Hey, We’re Number … Uh … 36!

According to the United Nations (UN) list of nations by life expectancy (which uses data between 2005 and 2010), the United States ranks number 36. The average male and female life expectancy here is 78.3 years. That ties us with Cuba and Denmark. Japan is number one, at 82.6 years. (That, of course was before the earthquake and tsunami.) Spain is number 6, France, 10; Canada, 11; the United Kingdom, 20. You can check it out at the “List of countries by life expectancy” entry in Wikipedia.

Our own CIA estimates us at number 50 in its 2011 World Factbook.

(Monaco is 1, Japan is 5; Canada is 12; France is 13; and the United Kingdom is 28.) This is in spite of the fact that the United States spends more per capita on health care than any other country in the world. Clearly, we are not getting our money's worth.

What characterizes most of the countries ahead of us is that their health care is government-sponsored. That doesn't mean it is free. It is paid for through taxes, but that means the cost is widely distributed. Yes, that implies that some people's taxes go to pay for health care they don't need (but most likely will someday). In our private system, some people pay for health care insurance they don't use, but that costs more than taxes under a government-sponsored system because the overhead is higher and fewer people share the costs.

That is why the 2010 Health Care Reform Act required everyone to purchase insurance. Spreading the cost reduces the price tag for all.

On a trip to Spain a couple of years ago, I fell ill. The hotel clerk directed me to a neighborhood clinic, where I had a consultation with an English-speaking physician. When I asked the fee, he said it was too bad I was not from a European Union (EU) nation. If I were, it would be free.

Here, some people who cannot afford health care insurance have found their own version of free care: they use the emergency room when they get sick or injured, and the state or the hospital picks up the tab. If the state pays, the cost is passed on to taxpayers; if the hospital bears the expense, the cost is passed on in the form of higher insurance premiums.

(A man in North Carolina, James Richard Verone, found another way to get the care he could not afford. He robbed a bank – demanding one dollar – and then waited patiently to be arrested. He knew that he would get free care in jail.)

As we wrestle with the increasingly expensive burden of health care, why does such a large segment of the American population ignore or spurn the example of countries that provide their citizens better care at a lower price? Part of the reason must be that these Americans don't know about those examples. Early in the health care debate, I insinuated myself into a rally against Obama's proposal. I stood next to a man holding a placard that read “No Government Health Care,” and I said, “What I don't understand is why people in countries with government-run health care live longer than we do.”

“They do?” he said in astonishment. I suggested he look it up.

Most of the opposition, however, results from the successful effort of right-wing media to make “socialism” a dirty word and to pin that label on anything government-run. It may be no use telling them about the success of government-run health care in other countries because there is evidence that some people refuse to be dissuaded by facts.

In a series of experiments, psychologists David Gal and Derek Rucker found that presenting people with evidence contrary to their strongly held beliefs only made them cling more strongly to those beliefs. “Across three experiments, people whose confidence in closely held beliefs was undermined engaged in more advocacy of their beliefs … “

The Obama proposal was not a government-run system, but right-wing demagogues applied that label to it anyway. In 2010, several polls showed that a majority of Americans believed the health care bill (a k a “Obamacare”) being debated would result in a government takeover of the health care system, even though it clearly left the system in private hands.

Some people point to Canadians who come to the US for health care as proof of the superiority of our system. But most of the people who come here can afford expensive private care and come to the United States for nonurgent procedures for which there is a long waiting time in Canada. Many more Americans, over 100,000 last year, go from the United States to other countries (India, Thailand and Costa Rica are the most popular) for comparable care at a much lower cost, and are often treated by US-trained doctors. See, for example, Josef Woodman's medical tourism guide, “Patients Beyond Borders.”

Medicare, which is as close as we come to a government-run system, is so popular that, while people may criticize some elements of it, no one denounces it as a whole or calls it socialist. (It is government-sponsored: government regulates and pays, but care is delivered by private caregivers. Even the Ayn Rand acolyte Rep. Paul Ryan (R-Wisconsin), who has proposed eliminating Medicare as part of his massive spending-cuts plan, “Path to Prosperity” and offering vouchers instead, does so without disparaging the program. Yet ignorance and fear of government-run health care is exemplified by the woman in South Carolina who, at a town hall meeting with her Congressman, shouted, “Tell the government to keep its hands off my Medicare!”

It's not just a homemaker in South Carolina who is ignorant of government involvement in health care. Attempting to extol the superiority of America's mostly private system compared to Great Britain's government-run arrangement, an August 1, 2009, editorial in Investor's Business Daily during the debate on health care reform asserted that, “People such as Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” (Hawking, a physicist, was diagnosed with amyotrophic lateral sclerosis, or Lou Gehrig's disease, when he was 21. He is now 69.)

He rebuked the assertion and reiterated his position recently in an interview in The New York Times Science section, saying:

I entered the health care debate in response to a statement in the United States press in summer 2009 which claimed the National Health Service in Great Britain would have killed me off, were I a British citizen. I felt compelled to make a statement to explain the error.

I am British, I live in Cambridge, England, and the National Health Service has taken great care of me for over 40 years. I have received excellent medical attention in Britain, and I felt it was important to set the record straight. I believe in universal health care. And I am not afraid to say so.

So, what are our chances of moving up the longevity ladder? Until we allow ourselves to learn by example, they don't look good. But, hey, we're 14th in reading, (17th in science, 25th in math … ).