American Health Care Is Worst in Rich World

Empire State Building New York
The Empire State Building in Manhattan, New York behind the light of an emergency vehicle, June 9, 2016 (Unsplash/Dapo Oni)

America has the worst health-care system out of eleven rich nations.

The Commonwealth Fund, a century-old foundation dedicated to improving health care, places the United States behind Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom in its latest report. The Netherlands and Norway share first place.

America is the world’s top innovator of new medications and treatments. The best medical schools are in the United States. The country spends relatively more on preventative care than most. But this doesn’t outweigh its poor scores on the Commonwealth Fund’s other criteria: access to care, administrative efficiency, equity and outcomes.

In practical terms, this means especially low-income Americans don’t get the health care they need, either because it’s too expensive, too complex or both. Preventable deaths, including infant and maternal mortality, are higher in the United States than in other wealthy nations. Life expectancy is lower.

The Commonwealth Fund’s findings match those of the Euro Health Consumer Index, OECD, Peterson Center on Healthcare and Kaiser Family Foundation, all of which rank the United States below Australia, Canada and countries in Northern and Western Europe. Read more “American Health Care Is Worst in Rich World”

America’s $1 Trillion Infrastructure Bill, Explained

San Francisco California
The sun sets over the San Francisco Bay, California, September 29, 2015 (Thomas Hawk)

The United States Senate is expected to pass a $1 trillion infrastructure bill this week with funding for everything from broadband Internet to road safety.

The bill, which is believed to have the support of enough Republicans to overcome a forty-senator filibuster, falls short of the $2 trillion President Joe Biden had proposed to spend on (green) infrastructure over four years.

The compromise bill has $550 billion in new spending. The rest consists of existing infrastructure funds which are either being diverted or renewed.

Unlike Biden’s $2 trillion proposal, which would have been funded by corporate tax increases, the compromise version draws money from various sources, including around $200 billion left over from COVID-19 relief programs. Read more “America’s $1 Trillion Infrastructure Bill, Explained”

Biden’s Child Benefits Don’t Make Child Care Cheaper

Joe Biden
American president Joe Biden meets with staff in the Oval Office of the White House in Washington DC, June 2 (White House/Adam Schultz)

Last week, American parents received their first monthly child benefits worth $300 for children under the age of 6 and $250 for kids up to the age of 17.

Couples making under $250,000 per year, or single parents earning less than $112,500, qualify.

President Joe Biden described the cheques, worth $15 billion, as “the largest ever one-year decrease in child poverty in the history of the United States of America.”

That’s probably true, and the hope is that the benefits, introduced as part a COVID-19 rescue plan, will become permanent.

But they don’t lower the price of child care. Read more “Biden’s Child Benefits Don’t Make Child Care Cheaper”

Judges Need to Know Their Place

Supreme Court The Hague Netherlands
Seat of the Supreme Court of the Netherlands in The Hague, February 3, 2016 (Rijksvastgoedbedrijf/Bas Kijzers)

European judges have discovered they can compel politicians to take action against climate change.

France’s Council of State has given the government of Emmanuel Macron an April 2022 deadline (one month before the election) to ensure the country will meet its target of reducing greenhouse gas emissions 40 percent by 2030 compared to 1990.

Germany’s Constitutional Court issued a similar ruling in April and gave the government an end-of-year deadline to update its policy.

A Dutch court has gone further, ordering Shell, the Anglo-Dutch oil giant, to reduce not just its own carbon dioxide emissions by 45 percent but those of its customers and suppliers as well.

It’s like we’re living in a kritocracy. Read more “Judges Need to Know Their Place”

Europe Doesn’t Need a Biden

Joe Biden
Ameican president Joe Biden boards Air Force One at Joint Base Andrews, Maryland, February 5 (White House/Adam Schultz)

European leaders are “weak”, the American president is “bold”. It’s a trope so old, at this point it tells us more about the people who perpetuate it than about elected officials on either side of the Atlantic.

Romano Prodi was “weak“. José María Aznar was “weak“. François Mitterrand was “weak“. His successor, Jacques Chirac, lacked “gravitas“.

A year before the election of Donald Trump, Robert Kaplan disparaged the “grey, insipid ciphers” who wandered Europe’s halls of power. An article in Foreign Affairs accused the continent’s “cowardly” leadership of rendering the EU “irrelevant”. A 2005 op-ed in The New York Times lamented the “weakness” of European leaders at the very time President George W. Bush called for a “renewal” in transatlantic relations. (The same George W. Bush who two years earlier had created the deepest crisis in transatlantic relations since the end of the Cold War by invading Iraq.)

Here we go again. Jef Poortmans, a commentator for Belgium’s Knack magazine, compares Joe Biden’s “zeal” with Europe’s “washed out” leadership. Timothy Garton Ash, whose expectations the EU has never met, argues the bloc faces “one of the biggest challenges of its life” (again). Philip Stephens contrasts Biden’s “ambition”, “audacity”, “energy” and “resolve” with the “defensive incrementalism” of his European counterparts, in particular Angela Merkel.

The “real significance” of Biden’s agenda, writes Stephens in the Financial Times — a $1.9 trillion coronavirus rescue program and a $3 trillion education and infrastructure bill — “lies in a bold reassertion of the responsibilities of government.”

His mistake is to assume America and Europe are starting from the same point. Read more “Europe Doesn’t Need a Biden”

Child Benefits Could Outlive Biden’s COVID-19 Stimulus

Joe Biden
Former American vice president Joe Biden campaigns in Des Moines, Iowa, July 4, 2019 (Gage Skidmore)

The United States Senate has approved President Joe Biden’s $1.9 trillion coronavirus recovery plan, more than twice the size of Barack Obama’s 2009 stimulus.

With the exception of a $15 hourly minimum wage, the soon-to-be-law includes nearly all the provisions Biden had called for, including additional spending on health care, extended unemployment insurance (if cut by $100 per week from the original version) and rental assistance. For detail, check out my post about the bill from January.

The part I want to focus on here is a child allowance that ranges from $250 to $300 per month per child. Read more “Child Benefits Could Outlive Biden’s COVID-19 Stimulus”

Biden’s Foreign Policy Begins at Home

Joe Biden
Joe Biden makes his first speech as president from the West Front of the United States Capitol in Washington DC, January 20 (DoD/Carlos M. Vazquez II)

The appointment of Jake Sullivan as Joe Biden’s national security advisor is a strong hint that the new president’s focus on domestic issues — COVID-19, the economy, racial equity — will influence American foreign policy in the next four years.

While at the Carnegie Endowment for International Peace during the Trump Administration, Sullivan co-authored a report that argued American foreign policy had failed the American middle class. As Biden’s closest foreign-policy advisor, he can push for the return to Obama-style multilateralism, but this time with a laser focus on the interests of middle America.

Here’s what that could mean for the top items on Biden’s foreign-policy agenda: Afghanistan, China and Europe. Read more “Biden’s Foreign Policy Begins at Home”

America Needs a de Gaulle

Charles de Gaulle
French president Charles de Gaulle gives a speech in Montréal, Canada, July 24, 1967 (Archives de Montréal)

Charles de Gaulle’s great achievement, to paraphrase his British biographer, Julian Jackson, was that he reconciled the French left to patriotism and the French right to democracy.

The history of France since 1789 has been a consistent struggle between a universalist left and the conservative right; between republic and monarchy; the Enlightenment and Catholicism; labor and capital; Paris and La France profonde.

History hasn’t ended. Emmanuel Macron and Marine Le Pen embody opposite visions of France today. But de Gaulle narrowed the divide and helped Frenchmen and -women think of each other as opponents rather than enemies.

That America could use a whiff of Gaullism isn’t my idea. Ross Douthat, the conservative columnist of The New York Times, called for an American de Gaulle two years ago.

I suspect he envisaged an authority figure on the right. Instead we have Joe Biden. Can he play the same role? Read more “America Needs a de Gaulle”

Biden Plans $1.9 Trillion Coronavirus Rescue Program

United States Capitol
Workers drape a flag from the facade of the United States Capitol in Washington DC for Joe Biden’s inauguration ceremony, January 9 (Victoria Pickering)

Joe Biden is planning to ask Congress for $1.9 trillion in the first weeks of his presidency to cope with the effects of the coronavirus pandemic in the United States.

Matthew Yglesias and Punchbowl News, a new Capitol Hill-focused newsletter, have the details:

  • $400 billion for health, including $50 billion for testing, $30 billion for protective gear and $20 billion for vaccinations.
  • Hire 100,000 public health workers.
  • A mandatory paid sick leave program.
  • $1,400 cheques to all Americans on top of the $600 cheques sent in December.
  • Extend federal unemployment benefits at $400 per week.
  • Extend the eviction moratorium.
  • $30 billion in rental assistance.
  • Raise the federal minimum wage to $15 per hour.
  • Raise the child tax credit to as much $3,600 per year for families with young children.
  • $350 billion in financial relief for local, tribal and state governments. Read more “Biden Plans $1.9 Trillion Coronavirus Rescue Program”