Once a week.
Subscribe to our weekly newsletter.
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.
Geologists discover a rhythm to major geologic events.
- It appears that Earth has a geologic "pulse," with clusters of major events occurring every 27.5 million years.
- Working with the most accurate dating methods available, the authors of the study constructed a new history of the last 260 million years.
- Exactly why these cycles occur remains unknown, but there are some interesting theories.
Our hearts beat at a resting rate of 60 to 100 beats per minute. Lots of other things pulse, too. The colors we see and the pitches we hear, for example, are due to the different wave frequencies ("pulses") of light and sound waves.
Now, a study in the journal Geoscience Frontiers finds that Earth itself has a pulse, with one "beat" every 27.5 million years. That's the rate at which major geological events have been occurring as far back as geologists can tell.
A planetary calendar has 10 dates in red
Credit: Jagoush / Adobe Stock
According to lead author and geologist Michael Rampino of New York University's Department of Biology, "Many geologists believe that geological events are random over time. But our study provides statistical evidence for a common cycle, suggesting that these geologic events are correlated and not random."
The new study is not the first time that there's been a suggestion of a planetary geologic cycle, but it's only with recent refinements in radioisotopic dating techniques that there's evidence supporting the theory. The authors of the study collected the latest, best dating for 89 known geologic events over the last 260 million years:
- 29 sea level fluctuations
- 12 marine extinctions
- 9 land-based extinctions
- 10 periods of low ocean oxygenation
- 13 gigantic flood basalt volcanic eruptions
- 8 changes in the rate of seafloor spread
- 8 times there were global pulsations in interplate magmatism
The dates provided the scientists a new timetable of Earth's geologic history.
Tick, tick, boom
Credit: New York University
Putting all the events together, the scientists performed a series of statistical analyses that revealed that events tend to cluster around 10 different dates, with peak activity occurring every 27.5 million years. Between the ten busy periods, the number of events dropped sharply, approaching zero.
Perhaps the most fascinating question that remains unanswered for now is exactly why this is happening. The authors of the study suggest two possibilities:
"The correlations and cyclicity seen in the geologic episodes may be entirely a function of global internal Earth dynamics affecting global tectonics and climate, but similar cycles in the Earth's orbit in the Solar System and in the Galaxy might be pacing these events. Whatever the origins of these cyclical episodes, their occurrences support the case for a largely periodic, coordinated, and intermittently catastrophic geologic record, which is quite different from the views held by most geologists."
Assuming the researchers' calculations are at least roughly correct — the authors note that different statistical formulas may result in further refinement of their conclusions — there's no need to worry that we're about to be thumped by another planetary heartbeat. The last occurred some seven million years ago, meaning the next won't happen for about another 20 million years.
Brain cells snap strands of DNA in many more places and cell types than researchers previously thought.
The urgency to remember a dangerous experience requires the brain to make a series of potentially dangerous moves: Neurons and other brain cells snap open their DNA in numerous locations — more than previously realized, according to a new study — to provide quick access to genetic instructions for the mechanisms of memory storage.
The extent of these DNA double-strand breaks (DSBs) in multiple key brain regions is surprising and concerning, says study senior author Li-Huei Tsai, Picower Professor of Neuroscience at MIT and director of The Picower Institute for Learning and Memory, because while the breaks are routinely repaired, that process may become more flawed and fragile with age. Tsai's lab has shown that lingering DSBs are associated with neurodegeneration and cognitive decline and that repair mechanisms can falter.
"We wanted to understand exactly how widespread and extensive this natural activity is in the brain upon memory formation because that can give us insight into how genomic instability could undermine brain health down the road," says Tsai, who is also a professor in the Department of Brain and Cognitive Sciences and a leader of MIT's Aging Brain Initiative. "Clearly, memory formation is an urgent priority for healthy brain function, but these new results showing that several types of brain cells break their DNA in so many places to quickly express genes is still striking."
In 2015, Tsai's lab provided the first demonstration that neuronal activity caused DSBs and that they induced rapid gene expression. But those findings, mostly made in lab preparations of neurons, did not capture the full extent of the activity in the context of memory formation in a behaving animal, and did not investigate what happened in cells other than neurons.
In the new study published July 1 in PLOS ONE, lead author and former graduate student Ryan Stott and co-author and former research technician Oleg Kritsky sought to investigate the full landscape of DSB activity in learning and memory. To do so, they gave mice little electrical zaps to the feet when they entered a box, to condition a fear memory of that context. They then used several methods to assess DSBs and gene expression in the brains of the mice over the next half-hour, particularly among a variety of cell types in the prefrontal cortex and hippocampus, two regions essential for the formation and storage of conditioned fear memories. They also made measurements in the brains of mice that did not experience the foot shock to establish a baseline of activity for comparison.
The creation of a fear memory doubled the number of DSBs among neurons in the hippocampus and the prefrontal cortex, affecting more than 300 genes in each region. Among 206 affected genes common to both regions, the researchers then looked at what those genes do. Many were associated with the function of the connections neurons make with each other, called synapses. This makes sense because learning arises when neurons change their connections (a phenomenon called "synaptic plasticity") and memories are formed when groups of neurons connect together into ensembles called engrams.
"Many genes essential for neuronal function and memory formation, and significantly more of them than expected based on previous observations in cultured neurons … are potentially hotspots of DSB formation," the authors wrote in the study.
In another analysis, the researchers confirmed through measurements of RNA that the increase in DSBs indeed correlated closely with increased transcription and expression of affected genes, including ones affecting synapse function, as quickly as 10-30 minutes after the foot shock exposure.
"Overall, we find transcriptional changes are more strongly associated with [DSBs] in the brain than anticipated," they wrote. "Previously we observed 20 gene-associated [DSB] loci following stimulation of cultured neurons, while in the hippocampus and prefrontal cortex we see more than 100-150 gene associated [DSB] loci that are transcriptionally induced."
Snapping with stress
In the analysis of gene expression, the neuroscientists looked at not only neurons but also non-neuronal brain cells, or glia, and found that they also showed changes in expression of hundreds of genes after fear conditioning. Glia called astrocytes are known to be involved in fear learning, for instance, and they showed significant DSB and gene expression changes after fear conditioning.
Among the most important functions of genes associated with fear conditioning-related DSBs in glia was the response to hormones. The researchers therefore looked to see which hormones might be particularly involved and discovered that it was glutocortocoids, which are secreted in response to stress. Sure enough, the study data showed that in glia, many of the DSBs that occurred following fear conditioning occurred at genomic sites related to glutocortocoid receptors. Further tests revealed that directly stimulating those hormone receptors could trigger the same DSBs that fear conditioning did and that blocking the receptors could prevent transcription of key genes after fear conditioning.
Tsai says the finding that glia are so deeply involved in establishing memories from fear conditioning is an important surprise of the new study.
"The ability of glia to mount a robust transcriptional response to glutocorticoids suggest that glia may have a much larger role to play in the response to stress and its impact on the brain during learning than previously appreciated," she and her co-authors wrote.
Damage and danger?
More research will have to be done to prove that the DSBs required for forming and storing fear memories are a threat to later brain health, but the new study only adds to evidence that it may be the case, the authors say.
"Overall we have identified sites of DSBs at genes important for neuronal and glial functions, suggesting that impaired DNA repair of these recurrent DNA breaks which are generated as part of brain activity could result in genomic instability that contribute to aging and disease in the brain," they wrote.
The National Institutes of Health, The Glenn Foundation for Medical Research, and the JPB Foundation provided funding for the research.
Research shows that those who spend more time speaking tend to emerge as the leaders of groups, regardless of their intelligence.
- A new study proposes the "babble hypothesis" of becoming a group leader.
- Researchers show that intelligence is not the most important factor in leadership.
- Those who talk the most tend to emerge as group leaders.
If you want to become a leader, start yammering. It doesn't even necessarily matter what you say. New research shows that groups without a leader can find one if somebody starts talking a lot.
This phenomenon, described by the "babble hypothesis" of leadership, depends neither on group member intelligence nor personality. Leaders emerge based on the quantity of speaking, not quality.
Researcher Neil G. MacLaren, lead author of the study published in The Leadership Quarterly, believes his team's work may improve how groups are organized and how individuals within them are trained and evaluated.
"It turns out that early attempts to assess leadership quality were found to be highly confounded with a simple quantity: the amount of time that group members spoke during a discussion," shared MacLaren, who is a research fellow at Binghamton University.
While we tend to think of leaders as people who share important ideas, leadership may boil down to whoever "babbles" the most. Understanding the connection between how much people speak and how they become perceived as leaders is key to growing our knowledge of group dynamics.
The power of babble
The research involved 256 college students, divided into 33 groups of four to ten people each. They were asked to collaborate on either a military computer simulation game (BCT Commander) or a business-oriented game (CleanStart). The players had ten minutes to plan how they would carry out a task and 60 minutes to accomplish it as a group. One person in the group was randomly designated as the "operator," whose job was to control the user interface of the game.
To determine who became the leader of each group, the researchers asked the participants both before and after the game to nominate one to five people for this distinction. The scientists found that those who talked more were also more likely to be nominated. This remained true after controlling for a number of variables, such as previous knowledge of the game, various personality traits, or intelligence.
How leaders influence people to believe | Michael Dowling | Big Think www.youtube.com
In an interview with PsyPost, MacLaren shared that "the evidence does seem consistent that people who speak more are more likely to be viewed as leaders."
Another find was that gender bias seemed to have a strong effect on who was considered a leader. "In our data, men receive on average an extra vote just for being a man," explained MacLaren. "The effect is more extreme for the individual with the most votes."
The great theoretical physicist Steven Weinberg passed away on July 23. This is our tribute.