How America Is A Third World Country

Health is wealth, and America is poor

Map of countries with free or universal healthcare (green, blue) and without (red)

This is a map of universal healthcare. It is also a map of who is at most risk from coronavirus. It’s the same thing. There is no public health without public healthcare. At this time of pandemic, the countries without healthcare are the ones that are going to get sick. It’s that simple.

America contains an Australia worth of uninsured people (28 million) and a nearly South Korea worth of underinsured people (44 million) sitting in the middle of 255 million other people who now have zero herd protection.

America is also one of the only countries without paid sick leave, one of the most effective ways to limit epidemics. The United States does not have a functioning public health system and they are about to get very sick. Shields down, shields down, incoming.

There are three worlds of healthcare, and America is in the third.

The Three Worlds

During the cold war, the three worlds were Team America, Team Russia, and Team Everybody Else. Everybody else was mostly poor, so that’s our concept of the third world. It’s not relevant anymore. There is a new world order.

Some of those ‘shithole’ countries became like South Korea, and some stayed relatively poor, like my home Sri Lanka, but invested in public health. Meanwhile, every ‘developed’ country besides America invested in public health because obviously, why would you live like this. They say health is wealth, and now we’re finding that out.

The First World

In this new first world are countries with universal healthcare. Health care which is both accessible and also very good, for the vast majority of cases. These countries are colored in green in the map above.

The Second World

In the new second world, you have countries with universal but not free healthcare. You have healthcare that’s accessible, but not very good. For a heart attack or car accident, you’re fine, but a serious cancer will require selling the house and begging for money. For stuff like epidemics, however, you’re covered. These countries are in blue.

The Third World

In the new third world, wealth is health. If you can get a company to pay for you or afford it yourself fine, but there is no public, universal healthcare. Because health depends on wealth, it is unevenly distributed. These countries are in red, for danger.

In these countries, many people cannot afford to go to the doctor and they get sick or die needlessly. This is treated as their problem, until during an epidemic it becomes everyone’s problem. A public health system is only as strong as its weakest link, and these countries have a lot of weak links. A virus rips through these populations like a lion through a herd of sickly gazelle.

In this sense, America is, unfortunately, a third world country. In terms of vulnerability to an epidemic, America is much closer to Sub-Saharan Africa than Norway.


This brings us to the novel coronavirus, COVID-19. Like any predator, it seeks out the weak, and it is especially dangerous to weak healthcare systems. These are countries which cannot flatten the epidemic curve, and which get flattened. Coronavirus is especially dangerous to the third world.

As I write this, America is at 574 reported cases, almost exactly where China was on January 23rd, but without the public health system and political will to flatten the curve. This is a lion meets limping gazelle moment and it will not be pretty. I am very scared for my American friends, especially their grandparents. I’m sorry.

I know what it’s like living in a poor country where stuff doesn’t work. Where systems don’t make sense and seem actively stupid or cruel. But many Americans are unfamiliar with that feeling. It was always happening to someone else. This will be hard, but I guess you’ll learn. It’s not a lesson worth learning. It’s just tragic.

Right now Americans are unable to get tested. They are lied to about this, but their government messed up and tests are simply not available. Americans are unable to self-quarantine and socially distance because they do not have federally mandated leave. They are afraid of going to the hospital because this will all cost money. They have a government that cares more about the profitability of a vaccine than its effectiveness — getting it to everyone to protect the herd. Americans are victims of a corrupt and nonsensical system that crushes their humanity. They are living in the third world.

I would say welcome to it, but it just sucks. I hope you get out. The entire world is getting sick and needs decent public healthcare, but the third world just doesn’t have it. That means sub-Saharan Africa, and the United States of America. Public health is the new world order, and Americans are now living in the third world.

I would send you thoughts and prayers but I know how meaningless that is. I just hope you can find the political will to join the rest of the world and, hell, maybe pay for Sub-Saharan Africa while you’re at it. If there’s one thing coronavirus has shown us, it’s that we’re all in this together. We need to get to one world fast.