Nothing Americans imagine or discuss doing can reverse our irreversible decline as a nation -- predicated primarily on our failure to right ourselves economically, which is a result of nothing so much as our inability to come to grips with health care (Note: NOT Medicare).


The Stanton Peele Addiction Website, July 22, 2011. This blog post also appeared on Stanton's Addiction in Society blog at

America Is Sinking: Told You So

This post is a response to America Is Already Gone by Stanton Peele


Last December, I pointed out that America has entered an irreversible decline -- a rather steep one -- and nothing we are doing can reverse it.

I cited five primary indicators-disaster areas. All have gotten worse because emergency measures being debated and negotiated in Washington can't afford to address any of these pressing needs.

1. Infrastructure deterioration. There is $2-3 trillion dollar backlog in the repair and upkeep of American bridges, sewer and water systems, highways, public transportation, airports, etc. These will only continue to get worse. Although we are not in danger of replicating the situations in developing nations, we are being far outstripped by our major world economic competitors in these areas (think Chinese trains). The President has half-heartedly proposed a National Infrastucture Bank to address these problems. The idea is going nowhere.

2. States are going down the tubes. It is amusing to watch someone like New Jersey's Chris Christie rise to national prominence by addressing his state's financial quagmire (I live in New Jersey), only to plummet in state polls. Being a governor is not a path to popularity and political success. They are presiding over their states' largest depreciations in budgets and resources in our history as federal stimulus money expires, no economic recovery looms, state pension obligations come due, and states take on current public employees (including teachers and police) to limit future obligations to state workers. This NY Times headline gives a good flavor for the situation governors face: "No Matter How Debt Debate Ends, Governors See More Cuts for States."

3. Public education is failing. Public services must decline along with decimated state and local budgets. Thus, despite incessant noise about the need to upgrade education in the United States, there is a steady, inexorable erosion of public education . All the famous proposals -- Race to the Top, charter schools, etc. -- are eyewash, as large-scale cheating has been revealed in the Atlanta public school system under its national-award-winning superintendent (and many more such scandals will follow), and as charter schools prove no more exempt from students' troubled backgrounds and family deficiencies than standard schools.

4. Entitlements. What America (and Europe) are struggling to "accomplish" is to pass along the excesses of baby boomers and the costs of their continuing care and entitlements to future generations. The Times' Thomas Friedman labels this "The Clash of the Generations : The generation that came of age in the last 50 years, my generation, will be remembered most for the incredible bounty and freedom it received from its parents and the incredible debt burden and constraints it left on its kids." As the AARP (to which I belong) and other senior lobbying groups fight tooth and nail any revisions of current Medicare and Social Security, the proposed changes simply mean later retirement ages, greater contributions, and fewer benefits for younger people -- all of which are inevitable.

5. Health care inflation. This major source of America's econmic decline both underlies, and extends far beyond, the coming Medicare crisis. All economists know what it is -- but it can't be spoken. So, at the same time that Times conservative columnist David Brooks applauded the possible rapprochement between the Speaker of the House and the President on the debt ceiling (oops on that!), Brooks announced: "We won’t fundamentally address the debt until we control health care inflation." Which we will never do because (a) conservatives insanely propose continuing a privately funded free-market health care system, (b) a legion of powerful interest groups (AARP, insurers, pharmaceuticals) resist all efforts to deinflate health care, and, most important of all (c) Americans won't hear of restricting our everyone-gets-to-have-everything approach to health care.

I call this "addiction to health care." As Brooks writes :

The fiscal crisis is driven largely by health care costs. We have the illusion that in spending so much on health care we are radically improving the quality of our lives. We have the illusion that through advances in medical research we are in the process of eradicating deadly diseases. We have the barely suppressed hope that someday all this spending and innovation will produce something close to immortality.

But that's not actually what we are buying. As Daniel Callahan and Sherwin B. Nuland point out in an essay in The New Republic called "The Quagmire," our health care spending and innovation are not leading us toward a limitless extension of a good life.

NOTHING being discussed addresses this; we are doomed.