New York has a trash problem. Unlike other major cities, there aren’t trash containers to roll to the curb or the big industrial dumpsters. The grid system of 1811, still used to today, specified how garbage in tin cans would pick up. The only thing that has changed today is the law replaced tin cans with plastic bags in 1971. That was over 50 years ago. Since then, the city continues to be overwhelmed with an exponential growth in the rat population and the amount of trash on the street. While other major cities moved to dumpster and containers that could be mechanically picked up, New York did not. Everywhere else, the situation is viewed with bemusement, such a simple elegant solution. Initially, it will cost, but but is this indulgence in stupidity worth it?
Obvious right? What about healthcare? There are 195 countries in the world and all but 43 countries in the world have free healthcare or access to universal healthcare for at least 90% of their citizens according to Hudson’s Global Residence Index. Why does the US not have this simple elegant solution? Week after week, we get a medical horror stories from the cost of an ambulance to a basic treatment bankrupting a family. Politicians continue to rail against healthcare. Why?
The inequities in the healthcare systems that disadvantage African Americans is a sinister strategy playing out. Early government programs to provide Americans with healthcare were met with great consternation after the civil war. There was no desire to provide healthcare to the formerly enslaved, and there was no way to write laws that would exclude them. It was believed without healthcare, the blacks would “die out,” and all sorts of misguided medical beliefs that blacks could withstand more pain and so on. The desire for extinction led to no treatment for the African Americans affected by the small pox outbreak in the 1860s.
White legislators argued that free assistance of any kind would breed dependence and that when it came to black infirmity, hard labor was a better salve than white medicine. As the death toll rose, they developed a new theory: Blacks were so ill suited to freedom that the entire race was going extinct. “No charitable black scheme can wash out the color of the Negro, change his inferior nature or save him from his inevitable fate,” an Ohio congressman said.
Why doesn’t the United States have universal health care? The answer has everything to do with race.
But wait, there is more. Not only do our health care policies have racists roots, the US healthcare system, compared to other major countries woefully lacks effectiveness. Even if we ignore the historical rationale around a lack of healthcare, the current system fails.
Health care spending, both per person and as a share of GDP, continues to be far higher in the United States than in other high-income countries. Yet the U.S. is the only country that doesn’t have universal health coverage.
U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes
Other countries have workable models and there is an opportunity to create the best system in the world, but, it appears we are literally stuck on stupid. Sometimes solutions require innovation, a new way o do things and other times, the answer is just look around and see what is works for everybody else.
This week, consider issues you face. Are you in need of innovation or just stuck on stupid?
Balancing on Unstable Surfaces 