The State of U.S. Healthcare

America has one of the lowest ranked healthcare systems of an developed nation anywhere in the world despite being one of the most expensive. Among the top seven most industrialized nations, the U.S. is ranked dead last.

When it comes to life expectancy, America comes in at 47th among 201 countries. We average 79.4 years of age, with women living to be around 82 while men tend to live to age 77. Although that sounds pretty good, it's actually considered pretty low when compared to some of the top ranked nations such as Italy where the average age is 84.20 or any of the Scandinavian countries where most people live to around 83 years of age.

So, with the United States ranking among the lowest developed nations in terms of healthcare, who are at the top? The top three are all Asian countries, namely  Japan, Macao, and Hong Kong with overall life expectancies of 84.95, 85.51, and 85.83 respectively.  

The majority of top tier industrial nations are also in the top 20. The few exceptions include China in the 52nd spot with an average age of 78.79, Poland in 54th place with a expectancy of 78.60, and Saudi Arabia at 60th with a average expectancy of 78.10.  It should be noted that in every instance, women outlive men by an average of roughly ten years.

In terms of infant mortality, America again ranks last. The average is currently 5.4 per 1000 births, making us the highest of any top tier country. It's worth noting that as of 2021, the U.S. spent 17.8% of its  Gross Domestic Product (GDP) on healthcare, which is two times that spent by any other top industrial nation.

The primary reasons cited  is poor prenatal care such as smoking, drug and alcohol abuse, failure to take proper medications, and improper diet. Other factors include the high rate of cesarean sections as well as high rates of poverty which contributes to other health problems such as obesity, high blood pressure, heart disease, and diabetes. 

In addition, the groups most affected tend to be minorities, especially Native Americans, Black Americans, and Hispanics (as an aside, these same groups also tend to have the lowest life expectancies). 

When it comes to prescription prices, the U.S. spends more per capita than any other top tier nation. On average, we spend $1000+ per person annually on prescription drugs while average in other top tier nations is just $552 per person. At the same time, three in four Americans report being unable to afford the price of their medication. Spending on medication from 2004 through 2019 increased 69% in the U.S. while elsewhere it increased by just 41% on average.

Why is that? In part, it's because prescription drugs are, on average, nearly three times more expensive for a given drug than in any other country. A Humira Pen, for instance, used to treat inflammation in diseases like arthritis, averages nearly $5000 dollars per injection while in other industrial countries the same pen would cost about just under $3000 dollars.  The result is that many Americans are forced to chose to either do without or to ration their medication which often means not taking them as prescribed.

Another key reason is the emphasis of the healthcare industry on treatment (and thus writing more prescriptions) and less of emphasis on prevention. It also worth pointing out in other industrial nations, doctors are less time restricted when it comes to treating patients while in the U.S. physicians are typically capped at 15 minutes per individual and follow a quota system. The result is a focus on profitability and less on the long term welfare of the patient.  As the expression goes, "a cured patient is a lost customer".  

In addition, the United States also ranks at the bottom when it comes to the availability of hospital beds, and subsequently the length of the average stay of a patient. In the U.S. there are approximately 2.8 hospital beds available per 1000 individuals.

In terms of long term care, the costs per patient is the fourth  lowest at $924.00 dollars per patient. Italy is the cheapest at $422.00 dollars per patient, followed by Australia and Japan. The UK is next after the U.S. at $952 dollars. The most expensive costs per patient for long term care is the Netherlands at $1,858.00 dollars. Also among the most expensive are Sweden, Switzerland, and Germany at $1,567.00, $1559.00, and $1,445.00 respectively.

Among the other top industrial nations, that number is 4.3 beds per 1000. The lack of beds obviously affects the length of an average hospital stay. In the U.S. the typical patient is in the hospital for about 4.8 days (only the Netherlands is less, at 4.7 days). In Canada, Germany, and Switzerland is roughly 8.5 days. In France it's 9.1 days, and in South Korea it's a whopping 19.1 days! Can you imagine eating hospital food for nearly three weeks? Blah!

Lastly, we need to look at how the United States compares other industrialized countries when it comes to the availability of physicians. Based on the latest data, which is from 2019, the U.S. has least number of practicing physicians of the top 13 industrial nations.

The U.S. has just 2.6 doctors per 1000 individuals. That compares to France where the ratio is 3.2 per 1000. Australia has 3.7 per 1000 while Germany and Switzerland has 4.3. In Austria that number is 5.2 doctors available per 1000 potential patients. 

As an aside, the American healthcare system has more nurses than does comparable healthcare systems worldwide, and while the U.S. has more hospital staff than other nations, the majority of them are clerical/non-medical administrative personnel.  

As a result, the U.S. is tops when it comes to medically related administrative costs; an average of $925.00 per patient compared to an average of $204.00 among the top wealthiest countries. Sweden and Japan by comparison spend just $70.00 dollars per patient.

Lastly, what about quality of life? According the World Population Review, Northern Europeans clearly have the highest quality of life. In fact, the top ten nations are almost always include the Scandinavian countries of Iceland, Finland, Sweden, Norway, and Denmark, along with Germany, Switzerland, Netherlands, Canada, New Zealand, and Australia.

As for the United States, we currently rank 20th in the world, just behind Spain. You'll note that the countries with the highest quality of life also tend to have the longest life expectancies and the better healthcare.  

What does this say for the United States? The majority of the countries which rank higher than the U.S. in terms of life expectancy, healthcare, prescription prices, and so forth all focus on prevention first followed by treatment. They also place a greater emphasis on the overall wellbeing of the patient and less on meeting quotas or cost per patient ratios.

The majority of the countries follow a decentralized national healthcare system which is available to all its citizens. The healthcare is government managed with about 75% - 85% of the costs paid by tax revenue collected at the local and national levels. Prescription prices are often negotiated by the State rather than insurance companies or hospitals to ensure the best quality at the lowest cost.

Dental coverage for children are typically free while adults can buy dental insurance which is often subsidized by the government. There is also cost sharing between the patient and state based on the patient's income with costs being capped overall.  The costs of various medical services such as ambulances are typically bore by the State.

Hospitals and medical practices are given various financial incentives to improve efficiency and productivity. As stated previously, the State also encourages health conscious lifestyles such as regular exercise, longer vacation times and extra time off for "mental health", healthy diets, while encouraging cessation to bad health behavior such as smoking, poor diets and obesity.  

Free clinics can be found nearly everywhere, which is in part to help encourage males to seek treatment (men are notoriously for not wanting to get checkups, thus contributing to their higher mortality rate). Maternity leave is typically paid and extended to include the fathers as well.

The American healthcare system is a primarily profit driven enterprise with an emphasis on treatment and less on prevention. That has to change. While Americans are keenly tax adverse, a single payer tax system provided by the government would go a long toward improving overall healthcare, lower costs in the long run, and ensure health coverage for all, which would reduce costs now picked up by taxpayers.   

It would have the added benefit of allowing small businesses unable to afford health coverage for employees to compete with larger companies who can. Insurance can still be purchased by those looking for additional coverage.

Finally, doctors and medical professionals need to spend more time with patients and focus more on care and less on quotas. There also need to be more emphasis on mental illness treatment, which would go a long in alleviating some of the homeless problems facing communities today. Government funded research must pay along costs savings to the public. In addition, each state should negotiate prescription prices with the manufacturer to ensure patients receive the lowest cost possible for their medicine.

Meanwhile, there needs to be an additional effort made by the State and employers to encourage healthier lifestyles, including perhaps providing free or low costs classes in dietary choices, exercise, mental health, prenatal care, growing gardens, and so forth. 

 

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Healthcare in the Nordics

America's State of Freedom: How Do We Compare?

There has been much discussion recently about the decline and pending fall of the American Empire, but how much of that is actually true? Is the United States as we know it tittering on collapse? Well, let's take a look at some of the studies, surveys, and polls to see where the U.S. currently stands on a number of key issues.

First up is freedom. After all, that's what we're known for ---"land of the free and home of the brave" right? According to the independent and non-partisan World Population Review, the top ten freest countries in the world are Switzerland, New Zealand, Denmark, Estonia (yes, the former Soviet Republic), Ireland, Finland, Canada, Australia, Sweden, and Luxembourg.  Wait. What? No United States in the top ten?  Nope.

Actually America comes in 15th place, just behind the UK and ahead of Japan and Germany. Also ahead of us are Iceland, Norway, and the Netherlands. The ten least freest countries are all in the Middle East and Africa (with the exception of Venezuela). Some include Egypt, Somalia, Iran and Iraq (naturally),Yemen, and the Sudan. 

Americans are known for their rugged individualism. It's the staple of practically every Western movie and TV show ever made.  Individualism, and with it our rights to personal freedom are at the core of what it means to be an American. So would it surprise you to know that the U.S. isn't in the top ten (again)? It's not even in the top 20 when it comes to personal freedom.

The United States has become a neo-fascist Corporatocracy. It's run (or managed if you prefer) by a relatively small clique of uber wealthy oligarchs (sometimes referred to a kleptocrats). These corporations and individuals have done their best to gradually impinge on our individual freedoms under the guise of "national security" (creating a surveillance state) and giving "personhood" to corporations.

So, the fact that we aren't in the top 20 shouldn't come as any surprise to you.  The countries with the greatest amount of personal freedom are all the "socialist"  Scandinavian countries as well as Japan, Australia, Ireland, Canada, Taiwan, Latvia and the Czech Republic (both former Soviet satellites),  the UK and others.

When it comes to personal freedom, the United States ranked an embarrassing 24th in the world. We are just behind Italy and ahead of Uruguay and Spain.  In terms of economic freedom, we did much better, which you'd expect with us being an Corporatocracy and all.  However, we're still not in the top five.

The top four most economically free are the Pacific nations of Taiwan, Hong Kong, Singapore, and New Zealand. Switzerland rounds out the top five. Coming in sixth place is the former Soviet republic of Georgia with the U.S. in the seventh spot. Ireland, Lithuania (another former Soviet state), and Australia rounding out the top ten. It's worth noting that most of the countries which ranked high in personal freedom ranked in the bottom half of the top 20 freest economic countries.

In looking at a report by the conservative Heritage Foundation for 2022, it's worth noting that the top economically freest countries are Singapore, Switzerland, Ireland, New Zealand, Luxembourg, Taiwan, and Estonia. The Netherlands, Finland, and Demark finish the top ten. 

The United States comes in 25th place between the UK and Georgia in the lower half of the "Mostly Free" column. We also became a debtor nation in 1985. An early warning? Germany was 16th and South Korea was 19th. The Ukraine was 130th while Russia was 113th. Both are in the "Least Free" section.

As an aside, America is also listed as a "flawed democracy". I've mentioned that this and other independent media sites are often "shadow blocked", so it should be no surprise that Reporters Without Borders should rank freedom of the press in the United States as barely satisfactory. In fact, the U.S. is ranked 43rd in the world. There are actually some third world nations ranked higher the U.S.!

Education has been called the "road to success" (or as John Wayne once said, "life is hard. It's harder if you're stupid). Either way, I have to agree. Education not only provides the individual with the keys to success, it also largely determines the success of a nation.

America has long struggled academically when compared to the rest of the world although we tend to spend more private and tax dollars on education than any other country. According to a 2021 academic report, the United States had the best overall educational system in the world followed the UK, Germany, Canada, France, Switzerland, Japan, Australia, Sweden, and the Netherlands.

When it comes to science and math, we ranked near the bottom of the second tier of developed nations. In the latest 2018 test of OECD (Organization for Economic Cooperation and Development),  we scored 478, which was below the average score of 489. The top five highest scoring countries were all Asian (Singapore, Macao, Hong Kong, Taiwan, and Japan).

In science, we did a little better, scoring just above the OECD average of 489 with a 502, but was well below the top five countries of Singapore (551), Macao (544), Estonia (544), Japan (529), and Finland (522).  In literacy, we ranked at about average with Denmark coming in first.

Another indicator of our decline is healthcare. You would think that with the resources that the United States has our healthcare would be second to none. Sadly, the U.S. has one of the worst healthcare systems of any industrial nation. While the world's overall life expectancy has continued to rise (it was 82 years old in 2020), it was 77 years of age in the U.S..

Meanwhile, mortality rates in the America have remained higher than in other OECD nations despite a general decline overall due to improved technology and medicine. The mortality rate in the U.S. dropped from 1980 to 2020 by 19% while for other industrial nations the drop was 43%.   

Early or premature deaths due to diseases and disabilities were also higher in the U.S. than elsewhere. In fact, they were roughly 37% higher. In 2019 (the latest record) non-age related deaths due to disease or disability were 26,061 per 100,000. The global average was 18,987. 

The United States also had the highest infant mortality rates of any OECD country as well with just under 24 deaths per 100,000 live births. The next closest country was Canada with 8.4 per 100,000. The Netherlands and Australia had the lowest with 1.2 and 2.0 respectively. The world average was 4.5.

Where we did well was with heart attack and stroke treatment. Using 2018 data for individuals age 45 or older over the first 30 days following the event, the mortality rate per 100 in the U.S. was 4.9 compared to 5.9 among industrial nation.. For strokes it was 4.1 versus 6.4, and for hemorrhagic (bleeding) strokes the mortality  was 19.4 as opposed to 20.7 globally.

But when it came to asthma, COPD, congestive heart failure, and diabetes we had mixed results. In measuring mortality rates per 100,000, the U.S. had 37.1 deaths related to asthma compared to an average among industrialized nations of 34.7. For diabetes, the U.S. had 226 versus 137.5.

However, with COPD we had 194.1 with 228 among comparative nations. When it came to congestive heart failure, the average among industrialized nations was 272.3. The U.S. had an appalling 411.7. There are 2018 figures, which are the latest measurements.

Finally, the United States ranks last when it comes to access to medical care and quality compared to other industrialized nations with the Netherlands, Australia, Sweden, Japan, and Austria in the top five spots.  It should also be noted that the U.S. places far less attention on preventative care and alternative medicinal treatment. There are fewer beds available in hospitals than in other OECD nations.

The United States also has among the highest prescription costs of most any nation in the world, which is attributable to its poor medical care coverage. The majority of nations have some form of nationalized (or "socialized" medicine if you prefer), resulting in lower costs and faster recovery but occasionally longer waiting times for non-life threatening treatment.

One component to having a long and healthy life is having a high overall quality of life. So how does the U.S. rank? As has been the trend for many years now, those "socialist" nations of Scandinavia have not just a better education system, better health care and higher life expectancy, they also have the highest quality of life, but they're not the only ones!

Sweden ranked number one, followed by Denmark, Canada, Switzerland, Norway, Finland, Germany, Netherlands, Australia, and New Zealand.  Other top nations include Ireland (#16), Japan (#14), and the UK (#12). As for the United States, we came in at #21, just behind Italy and Portugal but ahead of Poland and Singapore. By comparison, China and the United Arab Emirates are #24 and #25 respectively.

It's no secret that the U.S. has highest percentage of its population behind bars than any industrialized nation with an average of 625 individuals per 100,000, or to put it another way, with the U.S. having roughly 5% of the world's population, we have 25% of it behind bars. The states with the highest percentage incarcerated are Louisiana and Oklahoma. 90% of those behind bars are men.   

Following the United States is China, Brazil, India, Russia, and Thailand with the most number of people in jail (China and India dwarf the U.S. in terms of population). Israel and Bahrain have the least number of people behind bars. When examining the highest rates of incarceration based population, the U.S. again is number one followed by Rwanda, Turkmenistan, El Salvador, and Cuba.

In terms of voter approval, of the top 11 foundational institutions which support the federal government, only the military and small businesses have positive numbers. Congress consistently polls terrible. The disapproval rate for Congress is currently hovering around 77%.  In other countries their numbers would be concern for a revolt or revolution. In fact, 43% of Americans believe a civil war or revolution will occur within the next ten years.  

President Joe Biden has a disapproval rate of 51.4% while his Vice President, Kamala Harris, has a disapproval rating of 48.7%. The approval rating for former President Donald Trump is 55.7%, which seems to prove that persistent negative campaigning (aka "character assassination) works.

Meanwhile, only 30% of Americans approve of the direction the country is going in.  74% of Americans are sick and tired of bi-partisan bickering and finger pointing, including 78% of Independents, 82% of Democrats, and 68% of Republicans.  The average American has a consumer debt of nearly $100,000 while corporate CEOs earn approximately 324 times more than an average employee.  In 2020, the average corporate CEO made $670 dollars for every dollar an average employee earned.

As an aside, both corporate owned parties---Democrat and Republican---are losing more voters than gaining. Independents remain the largest political bloc and continues to grow while the Democrats and GOP battle over a shrinking piece of the political pie. Americans in large numbers disapprove of corporate lobbyists writing legislation, partisan gerrymandering, partisan offices, Citizens United while supporting citizen ballot initiatives, term limits, voter approval for tax, fee, and rate increases.

A country, no matter how large or developed, can't sustain numbers like these indefinitely, and yet that's exactly what Congress, the Presidency and Big Business expect. We continue to bolster corporations with taxpayer money and cut taxes for the rich while Americans struggle to make ends meet. In terms of poverty levels among OECD nations, America is third behind Costa Rica and Hungary.  

It's clear that the ruling Oligarchy will do nothing that impinges upon their growing control on power beyond smoke and mirrors. When citizens see no hope for real and meaningful change; when their propaganda or bread and circuses no long work, what then?  

 

If you want to know more about this article's topic, please check out the links below. If you enjoyed the article, please consider passing it along to others and don't forget to subscribe. It's free! Lastly please be sure to "like" us on whatever platform you use to read anotheropinionblog.com. It helps with the algorithms and keeps our articles in circulation. Thank you! 

 

World Population Review: Freest Countries 2022

2022 Index of Economic Freedom

Press Freedom Index

U.S. Education Rankings Are Falling Behind the Rest of theWorld

How does the quality of the U.S. health system compare toother countries?

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Incarceration rates by country

Quality of Life

FiveThirtyEight: Polls

Congressional Approval Rating

Americans are sick of lawmakers bickering. They don't have much hope that will change

Wage gap between CEOs and US workers jumped 670-to-1 lastyear, study says

Poverty rates in OECD countries as of 2019

Our Quality of Life and Positives Changes We Can Make

 

As pointed out in our previous article, one of the ways to judge a country's future is to look at its infrastructure. In our case, it looks pretty bleak. Another indicator of a nation's health is to look at its quality of life.

In terms of freedom and quality of life, America ranks fairly low. According to the "Democracy Index", which is published by the Economist Group, America is defined as a "flawed democracy", which should come as no surprise given that we're an Oligarchic led Corportracy. As an aside, a "flawed democracy" is just one step above a "failed democracy", and the bad news is that social indicators don't show us moving up.

When it comes to overall health and quality of life, Spain and Portugal are one and two. They're followed by Switzerland, Japan, and Iceland. Others in the top ten include Singapore, Norway, and Austria. And the U.S? We didn't do so well. We came in 153 out of 166.  

We also have one of the lowest life expectancies of any industrial nation, with an average of 79.11 years (81.65 for women and 76.61 for men).  We are between Estonia and Panama. The top five belong to Hong Kong  with an average of 85.29, Japan (85.03 avg.), Macao (84.68 avg.), Switzerland (84.29 avg.), and Singapore (84.07 avg.). In fact, everyone in the top 39 positions have an average in the 80's.             

The Conde' Nast Traveler, which provides travelling advice and ranks travel agencies, and so forth, published a report in March of this year of the world's happiest countries. As with previous reports, all of the Scandinavian countries make the top ten, which Finland, Denmark, Switzerland making the top three. The U.S. came in 14th, just behind Ireland and ahead of Canada (in 2019, we were 19th).

Another indicator economists, historians, and other social scientists look at in judging the stability of a country is the percentage of its population which is incarcerated. Unfortunately, we again don't stack up well compared to other countries.

According to the Prison Policy Initiative, about one in one hundred Americans are behind bars at either the federal or state level; 2.3 million people (which includes juveniles as well as adults). Globally, that's one in five of the world's population. To put it another way, while we have just 5% of the world's population, we have 20% of it behind bars.

The next closest country is Communist China, which imprisons 1.6 million. Even Russia and Iran jails fewer people...by far!  So how can we justify calling Russia, China, Iran, Cuba, Rwanda, or Venezuela "tyrannies"  when we imprison a greater percentage of our population people than any of them?

Of course, one answer to that question is that our prison systems outsources to more "for profit" prisons than any other nation. The overwhelming majority of countries utilize state run and financed institutions (through taxes, etc) to house inmates. We tend to emphasis time served rather than focus on reform and other methods to change behavior---even for first offenders.

In doing my research, I came across another interesting statistic. Of the so-called "top tier" or "first world" nations, we are the only ones which still utilizes the death penalty (albeit, it's decided at the state level). Of course, you can expand the definition of "top tier" to include nations like Saudi Arabia, Japan which also employ the death penalty. However, as of 2020, just 53 countries in the world have a death penalty; most of whom are third tier nations.

So, with all the statistics and other data about the United States and how it compares to the rest of the world, what does this tell us? There are a number of takeaways to consider. First, we have to understand that we are not the America our Founders had envisioned. I suspect that if they could see us now, they would have paid that damn tea tax!

Secondly, those elected to handle "the People's business" are actually "doing their business" on the People. We've lost our Republic plain and simple. Perhaps it was while we were busy trying to keep a roof over our heads and food on our tables. Maybe it was while we were distracted by all the "reality" shows, sports programs, video games, and manufactured propaganda masquerading as "news".

Congress represents Big Business, not us. Their lobbyists write the legislation. They help push it through committees and work to get it passed. These bills serve their interests, not ours. Not by a long shot. We get the crumbs.  We don't have lobbyists to represent our interests or to write bills for our wellbeing.

Corporations do their best to evade paying their fair share of taxes, and while the percentage of what we pay isn't the highest in the world, what we get for our money isn't the best either. Corporations are not "people" despite the Supreme Court's misruling. They do not necessarily represent their employees. Their loyalty is to their corporate officers, shareholders, and ultimately, their bottom line.

Corporations should also pay their fair share of taxes, even if that means establishing a minimum tax rate for "Big Business", plus a penalty for off shoring jobs and then shipping product back into the United States tariff free. Corporate lobbyists should never write legislation. Period. If a corporation or its industry is deemed to be essential to national security, it should be regulated if not nationalized in case of national emergences.

We have the highest incarceration rate in the world. We make the Chinese look like truants! We need to take the profit out of the prison system. We need to focus on reform, especially for first and non-violent offenders. We need to invest in reform and post incarceration support, such as helping with remedial education (GED, etc) and developing employable skills, helping to find stable employment, and periodic follow-up down the road. It's better for all of us in the long run and it's cheaper than building more prisons and housing more prisoners.  

As for the death penalty, I've always supported the "eye for an eye" principal. But, if we're going to take someone's life, let's make damn sure we have the right person. Coming back later and saying "Oops. We're sorry" ain't going to cut it. If there is one iota of doubt, take the death penalty off the table. Let's also make sure we're doing it for the right reasons; that the punishment fits the crime. Let's also make sure that we judge and sentence based on the crime, not on race, gender, income bracket, or other factors.

Prisons should also not be "resorts". A wealthy white collar crook shouldn't be sent to a less restrictive and better quality prison than a poor one trying to survive. Perhaps if the white collar crook had to spend their time with the "common riff raff", it might change their perspective. Everyone should be subject to the same laws and same penalties. No more two tier judicial system; one for the rich and one for the rest of us.

Prisons should be, as much as possible, self sufficient, including growing as much of their own food as possible. All prisoners should be required to take courses in civics and social behavior, and when possible, pay restitution to their victims. Finally, they should not have "state-of-the-art" gyms and weightlifting equipment. The last you should want is murderers and rapists getting bigger and stronger!

But none of this means anything unless we take back our country from the ruling Oligarchs who are taking this Corportracy that used to be our country  down the road to a neo-fascist surveillance dystopia.  Unless we do, the only thing that will change is the speed by which things will get worse.

They tried to frighten us with words like "socialism", which they equate with "Communism" or (wrongly) with Hitler and "Nazism" (a totally different political ideology). Why? It threatens their ability to control. They use these words because they create images which frighten people in lieu of what they actually mean---democracy, which  puts control  in the hands of people, which is their ultimate fear.

Ideally, socialism is control by the people. In practice, however, it's controlled by the state. While I don't consider myself a "socialist" and prefer a low intrusive democratic government, I do believe that there are some things the state should do or can do more effectively, as did some of the Founding Fathers.

There are features which were once considered "socialist" or even "Communist" just a few generations ago which I support such as Social Security, the right to organize and bargain, having a safe work environment, clean water and air, anti-child labor laws, COLAs, women's suffrage, equal rights and equal pay (which still has yet to be obtained), unemployment insurance, and so forth. 

When it comes to a minimum wage, we forget that it was established for entry level jobs and help people get started in the job market. It was never intended to a "living wage" (to support a family for instance). Ultimately, the job market is the best place to establish an acceptable wage. If no one takes a job for the pay you're offering, then maybe you need to do it yourself or offer more.

As an aside, I also like worker co-ops. In many cases, it isn't just a matter of the employees knowing how to run a company at least as well as the former owners, it's a way to keep the company open and people employed. Companies are likely to do better when everyone has a stake in its success.

I think that America, like all other developed nations, should have a minimum national insurance plan. Not all employers can afford insurance for their employees, especially small businesses.  Without one, we often lose the local "mom and pop" businesses to mega corporations.

A basic national insurance plan, like single payer, would help to level the playing field between small companies who can't afford insurance and the larger ones who can. Individuals could purchase additional insurance on the open market to suit their specific needs. I should add that all taxpayer based jobs should be required to have the same insurance as the rest us, including Congress, which is exempt.

I also believe that the Federal Government only has powers designated to it by the states, and not that it has all the powers except those specifically reserved by the states. In other words, a smaller and more decentralized federal government. I believe that the closer you are to the source of a problem, the easier it is to solve. Therefore, we need to focus on solutions at the state and local levels as much as possible.

There are things we can do to reclaim our nation, as I mentioned above, but there are some other things we should push for too. We need to restructure our tax system and adopt either a flat or consumption tax, in addition to establishing a minimum tax for global corporations.

Corporate lobbyists, consultants, or advisors, should not have a hand in writing any legislation or make recommendations about which bills to support. Corporations are not "people" and money is not "free speech". Therefore, we need to rescind Citizens United and remove virtually unlimited corporate funding of elections.

Any tax increase proposals, as well as fee or rate changes, should be subject to a public vote. To paraphrase the TV commercial says, "it's our money and we want a say how".  We need to end partisan gerrymandering. We need to level the election play field by making all election requirements the same regardless of registration. Appointment to boards or commissions should be based on qualifications only, not party control.  Citizen's initiatives and referendums should be a matter of law.

Aside to term limits, Rank Choice voting should also be added to provide a more equitable choice of candidates. Some public offices should be non-partisan such as Treasurer, Secretary of State, County Clerk, County Judge, or  Secretary of Agriculture. For that matter, once elected, politicians should resign their party affiliation. They're there to represent everyone, not just their party, which means everyone else is taxed without representation (proportional representation would fix that).

These are but a few of the things we must do, to restore our country to the American People and make this a top tier nation once again. As it is, America will soon be no different from any other second level nation with pockets of cities and communities which look like they belong to a third world nation than to the United States. It won't be easy, but I think it's a worthy cause. I hope you do too.

 

OECD Better Life Index

Sustainable Public Transit

World Happiness Report

 

The Healthiest Places To Live

What Percentage of the U.S. Population is Incarcerated?

Which countries have the death penalty and how many peopleare executed every year?

Life Expectancy of the World's Population

 

Where are the "Happiest" Places to Live? A Look At the Happiest Countries, States, and Cities

How many of you remember the little ditty from childhood, "If you're happy and you know it clap your hands"? How many of you can honestly clap your hands these days? What does it really mean, to be "happy"? What are some of the internal and external facts that affect your overall happiness? Lastly, what countries are considered the happiest? What about individual states and cities? Which ones are the considered the happiest places to live?

While "happiness" it difficult to quantify, it's generally considered to a measure of contentment, be it your personal happiness or that of a group and even a country. Many factors, both internal and external, go into the concept of happiness. It could be the amount of pleasure or enjoyment you derive from something, be it tangible or perception. Happiness can also be seen as security as in the amount of physical or psychological comfort you receive. This could mean having a home, a good job, or being in a loving/caring relationship.

On a more macro basis, happiness could be viewed as having quality medical care, good roads, a good educational system, or a stable economy capable of providing growth and opportunities. Some might argue that a strong military brings them a measure of happiness since it provides security from outside threats while others might say that having a responsive police, fire department, or EMS actually brings them more comfort than a strong military since it provides a more immediate amount of security than the threat of external threats. Other features of happiness at the macro level might include infrastructure, the availability of food or on demand electricity and clean water.

The thing about happiness is that there's no right or wrong answers as our individual needs or wants differ based on a multitude of factors like upbringing, education, gender, social class, or religious beliefs. Thus happiness could mean the availability of fresh food, clean drinking water, having a stable economy which every business needs in order to function and grow, a progressive social safety net, reasonable taxes (I say "reasonable" because no one likes to pay taxes, but that's the price of civilization. Reasonable means the services you receive for your tax dollars).

It also includes having a responsive government. Note that doesn't necessarily mean a "democratic" style government nor having the same "freedoms", however you want to define that term, as the next country. Historically, people have always been willing to sacrifice their freedoms, or at least some of them, for security. People look to government to provide those things which most of us are unable to acquire on our own, either because of the expense or lack of expertise or resources needed. if a government is able to provide what the people need (as oppose to want) on a consistent basis, it typically doesn't matter the form government takes in the long run. That's why feudal states did so well for such a long time. However, when government acquires to much powerful while not meeting our changing needs, we usually see pushback in the form of reform movements, revolts or revolutions.

So, having said that, let's look at those countries where the people there say they are happy. We'll also take a look at which US states and cities are ranked by their level of happiness. According to the "World Happiness Report of 2018 (yes, that's actually a report), which is published by the United Nations, people are surveyed using a ranking system called the "Cantrill Ladder" (it ranks questions on a scale of 0 for the least to 10 for the most). The survey examines areas such as macro and micro economics, national statistics, psychology, as well as national policies, ethics/values, along with other reports tied to the Organization for Economic Co-operation and Development (OECD) of 156 countries.

Coming in the tenth spot was the country from down under, Australia. In ninth place was Sweden. Eighth place belonged to Australia's neighbor, New Zealand. Number seven was Canada. The sixth ranked country in terms of most happy was Switzerland. Iceland placed fourth while Denmark was third. The second happiest county was Norway. Finally, the country with the happiest people was Finland. As an aside, Scandinavia, and in particular Finland, have ranked in the top ten happiest countries for five years in row. You'll also note that these same countries also rank in the top ten when it comes to education, lowest crime, and best healthcare. While these countries do have higher taxes than other countries, especially compared to the US, they obviously get the biggest bang for the buck.

Honorable mention goes to Israel and Austria, which just missed out of the top ten and came in eleventh and twelfth place respectively. Germany placed fifteenth. Meanwhile, the United States ranked well out of the top ten and came in eighteenth, just behind Luxemburg and ahead of the United Kingdom. The Republic of Ireland was ranked in the fourteenth spot. Rounding out the top twenty was the United Arab Emirates. So, if these are the happiest places to live, who are on the other end of the survey? Who are the bottom ten?

Starting in tenth place was the country of Malawi, which is located in southeast Africa between Zambia, Tanzania, and Mozambique. In the ninth spot was Haiti. Eighth place belongs to the African nation of Liberia. Coming in seventh was worn torn Syria. Next was Rwanda, which has suffered for decades from famine (some being natural while some being man-made) and ethnic violence between the Tutsi, Hutu, and Twa tribes.

In fifth place was another war ravaged nation, Yemen, which is located at the southern edge of the Arabian Peninsula. The fourth worse place to live in terms of happiness was another African country, Tanzania. South Sudan in Africa's east-central region was third. The second worst country for happiness was Central African Republic. Finally, the worse country to when in when it comes to happiness was the nation of Burundi, a teeny tiny country in east central Africa.

Other countries of note include Russia, which was ranked 59th, Italy in 47th place, and Japan at 54th. South Korea was 57th. Turkey was ranked 74th happiest place while Greece was 79th. Singapore and Hong Kong, which were ranked as two of the "freest" countries in the world came in 34th and 76th while China placed 86th. South Africa, which is dealing with an ongoing genocide of white residents, was 105th while Vietnam was 95th. The largest democracy in the world, India, came in 133rd compared to less democratic nation of Pakistan which was ranked 75th. Iran was 106th happiest nation and the Ukraine was 138th. France and Mexico placed 23th and 24th respectively. Finally, Venezuela, which is in economic freefall, was ranked 102.

Now that we've looked at which countries are the happiest, what about which states are considered the happiest? According to WalletHub, which looked at 31 factors broken down into three categories---Emotional and Physical Wellbeing, Work Environment, and Community and Environment, ranked all fifty states, assigned individual scores by category along with a total overall score. So, coming in tenth was the state Nebraska. In ninth place was South Dakota. The eight happiest state was Iowa. In seventh place was Maryland. Next came Idaho. Despite a plethora of natural disasters and high taxes, California took fifth place. The fourth spot was North Dakota. Ranked third as the happiest place to be in the US was Minnesota. The second best spot to be was Utah. Lastly, the happiest state belongs to Hawaii with its sun and surf.

Well, if these are the ten happiest places to live, who are the least happy states? The tenth least happy state is New Mexico. Next was Missouri. In eight place was Mississippi. Kentucky was the seventh least happy state to be in. Coming in sixth place was Alabama. The fifth spot went to Oklahoma. Interestingly, despite all its majestic scenery and low taxes, Alaska was fourth. Third on the list of least happy states was Louisiana. In second was "Razor Back" state of Arkansas. The least happy state in the nation went to West Virginia. Some other states of interest include New Jersey and New York (13th and 14th respectively), North Carolina (20th), Texas (23rd), Kansas (25th), Indiana (32nd), and Tennessee (40th).

As an aside, I mentioned that Kentucky was seventh ranked least happy state. The same report pointed out that Kentucky also had one of the highest levels of adult depression, coming in at 47th. It was 48th in terms of least amount of adequate sleep. Meanwhile, the state with the least amount of adult depression was New York, and the state which got its fair share of restful sleep was South Dakota. So, now that we know the happiest states, let's take a look at the happiest cities in the US.

Coming in just ahead of Bismarck North Dakota in tenth place was San Francisco. Ninth place went to Scottsdale Arizona. The eighth spot belonged to San Jose California. Grand Prairie Texas was seventh while Fargo North Dakota was sixth. For the fifth spot, Huntington Beach California was the place to be. Another California city, Fremont was fourth. Madison Wisconsin was third. In second place was another California city, Irvine. Finally, the happiest city in the US was Plano Texas.

Ranked as the tenth least happy city was Mobile Alabama. Newark New Jersey was ninth. In the eight spot was Huntington West Virginia. Next was Little Rock Arkansas, which was just behind Gulfport Mississippi. In fifth place was Cleveland Ohio. Fourth place fell to Birmingham Alabama. The third least happy city was Charlestown West Virginia. The second least happy city was Toledo Ohio. Finally, the least happiest city in America was Detroit Michigan.

Honorable (and dishonorable) mention goes out to Sioux Falls South Dakota (15th), Raleigh North Carolina (23rd), Cape Coral Florida (24th), Lincoln Nebraska (36th), Tempe Arizona (39th), Ft Worth Texas (42nd), Arlington Texas (49th), Seattle Washington (54th), Boston Mass (58th), Yonkers New York (65th), Cheyenne Wyoming (73rd), Reno Nevada (77th), NYC (90th), Nashville Tennessee (105th), Chicago Illinois (107th), Lexington Kentucky (113th), Richmond Virginia (121st), Jacksonville Florida (136th), Louisville Kentucky (138th), Indianapolis Indiana (151st) and Columbus Georgia (166th). All together, 182 cities made the survey.

The most hours worked went to Anchorage Alaska (I wonder if that has something to do with the "Midnight Sun" and all that?) while the least amount went to Burlington Vermont. The city with the highest income growth was San Francisco while the city with the least amount income growth was Gulfport Mississippi. The city with the highest suicide rate was Juneau Alaska (must be all the hours they work in Alaska). Boston Massachusetts had the lowest. The city with the lowest divorce and separation rate was Fremont California (followed by Irving California), while the city with the most was Detroit Michigan, which beat out Cleveland Ohio.

So, what does this tell us? Well, first it should tell us that the countries, states, and cities with the highest taxation aren't necessarily going to be the most unhappy. In fact, in looking at countries, democratic socialist Scandinavia has consistently ranked in the top tier (usually the top ten) for years while some non-democracies do as well, if not better, than many democracies. These countries also ranked among the highest in terms of education, healthcare, and until recently---with the arrival of the so-called "migrants"---had the lowest crimes rates. They also rank in the top ten for the highest quality of life, lowest child mortality rates, and had longer life expectancy.

Meanwhile, countries which rank the highest in terms of lowest taxes or the most "free" and capitalist friendly don't always rank among the highest when it comes to being the happiest such as Singapore, Japan, or Hong Kong. The same seems to apply to states and cities. You'll notice that states with the highest taxes also ranked generally high in terms of happiness. Of course, that's not to say this applies to everyone across the board. There are several instances where high taxes doesn't equally apply to happiness, such as New York and New Jersey or Chicago and Detroit.

As we discussed at the beginning of this article, a lot of other factors come into play, including quality of education, job growth, taxes to services, and externals like parks, entertainment and recreation spots, the level of pollution, medical care, police, fire, and EMS considering happiness. Ultimately, you can't assume that a certain rural location low taxes, or even living under particular type of government automatically equates to happiness. As with most things in life, you have to look at the total picture if you want to fully understand any situation. Happiness, at least as discussed here, is no different.


World Happiness Report

Happiest States In America

Happiest Cities in America

The U.S. vs The World: How Do We Stack Up?

As anyone who knows me will attest, I love surveys, quizzes, and polls. So, it won't come as a surprise to anyone that my curiosity was peaked when I read an article recently about best places to live, in this case, if you're a woman. The article looked at a variety of factors, such as income parity, healthcare, and so forth. The US, it seems, is 23rd on the list, down from the 17th spot in 2011. In fact, when it came to income parity, which is essentially equal income for similar work between sexes, the US was a woefully 67th, while at the same time, it ranked 6th in economic participation or the ratio between men to women in the workplace. So, naturally, I decided I'd take a look at some other ranking to see where the Good Ole U S of A stacks up to other countries on other issues.

The factor I wanted to look at first was the overall quality of life. After all, what's the sense in living there if it's a lousy place to be? It turns out the place with the best quality of life is Australia, followed by Sweden, Canada, and Norway. The US came in 6th place, just ahead of Denmark and Holland. Iceland and Luxembourg rounded off the top 15. Forbes Magazine said in a 2013 article published on January 4th that Ecuador was their top spot to retire, followed by Panama, Malaysia, Mexico and Costa Rica. Ok, so how about overall life expectancy? Being an ageing Babyboomer, that's kinda important.

The country with longest life expectancy turns out to be two countries actually, Japan and Switzerland, with an average age each of 83. However, if you're a guy, the best place to be is in the fourth ranked country, Italy. While the average life expectancy is 82, it has the highest life expectancy for men at 82. But hey ladies, Italy is pretty good to you too. It's ranked number one for gals with a life expectancy of 86! The United States is ranked 33rd in the world with an average age of 79. For men, the US comes in 36th place with an average life expectancy of 76 and 35th place for women with 81 years. But what about the quality of those years?
It turns out that Sweden is the best place to grow old in (a bit cold for my tastes). Norway, was second with Germany, Holland, and Canada rounding out the top five. The US was ranked 8th, just behind New Zealand and just ahead of Iceland. Going hand-in-hand with the best places to grow old, is which places have the best healthcare. It turns out that Hong Kong, despite its dense population has the best healthcare system, and is just ahead of Singapore and Japan.

Next on the list was Israel, Spain, Italy, and Austria, with Sweden finishing the top 10. As an aside, it also seems that Hong Kong has the highest life expectancy on the list with an average of 83.4 years. The US ranked a dismal 46th out of 48, just ahead of Serbia, Brazil and behind China, Algeria, and Iran. American efficiency in terms of healthcare dollars was a poor 20%, and yet we spend more per person on average ($8608.00 per year) than any other nation except number 9 on the list, Switzerland, which spends $9,121.00 (US dollars) per person. Along a similar line, the overall healthiest people are the Japanese, followed by the Austrians, French, Swedes, and Italians. So, what about education? Surely we have to do better in this area than anyone else.

Well, as it turns out, not so much. The best educated nation is the Finns, though close behind are the South Koreans and Hong Kong. Two other Asian giants came in fourth and fifth, Japan and Singapore respectively. Next on the list was the Brits, Dutch, and New Zealanders. The Swiss and Canadians rounded out the top 10. America came in 17th place, just behind the Belgians and just ahead of the Hungarians and Slovakians.

What's really interesting about this is that, according to the Organization for Economic Cooperation and Development, the US spends more per student (just over $15,000) than any other nation. Switzerland comes the closes with an average cost of $14,922.00 per student while Mexico spends among the least at just under $3000.00 (as an comparison, the US spends, on average, around $32,000.00 per person in prison). At the same time, US students score far below students in other highly developed nations and do only slightly better than students in second and third tier countries. The US literacy rate 99%, which is pretty good, we're still ranked 26 in the world. The Ukraine, for instance, is ranked 12th while Norway is ranked 1st. The report indicated that the average cost per student was $9,313.00. What's also interesting is that the US lags behind the other Western nations in math, science, reading in 25th place while the East Asian nations score top marks across the board.What was also interesting was that US teachers were, on average, among the best paid in the world too. Obviously, something is very wrong here.

Speaking of expenditures, I wondered how we compared to other nations in terms of taxes. It turned out, that we do fairly well. The US ranks 23rd on taxable income, while other nations which as we've seen score well, did poorly here. Sweden has the highest tax rate at 56.6%, followed by Denmark at 55.4% and Holland at 52%. Austria and the UK were tied at 50%. Obviously, if you want better healthcare and quality of life (though not necessarily a better education), you'll have to pay dearly for it. It's all a matter of priorities. In terms of national debt, which certainly affects everything we've discussed thus far, the US is by far the most indebted nation in the world at approximately (in millions) $15,940,978. The next closest country are our British cousins at $9,307,090.

In terms of economic freedom, which by its very definition is subjective, the 2013 Index of Economic Freedom Report, list the most economically free country as Hong Kong with a score of 89.3. Singapore comes in 2nd with a score of 88. Australia and New Zealand are 3rd and 4th respectively. The United States comes in shocking 10th, just ahead of Ireland but behind Canada, Chile and Denmark. The UK is 14th and Germany ranks 19th.

In looking at crime, the US again came in first place with some 12,408,899 crimes reported in 2011. The next closest nation was Germany with some 2,112,843. Russia was fourth with just over 1 million reported crimes while Holland had approximately 372,300 reported crimes in 2011. The US ranked first among developed nations in violent crimes such as murder. Only four countries, Estonia, Russia Mexico and Brazil ranked higher. On the opposite side of the social spectrum, I was also interested to know who were the most and least religious people in the world, regardless of their religion.

As you might guess, religiosity seems to be closely related to wealth. It is also, sometimes, tied to political dogma. The poorer a country is, the more religious it is while the richer a country is, the less likely it will be overly religious. As it turns out, Ghana, as extremely poor nation, was top with 96% of the population claiming to be religious. Close behind them was Nigeria at 93% and Armenia at 92%. While globally, religion has declined 9% since 2005, Macedonia's religiosity was still at 90% with Romania at 89% and Iraq and Kenya tied at 88%.

On the other side of this issue, Ireland, once a devoutly Catholic nation now claims a whopping 10% atheist population, alongside Austria and Iceland. Holland was 15% atheist while Germany and South Korea were 15%. Surprisingly, the once very Catholic are now 29% atheist which the Czechs are 30%. What perhaps surprised me was the Japanese are 31% atheist, and unsurprisingly, the Chinese are 47% atheist. As for the US, 65% of us said we were religious. This ranked us 60th in the world. While 65% seems to be pretty good considering, it's still at drop of 13% since 2005.

So, the next time you want to know how America stacks up against other countries, you'll know. As can be seen, however, for a nation with the amazing diversity of people and resources, we can and need to do better; much better. There's no excuse for us to spend what we do on education, yet do so poorly, nor is the there an reason we should not do better in terms of reducing crime or improving the quality of life in America.

The Most Efficient Health Care Systems in the World
http://www.huffingtonpost.com/2013/08/29/most-efficient-healthcare_n_3825477.html



The Best Countries to Grow Old In
http://247wallst.com/special-report/2013/10/08/the-worst-countries-to-grow-old-in/2/

2013 Index Economic Freedom Report
http://www.heritage.org/index/ranking



Top Ten Countries with the Most Debt
http://www.mapsofworld.com/world-top-ten/countries-most-in-debt-map.html



Top Ten Countries with the Most Reported Crimes
http://www.mapsofworld.com/world-top-ten/countries-most-in-debt-map.html



The Top Ten Countries with the Highest Income Tax Rates
http://www.fool.com/investing/general/2013/11/10/the-10-countries-with-the-highest-income-tax-rates.aspx



A revealing map of how students around the world test on math science and reading
http://www.washingtonpost.com/blogs/worldviews/wp/2013/12/03/a-revealing-map-of-how-students-around-the-world-test-on-math-science-and-reading/



U.S. education spending tops global list, study shows
http://www.cbsnews.com/news/us-education-spending-tops-global-list-study-shows/



Most Religious Countries and Most Atheist Countries
http://www.huffingtonpost.com/2013/07/23/most-religious-countries-least-religious_n_3640033.html


Global Index of Religion and Atheism
http://redcresearch.ie/wp-content/uploads/2012/08/RED-C-press-release-Religion-and-Atheism-25-7-12.pdf