Is the United States exceptional?

America has exceptional statistics across social, health and welfare areas

Question: Is the United States exceptional?
Position‹3 of 3: Yes, America is exceptional but not necessarily in a good way
Argument‹2 of 2: America has exceptional statistics across social, health and welfare areas

The argument

There are a number of social measures where America performs relatively poorly, including poor health, homicides and gun violence. Health outcomes compared to money spent: The U.S. devotes more of its national income to healthcare relative to other OECD countries (e.g. in the UK people contribute £4,000 pa on their healthcare compared with £10,000 in the USA) with hundreds of thousands Americans per year declaring bankruptcy due to health care bills. Three times the world average of this is on administrative costs. Despite the amount spent, the USA is amongst the very worst of wealthy nations on a succession of health measures including average life expectancy, where the US sits with South America, well below the UK, Western Europe, NZ, Australia and Canada. The contrast with the amount spent on health makes the US even more of an outlier. Incarceration: The United States has less than five percent of the world’s population, but about 25 percent of the prisoners. Prison conditions and sentences are “vastly harsher” than comparable countries It is the length of sentences that makes the statistics so stark. Reasons include draconian drug laws and bail policies that criminalise poverty and sentences that do not fit the crime. Gun violence is closely linked to gun ownership, which is twice the rate of the next closest country. 73% of all homicides are gun related c/w 3% in UK. It is the leading method of suicide. There were 1,004 people shot dead by police in 2019. The second amendment right to bear arms and the $5 million a year on lobbying by the NRA has meant that despite a seemingly endless procession of mass shootings it is only recently that polls found more people were interested in gun control than the right to bear arms. Parental leave: The USA only OECD member that has not passed laws requiring businesses and corporations to offer paid maternity leave to their employees. There is a patchy record on all civil rights. These range from state sanctioned torture at at Abu Ghraib to the contradictory position that see women’s reproductive rights increasingly curtailed whilst little welfare or care available for women living in poverty who decide to keep a child.

Premises

[P1]The US spends far more of its income on healthcare than peer OECD nations yet ranks among the worst wealthy countries on life expectancy and other health measures, with hundreds of thousands of medical bankruptcies a year. [P2] It holds about 25% of the world's prisoners with under 5% of its population, has gun-violence and homicide rates far above comparable nations, and is the only OECD member without mandated paid maternity leave. [C] Therefore, America is exceptional across social, health, and welfare statistics — but not necessarily in a good way.

Counter-arguments

The statistics assembled here are real, but the argument selects only the measures on which the United States performs badly and then treats the resulting picture as a verdict. On other internationally comparable measures — research output, university standing, patenting, income per head, charitable giving — the country is an outlier in the opposite direction. A survey that takes both sets seriously supports the plain claim that the US is unusual, which is the sibling position, rather than the loaded claim that it is unusual in a bad way. Several of the specific comparisons are also weaker than they look. Health spending is presented as a personal contribution of £4,000 against £10,000, which conflates per-capita national spending with what individuals pay; the medical-bankruptcy figures are contested in the research literature, where the dispute is over whether medical bills are the cause of filings or one of several concurrent pressures. Abu Ghraib is offered as state-sanctioned torture, though the conduct was prosecuted domestically — which is evidence of a scandal, and also of the accountability mechanism that acted on it. Most fundamentally, being worse than peers on a set of indicators is a difference of degree. Exceptionalism, as usually argued, is a claim about a distinctive national character or role, and poor outcomes on chosen metrics do not establish one.

Rejecting the premises

[Rejecting P1] The spending comparison conflates national per-capita expenditure with individual contributions, and the causal role of medical bills in bankruptcy filings is disputed in the research rather than settled. [Rejecting P2] The incarceration, gun and parental-leave figures show the US is an outlier on selected measures; they do not establish exceptionalism in the qualitative sense, and the same exercise run on research output, income and philanthropy produces outlier status in the other direction.

The argument

Premises

Counter-arguments

Rejecting the premises

Further reading