When I think about what concerns me the most about the direction we’re headed in, I think it comes down to the realization that facts don’t seem to matter much anymore.
I had a stark reminder of this last Friday when I went to hear journalist T.R. Reid talk about what he learned in writing his book about health care, The Healing of America. Reid travelled around the world twice – once on his publisher’s dime and again to film a documentary for PBS – to learn about how health care is delivered in different countries. He found that there are four basic models: private insurance, government run health care, public insurance, and out of pocket. The U.S. is the only country running all four systems. We all know about private insurance, the VA hospital system is an example of government run health care, Medicare is an example of public insurance and we all know that there are millions of uninsured who either pay out of pocket or don’t get the health care they need.
It’s common to hear someone say about the U.S., “We have the best health care system in the world.” Based on what facts? The U.S. leads the world in health expenditures as a percentage of GDP at 16.5%. According to World Health Organization stats, the U.S. doesn’t even make the top 10 countries for healthy life expectancy. The CIA’s World Fact Book notes that the U.S. ranks only tenth in the world in terms of low infant mortality rates. The facts seem to belie the opinion that we have the best health care system in the world.
I have to confess that I was angry when I left Reid’s presentation and that it took me a couple of hours to calm down. (I’d like to offer my apologies to a few friends who had the misfortune of listening to my rants on Friday afternoon.) I wasn’t angry with Reid. All he did was share with us what he learned. I was angry because the national “debate” that we’ve had on health care over the past year was long on opinions and spin and very short on facts. The most frustrating thing, I think, is the health care debate is emblematic of what passes for public policy these days. The money pours into the system to ensure that all we get is demagogic spin from either end of the spectrum. The end of the spectrum with the most money usually wins.
Here’s one other quick example of the difference between opinions and facts. You might have the opinion, as I did, that the U.S. government really stepped up after the devastating earthquake in Haiti back in January by pledging $1.15 billion in relief. The fact, according to an Associated Press report that my friend Perry shared with me last week, is that the money is being held up in the Senate and none of it has been released. Meanwhile, a million Haitians are still sleeping in the streets with the rubble. Perry was there last month and saw it herself.
When I read Perry’s email, I wrote her back asking, “What in the (beep) is wrong with us?” Her response was short and sweet – “We are all unconscious. Our job is to wake them up, my dear.” So, this post is one small contribution to waking us up. Leadership, if it’s anything, is about creating meaningful, positive change. You’ve got to be awake to do that. And, it helps if you start with the facts.