The United States Is Number 12! (Or Are We...?)

The London-based Legatum Institute recently released its Prosperity Index, which ranks countries according to eight broad criteria. Using Legatum's methodology, the Greatest Nation On Earth ranks twelfth. By category, the ranking broke down like this—

• Economy — #20
• Entrepreneurship & Opportunity — #12
• Governance — #10
• Education — #5
• Health — #2
• Safety & Security — #27
• Personal Freedom — #14
• Social Capital — #10

I made your life easier by highlighting the ringer in the bunch — the United States is ranked #2 in Health!

For over 20 years now, many Americans have considered access to basic health care to be the Number One Problem in the United States, and for good reason. In fact, President Barack Obama, who will be the President until January, 2017, took it upon himself to make health care his #1 priority during his first term. As a result, the Congress passed and Obama signed the Affordable Care Act, aka. Obamacare, which broadened the Medicare & Medicaid "entitlement" umbrella, reformed the payout rules in those programs, and changed the rules for getting health care by requiring Americans to get said health insurance in 2014, if they can afford it.

Some fiscal "hawks" have pointed out, as I have, that Obamacare, Medicare and Medicaid are still on track to totally bankrupt the nation by 2022, or maybe 2025 if the exact year matters to you. Obamacare is intended to slow the rate of increase in the cost of government-sponsored health care, not decrease those costs. Overall, Obamacare will add to fiscal outlays. The situation is completely out of control. See my post The Coming Health Care Debacle (March 29, 2012).

Early Obamacare provisions have led to a small decrease in the number of Americans without coverage according to the 2011 Census data.

The number of people without health insurance coverage declined from 50.0 million in 2010 to 48.6 million in 2011, as did the percentage without coverage — from 16.3 percent in 2010 to 15.7 percent in 2011.

Needless to say, the large majority of these 48.6 million Americans have no health insurance because they can not afford it. That's a lot more people than the total population of countries which were ranked well behind the United States in Health by the Legatum Institute. And among people who do have health insurance in the United States, especially private insurance they must pay for themselves, most are experiencing inflation in the the cost of that insurance which will give them a stark choice in about 10 years—they can buy health insurance OR they can eat, buy gas and electricity, keep a roof over their heads, etc. In short, millions and millions of Americans are headed for a situation in which their choices will be buy health insurance and die, or don't buy health insurance and take your chances.

Will the Federal government cover all these people? Fat chance!

Inflation for selected items since 1985. I used this graph in my March 7, 2012 post The Screwing Of The American People Continues

And yet, the United States is #2 in the category Health according to the Legatum Institute. Have soaring health insurance costs slowed down? Yes, but not enough, if one year a trend makes. I'll quote from the Reuters report Employer healthcare premiums outpace inflation, wages (September 11, 2012)

A study released on Tuesday showed that premiums for employer-sponsored health plans, which cover about 149 million Americans, grew a modest 4 percent to $15,745 in 2012.

It was a substantially slower rate of growth than in past years, including 2011, when premiums jumped 9 percent.

But the study's authors at the nonpartisan Kaiser Family Foundation and the Health Research and Educational Trust, said higher costs still took a bigger bite from the income of middle-class employees, whose wages advanced only 1.7 percent, as employers shifted more healthcare costs to their workers.

This year's 4 percent increase eclipsed a general inflation rate of 2.3 percent. Some employers told researchers that insurers plan to push premiums up another 7 percent in 2013, the study said.

There are many other issues I could get into here, but I don't have enough time today. For example, we could talk about disturbing trends in life expectancy and infant mortality. I have already discussed the Type-2 Diabetes epidemic among teens and the obesity which advances it in my posts An Epidemic Of Diabetes In American Teenagers and The Fattest People On Earth.

So is America really #12 on the Prosperity Index? Hell, no!

I don't know what the Legatum Institute was thinking. Maybe money changed hands

Comments

[Chris in Chicago]

Great topic Dave. I am self employed and have seen my premiums go up 10-15% every year. You are exactly right that people dont have health insurance because they cant afford it. The average person in this country who makes 25k a year cant afford 8k for health insurance.

I am fast approaching the fiscal cliff were i can no longer afford it either.

[Oliver]

Dave - On this topic, I have a gem to share with you from the Olde Countrie, a.k.a. the UK.

Since 1948, we have had a National Health Service - funded from general taxation* - that provides medical treatment free of charge at the point of supply. Guess what? It is right now being rapidly dismantled because - wait for it - the geniuses in the coalition government admire the US system of medical care!

Creepy Etonian David Cameron has just appointed a smiling chappie by the name of Jeremy Hunt as Secretary of State for Health, who is particularly enamored with your healthcare. If you know Cockney rhyming slang, you can guess what his name has now come to mean.

Richard Branson - the golden boy of British entrepreneurialism with his Virgin Empire - is hugely tarnished by collaborating with the government in this privatization process, which is in fact an exercise in giving him and his super-rich cronies a license to print money at the ailing public's expense.

Soon, as in the USA, citizens will need to be wealthy to get medical care, which is in essence a Darwinian cull-the-weak process so favored by the fascists that pervade most of the political parties and plutocrats on both sides of the Atlantic.

Anglo-Saxon comes in handy here. Fuck 'em all.

* mostly paid for by the highly taxed, financially stretched middle class, because the rich evade almost all their taxes.

[J. Drew]

Well, In 2000, the last year the World Health Organization ranked countries healthcare systems, the united states ranked 37th in the world, which is probably a lot closer to what it's "real" rank is than #2, which is just crazy. They apparently don't rank countries anymore because it's "too complicated", however the conspiracy theorist in me suspects certain first world countries that provide the WHO its funding just didn't want to see their names down their in the thirties anymore. Although I am not an American and have no personal experience with your healthcare system, but I suspect if you only looked at the quality of care given to those who can afford it, and ignore the fact that 50 million people don't have access to this care, the U.S. healthcare system may well be #2- albeit with a a hell of an asterisk next to that number.

[J. Drew]

Here's a link to the page at the Legatum institutes webpage explaining their methodology for ranking heath. See if you can find the flaws! http://www.prosperity.com/Subindexes-5.aspx

[Dave Cohen]

@J Drew

We're Number 37!!!

Or at least we were in 2000. The Commonwealth Fund ranked us against six other developed countries two years ago. And I quote--

New York, NY, June 23, 2010—Despite having the most expensive health care system, the United States ranks last overall compared to six other industrialized countries—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—on measures of health system performance in five areas: quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives, according to a new Commonwealth Fund report. While there is room for improvement in every country, the U.S. stands out for not getting good value for its health care dollars, ranking last despite spending $7,290 per capita on health care in 2007 compared to the $3,837 spent per capita in the Netherlands, which ranked first overall.

http://www.commonwealthfund.org/News/News-Releases/2010/Jun/US-Ranks-Last-Among-Seven-Countries.aspx

-- Dave

[Don Levit]

As I understand the PPACA, policyholders (family or individual) are to get back each year 80 cents for every dollar of premium paid. If they get back less, the insurance company is supposed to send them a refund.
Refunds could be $8,000. Could people use that money for trips?
Don Levit

[J. Drew]

Believe it or not I am pretty sure It is that high per capita expenditure that got the U.S. It's number 2 spot on the Legatum Institute list. By the looks of it their most important variable was how much a country spent on healthcare, and they didn't bother to weight that number against the appropriate variables like the Commonwealth Fund did. I guess this is what happens if you believe economists are qualified to rank healthcare systems.

[Mike Roberts]

Talking of type 2 diabetes, here's an interesting talk on Sugar: The Bitter Truth.