In our own nation, Senator Phil Gramm stated in 1995 "The odds that a boy born in America in 1974 will be murdered are higher than the odds that a serviceman in World War II would be killed in combat.” Think about this. No Vietnam deaths in this group, no major deaths in conflicts, no chance for medical care to save them. Simply sudden and irrevocable death, often unprepared with spouses, family, and children left behind in chaos.
In my city this week, another 4 month old died when someone emptied a gun into a house. My heart goes out to the father and mother and I hope and pray their marriage survives this tragedy. The odds are that it will not.
Such evil is not confined to certain census tracts. I find that many of the problems of my own kids arise from fatherless kids and other teens who have had severely troubled lives. The situation in my own family mirrors the stresses and strains in society, dependency, drug abuse and codependency, and more. Discussions on list serves and in locker rooms reveal a host of others in similar circumstances. Visits to rehab centers reveal 3 and 4 generations of a family impaired by drug and alcohol abuse.
This increasing lack of safety and security in our own country breeds hopelessness. Now more than ever we should know that hopelessness spawns violence and terrorism. Although terrorism involving other nations is relatively easy to discuss, terrorism in this country is a bit more difficult to address. How many of our murders and crimes are really violent acts by hopeless people. Those who understand this also understand that the final cure for terrorism is not military, it involves restoring hope. This does not mean that disciplinary actions are not needed, by military or police or government.
The problem comes when deciding how much of our resources we need to invest in fighting terrorism abroad, as opposed to the root causes of hopelessness in this nation. Education, housing, health, and social conditions all interact together. The problem of fatherlessness (Statistics of a Fatherless America) has recently impressed me as a symbol of the complex problems in the nation and the broad impacts on all facets of society. The Bible mentions the need to help the fatherless so much it is nearly an 11th commandment. God gives us government, churches, and families for order and trust. The lack of discipline, the impairments, and the weakening of our families makes us a much more poorly prepared nation to deal any issues, especially international ones.
Does President Bush realize that we are facing our struggles today with a nation that has become uncaring and has the discipline of the fatherless? As I listened to his 2003 State of the Union and read and re-read his message, I had a hard time believing some of the things he was saying. Where are the reforms in education? Does holding a few exposed corporate criminals accountable make up for a corporate culture that thrives on greed and corrupts areas such as education and health care that have resisted such corruption? Will efforts to restore more spending power to Americans mean that they will invest wisely?
We have some hard questions to face and time is running out on some. We are facing the same problems with the same solutions and failing the same way. We have not had the money to throw at such problems for some time, yet we continue to attempt this. Each attempt mires future generations in debt and frustration, with further loss in trust in government.
Our problems are widespread and serious. This is not the result of enemies from without.
We can no longer throw money at problems. Money doesn't care or make a difference. We must throw ourselves into the problem-solving.
It is time to take this "new" approach and address some of the attitudes that are defeating this nation. The United States dominates the world like no nation past, present, or likely in the future. Our nation will never be defeated by a foreign enemy. Even the terrorists have no hope of defeating us. However they have learned from our Cold War victory that significant pressure can cause a nation to focus on defense and military spending so much that internal problems can break it apart. Our nation may be even more vulnerable to these efforts.
Our senior generations are focused on retirement, our younger generations are bound by dependency, all generations have developed a distrust of government, and unbridled greed has spread throughout the land.
In order to solve our problems, we must put a name on them, bring them out into the open, and then engage the problem-solving at the community level that characterized and built America.
First of all, it is important for all of us to prepare for a time when we will not be able to be as functional. There are some good aspects of this. However far too often retirement has become a rallying point for those who promote dependency, special privilege, and greed.
Who will take on the retirement lobby and tell them that their demands for retirement and health care will bankrupt the nation? Will Congressmen cave in when seniors attack their cars again (Rostenkowski incident)? How can we stand up to Sadaam Hussein if we cannot stand up to selfish senior citizens or those who make money off of retirement issues? How can state and national leaders pledge not to impact future generations and not deal with this? Studies show that seniors in some areas of the nation are using resources much faster than others and not getting better care http://www.annals.org/issues/v138n4/full/200302180-00006.html Will those using up the resources be held accountable, seniors as well as those caring for them?
If our President wanted a concept to attack, perhaps he needs to defeat the concept of retirement. It is bad for health, bad for relationships, bad for communities, and bad for the nation. Retirement is becoming an excuse - "it is now someone else’s job to work, to care, to live correctly." Retirement has become the symbol of escapism and selfishness. Why else would people fight so hard to retain it and the trappings around it?
Life and liberty are being lost in the pursuit of happiness by a privileged few.
We need to be a nation of involvement and mentoring the young and distributing the wealth more broadly. We cannot last as a nation of selfishness, retirement, and unbelievable concentrations of wealth. We were given talents and resources to use. We cannot take them with us. Why not devote them to great national efforts? In place of retirement we should develop an attitude of pursuing meaningful work over a lifetime.
Where life deals obstacles in terms of health, we should develop policies allowing re-direction and re-training. This leads to another problem of
There are many sources of dependency. Disability, welfare, and distortions of the legal system contribute millions that continue to recur in dependency for generations. When teens go on welfare at an early age, before they have decided what they want to become, they often lose the will to become anything. We have even created a massive bureaucracy of dependents upon dependency such that it is difficult to tell whether a program is actually helping the poor, the helpless, or the needy.
We have great drugs for diseases, but we have rarely invested in research to heal families. We have no way to support care facilities that could free parents, children, and their children of the recurrent nightmares of abuse, drugs, or simply ignoring each other. These may all be small contributors compared to the massive impact of fatherlessness. Yet we continue to divide fathers from their families in laws and in courts. And we wonder why our health care costs go up and up and why good people and children die at the hands of the impaired, while dependency continues on its pandemic.
Policies and programs cannot care, only people can care. Only communities of caring can really make a difference in most if not all of the problems facing this land. We can create programs, but we rarely develop the communities of caring that are so crucial to reversing dependency of all types. It is far to easy to attempt to wall off the dependent, in certain parts of towns, in prisons, and in institutions. Security systems and exclusive communities will never fully protect us from this plague. Given the accelerating costs of such an approach, this is no longer an option.
Education, Health Care - Our country must commit itself to providing quality education and at least a minimum level of health care to all. Far too often those who attempt to escape poverty find themselves back in dependency via failures of the legal system, workers compensation, and the intricate delaying tactics of insurance companies and businesses. Poverty, poor education and housing, rampant crime, poor health, and injustice conspire to fuel hopelessness.
Military and dependents - Those in our military have had a promise extending back to Abraham Lincoln regarding them and their families. The TriCare insurance program is a disgrace to them and all of the brave efforts of all veterans. Do we really want to make military-trained people resent our government and those providing health care to them? When we sent soldiers overseas that know about the problems with TriCare, veterans benefits, and more, will they be as likely to sacrifice their lives and their health for our country? Will moving the veterans to more and more TriCare administration help or hurt?
Unjustice - We have become a land of injustice, within our own borders. Once we were urged to treat alien vistors well (Kennedy address), because they would often be leaders in other lands. Now we treat immigrants poorly, rounding up hundreds unjustly, not just for fear of terrorism, but because they are different (incidents in Maine, Norfolk NE, other locations). Have we forgotten that those impacted with injustice also include some that have leadership skills? Will they use these skills for or against America? Will they grow up with a hate of America and Americans that none of our efforts will quench? Not only is this bad now, it is worse in the future as they become citizens. They will then be raising their kids in an environment of distrust of government and hate.
Recurrent Communities of Poverty - I have looked back on famous addresses in crisis situations. One stands out to me, the Kennedy Address to Congress in May of 1961. Most remember the man on the moon portion. This was actually a small portion. Now as I look back on the Kennedy address, I wish it to be repeated today, with one exception. Instead of envisioning a man to the moon or stars, I would want such a speech today to end with a declaration of a goal of ending communities of poverty, at least in the United States. Ending poverty is too much to ask, for even Jesus said that we would always have poor people (Matthew 26:11). But I believe that we must not tolerate communities, regions, or entire countries of the impoverished. We can make the sacrifices before others suffer greatly, we can attempt to wall ourselves off in ways expensive in dollars and in the pursuit of liberty. We can and must reach out to others in great need. There is no other real choice.
Residents of rural counties were at greater risk for health problems compared to residents of metropolitan and central core counties. In adjusted models, the health disadvantage of rural areas was partly explained by differences in population composition. The residual rural disadvantage was concentrated in persons with less than a high school education. Tract poverty and county per capita income were also important independent predictors of morbidity. The results of this study suggest that special attention should be paid to improving education in disadvantaged places and to better understanding the ways in which economic growth and its benefits are distributed. The Health Effects of Rural-urban Residence and Concentrated Poverty, Amy H. Auchincloss, MPH, Wilbur Hadden, PhD
Loss of innocence - What about the filth that permeates our video and internet? Innocence is lost at a shocking rate in children of younger and younger ages. The little innocence that remains stands out and causes us a few of us shame and great longing. Young men are currently disappearing from college and higher education at a rate that some have predicted that 2044 will be the year that the the last young man dares to invest enough to get a bachelor's degree. Will self gratification become so rampant that no one will want to spend time finishing high school? Will investments of time and energy in education defeat the improvements in college and high school education that we have had throughout the past century, efforts spurred on by Sputnik and Flexner's reforms in medical education.
Our nation’s economy continues to be one of our major strengths, but we have allowed it to dominate the direction of our nation, including its foreign policy, its ethics, and even our language. How shameful it was to hear a former Secretary of State say that the slavery issue in Sudan was “not marketable” to the American people, and our lack of response is even more shameful.
Business scandals are a daily affair. Large corporations pray upon the rich and poor. Concentrations of wealth are building in the insurance industry worldwide that will make it difficult to make any changes in a number of areas, such as health care. Health corporations such as Kaiser Permanente make major contributions to defeat Oregon health reform efforts and facilitate physician assisted suicide. Our thirst for oil continues to impact decisions at all levels. The escape from poverty involves better education and health, yet states and businesses have combined to prevent poor people from making it out of poverty, even though this costs the states millions of dollars Poorer Health in the Process What else will corporations do in the future to impact policy, elections, and actions?
Gambling - What about the disease of gambling that is crumbling our infrastructure of values and family, taking ever more away from the hopeless poor, and doubling the numbers who default on public housing rents? At the heart of gambling is greed, and we have legalized a full scale state by state, community by community assault on our nation and its values. Even the lottery winners have not improved their lives much and many wish that they had never won. We have allowed an illegal activity (condemned for generations) a household activity. What if our seniors spent time with youth in need instead of conversing with each other with a handle in their hand? Senior centers dedicated to improving the health and lives of senior citizens are emptying into gambling casinos where alcohol and tobacco abound.
Dealing Death through greed - Our CEO noted with tongue in cheek that if we wanted to make money, we would deal drugs on the street. Thankfully he is committed to caring for all patients as a true non-profit, but what he said is not far from the truth. Drug dealing and making have become epidemic. Any teen can find illegal drugs in less than 5 minutes. President Bush mentioned drug abuse, but why do we spend billions on anthrax and smallpox that have not killed, when methamphetamines every day of every week of every month of every year kill, maim, and destroy not just teens, but their parents, their grandparents, and their kids. Meth has penetrated every town in every county in the nation. It destroys education, health care, mental health, and legal systems. Entire regions of the nation live in fear of those impaired by meth who sleep for days on end and come out to rob, steal, abuse, or kill.
We know it takes months if not years to restore meth-impacted brains to some ability to function and resist temptation, yet mental health and caring communities are last place on the budget listing. States such as ours laugh at us when regional mental health funds are exhausted 3 months before the end of the fiscal year and expect us to continue to care for patients for free. It is amazing that we have any mental health care left.
At the heart of meth and stimulant abuse is the worst kind of greed, the kind that kills people and society. The dependency created damages people and their loved ones for life. The environment created by meth involves total disregard of our communities and nation.
Great nations depend on an ethical people who work together, sacrifice together, and trust each other and government. Even in 1961 Kennedy had doubts about committing to great projects where some were bound to latch themselves on for profit. Here is what he said about the space effort:
“This decision demands a major national commitment of scientific and technical manpower, materiel and facilities, and the possibility of their diversion from other important activities where they are already thinly spread. It means a degree of dedication, organization and discipline which have not always characterized our research and development efforts. It means we cannot afford undue work stoppages, inflated costs of material or talent, wasteful interagency rivalries, or a high turnover of key personnel. New objectives and new money cannot solve these problems. They could in fact, aggravate them further--unless every scientist, every engineer, every serviceman, every technician, contractor, and civil servant gives his personal pledge that this nation will move forward, with the full speed of freedom, in the exciting adventure of space.”
Kennedy feared that large sums of money sent into the space program, or other programs, would basically spawn bad attitudes and waste. His words have been prophetic. These problems are rampant in government programs, defeating them before they have a chance to prove their worth and destroying trust in the process. In health care, the massive research expenditures have fueled major changes in education, health, and other areas. These have resulted in increased health care costs for all. Layers of bureaucracy intercede between those in need and federal resources. Dependents upon dependency line their pockets while the needy get less and less effective help. This is seen also in who gains federal designations, and who does not.Major Medical Centers
Americans may indeed be a resolute people, but are they resolute for concepts such as freedom and fairness, or is their resoluteness based on personal gain?
Only time will tell. If our values are personal gain, then we can only fall into recession and depression and defeat. If our values are freedom and fairness, then we will yet rise to greater heights.
Leadership Factors in Developing RME
Great civilizations and nations are built when people are willing to sacrifice, for greatness, for freedom, for a better life for their families. Great nations turn to ashes when people are no longer willing to make sacrifices.
President Kennedy did not know if the nation would accept his challenges. He hoped that it would, and it did. We accomplished much in terms of human improvements in this land and others. We did place a man on the moon. We continued in other efforts.
President Bush said, "Americans are a resolute people who have risen to every test of our time. Adversity has revealed the character of our country, to the world and to ourselves. America is a strong nation, and honorable in the use of our strength. We exercise power without conquest, and we sacrifice for the liberty of strangers."
My experiences as a child growing up in America, as a physician, as a father, and as a rural health advocate color a different picture, with gains for decades supplanted by years of recent losses.
We can regain our soul in America, but only by:
· Replacing retirement with the pursuit of service to younger generations,
· Replacing dependency with acceptance of responsibility,
· Replacing broken promises with consistency and eventually trust of government and
· Greed with caring
Doctors have a special role in bringing the truth to light and also healing the nation, since we can be the best examples of the reverse of all of these.
More about physicians roles at Restoration of Communities, Nations, People: Role of Rural Family Docs
We should begin by examining those who pursue government, who desire higher education, and who would share a relationship with us, for these values.
Robert C. Bowman, M.D.
2/5/2003 - hyperlinks revised 2006
Hope itself is like a star-not to be seen in the sunshine of prosperity, and only to be discovered in the night of adversity. Afflictions are often the black foils in which God doth set the jewels of his children's graces, to make them shine the better. Charles Spurgeon
Statistics of a Fatherless America
Cities await vaccines, anti-nerve gas agents, and pay tens of millions a year for similar preparedness for communications, supplies, equipment, extra training, and extra personnel. These are tough choices in tough economic times and are all likely to result in more hopelessness for those left out. Some of these cities will be facing a long hot summer, in more ways than weather.
Proper planning before war ensures that we win not just the war, but also the peace. To date, much of the "attack Iraq debate" has focused on the immediate effects on regional security and the United States economy. Both are important. However, if an American-led coalition goes to war with Iraq, the post-combat actions and economic policies enacted will determine long-term regime success, and, more importantly, the possibility for continued political stability and potential democratic expansion in the region.
Army Capt. Jason Cummins teaches economics at West Point. His views are his own and not necessarily that of the Army or any other government organization.
Senator Webb from Virginia ran on 3 prongs. The concerns that he expressed similar to above and 6 months before the war, his concerns about divisions between upper income and other people in America, and concerns regarding abuses of government.