What would we do if we truly loved and cared for others? That seems a good question to ask on Christmas Day.
I’m not talking about kisses and hugs. I’m talking about concrete action. I’m talking about turning toward the welfare of others. What would be the most transforming— but doable— actions?
I have two suggestions. If we could get these done, we’d be living in an amazing, caring country. I hope you’ll think about them.
—A Radical Shift in Health Care.This change would enlarge the cup of life for all, not just the most wealthy and educated. It would narrow the growing inequity in life expectancy between those who are well-off and those who are poor.
The shift would require reversing healthcare. Have it focused on public health first, private health second. It is one thing to have great differences in personal wealth, quite another to have the massive differences in life expectancy that have developed over the last 20 years. Today, those in the top tenth of income and education can expect to live a decade longer than those in the bottom tenth.
We could, of course, just blame the victims. That’s what we usually do.
But I don’t understand why we don’t feel profound shame that life expectancy for some people is actually falling. I don’t understand how we aren’t embarrassed that the United States ranks at the bottom of all industrial nations in life expectancy. Or that we aren’t curious how Cuba and Costa Rica, both poor nations, have life expectancies like ours but spend a fraction of what we spend.
We can make this radical shift because we truly have nothing to lose. Our present healthcare system doesn’t work.
Our goal should be that everyone has a good chance to drink deeply from the cup of life. How do we measure that? Simple, in 1910 every 100,000 people born would collectively have 5.3 million person-years of life. That’s only 53 percent of the 10 million person-years they would have if everyone lived to age 100.
We’ve enlarged the cup of life over the last century. It contained 6.6 million person-years in 1940. It contains 7.8 million today. But now it is draining. The cure is in public health, not ever more expensive treatments of dubious benefit. You can get a better understanding by reading Dr. H. Gilbert Welch’s “Less Medicine, More Health: 7 Assumptions that drive too much medical care.”
Declare Peace On Drugs. The war on drugs, officially declared by President Richard Nixon in 1971, is now 45 ever-more-fruitless years old. Yet deaths from drugs are rising, prisons are overcrowded and our efforts to stop the flow of drugs do nothing but guarantee enormous profits for this booming industry. What has changed in those 45 years? Distribution is now fully developed and nationwide, providing an abundance of choices and deep supply to all Americans.
In Dripping Springs, Texas, the rural, white, largely Christian and mostly Republican community where my wife and I live, I have been told that it is almost as easy to get drugs— from marijuana to meth to heroin— as it is to get pizza. Hyperbole? Perhaps. But just ask how many kids at your local high school have a drug problem. The story here isn’t about the failure of enforcement. It’s about the ubiquity of demand and the success of distribution.
We can stop the carnage by declaring peace. We can legalize the use of drugs. We can gut the extraordinary profits that have corrupted governments around the world. Then we can regulate and tax the drug system. We can use the billions spent on prosecuting the war to provide detox and rehab services. Provide nearly free access to drugs like suboxone to help addicts work toward normal, productive lives. This is the caring, love-thy-neighbor, thing to do. This is what Portugal did in 2001, with great success.
It’s time to admit that the war on drugs, like Prohibition before it, is an abysmal failure. You can get a better understanding by reading Johann Hari’s amazing book, “Chasing the Scream: The First and Last Days of the War on Drugs.”
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Related columns:
On the web:
World Health Organization; Life Expectancy at Birth http://gamapserver.who.int/gho/interactive_charts/mbd/life_expectancy/atlas.html
Dr. H. Gilbert Welch, “Less Medicine, More Health: 7 assumptions that drive too much medical care.” Beacon Press, 2015 https://www.amazon.com/Less-Medicine-Health-Gilbert-Welch/dp/0807077585/ref=sr_1_1?s=books&ie=UTF8&qid=1481233608&sr=1-1&keywords=more+health+less+medicine
Johann Hari, “Chasing the Scream: The First and Last Days of the War on Drugs,” Bloomsbury Publishing, 2015 https://www.amazon.com/Chasing-Scream-First-Last-Drugs/dp/1620408910/ref=sr_1_1?ie=UTF8&qid=1481233394&sr=8-1&keywords=Chasing+the+scream
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Photo: Scott Burns:
(c) A. M. Universal, 2016