© Josh Sager – February 2016

Politicians of both parties love to talk about “American exceptionalism” while rallying their supporters. This term refers to a nebulous sense common among many Americans that something about the USA makes us special when compared with other nations—that we have more “freedom,” better standards of living, a more fair and accessible society, or a place as the defender of freedom across the world.

While most of the references to “American exceptionalism” are simply delusional jingoism—we aren’t happier, healthier, more free, better educated, or more able to better our economic circumstances than other developed countries—the USA is truly exceptional in some regards.

Unfortunately, the story of Rex Iverson illustrates several of the more unfortunate ways that the USA is truly exceptional on the world stage.

Rex Iverson was a 45 year old resident of Bear River City in Utah. Like many Americans, he had a hard time finding a steady and well-paying job, thus was unable to pay an ambulance bill stemming from an incident on Christmas 2013. He owed just under $2,400 to the ambulance company and, because he was unemployed, there was no way for the company to collect. This led the company to bring Iverson to small claims court, where he was held in contempt for refusing a summons. This contempt citation led to Iverson’s arrest and, within 12 hours of being detained, Iverson was pronounced dead. Nobody knows what the cause of death was, but early reports say that the authorities do not suspect foul play.

In defense of their actions, the county sheriff argued “We go to great lengths to never arrest anybody on these warrants. The reason we do that is we don’t want to run a debtors’ prison.” While I will give the sheriff some credit for not WANTING to run a debtors’ prison, the simple fact is that this is exactly what he is doing. Investigations by journalists after this death was reported found that at least 13 other low-income individuals in this county had also been jailed for not paying civil debts. This indicates a systemic practice of jailing debtors, in violation of federal laws and SCOTUS rulings dating back to 1833.

Iverson’s story may seem extreme, but the fact is that he is far from unique. Recent polling indicates that 63% of Americans cannot afford to pay a $1,000 surprise medical bill.

If you were to visit any other developed western nation (e.g. France, Canada, Italy, etc.) and try to explain this situation to one if its citizens, they would likely look at you like you were speaking in Urdu—it simply would not register because this is a situation that is unheard of in their society.

The United States is the only developed nation where citizens end up thousands of dollars in debt for daring to take an ambulance when injured. In all other developed nations, the healthcare system is either free and universal (e.g. France) or fully nationalized (e.g. the British National Health Services). Nobody goes into debt for taking an ambulance and everybody has the presumption that they will have affordable, if not taxpayer funded, healthcare.

The USA’s “exceptional” market-based system of healthcare provision is the sole reason for this type of medical debt. We allow companies to make exhortative profits from human sickness and have refused to pass a public option to catch those who fall through the cracks. While programs like Medicare and Medicaid are a Band-Aid over this problem, they are simply not capable of addressing its full scope.

The United States is the nation with the largest prison population across all levels of development—this is true whether talking about overall prison population or the percentage of the population being incarcerated.

In other OECD nations, they do not incarcerate people for debts, and have a much higher focus on rehabilitation than punishment. Even if Iverson were to incur debts in their nation, he would not be incarcerated and would likely be given unemployment assistance until he managed to get a new job and start paying back what he owed.

It may be uncomfortable to confront the fact that our nation is not exceptional in the ways that many have declared, but change only happens if we recognize that there is something that needs to be fixed. Currently, our exceptionalism is largely a function of our giant military, lack of strong basic social welfare programs, incarceration of our citizens, and falling metrics of societal health (e.g. income mobility, education, happiness, etc.).

If Americans want to improve our nation and become exceptional in some positive metrics, we must push for real social change. Our nation has the resources to create top-tier education, healthcare, and social welfare systems, yet has allowed the rich to hoard this money by buying off politicians until they cut high-income/corporate tax rates. Additionally, we keep pumping money into our bloated military (which is larger than the top 16 runners up combined) and spending money on things like incarceration and corporate welfare.

By taxing the rich a fair share, streamlining the military, and—to borrow a phrase from Bernie Sanders—“investing in jobs and education for our kids, not jails and incarceration,” America can dramatically improve itself and begin earning a truly exceptional place on the world stage. If we do this, we truly can be one of the best educated, longest living, happiest, and healthiest nations, albeit after years of work and dedication to the cause.