How nice to live a longer, healthier life without mortgaging our children’s futures to get it. That would be “building back better” bigly! It would also Make America Great Again.
Win-win! Turns out: Yes, we can!
I’ve bemoaned the many weird melodramas that beset America, via the mass media, besmirching our politics like so many Zombie Apocalypses. Let’s escape!
Joe Biden, a decent fellow, enjoys the pomp and glory of the presidency, of course. He also yearns to leave a durable historic legacy.
Alas, pushed by his party's progressive militants, President Biden is favoring unsustainably extravagant programs. That’s not his real nature.
Even if he can hold his paper-thin Congressional majorities together and get something like the utopian fantasy of his party's left wing enacted it will prove a pyrrhic victory, costing him his House or Senate majorities. Likely, both.
Since one Congress cannot bind another, he would likely see his partisans’ utopian policies repealed rather than endure. There’s a better way.
Costa Rica is showing us how to build back better without breaking the bank. Costa Rica has emerged from ill health and immiseration to surpass the USA in longevity.
And it is spending far, far less on health than we do. How? Just put aside the melodrama and embrace what works.
Atul Gawanda, recently at The New Yorker, treats us gringos (an affectionate epithet derived from the Spanish word for gibberish) to Costa Ricans Live Longer Than Us. What’s the Secret? We’ve starved our public-health sector. The Costa Rica model demonstrates what happens when you put it first.
“Life expectancy tends to track national income closely. Costa Rica has emerged as an exception. … Across all age cohorts, the country’s increase in health has far outpaced its increase in wealth. Although Costa Rica’s per-capita income is a sixth that of the United States — and its per-capita health-care costs are a fraction of ours — life expectancy there is approaching eighty-one years. In the United States, life expectancy peaked at just under seventy-nine years, in 2014, and has declined since. … People who have studied Costa Rica… have identified what seems to be a key factor in its success: the country has made public health — measures to improve the health of the population as a whole — central to the delivery of medical care. … The covid-19 pandemic has revealed the impoverished state of public health even in affluent countries — and the cost of our neglect. Costa Rica shows what an alternative looks like.”
Costa Ricans now enjoy radiant health compared to Americans. Credit an ebullient Costa Rican “walrus-mustached” “bear of a man” Dr. Alvaro Salas. He formulated, pioneered, and took to scale a simple, politically popular, strikingly effective plan there.
Credit is also due to the younger generation of what Salas calls Quixotes, the next generation “who think and can see twenty years, thirty years ahead.”
Costa Rica has leapfrogged the United States of America. What does this look like in practice? Per Gawanda:
“The plan had three principal elements. First, it would merge the public-health services of the Ministry of Health with the Caja’s system of hospitals and clinics — two functions that governments, including ours, typically keep separate — and so allow public-health officials to set objectives for the health-care system as a whole. Second, the Caja would integrate a slew of disparate records, combining data about household conditions and needs with the medical-record system, and would use the information to guide national priorities, set targets, and track progress. Third, every Costa Rican would be assigned to a local primary-health-care team … which would include a physician, a nurse, and a trained community-health worker known as an atap. … Each team would cover about four or five thousand people. The ataps would visit every household in their assigned population at least once a year, in order to assess health needs and to close the highest-priority gaps….”
President Biden? With all due respect (no snark, Hayek approved of state-provided social insurance) to your devotion to expanding happiness-fostering social democracy as splendidly exemplified by Social Security and Medicare?
It is as important to do the thing right as it is to do the right thing. Costa Rica shows how.
To go down in history as having built back better for millions and for generations, thus rising to the level of an FDR, follow the wise counsel of JFK/LBJ economic adviser Walter Heller who told the Congress on May 7, 1985, to “Rise above principle and do what's right.”
Costa Rica did that. It did and does what really works to improve public health. This plan, if adopted, will save millions of lives and trillions of dollars. Invite Dr. Salas for an oval office chat.
Mr. Biden? Build back better.
Follow Costa Rica to end the Zombie apocalypse now!
Ralph Benko, co-author of "The Capitalist Manifesto" and chairman and co-founder of "The Capitalist League," is the founder of The Prosperity Caucus and is an original Kemp-era member of the Supply-Side revolution that propelled the Dow from 814 to its current heights and world GDP from $11T to $88T. Read Ralph Benko's reports — More Here.
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