Benjamin Franklin And a Modern American Portrait of Physical Health and Hunger

Our problem is not debt or taxes; it is an unwillingness on the part of a significant fraction of our citizens to recognize that for a healthy democracy to thrive, a nation must have a healthy middle class.
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No founder had as detailed a plan, or worked more diligently to create the kind of country he had in mind than Benjamin Franklin. Two things he knew were important were healthcare and having enough to eat. He was a founder of the first hospital on these shores, and worked tirelessly to create opportunities so that more and more poor people could move up into the middle class, thus assuring hunger would not be an American issue. As we prepare to vote it is worth considering where we are on Franklin's goals on the eve of the election.

Physical Health

In 1950, before the inception of the present illness profit industry, the United States, compared with the world's other leading industrial nations was fifth with respect to female life expectancy at birth, surpassed only by Sweden, Norway, Australia, and the Netherlands.

In 2010 the United States position concerning female life expectancy had fallen to forty-sixth. And when both men and women were combined it fell to forty-ninth. Americans live 5.7 fewer years of "perfect health" -- a measure adjusted for time spent ill -- than the Japanese.

Is this the result of lack of spending on the part of the U.S.? Most emphatically it is not.

Health Policy expert Uwe E. Reinhardt, the James Madison Professor of Political Economy at Princeton University, headed a team that specifically considered this. They found,

...per capita health spending in the United States increased at nearly twice the rate in other wealthy nations between 1970 and 2002.6 As a result, the United States now spends well over twice the median expenditure of industrialized nations on health care, and far more than any other country as a percentage of its gross domestic product (GDP).

Peter A. Muennig, assistant professor of health policy and management at the Mailman School of Public Health, Columbia University, in New York City, and Sherry A. Glied professor of health policy and management at the Mailman School of Public Health, and currently on leave as Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services (HHS), analysed Reinhardt's and many other studies, in a ground breaking exegetic survey of health care. They concluded that:

[N]one of the prevailing excuses for the poor performance of the US health care system are likely to be valid. On the spending side, we found that the unusually high medical spending is associated with worsening, rather than improving, fifteen-year survival in two groups for whom medical care is probably important.

We speculate that the nature of our health care system specifically, its reliance on unregulated fee-for-service and specialty care may explain both the increased spending and the relative deterioration in survival that we observed. If so, meaningful reform may not only save money over the long term, it may also save lives."


It doesn't get much more basic that not having enough to eat. It is hard to think of America as a place where large numbers of people are facing hunger as a daily reality for themselves and, even worse, for their children. That happens in Africa, Haiti, someplace like that, but surely not here. You think not? Welcome to the American reality; millions of your fellow citizens routinely are forced to make life decisions based on whether they or their children will eat or go without in order pay for housing or medical bills. Today as we prepare to go the polls more than 1 in 8 Americans are now on food stamps, participation in the program has jumped about 70 percent from 26 million in May 2007, while the nation's unemployment rate rose from 4.3 percent to 9.2 percent through September of this year.

According to the largest study of domestic hunger ever done, Hunger in America 2010, a study which based on more than 61,000 interviews with clients and surveys of 37,000 feeding agencies "hunger is increasing at an alarming rate in the United States."

Feeding America, the largest foodbank system in the country has just reported it is "annually providing food to 37 million Americans, including 14 million children. This is an increase of 46 percent over 2006, when they were feeding 25 million Americans, including 9 million children, each year."

Here are more of their findings:

  • Feeding America's nationwide network is feeding 1 million more Americans each week than they did in 2006.
  • Thirty-six percent of the households they serve have at least one person working.
  • More than one-third of client households report having to choose between food and other basic necessities, such as rent, utilities and medical care.
  • The number of children the Feeding America network serves has increased by 50 percent since 2006.
  • They have seen a 64 percent increase in hunger in senior citizens' homes.

"Clearly, the economic recession, resulting in dramatically increasing unemployment nationwide, has driven unprecedented, sharp increases in the need for emergency food assistance and enrollment in federal nutrition programs," said Vicki Escarra, president and CEO of Feeding America, which operates some 200 food banks across the country.

"It is morally reprehensible that we live in the wealthiest nation in the world where one in six people are struggling to make choices between food and other basic necessities," Escarra said in a statement.

She added, "[t]hese are choices that no one should have to make, but particularly households with children. Insufficient nutrition has adverse effects on the physical, behavioral and mental health, and academic performance of children."

Feeding America's report is far from alone in reporting this food catastrophe.

The Food Research and Action Center reported that: "In July 2010, SNAP/Food Stamps participation set a new record: 41,836,330 persons, an increase of 560,873 individuals from July 2010, the prior record level, and an increase of more than 6.2 million people compared with the prior July."

Further that, nearly one in five of America's men, women, and children -- 18.5 percent -- reported that they had gone hungry in the past year. This was up from 16.3 per cent at the start of 2008. Even more alarmingly they said households where children were present were even likelier to experience hunger. Nearly 25 per cent of these families reported hunger in the past year.

Perhaps worst of all, the Feeding America study shows just how close to the edge the entire private food network has become. A point which is important since anti-government ideologues expect what social safety net there would be, if they had their way, would be private. Feeding America says 70 percent of their emergency food centers are reporting "one or more problems that threaten their ability to continue operating."

While belief in this American Dream remains a unifying tie for an increasingly diverse populace, it is showing signs of wear, with both public perceptions and concrete data suggesting that the nation is a less mobile society than once believed. This is not good: the inherent promise of America is undermined if economic status is, or is seen as, merely a game of chance, with some having the good fortune to live in the best of times and some the bad luck to live in the worst of times. That is not the America heralded in lore and experienced in reality by millions of our predecessors.

The world Franklin hoped for us.

Tuesday we are going to decide whether to further degrade the already frayed social network that has left us in this situation. Our problem is not debt or taxes; it is an unwillingness on the part of a significant fraction of our citizens to recognize that for a healthy democracy to thrive, a nation must have a healthy middle class. A healthy middle class can only be achieved when a compassionate social government network assures a minimum quality of life. No other institution can do this. To achieve it we need to develop policies based on data, not ideological mantras.

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