I’m not special. You are not special. The US isn’t Special.

I’m not special. You are not special. The US isn’t special. 

I know that sentiment may seem radical, but why should it? I am important and worthy of love and unique even, but I am not exceptional. You can be interesting and even have some trait of which you are the singular n=1 example in the known universe without suddenly becoming unknowable, otherworldly, or exceptional. 

Michael Phelps is still a normal person in 99% of his life; it’s just the swimming and related things that are different. Elon Musk, while maybe not normal, is certainly as fallible as every other human. His immense wealth has not granted him immortality or God-like quality of character as our Western society once assumed it must. 

So if Americans are not exceptional individually, or at least not so exceptional that we must consider them a different sort of being, then it seems to me that the US is not a special country – or at least not so very special that it’s very essence is incompatible with universal healthcare. 

I’ll revisit the healthcare part in a moment. Briefly, I personally find the myth of exceptionalism, particularly American exceptionalism, to be insidiously damaging. On a personal level, it’s kept me from seeking help when I needed it. The thinking can easily run like this
“I’m not really disabled, chronically ill, poor, hungry, a victim….I’m not like everyone else who really needs those kinds of support and programs. I’m different because I’m me and I’m….[fill in the blank]” (for example:)

• a healthy person stuck in this disabled body;
• a financially savvy high-earner who's just had a temporary setback;
• a good person who really loved the people who hurt me the most.

You get the idea. I’m not a mental health expert, but as far as I know, the thinking is protective because we are trying to distance our sense of self (ego) from something we don’t consider to be a good group to belong to. (poor, ill, victimized, whatever) At some level, we don’t really think about these biases we’ve accumulated against these groups because we are just part of society – we see them reflected back at us in media, in our neighbors, in our colleagues, in our doctors, so we don’t think we have anything to work on individually. But trust me, if you haven’t spent time thinking about how to identify your own biases and mitigate the harm you can do, then you are harming – likely to other people, but also to yourself.

Anyway, the way out of this particular trap is to realize that basically EVERYONE feels like this. Like they are the exception, yet we know that can’t be true for everyone, so why would it be more true for us? For you? I see it this way – everyone has their own combination of genetics, circumstances, and supports – some of these will be adequate and helpful, and some won’t. The particular combination any one person has does not preclude the possibility of doing anything, achieving anything. It just might look different. 

So, as it turns out, I’m not special. You aren’t special. If you feel a bond to that support group, reach out. If you qualify for assistance, take it. 

Now, as a country, I think the story of “The American Experiment” and the American flavor of daring to dream big and take risks has a lot of appeal. It’s exciting! Objectively, this national identity has given us a lot – a sense of hope to rally around in times of despair, probably the transcontinental railroad, and a booming post-WW2 economy.

It’s also cost us deeply. Why did we think we wouldn’t get sucked into WW2? Why do we think we are immune to pandemics that happen in other parts of the world, or that fascism can’t happen here? Most interestingly, to me, why do we think America is too special for universal healthcare?

There are dozens of countries around the world with universal healthcare, on every continent with a permanent human population. Some of the arguments about why the US can’t possibly manage to enact universal healthcare – which means making sure every person within the country has access to doctors, nurses, hospitals, medicine, and other necessary support they need to live, stay healthy, and function in society without risking expenses that would destroy them – follow. 

The US has a big land mass – sure. So do Russia, China, and Brazil. They’ve all figured it out to a higher degree than we have.

Americans don’t believe we should take care of each other. Health is a privilege bought with money, not a right. Ok – so does that make the American public cruel? Or at least less generous than the people of any of the many countries we’ve immigrated to the US from? I don’t think cruelty is a uniquely American value.
The US doesn’t have enough money – its too expensive. This one is the funniest to me. Americans spend the most on healthcare for the lowest overall population health. If Malaysia, Turkey, Greece, Burkina Faso, and so many more countries with far lower GDP than the US can manage it…

The US has some geographically isolated areas. Yup – I live in/near one! But so does Brazil, Norway, Chile…
So, if the US isn’t exceptional in any of these ways, why haven’t we figured this out yet (despite it frustrating the heck out of a bunch of other people and me)? 

I guess the myth of exceptionalism is at play. As is the case with how we talk about health in our political discourse, the conversations I’ve heard in the media and among friends/family have become increasingly heated and vitriolic over the past 20-25 years. I seem to remember a time when everyone basically agreed that US healthcare was a mess and none of the politicians had a single good idea for how to fix it. I think the issue of healthcare access and cost is not one of left vs. right or liberal vs conservative. I think it is much more about the bottom vs the top. 

Let me explain. Although the US ranks poorly on a population level for health outcomes (e.g., preventable deaths, maternal mortality, happiness, lifespan), the population level includes everyone. The US does fairly well in caring for the wealthiest patients. I’ve certainly seen how throwing money at the problem of illness on an individual level can make a difference. Money can buy better care facilities, more personal attention, better food, and nicer rooms. It can buy fancier drugs, more tests, and more doctor time. It can also give you access to travel to any location where a service might be available, including for an organ transplant. It can buy you an entire hospital wing, where you can be sure the staff will give you and your family special attention and assign you the very best surgeons. 

Now, lots of that is true in many countries. What matters, in my view, isn’t how the very few people are treated, it's how everyone lives. In this country, the story for almost all of us is and has been for a long time – boy, I hope I don’t get sick, like really sick, because I don’t know what I will do. If I can’t work, I can’t have health care, then I will be too sick to work… That is not a uniquely American sentiment, though. It’s one we share with people in many developing nations and those facing the starkest inequities. Our societies do not have to be this way. Just as we can, on an individual level, choose to help our friends and family and accept help when offered, we can do so on a nationwide level.

I am a board-certified patient advocate, former family medicine physician, and medical writer/editor. After graduating from medical school with an MD, I entered a family medicine residency program but left early, dusted off my journalism skills, and switched into medical writing. My focus was on creating well-researched patient education materials that anyone could read. I have always been passionate about enabling informed decisions.

Bio: Lauren Wheeler, BCPA, MD, is a board-certified patient advocate, former family medicine physician, and medical writer/editor. She is the founder of Lost Coast Advocacy. After graduating from medical school with an MD, she entered a family medicine residency program but left early, dusted off my journalism skills, and switched into medical writing. Today, her focus is on creating well-researched, accessible patient education materials that help people make informed decisions. To learn more about Lauren, visit her website at lostcoastadvocacy.com.