By Noel T. Braymer
Rail Passenger service at any speed is often condemned by pundits as a boondoggle: mismanaged, unwanted and a wasteful service which will bankrupt the country. So is rail service or even government spending on transportation costing that much money? According to the 2015 Federal Budget, transportation was the 8th largest cost item at $85 billion dollars. That’s a lot of money. But military spending was much greater at $609 billion dollars and was the third largest budget item in 2015. Number 2 at $1.05 trillion dollars was for Medicare and health spending. Number 1 at $1.28 trillion dollar which was almost a third of the Federal Budget was Social Security, unemployment insurance and labor spending. But this doesn’t tell the whole story since a major cost for State and local governments is health care. On that basis the number one cost of government at all levels is for health care. So for all that money the United States has the best health care in the world right? Well it does have the most expensive as well as the most profitable health care. In 2015 healthcare costs at all levels in this country was $3.207 trillion dollars. This comes out to around $10,000 per person in 2015.
But we are the healthiest nation in the world right? Well actually since the 1980’s it seems American life expectancy has been falling behind that of other countries. In 2014 life expectancy in this country was 79 years. In Chile life expectancy had reached 81 by 2014. In 2005 the life expectancy in Cuba was 79 while at the same time life expectancy in the United States was 77. Cuba has one of the highest smoking rates of almost any country in the world. But it also has one of the most extensive health care systems in the world for its population. Its health care system is government run and doesn’t make a profit. It also has fairly low labor costs since salaries for its managers and health care workers aren’t very high.
So what could be done to save money and improve health in this country? Ben Franklin’s axiom that “an ounce of prevention is worth a pound of cure” still applies. Obesity is at the heart of many of the heath ills in this country. We spend billions on medication and treatment for diabetes, heart disease, cancer and many other health problems which are largely caused by a combination of poor diet, substance abuse, and unhealthy life style. For a fraction of what we spend on medication we could encourage more people to cut down on junk food, eat healthier and get more exercise. The problem with this approach is junk food and health care are both multi-billion dollar industries in this country. Any local attempt to tax foods high in sugar is quickly met with a well funded campaign to ridicule such a plan. Yet much of the rise in obesity starting in the 1980’s can be traced to the introduction of high fructose corn syrup in most processed foods. High fructose corn syrup is cheaper and sweeter than old fashion table sugar. Eating it also increases appetite which often means people eat more. This is good for profits for food processors, but not for the waistlines of people around the world.
My history with weight gain is much the same as for many people around the world. From around 1968 to the mid 1980’s I had a waistline of 36 inches. Not bad for someone who is 6 foot 3. But in my late 30’s I started gaining weight which at the time I blamed on not getting enough exercise. From roughly 1990 to 2003 I had a waist of between 46 and 48 inches and exercise had little impact on helping me lose weight. Around 2003 after doing some research I basically cut out junk food and greatly reduced my consumption of foods with added sugar from my diet. Within months I went down to a 42 inch waist and never felt hungry as I lost weight. Then I stopped losing weight. I still wanted to get down to a 36 inch waist. I even bought a pair of 36 inch waist pants for the day I could wear them. Last fall I made some changes in my diet to control my appetite and I cut down on what I ate. I can now get into the pair of 36 inch pants that had been in my closet for years. I still have a few more pounds to lose to be where I was at in my 20’s, but I am very close now.
Getting back to the point of this essay, we can save money on things like health care while having a healthier population and spend more on other things people need like affordable housing and good transportation. Around the world people spend less money per person on medicine and health care than we do in this country. Also most developed countries also spend more money per capita on infrastructure with rail passenger service that works and roads that are in good shape. Most countries also have lower construction costs with more efficient construction methods than what we have in this country. The fact is costs for drugs in this country are much higher than these same drugs are in the rest of the world. The reason for this is in many countries the government buys the drugs and negotiates the price it pays and saves the taxpayers money buying in bulk. But in this country the drug companies can charge as much as they want and often do. Needless to say in this country some of the largest political donations to our elected official come from the health care industry. But you can save money on health care by eating healthy fresh foods, cutting down on bad habits and exercising by doing something you enjoy.
So the point of this essay is we can afford and benefit from better rail passenger service. Just the money spent on construction for transportation stimulates local economies. This is happening now in the San Joaquin Valley with High Speed Rail construction. But improvements in transportation also leads to increased economic activity. Major cities are always at places with major transportation hubs. Towns with dirt roads are almost always poor. There is a rational fear that growing medical costs in this country if they continue will damage the economy. Certainly money spent on medical care is money that can’t be spent on other important things. Medical bills are often more than what people can afford even with health insurance. That’s money people can’t spend for stuff which is the basis of our consumer economy, which is why the United States had the highest standard of living in the post World War 2 era. Back then housing, transportation and medical costs were much lower as part of the cost of living than what we have today which gave people in America more disposable income in the past..