Tag Archives: American Exceptionalism

COVID and American Exceptionalism

American Exceptionalism

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.

New World Encyclopedia

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?

By Elizabeth Ziemba, JD, MPH, President of Medical Tourism Training and Regional Office Director for Temos International Healthcare Accreditation

“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.

#COVID-19 #clevelandclinic #mayoclinic #publichealth #exceptionalism #WHO #COVAX #reputationdamage #brandreputation #brand #healthcare #hospitals #clinics #access

[i] https://www.numbeo.com/health-care/rankings_by_country.jsp

[ii] https://www.who.int/whr/2000/media_centre/press_release/en/

[iii] https://www.beckershospitalreview.com/finance/42-hospitals-closed-filed-for-bankruptcy-this-year.html?_ga=2.253900616.1111462226.1600093493-1451317812.1600093493

[iv] https://www.nytimes.com/2020/09/25/world/asia/trump-united-states.html?action=click&module=Top%20Stories&pgtype=Homepage

RESISTANCE IS FUTILE!: What is the reason behind Medical Tourism’s Rejection?

My friend, Maria Todd, PhD, noted International Expert on Healthcare & Health Tourism Business Strategies & Operations, Business Owner, Author, and Speaker, has written a very cogent and to the point article challenging American hospitals on why they eschew inbound medical tourism.

For the uninitiated, inbound medical tourism, or travel, refers to foreign patients traveling to the US or other countries for medical care from their home country.

A case in point was the late, and not lamented, Shah of Iran who was allowed to come to the US for treatment of his cancer, and which led to the taking hostage of our embassy staff, destroying what was left of one presidential administration, and secretly aiding another to win the election, and thus look good in the eyes of the American people, only some time later to that administration selling arms to Iran for other hostages, the cash then used to support the Contras in Nicaragua.

But I digress.

As the Shah had money, he was welcomed with open arms, but Maria wonders why other American hospitals, knowing that they will receive cash, still refuses to seek out inbound medical tourism as an alternative source of revenue.

According to Dr. Todd, “It is estimated that the USA is the 3rd most popular destination for inbound medical tourism from other countries, but the practice of traveling for health has been a “thing” in the USA for more than 100 years.

Corporations such as Pepsico, Lowe’s Home Improvement, Boeing, WalMart and many other corporations, she writes, with self-funded health plans under ERISA, have the freedom to contract with any hospital, anywhere in the world without going through a managed care network, but can’t because the hospitals with lots of value to offer simply don’t seem interested enough to talk to them.

She wants to know why not? In order for her to find the answer to that and other questions, she is asking her colleagues in healthcare business development and business administration who are executives at leading healthcare institutions and well-equipped ASCs across America: “Why do you eschew medical tourism business?

This question, and the others that she poses in her article, also relate to outbound medical tourism as well.

Why do employers, insurance companies, the domestic health care industry, which is beset by so many problems and potential shortages and inefficiencies, as well as the entire workers’ compensation industry eschew medical travel for non-work-related illnesses and diseases, and work-related injuries requiring surgery?

I’ve written about this many times before. I have cited American Exceptionalism, racism, xenophobia, greed, ignorance of the quality of medical care abroad, and many other factors, but as Maria points out for US hospitals turning down cash patients, employers and carriers can save money by looking outside our broken and dysfunctional medical care system under workers’ comp.

It’s high time the US joins the rest of the world, and allows our citizens the freedom to go wherever they want for medical care, no matter what the cause, or condition that prompts them to seek medical care that is high quality, and will save money for their employer, and provide them an opportunity to see the world that also belongs to them.

Not to do so is tantamount to enslavement to a corrupt and rigged system that benefits unscrupulous physicians, pharmacies, pain management centers, and other workers’ comp service providers, and harms injured workers.

Medical travel will happen. Resist at your peril.

Angry People Buy Guns, Smart People Write Articles

While perusing my email today, I chanced upon the scriblings of the self-styled, right-winger who had called medical travel a hoax and my idea a non-starter.

This individual saw fit to announce to the world that he had recently purchased 1000 rounds of ammunition, and said that it was for him and his wife.

The point of his rantings was something about letting in new ideas into workers’ comp, and called me an angry man. Funny, if I am angry, then how come he’s the one who bought ammo?

It must be obvious that he is the angry one, just like all the rest of his kind who shoot first (their mouths, then their guns) and ask questions later.

One is not angry if they advocate for an idea they believe will benefit injured workers, when the person calling you angry, buys 1000 rounds of ammo. One is visionary and forward-thinking, unlike the gun nut who shoots his mouth and gun off.

I am not really worried. You see, one day, he will be dead, and hopefully so will his outright hatred and disgust for medical care outside the “good ole US of A”, where we all know only Americans are good at providing quality medical care.

And I also know that when the space plane is made available later in this century for commercial flights, traveling to “Turkishmaninacanstan” will take no more time than going from NYC to Washington, DC, and maybe even less so.

No, the really angry man is the one who, making up for his shortcomings, both physical and mental, needs to buy 1000 rounds of ammunition to hold off new ideas in workers’ comp. Why? So that the status quo stays the status quo.

Or maybe, the only new ideas he likes are the ones that conform to his racist, bigoted, xenophobic hysteria, and that is why he needs 1000 rounds of ammo.


‘Turkishmaninacanstan’ Strikes Back

Readers of this blog know that from time to time, I have had to criticize those in the workers’ comp industry for their short-sightedness, narrow-mindedness, excessive American Exceptionalism, “Know-nothingism”,  xenophobia and subtle racism.

But when a well-respected online journal re-posts an article by the chief anti-medical travel opponent in the workers’ comp world, it is high time that the medical travel industry speak up and defend itself.

As a tireless advocate for medical travel in workers’ comp, I am leading the charge that you, my friends around the world must do for yourselves.

You will notice the title of this post. This is what the individual in question calls those countries that provide medical travel services. Also, please note that by using this canard as my title, I am in no way insulting Turkey, or any other nation that markets their medical care to the world.

There is fair criticism of Turkey and many other countries in the medical travel industry, but those criticisms are meant to improve the services and to correct the mistakes of the past, and not to pass judgement on them.

But when someone uses a term such as ‘Turkishmaninacanstan’, it conjures up the worse images of third world poverty and backwardness in all aspects of life of the nations so broadly brushed with that epithet.

The individual who coined that despicable name is a self-styled, right-wing American conservative who lives on the gulf coast of the state of Florida, a region where many individuals like him retire to after their careers have declined to play golf.

While this individual may not be one of those just yet, the fact that he dismisses new ideas, that he insults the millions of men and women around the world who are trying to offer real low cost medical care at equal or better quality, that he insults the very nations who could use those resources they are spending to bring medical travelers to their countries as a way to improve their balance of trade and economic power in the global economy, when they could be used to raise the living standards of their poorest citizens, is something that can no longer go unanswered.

So, I ask all of you, doctors, nurses, travel agents, medical tourism promoters and facilitators who are legitimately trying to provide better medical care at lower cost to all of the world’s citizens, to speak up and tell this individual and those like him, that your countries are not ‘Turkishmaninacanstans’, and that you are developing world-class medical facilities that outshine those in his own country, and mine.

Basically, he is calling you con artists and frauds, and that is something that only you can stop.