Phil Carville: National Fitness |

Phil Carville: National Fitness |

Fitness is a comprehensive topic. I usually talk about personal fitness, which includes the basics of diet and exercise. Follow the basics and you’ll be healthy, unless you get sick.

By disease, I mean that you have had some event such as diabetes, cancer, a car wreck, or a physical accident. Since 78% of American workers live from paycheck to paycheck, “illness” greatly increases the likelihood of bankruptcy and financial ruin.

system “sick”

Healthcare assessments include doctors, hospitals, dentists, psychology, nursing, physical therapy, and more. When we look objectively at our national healthcare rankings, we find a situation that is a stigma.

According to CEOWorld Healthcare Index, the United States is ranked 30th in the world for health services. South Korea No. 1, Taiwan No. 2, Denmark No. 3 and Austria No. 4.

Nationally, we spend more on healthcare per person than any other country, yet we are No. 30 in healthcare performance. South Korea spends $3,500/person/year on healthcare or 8.41% of its GDP. We spend 12,931 USD/capita/year, or 19.7% of GDP or 3.24 times more per capita, but the results are much worse. Health care in South Korea is provided to all citizens and is financed through a combination of payroll taxes, government subsidies, tobacco surcharges, and foreign contributions. Denmark spends $6,003 per capita per year or 50% less per capita than we spend, but with better results.

Compared to other developed countries in the Western world, the United States is almost at the bottom of the list…yes, finally. Something very wrong here.

Politics or passion

Politics, not empathy, often dominates the debate about health care. Denmark spends about 10% of its GDP and the average in the European Union (EU) is 9.9%. 19.7% of the GDP we spend means that one in every five dollars spent in America will be spent on health care.

Unless something changes, the estimate for US healthcare costs for 2050 is 37% of GDP…leaving less than that for national security, education, housing, food, etc. What kind of nation will we have then?

Brains, not explosives

It’s time to apply reason and compassion to resolve the situation. If other countries in the world can do it, why can’t we?

Arguments like “it’s socialism,” “we can’t afford it,” or “we have the best health care in the world” are all bogus. They are distortions that do not lead to clear thinking and real solutions.

There are 29 countries in the world that have higher-rated healthcare systems than we do. Some are “single-payer” but most have a combination of national health care coverage and some form of private insurance. France, for example, has a national health insurance program, but doctors are in private clinics. Supplemental coverage can be purchased from private insurance companies.

Switzerland and Taiwan have single-payer models with high-quality care at surprisingly low costs. Switzerland spends 11% of GDP on healthcare while Taiwan spends only 7% of GDP on healthcare.

Germany has a global multi-payment system which is a combination of 77% government-funded and 23% private insurance. The German healthcare system has a record reserve of €20 billion, making it one of the healthiest in the world.

The health care system does not have to be an “either or” – fully government-run or unregulated free market. But whatever the system, we must start working on real solutions now!

Education and commitment

National fitness is based on the same issues as personal fitness: education and commitment.

We must devote ourselves to finding solutions to America’s crippled health care system. If we want to have a vibrant and healthy democracy in the twenty-first century, we must have an informed, educated and healthy population.

If we don’t start solving our major problems today, the future won’t be as good as the past. Maybe it’s time we all get involved in the solution. Time is not our friend!

Phil Carville is one of the owners of the South Yuba Club. He is happy to answer questions or respond to comments. He can be contacted at

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