Express Elevator to Hell- Going Down!
For most of our history Americans had the best standard of living in the world. This may not have been actually true, but we wanted to believe it, and there was enough truth in it to make other stuff, like American medicine, "work". Our doctors were, and are, largely greedy numbnuts, but we survived because of good food and, yes, the clean air of the suburbs, as it turns out.
Americans still believe we have the best healthcare, but eventually we'll notice that if you're #39 on one list and #32 on another and #22 on a list that only has 24 countries, you're not #1.
While it lasted, our belief that "all was for the best in the best of all possible worlds" had one major practical (or impractical) result- if it wasn't broke, we had no intention of fixing it. Americans didn't join unions and were the last to create public pension plans, workman's comp, or national approaches to national problems.
In short, we're the rubes, the noobies, the people who, lacking experience, simply lack the know-how build a public health service, provide low income housing, cluster growth on transportation nodes, build innovative tech industries that export goods instead of jobs- and the list could go on.
Fortunately, there's one thing we're really good at- admitting that we are bankrupted addicts who need to change or die. And we all know that the first step on the road to recovery is admitting we were wrong.
Most of these twelve-step programs advise you to leave the heavy lifting up to God, but our Constitution endows our government with powers derived from the consent of the governed- rather a good thing, really, as God has built no trolley lines that I am aware of. Turning the powers of government to solving problems instead of creating them will be easier as people realize that we are not actually Number One.
Still, like our roads, our infrastructure of self-government has suffered neglect. Expect some major washouts and bridge failures as we journey towards the future.
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That's some serious doom-and-gloom without any real substance or context. I work in the Healthcare IT field and as Americans we have access to the highest level of care. Granted, the level of access is unequal and that is why we are so far down on those lists you hold so dear, but that's really another issue altogether (and some would argue, not even an issue.)
Chris, I work for a 'large software company' and have access to pretty much the best the US has to offer. I'm marrying a French woman. Having been present when she's done doctor visits? Her care is better. By a long shot.
Not to mention that as long as 50 million or more Americans aren't covered, you can't say squat about our system. Health is a public good. The cost of those 50 (or is it 60?) million uninsured Americans is far greater than providing for them. Our system isn't built to make cost effective choices for the group, only for the individual.
Chris -- you should qualify that. Some Americans have access to the highest level of care. Tens of millions do not. And it's not realistic to bracket this as "another issue altogether." The reason why these millions of Americans have no care is precisely because we spend 16% of GDP -- far more than any other developed country -- giving too much, overly expensive and wasteful care to those who can afford it.
See Sharon Brownlee's book, Overtreated, or Jon Cohn's book, Sick, for the substance and context you seek.
But this blog is not a health care blog. There are plenty of others that cover this issue better than we can.
Ha ha, I've been an RN, with a BS, for 25 years. I've had plenty of time to think about how well we're doing what we do.
Even today, a full half of what doctors do has no scientific justification. Shannon Brownlee had a great post this morning about that and some reactions by doctors.
I thought the substance here was pretty plain, but as Chris has apparently missed it I will repeat- when we had visibly the best standard of living in the world, there wasn't a lot of reason to change things. Why rock the boat?
But those days are gone, and plenty of people are now thinking maybe we should change things, even if it means we have to go to the effort of governing ourselves. After all, the French and the Dutch and the Germans do it, and they work a lot less than we do to get results that are just as good.
And we will use our government to build rail transit and renewable energy, or find ourselves stranded by AGW and the End of Oil, like some poor whale that swam up the wrong river. In short, a major change in the direction of a current of American history that has carried us in one direction for 200 years.