A trillion here, a trillion there Ð after a while youÕre talking about real money. When Senator Everett Dirksen used the phrase forty-five years ago, the numbers were billions Ð a thousand fold less than the government costs we see today.
As Congress considers a bailout, which will total nearly a billion dollars, we have to ask what weÕre getting for our money. When it comes to health care, itÕs not much. A system costing $2.3 trillion a year produces the health statistics of Cuba. CubaÕs inefficient, authoritarian government spends perhaps 3 cents on the dollar compared to us. Is there a better way to spend our money, particularly the new ÒbailoutÓ funds, in ways that will promote the economy and health?
Yes. What is necessary is to spend our funds for dual purposes. That means spending money on health, not health care. If Asian American women in Suffolk County can live on average to 95.6 years of age, itÕs not because eastern Long Island has the ÒbestÓ health care in the world. Health is about how we live. There are lots of ways we can make our lives longer and healthier as we rebuild our economy.
Here are a few ideas:
- Build parks. Data from Britain demonstrate that poor people who live near green spaces have vastly better health than those who donÕt. Fully half the differences in longevity between upper and lower classes seems to disappear when there are cohesive green spaces for people to use (in the US, the life expectancy differences between socio-economic groups can extend to more than thirty years.) Real estate values have been decimated throughout the United States. ThereÕs greenspace to use, and itÕs cheaper than before.
- Set up pedestrian streets throughout most towns and cities. Americans are becoming progressively more obese, and more apple shaped, as our diet and life style promote metabolic syndrome. Many pedestrianizing projects could be Òshovel readyÓ in relatively little time. Providing travel arrangements are made for those who cannot walk, there are many advantages to pedestrianizing: a healthier population, easier access to shops, less pollution, increased local shopping, and potentially improved neighborhood and community spirit.
- Create combined pedestrian walkways Ð bike lanes on our sidewalks. Used throughout much of Europe and East Asia, such arrangements get traffic moving more quickly, saves overall energy costs, and makes for a more active, neighborhood aware population.
- Increase mass transport spending throughout both small and larger cities. In cities with subways, trams, and light rail, overall population health statistics are considerably better than where only cars can be used. Despite its nature as a Òcity of light,Ó overall energy use in New York City is one-third the national average, similar to what is seen in energy thrifty European nations. Mass transit saves on energy, leads to more national energy independence, moves people more quickly, revives neighborhoods near stopping points, and gets people out of cars, locomoting under their own power.
- Recognize a healthy population requires a healthy environment. Clean water and clean air mean longer lives. The decrease in soot over the life of the National Clean Air Act is thought to have increased the average American life span by about seven months. Disaster occurs without such controls. The increased use of coal in central and northern China is thought to have increased birth defects there by at least fifty percent in ten to twenty years.
With less pollution, you get a healthier population. With less energy use and more self transport, you get a healthier population. With less energy use, you begin to slow the advance of global warming.
Think the present economic crisis is terrible? Consider what global warming will do to the world economy and your childrenÕs lives.
Under several models, areas like Southwest Florida go under the waves. With increased ocean levels worldwide, the cost of dikes and geoengineering quickly becomes almost unimaginable. No need to worry about the real estate market at that point.
Half the worldÕs population lives on or near coastlines. Rising water levels threaten most of the worldÕs great capitals, and overall economic survival. Will it be cost efficient to move most of CaliforniaÕs industrial production to North Dakota?
Recognize the future: controlling energy use can promote the national economy through green industries; the national health, through more physical activity with less obesity and diabetes; greater financial independence, by not paying huge sums supporting petrostates and petrodictators who want us gone; and postpone or prevent the day when we will have to uproot our populations to cope with the climactic volatility that will fundamentally change our way of life.
ItÕs time to use the economic stimulus moneys in ways that will multiply benefit all of us, and not through bailouts to bankers and investment managers who have helped bring down the entire global economy. If we do things intelligently, we just might make improve our health, our environment, and our economy.
Dr. Matthew Edlund practices sleep medicine and psychiatry in Sarasota. His new book, Designed To Last, is available online. He can be reached at 365-4308 and via his Web site at doctoredlund.com.
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