One month ago, I wrote about three areas in which the U.S. needed to catch up with the rest of the world’s wealthy nations: health care, education and child care for workers. Of these, the most urgent and obvious area requiring immediate attention is health care. Why? Because we spend twice as much money as a percent of GDP than the other countries in the Organization for Economic Cooperation and Development and get worse results. In addition, they all cover every citizen while, as of 2019, 28.9 million Americans were uninsured.

Our results? The U.S. ranks 40th in the world in life expectancy at birth, 78.5, while Japan ranks first at 84.3.

The U.S. ranks 37th in the world in life expectancy at age 60, 83.1, while Japan ranks first at 86.3.

The U.S. ranks 47th in the world in infant mortality — 6.5 per 1,000 live births — behind all of Western Europe and Japan. Even Russia is better at 5.8 per 1,000 live births.

I could go on, but you probably get the message at this point. This country spends extravagantly on health care as a percent of our GDP, produces poor results and does not insure everyone. In fact, according to a 2019 study by the American Journal of Public Health, 66.5% of personal bankruptcies in the U.S. are due to medical issues. Spending more and producing low-quality results is not a winning formula. The U.S. health care system can only be described as the worst of all worlds. Can anyone look at these facts and disagree?

There are two questions we should probably be asking ourselves: 1) How did we let it get this horrible? and 2) Why aren’t our representatives and senators falling all over themselves to fix it? If I can get the above information, we know that they can as well.

First of all, fundamental Republican ideology assumes that the free market will always work better than the government. In many cases this is true and is the foundation for our capitalist system. The free market works well when competition restrains prices. For example, if Chevy priced their Silverado $20,000 higher than a comparable Ford F-150, they would have a hard time selling their trucks. In health care, however, competition is minimal and prices are not readily available, so cost-control is virtually nonexistent. Imagine that you are at home in Portland and are hit with an incredibly painful appendicitis attack. Your wife helpfully calls the EMTs but, in the meantime, might you be out on the web trying to find the hospital with the lowest prices? Is this information even decipherable?

From a Republican perspective, our health care system is working exactly as intended in that it is creating wealth; we have the highest paid doctors in the world and our health care companies, up and down the food chain, are highly profitable. To Republicans, the fact that we spend more than other countries, produce miserable results and leave 30 million Americans uninsured is irrelevant compared to industry profitability.

There has been an attempt at a fix. The Affordable Care Act was passed and signed into law by former President Barack Obama in March 2010. The ACA fell significantly short of being a total solution, but it did solve the problem of those who, through a job change, could not obtain affordable insurance due to a preexisting condition. Through its additional funding of Medicaid and availability of insurance through health insurance exchanges, coverage was expanded by roughly 20 million people. Unfortunately, it did very little to address the cost of either services or pharmaceuticals.

The U.S. health care system is obviously broken; the statistics don’t lie. What should voters say to any congressman or senator who isn’t working toward a solution that reduces costs and provides health care for all? “You’re fired!”


Rich Belzer served as director of federal marketing for a NYSE-listed computer company and was subsequently a senior executive with two NASDAQ-listed high-tech companies. He moved to Bend to join Columbia Aircraft where he became vice president of worldwide sales.

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