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Posted by on Dec 11, 2012 in At TMV, Featured | 22 comments

The Enduring Myth of American Exceptionalism

A belief in American exceptionalism has been in the nation’s DNA since its birth, fostered by the Founding Fathers and foreign visitors like de Toqueville. Indeed, the reality of a republican form of government, with free men able to elect their own leaders, was alien to the rest of the world when the Declaration of Independence and the Constitution were written and America came into being in the late 18th century.

Over time and after much conflict, America’s franchise was expanded to include all adults, male and female, black and white, and its system of government stood as an example for other nations. But in addition to the universal franchise and freedoms defined in the Constitution and its amendments, America also offered a chance for anyone who was smart and willing to work hard to be successful; to climb from the lower segments of society and accumulate wealth and power. This ability to transcend status at birth and enjoy upward mobility was at the heart of American exceptionalism along with the vote and guaranteed freedoms. America was seen as a land of opportunity and the reason immigrants from all over the world wanted to come to our shores.

Throughout our history, politicians have lauded American exceptionalism and emphasized how their policies would preserve and augment what makes America special. During the last half century, they described how America’s military was the strongest, its economy the most vibrant, its educational system superior, and its health care system the best in the world. For the most part, they ignored the nation’s deficiencies, particularly if additional revenues would be required to fix the problems.

Though it is true that America’s military is the strongest in the world, it has cost us trillions of dollars over the years, money that might have been utilized to bolster the nation in ways that could have been more fruitful. America spent more on defense last year than the next thirteen nations combined, including China, Russia, Iran, Japan and the European powers. And though we fought two wars in the last decade, taxes were reduced at the same time, increasing our debt and dependence on other nations. As Paul Kennedy noted in The Rise and Fall of the Great Powers- “If too large a proportion of the state’s resources is diverted from wealth creation and allocated instead to military purposes, then that is likely to lead to a weakening of national power over the longer term.”

Because we have had misplaced priorities in apportioning government funds, inefficiencies in monitoring what we spend, and an unwillingness to raise adequate revenues, America is no longer exceptional in many ways. Included is our health care system, where unnecessary care flourishes, costs are the highest in the world, and overall care is mediocre, as shown by the rankings in life expectancy and infant mortality. In addition, America’s once impressive educational system is currently inadequate on the K-12 level. The nation’s infrastructure is crumbling and broad band connectivity lags many other advanced nations. Government support for research and development, which once led the developed world and was responsible for the Internet and other innovative technologies, has been steadily decreasing, a concern for our economic future. Of course, over all hangs the specter of our national debt.

And though our nation is still perceived as the land of opportunity, the ability to rise from the lower to the middle or upper classes in America is more difficult now than in most other industrialized nations. One important element that stifles upward ascension is the cost of higher education. The vast degree of income inequality is another constraining factor for those on the lower rungs. Weakening of the union movement, with its effect on wages and benefits for workers, also plays a role. Most of the electorate, however, is unaware of the change that has occurred in social mobility and still believes the American dream is intact for those willing to work hard.

Though our budget deficits and the national debt must be addressed, our other problems also have to be considered if American exceptionalism is to be more than a meaningless phrase. This will require more revenue for the federal government, more support for vital programs, as well as managing spending cuts in a logical fashion. Taxes on the wealthy must be raised and since the entitlement programs of Medicare and Medicaid are major sources of our debt, ways must be found to make them more efficient and lower their costs. If unnecessary care, which makes up 30 percent of overall health care spending ($900 billion last year), could be significantly curtailed, this would be an important step forward.

Current income inequality must be reduced and social mobility increased, if we wish to insure the reality of American exceptionalism and the American dream.

Resurrecting Democracy

em>A VietNam vet and a Columbia history major who became a medical doctor, Bob Levine has watched the evolution of American politics over the past 40 years with increasing alarm. He knows he’s not alone. Partisan grid-lock, massive cash contributions and even more massive expenditures on lobbyists have undermined real democracy, and there is more than just a whiff of corruption emanating from Washington. If the nation is to overcome lockstep partisanship, restore growth to the economy and bring its debt under control, Levine argues that it will require a strong centrist third party to bring about the necessary reforms. Levine’s previous book, Shock Therapy For the American Health Care System took a realist approach to health care from a physician’s informed point of view; Resurrecting Democracy takes a similar pragmatic approach, putting aside ideology and taking a hard look at facts on the ground. In his latest book, Levine shines a light that cuts through the miasma of party propaganda and reactionary thinking, and reveals a new path for American politics. This post is cross posted from his blog.

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Copyright 2012 The Moderate Voice
  • yoopermoose

    For me, our exceptionalism took a big hit when the Bush administration OKed torture and Indefinite detention with no access to our justice system. These are the tools of third world countries, not the shining city on the hill.

  • Dr. J

    our other problems also have to be considered if American exceptionalism is to be more than a meaningless phrase. This will require more revenue for the federal government, more support for vital programs, as well as managing spending cuts in a logical fashion

    How do these connect with the problems you cited, Robert? Specifically social mobility, unnecessary medical care, and income inequality seem outside the sphere of what government programs can affect.

    Even affordable higher education is starting to look like affordable health care in terms of how much the government can do about it. Rampant, long-term cost inflation (and arguably a market bubble) is pushing college beyond the means of more and more Americans. Government can subsidize it, but that just shifts the inflated costs around a bit–meaning the middle class will call it “taxes” rather than “tuition” when they pay it. Such subsidies don’t fix the root inflation problem and may make it worse.

  • Government can play a role in increasing social mobility by making education more affordable- give more grants and loans to students who cannot afford college, but insist that their schools graduate most students and that these credentials are warranted.
    Having medical experts determine what is unnecessary care would be helpful in cutting health care costs, but fee-for-service medicine must be eliminated to take away incentives for unnecessary tests and procedures. Also need malpractice reform to stop defensive medicine.
    Income inequality can be addressed somewhat by a more progressive tax code, or a wealth tax instead of an income tax.

  • Dr. J

    I agree about paying for health results rather than treatments. That doesn’t require more government spending, it just requires changing the rules of existing programs.

    Taxes on their own will not budge income inequality statistics, as income is calculated pre-tax.

    Do you share my concern that college tuition subsidies still burden the middle class and may be fueling a bubble?

  • Momzworld

    Having medical experts determine what is unnecessary care would be helpful in cutting health care costs, but fee-for-service medicine must be eliminated to take away incentives for unnecessary tests and procedures. Also need malpractice reform to stop defensive medicine.

    I certainly agree with this from the patient’s perspective. Some things I’ve found annoying if not frustrating comes when having two doctors wanting virtually the same blood work. In order to avoid being stabbed twice I take both scripts to the lab. But the tech still has to fill additional vials for the second doctor!! Cigna has to pay for each set separately. Finally my cardiologist, who happens to be Asian, asked if my PCP was monitoring my cholesterol, which he is, so the cardio doctor has turned that over to the PCP and finally, I only have to see the cardiologist every six months. Then there is the PCP who requires that we see him every 3 months. Dr. Levine, you’re a doctor. Why is this? Two of those visits each year are pretty useless from where I sit as a patient. My husband is diabetic, so I concede that it’s probably good to go in more often. But he has a foot doctor he sees every 10 weeks to have his feet checked and his nails trimmed. I have a Parkinson’s doctor who says I must see her or another neurologist four times a year. We almost literally would not have a thing to do if it weren’t for all these doctor’s appointments and running to the drug store to fill the prescriptions. Is all of this frantic running around really necessary. Medicare is paying for all of this!!

  • slamfu

    The govt can affect the pricing of healthcare and education in a very simple way. Build more schools, build more hospitals. Giving more money out without increasing supply of these services simply means those that are out there can charge more. Easy access to college loans is the single biggest driving force of inflation of college tuition. Supply and demand can be implemented here, and its simply not being done. When hospitals were locally run things were better, now its all been handed off to be managed by the AMA and for profit HMO’s. No wonder things have gone to hell in a handbasket.

  • clarkma5

    Exceptionalism requires a culture that’s invested in being exceptional. That’s an investment in spirit, in emotion, in action, and in dollars. That culture is at least a generation departed from our current state, probably more like two.

  • dduck

    The trouble with exceptionalisim is that it is not a constant. Rather it is often a transient state that often wanes and a reputation that is milked shamelessly.
    Saladin was an exceptional leader and ruler. The next one not so much. Same could be said of Caesar, Washington, Churchill and they could be debatable as exceptional. It is consistency and longevity of the exceptional behavior, for good or bad, btw, and we aren’t up to snuff at the present compared to the days, of say, the Marshall plan.

  • slamfu

    Man you got that right.

  • zusa1

    From an interesting article regarding tuition inflation:

    “Do Increases in Pell Grants Increase College Tuition?: Testing the Bennett Hypothesis

    One can say a nonrecursive relationship exists between Pell grants and tuition increases. That is, Pell grants and tuition increases are in a reciprocal relationship, depicted by the following path diagram:

    Pell grants increase ———-> Tuition increase
    < ———- The relationship arrows point in both directions. This is an interesting finding as a brief review of the literature finds support and lack of support for Bennett’s hypothesis. Perhaps ‘Granger-causality’ reveals a better model which conforms with the data.

  • In answer to Momzworld, fee-for-service medicine will continue to result in unnecessary tests and procedures as long as that enhances physicians’incomes. It’s human nature and the reason why the market will never work to lower medical costs.

  • sheknows

    Our country took a hard right many decades ago when capitalism, not exceptionalism became the blueprint for the american dream. When how much you have, not how much you have to offer became the new yardstick for measuring worth.
    Consequently everything revolves around money. Industry titans control not only our economy, but the politics of our government. Pretty hard to make changes to a system ruled by the almighty dollar.
    Healthcare will not see any changes and costs will continue to skyrocket as long as our free enterprise system goes unchecked. Wasteful spending to curry favor for votes and power,necessary spending curtailed to pay for special interest groups, and special interest groups buying votes to further their bottom lines.
    What makes us exceptional today, is our ability to speak out against the appauling conditions that prevail in a once strong and vibrant democracy for all people.
    We need a SERIOUS overhauling of our values if we wish to not only compete, but to thrive as a leading nation of the world.

  • zephyr

    Excellent post Robert. Right on target!

  • slamfu

    I really don’t think doctor compensation is the prime source of the medical gouging. They make less than they used to, while healthcare costs go up and up. Its the privatized industries that have taken over, adding another HUGE layer of costs in the profit taking part of the equation. Pharma companies, medical device companies, HMO’s, and the AMA are keeping healthcare expensive. Capitalism does not apply to healthcare. Free market principles don’t apply to things you have to buy. And nobody buys healthcare unless they have to. Healthcare is the very definition of a cost that needs to be addressed socially, and not via market solutions.

  • slamfu

    Sorry I seem to be way off topic there. I guess I don’t really understand American Exceptionalism. It sounds like we don’t have to play by the rules others have to play by because, well, we’re Americans. That seems like a REALLY bad premise for a philosophy.

  • sheknows

    I think we are the only country in the world where the healthcare industry is a huge profit making business. To present any kind of legislation to change that is as likely to happen as a planet killing comet hurtling to earth.
    Half of our nation now wants to privatize insurance for everyone, and cut back on the only tiny bit of socialized healthcare we have, medicare. If that weren’t bad enough, there are those who take advantage of that system now and dishonestly bilk billions from it’s poorly run and lamely monitored structure.

    Perhaps we need to look more closely at other countries who have successfully implemented socialized medicine and examine what elements were present in their government and philosophy that we are lacking to make that more feasible.

  • IMO our exceptionalism stopped when we strangled ourselves with our own inflexibility regarding our own government.

    Examples: gerrymandering & other tricks to enforce incumbency; taking a literalist, unchanging view of our Constitution; always looking to emulate past greatness (FDR, JFK, Reagan, even The Founders) instead of looking to the future.

    We are ideologically stagnant. We can’t “think big”: our self-congratulatory view of our own past is weighing us down.

    In some ways we’re like a dog tangled up in his own leash, in other ways we’re like a former jock who looks more at his trophy case than in his own mirror.

  • sheknows

    Good perception Barky!

  • dduck

    I think this song applies nicely: “But I just can’t let it get me down, Cause this big old world keeps spinnin’ around. I’ve been a puppet, a pauper, a pirate, A poet, a pawn and a king. I’ve been up …

  • I see it the opposite way: we have constantly been making the constitution “more flexible” (weaker), since this country was founded. College education costs have skyrocketed since the student loan program separated costs from the value of the degree, and medical costs skyrocketed after employer-funded “insurance” (prepaid medical) became popular. Of course doctors will order unneeded tests for profit, because the patients won’t, and often can’t, turn them down because someone else is paying for them. It’s amazing how defensive medicine goes away when medicaid prices kick in.

  • slamfu

    “our self-congratulatory view of our own past is weighing us down.”

    Amen to that Barky. So many of us seem to think being #1 is something we can take for granted and will always be the case even if we turn into a nation of self-congratulating slackers. Being the best has to be earned. And being the best nation is a TEAM effort.

  • Slam, IMO the problem is even considering that we should be #1. It’s a false goal, a bogus direction. We should have Important, humble goals like providing good education, promoting liberty, having a decent society. It’s about fairness, integrity, & real prosperity across all facets of life.

    “#1” is just a number. Focus on the important stuff, and the number will take care of itself. Or not, who gives a sh*t as long as we have a good country to live in

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