Overall, despite a level of spending that dwarfs the other countries in the study, the U.S. comes in dead last in three of the five, and arguably the most important three, of the five domains: health outcomes, equity, and access. We are tied for last on administrative efficiency and about average on care process. The U.S. is also last in their summary indicator aggregating all five dimensions.
Keeping with a habit that goes back to my tender years, I try to schedule my off time around music concerts and festivals. It allows me to feed a jones for live music instilled at a very young age. My first show was to see the jazz I played in school bands done properly by Count Basie, Ella Fitzgerald and Oscar Peterson with Joe Pass at the Gleason on Miami Beach. After that show with my parents, I was set loose on the town with my running mates. The next show was either Peter Frampton, J. Geils Band and Rick Derringer at the old Miami Baseball Stadium or Bob Seger & the Silver Bullet Band (on the Night Moves tour) at the long-defunct Hollywood Sportatorium (my recollection is that they were held the same year). Those shows were quickly followed by Lynyrd Skynyrd’s next to last show before that plane crash and some other random shows including one at Hialeah Race Track where they released the flamingoes between sets of Dave Mason and the Atlanta Rythm Section.
Over the years since, I’ve enjoyed indoor shows in college rathskellers (White Animals), small clubs (the haunted Tobacco Road in Miami and too many strip mall bars to count), gymnasiums (Hoodoo Gurus and REM standout in my memory), arenas (Springsteen and Stevie Ray Vaughan) and the iconic but terrible Orange Bowl (U2, the Rolling Stones, The Eagles).
Lately, I’ve enjoyed the burgeoning festival scene where kids descend on one field or another to do their thing. This helps me keep up with what the kids are listening to while enjoying myself at a more – let’s just say – leisurely pace than I used to exhibit. One thing that has not changed over the years, is that music (when properly conceived and executed) has the power to pull strangers together – whether it’s a few dozen in a small sweaty room or tens of thousands in a field. When that happens, the crowd can lift itself like a living thing. There are – frequently enough to keep coming back – moments when thousands of people come together en masse and meld their otherwise disparate experiences for a brief moment into a common one. Our shared experience of hearing the recorded music separated by time and distance is distilled – for a brief moment – into an epiphany. When the artificial wall between the audience and performer falls, it feels like levitating.
When I think about the piecemeal, special interest driven, top-down approach to devising a healthcare system in the United States, I often think about the spirit of those shows and festivals. People working together, even if briefly, to uncover some good. A shared experience. Rather than using access to healthcare to drive us apart, what would happen if the people in charge let the artificial barrier between themselves and the audience drop just so we could all share in a moment at the top of the human experience – with equal opportunity. Together. What would our health and happiness look like then?
