Can Republicans Stop Pretending It's A Mystery Why Europe Is Healthier Than We Are?
IT'S NOT A MYSTERY.
While on his post-Senate hearing press tour, Health and Human Services Secretary Robert F. Kennedy Jr. has been going around trying to justify decimating the CDC by repeating his claim that they were the ones responsible for why the United States had worse pandemic outcomes than every other nation on earth.
“Senators may want to make a little speech and then shut me down, but they can’t deny the fact […] we did worse in COVID than any country in the world,” he told Fox News this weekend. “We have 4.2 percent of the world’s population and we had 20 percent of the world’s COVID deaths. We literally are the worst team in the league. I’ve been brought in as the new manager and my job is to shake up the organization, to fire the people who were responsible.”
The United States of America didn’t do poorly because of the CDC, we did poorly because people did not listen to the CDC. You can’t blame the CDC for that! Other countries had uniform rules that people largely abided by, and that is why they did better than we did. The United States had different rules all over the place and a whole lot of people who were not willing to abide by them. If it had been up to RFK Jr., we would … well, I guess we’d all be dead now.
Kennedy has compared the US to the rest of the world a lot lately. During his hearing, he was sure to note the fact that Europe pays less for healthcare than we do and has better outcomes. He did not, however, mention why.
Both Kennedy and Trump have adopted the left-wing talking point of noting that we pay far more for pharmaceuticals and healthcare in general than any other nation in the world. Of course, they do not mention why.
Is it because there are fewer additives in the food in Europe? Is it because pharmaceutical companies hate our freedom and like Europeans better? Is it because they do things like French Girls?
Or is it, perhaps, that they can’t say why because it is very obviously the socialized medicine and they are opposed to socialized medicine?
In the United States of America, most of us who have health insurance have private health insurance. Because Americans like choice, right? Oh, how we love choice!* Well, as of 2023, there are 1,176 private health insurance companies to “choose” from in the United States (or rather, for your employer to choose from, depending on your state).
Each of these groups is responsible for negotiating rates for their members — for pharmaceuticals, for hospitals, for doctors, etc., etc. In most countries, the whole country (or most of it) is basically one big insurance group. Therefore, when they want to negotiate, they have what is called “leverage.” They can say “charge us this price or you don’t get to sell your product in this country.” One could also think of it as buying in bulk or wholesale. Like at Costco! Things frequently cost less when you buy large amounts of them at once.
United Health is the largest health insurance company in the nation, covering about 15 percent of all insured Americans — about 32 million people. United Kingdom has 69 million people. Who do you think is going to get a better deal?
Doing things this way also has a lot of added costs, administrative and otherwise. Our money goes towards advertising, paying everyone from executives to the pharmacy benefit managers who negotiate the prices of pharmaceuticals, all the way down to the people whose job it is to try to get the company out of covering whatever it is we need. Then, hospitals also need to pay people to negotiate with the insurance companies and to navigate a very complex billing system. On average, that costs our hospitals about $40 billion a year, which then gets factored into our other hospital costs.
If everything is covered and it’s all going to one place (the government), that’s a whole lot less money you have to spend on all of that extra stuff.
Speaking of which, our health insurance costs are about to increase by the biggest percentage in 15 years.
Everything is a trade-off. As I have been repeatedly reminded over the years (and not just by Republicans, mind you), Americans want their private health insurance companies and do not want to give them up. They want “choice,” even if I can’t personally understand what choice it is that they think they are getting. We chose the “boutique” system where fewer people can get less for more, while most other countries have chosen the wholesale system. This is Retail 101. It just costs more to shop at Intermix than it does to shop at Costco.
There are better outcomes in Europe because everyone has healthcare. Everyone can go see a doctor and receive preventative care, which saves money in the long run. When there is an infectious virus, everyone can seek treatment, thereby limiting its spread.
Even the sociopathic fiction of “Well, we have shorter wait times! If everyone had health care, we’d have to wait longer to see a doctor!” is increasingly false. The average wait time to see a GP in the United States is three weeks, which is two to ten times more than the average wait times in European countries. To be fair, this is not because we don’t have socialized medicine, but because we don’t have enough doctors for everyone — in part because the Balanced Budget Act of 1997 froze the number of Medicaid-funded residencies at 1996 levels. Every year, there are about 9,500 medical school graduates who don’t get placed in residencies because we want to save money, not lives (even though we end up not actually saving money in the long run).
To be fair, while “everyone has healthcare and people are not dying as often from treatable conditions because they can’t afford to see a doctor or are terrified to get in an ambulance” is really the most obvious reason, there are a number of other factors.
You know how they say stress is the big killer? Well, take a moment and imagine that you do not have to worry about losing your health care or your family losing their healthcare if you lose your job or quit and strike out on your own. Then, imagine that your boss can’t actually fire you unless there is cause and you have actually done something wrong. Imagine that if you have a kid, you get 14 months of paid leave and then subsidized childcare — and, on top of that, college is cheap or free. Imagine your rent for a one-bedroom apartment is, on average, around $900 (like in most of Italy or France) instead of around $1700 like it is in the US (though to be fair, Ireland and Iceland have crazy high rents). Imagine that you don’t have to worry about getting older because there is an abundance of senior support care. Imagine that you get 20-25 paid vacation days off per year (about the average in Europe), plus holidays, plus, in many countries, paid sick days/leave. Oh! And literally zero cultural expectation that you work more than the hours for which you are paid or answer emails in your off hours? How much less stress do you have?
This is the scary socialism you’ve been warned about.
But what about non-economic things? Well, one thing people in Europe do is walk everywhere. In the United States, however, the minute people started talking about “15-minute-cities,” which were meant to allow people to walk/bike/take public transit to most of what they need in 15 minutes, the conspiracy theorists started losing their minds about how they thought we were going to take their cars away and wall them off somehow.
Naturally, all of those people are just fine with Trump sending the National Guard in to our cities for a military takeover, but that’s clearly far less oppressive than being able to walk to the grocery store.
But let’s talk about the grocery store, because that does seem to be Kennedy’s primary focus. All of our problems, he seems to think, are caused by dyes and seed oils (seed oils are fine, actually) and food additives and preservatives and what have you. That’s what’s making us unhealthy! (Well, that and the vaccines.)
Now, personally, I have no issues with getting rid of food dyes or anything else that is unnecessary or not good for you in food. I am, notably, a very big fan of safety regulations and food regulations and think that we should do what Europe does and require that food additives be proven safe first rather than assumed safe until proven harmful.
It is, however, also worth considering that this is not the only way to explain the differences in the food we eat. Access also matters. The ability to afford and actually obtain healthy food matters. This is why people in Europe who live in food deserts have very similar health problems to US citizens, because not having easy access to fresh foods means that you don’t eat as much fresh, in-season fruits and vegetables because you have to worry that they will go bad.
Here is a map of food deserts, by county, in the United States.
Now here is a map of obesity rates by county. To be clear — fat does not mean unhealthy, people can be healthy or unhealthy at any size, but it does pertain to the ability to afford and access healthy foods.
Now, here is a map of life expectancy rates by county.
They’re all the same map.
There are ways to combat this issue. For one, you know the government-run grocery stores that Zohran Mamdani is advocating for? The ones that centrists and conservatives are all up in arms about and weirdly comparing to the “bread lines” of the Soviet Union? Those are meant to combat food deserts in areas where private grocery stores won’t go for reasons of profitability.
Or, you could just go with the method Republicans seem to prefer — fat shaming and bullying people, which does not actually work.
Of course, Americans who have cars and don’t live in food deserts tend to go on a big grocery shopping trip every week or two weeks, whereas Europeans tend to do smaller trips more frequently and buy more fresh fruits and vegetables. There are all kinds of lifestyle differences that have nothing at all to do with affordability or access, but there is also no question that affordability and access makes an enormous impact.
Inequality is inherent in capitalism, so there is just never going to be a purely capitalist solution to making everyone healthy. There can’t be. There’s no world in which we get the same results Europe has gotten without a little bit of socialism, so Republicans are either going to need to embrace that or shut the hell up about it.
*Love of choice not applicable to certain bodies in certain states.
PREVIOUSLY ON WONKETTE!
My daughter was in a massive car accident in June, smashed into by a guy who was allegedly texting and factually failed to notice "for some reason" that the entire Interstate had come to a standstill except him. When the dust settled, it involved four cars and five sets of insurance (she was in a rental that was separately insured from her regular car insurance). She was hospitalized at a major university hospital in the ICU for 3 days and the trauma ward for 2 more and her bill is well into six figures. The insurance was (is) a nightmare. For about a month I had a hospital threatening to put a lien on my house if we did not cough up this six figure amount. I didn't sleep at night, not just because I was caring for her, but because I was pretty sure an accident that was not her fault and already took out her whole summer and her long-term health, was going to destroy our family financially. We have good jobs, all three of us. We have every insurance you can imagine. And none of them were working for us. When it finally cleared up, this week, after months of frantic phone calls to many lawyers and many insurance people, I had the first decent night's sleep in months. We should not have to live this way.
The single reason we do not have single-payer health care in this country is that our current f'd up system is too profitable to too many important people. Full stop.