Opposites Do Not Attract… Unless You Are a Magnet

A popular saying about relationships is that “opposites attract”.  But, is this really true?  Do people really want to be with someone who is totally opposite of them?  Do people prefer friends who are opposite of them?  Do people prefer to marry someone opposite to them?  Or is the converse popular saying true: “Birds of a feather flock together?”  In this paper, I will attempt to show that, in general, the statement and sentiment that “opposites attract” is false and that in successful, happy relationships there are usually strong similarities and common respect for the others’ cherished attributes.  These issues are important to society as we all have the choice to decide who we will spend our time with, who we will associate with, or who we marry.

Charles-Augustin de Coulomb
 with a magnet attraction diagram

The popular idea of opposites attracting could possibly be traced to publications from Coulomb, a French physics in the 17^th century.  Coulombs’ publications form the foundations of Coulomb's law which deal with electrical charges and magnetism.  His publications show that like, or similar, charges repel each other, while opposite charges attract each other (1788).  This law is informally explored by many of us while experimenting with magnets.  Flat magnets have two polar opposite sides: one positively charged and one negatively charged.  As one moves two magnets together, there is an invisible attracting or repulsing force depending on the polarization of the ends that are moved.  If a positive end is placed near to a positive end, they will repulse each other, while if a positive charge end is placed near a negative charge end the magnets will be attracted to each other, or in other words the “opposites attract”.  While “opposites attract” may be a very reliable and valid physics principle, to apply it to interpersonal relationships is generally inaccurate.

"Aristotle with a Bust of Homer"
Rembrandt van Rijn
Oil on Canvas 153

Aristotle (384 BC - 32 BC) noted in his Rhetoric and Nichomachean Ethics that people often love those who are like unto themselves (Aristotle, 1934).  Since then there have been several studies that have set out to determine what attracts individuals to relationships with others (DeArmond & Crawford, 2011; Kiesler, 1996; Nangle, Erdley, Zeff, Stanchfield, & Gold, 2004).  There has been found in such studies great evidence that people are attracted to others of similar social status, behavior, humor, personality traits, and beliefs.  Studies have shown evidence that children are well liked by their peers who are similar to them in social status and behavioral style, while dissimilar children are disliked by peers who do not share such similarities (Akers, Jones, & Coyl, 1998; Nangle, Erdley, & Gold, 1996). Additionally, Hymel and Woody (1991) show evidence that children prefer others with a similar sense of humor. Studies also show that college students generally prefer roommates with similar personality traits (Carli, Ganley, & Pierce-Otay, 1991; Deutsch, Sullivan, Sage, & Basile, 1991) and prefer strangers that share similarities to them (Hodges & Byrne, 1972; Reagor & Clore, 1970; Lombardo, Steigleder, & Feinberg, 1975), particularly if they share a common negative view (Bosson, Johnson, Niederhoffer, & Swann, 2006; Weaver & Bosson, 2011).   Studies show evidence that couples in general prefer (Buston, & Emlen, 2003) and are similar to each other rather than being dissimilar or opposite (Botwin, Buss, & Shackelford, 1997; Chen, Luo, Yue, Xu, & Zhaoyang, 2009, Gonzaga, Campos, & Bradbury, 2007; Klohnen, & Mendelsohn, 1998; Luo, & Klohen, 2005; McPherson, Smith-Lovin, & Cook, 2001) particularly in weighty matters such as religious practices (Call & Heaton, 1997; Heaton & Pratt, 1990; Strycharz, 2004).  It has even been shown that those who are depressed prefer other depressed companions to non-depressed companions (Locke & Horowitz, 1990).  These evidences indicate that the saying “opposites attract” when applied to interpersonal attraction and preference is flawed.  While there may be incidental cases of apparent opposites attracting, in general, this theory is untrue.

Similarity preferences can be seen in simple things such as an individuals tend to have more same-sex friends than opposite-sex friends.  Another example is that we tend to spend time with people of similar ideas such as entertainment and interests. 

An Example Confirmation Bias

One may ask, “If the saying that opposites attract is false, then how and why did it come into being?”  The answer could lie in how we perceive people and attributes.  Imagine you are an important business man and you receive frequent phone calls, which have an equal chance of ringing during your whole work day.  When the phone rings you generally answer it.  However, occasionally while you are on the phone with someone, you receive a second phone call that you must either ignore or put your current conversation on hold to answer.  You complain to your secretary and hypothesize that you spend more time juggling several conversations at once than you do talking to just one person. You conclude it is more likely that someone will call you while you are already in a conversation on your phone than not.  In reality, this is not true; you receive more phone calls while you are not already on your phone.  However, rarely if ever do you think to yourself at these times, “Someone called me when I am not talking to anyone else on the phone, and this is evidence that my hypothesis is incorrect”.  In contrast, when you are already on the phone with someone else and you receive another incoming phone call, you often say to yourself, “This is evidence that my hypothesis is correct.”

We, as humans, pay more attention to unusual events and stimuli while giving less attention to usual or perceived mundane events and stimuli. This Phenomenon is called Availability Heuristic (Tversky, & Kahneman, 1973).  We also give selective attention to the evidence that supports our ideas and hypotheses while ignoring contrary evidence.  This phenomenon is called confirmation bias (Dawson, 2000; Gurmankin et al. 2002; Gambrill, 2005; Klayman, 1995; Nickerson, 1998).

In relation to attraction, when we see two friends or a romantic couple with strikingly different characteristics from each other, we often pay more attention to them than to others with no apparent striking differences, even if they are in the minority.  As we examine dissimilar groups and see a striking difference, we seldom think of all the similarities which they have to each other.  Instead, we focus only on their differences, thus providing excellent conditions for a confirmation bias, as we choose to ignore much of the contrary evidence. 

There are many today who believe that opposites attract. However, these significant studies show that people generally are attracted to others of similar social status, behavior, humor, personality traits, and beliefs. The theory that opposites attract is inconsistent with these scientific studies, and must be dismissed as a myth.

References

Akers, J. F., Jones, R. M., & Coyl, D. D. (1998). Adolescent friendship pairs: Similarities in identity status development, behaviors, attitudes, and intentions. Journal of Adolescent Research, 13, 178–201. doi: 10.1177/0743554898132005

Aristotle (1934). Rhetoric. Nichomachean ethics. Rackman transl. Cambridge: Harvard Univ. Press.

Asher, S. R., & Dodge, K. A. (1986). Identifying children who are rejected by their peers. Developmental Psychology, 22, 444–449.

Bosson, J. K., Johnson, A. B., Niederhoffer, K., & Swann, W. B., Jr. (2006). Interpersonal chemistry through negativity: Bonding by sharing negative attitudes about others. Personal Relationships, 13, 135-150. doi: 10.1111/j.1475-6811.2006.00109.x

Botwin, M. D., Buss, D. M., & Shackelford, T. K. (1997). Personality and mate preferences: Five factors in mate selection and marital satisfaction. Journal of Personality, 65(1), 107-136. doi:10.1111/j.1467-6494.1997.tb00531.x

Buston, P.M., & Emlen, S.T. (2003). Cognitive processes underlying human mate choice: The relationship between self-perception and mate preference in Western society. Proceedings of the National Academy of Science of the United States of America, 10(15). doi: 10.1073/pnas.1533220100

Call, V.R.A., & Heaton, T.B. (1997). Religious influence on marital stability. Journal for the Scientific Study of Religion, 36, 382-392. doi: 10.2307/1387856

Carli, L. L., Ganley, R., & Pierce-Otay, A. (1991). Similarity and satisfaction in roommate relationships. Personality and Social Psychology Bulletin, 17, 419–426. doi:10.1177/0146167291174010     

Chen, H., Luo, S., Yue, G., Xu, D., & Zhaoyang, R. (2009). Do birds of a feather flock together in China?. Personal Relationships, 16(2), 167-186. doi:10.1111/j.1475-6811.2009.01217

Coulomb, C.A. (1788). Histoire de l'Academie royale des sciences. Paris: Académie Royale des Sciences.

Dawson, N.V. (2000). Physician judgments of uncertainty. In Decision Making in Health Care: Theory, Psychology, and Applications (ed. G. B. Chapman and F. A. Sonnenberg), pp. 211-252. Cambridge University Press: New York.

DeArmond, S., & Crawford, E.C. (2011). Organization personality perceptions and attraction: The role of social identity consciousness. International Journal of Selection and Assessment, 19(4) 405-414. doi: 10.1111/j.1468-2389.2011.00568.x

Deutsch, F., Sullivan, L., Sage, C., & Basile, N. (1991). The relations among talking, liking, and similarity between friends. Personality and Social Psychology Bulletin, 17, 406–411. doi: 10.1177/0146167291174008

Gambrill, E. (2005). Critical thinking in clinical practice: Improving the quality of judgments and decisions. Hoboken, NJ: John Wiley & Sons Inc.

Gonzaga, G. C., Campos, B., & Bradbury, T. (2007). Similarity, convergence, and relationship satisfaction in dating and married couples. Journal of Personality and Social Psychology, 93(1), 34-48. doi:10.1037/0022-3514.93.1.34

Gurmankin, A.D., Baron, J., Hershey, J.C., & Ubel, P.A. (2002). The role of physicians' recommendations in medical treatment decisions. Medical Decision Making 22, 262-271. doi: 10.1177/0272989X0202200314

Heaton, T.B., & Pratt, E.L. (1990) The effects of religious homogamy on marital satisfaction and stability. Journal of Family Issues, 11, 191-207. doi: 10.1177/019251390011002005

Hodges, L. A., & Byrne, D. (1972). Verbal dogmatism as a potentiator of intolerance. Journal of Personality and Social Psychology, 21, 312–317. doi:10.1037/h0032315

Hymel, S., & Woody, E. (1991, April). Friends versus non-friends; Perceptions of similarity across self, teacher, and peers. Paper presented at the biennial meeting of the Society for Research in Child Development, Seattle, Washington.

Kiesler, D. J. (1996). Contemporary interpersonal theory and research. New York: Wiley.

Klayman, J. (1995). Varieties of confirmation bias. Psychology of Learning and Motivation, 32, 358-418. doi: 10.1016/S0079-7421(08)60315-1

Locke, K. D., & Horowitz, L. M. (1990). Satisfaction in interpersonal interactions as a function of similarity in level of dysphoria. Journal of Personality and Social Psychology, 58, 823–831. doi:10.1037/0022-3514.58.5.823

Lombardo, J. P., Steigleder, M., & Feinberg, R. (1975). Internality-externality: The perception of negatively valued personality characteristics and interpersonal attraction. Representative Research in Social Psychology, 6(2), 89-95.

Luo, S., & Klohnen, E. C. (2005). Assortative mating and marital quality in newlyweds: A couple-centered approach. Journal of Personality and Social Psychology, 88(2), 304-326. doi:10.1037/0022-3514.88.2.304

McPherson, M., Smith-Lovin, L., & Cook, J. M. (2001). Birds of a feather: Homophily in social networks. Annual Review of Sociology, 27, 415–444. doi:10.1146/annurev.soc.27.1.415

Nangle, D. W., Erdley, C. A., & Gold, J. A. (1996). A reflection on the popularity construct: The importance of who likes or dislikes a child. Behavior Therapy, 27, 337–352. doi: 10.1016/S0005-7894(96)80021-9

Nangle, D. W., Erdley, C. A., Zeff, K. R., Stanchfield, L. L., & Gold, J. A. (2004). Opposites do not attract: Social status and behavioral-style concordances and discordances among children and the peers who like or dislike them. Journal Of Abnormal Child Psychology: An Official Publication Of The International Society For Research In Child And Adolescent Psychopathology, 32(4), 425-434. doi:10.1023/B:JACP.0000030295.43586.32

Nickerson, R.S. (1998). Confirmation bias: a ubiquitous phenomenon in many guises. Review of General Psychology, 2, 175-220. doi: 10.1037/1089-2680.2.2.175

Reagor, P. A., & Clore, G. L. (1970). Attraction, test anxiety, and similarity–dissimilarity of test performance. Psychonomic Science, 18, 219–220.

Strycharz, S.J. (2004). The relationship of spirituality and marital satisfaction among Roman Catholic couples. Dissertation Abstracts International: Section B: The Sciences and Engineering, 64, 4115.

Tversky, A., & Kahneman, D. (1973). Availability: A Heuristic for judging frequency and probability. Cognitive Psychology, 5, 207–232.

Weaver, J. R., & Bosson, J. K. (2011). I feel like I know you: Sharing negative attitudes of others promotes feelings of familiarity. Personality And Social Psychology Bulletin, 37(4), 481-491. doi:10.1177/0146167211398364

After reviewing these pictures I formally recant my above statements and conclusions. Perhaps opposites do attract.  

Vincent van Gogh - A Life of Beautiful Sadness

Vincent van Gogh

"I put my heart and my soul into my work, and have lost my mind in the process." - Vincent van Gogh

            Few names are better known than that of Dutch artist Vincent van Gogh. Vincent van Gogh was a post-impressionist painter born on the thirtieth of March 1853 in Zundert, Netherlands. He is well known for paintings such as Starry Night (1889), the Sunflowers series, Irises (1890), and Portrait of Dr. Gachet (1890). In this essay I will examine the details of Vincent van Gogh’s life, work and contribution to art.

"Portrait of Dr. Gachet"
Oil on canvas, 1890

On the list of the 42 most expensive paintings, Vincent van Gogh reserves 7 spots, one being “Portrait of Dr. Gachet" (1890) which is the fourth most expensive painting in the world being estimated at 144,100,000 American dollars. How can a painting be worth so much? We know that much of this price has to do with the tiny signature located at the bottom right of the painting. So why is that signature worth any money at all? Why does it increase the price so much? When you buy a painting such as this you are not only buying the canvas, paint and concepts portrayed, but you are buying a piece of history, and really a piece of the artist.

            Vincent van Gogh may be firstly remembered for his artistic skill but he may be just as well known for his outrageous and exuberant lifestyle. He is a spectacle and an oddity; a paradox. His life invites examination and interpretation.

            Vincent van Gogh from childhood was an artist; he was largely self-taught and began drawing as a young child. He continued making drawings throughout his early years leading him to his eventual decision to become a professional artist. This decision did not occur until 1880 at the age of twenty-seven.

"Road with Pollard Willows and Man with Broom"
 Drawing, Pencil, washed 1881

During his early years as a professional artist he felt that he had to master black and white before working with color, and thus he concentrated on learning the basics of figure drawing and landscapes in a correct perspective. Van Gogh did not receive formal training until 1882 when he moved to Hague where he received three weeks of formal instruction from his cousin Anton Mauve, a Hague School artist. Anton was a realist painter, a close friend, a sponsor, and an important artistic influence of Van Gogh. Anton introduced Vincent to oil painting and watercolor which would shape his life from then on. Vincent also got support from his brother Theodorus (Theo) van Gogh. In the winter of 1880 Theo started supporting Vincent financially and would  later manage and sell his paintings.

Van Gogh continued on as a generally unappreciated aspiring artist occasionally moving from city to city until in April 1885 Vincent finally made painting that got recognition and would generally be considered his first work. The work was entitled, “The Potato Eaters”, an oil painting on canvas. The painting attempted to depict the working class as they really were. He purposefully chose rough and ugly models so as to be natural and unspoiled in his finished work and to show that they “have tilled the earth themselves with these hands they are putting in the dish, and so it speaks of manual labor and — that they have thus honestly earned their food.”

"The Potato Eaters"
 Oil on canvas, 1885

"Impression, Sunrise"
Claude Monet, Oil on canvas, 1872

This painting, and Van Gogh’s style in general are thought to be “impressionism” which stemmed from Claude Monet’s “Impression, Sunrise” and is characterized by small, thin, visible brush strokes, open composition, emphasis on accurate depiction of light in its changing qualities, ordinary subject matter, and unusual visual angles. However, Van Gogh stated in 1884 to his brother Theo van Gogh:

When I hear you talk about a lot of new names, it’s not always possible for me to understand when I've seen absolutely nothing by them. And from what you said about ‘Impressionism', I’ve grasped that it’s something different from what I thought it was, but it’s still not entirely clear to me what one should understand by it.

            This letter is revealing as it shows that Van Gogh was not merely coping a style or working off of what he knew to be impressionism, but rather his roots more likely lay much closer to home in the artists of the Hague school such as Anton Mauve and Jozef Israels.

"Still Life with a basket of Potatoes, Surrounded
 by  Autumn Leaves and Vegetables"
Oil on canvas 1885

            Van Gogh’s early paintings are generally not the "Van Gogh’s" we think of now with bright vivid colors, but rather they were smooth with meticulous brushwork and fine shading of colors. His palette consisted mainly of somber earth tones in contrast with his later brilliant colors and hues. At this time Vincent was known by some, but his paintings were not selling. Vincent sent a letter to Theo chastising him for not putting enough effort into selling his paintings to which Theo replied that his paintings were too dark and not concordant with the style of bright popular Impressionist paintings of the day, a problem that Vincent would soon remedy.

"Still Life: Vase with Fifteen Sunflowers"
Oil on canvas, 1888

            1886 he moved to Antwerp, Belgium and applied himself to the study of color theory. He spent time in museums, he studied the works of Peter Paul Rubens, a Baroque style artist that emphasized movement, color, and sensuality, and also studied Adolphe Joseph Thomas Monticelli, an impressionist. Both of these artists encouraged him to broaden his palette and to include bolder colors, particularly carmine, cobalt and emerald green. At this time Van Gogh also attended the higher-level admission exams at the Academy of Fine Arts in Antwerp; this was a time of learning and reshaping for Vincent.

            Van Gogh may be best known for an event that transpired on December 23, 1888. Van Gogh was living with one much respected friend Eugene Henri Paul Gauguin, a French Post-Impressionist. However, Van Gogh felt that Gauguin did not treat him as an equal. Frustrated, Vincent confronted Gauguin with a razor blade, but shortly he left the apartment scared and escaped to a nearby brothel. While he was there, he cut off the lower part of his left ear, wrapped the severed ear in newspaper and handed it to a prostitute. He then staggered home where he was later found by Gauguin lying unconscious with his head covered in blood.

"Corridor of Saint Paul Asylum in Saint-Rémy"
Watercolor, Black Chalk and Gouache on pink ingres paper,
 1889

            At this point Van Gogh continued to unravel suffering from hallucinations and delusions that he was being poisoned. Due to these delusions he spent his time in and out of a hospital in Arles. In March of 1889 the police closed his house due to a petition from 30 townspeople who angrily called him "fou roux” meaning “the redheaded madman.”

            Van Gogh was eventually released from the hospital but suffered a severe mental setback in 1889 which he described as a "crisis that was worse than all the preceding ones."

On 27 July 1890, aged 37, a distraught van Gogh shot himself in the chest with a revolver. However, the bullet he was shot with did not hit any organs and he survived. The following morning Theo rushed to be with Vincent and found him in apparently good shape; however, within hours the result of untreated infection in the wound took its toll and inflicted death upon Vincent. Theo reported that his brother's last words were, "the sadness will last forever," a sad epitaph for a troubled life.

Van Gogh has been dead for over 100 years now, but yet his contribution to art and the impressionist movement is still felt strongly today. He was a departure from Monet with the broader brush strokes and livelier colors. Further, his work was unique because it purposely showed the hand of the artist in the production of the piece rather than trying to hide the presence of the artist, as is typical in Renaissance or Baroque forms of art.

"Starry Night"
                       Oil on canvas, 1889

As a crucial part of the impressionist and post-impressionist scene, Van Gogh contributed to the breakdown of the strict realism of paintings and expression and allowed ways for artists to better communicate emotions and concepts.

Van Gogh was a mix of styles: impressionism, post impressionism and even some say early surrealism. He painted in oil and in watercolor and made vast amounts of sketches. Overall, he produced more than 2,100 pieces of artwork in the relatively short period of time he was an active artist. During his life he came to little and only local success, and went largely unrecognized. It was only during his last year of life that his works started spreading to France and Belgium. However since that time his works spread further and further being treated with revere and reverence. Today anything with his name on it will sell; even those painting that were most rejected and unwanted sell for thousands of dollars. His name is known to all and his fame is indisputable, he is arguably the best known painter in all of human history.

"Old Man with his Head in his Hands (at Eternity's Gate)"
Graphic, Lithograph, 1882

            Vincent van Gogh has left a great legacy of originality, innovation and emotion in the art world. He truly has changed the world of art forever and there are thousands that receive inspiration from him and aspire to be like him however we must not overlook the entirety of the man; his life was tragic and lonely. Despite his genius, despite the beauty, despite his life of observation, despite even his rising success he was miserable, it was not enough for him. His affections seemed unreciprocated and unwanted; he was rejected by Gauguin in his hour of most need, ejected out his home, his only source of normality in his later years. The only caring soul seemed to be his brother Theo, his loving brother who was in regular corresponding with. Theo himself did not long outlive his brother Vincent by more than six months. 
            Theo was heavily affected by his brother death; Within months of Vincent's death Theo had been admitted into the Willem Arntz Hospital, a psychiatric hospital, and diagnosed with dementia paralytica, a syphilitic infection of the brain. He died on 25 January, 1891, due to "heredity, chronic disease, over work, [and] sadness".  Undoubtedly Vincent's death had a great affect on Theo's own death. In 1914 his body was exhumed and buried next to Vincent.  They were true brothers, they lived together, worked together, shared together, died together, and now they rest together 
            Through examination of Vincent's life you can see his plea for attention; his thirst for friendship and familiarity. While beauty exudes from him, he himself did not the find the beauty in life, at the end he did not find life worth living. As if a child starved for attention he attempted to attract people to him by threats, self mutilations, and suicidal attempts. He wanted happiness and affirmation, something that through his actions and choices he continually made impossible for himself to find. While his art had beauty it was a mask and a false representation of his life. He lead a beautiful yet very sad life. If the sadness truly will last forever there are none more responsible for this than Vincent himself. 

Work Cited

Hughes (2002), 8        

Hulsker (1980), 480–483

Hulsker (1990), 395, 404
Veen, Wouter Van Der, Vincent Van Gogh, and Peter Knapp. Van Gogh in Auvers: His Last days. New York, 2010. Print

 "Letter 497". Vincent van Gogh. The Letters. Amsterdam: Van Gogh Museum.

"Letter 450". Vincent van Gogh. The Letters. Amsterdam: Van Gogh Museum.

Why are they Changing Health Care?

          Recently I was in a university math class when the boy beside me made some snide comments about my Canadian health care, punctuated withsome ill informed statements about the current American health care reform. This rather annoyed me as I was aware of some rather abysmal facts about the previous United States health care system.  That is the event which inspired me to investigate more closely the United States Heath Care System, its benefits, its shortcomings, and the newly introduced health care system.

          We are all aware of the benefits of health care, or at least we would quickly be if we did not have it.  Any health care is good health care, but our goal is not to have adequate health care, but the best possible to ensure a high quality of life.  In this publication I will examine some of the current health care problems, many of which this new system was, and is, being designed to correct.  This hopefully should allow you to understand why such a health reform is in process, and what issues need to be addressed.

          This publication is not meant to examine Obama's health care, or the United States health care in general, it was designed solely to show some of the reasons why a change is necessary or logical.  The United States has one of the best health care systems in the world. I am showing some statistics that focus in on why the United States needs to continue to reform, while doing so I am not focusing on the currently working programs of the United States health care except as they related to the negative ones.

PRICE

Something commendable about the United States Health Care is that they are not skimping on monetary support.  The United States spent 17.3% of their gross domestic product (GDP) in 2009 which is up from a little over 13% in 1999.   That is a rise of about 30% in the last ten years.  It is estimated that by 2017 the GDP percent will have raised to 19.5% a 3% rise in 7 years.  That's a total of $2,466,336,000,000 (2.5 Trillion) or $8,000 a person (307 million people in the USA).  There are a minimum of 15.3% of citizens uninsured (22,933,893) (excluding illegal citizens who still get emergency care).  So in reality the average American pays ($2,466,336,000,000 / (307,000,000(US POP) – 22,933,893(Uninsured))) $8,682 annually. That is 20 %( 2003 stat) of the long term American earning average of 43,000 a year.

             This amount of money in comparison to other countries is exorbitant. The next closest contender is Switzerland at a little over 11%, which would have to increase its price by 40% to match the United States GDP output towards health care.  It is 60% more than Canada's cost.

            Now heath and quality of life should be worth that money right?  So if the US is spending head over heels more than any other country then there should be Rudolph Giuliani stated "the best medical care in the world". And this could very arguable be true for the top medical centers in America but as the New York Times declared "the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care".



INTERNATIONAL OVERALL RANKINGS

            The World Health Organization preformed an assessment of the level of health and health care in countries around the world.  According to this study the United States Rates 37^th in the world out of 191 countries, which is on the outside of the top quarter for overall health care system.  This was assessed by several factors.  Of those factors the funding and responsiveness significantly boosted this mark while the overall health in the United States and the fairness in financial contribution drug the mark down.  The following are the categories and ranking.

Category	Rank out of  191
Health Level	24
Health Distribution	32
Responsiveness Level	1
Responsiveness Distribution	3-38
Fairness in financial contribution	54-55
Overall Goal Attainment	15
Health Expenditure per captia	1
Overall level of health	72
Overall health system performance	37

            Other notable countries rankings are:

Country	Overall Rank
France	1
Italy	2
The United Kingdom	18
Canada	30
Australia	32
Chile	33
Cuba	39

            A second study done by the Common Wealth Fund compared with five comparable countries  (Australia, Canada, Germany, New Zealand, the United Kingdom)  the US ranks last (if GDP spending is not taken into the equation), or second to last (if GDP spending is taken into the equation as a positive).  From the Common Wealth Funk:

"Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004…The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance…The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance"


CHILD CARE

            The association "Save the Children" published a report called "The State of the Worlds Mother Reports" where it gauges the combined and individual health care quality of care for mothers and children. The United States placed 28^th out of the 43 in the "tier 1" countries overall ranking. Below is a listing of key developed countries in the weighted ranking system which I  have abbreviated.



Following are some comments from this study regarding the low United States ranking

"One of the key indicators used to calculate well-being for mothers is lifetime risk of maternal death. The United States' rate for maternal mortality is 1 in 4,800 – one of the highest in the developed world. Thirty-five out of 43 developed countries performed better than the United States on this indicator, including all the Western, Northern and Southern European countries… A woman in the Unites States is more than five times as likely as a woman in Bosnia and Herzegovina, Greece or Italy to die from pregnancy-related"

"At this rate, a child in the U.S. is more than twice as likely as a child in Finland, Iceland, Sweden or Singapore to die before his or her fifth birthday."

"Only 61 percent of children in the United States are enrolled in preschool – making it the seventh lowest country in the developed world on this indicator."

"The United States has the least generous maternity leave policy – both in terms of duration and percent of wages paid – of any wealthy nation."

"The United States is also lagging behind with regard to the political status of women. Only 17 percent of seats in the House of Representatives are held by women, compared to 46 percent of seats in Sweden and 43 percent in Iceland."

          On the official United States of America's Central Intelligence Agency (CIA) the United States ranks 48^th lowest infant mortality rate at birth with 6.7/1,000(2008) which is high comparative to other systems.  Furthermore is seems to be on the rise from 5/1,000 in 2006. As Medical New Today said:

"…the USA has fallen a long way behind [in the live birth death ratio]."

Below is a list of comparable countries.

Country	Rank	Mortality Rate (X/1000)
Japan	4	2.79
Hong Kong	5	2.92
France	8	3.33
Germany	15	3.99
Australia	29	4.75
United Kingdom	32	4.85
Canada	36	5.04
United States	46	6.26
Russia	73	10.56

QUALITY OF HEALTH

            The quality of health of a country is a good indicator on the effectiveness of the health care system.  The health care system is specifically to support the people in becoming and staying healthy.  Although ultimately personal health is primarily the responsibility of the individual, the greatest testimony of a user system are the users.

     We have seen in the above health care assessment study that statistically the overall health of Americans ranks 72^nd in the world.  As an established nation when we think of health we may firstly jump to the thought of weight, as that is the most common ailment in our society, this is a big contributor to this number but if this were the sole factor the united states would be ranked 191 out of 191.  The rank of 72^nd is abysmally low for an established nation, this is below many south America countries, and is on par with Iraq.
            
Body Weight

    Having said this, statistically 30.6% of Americans are obese (Meaning that they have a BMI (body mass index) greater than 30 Kg/sq.meters).  This is over double the international average and the highest percent in the world.  It ranks high even in comparison to its immediate neighbors Canada and Mexico; Canada being ranked 11^th at 14.3% and Mexico being ranked 2^nd at 24.3%.

What is more is that a good majority of Americans are overweight (67%), making it the norm.  Possibly more disturbing is the rise of child obesity currently at 17%.  Being overweight makes it more difficult and more expensive to get health care.  It leads to a spectrum of illness and conditions, which brings down the overall health of the American people.  Although we cannot say that medical care is to blame on these statistics, it does shoulder a portion of the blame. What is clear is that what we are doing is not working, and it is not getting any better.

When it comes down to it, controlling weight is up to the individual, which means what has to change is the mentality.  This focus can start on a national level with health care. There is hope that in the new health care will focus more on child obesity, rising awareness, and getting doctors to focus more on keeping the citizens healthy.  With this focus in school, with regular check-ups and evaluations it is hoped to change the American mentality on weight.

Smoking

Aside from weight and the associated complications therein, America still has several health issues that it is trying to resolve.  One of these is smoking.  An article from "America's Health Rankings" summarized the recent efforts to cut smoking out of the American lifestyle:

"Despite focused efforts, nearly one in five Americans [or 21%(2003)] still smoke, which is only 8 million people fewer than 20 years ago."

Although this number may seem high to some, and the decrease of habitual smoking depressing, the percent of Americans that smoke is below the international average of 24%.  It is ranked 44^th highest female smoking rate and 115^th highest for men.  These statistics are on par with most of the established world nations.  Although this is a serious problem in the United States it has little to no negative effect on the overall ranked health of the United States in comparison with other nations.

Life Expectancy

As the purpose of health care is to support and encourage good health a great measure of its effectiveness is how long a person lives.  The United Nations publishes a "Human Development Index" which measured the quality of life in selected developed and developing countries.  This index, or ranking is weighted on three dimensions: Life expectancy, Education, and standard of living.

In their assessment of life expectancy they placed the United States ranked 38^th highest life expectancy in the world with a life expectancy of 78.2 years (75.6 for females and 80.8 for males). This is above the international average of 67.2 (2005) by 11 years.  Below is a comparison of a few countries and life expectancy.

Country	Rank	Life Expectancy
Japan	1	82.6
Australia	5	81.2
Canada	10	80.7
France	10=	80.7
United Kingdom	22	79.4
Germany	23	79.4
United States	38	78.2
Mexico	48	76.2
Russia	137	65.5

  So although the United States does have an above average score, but compared to other economically leading countries, the average is much lower then would be expected.

Below is a graph showing the correspondence between amount paid to life expectation.

Years of Potential Life Lost (YPLL)

Year of Potential Life Lost (YPLL) is a measure of premature death.  It shows the additional years a person would have lived if they had not prematurely died.  It examines the overall expected life expectancy of the desired sample group, then calculating the difference between actually life length and the expected age (Expected Life - Age of Death = Potential Life Lost). To get a country's YPLL you calculate the cumulative number of years lost of a sample size, the total YPLL is generally calculated per 100,000 people. The United States is currently rated the 3^rd highest YPLL country with 10%.  Comparatively this is 48% higher than its northern neighbor Canada which has a rate of 6.7%.   Below is some key countries YPLL.

Country	Rank	YPLL	% Compared to US
Mexico	1	6,778	+73%
United States	3	4,962	0%
New Zealand	8	3,644	-36%
France	9	3,459	-43%
United Kingdom	10	3,392	-46%
Canada	11	3,361	-48%
Australia	15	3,118	-59%
Japan	29	2,614	-90%

A health care should be striving to minimize premature death.  Some may assert that these years are generally not related to health care as much as the United States homicide, suicide, and accident rates.  It is true that the US has an above average homicide rate in established nations, it being three time the amount in Canada.  But in comparison to overall world homicide average, it is much lower with it being only 10% of the homicide rate of Honduras rates.  Although the US has a higher than average homicide rate for an established nation it does not hugely effect the overall YPLL rate of the United States as out of 100,000 deaths only 4.2 are murders, to find the actually effect of murder is on the YPLL you need to multiply this number by the years they lost.  The mean age of murder victim is 27, 51.2 years younger than the US average of 78.2. Thus the YPLL attributed to murder for the US is around 215 years (51.2 X 4.2), which accounts for only 4.4% of total YPLL.

A large percent comes from infant and child deaths, as we have discussed above, but the Majority of the YPLL comes from medical reasons.  Some of those medical fatalities are for reasons that our current medical knowledge considers unpreventable, or untreatable.  But a large portion of these years come from people who are uninsured or underinsured.  45,000 people die a year because they do not have insurance. Many die because they do not receive medical preventive measure because their insurance will not adequately cover the treatments, or because they simply do not have the money to make the copayments to combat chronic illnesses.  I am not suggesting that the majority, or even a large minority, is because of lack of medical care, but a significant number do die due to problems with health care.  Below is a graph showing the breakdown for premature death. Keep in mind that this accounts for reasons of death and not PYLL.

 Death Amenable to Health Care            

To get down to some "real" health care meaty statistics we can look at the extreme topic of death  amenable  to health care, or death that could have been prevented to timely and effective health care.  This is quite simply how many people died a year when they didn't have to.  This is one of the best ways to measure the quality and coverage of national health care.

            In a study published in the peer-reviewed research and commentary "Health Affair" it aims precisely at this topic. The goal of the study was to see how the countries that participated in the World Health Organization's health care ranking system would be ranked if all the other factors were stripped away and all that was left was death amenable to health care.  The way this is tabulated is that they took the World Health Organizations constructed list of ailments or conditions that can generally be treated at their corresponding ages by proper health care attention.  Then they took the countries with highest quality mortality documentation and plugged it into the list that was constructed. Then they received the list of people that hypothetically could have been saved if they had access to proper medical care at the proper time.

 So how does the US stack up against the other countries?

The following are the statistics from 1997 – 1998 study a little more than 10 years ago.

 The United States is on the lower quadrant of the graph, but from statistics that we have already seen this is not a big surprise.  Overall it is not doing all too terribly but is only a little behind the average.

The following are the statistics from 2002 – 2003 only 5 years later.

            An important note is that everyone is decreasing in deaths  amenable to health care, this is a good sign, and it means that we are continuing to hone our health care systems and techniques.  The average improvement of any given country in this graph is 16%.  If we look at the United States though we notice that it only decreased by 4%, a much lower rate of decline than any other country on the graph. What is more it is now has the highest mortality rate  amenable to health care out of all of the countries listed.  So apparently this can tell us that the Health Care system is considerably underperforming in comparison with other developed countries and what is more, is that it is not significantly improving. The United States could take a couple leaves  out of the other countries books when it come to health care.

                    The major contributor to these low number is that all those other developed countries have universal health care whereas the United States has been working off of privatized health care, where money talk;   If you have the money to pay for health care you can have the some of the best health care in the world.  But if you don't, well then you can come to the hospital is you are dying, but don't expect too much.



COVERAGE 

The narrow coverage of the United States health care is the source of the majority of negative attention in international health comparisons.  The U.S. Census Bureau estimates that 45.7 million Americans (15.3% of the total population) have no health insurance coverage. The Commonwealth Fund published an article in Health Affair that states 16,000,000 (16 million) (5.3%) (2003 statistic) Americans were underinsured.  That is a huge percent! One in every five Americans have inadequate insurance.

The following are some statistics retrieved from surveys:

"Among adults surveyed in the U.S., 37% reported that they had foregone needed medical care in the previous year because of cost… 42%—among those with chronic conditions"

"19% of U.S. adults surveyed reported serious problems paying medical bills, more than double the rate in the next highest country [in the study]."

Mental Health

In one study the United States dominated a study of 14 countries in prevalence of mental illness at a rate of 26% of the population is mentally ill, or will be diagnosed as such.  This could also be linked to diagnosis practices and effectiveness for less developed countries, but for established countries it is fairly accurate.  A look to Canada shows an estimated 20% that will suffer from mental illness, this is still a 30% lower rate than the US, but it is much higher than the other countries in the study. There is currently a lack medical coverage for mental health. It is estimated that less than half of those suffering a mental illness receive treatment for it because of lack of access to care or because of stigma. This leads to more and more serious conditions then if they would have received health care in a timely and efficient manner.

The Medically Uninsurable and Underwriting

With privatized medicine it isn't focused on the people as much as it is about the money. It is a business and a competition. In most states the people go through a medical screening process called underwriting.  This is essentially the policy that the private medical country has the right to deny coverage based on the health information provided, and also to set the rate of the premium. This is to ensure that the company makes a profit off that plan. All in all it is an investment and a gamble.  The Medical Insurance is betting that you will pay more money in then you will get out, while you are betting against those odds.  Because of this practice there are some people out there that insurance companies will not bet on, and thus they are labeled as "uninsurable". These are those who are not able to get health care anywhere because of preexisting conditions. Disease is a big part of the factors that keep these people uninsurable but also common ailments such as acne or being overweight or underweight.  An estimated 5,000,000 in America are considered uninsurable because of preexisting conditions.

A survey of a large company showed that 13% of all applicants were denied plans, out of the 87% that were accepted 22% were offered higher than average insurance rates, which the other 78% received regular rates.  Insurance acceptance rises correspondently with age, thus it will be easier and cheaper to have insurance when you are young, as the insurance companies see it as a easy bet.

SOCIALIZED MEDICINE AND HEALTH CARE

          As discussed in my previous post "Propagating Propaganda", a way to manipulate people and their ideas is to latch on words with negative connotations to influence the people to reject the idea, not based on content but based on association. It comes from the human desire to put everything into a box. If you can link negative images and emotions in the mind of a person the object then becomes associated in negative ways. The government constantly uses this in even small ways such as changing "The Department of War's" name to "The Department of Defense". In our minds we associate war with negative emotions, and defense with positive emotion.  We see war as bad and defense as good, even though the functions of the department didn't change the thoughts, emotions and connotations changed because of the change of name.  It gets placed in a different box because of the title we give it.

           During and post World War II there was and is a huge communist scare.  There were many people calling others "communists" as a dirty word, a way to label people.  Communism in general is not inherently evil; if it were conducted purely it has many, many good effects and very few negatives.  The obvious problem in the soviet system was that it wasn't being conducted that way, and as far as we know there have been no successful communistic societies.

           Universal health care is the focus of pejoratively.  It is labeled unaffectionately by many Americans as socialized health care this to predispose the people against it.  The term first came around to public usage to employ this propaganda method against Harry Truman's health care initiative in 1947.

 Universal health care goes back to the Germans who introduced a universal health care in 1882.  Britain constructed their universal health plan in 1911. Most other developed nations adopted it shortly after World War II concluded as a result of the Universal Declaration of Human Rights. This article was presented by the United Nations to set a standard of rights that everyone is entitled to.  In it was discussed the right of life, the right of equality, the right of freedom, the right of non-discrimination,  the right of presumed innocence, the right of privacy, and several other fundamental issues that were not observed during World War II.  It was signed by the majority of developed countries at the time.  The United States did not ratify the 25^th article which states:

  1)Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

           For this cause at this time most of the developed countries adopted universal health care, which generally greatly improved the general health of the countries.

           Despite what may be said about Universal health care, it is the most widely used health care system in developed countries; it has and is replacing the privatized medicine.  The top ranked (according to the World Health Organization's ranking) medical care countries are all using universal health care.

Below is a map from Wikipedia made before the new United States health care decision which shows the prevalence of universal health care. Both blue and green are Universal health care systems where grey are other systems or where there was no data available.

CONCLUSION

How much is a human life worth?  Having discussed this topic with many Americans due to the current reform, and the propaganda spread about universal health care, in particular Canada's health care, I have noticed a prevailing selfish attitude among the majority of people.  Many get angry that they would have to pay for someone else to receive health care. The health care in the United States is catered for the rich while is buries the poor. According to the statistics for 2002-2003 there around 337,700 people that die every year that don't have to, that is the size of New Orleans. The American people are griping about paying less to save more lives, not because of the price, but because that means they feel they are paying for indolence, that they may in the process help someone who doesn't deserve to be helped.

 Where is the most expensive medical work preformed? The hospital. The United States public is already paying for the health care of those uninsured and underinsured by the means of hospital bills. Rather than these people getting the preventative measured they need they are forced, or choose, to go without because of the exorbitant price.  In a few months they will get the care they need from the hospital staff, but you can bet this far down the road it will not be their last visit.  At this point they will need to make regular stops at their hospitals, they will not able to secure health insurance, and will be caught in the rapid whirlpool of health care with no hope of escape.  As the platitude rightly states:

"An ounce of prevention is worth a pound of cure."

Out of the federal budget (not GDP) the United States spends 23% on the Department of Defense, formerly the Department of War, which for 2011 has a predicted budget of $1.003–$1.223 trillion $1,223,000,000,000.00.  That is about $4,000 a person. Maybe instead of sending off trillions of dollars to other countries to fix their governments, the United States should look to fix their own first.  Instead of spending their money on guns that are in part responsible for the 5,400 Americans that have died in war this past decade and 120,000 Afghanis and Iraqis, maybe it should be spend in saving the lives of the (estimated) 3,377,000 Americans that, in the same amount of time, died unnecessarily due to the inefficiency of health care.