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Agreed. If we're going to go with the "a purpose of a system is what it does", then the US public health apparatus is awful. We spend by far the most money in the world and get the life expectancy of (checks notes) Turkey, Ecuador, and Albania.
It would probably help if Americans drove less, exercised more, were less fat, did fewer drugs, and stopped shooting each other and themselves. However, the public health interventions needed to address these cultural and lifestyle issues are fairly unpopular.
Let's see what RFK can do. Maybe we'll start directing dollars towards effective interventions and away from ruinously expensive and ineffective ones.
I agree that America should be more like Europe and Asia by harshly prosecuting violent crime and refusing to tolerate drugs. We should probably also adopt European food standards where breakfast cereal has 5 simple ingredients instead of 20 unpronouncable ones.
Can you to be more specific about what effective interventions you're thinking about? The main causes of the European-American life expectancy gap is not a mystery, and I promise you it's not tripotassium phosphate or excessive vaccinations.
Like, stricter regulations on microplastics or whatever would be great, but the effects on life expectancy are going to be completely swamped by obesity, drugs, car accidents, and suicides. (Not to mention, the GOP traditional stance on environmental and health issues makes me think there's not going to be much appetite for imposing additional standards on industry).
The US prosecutes violent and drug crimes far more harshly than Europe, as I'm sure you are well aware. Tolerance is not the issue.
A focus on reducing obesity and preventing sickness would be a welcome change. Will it dramatically increase life expectancy? Maybe not at first, but it's a start. And it might at least stem the rapid increase in costs. We're getting very little for our expensive medical system.
What changes would you propose? Cities like Chicago and DC have done literally everything that establishment figures say is good, and look at the results. These are intractable problems. The state can't simply snap its fingers and will away problems. Except crime. That can be made much less via mass incarceration.
I am not aware. Here in Seattle open air drug markets are tolerated and people who have been arrested for dozens of crimes (including violent crimes) are frequently released onto the streets without trial. It's hard to imagine a more lenient system.
Reducing obesity is a goal, not a policy. Obama focused on reducing obesity. Didn't achieve much. What is the Trump administration and the GOP going to do? What policies that are both effective and palatable to a) Republican voters b) Republican elites do you expect them to pursue
Tax sugar (or Ozempic4All, if you're feeling pro-injection and like free healthcare). Invest in public transit and rework urban planning (15min cities are back, baby) so people drive less (fewer car accidents) and have more active lives (-obesity, +basically every other aspect of human health).
Of course, these are already ballot box poison (and that's before we even try to do anything about suicide, where massive social engineering might be more politically viable than restricting access to guns). Which points back to what I was originally saying: low American life expectancy is revealed preference re: lifestyle. Policies to address these issues have been floated repeatedly and outside of a few locations they've been shot down.
(Not a clue, re: drugs. There's some proximate interventions you can do to reduce OD deaths, but that's just nibbling around the edges of the problem)
Can you be more specific? Which establishment figures, which policies?
Sidebar: I would note that the stereotypically very liberal states like CA and NY have the highest life expectancy; the worst states are in the ultraconservative Deep South. Again, I don't think this is really about policy (cf. Idaho, which is also extremely conservative), except perhaps insofar as state governments could spend money on ameliorating the consequences of Southerners' unusually unhealthy lifestyles but don't (generally with the support of their electorate).
Well I'm pleased to inform you that the world did not start three years ago, nor did America's durable problems with drug use and violent crime, nor its unusually harsh sentencing practices. The US has mass incarceration. It, rather notoriously, has more prisoners per capita than almost anywhere on Earth, including actual totalitarian regimes. It doesn't seem to have had the desired effect. Unless you can do something about the processes that produce new criminals, the problem isn't going to go away just by throwing more and more people in prison.
I'm 100% with you. But first, we need the DOGE man to come and fix government.
Too many people think that dollars = progress. This is obviously false. California has spent on the order of $100 billion on high speed rail and has nothing to show for it. If we had the efficiency of Spain or China we could do stuff. Unfortunately we are hamstrung by a corrupt and incompetent government.
Until that is fixed, we could spend infinite dollars and get nothing for it.
So I assume that you agree with me that the best way to get car-free cities is to start by gutting the corrupt people who are preventing public money from being utilized.
Yes, rich people who benefit from our economic system have better life outcomes. How can we help disadvantaged people get the same thing? I don't think standard liberal politics have the answer. Look at Philly, DC, and Chicago.
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Perhaps the argument could be made that we can in fact throw the book hard at drug offenders, and that we have indeed done so to the point that DAs, lacking a less-harsh punishment, choose not to punish at all.
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