Universal Education Revolutionized the World. So Too Will Universal Healthcare.
In the mid-1850s, Horace Mann led a revolution for universal education in the United States. Education at the time was predominantly funded privately, available to families with means. Mann was tasked to convince legislators to fund public education, while contending with a civil dogma that state-run education impeded upon the liberties of parental choice in educating their children. The political divide on the issue was as stark as the divide on universal healthcare today, infused with hostile rhetoric. Mann even used the word “hostages” to refer to children who were deprived of public education. However, Mann promoted education as a means for “universal improvement” for humanity. The same is true for universal healthcare.
Today, universal public education is a foregone conclusion. As Mann predicted, education produces a skilled and sophisticated society that increases freedom of thought and choice of career paths. However, the United States faces another issue impeding our advancement as a civilization. As described in the New England Journal of Medicine, “There is evidence that this generation will be the first to live shorter lives than their parents.” The ravages of an unfettered processed foods industry, social disparities, unequal access to healthcare, and lack of basic health skills has produced a citizenry with epidemic cardiometabolic diseases. The vast majority of adults are affected, and a plurality of children have chronic illnesses previously only seen in adult populations. Like fish oblivious to water, and birds oblivious to air, United States citizens live in a milieu of disease that is accepted as an inevitable condition of humanity. It is not. Rare genetic and infectious diseases notwithstanding, if each of us has access to and implementation of proper diet, time to cultivate our minds, and physical activity, the natural state of humanity is exceptionally healthful and happy.
In the United States, we require a health revolution. Just as the education revolution required universal publicly funded education, a health revolution requires universal publicly funded healthcare. A health revolution will also require a transformation of healthcare from an industry concerned with repairing the wreckage of tragic illness to an industry-mandated to provide comprehensive preventive health programs. U.S. healthcare is currently a private industry that consumes 3.3 trillion dollars per year; 90 percent of which is spent treating preventable lifestyle-related chronic diseases. This private industry has failed to produce health for our citizens and has demonstrated little capacity to alter its business practices for decades.
In the case of education, governments successfully establish standards of education that private educators must compete against, satisfying Jon Stewart Mill’s libertarian exhortation that State education should serve as a “stimulus to keep the others up to a certain standard of excellence.” With federally-mandated universal healthcare, there would be an opportunity to merge models of healthcare and models of education. Through an integration of medical science, health research, and educational models, healthcare and school systems could be required to teach—and evaluate the acquisition of—evidence-based skills and behaviors regarding diet, mental health, and physical activity. The effects on health would be profound. According to the Bipartisan Policy Center, 50 percent of health outcomes are governed by lifestyle behaviors, whereas access to the current private healthcare system can intervene upon less than 10 percent of healthcare outcomes. Yet, 88 percent of health spending goes toward the current private healthcare system. It is an actuarial nightmare.
There are those who would say with ever-dreading fear that a government takeover of healthcare delivery in the United States would encroach on civil liberties. Their fears are no more founded than the dogmatic fears of the 1850s that government-run education would encroach on the freedom to self-educate. With universal public education, private education prospered due to the fact that more students were engaged in education overall. Private education had more substrate to work with. An educated public seeks more education overall, public and private, and the combination of public and private educational enterprise allowed mental freedom to flourish. A transformed government-run healthcare would likewise establish a standard of health available to all citizens, providing a stimulus for the private health industry to prosper, with both private and public systems exploring novel health approaches by experimenting with ways to improve longevity, cognitive performance, emotional maturity, and athletic performance.
The initial transformation to a universal health revolution would begin by marketing the health evidence that the scientific community has already amassed. Dedicating 1 percent of current healthcare expenditures to health education would afford a $33-billion-dollar-per-year campaign, providing more than sufficient resources to educate and inspire U.S. citizens into an extraordinary new level of vitality with lifestyle at its foundation. As healthcare costs reduce, the expenditures that would have been allocated to treating preventable illnesses would become available for investment in novel research into transformative health techniques that can more fully realize the potential of humanity. The rollout will not be perfect. Neither was the initial rollout of universal public education. However, as centuries progress, our methods will improve our madness, and we will eventually create a system that evolves humanity with health and education as its foundation.
The education revolution of the U.S. was arguably more powerful than the democratic revolution. Indeed, there are more countries today that offer universal education to their children than there are countries with democratic systems. Some philosophies of the human condition are so universal that they insert themselves within and extend beyond political ideologies of the day. It is my hope that a health revolution in the United States will ripple through the world as a universal philosophy. Health is the greatest of all philosophies, for its wisdom will never fade in any age.
Jonathan Burgess is an Accelerated MPH student in General Public Health.