The best country in the world for a mother is Sweden. The 27th best country in the world for a mother is the United States, according to Save the Children’s “State of the World’s Mothers” report, just released.
Among the factors figured into the ratings are risk of maternal mortality, female life expectancy, and under-5 mortality rate. Norway and Iceland are in second and third place.
Why are those Scandanavian countries so high, and the U.S. – which spends wildly on health care – so low? Because the Scandanavian countries have a long tradition of social democracy, and the United States has a market-driven health care system. There are some things that socialism does much better than capitalism. Health care is among them. Let’s be clear: More mothers die in childbirth, more infants and toddlers die in the United States, because the U.S. does not have universal, government-backed health care.
As Ezra Klein just wrote , the standard claim for American health care – no waiting for care – is nonsense. Some waits are hidden by poor reporting. More important, many people don’t wait for care – they don’t get it all.
The Save the Children report anachronistically lists Israel in Tier II, Less Developed Countries, so it doesn’t directly compare us to Sweden and the United States. In Tier II, Israel is the best place for mothers. Women’s life expectancy is higher than that in the U.S. (83 years in Israel, 81 in the U.S.). In Israel, 5 children out of 1,000 die under the age of 5. In the United States, 8 do.
Why is it healthier to live in Israel than in the United States? Uh, it’s not because life is less tense here, or because people drive better. Nor is it because we are a richer country. It’s because we have socialized medicine. Because the government still stands behind medical care. Not as firmly as it used to, unfortunately. The neoliberal economic policies of recent governments combine lower tax rates on the rich with insufficient health funding, leading to a transfer of the some health costs (prescriptions) from the government to the patient. But the socialist tradition of Israel’s founding days still has a strong enough influence on the structure of society that fewer kids die here, even though we spend a smaller portion of our GDP on health care than America does. Am I glorifying Israel’s socialist past here? You bet I am.
I’m not claiming that the government does everything better than the market. But the opposite claim is mere propaganda for policy decisions that benefit business.
I’d even be willing to put up with rude clerks in order to insure that poor people are less poor, and get the medical care they need. Fortunately, the choice is nowhere near so simple.
Example: Out of blind belief in privatization, the government recently gave up administering the written tests for drivers’ licenses, turning that over to a private company. My daughter went to take her test. The line outside was hours long. No numbers were given out, so people just stood and tried to get in the office. The private company, obviously, was trying to make a profit by reducing its costs, and the customer paid in misery.
It’s true that service at both the post office and the phone company have improved in recent years. Both remain highly regulated utilities. Service also improved drastically at the Interior Ministry – which is still simply a government bureaucracy.
In the meantime, service has gotten much worse on U.S. airlines, which already had a rep in the world for rudeness. Faced with falling profits, the airlines have cut back on services rather than trying attract customers with better treatment. This is a death spiral: The same attitude killed Pan-Am and TWA. But stupid management is not a monopoly of government or the private sector. (See under: Enron.)
I suggest that the all-present propaganda for the market influences perception: When service improves at a private company, we tend to associate it with market forces. When service gets worse, we just complain. When the lines get shorter at the Interior Ministry, the change gets little notice, because it doesn’t fit the prevailing paradigm.
On Independence Day, I choose to toast the socialists who founded this country.