By Dov Michaeli

I sometimes wonder if repeating something again and again can become a self-fulfilling prophecy. In the cottage industry of self-improvement, repeating the mantra that you are great, and born to be even greater, makes you feel better about yourself. It may even produce stories of incredible success. But by and large this feel-good talk, is just that –it makes us feel good. In Medicine we have a word for it: placebo.

Since I moved to the United States in 1960 I have been wondering about a recurring mantra about American Exceptionalism. I admit, it made me feel good being part of an exceptional nation. But I also had a nagging little question that lived just under the surface in my mind: what does it really mean? Does it mean that our society is more just than others? Or is our economic system more successful? Or maybe we are the embodiment of the biblical “Light unto the Nations”, exporting our system of values to the backward societies of the world? I saw the war in Vietnam as the battle between Light (us) and Darkness (them). I saw the economic prosperity of those days as a ringing endorsement of our Exceptionalism.

My training in science helped me to develop a more critical view of the issue. I was looking for hard data to prove that we are indeed exceptional. Alas, even at the zenith of our exceptional success, the data were at best muddled. We were truly great in some categories, and quite mediocre in others. We were unquestionably the strongest militarily. We were not as great when it came to civil rights of our minorities. One thing made us truly exceptional, in my mind: when we realized there was a problem, we confronted it. When the police dogs of Selma Alabama attacked peaceful demonstrators we reacted with revulsion; even the powerful Southern senators of that time couldn’t stop the tide of Civil Rights legislation. It was a messy process, it was sometimes downright ugly –but we did it; and we should be proud of it. Few other nations confronted such explosive issues the way we did. We were exceptional.

So what happened on the way to the 21st century? We are still repeating the same mantra. But is there substance behind the slogan? Are we still

Belief in “Exceptionalism” became in some quarters synonymous with patriotism. During the 2008 presidential campaign, and even after, President Obama was vilified for not believing in American Exceptionalism. It became a blunt instrument with which to bash a political opponent. But still, we had only scant data to justify this certitude in our superiority.

Here are the Data

Charles blow of the NYT ( America’s Exploding Pipedream, Oct. 28, 2011) reported  on a report released by the Bertlelsmann Stiftung foundation of Germany entitled “Social Justice in the OECD — How Do the Member States Compare?” It analyzed some metrics of basic fairness and equality among Organization for Economic Co-operation and Development countries. At last, some real data. I rushed to the source, and here some of the findings.

Overall Social Justice Rating:

Top of the heap: Iceland 8.73, Norway 8.31, Denmark 8.20, Sweden 8.18, Finland 8.06.

Bottom of the heap: United States 5.7, Greece 5.37, Chile 5.20, Mexico 4.75, Turkey 4.19

Overall Poverty Rate (%):

Lowest: Iceland 6.4, Norway 7.8, Denmark 6.1, Sweden 8.4, Finland 8.0

Highest: United States 17.3, Greece 10.8, Chile 18.4, Mexico 21.0, Turkey 17.0

Child Povery Rate (%):

Lowest: Iceland 6.7, Norway 5.5, Denmark 3.7, Sweden 7.0, Finland 5.2

Highest: United States 21.6, Greece 13.2, 24.0, Chile 24.0 Mexico 25.8

Pre- Primary Education (expenditure as % of GDP):

Highest: Iceland 0.75, Norway 0.42, Denmark 0.60, Sweden 0.67, Finland 0.36

Lowest: United States 0.33, Greece 0.11, Chile 0.59, Mexico 0.59, Turkey 0.02

We are being bombarded by the propaganda that we have the best health care in the world. So here is a metric that hopefully will explode this myth:

Health Rating (inclusiveness, quality of service, and perceived health between highest/lowest incomes):

Top of the heap: Iceland 8.53, Norway 7.30. Denmark 7.53, Sweden 7.87, Finland 7.17

Bottom of the heap: United States 6.23, Greece 6.61, Chile 5.65, Mexico 3.5, Turkey 3.79

The Icelandic Saga

If we are ever going to adopt an evidence-based approach to policy, we should take a close look at Iceland, a country that came on top in almost all categories, and we know close to nothing about. Paul Krugman, a Nobel Prize economist wrote this (NYT, Oct.27,2011):

“If you’ve been reading accounts of the financial crisis, or watching film treatments like the excellent “Inside Job,” you know that Iceland was supposed to be the ultimate economic disaster story: its runaway bankers saddled the country with huge debts and seemed to leave the nation in a hopeless position. But a funny thing happened on the way to economic Armageddon: Iceland’s very desperation made conventional behavior impossible, freeing the nation to break the rules. Where everyone else bailed out the bankers and made the public pay the price, Iceland let the banks go bust and actually expanded its social safety net. Where everyone else was fixated on trying to placate international
investors, Iceland imposed temporary controls on the movement of capital to give itself room to maneuver.

So how’s it going? Iceland hasn’t avoided major economic damage or a significant drop in living standards. But it has managed to limit both the rise in unemployment and the suffering of the most vulnerable; the social safety net has survived intact, as has the basic decency of its society. “Things could have been a lot worse” may not be the most stirring of slogans, but when everyone expected utter disaster, it amounts to a policy triumph.

And there’s a lesson here for the rest of us: The suffering that so many of our citizens are facing is not necessary.  If this is a time of incredible pain and a much harsher society, that was a choice. It didn’t and doesn’t have to be this way.”

So who is exceptional here? Is it us, or little Iceland. You be the judge.


Dov Michaeli, MD, PhD
Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.


  1. Great essay. I’m so tired of hearing how great the United States is. As an older man I travel and observe. I’ve developed my own happiness rating system. When I travel I observe faces, posture and language. The United States is one of the most unhappy nations I’m aware of. I was in Canada a few years ago and noticed how relaxed and happy the Canadians seemed. I made some friends and asked them about this. They said their are two reasons they fell so relaxed. Number one they only have 10% of the US population so they don’t feel the population pressures. Secondly they have universal health care so they don’t have to worry about going bankrupt if they get sick.


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