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Nearly every country wants universal health care (except for one)
Most other countries don't have universal healthcare because of poverty or war. Why does the U.S. keep clinging to a bad system?
- It's long been known that the U.S. is the only wealthy country without universal healthcare. But even significantly poorer countries also have some kind of universal healthcare system.
- The reasons why the U.S. doesn't have a universal healthcare system are unique in the world but aren't insurmountable.
- In order to join the rest of the developed world, the U.S. needs to realize that not having universal healthcare is something countries do out of necessity, not out of choice.
In 2015, Leon Lederman had a very difficult decision to make. His medical debts were mounting, and he only had one asset valuable enough to cover his debt: his Nobel medal, which he won in 2012 for his work on subatomic particles. Although it represented decades of hard work, it had to be done. Lederman sold his medal for $765,000 in order to get healthcare.
Americans might not be able to agree on what their healthcare system should look like, but nearly everybody agrees that the current one is about as useful as window wipers on a submarine. We've known for a long time that most other wealthy countries have some form of universal healthcare (defined here as a system that covers >90% of the population). But even countries that aren't typically thought of as rich have this system. Kuwait, for instance, has universal healthcare, and it's GDP was about $120 billion in 2017. For comparison, the state of Nebraska alone has a higher GDP than Kuwait. So do 35 other states.
Who else doesn't have universal healthcare?
Without a universal healthcare system, the U.S. has put itself in an awfully exclusive club. Out of the 195 countries in the world, a little under 40 don't have universal healthcare systems. In this regard, America's list mates include Afghanistan, Syria, and Kuwait.
On the Human Development Index (which evaluates countries based on factors like life expectancy, quality of life, etc.), the U.S. places 13th in the world. In the club of countries without a universal healthcare system, the next highest is the Caribbean nation Saint Kitts and Nevis, which placed at 72nd. There are 59 other countries worse off than the United States who still managed to look after most of their citizens' lives.
Families members visit patients in an Iraqi hospital. Iraq used to have a very prestigious and effective healthcare system, but during the last decade of Saddam's rule and the ensuing chaos from the war, the system deteriorated drastically.
(Photo by WALEED AL-KHALID/AFP/Getty Images)
What got us here?
Why is the U.S., the wealthiest nation in the world, holding on to systems that the poorest countries in the world use out of necessity? There are some cultural reasons, of course, namely American's dedication to the free market system and ideas of individualism and personal responsibility. The impact of abstract concepts like these, though, are tough to quantify.
It's more practical to look at the actual steps the U.S. took towards implementing free-market style healthcare. In fact, the current, bonkers U.S. healthcare system makes a lot more sense considering that its creation was entirely accidental.
In World War II, Franklin Roosevelt set price controls on the U.S. economy. Essentially, these limited the prices of rent, gasoline, and other resources critical to the war effort, as well as wages. Although this was a drastic step that would really rattle modern-day Americans, it was a necessary one to ensure that the war effort didn't throw the U.S. economy into chaos. Because the war was sucking up all of these resources and labor (it's tough to work on your farm if you're fighting in Europe), demand was soaring. To keep prices down, Roosevelt set limits to wages, preventing them from rising too high to be unsustainable.
This meant that companies had lost one of their primary mechanisms to attract workers. Instead, they turned to one of the areas they still had control over: fringe benefits. Companies began offering pensions, paid vacations, and health insurance. Rather than a national movement for universal healthcare, unions began negotiating directly with companies to pay for their employees' health insurance.
In an effort to safeguard the U.S. economy during the war, FDR accidentally encouraged the creation of the current, employer-based healthcare system used in the U.S. today.
What's keeping us here?
After the war, a series of revisions to the tax code incentivized corporations to keep this system in place, revisions that were originally lobbied for by corporations themselves to cut down on the cost of the now-expected practice of supplying employees with health insurance.
Not only that, but the American Medical Association (AMA) successfully fought against numerous public health plans, starting with Harry Truman's national healthcare plan, which it labeled "a definite step toward either communism or totalitarianism." Since the AMA represents the interests of the medical community, this makes sense. There is a lot of money to be made.
In 2016, every American paid on average $10,348 on healthcare, more than twice as much as comparably wealthy countries with universal healthcare systems. According to a 2009 OECD analysis, hospital costs and drug prices are about 60% more expensive in the U.S. than in Europe. These high prices get passed on to the galaxy of doctors, hospital administrators, and health insurance companies. The average physician's salary has increased by 50% in the last seven years, from $200,000 to about $300,000. In the second quarter of 2017, the top six health insurance companies' profits increased by 29% as compared to the year before, primarily due to challenges facing the Affordable Care Act in Washington during that time.
Nearly every other country without a universal healthcare system does so because of major political unrest, such as Syria, for example, or because of poverty — like Liberia or Haiti. In the U.S., the opposite is true. Americans don't have universal healthcare precisely because it is the wealthiest nation on Earth and, for a time, Americans could afford to have their healthcare prices gouged.
But this is becoming increasingly less sustainable. Medical debt has been the number one cause for bankruptcy in America for years. After the Affordable Care Act passed, bankruptcy filings dropped by 50%. The Affordable Care Act was by no means a form of universal healthcare, but it represented a step toward the system that countless other free and wealthy countries have demonstrated to be effective. Whether we keep moving forward, however, is an entirely uncertain proposal.
Certain water beetles can escape from frogs after being consumed.
- A Japanese scientist shows that some beetles can wiggle out of frog's butts after being eaten whole.
- The research suggests the beetle can get out in as little as 7 minutes.
- Most of the beetles swallowed in the experiment survived with no complications after being excreted.
In what is perhaps one of the weirdest experiments ever that comes from the category of "why did anyone need to know this?" scientists have proven that the Regimbartia attenuata beetle can climb out of a frog's butt after being eaten.
The research was carried out by Kobe University ecologist Shinji Sugiura. His team found that the majority of beetles swallowed by black-spotted pond frogs (Pelophylax nigromaculatus) used in their experiment managed to escape about 6 hours after and were perfectly fine.
"Here, I report active escape of the aquatic beetle R. attenuata from the vents of five frog species via the digestive tract," writes Sugiura in a new paper, adding "although adult beetles were easily eaten by frogs, 90 percent of swallowed beetles were excreted within six hours after being eaten and, surprisingly, were still alive."
One bug even got out in as little as 7 minutes.
Sugiura also tried putting wax on the legs of some of the beetles, preventing them from moving. These ones were not able to make it out alive, taking from 38 to 150 hours to be digested.
Naturally, as anyone would upon encountering such a story, you're wondering where's the video. Thankfully, the scientists recorded the proceedings:
The Regimbartia attenuata beetle can be found in the tropics, especially as pests in fish hatcheries. It's not the only kind of creature that can survive being swallowed. A recent study showed that snake eels are able to burrow out of the stomachs of fish using their sharp tails, only to become stuck, die, and be mummified in the gut cavity. Scientists are calling the beetle's ability the first documented "active prey escape." Usually, such travelers through the digestive tract have particular adaptations that make it possible for them to withstand extreme pH and lack of oxygen. The researchers think the beetle's trick is in inducing the frog to open a so-called "vent" controlled by the sphincter muscle.
"Individuals were always excreted head first from the frog vent, suggesting that R. attenuata stimulates the hind gut, urging the frog to defecate," explains Sugiura.
For more information, check out the study published in Current Biology.
New research from the University of Granada found that stress could help determine sex.
Stress in the modern world is generally viewed as a hindrance to a healthy life.
Indeed, excess stress is associated with numerous problems, including cardiovascular disease, high blood pressure, insomnia, depression, obesity, and other conditions. While the physiological mechanisms associated with stress can be beneficial, as Kelly McGonigal points out in The Upside of Stress, the modern wellness industry is built on the foundation of stress relief.
The effects of stress on pregnant mothers is another longstanding area of research. For example, what potential negative effects do elevated levels of cortisol, epinephrine, and norepinephrine have on fetal development?
A new study, published in the Journal of Developmental Origins of Health and Disease, investigated a very specific aspect of stress on fetuses: does it affect sex? Their findings reveal that women with elevated stress are twice as likely to give birth to a girl.
For this research, the University of Granada scientists recorded the stress levels of 108 women before, during, and after conception. By testing cortisol concentration in their hair and subjecting the women to a variety of psychological tests, the researchers discovered that stress indeed influences sex. Specifically, stress made women twice as likely to deliver a baby girl.
The team points out that their research is consistent with other research that used saliva to show that stress resulted in a decreased likelihood of delivering a boy.
Maria Isabel Peralta RamírezPhoto courtesy of University of Granada
Lead author María Isabel Peralta Ramírez, a researcher at the UGR's Department of Personality, Evaluation and Psychological Treatment, says that prior research focused on stress levels leading up to and after birth. She was interested in stress's impact leading up to conception. She says:
"Specifically, our research group has shown in numerous publications how psychological stress in the mother generates a greater number of psychopathological symptoms during pregnancy: postpartum depression, a greater likelihood of assisted delivery, an increase in the time taken for lactation to commence (lactogenesis), or inferior neurodevelopment of the baby six months after birth."
While no conclusive evidence has been rendered, the research team believes that activation of the mother's endogenous stress system during conception sets the concentration of sex hormones that will be carried throughout development. As the team writes, "there is evidence that testosterone functions as a mechanism when determining the baby's sex, since the greater the prenatal stress levels, the higher the levels of female testosterone." Levels of paternal stress were not factored into this research.
Previous studies show that sperm carrying an X chromosome are better equipped to reach the egg under adverse conditions than sperm carrying the Y chromosome. Y fetuses also mature slowly and are more likely to produce complications than X fetuses. Peralta also noted that there might be more aborted male fetuses during times of early maternal stress, which would favor more girls being born under such circumstances.
In the future, Peralta and her team say an investigation into aborted fetuses should be undertaken. Right now, the research was limited to a small sample size that did not factor in a number of elements. Still, the team concludes, "the research presented here is pioneering to the extent that it links prenatal stress to the sex of newborns."
Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
The world's 10 most affected countries are spending up to 59% of their GDP on the effects of violence.
- Conflict and violence cost the world more than $14 trillion a year.
- That's the equivalent of $5 a day for every person on the planet.
- Research shows that peace brings prosperity, lower inflation and more jobs.
- Just a 2% reduction in conflict would free up as much money as the global aid budget.
- Report urges governments to improve peacefulness, especially amid COVID-19.
What is the price of peace?
Or put another way, how much better off would we all be in a world where armed conflict was avoided?
To give some context, 689 million people - more than 9% of the world's population - live on less than $1.90 a day, according to World Bank figures, underscoring the potential impact peace-building activities could have.
Just over 10% of global GDP is being spent on containing, preventing and dealing with the consequences of violence. As well as the 1.4 million violent deaths each year, conflict holds back economic development, causes instability, widens inequality and erodes human capital.
Putting a price tag on peace and violence helps us see the disproportionately high amounts spent on creating and containing violent acts compared to what is spent on building resilient, productive, and peaceful societies.
—Steve Killelea, founder and executive chairman, Institute for Economics & Peace (IEP)
The cost of violence
In a report titled "The Economic Value of Peace 2021", the IEP says that for every death from violent conflict, 40 times as many people are injured. The world's 10 most affected countries are spending up to 59% of their GDP on the effects of violence.
Grounds for hope
But the picture is not all bleak. The economic impact of violence fell for the second year in a row in 2019, as parts of the world became more peaceful.
The global cost dropped by $64 billion between 2018 and 2019, even though it was still $1.2 trillion higher than in 2012.
In five regions of the world the costs increased in 2019. The biggest jump was in Central America and the Caribbean, where a rising homicide rate pushed the cost up 8.3%.
Syria, with its ongoing civil war, suffered the greatest economic impact with almost 60% of its GDP lost to conflict in 2019. That was followed by Afghanistan (50%) and South Sudan (46%).
The report makes a direct link between peace and prosperity. It says that, since 2000, countries that have become more peaceful have averaged higher GDP growth than those which have become more violent.
"This differential is significant and represents a GDP per capita that is 30% larger when compounded over a 20-year period," the report says adding that peaceful countries also have substantially lower inflation and unemployment.
"Small improvements in peace can have substantial economic benefits," it adds. "For example, a 2% reduction in the global impact of violence is roughly equivalent to all overseas development aid in 2019."
Equally, the total value of foreign direct investment globally only offsets 10% of the economic impact of violence. Authoritarian regimes lost on average 11% of GDP to the costs of violence while in democracies the cost was just 4% of GDP.
And the gap has widened over time, with democracies reducing the cost of violence by almost 16% since 2007 while in authoritarian countries it has risen by 27% over the same period.
The report uses 18 economic indicators to evaluate the cost of violence. The top three are military spending (which was $5.9 trillion globally in 2019), the cost of internal security which makes up over a third of the total at $4.9 trillion and homicide.
Peace brings prosperity
The formula also contains a multiplier effect because as peace increases, money spent containing violence can instead be used on more productive activities which drive growth and generate higher monetary and social returns.
"Substantial economic improvements are linked to improvements in peace," says the report. "Therefore, government policies should be directed to improving peacefulness, especially in a COVID-19 environment where economic activity has been subdued."
The IEP says what it terms "positive peace" is even more beneficial than "negative peace" which is simply the absence of violence or the fear of violence. Positive peace involves fostering the attitudes, institutions & structures that create and sustain peaceful societies.
The foundations of a positively peaceful society, it says, are: a well functioning government, sound business environment, acceptance of the rights of others, good relations with neighbours, free flow of information, high levels of human capital, low levels of corruption and equitable distribution of resources.
The World Economic Forum's report Mobilizing the Private Sector in Peace and Reconciliation urged companies large and small to recognise their potential to work for peace quoting the former Goldman Sachs chair, the late Peter Sutherland, who said: "Business thrives where society thrives."
The lush biodiversity of South America's rainforests is rooted in one of the most cataclysmic events that ever struck Earth.