“I have to tell you, it’s an unbelievably complex subject . . . No one knew that healthcare could be so complicated,” explained President Donald Trump to Republican governors attending the 2017 National Governors Winter Conference. Many consider the President’s comment the understatement of the year due to the uneven, often unintentional evolution of health care in America.
While there are still things you can do personally to reduce the cost of healthcare, the latest political effort to fix one of the more inefficient and most expensive health care systems in the industrialized world. After promising for seven years and voting more than fifty times in the last four years to repeal the Affordable Care Act (ACA), the Republican majority in the House of Representatives could not agree on a replacement plan. As a consequence, the ACA – with all of its strengths and weaknesses – will continue.
If you’re wondering how we got here, you’re in the right place. In the following sections, we’ll cover the history of healthcare in the U.S., previous reform efforts, common debates, future solutions, and more.
Our Existing Health Care System
Today, the country spends $3 trillion annually on healthcare or $9,523 per person. According to consulting firm Deloitte, America spends more per capita on healthcare than any other country in the world – more than 2.5 times than the U.K., 1.8 times the rate of Germany, and 1.6 times the amount Canada spends.
BASE jumping is one of the most dangerous sports a human can undertake, with one fatality per 60 participants. The desire to jump from great heights is practiced by a small percentage of extreme sports enthusiasts. BASE jumping, like sky-diving, skiing potentially fatal slopes, or rock climbing without a rope, is a high-risk activity.
According to The New Zealand Medical Journal, the likelihood of injury or death from BASE jumping is 5 to 8 times greater than skydiving. Why would any sane person take such risks? Dr. Erik Monastery, one of the authors of the study, noted that BASE jumpers score high on a measure called novelty seeking: the person’s propensity to become easily bored and look for exciting activities. They also have a low sense of harm avoidance, so they have the advantage of “confidence in the face of danger and uncertainty, leading to optimistic and energetic efforts with little or no distress.”
Some have characterized those who regularly take such risk as adrenaline junkies or daredevils. They actively seek sensation in activities like skydiving. Dr. Cynthia Thomson of the University of British Columbia suggests that risk-taking behavior may be genetically based. Her research found that people attracted to dangerous sports shared a common genotype, a variant of the DRD4 receptor commonly called the “adventure gene.”
So, is risk-seeking behavior genetic or a matter of choice? How can we use these answers to make better decisions and lead happier lives?
What Is Risk?
Uncertainty pervades every aspect of life; the future is unknown. The term “risk” refers the negative aspect of that uncertainty – the possibility that something harmful may or may not occur. Risk differs from loss just as uncertainty differs from certainty. Running across a busy street blindfolded is a risk; getting hit by a car while doing so is a loss.
Risk is present in everything we do. For example, a person could be injured by a herd of stampeding zebras while walking the streets of Manhattan, although there are no recorded instances of such occurring.
For that reason, the Stanford Encyclopedia of Philosophy refined the definition by replacing the word “possibility” with “probability.” In common terms, risk is referred to as “odds.” For example, the probability of your home being damaged by a fire in the coming year is about one-quarter of 1% (0.0028%) while the probability that you will die in the future (based on current science) is 100%. The risk of death is not an if, but when. However, probability alone is not enough to understand risk and effectively manage it.
A second dimension of risk is consequence. In other words, what is the impact upon those experiencing the event? The impact may be slight or catastrophic. For example, the probability of the paperboy tossing your morning edition into the shrubs sometime during the year is high, but the consequences are slight (inconvenience and possibly scratched retrieving the paper). On the other hand, the likelihood of a tornado destroying your home in Elmhurst, New York is low, but the financial costs of such an event would be significant.
More than one-half of Millennials believe there will be no money in the Social Security system by the time they are ready to retire, according to a 2014 Pew Research report. “I don’t think anyone honestly expects to collect a single penny they pay into social security. I think everyone acknowledges that it’s going to go bankrupt or kaput,” says Doug Coupland, author of “Generation X.”
What went wrong? Will Social Security go bankrupt?
A Brief History of Social Security
In 1935, few of the program’s creators could have anticipated the condition of the Social Security program today. The country was in the midst of the Great Depression with a quarter of its labor force – 15 million workers – idle, and those with jobs struggled to make ends meet as their hourly wages dropped more than 50% from 1929 to 1935. Families lost their homes, unable to pay the mortgage or rent. Older workers bore the brunt of the job losses, and few had the means to be self-supporting. One despairing Chicago resident in 1934 claimed, “A man over 40 might as well go out and shoot himself.”
Hundreds of banks failed, erasing years of savings of many Americans in a half-decade. People lived in shanty towns (“Hoovervilles”) or slept outside under “Hoover blankets” (discarded newspapers). Breadlines emerged in cities and towns to feed the hungry. Thousands of young American men hopped passing trains, sneaking into open boxcars in a desperate attempt to find work.
Democrat Franklin D. Roosevelt (FDR), promising a New Deal, defeated former President Herbert Hoover in 1932 with more than 57% of the popular vote and 472 of 531 Electoral College votes. Three years later, FDR signed a bill that would “give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age.”
“Sticks and stones may break my bones, but words will never hurt me.” This old English rhyme is often heard during one’s childhood, typically as comfort to a victim of ridicule by other children. Implicit in the advice is the unspoken admonition to the child to grow up and ignore the pain of verbal abuse – after all, it’s only words.
Many believe that the avoidance of words that may offend, marginalize, or insult a group of people – political correctness (PC) – has gone too far. According to PC critics, PC promotes a society of victimhood and endangers the public at large by limiting discussion about controversial subjects. Chris Cox, the executive director of the NRA Institute for Legislative Action, wrote in a USA Today op-ed about the Orlando mass shootings that the “administration’s political correctness prevented anything from being done about it.”
Conservatives claim that PC is a threat to the first amendment and our right to free speech. Columnists liken modern-day America to Ray Bradbury’s “Fahrenheit 451” or George Orwell’s future society in “1984“. In “1984”, Big Brother’s thought police relentlessly pursue anyone foolish enough to say anything that might be offensive to someone. Surprisingly, liberals – often blamed for the expansion of PC – have their own misgivings about verbal censorship. Ralph Nader, a former third-party candidate for president, says, “You can’t say this about that, and you can’t say that about this. And the employer tells you to hush. And perhaps your wife tells you to hush, and your kids tell you to hush. It’s gotten absurd.”
Does one’s choice of words matter? Have efforts to avoid offense stifled free speech as many claim? Is political correctness an expression of politeness, evasion of hard truths, or extreme sensitivity? Or is an expression of anti-PC sentiment simply incivility, indecency, or vulgarity, as Mark Hanna writes in TIME?