The American Way

What does it mean to be a U.S. citizen? Understanding the American psyche.

Americans' Rage Against Death

The United States is dying because we can't accept death
Stanton Peele, Ph.D., J.D.
This post is a response to America Is Already Gone by Stanton Peele

America's fear of death is killing us (we're already gone).

I'm not talking about Ted Williams and cryogenics - although that's an example. Privileged Americans want to live forever. Nothing excites Americans more than genetic discoveries about long-lived people or rats. Will we find the genetic solution to death? (Why are kids - not only kids - fascinated by vampires who live - and remain cute - forever? So what if they can't have sex - this is America, after all.)

As a result, when Americans speak about excellent health care, they mean high-end treatments for serious illnesses.

But that doesn't make a good health care system - and the American system stinks. It is the most expensive in the world, and the least cost-effective. A remarkable study published in JAMA found that: "The U.S. population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer" - about twice as unhealthy, despite spending twice as much per capita as the British.

More, among 33 countries, the only ones Americans' life expectancy exceeded were Cyprus, Slovenia, Slovakia, and the Czech Republic.

And our health care costs are EXPLODING. But no representatives in America hear this. Listen to Times columnist and Nobel Prize winner Paul Krugman :

The whole budget debate, then, is a sham. . . .

What would a serious approach to our fiscal problems involve? I can summarize it in seven words: health care, health care, health care, revenue.

Notice that I said "health care," not "entitlements." People in Washington often talk as if there were a program called Socialsecuritymedicareandmedicaid, then focus on things like raising the retirement age.

Our health care system is CRUSHING America. Here are excerpts from graduation speeches given by Atul Gawande at the University of Chicago:

Our country's health care is by far the most expensive in the world. It now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance. It's also devouring our government at every level -- squeezing out investments in education, our infrastructure, energy development, our future.

and at Stanford:

By the end of the decade, at the present rate of cost growth, the price of a family insurance plan will rise to $27,000. Health care will go from 10 per cent to 17 per cent of labor costs for business, and workers' wages will have to fall. State budgets will have to double to maintain current health programs. And then there is the frightening federal debt we will face. By 2025, we will owe more money than our economy produces. One side says war spending is the problem, the other says it's the economic bailout plan. But take both away and you've made almost no difference. Our deficit problem -- far and away -- is the soaring and seemingly unstoppable cost of health care.

The Republican response is to reverse even the halting steps at cost containment represented in the Obama health care bill, and to return the American health system to a purely free market approach - like a wet dream they are having that we live in Colonial American (Glenn Beck is fond of pointing out that the Constitution doesn't guarantee health care). What they - politicians and pundits like Sean Hannity, Bill O'Reilly, and Rush Limbaugh - mean when they say that America has the best health care system in the world is that they can get the best health care available in the United States for themselves and their families.

But ninety percent of health care outcomes are determined by allowing ready access for basic care - quick treatment of infections, prenatal care, and management of chronic diseases. When you get cancer, there is a limited amount that can be done for you.  No matter how wealthy you are and how moving those cancer-cure TV ads, and despite the trillions spent on cancer research and treatment since Nixon announced his war on cancer in 1971, American death rates due to major cancers have remained the same: "The death rate for cancer has barely changed since 1950, despite Richard M. Nixon's pledge to cure cancer in five years."

The liberal position is really not that different - the burden of Michael Moore's film Sicko was to lambast insurance companies for not providing multi-million-dollar unproven treatments for people with serious illnesses. His goal isn't to imitate the Canadian and French systems he lauds - which regularly deny people expensive experimental treatments in favor of giving ready access to health care to everyone. His goal is for the United States to spend more money providing every possible treatment (like the kinds Hannity, O'Reilly, and Limbaugh would receive) for every severely ill American.

Here is why we will never depart from our doomed system, and thus we will die as a society:

  1. Privileged people want to live forever, and the health care system is geared towards this goal (of course, the JAMA study above found that in most cases, "the top of the SES distribution is less healthy in the United States as well").
  2. Americans believe that we can define every social and health problem as a disease that medical technology can cure (the most striking example of which is our addiction-as-disease delusion).
  3. The first people to be thrown overboard - by both liberals and conservatives - are the poor (Medicaid is being decimated by failing state budgets).
  4. Next to go are average Americans - who are already seriously challenged in getting insurance or affording health care.
  5. What would make the American population most healthy are community support, built-in physical activity, less access to easy calories and constant electronic stimulation, happy and satisfying lives - none of which will happen.

As I said, we're already gone.

The American Way