American exceptionalism has been historically referred to as the belief that the United States differs qualitatively from other developed nations because of its national credo, historical evolution, or distinctive political and religious institutions. The difference is often expressed in American circles as some categorical superiority, to which is usually attached some alleged proof, rationalization or explanation that may vary greatly depending on the historical period and the political context. However, the term can also be used in a negative sense by critics of American policies to refer to a willful nationalistic ignorance of faults committed by the American government.
In the nearly nine years writing this blog, I have mentioned the idea of American Exceptionalism fifteen times, but at no time since the arrival of the COVID-19 virus, have I mentioned it in relation to the pandemic.
Thanks to Elizabeth Ziemba, Founder and President of Medical Tourism Training Inc., the following article is re-posted with her kind permission.
She correctly states that the pandemic has exposed the American health care system as unable to deal effectively with COVID, and while she has not offered any alternative to our current system, it is apparent to me that the only alternative left, especially after the Supreme Court of the United States overturns the ACA, once Trump’s nominee to fill Ruth Bader Ginsburg’s seat, Amy Coney (Island) Barrett is confirmed, is Single Payer/Medicare for All.
Here is Liz’s article in full:
COVID-19 has ended the age of American exceptionalism in healthcare
Published on September 28, 2020
How difficult will it be to rebuild its damaged brand?
“From Myanmar to Canada, people are asking: How did a superpower allow itself to be felled by a virus? And why won’t the president commit to a peaceful transition of power?” From the NY Times article, “I feel sorry for Americans” [iv]
A global pandemic has finally ripped the bandages off the US healthcare system that has been struggling and failing its citizens for years, revealing its weaknesses for all the world to see. With more than 200,000 COVID-related deaths and counting, it is a system that is going off the rails with no one at the wheel. What happens next will impact the health of Americans for years to come.
Some of the world’s best healthcare institutions are in the United States. Stars like Cleveland Clinic and Mayo Clinic shine so brightly that they blind many to the truth that they represent the exceptions rather than the norm. The devastation of COVID-19 is so profound that it is casting black clouds over the few examples of international excellence and shining rays of light on the abundant weaknesses of the country’s healthcare system.
The US has long spent more on healthcare per person than any other country in the world but produces outcomes that do not justify the investment. Global healthcare rankings of countries place the US as 30th[i] or 37th[ii]. Access to healthcare services is a major factor in determining “best in class”. The US consistently scores low with millions of people with inadequate insurance or no insurance at all. At the end of June 2020, 42 US hospitals have closed or declared bankruptcy[iii], mostly in rural areas where they were the primary services for their communities. People will have to travel farther for care or forego services altogether. Rural and minority areas are particularly hard hit, further increasing inequities of access.
The country’s response to COVID-19 has been mishandled at every step of the way. Public health experts have been sidelined in favor of political gain. Lessons that could have been learned from other countries what were hit hard before the US represent missed opportunities, supplanted by “we know what is best”. This attitude of exceptionalism – the United States is different, better than everyone else – may have worked in the past, creating a “Can Do” attitude that fosters innovation in medical technology and highly sophisticated treatment but that fails during a pandemic.
The national pandemic response should have been immediate, uniform, and standardized according to international best clinical practices. These three pillars of public health are what has enabled governments around the world to respond with the best results. Instead the 50 states were left to fend for themselves, combatting shortages, inconsistent and confusing messages on the national level, and political nonsense. What a recipe for disaster resulting in a mounting death toll and economic devastation for millions of Americans – all for lack of national leadership and the political will to behave like the United States of America.
The damage done to the country’s international reputation will further hamper the rebuilding of the healthcare system that is needed not only to serve the country but to resuscitate its international brand. The best and the brightest healthcare professionals including scientists and public health experts will retire or take their skills to countries and organizations where their knowledge will be respected and utilized. International patients and the money that they bring to the US when seeking highly specialized and expensive care will go elsewhere. These patients are abandoning the US for destinations with better healthcare.
Exceptionalism during this pandemic leaves Americans with fewer choices for accessing care. Lack of access to healthcare services typically results in people foregoing treatment and presenting sicker with fewer treatment options. The cost of healthcare rises to account for this trend. People’s health, the most precious of all commodities, will suffer. It is time to acknowledge that exceptionalism is dead, and our healthcare system must get back to the business of getting and keeping people healthy.
This virus and the other pandemics that will come in the future require engagement with the international community. Diseases do not observe the niceties of national boundaries. The US government must fully support the efforts of the World Health Organization to create the best possible solutions to pandemics. Engagement by our scientific and pharmaceutical experts in COVAX represents the fast and sensible way forward for the United States to assert global leadership, now and in the future.
By persisting on the course of exceptionalism, the country will struggle to rebuild its healthcare system for the people of the United States and its reputation for the world.
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