John Robert’s ruling on the Healthcare issue opens up the ability of states to resist federal requirements that they spend money on: disabled children’s education, poor peoples health (Medicaid), and other programs designed to ensure a healthy, educated population. Robert’s ruling raised the specter of federal forcing states to do things that they wish not to do.

The bright side of this conversation could be clarity on the role of states and the role of the federal government in keeping the population healthy, educated and safe. Just who IS responsible for this? Does it matter if people aren’t educated? Does it matter if people aren’t healthy? Even under Obama’s new health mandate 26 million people will still not have heath care. That’s 26 million out of 500 million – does that matter from a national security standpoint, from a humanitarian stand point, from an economic stand point (do we pay more for emergency care and family support than in keeping people well)?

When we make state and national policy decisions what is the actual cost when money becomes the sole criteria? Now I’m not suggesting that we go ahead and the cost be dammed. That is a false dichotomy and one that I think is a major driver of this skewed discussion. To keep the discussion on track my suggestion would be to clarify what kind of country we want and to consciously choose how much poverty, how much illness, how much bad education we can afford and then drive policy to create that.

Is a country healthy with .05% of its people sick, uneducated and 15% living in poverty? The Census Bureau suggests that: “Minorities were hit hardest. Blacks experienced the highest poverty rate, at 27 percent, up from 25 percent in 2009, and Hispanics rose to 26 percent from 25 percent. For whites, 9.9 percent lived in poverty, up from 9.4 percent in 2009. Asians were unchanged at 12.1 percent. “ Are we OK with this?

We still believe that we the greatest country in the world – even though this is what is really true:

• We rank #9 in freedom.
• We are #22 in freedom from corruption - According to the Heritage Foundation’s 2012 Index of Economic Freedom, the United States has a freedom from corruption score of 71, which makes the United States tied for twenty-second with Belgium out of one hundred seventy-nine ranked countries. Denmark, New Zealand and Singapore are tied for first, with a score of 94.
• We are 14^th in education - The three-yearly OECD Programme for International Student Assessment (PISA) report, which compares the knowledge and skills of 15-year-olds in 70 countries around the world, ranked the United States 14th out of 34 OECD countries for reading skills, 17th for science and a below-average 25th for mathematics. US ranked 19th in graduation rate - America’s high school graduation rate ranks 19th in the world, (Forty years ago, we were first.) according to Strong American Schools
• We are 37^th in health based on the World Health Authority report - the US ranks in comparison to other countries in terms of healthcare systems and their efficiency (infant mortality, etc.). The US in 37, behind virtually every EU country and Canada.

Are these numbers good enough? The real question is where do we want to put our money and the follow up is how can we rethink these issues so that we spend our money wisely. We have a long way to go to get to this conversation!

Categories: culture  |  leadership  |  sustainability strategy  |  unintended consequences
Tags: Culture  |  democracy  |  ethics  |  leadership

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