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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.
A new study finds that dogs fed fresh human-grade food don't need to eat—or do their business—as much.
- Most dogs eat a diet that's primarily kibble.
- When fed a fresh-food diet, however, they don't need to consume as much.
- Dogs on fresh-food diets have healthier gut biomes.
Four diets were tested<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU5ODI1MS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1NjY0NjIxMn0._w0k-qFOC86AqmtPHJBK_i-9F5oVyVYsYtUrdvfUxWQ/img.jpg?width=980" id="1b1e4" class="rm-shortcode" data-rm-shortcode-id="87937436a81c700a8ab3b1d763354843" data-rm-shortcode-name="rebelmouse-image" data-width="1440" data-height="960" />
Credit: AntonioDiaz/Adobe Stock<p>The researchers tested refrigerated and fresh human-grade foods against kibble, the food most dogs live on. The <a href="https://frontierpets.com.au/blogs/news/how-kibble-or-dry-dog-food-is-made" target="_blank">ingredients</a> of kibble are mashed into a dough and then extruded, forced through a die of some kind into the desired shape — think a <a href="https://en.wikipedia.org/wiki/Food_extrusion" target="_blank">pasta maker</a>. The resulting pellets are sprayed with additional flavor and color.</p><p>For four weeks, researchers fed 12 beagles one of four diets:</p><ol><li>a extruded diet — Blue Buffalo Chicken and Brown Rice Recipe</li><li>a fresh refrigerated diet — Freshpet Roasted Meals Tender Chicken Recipe</li><li>a fresh diet — JustFoodforDogs Beef & Russet Potato Recipe</li><li>another fresh diet — JustFoodforDogs Chicken & White Rice Recipe.</li></ol><p>The two fresh diets contained minimally processed beef, chicken, broccoli, rice, carrots, and various food chunks in a canine casserole of sorts. </p><p>(One can't help but think how hard it would be to get finicky cats to test new diets. As if.)</p><p>Senior author <a href="https://ansc.illinois.edu/directory/ksswanso" target="_blank" rel="noopener noreferrer">Kelly S. Swanson</a> of U of I's Department of Animal Sciences and the Division of Nutritional Sciences, was a bit surprised at how much better dogs did on people food than even refrigerated dog chow. "Based on past research we've conducted I'm not surprised with the results when feeding human-grade compared to an extruded dry diet," he <a href="https://aces.illinois.edu/news/feed-fido-fresh-human-grade-dog-food-scoop-less-poop" target="_blank">says</a>, adding, "However, I did not expect to see how well the human-grade fresh food performed, even compared to a fresh commercial processed brand."</p>
Tracking the effect of each diet<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU5ODI1OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY3NjY1NTgyOX0.AdyMb8OEcjCD6iWYnXjToDmcnjfTSn-0-dfG96SIpUA/img.jpg?width=980" id="da892" class="rm-shortcode" data-rm-shortcode-id="880d952420679aeccd1eaf32b5339810" data-rm-shortcode-name="rebelmouse-image" data-width="1440" data-height="960" />
Credit: Patryk Kosmider/Adobe Stock<p>The researchers tracked the dogs' weights and analyzed the microbiota in their fecal matter.</p><p>It turned out that the dogs on kibble had to eat more to maintain their body weight. This resulted in their producing 1.5 to 2.9 times the amount of poop produced by dogs on the fresh diets.</p><p>Says Swanson, "This is consistent with a 2019 National Institute of Health study in humans that found people eating a fresh whole food diet consumed on average 500 less calories per day, and reported being more satisfied, than people eating a more processed diet."</p><p>Maybe even more interesting was the effect of fresh food on the gut biome. Though there remains much we don't yet know about microbiota, it was nonetheless the case that the microbial communities found in fresh-food poo was different.</p><p>"Because a healthy gut means a healthy mutt," says Swanson, "fecal microbial and metabolite profiles are important readouts of diet assessment. As we have shown in <a href="https://academic.oup.com/jas/article/92/9/3781/4702209#110855647" target="_blank">previous studies</a>, the fecal microbial communities of healthy dogs fed fresh diets were different than those fed kibble. These unique microbial profiles were likely due to differences in diet processing, ingredient source, and the concentration and type of dietary fibers, proteins, and fats that are known to influence what is digested by the dog and what reaches the colon for fermentation."</p>
How did kibble take over canine diets?<p>Historically, dogs ate scraps left over by humans. It has only been <a href="https://www.thefarmersdog.com/digest/the-history-of-commercial-pet-food-a-great-american-marketing-story/" target="_blank">since 1870</a>, with the arrival of the luxe Spratt's Meat Fibrine Dog Cakes—made from "the dried unsalted gelatinous parts of Prairie Beef", mmm—that commercial dog food began to take hold. Dog bone-shaped biscuits first appeared in 1907. Ken-L Ration dates from 1922. Kibble was first extruded in 1956. Pet food had become a great way to turn <a href="https://www.dogfoodadvisor.com/choosing-dog-food/animal-by-products/" target="_blank">human-food waste</a> into profit.</p><p>Commercial dog food became the norm for most household canines only after a massive marketing campaign led by a group of dog-food industry lobbyists called the Pet Food Institute in 1964. Over time, for most households, dog food was what dogs ate — what else? Human food? These days more than half of U.S. dogs are <a href="https://www.nytimes.com/2014/08/03/magazine/who-made-that-dog-biscuit.html" target="_blank">overweight or obese</a>, and certainly their diet is a factor.<span></span></p><p>We're not so special among animals after all. If something's healthy for us to eat—we're <em>not</em> looking at you, chocolate—maybe we should remember to share with our canine compatriots. Not from the table, though.</p>
New study suggests the placebo effect can be as powerful as microdosing LSD.
- New research from Imperial College London investigated the psychological effects of microdosing LSD in 191 volunteers.
- While microdosers experienced beneficial mental health effects, the placebo group performed statistically similar to those who took LSD.
- Researchers believe the expectation of a trip could produce some of the same sensations as actually ingesting psychedelics.
Psychedelics: The scientific renaissance of mind-altering drugs<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="92360c805fe66c11de38a75b0967f417"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/5T0LmbWROKY?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>For the study published in eLife, the team recruited 191 citizen cosmonauts to microdose either LSD or a placebo over the course of several weeks and note the psychological effects. Volunteers were already microdosing LSD, so there was no true control. Each volunteer was given instructions on creating their own low-dose gel capsules, some containing LSD, others not. Then they mixed the capsules in envelopes so they didn't know if they were taking the real thing or not.</p><p>The trial design was ingenious: each capsule featured a QR code that was scanned after the addition of ingredients but before they were placed in the envelope so that researchers knew what they were ingesting.</p><p>The problem: volunteers sourced their own LSD. Lack of quality control could have had a profound effect on the results. </p><p>The results: LSD microdosers reported feeling more mindful, satisfied with life, and better overall; they also noticed a reduction in feelings of paranoia. </p><p>The catch: the control group felt the same thing, with no statistical difference between the groups. </p><p>Lead author Balázs Szigeti comments on the findings: "This suggests that the improvements may not be due to the pharmacological action of the drug but can instead be explained by the placebo effect." </p>
Credit: Alexander / Adobe Stock<p>Psychedelics are notoriously difficult to control for given the intensity of the experience. Yet there is precedent for the above findings. A <a href="https://link.springer.com/article/10.1007/s00213-020-05464-5" target="_blank">2019 study</a> found that 61 percent of volunteers that took a placebo instead of psilocybin felt some psychedelic effects, with a few volunteers experiencing full-on trips.</p><p style="margin-left: 20px;">"Several stated that they saw the paintings on the walls 'move' or 'reshape' themselves, others felt 'heavy. . . as if gravity [had] a stronger hold', and one had a 'come down' before another 'wave' hit her."</p><p>The Imperial team believes the expectation of a trip might have been enough to produce similar results. Senior author David Erritzoe is excited for future studies on the topic, believing they tapped into a new wave of citizen science that could push forward our knowledge of psychedelic substances.</p><p style="margin-left: 20px;">"Accounting for the placebo effect is important when assessing trends such as the use of cannabidiol oils, fad diets or supplements where social pressure or users' expectations can lead to a strong placebo response. Self-blinding citizen science initiatives could be used as an inexpensive, initial screening tool before launching expensive clinical studies."</p><p>As investments into the psychedelics market explode, with one company <a href="https://www.bloomberg.com/news/articles/2021-03-03/thiel-backed-magic-mushroom-firm-atai-hits-2-billion-valuation" target="_blank">reaching a $2 billion valuation</a>, a recurring irony appears in the long arc of psychedelics and research: the power of our minds might be enough to feel greater life satisfaction and a deeper sense of mindfulness. If that's possible with a placebo, we have to question why the rush to create more pharmacology is necessary. </p><p>This is, mind you, a separate conversation over the role of psychedelics and rituals for group bonding. The function of group cohesion around consciousness-altering substances will continue to play an important role in many communities. </p><p>Of course, we should continue to explore the efficacy of psychedelics on anxiety, depression, suicidal ideation, PTSD, and addiction. <a href="https://bigthink.com/surprising-science/antidepressant-effects" target="_self">Pharmacological dependence</a> is a stain on the psychiatry industry. Whether or not psychedelics can be prescribed for daily use remains to be seen, but we know a moneyed interest is expecting a return on investment—the above company, ATAI Life Sciences, raised $157 million in its Series D round. </p><p>When it comes to wellbeing, some things money just can't buy. How we navigate the tricky terrain of mainstreaming psychedelics remains to be seen. </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a>. His most recent book is</em> "<em><a href="https://www.amazon.com/gp/product/B08KRVMP2M?pf_rd_r=MDJW43337675SZ0X00FH&pf_rd_p=edaba0ee-c2fe-4124-9f5d-b31d6b1bfbee" target="_blank" rel="noopener noreferrer">Hero's Dose: The Case For Psychedelics in Ritual and Therapy</a>."</em></p>
What makes some people more likely to shiver than others?
Some people just aren't bothered by the cold, no matter how low the temperature dips. And the reason for this may be in a person's genes.