in the town hall meetings, I think the only people standing up for the status quo are people who are already covered by the government.

Posted by: American Citizen on October 14, 2009 at 2:42 PM | PERMALINK

Fundamentally, their pitch on "best health care in the world" is similar to their pitch on taxes. We have the best care if money is no object, but that's not true for a large majority of people (including a large majority of the Republican base.) So they fearmonger the idea that there will be "rationing" and you won't be able to get that great care even if you become rich (and leave out the fact that you can't get it now, and are unlikely to become rich enough to get it), just like they sell tax cuts for the wealthy on the hope of their base that they'll be wealthy some day (and leave out the fact that it means higher taxes, reduced services, or higher deficits for you now.)

Posted by: Redshift on October 14, 2009 at 2:43 PM | PERMALINK

Saying that America has the "best healthcare in the world" is like saying America builds "the best cars in the world."

If you are rich enough to own a Corvette, Viper, or Tesla Roadster, you might be able to make an argument. But if you drive a Ford Windstar [hundreds of thousands recalled this morning for a faulty cruise control switch] and your nextdoor neighbor has a Turbo Carrera, you know the claim is bullshit.

Posted by: chrenson on October 14, 2009 at 2:44 PM | PERMALINK

It truly is the best health care money can buy.

Over the past few years, retail stores have gotten into the flu vaccination business. Where I live, you can't pass a grocery store or convenience store with out seeing 'Flu Shots Today' signs.

They all have policies which restrict administering them to children. For example, Target won't give them to children under nine and Walgreen's won't give them to children under fourteen.

The kicker is that the retailers have monopolized the supply. My child's doctor said their last order was canceled because it was out of stock. My family doctor is also out and can't order more currently. It is the same with every doctor in the area.

But I haven't driven past a Walgreen's that doesn't have them. Only they exclude one of the two at risk groups because they've deemed it a liability to their bottom line.

There is something very wrong with our system when doctors are unable to get vaccinations because retailers have decided the profit margins are good as long as you can monopolize the supply and bully the doctors out.

My anecdote is not an isolated incident.

Posted by: doubtful on October 14, 2009 at 2:50 PM | PERMALINK

Yep, and let's also remember that some one does in this country every FOUR MINUTES because they don't have health insurance because they can't afford it. The 'best health care in the world' ... right .. and fuck you ..

Posted by: stormskies on October 14, 2009 at 2:52 PM | PERMALINK

"None of these countries wants their system to resemble the U.S. system in the slightest."

Over here in Britain, I'm sad to say, we - have - been moving towards the American model of healthcare for the last 30 years. It's been wrapped up in terms like "modernisation" and "expanding choice", but the end result has been to put the NHS into hock to the private sector for hundreds of billions of pounds over decades long contracts.

That means for every pound in public money given to the NHS to provide healthcare and maintain its structure, a bigger and bigger chunk of that is being siphoned off into the coffers of and increasingly smaller number of private health-care providers, who then reward the government ministers who forced these deals on the NHS with massively well-paid executive director or senior lobbyist positions in their companies.

Sound familiar? Well you'll recognise this too. Whenever the topic of declining standards in the NHS is brought up, the conventional-wisdom line put out by the Media on behalf of the government is that more "modernisation" is the proven answer.

Shorter me - Why wouldn't foreign politicians want to get on the gravy-train that their American counterparts have been riding for all their careers? They're certainly doing it here.

Posted by: Tony J on October 14, 2009 at 2:57 PM | PERMALINK

I actually think they are being intentionally vague. We DO have the best health care in the world. Technologically speaking, all the latest and greatest medical marvels can be found here, in the U.S. USA! USA!

The problem, of course, is that our delivery systems sucks, and creates the massive inequities you note.

I think the Republicans are being intentionly vague and trying to link the lack of "socialized medicine" to the technological quality of the services provided to those who can afford them, as if to quietly imply that socialized medicine reduces services to the least common denominator.

That our lead in cutting edge services may go down may or may not be true as a simple matter of markets and economics. (I tend to think not, since much of th truly great innovations come from teaching institutions sponsored by corporate backers.) But, it doesn't alter the fact that the latest life saving drug for Toe cancer isn't really of much interest to the family that can't afford to see a doctor until their kid has a seizure from a fever and ends up in the emergency room.

Posted by: Joe Blow on October 14, 2009 at 3:06 PM | PERMALINK

America, c'est moi.

Posted by: hells littlest angel on October 14, 2009 at 3:30 PM | PERMALINK

The Democrats surrendered single payer before so much as a single shot was fired. Then the Baucus bill (Which seems to be the framework for any final bill) made sure to abandon the public option. Modifying the fee-for-service model, which is the main driver for escalating health care costs, isn't even mentioned.
That's all fine with me now. If they want to force everyone to buy health insurance without doing anything to ameliorate the double-digit inflation in the cost of that insurance then let them. This Congress remains unwilling to in any way challenge the health care industry and so the next round of legislation, when we're all close to going broke for the worst health care outcomes in the industrialized world, will mandate single-payer because there will be no other choice.

Posted by: Dennis-SGMM on October 14, 2009 at 3:30 PM | PERMALINK

Howard Dean just rocked the house on David Schuster's show...he needs to organize OTHERS and speak out more..do a commercial or whatever..he's the most cogent, most forceful ...maybe along with that insurance company whistle blower who was also on with him...or with others..HE JUST SAID HOW WE MUST GET THIS DONE AND WITHOUT IT, THERE IS NO PLAN...VERY ELOQUENTLY AND FORCEFULLY LAID IT OUT..



No we now why the Corporate co-ordinated media went out of it's way to humiliate him when he ran for President. We all remember how they purposefully doctored the video of Dean when he was screaming because of the SCREAMING CROWD that was in front of him. THE MEDIA in a planned and co-ordinated effort removed that volume of the crowd to make it look like Dean was insane ... and they were successful ..........

Posted by: stormskies on October 14, 2009 at 3:59 PM | PERMALINK


It wasn't (and still isn't) just the media who marginalized Doctor Governor Chairman Dean. Rahm Emanuel and this administration have, and that's a shame.

Posted by: doubtful on October 14, 2009 at 4:05 PM | PERMALINK

It is heartwarming that Shelby of Alabama thinks we have the best healthcare on the planet, I guess that means that everyone in Alabama is 100% satisfied.

Posted by: JS on October 14, 2009 at 4:08 PM | PERMALINK

We certainly do get princes and PMs coming here for high-end procedures.

And then there are the estimated 1.7 million Americans who will go overseas next year to get procedures they can't afford to have done here, a practice heartily encouraged by our best-in-the-world insurance companies.

That's more than twice as many Americans who went abroad for medical care in 2007, by the way.

Posted by: shortstop on October 14, 2009 at 4:55 PM | PERMALINK

In many ways we do have the best health care system in the world. Unfortunately we also have the worst health care delivery system in the industrialized world. It is a problem if we are the best in the world at treating breast cancer but worst in the industrialized world at providing coverage to screen for breast cancer.

We do have some classes of people in this country who do receive health care comparable, and sometimes even better than those in European countries. This includes those who have the better employer-paid health care plans (which explains the correlation with income).

The other group which has health care comparable to Europe is the elderly--those on the government Medicare program. You can't see this effect in the study (unless there is more detail than what I've skimmed) as I notice it breaking down by over and under 50. It would be interesting to separate out those 50-64. Those often have the worst care as they have more difficulty getting coverage if needed on the individual market, as compared to those over 65 who have Medicare.

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