Cristina Alphonso Mateo is a 21 year old native of Spain who is living currently in the United States while she attends college.  She spoke with me recently about health care in her home country.

Spain has both privately and publicly delivered health care.  The public health care system is designed to provide every Spanish citizen with medically necessary care without cost at the point of service.  Those who wish to may pay for private care.  The per person cost of health care in Spain is less than one-half of the comparable cost in the United States.  Highly advanced care is delivered through the Spanish health care system, which is ranked internationally #1 in organ transplant care, as an example.

Cristina has never heard of anyone in Spain ever failing to get needed care for any reason, including if they simply don’t have much money.  She has never heard of anyone being bankrupted by the cost of health care in Spain.  

Recently, before she left for the US, she was on an outing with her friends and fell, injuring her hand.  She went to a local emergency room and waited 3 hours to be seen by a physician.  An X-ray was ordered, no fractures were noted, and she was discharged with her hand wrapped and given instructions about further care.  She felt that a three hour wait was too long and said that the Spanish health care system has room for improvement.  When asked, she said that she could depend upon getting an appointment with her primary care physician in Spain within 3 days of making a request.  Again, she felt that that wait was too long and indicated a need for Spanish health care to improve.

In contrast, when I was recently taken to an emergency room (by ambulance) in Chicago, I waited more than three hours before I received definitive care.  To be fair, I was triaged by a nurse within the hour of my arrival at the emergency room.  So the ER staff knew that I would be able to wait a while for definitive care.  I can not get an appointment with my primary care physician within 6 months of making a request to see her.  Again, to be fair, if I am acutely ill, I will be seen by someone at clinic that same day.  

So, which health care system is functioning well?  Spain, where everyone has access and financing for needed care and where the highest level care is top notch on international standards?  Where no one is ever bankrupted by health care costs?  Where no one ever dies because they can not get the care they need?  Or the United States, where care costs more than twice as much as it does in Spain while 200,000 people die prematurely each year because of health system dysfunction and 600,000 personal bankruptcies occur annually because of health care costs? (Most of those bankrupted by health care costs in the US are insured at the time that their injury or illness occurred.) Wait times for emergent and primary care are apprently shorter in Spain than in the US.  

It is time for US citizens to acknowledge that our health care system is failing us.  No matter where you look elsewhere in the developed world, those health care systems have measurably better function at a lower cost.  There is no developed country in the world, except the US, where people can’t get needed care because they can’t afford it and are therefore more likely to die prematurely.  There is no first world country, other than the US, where people go bankrupt because of health care costs.  Stop making a fuss about wait times being so bad, or death panels killing grandma, or innovation lagging, or whatever other nightmare the medical industrial complex propaganda has told you to anticipate and worry about with universal care. And especially stop making silly statements about how the government in health care will make everything so bad.  It is the MARKETIZED US health care system that is failing American patients, not the government.

Without government involvement in health care in the US these past 80 years, there would be no recognizable health care system in our country.  No innovative care, no hospitals in many counties, no trained physicians and nurses, nothing resembling modern clinical care.  What is the problem in US health care (as opposed to the care Cristina is used to getting at home in Spain), and the major reason why Americans can’t get the care they need at a reasonable price (again, unlike what Cristina is accustomed to in Spain), is the interjection of the private for-profit business model into American health care, stealing the funds necessary to pay for care for all, driving up the prices, and skewing research and development away from what is really needed to improve patient care.  

If you are at all persuadable by facts then become acquainted with the real facts about health care and how bad it is in the US.  But also how much better it could be if we could learn from other developed nations and finally implement meaningful change in the way we do health care business.  For the fact seekers, please go to View source at utahcares.health and learn how we at Utah Cares propose to make a difference in the lives of Utah patients and their families.  While you are perusing our website, make a donation to the campaign to put the Utah Cares Act on the ballot.

Many thanks.

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

The care of the sick and injured is valued by every religion, belief system, or ethical standard that I know of.  This appears to be a universally human trait, perhaps inborn, that we accept as a standard for our individual and group behavior that our fellow human beings, when unwell, deserve our time and attention; we should care about members of our species.  In this essay, I am going to point out the call to care as I see it articulated in the writings which are sacred to members of my religious group, the Church of Jesus Christ of Latter-day Saints.  I do that for several reasons.  First, these are the scriptures and teachings that I know best and can therefore more authoritatively represent to my readers.  Second, I am leading the effort to organize a campaign to universalize the care of the sick and injured in Utah, where my church remains an important part of the social fabric and wish to motivate my fellow Latter-day Saints to join in this effort.  Third, I would like to grow the movement for universalizing healthcare beyond Utah into the entire Intermountain West, including into Idaho, Montana, Wyoming, Nevada, and Arizona, where substantial populations of Latter-day Saints live. These states are the home of many patients who find their way to Salt Lake City for tertiary or higher level care so reforming health systems throughout this region will have a major positive impact on healthcare in Utah.  And finally, Latter-day Saints embrace the Bible as scripture and of course share that with all people in the broader Judeo-Christian tradition.  Thus, many of the LDS teachings about the need to care for all of our brothers and sisters in the family of God will be recognizable to other Bible reading people.

 By focusing my essay on LDS teachings specifically and Judeo-Christian principles generally I do not at all cast aspersions on the teachings of other religions and belief systems, nor wish to denigrate adherents of all other ethical patterns.  My message is that we all should be working towards systems of health care that make better, simpler care financed fairly for all the norm wherever we live and whatever we believe, because that is a best practice for individual and group living. 

As its name clearly states, the Church of Jesus Christ of Latter-day Saints identifies Jesus of Nazareth as the central figure of its teachings and the source of its authority.  He is, for me and my fellow LDS believers, the pre-eminent Person (or Son of Man) of human history, the Example for how to live a blessed life, the master Teacher, the Creator of the earth where we find ourselves in this life, and the Hope for meaningful life beyond our present existence.  Two thousand years ago He announced the establishment of His Kingdom on earth and produced evidence that He was the Messiah that the House of Israel had been taught to anticipate by performing remarkable acts of healing, including raising the dead, and ultimately rising Himself from death.  Written into the record of His life and ministry (now known as the Gospels in the New Testament) is evidence that in fact He did heal the sick and injured.  Apparently His opponents essentially acknowledged that He performed these miracles by making the claim that He did so not with God’s power, but with the power of the Devil.  These perverse claims were supposed to be embarrassing to Him, and cause Him to shun the limelight, but He and HIs friends simply reiterated the opposing criticism of His miracles and asked the people at large to judge for themselves whether His miracles were good (came from God) or evil (came from satanic sources).  He became widely known for His healing power.  People came from all over Galilee, Judea, and neighboring areas to ask Him for healing and He gave freely of this power.  Right up to the last hours of His life He healed, including restoring the ear of a soldier who came to arrest Him before His crucifixion.  Jesus, as a resurrected Being, appears in the Book of Mormon where He likewise invites all with physical ailments to come to Him and be healed. Latter-day Saints (and other Christians) must, I think, acknowledge that Jesus cares about health care.  That being the case, we should care about it, too, and be sure to organize society so that healing is offered to all.

To underscore this point, consider what Matthew records as the final public teaching that Jesus made.  This teaching, like many of his precepts, came in the form of a parable, this time about dividing sheep from goats (Matthew 25:31-46). Unlike most of His parables, which are directed to individual listeners, this teaching addresses the behavior of nations, which the Son of Man shall gather before himself after He comes in His glory, in order to separate them (the nations) into those on his right hand (the sheep) and those on His left (the goats).  To those on His right He offers an inheritance in HIs kingdom, because they cared for the hungry, thirsty, estranged, unclothed, imprisoned, and SICK.  When asked by the right hand nations how they had managed to earn this blessing, the Son of Man said: “Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.” On the left hand there was no blessing, only a curse with an order to ‘depart into everlasting fire’ because of failure to care for those in need.  The final summary statement avers that the goat nations, on the left hand, shall go away into everlasting punishment but the sheep or right hand nations into life eternal.  So, not just on the individual level, but the group, even national level, if we believe in Jesus of Nazareth we should care about arranging for health care even for the least members of our society.

These teachings about the societal need to care for all were not new to the Jewish nation.  Six hundred years before Jesus walked the streets of Jerusalem, two prophets, Jeremiah and Ezekiel, who were eyewitnesses to the demise of the kingdom of Judah at the hand of the Babylonian nation, asserted that a lack of care for the sick and injured led to the societal weakness which made conquest inevitable.  

The first of these prophets, Jeremiah, lived and prophesied for 40 years in Jerusalem, relentless in his ministry despite imprisonment and persecution.  He said: “The harvest is past, the summer is ended, and we are not saved. For the hurt of the daughter of my people I am hurt; I am black; astonishment hath taken hold on me.  Is there no balm in Gilead; is there no physician there? Why then is not the health of the daughter of my people recovered?” (Jeremiah 8:20-22).

Jeremiah knew, as did all of his listeners, that there was a plant in the desert regions around and near the Dead Sea including the area known as Gilead, from which a medicinal balm could be extracted.  He is, therefore, asking rhetorically about the whether the balm was available.  He knew it was obtainable and he also knew that the governing elites in Jerusalem were making no effort to find a way to use it and other means to care for the sick in the kingdom of Judah.  

To emphasize this point, he sarcastically asks whether physicians were not available. Everyone knew that physicians were present, they just weren’t being made available to treat all of the sick.  The result was the painful realization that failing to properly care for the sick and injured amongst the population (or, as Jeremiah states it, the daughter of my people) actually caused hurt and anguish to all through the downfall of a weakened society.  In essence he says that the people of Judah have hurt themselves and in the end caused their own demise because they did not look to the needs of the sick and injured.

Ezekiel, a generation younger than Jeremiah, was not in Jerusalem when the final battle ended with the razing of the temple of Solomon and the burning of the city.  He had been taken prisoner to Babylon during an earlier of siege of Jerusalem by the King Nebuchadnezzar.  In Babylon he received his call to prophesy to the captured nation of Judah.  Among the themes he developed as the spokesperson of God was the following:  “Woe be to the shepherds of Israel that do feed themselves! Should not the shepherds feed the flocks? Ye eat the fat, and ye clothe you with the wool, ye kill them that are fed: but ye feed not the flock.  The diseased have ye not strengthened, neither have ye healed that with was sick, neither have ye bound up that with was broken, neither have ye brought again that which was driven away, neither have ye sought that which was lost; but with force and cruelty have ye ruled them.” (Ezekiel 34:2-4). Here again a prophet is teaching that society is only as strong as how it treats its weakest members.  A social structure which does not heal the sick and injured, but instead preys upon those in greatest need in order to enrich the elite in society is ripe for destruction because it is weakened from the inside out.  

Modern day America needs to relearn these prophetic lessons.  The elite in our country are feasting on the illnesses and injuries of our fellow citizens.  The care of the sick has become a business opportunity.  There is a balm of Gilead in America, and there are physicians available, but we are failing to deploy them to help those who need care.  In the blind pursuit of profit, health insurance is sold that provides no benefit.  Medications are manufactured for pennies and sold for hundreds or thousands of dollars and thus priced out of reach of people who die for lack of treatment.  Elaborate, expansive, elegant health facilities are erected in urban centers where wealthy people congregate, while vast areas of rural America have no hospital, clinic, or urgent care facility.  The obvious harshness of the American health care business model has been angering American patients and their families for several decades now.  That anger is playing out in our politics as people are voting for those who best personify vitriol without any reference to actually governing.  As a consequence, we have a hollowed out nation no longer strong enough to do its own business at home, and certainly vulnerable, as was Jerusalem in the day of Jeremiah and Ezekiel, to attack from without.  This is what Jesus meant when He condemned the nations on His left hand to fiery destruction.  

During my tenure as a bishop of an LDS ward in Salt Lake City a few years ago, I was taught that the welfare funds of the church were to be used carefully and only for housing, clothing, food, health care, and other essentials.  Among those few needed basics for which I used church welfare funds, not surprisingly the price for health care was particularly onerous.  But for LDS bishops in other developed nations, there never are health care costs to be paid.  Only in the United States of America, among wealthy nations, will patients be unable to pay for needed health care and either die for the lack of treatment or go bankrupt in an effort to live. Thus, alone among the wealthy nations of the world, we Americans find ourselves on the left hand of God, among the goats.  Like Jerusalem 600 years before Christ, we are ripe for destruction, because we have weakened ourselves from the inside through the force and harshness of our for profit healthcare business practices.  

If we do not change how we handle health care, the most likely scenario leading to our national destruction will be an economic implosion.  Health care costs consume a growing portion of our gross domestic product, now approaching 20% of all expenditures in America.  When the Soviet economy was skewed by defense spending at 20% of their GDP in the late 1980s, the wheels came off their economy and they plummeted from first world status into second class standing, where they remain today.  Though the American economy is far larger now than the Soviet economy was then, there is no guard rail that will prevent our fall into second class status as a nation if we don’t amend our health care ways and stop the greed which is harshly ignoring our patients.  

Health system reform is in our national interest.  With the prophets of old I ask, is there no balm in Gilead? Can we not provide physician care for everyone who is sick and injured, even the least of these? Why weaken our nation by the force and harshness of for profit healthcare when doing so places us on the left hand of God?

Please visit the website of the Utah Cares Political Issue Committee to discover what needs to be done and how we can do it.  View source at utahcares.health

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

Luke Savage of truthdig.com recently published an article saying what I have been saying for years: there is not a dime’s worth of difference between Ds and Rs when it comes to what they DO about healthcare policy. If you find that hard to believe (that I have been saying for years what Mr. Savage is now finally publishing) please check out page 145 of my first book The Purple World: Healing the Harm in American Health Care (you can purchase a copy of my book here: ebook; audible), which I published in 2018.

To be sure, there is a big difference between what Rs are saying about health care and what Ds SAY.  Many of my friends who are dyed-in-the-wool bleed blue democrats are incensed when I insist that their party does nothing different about health care than does the other party, and they point to the rhetoric from elected Ds.  But rhetoric does not get the job done.  

Here is what Luke Savage is saying now (The Democratic Healthcare Hoa):

“Democratic elites have — for going on two decades — relied on a rotating arsenal of talking points designed to preclude all except the most minor changes in healthcare policy. In their bid to muddy the waters as much as possible, liberal opponents of Medicare for All have sought to quietly redefine the phrase “universal healthcare” such that it means universal insurance coverage through a patchwork of different programs rather than a single program, free at the point of use and available to all. Instead of talking about “free healthcare, which is both the right moral horizon and straightforward to explain, liberal opponents of Medicare for All make incessant use of words like “affordability” and “access.” Rhetorically speaking, this evokes a vague spirit of reform while enabling elite Democrats and their auxiliaries to avoid making clear commitments of any kind. And it goes without saying that making something “affordable and accessible” is not the same as making it universal and free. Tying it all together, we have the transparently false insinuation that there is some kind of good-faith policy debate at play here, i.e., every Democrat shares the same ultimate goal but some respectfully disagree about how it can be best achieved. This final point is particularly important because it speaks to what the real nature of America’s healthcare debate has always actually been: a political struggle pitting the basic needs of millions of Americans against the narrow interests of an immensely lucrative industry whose profits depend on the status quo. The former group might be more numerous, but its democratic weight pales in comparison to what the healthcare industry has in its corner.”

As I have stated in a previous Substack essay, American politics is essentially a fight about health care, and will continue to be such until we get health care right, or our nation fails economically due to the skewed GDP spending imposed by the greedy medical industrial complex upon all of the rest of us (American politics is a fight over health care)

And that fight is raging within the Democratic Party, sometimes within the soul of individual Ds. For instance, during his tenure as an Illinois State Senator, Barack Obama held a press conference at the national offices of Physicians for a National Health Program (PNHP), the premier single payer advocacy group for the past 40 years, extolling the virtues of single payer health system reform and calling upon the nation to step up to the plate and do the right thing for America’s patients—pass single payer health care.  Just a few years later, however, after having won the presidency on a platform of ‘affordable’ health care, but before he was sworn in, Mr. Obama made a deal with the health insurance industry which gave the store away (please look up the Frontline special report about this event entitled Obama’s Deal).  

Why the about face by Obama?  Very simple—he needed the money of the medical industrial complex to run for president.  So he took that cash and, against what he had himself declared to be the best policy in health care, gave up on single payer reform and instead created the mess that is known as the affordable care act, or ObamaCare. Only one thing was accomplished by the ACA-enriching the medical industrial complex and its shareholders.  During the decade from when Mr. Biden stood behind Pres. Obama while he signed the ACA into law and when Mr. Biden himself took the oath of office of POTUS, stock values for health insurers increased 1000%.  

Mr. Savage agrees with me, saying: “As David Sirota has noted, politicians like Hakeem Jeffries can rake in hundreds of thousands (and sometimes more) in campaign contributions from healthcare PACs in a single election cycle. Health insurance companies are also major advertisers, which is among the main reasons you’ll rarely find support for Medicare for All anywhere on cable news”. Apparently the medical industrial complex can buy D votes as readily as it can by R votes, and influence left leaning mainstream media as easily as right leaning mainstream media.  Fake news, indeed.

Here is Mr. Savage’s conclusion:  

“In any case, I’m not sure any single issue better illustrates the moral cynicism and rank hypocrisy of the people leading the Democratic Party. Ahead of every election cycle, they are content to make the rounds on TV and rattle off the same dishonest talking points while fully cognizant of the fact they are actually standing in the way of reform. Jeffries, who inherited the conch from Nancy Pelosi, will eventually hand it off to a successor who will dutifully court all of the same donors and say all of the same things — as will the likes of Kamala Harris and Gavin Newsom come 2028.

The GOP is widely understood to be a party more radical and extreme than its Canadian or European equivalents. Less well understood, by liberal Americans especially, is the fact that its would be center-left opponent has been a functionally center-right formation since the 1980s: “progressive” in an aesthetic sense, perhaps, but small-c conservative when it comes to most things that matter.”

Personally, I don’t believe that we Americans will ever get the health care we deserve from Congress or any legislative body.  Those institutions, though supposed to be doing the people’s business, are bought and paid for by corporate health interests.  Our collective hope must be in the possibility of succeeding with a ballot initiative.  To be sure there has never been a successful single payer ballot measure, though approximately 2 dozen of these measures have been launched.  Generally, the proponents of single payer ballot measures find themselves outspent 10:1 during the campaign with the opposition sowing doubt and confusion about what single payer health care is and will do.  But as slim as that hope is, it is much more likely that a ballot measure will pass than that a legislature in the United States of America will get a single payer bill past the immense lobbying power of the medical industrial complex.  

So, during the current election year, what should we do?  First, do not automatically vote by party.  Party first voting has created the nightmare we now are living in.  Second, consider dumping incumbents, no matter which party they belong to.  Incumbents have already had a chance to help us, to serve the public, to get health policy right, and they have failed. Third, don’t put all your muscle and effort into candidate elections.  Save a significant portion of what you can donate and do for ballot measures.  If your state does not have ballot initiatives, or if it does and there is no single payer ballot initiative proposed, please find an alternative state where single payer legislation is being pursued by ballot initiative AND DONATE TO THAT CAMPAIGN. 

In all humility, allow me to encourage your patronage of the Utah Cares Political Issue Committee.  We have drafted the necessary single payer legislation for the Beehive State (read it at View source at utahcares.health).  We have already studied the economics of single payer health care in Utah (all three studies are also on View source at utahcares.health).  The health policy choices leading to our drafted legislation are discussed at length in two books I have written, which you can also link to on the website (View source at utahcares.health).  And we have produced a feature length documentary which outlines the problems with health care in the US and points to the single payer solution, entitled Healing US.  You can find a link to that film on that same website:  View source at utahcares.health.  Watch it and then organize a community meeting for your neighbors to watch and invite me to come speak to the group.  

The Utah Cares PIC has done all that work to further the cause of single payer reform.  We hope we have pioneered a pathway that others can use.  But further progress here will require the assistance of many from across the nation.  We plan to have the Utah Cares Act on the ballot in 2028, but we will need your donated funds to make that happen.  We would be very grateful if you could go to the website: View source at utahcares.health and make whatever size donation is possible for you.

Many thanks..

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

The house pictured here was where I lived with my family in Reno, NV from 1986 to 1990.  Our fourth child, a daughter, was born in Reno and came home from the birth hospital to this house.  My wife was pregnant with that daughter when we moved to Nevada so that I could begin work as the State Health Officer for the Silver State.  As the newly appointed lead public health official in the state, I was invited to meet with individuals and groups with professional health interests. One such meeting was with the pediatric association in Northern Nevada, who gathered for a social evening prior to the birth of our daughter and invited me and my wife to attend.  During the gathering one of the pediatricians, noticing that my wife was heavy with child, told me that if problems developed in the pregnancy I should return to Utah (where I had lived and trained in public health) for the delivery.  He insisted that neonatal care in Reno was awful and that I would do better for my wife and child by being elsewhere.  That was, of course, a startling statement. 

 I had already discovered that Nevada at that time had the very sour distinction of being the state with the highest per day hospital costs in the US.  This was despite the fact that very few of the very expensive hospital services that I had known in Utah had become well developed in Nevada.  There was no trauma system, for instance. No Burn unit.  Open heart surgery was not common.  Neonatal intensive care was only well organized at one Las Vegas hospital.  Organ transplant services were not available in Nevada.  And yet hospital costs were higher than anywhere else in the US.  It was puzzling to me then.

I did confirm that neonatal care in Reno was substandard.  The Nevada Health Division, where I worked, did pay for the care of sick newborns using federal Title V funds and therefore had data about newborn outcomes throughout the state.  It was simply true that mortality rates in the Reno hospitals for sick newborns were twice as high as similar rates in Las Vegas.  

The fact is that poor quality care costs more. When you don’t provide optimal care for the sick and injured, then ultimately the care that is provided will be more expensive, because the patients will be sicker and die unnecessarily more often.  

This was one of the signal facts about health care that I learned forty years ago while serving as the State Health Officer in Nevada.  I have written about all the lessons that I learned as the Nevada State Health Officer in my book The Purple World: Healing the Harm in American Health Care.  You can find a link to my book on the website View source at utahcares.health

Health care in the US is vastly more expensive than anywhere else on the planet, both because the quality is poor to mediocre and because the financing is incredibly inefficient.  We Americans can do something about this.  We can choose to elect people who promise to radically reform our health care system rather than incrementally dabble at its edges.  And we can write our desires for better, simpler health care financed fairly for all into law with ballot initiatives.  We at Utah Cares have drafted the Utah Cares Act with exactly that in mind.  Read the Act at View source at utahcares.health

It is absolutely the case, however, that nothing will change in American health care without your help.  The campaign to reform health care is going against the single largest lobby in the history of the United States—the medical industrial complex.  They control one-fifth of the gross domestic product with profit margins in excess of 20%.  They can and do spend heavily to prevent change in the health care system.  You must engage and donate what you can to make it possible for us to reform health care.

Please help us with this campaign.  Make your donation at View source at utahcares.health

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

I recently returned from a vacation trip to Europe during which I interviewed several people about their health care experiences.  None of them had ever heard of bankruptcy due to health care costs.  No one in Europe has ever heard of anyone going without urgently needed care because they could not afford it.  In some countries there are deductibles, but no deductible is beyond the financial capacity of the average working citizen.  Other American health insurance gimmicks simply do not exist, such as limited provider panels, recission, surprise bills, or prior authorization.  Beyond this, European healthcare is measurably better, with better outcomes and longer lives.  Fashioning health policy around what is best for patients means better care and more simple health care financing—better, simpler care.  And that leads to much less health care cost.  Even the most expensive European health care system (Switzerland) costs 40% less than the cost of American health care.

Just as I returned home this past week, a large extended family I know (2 grandparents, 5 children with in-law spouses, and 22 grandchildren) gathered for a family reunion in the Wasatch mountains for 7 days.  Just at the start of that week, one of the grandchildren suffered a displaced fracture of the radius (an arm bone) and a crack in the neighboring ulna. (See x-ray below). This grandchild and his siblings and parents are 2000 miles away from their home while on this family vacation, and therefore a similar distance away from where they purchase health insurance.  While he was allowed to see an emergency room doctor for his injury with the insurance paying at least something, the family was informed that a visit to an orthopedic doctor away from home would not be covered.  The ER doctor could not reduce the fracture himself and so recommended that he be evaluated by an orthopedic doctor.  There is a possibility that an orthopedic surgeon could non-operatively reduce the fracture, set it well, cast it, and allow this family to continue their vacation without surgery.  But the rules of insurance are such that this family is not allowed that option unless they are willing to risk paying for any surgery that might be required because it would be “out of network”.

This issue is not merely a matter of convenience for the family.  Receiving definitive care for an injury at the time and place the injury occurs is an essential part of patient care.  The health care system should serve the needs of the patient, first and foremost.  The needs of the health insurance company should never be a consideration, much less the driving force of health care decisions.  When anything displaces the needs of patients from first consideration, then the health system fails.  It becomes more complicated, more expensive, and the quality of care suffers.  Patients don’t thrive, their lives are shortened, and costs skyrocket.  This is the essential difference between European and American health care. In Europe the needs of the patients come first.  Not so in the United States, where profits matter more.

Which way of doing health care business do you prefer?  Profiteering or patient care?

Learn more about this at View source at utahcares.health where you can also donate to the cause of reforming American health care.  Don’t wait until your grandchild can’t get the care needed because an insurance company refuses to pay for urgent care.  Act now.  DONATE what you can.  We must all join in this cause in order to succeed.

Many thanks.

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

Switzerland has perennially been in the top five wealthiest nations measured by per capita GDP. It’s a country with a long history of religious freedom and the rule of law, not monarchy. Famously and stubbornly independent and neutral, the Swiss believe in themselves and their national will to do everything well. Switzerland is a country also blessed with natural beauty as the accompanying photos attest.

I have good friends who live in Switzerland. They attest to something else that the Swiss do well. In Switzerland the care of the sick and injured is a priority. One of my friends recently fell and broke bones in her elbow and knee. She received urgent world class care including surgery for the elbow injury. She continues on physical therapy to restore joint mobility.

Routine care is also optimal in Switzerland. Primary care appointments are available within reasonable time frames. Prescriptions are readily filled. Referrals to specialists are easily accomplished. And this level of care is universal.

In the United States it is common to disparage health reform efforts striving to include everyone (I.e., make health care universally available) as socialist or communist and inherently poor in quality. Universal care, so these critics say, leads to long wait times, shortages in services, and a failure to innovate. The Swiss experience with universal care proves that is emphatically not true.

Health care in Switzerland is more expensive than anywhere else in the world—except the United States. We spend more on healthcare by far than do the Swiss ($15,000/person in US vs. $9,000/person in Switzerland) but we are the people waiting for care, dying because we can’t get needed care, and suffering family financial disaster because of the cost of care. Universal care is not socialism; it is the sensible policy choice when the societal objective is to support the individual pursuit of life, liberty, and happiness through the promotion of the general welfare.

Learn more about how to organize universal care at View source at utahcares.health and DONATE to the campaign to change how America does health care business.

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

My wife and I are on holiday staying near the Lauterbrunnen valley (see first photo) where we undertook a guided tour yesterday visiting, among various Sehenswürdigkeiten, Trummel Falls (2nd photo), Aarleschlucht (3rd photo), and Giess Falls (4th photo). Naturally I spent the time with our guide, Sergio Serra, talking about health systems.

Sergio, who is in his mid-fifties, was born on the island of Sardinia in Italy. At a very young age he emigrated with his father to North America, living as a child and youth respectively in Mexico and Canada.

As he became of working age he chose to return to Europe where he has remained for more than thirty years. His career in the travel industry has taken him to Spain, the Netherlands, Norway, Italy, Germany, and now Switzerland. He, therefore, has a breadth of experience with multiple health systems.

Canada, Spain, and Italy he described as public health financing systems wherein he was taxed a small amount (his description) and received healthcare without substantial out of pocket expense. Everyone he knew received whatever care they needed. If urgent, that care was delivered promptly. If the clinical situation was not urgent, then waiting for elective service could take a little time. Hospital patients in these systems would share rooms, in which there were no amenities. But he judged the care to be good.

The other countries where he has lived and worked were all in Northern Europe. They all had health systems which he referred to as privately funded. This meant that residents there were all required to pay out of pocket for a health insurance plan covering all healthcare except for injuries and illnesses arising out of work. Worker’s compensation was funded by payments from employers. He noted that Germany did have a public health insurance plan in addition to the many private plans on offer.

Switzerland, where he currently resides, is the most expensive country for health insurance in his experience. He now pays a monthly premium roughly twice the size of the premium he paid in the Netherlands (400 Swiss francs vs. 200 Swiss francs). His deductible now is 1500 Swiss francs. When he injured his back and had to be hospitalized, however, he paid no deductible because the injury occurred at work and was 100% covered by workers compensation.

He describes the healthcare facilities in Northern Europe as fancier than in Spain and Italy, particularly in Switzerland. The rooms at the hospital are, in his words, ‘like a hotel’. By which he meant private for each patient, with nicer furnishings, and better food selected from a generous menu of options.

I asked him if he had ever heard of anyone in any of the countries where he has lived going bankrupt because of the cost of injury or illness. He emphatically denied that something like that kind of financial devastation would ever occur in those various countries (though he pointed out that he was too young when he lived in Mexico to really know for sure). I then asked him if he ever knew of a resident living in any of these countries of his past or present residence dying because they could not afford needed medical care. Again, he denied that this might ever happen. He explicitly stated that even if someone in a Northern European country failed to pay their premiums or couldn’t meet their deductible they would still receive any urgent care needed and would never be left to suffer unattended.

When I explained to Sergio what health insurance costs in the US, including deductibles, he was astonished. When I further stated that hundreds of thousands of Americans are bankrupted by healthcare costs each year, he was astounded. And then I told him that plausibly 200,000 Americans die each year due to the health system failing to provide needed care, he was incredulous. His comment was: “America should be a better place than that.”

Ladies and Gentlemen, we have for decades allowed corporate interests, the medical industrial complex, to use excessive profits garnished from the financing of our illnesses and injuries, to burrow themselves into our political system and shield themselves from effective governance. We must fight to rid our nation of this unholy invasion into our lives or give up and watch our friends and family suffer financial ruin or premature morbidity and mortality at the hands of an uncaring health care system. If we do nothing our nation will soon suffer a financial collapse due to the unchecked greed of the medical industrial complex.

The Utah Cares Act represents for all states the way forward in this fight. There are similar drafted statutes elsewhere in the country (eg, New York and Washington). The campaign to enact these bills will be exceedingly difficult given that the opposition is well-heeled and tenacious in defense of its greed. When Colorado in 2016 attempted to pass similar legislation by ballot initiative the health insurance interests spent ten times as much in opposition as the proponents of the measure were able to raise in support.

Those of us working hard to give Americans a chance to defend their health care need donations to build the campaign for better, simpler care financed fairly for all. Please stop what you are doing, visit the Utah Cares website View source at utahcares.health and make a donation, however much you can afford, large or small, to this cause.

Sergio Serra is correct. We Americans are better than the egregious health care system we have allowed to entrench in our country. American politics will be a fight about health care until we get this right, or until the wrongs of our health system bury our country.

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

Nuno Sa is from Portugal but has lived for ten years in Switzerland. He’s employed in the travel industry and loves to talk about and show off the beauty of his adopted country. He picked me and my wife up at the Zurich Airport last night after a horrific 30 hour trans-Atlantic trek during which we lost our luggage. He placed us in cooled vibrating seats in his van and whisked us two hours into the Berner Oberland.

Here he is standing outside the train station in Lauterbrunnen Switzerland with its famous waterfall lit up behind him. He helped us find a seat on the next train to Wengen, a mountain town which allows no automobile traffic. We are staying in a new resort hotel there and as I write this I’m still waiting to see the view of the Jungfrau Joch from my room that the sunrise will bring.

As he drove us the two hours from Zurich to Lauterbrunnen, I asked him about his experiences with the Swiss healthcare system. He said that everyone who lives in Switzerland is required to buy health insurance. When he first arrived ten years ago he got around to making his health insurance arrangements three months after taking up residence. The Swiss law requires paying a health insurance premium every month so, even though he had not used the health care system during those 90 days, he had to backpay the premiums. People who fail to pay for the required health insurance will have their credit rating ruined which can make life hard in Switzerland, even impossible.

Nuno pays 350 Swiss franks per month for his health insurance. The only portion paid by his employer is for the workers compensation part of his healthcare risk profile. He has a deductible of 1500 Swiss francs and co-insurance of 10%. While that is more expensive than the cost of healthcare in many countries, it is of course much less expensive than similar costs in the United States.

The Swiss government regulates the prices of medical care, medications, and medical devices. These cost one-half to one-tenth as much as the price we pay for them in America. Swiss health insurers must guarantee that they will issue health insurance to any resident who applies and the premiums, deductibles, and co-insurance are highly regulated (life in Switzerland is highly regulated in all aspects). Once on the beneficiary list of a Swiss health insurer you cannot be denied or kicked off at the whim of the insurer. There is no fine print which allows unilateral actions by the insurer to adversely affect the insured. Swiss health insurance is nothing like American health insurance. Swiss health insurers are held accountable for the health financing of their beneficiaries.

While a Swiss resident may lose his/her good credit rating if the required health insurance premiums are not paid what he or she will never lose is their life due to not being able to pay for medically necessary care. No one in need of care is ever turned away. The Swiss also never lose their financial shirts due to the cost of illness or injury care. No one goes bankrupt in Switzerland due to the cost of care.

In summary, both the US and the Swiss health systems are expensive compared to healthcare in other wealthy nations, ranking #1 and #2 in cost respectively. But the Swiss system is $6000/person/year less expensive, guarantees everyone that medically necessary care will always be rendered, and never bankrupts a patient or his/her family due to healthcare costs.

Swiss health insurers or sickness funds are very unlike American health insurance. They are highly regulated and cannot deny, delay, or otherwise game the health financing of their beneficiaries. It has become common for American health policy analysts to say that a single payer system is not necessary to fix American health system woes while pointing to the Swiss system of multiple private payers. What these pundits fail to acknowledge is that American health insurers will resist the regulation required to tame them into a Swiss level of performance with the same ferocity that they fight single payer reform.

As stated here previously, American politics is basically a fight over healthcare. Since the fight to achieve a Swiss style multi payer healthcare system will be as onerous as the fight to achieve single payer healthcare, why not fight for the better, simpler and therefore less expensive healthcare system financed fairly for all?

You can learn more about single payer health system reform at View source at utahcares.health

The fight to reform healthcare in the US is in your hands. Political campaigns cost money. Stop supporting the campaigns of politicians who are helping American health insurers deny, delay, and destroy the care of our patients. Donate to the Utah Cares campaign, even small amounts, and join the fight for better, simpler care financed fairly for all.

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

Jonathan Chait published an “Ideas” piece on July 15, 2026 in the Atlantic Monthly that said one thing, only, that I can agree with: “American politics is, to a very substantial degree, a fight over health care.”  The remainder of the article is just wrong, which is why I am not offering a link here to the article.  I don’t want my readers to read what Mr. Chait otherwise opines, for reasons I will discuss briefly below.  But first, why I agree with that one statement.

The dominance of health care as the quintessential, signal, overriding domestic issue in the US should be obvious to everyone.  Only in the US (among wealthy nations) do everyday average patients find themselves priced out of medically necessary care, and die prematurely (a reasonable estimate is that 200,000 unnecessary deaths occur each year in the US do to dysfunction in the US health care system).  Only in the US is the cost of care for illness and injury the leading cause of personal bankruptcy (most who look into this estimate that 500,000 bankruptcies each year, or 60% of the total, are caused by health care costs).  As much as 20% of the unhoused in the US are homeless because illness and injury costs robbed them of the funds needed to pay for a roof over their head. American seniors who need long term care find themselves having to spend down their assets, including the equity in their home, in order to qualify for long term care financing.  Prices for pharmaceuticals and surgeries, and medical devices, etc. are two to ten times higher in the US than elsewhere in the world, and force untold numbers of Americans to decide between eating, paying for utilities, buying gas for the car to get to work, etc. and taking medicine or getting other needed care. Virtually all of the federal deficit on into the foreseeable future is due to forecasted health care spending.  The percentage of the US Gross Domestic Product  that is spent on health care is approaching 20%, will cross that threshold probably before the beginning of the next decade, and, at that level of spending, will threaten the entire US economy, big as it is.  That problem only exists in the US.  No other country allows the health care industry to starve other economic necessities of funds.  

These facts about American health care have been essentially true for decades now.  Health care costs have been the leading issue on the minds of American voters for many election cycles.  Health care costs are the leading issue in the current midterm election cycle.  Since Bill Clinton came to office, no first term American president has come to the office initially without running on health care in some important way.  American voters know that they are one illness or injury away from bankruptcy, or finding themselves unable to pay for needed care, and they want to hear what their candidates have to say about that.  Even Donald Trump has felt compelled to repeatedly assert that he has a plan for health care.  Primeval fears like these can easily be exploited by politicians, and that is exactly what has happened over and over again, and is happening now.  Remember Harry and Louise? Death panels? Immigrants coming for your health care? Socialized medicine?

American taxpayers pay more taxes to support health care programs than do the citizens of any other country.  That’s because we Americans want people to get health care when they need it.  Hill-Burton funds (from the federal government) built many hospitals across rural America (which are now closed or closing). Teddy Roosevelt was the first president to openly talk about universal health care.  His cousin, Franklin, actually tried to get it passed by Congress.  As did Truman.  Seeing their failure, LBJ settled for Medicaid and Medicare rather than universal care, health financing respectively for the poor and the elderly who had been abandoned by for-profit health insurance.  Clinton signed CHiP into law, a federal-state shared program for health care financing for children.  George W. Bush expanded Medicare to cover the prescriptions needed by seniors.  And Obama, famously, passed the poorly named Affordable Care Act.  But there are literally thousands of other public health programs and initiatives that have been created to put a finger in the leaking dam that is the American health care system.  And I haven’t even begun to point out how much has been spent by the federal government to fund the research needed to improve health care, train doctors and nurses, and prevent injury and illness from happening in the first place.  

One would think that with all this effort and spending on health care Americans would be admirably cared for, even if at great expense.  But one would be wrong to think that.  As Mr Chait says, American politics remains in large measure a fight over healthcare.

Whole areas of the country go without needed care, especially in rural and poor urban America.  That leads to unnecessary illness and death, of course, in those abandoned areas.  But, there are economic consequences as well.  When you remove 20% of the gross domestic productivity from a geographic area, you also remove the revenues and incomes that come with that activity.  Rural economies suffer without those white collar jobs.  As the flaws in American health policy have eliminated the care and the economic power of health systems from rural and frontier areas of the country, half the population of the US has awakened to the reality that their taxes are paying for the kind of care that they can’t have in their own county.  And those voters have become angry.  The immediate cause of the anger leading to the Tea Party revolt was losses associated with the Great Recession, for which Wall Street interests were never made accountable.  But giving the health care store away to the corporate health interests in the form of the badly named “Affordable Care Act” shortly thereafter reframed the anger of the Tea Party into the more permanent MAGA crowd, which Mr. Trump discovered and has consistently exploited for a decade.

Here’s where Mr. Chait’s article comes in. He has written this piece with the thesis that the progressive wing of the D party is wrongly accusing the mainstream Ds that they do nothing about health care. But he makes an error in this article; he conflates the ability to get health care with having a health insurance plan. His entire argument about how the mainstream D party supports universal health care is based upon the notion that Obamacare was a step toward universal care because more people having health insurance means fewer left out of health care. WRONG. Private for-profit health plans used the Affordable Care Act to make actual care so unaffordable that a new health policy term had to be invented to name the subsequent problem-functional uninsurance (what happens when tax payer subsidized premiums are paid so that less well off families can have health insurance but then these families can’t pay the coinsurance or deductible so they can’t afford the actual care anyway).

Mainstream Ds can become quite offended when I fault Obamacare for its failures. They are incensed that I’d criticize Mr Obama who they hold in such high regard. But Mr Obama knew very well that single payer was the only choice which could actually achieve the goal of universal health CARE. He once held a press conference to that effect while serving as a state senator. It’s just that the fight to get single payer would have put him at odds with the medical industrial complex—the single biggest sector contributor to D politics (and R too). Mainstream Ds, particularly the well heeled corporate elite (eg Nancy Pelosi) will not fight that lobby. They will give them anything they want. And that’s exactly what Obama did. Before he was sworn into office after winning in 2008 he cut a deal with the medical industrial complex and gave the store away. That is documented in the Frontline documentary “Obama Deal”.  That deal was a huge windfall for health insurers. Their stock values increased by an order of magnitude (10 fold) from the day Obama signed the ACA into law until the day Biden was sworn into office as president.

Mr Chait’s article simply skips over all discussion about how wrong American health insurance is. It’s dishonest. Ds are as much the problem with health care failure in the US as are Rs.

For more information about this, please read my book “The Purple World: Healing the Harm in American Health Care”.   

So politics in the US remains a fight over healthcare. You must choose a side in this fight. Your vote will count this year. Your donations will matter, whether small or large. Republicans obviously have nothing to offer on healthcare. Trump has never actually had a plan and his signature “beautiful “ bill is stealing funds from healthcare and enriching the wealthy. Mainstream Ds only offer what’s good for the profits of the medical industrial complex. I’d suggest you begin your political fighting this year by withdrawing support from incumbents.

In Utah we have drafted a bill-The Utah Cares Act-which will create better, simpler healthcare financed fairly for all. We tried to run it through the legislature but couldn’t even get a hearing. We plan to put it on the ballot in 2028 after not being allowed to enter it on the ballot this year. This ballot initiative will end the political fighting over healthcare. Stop funding politics as usual and instead this year donate whatever you can to get the Utah Cares Act on the ballot. If Utah succeeds (like it did with medical marijuana, Medicaid expansion, and gay marriage) then better, simpler healthcare for all will march forth from Utah to the rest of the nation.

Join this fight. Give what you can. Stop what you are doing and go to View source at utahcares.health and make your voice heard.

Thanks.

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

There were four physicians serving in the Continental Congress in 1776, all of whom signed the Declaration of Independence and heard the Liberty Bell ring.  They, along with their colleagues, believed that signing that document would probably lead to their deaths by hanging for treason.  That was a courageous act; the collective courage of these men, their fellow delegates to the Congress, and many, many other Americans who lived and served as patriots during the years of the Revolutionary War, is what we celebrate today.

Only one of those four physicians actually had a real medical degree—Dr. Benjamin Rush.  He received his medical education at the University of Edinburgh. His medical practice was up to date for the time meaning he was using bloodletting, including leeches, for virtually every malady.  It is likely that patients who were brought to the attention of medical doctors during the Revolutionary War era were more likely to be harmed than helped by the care they received.  

Dr. Rush was a forward thinking man who had the courage of his convictions.  He had a history of trying to solve societal problems using the openminded methods of the Enlightenment.  His treatment of the mentally ill has warranted a posthumous designation as the Father of American Psychiatry.  On Independence Day, I celebrate Dr. Rush and am grateful to him for his lifetime of service to the cause of liberty and social progress.

Progress in medicine, however, was slow in coming.  It remained the case that patients were more likely to be harmed than helped by medical doctors until early in the 20th century.  For most of that century, patients were marginally better off seeing a physician than not, on average.  Unfortunately, just as progress in medicine was actually improving the odds of success in the care of the patient, such that physicians were offering more than marginal improvement in outcomes, American business made access to physician care increasingly difficult.

When I was training as a medical student in the late 1970s and early 1980s, the percentage of American workers receiving solid health benefits from their employers reached its zenith.  And then something happened to those benefits to make them less solid. Just as remarkable new diagnostic technologies, such as CT Scans, became available, and remarkable new pharmaceuticals reached the market, such as cimetidine, ‘managed’ care became increasingly common.  

‘Managed’ care is a euphemism for methods to distance patients from care in order to optimize profits.  The tricks of the trade in health insurance always come out with benign sounding jargon.  ‘Health maintenance organizations’ sound like wonderful business plans, but what they actually do is delay, deny, and defeat care and the professionals who treat illness and injury in order to make more money.  

For instance, as one of two principal regulators of managed care in Nevada during the late 1980’s, I witnessed a new innovation in managed care by Sierra Health Services, the largest HMO then active in the Silver State.  Sierra Health Services began to routinely deny payment for routine care. Why?  Because of what is called “the Float”.  The funds that Sierra Health Services had received in the form of premiums were ostensibly available to pay for medically necessary care.  If a claim was filed by a physician who had provided care to a patient who was a Sierra Health Services beneficiary, but was denied, then those funds could be diverted away from accounts payable into a “Float” fund that could be invested.  Claim denial often became permanent because beneficiaries could only overcome the denial if they appealed it, and many did not.  That of course improved the bottom line of Sierra Health Services.  However, if an appeal was initiated by the patient, and eventually approved, then the float still had use of the funds for the interim time, often as long as weeks to months.  While the bottom line for Sierra Health Services always improved with each of its ‘managed’ care innovations, the likelihood of patients seeing a benefit from medical care which was thus ‘managed’ declined.  

We are at the point in American history where our nation’s capacity to improve human life through our collective will and policy is immense, but, in the case of health care, we are not improving.  We are sliding back to the time when the odds of harm with health care are greater than if the patient stayed away from the health care system to begin with.  The business of American medicine is imposing bloodletting upon the American populace.  Health insurance is a rent seeking enterprise, extracting wealth from health care without adding value.  Health insurers are thus leeches sucking the life out of both patients and doctors.  

Denial of care is not liberty.  

Surprise bills are not freedom.

There is no point in conducting research funded publicly to find new treatments for cancer and heart disease if deductibles keep patients from seeking life and happiness.

Today, July 4, 2026, 250 years after Dr. Benjamin Rush signed the Declaration of Independence, celebrate his courage.  Be glad for this land of opportunity where each of us has a right to vote and participate in our nation‘s political life.  

But, remember, if Dr. Benjamin Rush were here with us today, he would be astonished at the remarkable ability of modern medicine to treat patients, and chagrined at what he himself had done to patients in his day.  But he would also recognize the medical industrial complex for what it is, a plague on the American people which causes all of us to suffer, bleed and die unnecessarily and bleeds our family and public funds dry for the enrichment of the few.  

Let us therefore resolve to end the tyranny of health insurance over American physicians and patients.  We at the Utah Cares Political Issue Committee have drafted the Declaration of Independence from the business of insurance in health care, known as the Utah Cares Act (read it at View source at utahcares.health) and invite all Americans to join with us to get this Act on the ballot in Utah.  Once we succeed here, we will bring that success to every state in the Union.  

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

Across 250 years of its history, what is the single biggest failure of the United States of America?  

Every July 4, we Americans are fond of celebrating what is uniquely right about our country. Having just returned myself from a tour of the Normandy beaches where American lives were lost in the cause of world-wide freedom, I can join in the chorus of praise for American ingenuity, determination, leadership, and industry.  American troops took the toughest assignments on D-Day.  American leadership made the essential decisions.  American industrial power equipped the international armed forces.  The graves of American heroes crown the bluffs at Omaha Beach.  The United States has for a century been the essential nation in the cause of liberty.

My feelings of pride for my nation, however, are muted this year.  It is really unclear to me whether the US is any longer serving as that essential nation.  We have become an unreliable ally.  Our leadership is corrupt and self-serving.  Our national economy seems to be a vanity project.  How did we evolve as a nation from self-sacrifice to self-indulgence?  What mistake led us to our current state of divisiveness within which has been exploited by a narcissistic minority?

I offer as my opinion that the singular failure of the US which has so weakened our national willpower is our failure to care for each other when sick or injured.  After WWII, while other nations, including the nations that were our enemies during that conflict, were securing healthcare for all of their citizens, the United States failed to see the economic and social strength of a guarantee to care for its citizens during episodes of illness and injury.  Over the 20th century, health care grew from a cottage industry to a massive endeavor, big enough, if properly handled, to bolster the economy of every single county in the country.  The American populace enthusiastically supported all things health care, electing politicians who levied the world’s largest taxes to support world leading public institutions in public health, medical research, clinical education, and the delivery of health care.  We built hospitals in every corner of the country, with public money.  We educated the doctors and nurses who worked therein with public money.  We invented new and better ways to care for the patients, with public money.  And with public money we led the entire world in identifying and decreasing the threat of illness and injury everywhere.

But we made the mistake of allowing business interests to have a hold on the enterprise of health care.  It started as what appeared to be a benign allowance of tax credits to employers for the purchase of health plans, originally intended as a short term solution to inflation during WWII.  Eventually, however, this crack in the public interest blossomed into a health financing industry that ruthlessly rejects people who are in their hour of greatest need.  Business interests only care about what makes the bottom line better, and paying for health care in rural America does not make for good profits.  Likewise, that is true of inner city health care.  The care of the poor, the sick, the elderly were all too expensive (meaning not profitable enough).  They, too, were populations jettisoned by the burgeoning business of medicine.  As a result, whole areas of the country were denied the benefits of the publicly paid for development of clinical science.  Hospitals across rural America, many originally built with Hill-Burton federal funds, were closed, their patients abandoned, and left to suffer and die.  Also dieing were the rural economies that no longer had the white collar incomes of health care professionals.  

Rural America could see that their way of life was ending and they became angry.  It is, in my opinion, that anger (which I have in an overly simplified fashion described) which drives much of the political opportunity for the narcissistic minority.

What is the evidence for how much anger our health care failure has created?  Remember the shooting death of top UnitedHealthcare executive, Brian Thompson, about 18 months ago?  Remember the response of the general public to that event?  Here are a few quotes from back then:

“Thoughts and deductibles to the family.”

“Unfortunately my condolences are out-of-network.”

“I’m an ER nurse and the things I’ve seen dying patients get denied for by insurance makes me physically sick.  I just can’t feel sympathy for him because of all those patients and their families.”

“I pay $1,300 a month for health insurance with an $8,000 deductible.  When I finally reached that deductible, they denied my claims.  He was making a million dollars a month.”

The author Joyce Carol Oates stated that this outpouring of negativity about health insurance “is better described as cries from the heart of a deeply wounded and betrayed country; hundreds of thousands of Americans shamelessly exploited by health-care insurers reacting to a single act f violence against just one of their multimillionaire executives.”

Ladies and gentlemen, plausibly 200,000 Americans prematurely lose their lives every year because of the dysfunction of American health care.  500,000 Americas are bankrupted by the cost of health care in the US every year, while elsewhere in the developed world NO ONE IS EVER DENIED THE CARE THEY NEED OR ARE BANKRUPTED BY ITS COST.

There is power in simply putting our hands on each other when someone is sick or injured.  When we care for each other we will respect each other and find kindness flourishing among us.  The way forward, or, actually, back to a place where America is the essential country, is for us to care for our fellow Americans. Our biggest mistake as a nation was to fail to be caring.  

Learn more at View source at utahcares.health

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.

Fasting is a nearly universal practice with physical and spiritual benefits and has been used both by individuals and groups of people as a way to enhance self-discipline, encourage societal cohesion, build empathy for people in need or who are ill, recognize failings, and plead for betterment.  Muslims practice fasting during Ramadan, Catholics and Eastern Orthodox Christians do so during Lent, believers in Judaism fast during Yom Kippur, Hindus and Buddhists fast during selected days of the lunar cycle, the Bahai fast during their celebration of their new year.

The Prophet Isaiah summarized the need for and nature of fasting in the Old Testament:

“Is not this the kind of fasting I have chosen:
to loose the chains of injustice
    and untie the cords of the yoke,
to set the oppressed free
    and break every yoke?
7 Is it not to share your food with the hungry
    and to provide the poor wanderer with shelter—
when you see the naked, to clothe them,
    and not to turn away from your own flesh and blood?
8 Then your light will break forth like the dawn,
    and your healing will quickly appear;
then your righteousness will go before you,
    and the glory of the Lord will be your rear guard.
9 Then you will call, and the Lord will answer;
    you will cry for help, and he will say: Here am I.

Isaiah 58:6-9 NIV

Beyond religious observances, fasting together with prayers of thanksgiving has in the past been used to unify people in their national interest and bring about a remembrance of societal failings while preparing for a time of betterment.  For instance, Pres. Abraham Lincoln, after dedicating several different days of fasting during the Civil War, called upon the citizens of the United States to “set apart and observe the last Thursday of November next as a day of thanksgiving and praise…(and) also with humble penitence for our national perverseness and disobedience, commend to (God’s) tender care all those who have become widows, orphans, mourners, or sufferers in the lamentable civil strife in which we are unavoidably engaged, and fervently implore the interposition of the almighty hand to heal the wounds of the nation”. This, of course, eventually became one of just a few annual holidays shared universally by all Americans—Thanksgiving Day. 

In my own religion, the Church of Jesus Christ of Latter-day Saints, members are asked to abstain from food and drink (the meaning of fasting) for two meals every first Sunday of the month, focusing that effort on whatever spiritual or material needs appear to have importance.  Members are further encouraged to donate the funds saved through forgoing two meals to the care of the sick, injured, homeless, hungry, and unclothed.  

Personally, I find great power and solace in the practice of fasting.  I engage in the practice monthly, and more often when particular needs arise.  Though the funds donated each month are minimal, I have over my entire life now donated thousands of dollars to people with needs greater than my own.  During the time I served as the bishop of my LDS congregation, and was expected to use those funds to assist those in need, I saw the power of many small donations aggregating to make a real difference in the lives of my brothers and sisters:  the hungry were fed, the naked were clothed, the homeless were housed, and the sick were treated and cared for.  

This week we are celebrating the 250th year of independence for these United States of America.  There is much good that can be said of my country, but at the present, I find little to celebrate.  Among the many shortcomings that I could cite (and there are too many for me to enumerate here), I have chosen to focus my efforts on the shameful status of the American health care system.  We Americans alone among all wealthy nations have not arranged our national affairs such that the sick and injured can be uniformly cared for.  Plausibly 200,000 premature deaths occur each year in the US because of inequities and inefficiencies in how we deliver (or don’t) health care.  Yet, despite that remarkable failure to care, we outspend BY FAR any other nation when it comes to health costs, largely and lamentably because we are more interested in profiting from the illnesses and injuries of our fellow citizens than in caring for them.  In our health system we truly have cause to mourn, we have fallen so short of our national ideals of promoting the general welfare and enabling the pursuit of life, liberty and happiness.

The day after the coming July 4th celebration of our nation’s birth will be the first Sunday in the month of July.  As a member of the Church of Jesus Christ of Latter-day Saints I will be fasting two meals that day, July 5th.  And I will donate the funds thus saved to the welfare program of my church.  But, in addition, I will donate the same amount to the cause of better, simpler health care financed fairly for all Americans.  I will fast and pray that day that God will help me bring about a change or reformation in how health care is organized in my country.  I ask you in the spirit of Abraham Lincoln to join with me in that fast.  If your physical health allows it (and there are some people, for instance diabetics, who should not) choose two meals on July 5, 2026 and forgo both food and drink during the interval that would include them.  During your fast, look to your source of spiritual welfare, whatever that may be, and importune it to aid all of us in finding a better way to manage our health care system.  And then, give the money you saved (or however much your fiscal situation will allow) to the organization I chair, the Utah Cares Political Issue Committee, thus joining me in the cause of reforming the American health care system.  

You can learn more about the Utah Cares Political Issue Committee on our website:

View source at utahcares.health

There you can also make your donation.

Together, let us all do as the Prophet Isaiah advises: share with those in need so that  “your healing will quickly appear”.  Or as Lincoln also said, with malice toward none and charity for all let us bind up the nations wounds.  Your small donations will be seen in heaven, will be multiplied, and will suffice for us to change American health care forever.

Thank you.

Dr. Joseph Q. Jarvis is a public health physician, chair of the Utah Cares Political Issue Committee and author of several books, including The Purple World: Healing the Harm in American Health Care and What the Single Eye Sees: Faith, Hope, Charity, and the Pursuit of Discipleship.