Last night I was on Twitter instead of sleeping (because apparently I hate myself), and I came upon some threads by Linda Tirado (@KillerMartinis) about the proposed Medicaid work requirements and the U.S. Healthcare system. It got me thinking.

We often hear from conservative know-nothings about how the United States has the best healthcare system in the world and how awful it would be to make any changes to that.

And in some ways, we do have very good healthcare, or at least very good healthcare is -available- in the United States. There are stories every few months about foreign leaders and wealthy citizens of other countries traveling to the United States for medical care as if that proves something about our healthcare system. Here’s one from 2012 about a Saudi Prince coming for tests at the Cleveland Clinic. And it’s true, the Cleveland Clinic is one of the finest facilities in the world for cardiac care. But that says nothing about the healthcare system in the United States.

Let me explain, with an analogy to something that we Americans love: CARS. Someone might say “Italy has the best driving environment in the world! Take a look at the cars they have over there!”

Ferrari

Take a look at the cool cars they have in Italy!

And it’s true, Ferraris are awesome. And they do come from Italy. But that’s not in any way typical of what the experience of driving in Italy is like. A more common car in Italy is this:

A fiat

A more realistic Italian car

Or even more realistically, instead of a car, you have this:

A scooter

Lots of people just have scooters.

And traffic looks like this:

Traffic Jam in Rome

Doesn’t this look like fun?

So when someone says “The United States has the greatest healthcare system in the world, that’s why people come here for medical care!” understand how spectacularly bad of an example that is. It’s taking a very specific example (like a Ferrari) that is not available to the overwhelming majority and presenting it as typical.

The reality is that the level of care that Saudi prince received is not typical. Most communities do not have a world-class hospital. And, even in those communities that have such facilities, poor Americans, the self-employed, and anyone without a healthcare plan heavily subsidized by their employer are not able to afford treatment at them. These people don’t have a Ferrari. They don’t even have a scooter.