Wednesday, July 04, 2007

A National Gut-Check: Who Lives Better?

By TIMOTHY EGAN
Guest Columnist
The New York Times
July 5, 2007

One of the memorable scenes in “Sicko,” Michael Moore’s latest cinematic provocation, comes from France, where he shows doctors in their little white cars making house calls — for free.

But it’s not just France. When we lived in Italy some time ago, a doctor came to our farmhouse rental on Easter Sunday morning to diagnose a stomach ailment. He charged nothing.

Let’s stipulate that Moore is a one-sided pamphleteer, with a bit of Mark Twain and Pat Robertson in his schtick. But like all propagandists, his job is not to find some objective truth, but to anger, challenge, ask hard questions.

With Independence Day just passed, a good nationalist shouldn’t be afraid to answer those questions. So, who lives better, us or them?

In Italy, this was a regular parlor game when friends came to visit. Inevitably, after a few days of taking in our new world — a village public school for the kids, neighbors who opened the doors of their ancient homes to us, a lengthy siesta every afternoon — our houseguests would side with the Italians. I would counter for the U.S.A., to keep the argument alive.

The Italians won on health, family and food. The United States was better on race and opportunity.

With health care, the anecdotal often carried the argument. One day, a tenant farmer named Sergio, our neighbor, woke with a terrible eye infection. He was full of pain, unable to see. Sergio got world-class care in Florence. After three days of attentive fussing in the hospital, he came home entirely well and without a bill.

Had he showed up at any American hospital — poor, no insurance — well, good luck. Especially in a place like Texas, where 30 percent of adults lack health insurance and what can pass for medical care is a get-in-line form of triage.

But even with insurance, Americans are stuck with what may be the worst of all systems: one that lets a handful of corporations make life-and-death decisions, with incentive to dump and deny.

Little wonder that the United States ranks 37th in effectiveness of health care. Italy ranks 2nd. This is a country that can’t form a government to last longer than the soccer season, and yet, they make our medical system look barbaric.

If our system doesn’t kill you — see the infant mortality and life expectancy rates, bringing up the rear — it can put you in the poorhouse. Medical catastrophes are the leading cause of bankruptcy, and most of those are people who have some insurance, clinging to the frayed edge of the middle class.

O.K., so what about leisure? Americans spend nearly a third of their disposable income on good times, baby. But we can’t relax. Sorry — no time. Lunch averages 31 minutes. And the U.S. ranks dead last among 21 of the world’s richest countries when it comes to guaranteed days off, according to the Center for Economic and Policy Research.

Most Americans don’t even use their allotted days of leisure. The Italians take 42 vacation days a year — No. 1 in the world. The average American takes 13.

A quarter of Americans receive no vacation at all. And it’s not like we don’t need it: one in three are chronically overworked. We even work 100 hours a year more than the Japanese.

President Bush has it figured out, with his month off at the ranch. But for a profile in clueless, Bush set the mark when he lauded as truly American some citizen who told him she had to work three jobs. Ain’t that something?

Ah, but what about taxes? Europeans pay more than we do, to fund that free health care. Take that, Euro-trash, while lying on the beach. And yet, our tax system is approaching Gilded Age disparity. Listen to Warren Buffett, the third richest man in the world. Last year, he was taxed at 17 percent of his taxable income, he said last month. His receptionist paid nearly twice that, at 30 percent.

Where America shines is with our multiracial society and the easy access to opportunity. It was jarring to listen to otherwise thoughtful Tuscans denigrate Ethiopian immigrants or even their Sicilian countrymen.

By contrast, nothing made me prouder than telling Italians that I came from a place with an African-American mayor and a Chinese-American governor. Or that I grew up in a big Irish-American family with little money.

A patriot should not be afraid to have this debate, vigorously — after a nap.

Timothy Egan, a former Seattle correspondent for The Times and the author of “The Worst Hard Time,” is a guest columnist.

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