The United States is not best in the world at much of anything anymore.

Toyotas and Hondas, once derided as “economy cars,” now outsell and outperform Chevrolets and Fords.

A team of NBA All-Star basketball players coached by future Hall of Famer Mike Kryschewski could not win the 2006 World Championship.

And to call the U.S. health care system “best in the world” is a perfect example of living in invincible ignorance. Just ask any American business owner.

Kirk Newhouse, 44, owns and runs Carl’s Cafe. Carl’s annually wins “Best Breakfast” and “Best Lunch Under $5″ polls in the local newspaper. It’s a true family business. Kirk’s mom, 67, makes the pies.

Kirk plans to expand to a second and perhaps even a third location, which would be a significant boost to the local jobs market and economy. That plan is on hold, however, because Kirk doesn’t have the money to make payments on the necessary business loan. He is a good manager, yet struggles just to meet monthly expenses and clear a reasonable profit. One reason is that Kirk pays for everyone’s health care.

Kirk and his wife pay premiums to a managed care health plan. Their sons’ university tuition and fees include a bill for health care coverage. Kirk makes Medicare contributions that pay for his mother’s care. Finally, Kirk provides health care benefits to his employees through the system known as employer-provided health care. Kirk’s plans to expand Carl’s Cafe will remain on hold as long as this health care policy model is in place.

In nearly every other country in the world, health care is a right of citizenship for people of all ages. In contrast, health care in the United States is a right of citizenship only for those over 65 and those with certain named medical conditions.

For 160 million people (62 percent of Americans under age 65), health care is a right of employment. (1) Even so, some of the nation’s 50 million uninsured citizens are employed. As Social Darwinism (lack of concern for the human condition) became the norm in American business culture, employers became as comfortable with ignoring employees’ health care needs as they are with spending pension plan money now.

Until recently, criticisms of U.S. health care policy focused primarily on Medicare’s shortcomings and the plight of the uninsured. Now, suddenly, some critics shine a glaring spotlight on the employer-provided health care insurance policy model. Among stakeholders abused by this model is Kirk Newhouse, representative of young men and women trying to grow America against tremendous odds.

How did health care benefits come to join vacation time and pension plans as job perks? How can Kirk and other American business owners be relieved of that burden?

Where it began

Employer-provided health care was born in the 1930s after Franklin Roosevelt decided not to try for universal socialized medicine. In a move that seemed ingenious then because health care was comparatively cheap, the federal government passed laws offering economic incentives to businesses that provided health care to employees.

As a result, two objectives were met at once. Many Americans in the prime of life would now have health care coverage, and business owners and executives could spend less money to satisfy union demands. (2)

This employer-provided health care model is now being called an “accident of history.” Renowned medical economist Uwe Reinhardt of Princeton University says, “If we had to do it over again, no policy analyst would recommend this model. (3) Criticisms of employer-provided health care are hitting the public press. (4)

Ironically, health care organizations suffer a double hit because they are squeezed between providing health care for employees and stingy third-party payment formulas. As awareness of unfairness increases, don’t be surprised if health care businesses lead an effort to breathe new life into business/community/government coalitions.

Once simply bargain-seeking groups, these coalitions would put pressure on the politicians and insurers to scrap the employer-provided health care model and replace it with something better.

Ah, but there’s the rub. So far, no one has come up with a feasible replacement plan. The reason is that nobody’s looking very hard. Quick fixes that are comfortable, convenient and conventional are only rearranging the deck chairs on the Titanic. Such solutions offer hope and make us feel good in the short term, but only lead to disappointment and delay genuine lasting solutions.

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Consider these eight tough questions and answers about my proposed new system.

A new U.S. health care system

Q: Will the new uniform national health care system more closely resemble Canada’s, England’s, or Germany’s? (5)

A: There would be no uniform national health care system. Following federal guidelines they help create, each state would develop and implement a system.

Hawaii would be allowed to continue the effective working model that has evolved there.