When it comes to quality, in happiness rankings we don't do much better than we do in health rankings.  In fact happiness in the US has been declining ever so slowly over the last forty years and women have suffered the greatest declines.  You have another speaker coming to talk about happiness so I won't look at that now.

Why do we die so young?  Turns out that medical care doesn't do that much in making a country live that long. I tell people to ask “do you want health or health care?”  Turns out we don’t have either in the US. 

Our health has more to do with the stress in our lives, especially stress in early life, from the time you were conceived and before you go to school.   As we go from the erection to the resurrection, it is the first thousand days from conception to age two that are most critical for being healthy.   In those early years about half of our health as adults is programmed.  As a nation we don't have policies to make those first thousand days healthy ones.  We don't have paid leave policies for pregnant women.   All the other rich nations do.  We are only one of four countries in the world without paid parental leave policies.  The others are Papua New Guinea, Liberia and Swaziland.  Every other country has a law guaranteeing paid leave for mothers.  We don't.  Instead we preach family values.  Just tell the mom and dad to be good parents.  Moms and dads have to work, often at very stressful low paid jobs to make ends meet.  We have the most poverty of all rich nations and today we have a higher proportion of the people in this country in poverty than at any time in our history.  It is the poorer people who die younger for the most part because their moms and dads don’t have the time to parent.  Poverty kills.  Remember that.

Another way of looking at why we die so young is that we tolerate incredible economic inequality in the United States.  That is the reason we don't want to spend money on families and children or on poorer people in America.  The rich, who call the shots here, say that everyone should have to work hard to support their families.  We have the most inequality of all rich nations and the worst health.  The two are closely related.  Economic inequality is bad for our health.

How unequal are we?  What was the income of the highest paid person last year?  We all know what the minimum wage is but hardly anyone can tell you the maximum wage or the amount the highest earner makes.  There is a reason we don't pay attention to that.  We are not supposed to.  Last year the highest paid person made about $10,000 every 15 seconds.  Or about $2,450,000 per hour, or $4.9 billion dollars a year.  That is nice work if you can get it and as the Gershwin song says, you can get it if you try.  We believe if we work hard we can achieve anything including making billions of dollars a year.  That belief is killing us.

Inequality is at record highs.  Some people in this country are starting to question whether so much inequality is good for us.  Presidents, starting with Reagan, have preached to us that we should let the rich make all the money they can and they will invest it and create jobs for the rest of us.  The trickle-down concept.  About the only thing that is trickling down on us these days is the yellowish liquid coming from rich bladders.  You know what that is and it isn't creating health in America.  We die young for pissing in the USA.

The frenzy that has had us helping the rich get richer than they ever dreamed possible may be coming to an end.  That is the second point I want to make, namely that we are in the midst of a political revolution, not a rapid violent revolution where we see people dying from gun shots, drone missile strikes or bomb blasts but one proceeding at a gentler pace, with the violence coming from the unequal structure of society.  The world order as it has been since the Second World War is no longer serving the needs of we the people, whether we live in the US or in Greece, or in Egypt or in Pakistan.  The old world order is collapsing.  In various parts of the world people are massing together and protesting in ways they haven't done before.  Just as we are behind in our health status, compared to other nations, we are late in entering this revolution.  But we have started!

Our protests today started on Wall Street where the crisis began in 2008.  I was surprised that it took so long for us in the US to begin to question our political structure and the capitalist hysteria that was giving everything to the rich even when Wall Street was on the verge of collapsing.  Remember just those few years ago when we abandoned any concept of the free market and turned to socialism as we bailed out the rich.  It is difficult to calculate how much we gave the rich as part of their bailout package because those hogs are still feeding at the trillions trough.  As we gave them trillions they paid themselves billions in bonuses and we didn't bat an eyelash.  We forgot that the free market didn't apply to the rich.  The rich always need our help to stay rich.  But that is changing.

Last month a small group of protestors known as Occupy Wall Street began in New York, New York.  At first the media paid no attention. But protests are growing and spreading around the country.  Occupy Seattle with thousands protesting in solidarity with Occupy Wall Street has resulted in arrests being made.  That is the nature of protest at this stage.   If you draw attention to your issues by everyone getting arrested the media then report the arrests.  The protests are using social media in the same way the Spring Awakening in the Middle East did.  At this point there is no sense of where the protests are heading.   But one has to understand that there is a limit in the US to the amount of democracy that will be tolerated.  We see this all the time, most obviously during the Battle of Seattle 12 years ago when police were brutal.

The Trilateral Commission’s 1975 report, titled The Crisis Of Democracy was very specific that you can have “an excess of democracy.”  That was what the title meant, namely the crisis from people taking democracy seriously in the 1960s. I was a part of the protests in the 1960s.  If I learned one lesson from that era, it was that you can't become complacent, you can't think that the struggle is over when you get some media attention or get tossed a crumb.  There is only one thing the rich and powerful have wanted throughout history and that is everything.  They don't stop in their quest.  So we can't stop stopping them.

Since it is hard to predict the future, I want to recall the past to better understand how we got here.

You here know as much about what is going on in our society and what needs to be done as the experts who brought us the crisis.  What is happening now in the US, Latin America, and Europe?  As was true for Charles Dickens in the Tale of Two Cities, about the French Revolution, this is the best of times and the worst of times.

The last time there was this big a crisis of capitalism was 75 years ago, and the response was to create many mechanisms by which the government took care of ordinary people.  The reason that happened is that people organized, unions were vibrant, there was an excess of democracy, and this resulted in progressive legislation such as social security and the New Deal.

That previous big crisis of capitalism was preceded by the biggest polarization of wealth perhaps ever seen when the richest 1% held close to half of all the wealth in the country. The response to the New Deal legislation and economic justice policies that followed was that the richest 1%’s wealth declined to having only 23% of all the wealth by 1975.  The rich saw it coming, so they began organizing back in the 1960s to get their wealth share back.  In 1946 the highest tax bracket in the US was 96%, hard to believe but true.  I sometimes show students front pages of New York Times.   On April 28, 1942 the headline read:  $25,000 income limit asked by President.  Roosevelt proposed a 100% tax on all incomes above $25,000.  That didn’t pass, but a 94% tax passed that was later raised to 96%.  Today it is 35%. 

The key values in the country that were prevalent in the 1950s with the GI bills and low cost housing loans went as far as the Family Assistance Plan in 1969, which made the lead headline in the NYT on August 8.  It was to provide a guaranteed income for every American family.  Imagine a Republican, President Nixon, proposing that.  That legislation passed the House and languished in the Senate and when Nixon got embroiled in Watergate it never became law.

We are now back to greater levels of wealth inequality than back in the 1920s.  How did they do that in the US.  They distracted us into thinking of individual pursuits rather than organizing together.  We got in line to be one of the first to buy an iPad instead of demonstrating on Wall Street.

President Reagan said we should help the rich get richer and something will trickle down to us.   I remember in the 1980s how crazy this seemed.  You know what trickled down.  By preaching taxation as a bad thing, and the idea that we can all become rich some day, we bought into this. Many workers today believe the rich shouldn’t pay taxes because they believe they will strike it rich before they die. 

What happened with our crisis that burst forth 3 years ago is the result of processes set in place 4 decades ago as the richest 1%’s wealth share plummeted.   Our wages have not increased in inflation adjusted dollars for the last forty years.  The rich said their wealth share had declined so much that they weren’t going to pay us more in wages and they accomplished this in a variety of ways:

-they automated production, using technology and computers

-after WWII, the US was almost the only producer, but as other countries got up to speed, US companies faced competition.  So they got legislation passed to offshore production to remain competitive which is why you it is hard to find a made in USA label anymore.  The only big thing we’ve made recently is the global economic crisis.  It is definitely made in the USA and I’ll speak of it later.  We no longer make useful things here anymore which will make any economic recovery jobless unless we rethink work in our society.

-the rich supported waves of immigration of people who would work for less to under cut wages

-and women entered the work force in huge numbers and now outnumber men. 

To understand the scale of the changes, back in 1970 the median family with 2 parents and 2 children had only one parent working outside the home but that family had more disposable income than a median 2000, that is a y2k, family with two kids and both parents working.  Beyond putting more family members to work, another way to cope was to use consumer credit that became very easy so in effect you could borrow your salary.  You paid yourself from home equity loans that led to the housing bubble bursting and from credit card debt which reached record levels.

During this period the US went from being an industrial economy to a service economy, and financial services became prominent.  Many US corporations got into banking.

Back in the 1950s and 60s organized labor was one of the biggest contributors to the election process, but now the biggest contributors are big corporations so they have much more influence, while ordinary people have come to have very little sway, and the same is true of organized labor.

Political lobbying has become a huge industry as the number of lobbyists increased over ten fold since the 1970s.  Yet ordinary people, or the homeless, or the poor don't have their own lobbyists.  They can’t afford them.  So the poor or homeless get no benefits.  Only groups with highly paid lobbyists get noticed in DC.

Our democracy has become transformed so that corporate lobbyists masquerade as elected officials and we have the best democracy money can buy.  We should call our system a corporatocracy.

Let me give you an example.   General Electric was a company I remember as a child.  "We bring good things to light" was their slogan then. Today their line is "Imagination at work."  How does their imagination really work?  GE has grown immensely and last year made worldwide profits of $14.2 billion with $5.1 billion of that from its US operations.  Yet their US tax bill for last year was a credit of $3.2 billion.  They made $5.1 billion in US profits and we paid them $3.2 billion as their tax credit.  GE doesn't do much business with light bulbs anymore.  Much of its profit stems from the banking business.  It has offshored many tens of thousands of jobs.  Last year it spent $4.1 million on lobbyists.  That is what the invisible hand does, it gets lobbyists to wave it so GE doesn't pay any taxes.  Furthermore, their CEO is the chairman of President Obama's Council on Jobs and Competitiveness.  That is why our vote is no match for the power of the corporations. 

Neoliberal reforms came into being in the last decades that privatized something once it became profitable.  Massive subsidies for many industries and technologies were put in place that benefitted the rich both directly and indirectly.  Unprofitable research has been paid for by the government and when it becomes profitable, it is handed over to industry.  An prime example is the computer industry.  I worked with computers in the 1960s at a time that IBM and Control Data were heavily subsidized by the military because no profit could be made.  By the late 1970s the technology, whose development we paid for through our taxes, came to be used by visionaries such as Steve Jobs who could take that technology free of charge and create Apple Computer to make computers work for us.  The internet was similarly developed by the US army and in the late 1980s given away to industry, such as Google, who then made huge profits.  The modern commercial passenger airliners are basically modified military bombers that were developed entirely at taxpayer expense and Boeing makes huge profits.  Costs are socialized, profits are privatized.  Neither Apple Computer nor Boeing had to pay license fees to we the people who paid for developing the technology they used to made fantastic profits.

These neoliberal reforms have required cuts in spending for social services such as education, public transportation, and national parks.  At UW where I teach increased tuition fees and pay as you go programs are now becoming more common.

Another neoliberal reform has been to deregulate, since the market and the invisible hand is considered the best regulator.  Among key deregulations were those policies put in place back in the last great crisis of capitalism, especially the Glass-Steagall act.  It was passed in 1933 to separate investment banking from commercial banking and was designed to limit speculation.  These important protections were slowly whittled away with major emaciation in 1980, and ending with a bill that repealed the Act in 1999 by President Clinton.  Now banks could gamble with depositors money and create new instruments such as derivatives, credit default swaps and many others that allowed enormous amounts of virtual wealth to be generated on the order of hundreds of trillions of dollars.

The housing bubble that came crashing down in 2008 was just the tip of the iceberg of a crisis of capitalism.  Capitalism has this remarkable ability to sell us its mistakes, namely what we have been doing since then is giving the rich ever more and making sure that they don't pay for any of the problem that they created.

Naomi Klein wrote Shock Doctrine, the rise of disaster capitalism in 2007 which points out that during a crisis the rich can push through all sorts of legislation that benefits them, which is exactly what has happened since the made in America global crisis began in 2007.  Banksters received the bailouts, not you.

Another example of the Shock Doctrine at work was the Extreme Court's 2010 decision on Citizens United that allowed corporations unlimited spending to influence the political process in the United States.  The corporate influence in the future will become ever more powerful and opaque, since now they don't have to disclose their spending.

What happened after the crisis in the US?  We have bailed out the rich to a huge amount, estimates range in the trillions with some around 10-11 trillion dollars.  But somehow that was not enough and so we now are being told we need more austerity in order to lower the national debt.

It is amazing how brazen the rich can be, they want everything and they are willing to gamble even their security in that quest.

Capitalism can adapt to just about anything with today's example where it is selling back to us its failures. Some people wanted to hedge their bets on the bubble and profit from it.  So last year's highest income earner made $4.9 billion dollars as a hedge fund manager.  He bet on the falling housing market and made tons of money.  Compared to the minimum wage in Washington State, that is an income gap of almost 400,000 to 1, a world record.  Yet nobody is upset at that.  All of you in this room likely paid more tax last year than the highest income earner did.  Capitalism is this very unpredictable beast that will come out on top of all of us.  We thank the invisible hand for this providence.  We need to rethink whether or not we want to be slaves of the market and of capitalism.   

Limits are emerging in the US.  In February in Wisconsin there was the biggest support for organized labor since the 1960s and now Occupy Wall Street and Occupy Seattle and many more throughout the country.  These demonstrations will grow as we use the Shock Doctrine to our advantage instead of the rich.

Today people in this country are confused, and not knowing where to turn while the rich are trying to hold the front of the battle any various means they can.  These include getting the corporations to spawn the tea party to distract people from core issues.  We have corporate astro-turf where corporations pay companies to blog and tweet as individuals with extreme right wing views.  People think this is what others believe so they began to change their perspectives. 

The media continues its focus on individual stories, singling out the unfortunate and distracting us from the big process going on.  What would be a minor story, a congressman sending pictures of himself in his underwear to others becomes a major scandal. Celebrity gossip holds sway.  Telephone hacking, while symptomatic of corporate malfeasance, becomes a scandal of individuals rather than being presented as a example of the decay of capitalism.

There is a transition in the commercial media from major analyses of what is going on to focusing on bringing back consumption to its previous levels.  I read the New York Times every morning.  It has really changed immensely so that now a more accurate name for it would be “Better Homes and Gardens for ultra-rich New Yorkers.”  Independent journalism is fast disappearing, so now we have a press corpse.

People say the internet is replacing the press corpse, but search engines tailor what you get when you search to your own proclivities.  Two people sitting next to each other making the exact same search get different results that are designed to please them.  So we are limited in what information we can access easily.

Social media has become incredibly popular but in this country it is not being used for progressive purposes the way it is elsewhere.  That may change.  What is happening elsewhere?

In Latin America beginning in the 1980s, they began to question the neoliberal perspective and started popular organizing so today the most progressive governments and activism are taking place there.  They did not suffer so much for the economic meltdown in 2008.  We should look to them for ideas.

In Europe the rich saw their situation deteriorating.  In the US the rich were just doing so much better, so the European rich decided to craft policies that were bound to fail, especially in Ireland, Spain, Portugal and Greece so they could profit.  Then the rich began preaching austerity to the less fortunate in various ways that seem nonsensical to us.  They wanted to raise the retirement age in France from 60 to 62.  In Europe people work to live and want to enjoy life, whereas here we live to work, and now that the unemployment rate is so high, we are unhappy, whereas in Europe people expect benefits from their governments when they don't work.

Germany is a country whose economy hasn't tanked because they were not focused on consumerism.  The people have pushed to have green power by 2020 and not depend on any nuclear plants.

Greece with their pensions and civil service jobs, are presented to us as crazy demands because our pensions are so low or even non-existent, so we laugh at their demands and ignore the massive demonstrations.  In England they want to raise tuition at colleges and this produces massive protests.

Debt in Europe is seen as something taken on to invest in the future, something we used to do as well, but the rich see the opportunity there to cut benefits to ordinary people as a means of paying back the debt.  Europe’s ordinary people say to the rich:  “you brought us the crisis but you are not going to make us pay for it.” Millions take to the streets in France, Greece and England, while our media downplays these efforts.

How the so-called debt crisis will be resolved, both here and in Europe, is unclear.  We are seeing the emergence of a new world order.

In Northern Africa and the Middle East there have been massive uprisings linked to the repression of the last 30-40 years.  The rich and powerful are scheming to get their power back.  The military in Egypt are in control today and it is unclear if elections will happen. 

Japan had a disaster in March producing the nuclear meltdown from the tsunami.  Because Japan had been trying to get the economy out of recession for a long time, they were planning to give corporations there a tax holiday.  But after the tsunami, the corporations said they would forgo the tax breaks so the government could use the money to rebuild.  Can you imagine such a thing in the United States?

What is happening to rethink capitalism?  I used to believe that people in the US were lugubrious and not looking at what is going on but that isn't true.  We aren't buying stuff we don't need with money we don't have the way we used to. Having all the latest gadgets, or the newest clothes we wear once or twice, or cosmetics promising hope in a jar, or two garage cars, isn’t what life is all about.  Because we are not spending money we don’t have frivolously, business has less demand and thus less reason to produce goods that we don’t need.  No one is hiring workers, at least poor workers.  This is today’s rut.  Americans are smartening up and realizing that it isn’t stuff that makes you happy or helps you live the good life.  But they don’t know where to turn.

Meanwhile the experts who made all this happen have been useless at changing the situation except in ways that benefit the rich by trying to restart the engine of economic growth.

The world today is quite unstable, the climate is changing, human populations are growing, food production is tenuous, and we are running out of water where it is needed.   In rethinking capitalism we must recognize that economic growth has raised our standard of living as much as will benefit our health and well-being.  More growth will not be better for us, nor better for the planet.

We desperately need to start thinking of a post-capitalist system, or structuring an economy that benefits our lives.  The economy as it has existed over the last 40 years doesn't even benefit the rich and powerful in this country.  The most recent studies that came out in June from UW's Institute of Health Metrics and Evaluation showed that length of life is now declining for women in close to a third of US counties.   Other studies show our rich aren’t as healthy as ordinary people in much of Europe.

In the midst of our major revolution it is hard to see what is happening.  These revolutions take a long time and it is only after one has occurred that you see what has happened.  To understand this think of past scientific revolutions:

The media revolution began by changing the copying of manuscripts by hand to using the printing press.  That was strongly resisted and it took hundreds of years to take hold.  Now we are in a new state of that revolution as we transition from printed pages to digital format.

The Copernican revolution, where we came to see the sun at the center of the planetary system rather than the earth, also took hundreds of years to be accepted though it didn't matter to us except conceptually until we tried to launch rockets to the moon and other planets. 

Capitalism took hold with the industrial revolution hundreds of year ago.  The focus on economic growth really only began some 75 years ago when Simon Kuznets created a new measure, the GNP or very Gross National Product, as a new goal for the US government in the 1930s to increase economic output.  The GNP became the indicator that was followed.  We got what we measured, namely a focus on economic growth meaning producing more goods and services.  That might have been a good idea back in the 1930s, but it isn't what we should be looking at now.

What should we be measuring today?  That should be the topic of global discussion.  Where do we want to go as a species on this finite earth?  I would hope the measure would be for everyone to have enough of the basics for a good life, one that is sustainable, and doesn't create havoc for the planet.  We need to focus on measures of economic justice.   We will eventually see a post-carbon economic transformation.

This requires rethinking many aspects of society, namely how we organize ourselves and what we focus on.  Among concepts that require rethinking are:

-the nation state as a unit of organization, does it serve human welfare?  I don’t think it does.

-corporations as entities, especially now that corporations have the rights of individuals forever whereas our rights are gone when we die, Steve Jobs has no more rights but Apple has them in perpetuity.  We don't live that long as individuals in the United States compared to other countries so that needs fixing.  Local businesses may be the answer.

-the small units we associate with, the family, the community and society.  The community and society needs to scale down in size in order for our voices to be heard and manageable decisions made.  We need to become societalists.

-how our time gets used, and whether technology is making our lives better, and what sorts of technology really matter for that.  We need time to interact face to face with one another.

-money and finances, since money today is really debt held by banks, is that in our best interests?  Future transaction may need to be locally based perhaps on barter. 

Latin America is soundly rethinking capitalism, that produces a lot of tension between those who are too rich and those who don't have enough.  Economic inequality is declining in Brazil and some other Latin American countries.  It is healthy to be engaged in these ideas there.

Europe will be better able to engage in this revolution because there is more vibrant political discussion there, both on the streets, in the workplace, and in homes.

In the United States we have people in my age range who can remember the turmoil of the 1960s and the sense of a purposeful society dedicated to creating the good life for all of us.  Then demonstrations supported the civil rights movement, the opposition to our military engagement abroad and asked what the purpose of democracy was.

Today we have a large segment of young people who sense that their lives may not be as good as those of their parents.  They are trying to figure out what the world will be like and what they have to do to survive. 

Perhaps we need those like my age-cohort to interact with the youth and work together.  Old and young together, and then sweep in the middle.  

Learn from Steve Jobs who can teach us as a role model.  As a youth he was visionary and developed a basic computer, then enhanced it as a Macintosh that we drooled over because it was so cool.  He then suffered failure as he was ejected from Apple.  He didn’t dwell on his mistakes but kept trying and coming up with new ideas and new ways of seeing things.  His passion brought him back to Apple and he took over the helm not trying to make bank but got paid only a dollar a year as his income.  He wanted to innovate that much he would accept a dollar a year as his pay.  The lesson there is do what you love, the money will follow.  He never focused on making money but on making a difference in the world.  He commanded our respect right to the end.  That he died so young is a statement of the health of our union.  We don’t want that for our children and grandchildren.

We must recognize that there are only two superpowers left in the world.  One is the rich and powerful that control huge military might and awesome weapons of both mass destruction and mass distraction.  They number at most a few million.  The other superpower is vast, numbering six billion.  I'm talking of all of you here in this hall and around the world.  We have to recognize our collective superpower status that will only come when we work together.  Being physically together as in Tahrir Square in Egypt was a good example of sensing superpower status.  Other countries in the Middle East have responded as well as do people in Europe.  We are a threat to the rich and powerful.

What can we do?

We have already started by not moving the consumer muscle as much as we used to.  Next we need to move the citizen muscle.  You can start by becoming involved in Occupy your city demonstrations.

We need to understand what is going on.  There are three levels of understanding.

Most of us perceive there is a problem.  We need a rationale, a way of understanding what the core problem is and why it has happened.  Then we need to respond, use some strategy to deal with the problem. 

We need to develop a response ability.  We need to have the ability to respond.  Our ability to respond, ouy responsibility, can take a variety of forms.  We can talk in our families, at work, in our communities, in schools such as this one, and especially face to face.  Despite all the technologies at our disposal, acting face to face is the most effective response.

We need to ask the right question.  Far better an approximate answer to the right question, which is often vague, than an exact answer to the wrong question.  The rich try to distract us as Thomas Pynchon wrote:  “if they can get you asking the wrong question, they don’t have to worry about the answer.”  If you don't ask you don't know, and if you don't know, you can't act.

We can blog, we can tweet, and we can use social media.  But these media won’t help us work together unless we also have face to face discussions?  We need to use both in new ways.  There is no recipe for success here.

We are drowning in information, yet starving for wisdom.  Mark Twain said:  "It ain't what people don't know that worries me, it's what they know that just ain't so."  To paraphrase  Twain, don’t believe everything you think.   Consider things not with a grain of salt, but with a bucket of salt.  Misinformation abounds.  Use your critical thinking skills.

Seek out those who can synthesize, who can put together the right information at the right time, and think critically about how to make important choices wisely.

Great things always begin from inside.  Think of an egg.  If an egg breaks from an outside force, the life inside ends.  But if it breaks from inside, life begins.   So great things happen from the inside.  We need to get inside and break out.

Today's crisis is a terrible thing to waste.  The rich and powerful have been using it for their ends.  But we need to use it for benefit of we the people on this earth.

We can't rely on hope.  Hope is an opiate, like heroin. We have to rely on ourselves to work together.  Solidarity is the best medicine.  The way to fight organized money is with organized people. 

The way forward will depend on acting, that is doing something and then doubting whether or not it works, then acting again perhaps differently and doubting whether that works or not.  The metaphor of the political right or the political left may not serve us.  You can't fly a plane with just a right wing.  Or just a left wing.  We will always be setting a correction as we move forward.

Gandhi said you may never know the results of your action.  But if you do nothing there will be no results.   We won't know what has been the outcome of this process for a long time.  The history books will write it up.  But in the meantime don't be missing from the action.

Thank you.

Stephen Bezruchka MD, MPH

Departments of Health Services & Global Health

School of Public Health

University of Washington

When it comes to quality, in happiness rankings we don't do much better than we do in health rankings.  In fact happiness in the US has been declining ever so slowly over the last forty years and women have suffered the greatest declines.  You have another speaker coming to talk about happiness so I won't look at that now.

Why do we die so young?  Turns out that medical care doesn't do that much in making a country live that long. I tell people to ask “do you want health or health care?”  Turns out we don’t have either in the US. 

Our health has more to do with the stress in our lives, especially stress in early life, from the time you were conceived and before you go to school.   As we go from the erection to the resurrection, it is the first thousand days from conception to age two that are most critical for being healthy.   In those early years about half of our health as adults is programmed.  As a nation we don't have policies to make those first thousand days healthy ones.  We don't have paid leave policies for pregnant women.   All the other rich nations do.  We are only one of four countries in the world without paid parental leave policies.  The others are Papua New Guinea, Liberia and Swaziland.  Every other country has a law guaranteeing paid leave for mothers.  We don't.  Instead we preach family values.  Just tell the mom and dad to be good parents.  Moms and dads have to work, often at very stressful low paid jobs to make ends meet.  We have the most poverty of all rich nations and today we have a higher proportion of the people in this country in poverty than at any time in our history.  It is the poorer people who die younger for the most part because their moms and dads don’t have the time to parent.  Poverty kills.  Remember that.

Another way of looking at why we die so young is that we tolerate incredible economic inequality in the United States.  That is the reason we don't want to spend money on families and children or on poorer people in America.  The rich, who call the shots here, say that everyone should have to work hard to support their families.  We have the most inequality of all rich nations and the worst health.  The two are closely related.  Economic inequality is bad for our health.

How unequal are we?  What was the income of the highest paid person last year?  We all know what the minimum wage is but hardly anyone can tell you the maximum wage or the amount the highest earner makes.  There is a reason we don't pay attention to that.  We are not supposed to.  Last year the highest paid person made about $10,000 every 15 seconds.  Or about $2,450,000 per hour, or $4.9 billion dollars a year.  That is nice work if you can get it and as the Gershwin song says, you can get it if you try.  We believe if we work hard we can achieve anything including making billions of dollars a year.  That belief is killing us.

Inequality is at record highs.  Some people in this country are starting to question whether so much inequality is good for us.  Presidents, starting with Reagan, have preached to us that we should let the rich make all the money they can and they will invest it and create jobs for the rest of us.  The trickle-down concept.  About the only thing that is trickling down on us these days is the yellowish liquid coming from rich bladders.  You know what that is and it isn't creating health in America.  We die young for pissing in the USA.

The frenzy that has had us helping the rich get richer than they ever dreamed possible may be coming to an end.  That is the second point I want to make, namely that we are in the midst of a political revolution, not a rapid violent revolution where we see people dying from gun shots, drone missile strikes or bomb blasts but one proceeding at a gentler pace, with the violence coming from the unequal structure of society.  The world order as it has been since the Second World War is no longer serving the needs of we the people, whether we live in the US or in Greece, or in Egypt or in Pakistan.  The old world order is collapsing.  In various parts of the world people are massing together and protesting in ways they haven't done before.  Just as we are behind in our health status, compared to other nations, we are late in entering this revolution.  But we have started!

Our protests today started on Wall Street where the crisis began in 2008.  I was surprised that it took so long for us in the US to begin to question our political structure and the capitalist hysteria that was giving everything to the rich even when Wall Street was on the verge of collapsing.  Remember just those few years ago when we abandoned any concept of the free market and turned to socialism as we bailed out the rich.  It is difficult to calculate how much we gave the rich as part of their bailout package because those hogs are still feeding at the trillions trough.  As we gave them trillions they paid themselves billions in bonuses and we didn't bat an eyelash.  We forgot that the free market didn't apply to the rich.  The rich always need our help to stay rich.  But that is changing.

Last month a small group of protestors known as Occupy Wall Street began in New York, New York.  At first the media paid no attention. But protests are growing and spreading around the country.  Occupy Seattle with thousands protesting in solidarity with Occupy Wall Street has resulted in arrests being made.  That is the nature of protest at this stage.   If you draw attention to your issues by everyone getting arrested the media then report the arrests.  The protests are using social media in the same way the Spring Awakening in the Middle East did.  At this point there is no sense of where the protests are heading.   But one has to understand that there is a limit in the US to the amount of democracy that will be tolerated.  We see this all the time, most obviously during the Battle of Seattle 12 years ago when police were brutal.

The Trilateral Commission’s 1975 report, titled The Crisis Of Democracy was very specific that you can have “an excess of democracy.”  That was what the title meant, namely the crisis from people taking democracy seriously in the 1960s. I was a part of the protests in the 1960s.  If I learned one lesson from that era, it was that you can't become complacent, you can't think that the struggle is over when you get some media attention or get tossed a crumb.  There is only one thing the rich and powerful have wanted throughout history and that is everything.  They don't stop in their quest.  So we can't stop stopping them.

Since it is hard to predict the future, I want to recall the past to better understand how we got here.

You here know as much about what is going on in our society and what needs to be done as the experts who brought us the crisis.  What is happening now in the US, Latin America, and Europe?  As was true for Charles Dickens in the Tale of Two Cities, about the French Revolution, this is the best of times and the worst of times.

The last time there was this big a crisis of capitalism was 75 years ago, and the response was to create many mechanisms by which the government took care of ordinary people.  The reason that happened is that people organized, unions were vibrant, there was an excess of democracy, and this resulted in progressive legislation such as social security and the New Deal.

That previous big crisis of capitalism was preceded by the biggest polarization of wealth perhaps ever seen when the richest 1% held close to half of all the wealth in the country. The response to the New Deal legislation and economic justice policies that followed was that the richest 1%’s wealth declined to having only 23% of all the wealth by 1975.  The rich saw it coming, so they began organizing back in the 1960s to get their wealth share back.  In 1946 the highest tax bracket in the US was 96%, hard to believe but true.  I sometimes show students front pages of New York Times.   On April 28, 1942 the headline read:  $25,000 income limit asked by President.  Roosevelt proposed a 100% tax on all incomes above $25,000.  That didn’t pass, but a 94% tax passed that was later raised to 96%.  Today it is 35%. 

The key values in the country that were prevalent in the 1950s with the GI bills and low cost housing loans went as far as the Family Assistance Plan in 1969, which made the lead headline in the NYT on August 8.  It was to provide a guaranteed income for every American family.  Imagine a Republican, President Nixon, proposing that.  That legislation passed the House and languished in the Senate and when Nixon got embroiled in Watergate it never became law.

We are now back to greater levels of wealth inequality than back in the 1920s.  How did they do that in the US.  They distracted us into thinking of individual pursuits rather than organizing together.  We got in line to be one of the first to buy an iPad instead of demonstrating on Wall Street.

President Reagan said we should help the rich get richer and something will trickle down to us.   I remember in the 1980s how crazy this seemed.  You know what trickled down.  By preaching taxation as a bad thing, and the idea that we can all become rich some day, we bought into this. Many workers today believe the rich shouldn’t pay taxes because they believe they will strike it rich before they die. 

What happened with our crisis that burst forth 3 years ago is the result of processes set in place 4 decades ago as the richest 1%’s wealth share plummeted.   Our wages have not increased in inflation adjusted dollars for the last forty years.  The rich said their wealth share had declined so much that they weren’t going to pay us more in wages and they accomplished this in a variety of ways:

-they automated production, using technology and computers

-after WWII, the US was almost the only producer, but as other countries got up to speed, US companies faced competition.  So they got legislation passed to offshore production to remain competitive which is why you it is hard to find a made in USA label anymore.  The only big thing we’ve made recently is the global economic crisis.  It is definitely made in the USA and I’ll speak of it later.  We no longer make useful things here anymore which will make any economic recovery jobless unless we rethink work in our society.

-the rich supported waves of immigration of people who would work for less to under cut wages

-and women entered the work force in huge numbers and now outnumber men. 

To understand the scale of the changes, back in 1970 the median family with 2 parents and 2 children had only one parent working outside the home but that family had more disposable income than a median 2000, that is a y2k, family with two kids and both parents working.  Beyond putting more family members to work, another way to cope was to use consumer credit that became very easy so in effect you could borrow your salary.  You paid yourself from home equity loans that led to the housing bubble bursting and from credit card debt which reached record levels.

During this period the US went from being an industrial economy to a service economy, and financial services became prominent.  Many US corporations got into banking.

Back in the 1950s and 60s organized labor was one of the biggest contributors to the election process, but now the biggest contributors are big corporations so they have much more influence, while ordinary people have come to have very little sway, and the same is true of organized labor.

Political lobbying has become a huge industry as the number of lobbyists increased over ten fold since the 1970s.  Yet ordinary people, or the homeless, or the poor don't have their own lobbyists.  They can’t afford them.  So the poor or homeless get no benefits.  Only groups with highly paid lobbyists get noticed in DC.

Our democracy has become transformed so that corporate lobbyists masquerade as elected officials and we have the best democracy money can buy.  We should call our system a corporatocracy.

Let me give you an example.   General Electric was a company I remember as a child.  "We bring good things to light" was their slogan then. Today their line is "Imagination at work."  How does their imagination really work?  GE has grown immensely and last year made worldwide profits of $14.2 billion with $5.1 billion of that from its US operations.  Yet their US tax bill for last year was a credit of $3.2 billion.  They made $5.1 billion in US profits and we paid them $3.2 billion as their tax credit.  GE doesn't do much business with light bulbs anymore.  Much of its profit stems from the banking business.  It has offshored many tens of thousands of jobs.  Last year it spent $4.1 million on lobbyists.  That is what the invisible hand does, it gets lobbyists to wave it so GE doesn't pay any taxes.  Furthermore, their CEO is the chairman of President Obama's Council on Jobs and Competitiveness.  That is why our vote is no match for the power of the corporations. 

Neoliberal reforms came into being in the last decades that privatized something once it became profitable.  Massive subsidies for many industries and technologies were put in place that benefitted the rich both directly and indirectly.  Unprofitable research has been paid for by the government and when it becomes profitable, it is handed over to industry.  An prime example is the computer industry.  I worked with computers in the 1960s at a time that IBM and Control Data were heavily subsidized by the military because no profit could be made.  By the late 1970s the technology, whose development we paid for through our taxes, came to be used by visionaries such as Steve Jobs who could take that technology free of charge and create Apple Computer to make computers work for us.  The internet was similarly developed by the US army and in the late 1980s given away to industry, such as Google, who then made huge profits.  The modern commercial passenger airliners are basically modified military bombers that were developed entirely at taxpayer expense and Boeing makes huge profits.  Costs are socialized, profits are privatized.  Neither Apple Computer nor Boeing had to pay license fees to we the people who paid for developing the technology they used to made fantastic profits.

These neoliberal reforms have required cuts in spending for social services such as education, public transportation, and national parks.  At UW where I teach increased tuition fees and pay as you go programs are now becoming more common.

Another neoliberal reform has been to deregulate, since the market and the invisible hand is considered the best regulator.  Among key deregulations were those policies put in place back in the last great crisis of capitalism, especially the Glass-Steagall act.  It was passed in 1933 to separate investment banking from commercial banking and was designed to limit speculation.  These important protections were slowly whittled away with major emaciation in 1980, and ending with a bill that repealed the Act in 1999 by President Clinton.  Now banks could gamble with depositors money and create new instruments such as derivatives, credit default swaps and many others that allowed enormous amounts of virtual wealth to be generated on the order of hundreds of trillions of dollars.

The housing bubble that came crashing down in 2008 was just the tip of the iceberg of a crisis of capitalism.  Capitalism has this remarkable ability to sell us its mistakes, namely what we have been doing since then is giving the rich ever more and making sure that they don't pay for any of the problem that they created.

Naomi Klein wrote Shock Doctrine, the rise of disaster capitalism in 2007 which points out that during a crisis the rich can push through all sorts of legislation that benefits them, which is exactly what has happened since the made in America global crisis began in 2007.  Banksters received the bailouts, not you.

Another example of the Shock Doctrine at work was the Extreme Court's 2010 decision on Citizens United that allowed corporations unlimited spending to influence the political process in the United States.  The corporate influence in the future will become ever more powerful and opaque, since now they don't have to disclose their spending.

What happened after the crisis in the US?  We have bailed out the rich to a huge amount, estimates range in the trillions with some around 10-11 trillion dollars.  But somehow that was not enough and so we now are being told we need more austerity in order to lower the national debt.

It is amazing how brazen the rich can be, they want everything and they are willing to gamble even their security in that quest.

Capitalism can adapt to just about anything with today's example where it is selling back to us its failures. Some people wanted to hedge their bets on the bubble and profit from it.  So last year's highest income earner made $4.9 billion dollars as a hedge fund manager.  He bet on the falling housing market and made tons of money.  Compared to the minimum wage in Washington State, that is an income gap of almost 400,000 to 1, a world record.  Yet nobody is upset at that.  All of you in this room likely paid more tax last year than the highest income earner did.  Capitalism is this very unpredictable beast that will come out on top of all of us.  We thank the invisible hand for this providence.  We need to rethink whether or not we want to be slaves of the market and of capitalism.   

Limits are emerging in the US.  In February in Wisconsin there was the biggest support for organized labor since the 1960s and now Occupy Wall Street and Occupy Seattle and many more throughout the country.  These demonstrations will grow as we use the Shock Doctrine to our advantage instead of the rich.

Today people in this country are confused, and not knowing where to turn while the rich are trying to hold the front of the battle any various means they can.  These include getting the corporations to spawn the tea party to distract people from core issues.  We have corporate astro-turf where corporations pay companies to blog and tweet as individuals with extreme right wing views.  People think this is what others believe so they began to change their perspectives. 

The media continues its focus on individual stories, singling out the unfortunate and distracting us from the big process going on.  What would be a minor story, a congressman sending pictures of himself in his underwear to others becomes a major scandal. Celebrity gossip holds sway.  Telephone hacking, while symptomatic of corporate malfeasance, becomes a scandal of individuals rather than being presented as a example of the decay of capitalism.

There is a transition in the commercial media from major analyses of what is going on to focusing on bringing back consumption to its previous levels.  I read the New York Times every morning.  It has really changed immensely so that now a more accurate name for it would be “Better Homes and Gardens for ultra-rich New Yorkers.”  Independent journalism is fast disappearing, so now we have a press corpse.

People say the internet is replacing the press corpse, but search engines tailor what you get when you search to your own proclivities.  Two people sitting next to each other making the exact same search get different results that are designed to please them.  So we are limited in what information we can access easily.

Social media has become incredibly popular but in this country it is not being used for progressive purposes the way it is elsewhere.  That may change.  What is happening elsewhere?

In Latin America beginning in the 1980s, they began to question the neoliberal perspective and started popular organizing so today the most progressive governments and activism are taking place there.  They did not suffer so much for the economic meltdown in 2008.  We should look to them for ideas.

In Europe the rich saw their situation deteriorating.  In the US the rich were just doing so much better, so the European rich decided to craft policies that were bound to fail, especially in Ireland, Spain, Portugal and Greece so they could profit.  Then the rich began preaching austerity to the less fortunate in various ways that seem nonsensical to us.  They wanted to raise the retirement age in France from 60 to 62.  In Europe people work to live and want to enjoy life, whereas here we live to work, and now that the unemployment rate is so high, we are unhappy, whereas in Europe people expect benefits from their governments when they don't work.

Germany is a country whose economy hasn't tanked because they were not focused on consumerism.  The people have pushed to have green power by 2020 and not depend on any nuclear plants.

Greece with their pensions and civil service jobs, are presented to us as crazy demands because our pensions are so low or even non-existent, so we laugh at their demands and ignore the massive demonstrations.  In England they want to raise tuition at colleges and this produces massive protests.

Debt in Europe is seen as something taken on to invest in the future, something we used to do as well, but the rich see the opportunity there to cut benefits to ordinary people as a means of paying back the debt.  Europe’s ordinary people say to the rich:  “you brought us the crisis but you are not going to make us pay for it.” Millions take to the streets in France, Greece and England, while our media downplays these efforts.

How the so-called debt crisis will be resolved, both here and in Europe, is unclear.  We are seeing the emergence of a new world order.

In Northern Africa and the Middle East there have been massive uprisings linked to the repression of the last 30-40 years.  The rich and powerful are scheming to get their power back.  The military in Egypt are in control today and it is unclear if elections will happen. 

Japan had a disaster in March producing the nuclear meltdown from the tsunami.  Because Japan had been trying to get the economy out of recession for a long time, they were planning to give corporations there a tax holiday.  But after the tsunami, the corporations said they would forgo the tax breaks so the government could use the money to rebuild.  Can you imagine such a thing in the United States?

What is happening to rethink capitalism?  I used to believe that people in the US were lugubrious and not looking at what is going on but that isn't true.  We aren't buying stuff we don't need with money we don't have the way we used to. Having all the latest gadgets, or the newest clothes we wear once or twice, or cosmetics promising hope in a jar, or two garage cars, isn’t what life is all about.  Because we are not spending money we don’t have frivolously, business has less demand and thus less reason to produce goods that we don’t need.  No one is hiring workers, at least poor workers.  This is today’s rut.  Americans are smartening up and realizing that it isn’t stuff that makes you happy or helps you live the good life.  But they don’t know where to turn.

Meanwhile the experts who made all this happen have been useless at changing the situation except in ways that benefit the rich by trying to restart the engine of economic growth.

The world today is quite unstable, the climate is changing, human populations are growing, food production is tenuous, and we are running out of water where it is needed.   In rethinking capitalism we must recognize that economic growth has raised our standard of living as much as will benefit our health and well-being.  More growth will not be better for us, nor better for the planet.

We desperately need to start thinking of a post-capitalist system, or structuring an economy that benefits our lives.  The economy as it has existed over the last 40 years doesn't even benefit the rich and powerful in this country.  The most recent studies that came out in June from UW's Institute of Health Metrics and Evaluation showed that length of life is now declining for women in close to a third of US counties.   Other studies show our rich aren’t as healthy as ordinary people in much of Europe.

In the midst of our major revolution it is hard to see what is happening.  These revolutions take a long time and it is only after one has occurred that you see what has happened.  To understand this think of past scientific revolutions:

The media revolution began by changing the copying of manuscripts by hand to using the printing press.  That was strongly resisted and it took hundreds of years to take hold.  Now we are in a new state of that revolution as we transition from printed pages to digital format.

The Copernican revolution, where we came to see the sun at the center of the planetary system rather than the earth, also took hundreds of years to be accepted though it didn't matter to us except conceptually until we tried to launch rockets to the moon and other planets. 

Capitalism took hold with the industrial revolution hundreds of year ago.  The focus on economic growth really only began some 75 years ago when Simon Kuznets created a new measure, the GNP or very Gross National Product, as a new goal for the US government in the 1930s to increase economic output.  The GNP became the indicator that was followed.  We got what we measured, namely a focus on economic growth meaning producing more goods and services.  That might have been a good idea back in the 1930s, but it isn't what we should be looking at now.

What should we be measuring today?  That should be the topic of global discussion.  Where do we want to go as a species on this finite earth?  I would hope the measure would be for everyone to have enough of the basics for a good life, one that is sustainable, and doesn't create havoc for the planet.  We need to focus on measures of economic justice.   We will eventually see a post-carbon economic transformation.

This requires rethinking many aspects of society, namely how we organize ourselves and what we focus on.  Among concepts that require rethinking are:

-the nation state as a unit of organization, does it serve human welfare?  I don’t think it does.

-corporations as entities, especially now that corporations have the rights of individuals forever whereas our rights are gone when we die, Steve Jobs has no more rights but Apple has them in perpetuity.  We don't live that long as individuals in the United States compared to other countries so that needs fixing.  Local businesses may be the answer.

-the small units we associate with, the family, the community and society.  The community and society needs to scale down in size in order for our voices to be heard and manageable decisions made.  We need to become societalists.

-how our time gets used, and whether technology is making our lives better, and what sorts of technology really matter for that.  We need time to interact face to face with one another.

-money and finances, since money today is really debt held by banks, is that in our best interests?  Future transaction may need to be locally based perhaps on barter. 

Latin America is soundly rethinking capitalism, that produces a lot of tension between those who are too rich and those who don't have enough.  Economic inequality is declining in Brazil and some other Latin American countries.  It is healthy to be engaged in these ideas there.

Europe will be better able to engage in this revolution because there is more vibrant political discussion there, both on the streets, in the workplace, and in homes.

In the United States we have people in my age range who can remember the turmoil of the 1960s and the sense of a purposeful society dedicated to creating the good life for all of us.  Then demonstrations supported the civil rights movement, the opposition to our military engagement abroad and asked what the purpose of democracy was.

Today we have a large segment of young people who sense that their lives may not be as good as those of their parents.  They are trying to figure out what the world will be like and what they have to do to survive. 

Perhaps we need those like my age-cohort to interact with the youth and work together.  Old and young together, and then sweep in the middle.  

Learn from Steve Jobs who can teach us as a role model.  As a youth he was visionary and developed a basic computer, then enhanced it as a Macintosh that we drooled over because it was so cool.  He then suffered failure as he was ejected from Apple.  He didn’t dwell on his mistakes but kept trying and coming up with new ideas and new ways of seeing things.  His passion brought him back to Apple and he took over the helm not trying to make bank but got paid only a dollar a year as his income.  He wanted to innovate that much he would accept a dollar a year as his pay.  The lesson there is do what you love, the money will follow.  He never focused on making money but on making a difference in the world.  He commanded our respect right to the end.  That he died so young is a statement of the health of our union.  We don’t want that for our children and grandchildren.

We must recognize that there are only two superpowers left in the world.  One is the rich and powerful that control huge military might and awesome weapons of both mass destruction and mass distraction.  They number at most a few million.  The other superpower is vast, numbering six billion.  I'm talking of all of you here in this hall and around the world.  We have to recognize our collective superpower status that will only come when we work together.  Being physically together as in Tahrir Square in Egypt was a good example of sensing superpower status.  Other countries in the Middle East have responded as well as do people in Europe.  We are a threat to the rich and powerful.

What can we do?

We have already started by not moving the consumer muscle as much as we used to.  Next we need to move the citizen muscle.  You can start by becoming involved in Occupy your city demonstrations.

We need to understand what is going on.  There are three levels of understanding.

Most of us perceive there is a problem.  We need a rationale, a way of understanding what the core problem is and why it has happened.  Then we need to respond, use some strategy to deal with the problem. 

We need to develop a response ability.  We need to have the ability to respond.  Our ability to respond, ouy responsibility, can take a variety of forms.  We can talk in our families, at work, in our communities, in schools such as this one, and especially face to face.  Despite all the technologies at our disposal, acting face to face is the most effective response.

We need to ask the right question.  Far better an approximate answer to the right question, which is often vague, than an exact answer to the wrong question.  The rich try to distract us as Thomas Pynchon wrote:  “if they can get you asking the wrong question, they don’t have to worry about the answer.”  If you don't ask you don't know, and if you don't know, you can't act.

We can blog, we can tweet, and we can use social media.  But these media won’t help us work together unless we also have face to face discussions?  We need to use both in new ways.  There is no recipe for success here.

We are drowning in information, yet starving for wisdom.  Mark Twain said:  "It ain't what people don't know that worries me, it's what they know that just ain't so."  To paraphrase  Twain, don’t believe everything you think.   Consider things not with a grain of salt, but with a bucket of salt.  Misinformation abounds.  Use your critical thinking skills.

Seek out those who can synthesize, who can put together the right information at the right time, and think critically about how to make important choices wisely.

Great things always begin from inside.  Think of an egg.  If an egg breaks from an outside force, the life inside ends.  But if it breaks from inside, life begins.   So great things happen from the inside.  We need to get inside and break out.

Today's crisis is a terrible thing to waste.  The rich and powerful have been using it for their ends.  But we need to use it for benefit of we the people on this earth.

We can't rely on hope.  Hope is an opiate, like heroin. We have to rely on ourselves to work together.  Solidarity is the best medicine.  The way to fight organized money is with organized people. 

The way forward will depend on acting, that is doing something and then doubting whether or not it works, then acting again perhaps differently and doubting whether that works or not.  The metaphor of the political right or the political left may not serve us.  You can't fly a plane with just a right wing.  Or just a left wing.  We will always be setting a correction as we move forward.

Gandhi said you may never know the results of your action.  But if you do nothing there will be no results.   We won't know what has been the outcome of this process for a long time.  The history books will write it up.  But in the meantime don't be missing from the action.

Thank you.

Stephen Bezruchka MD, MPH

Departments of Health Services & Global Health

School of Public Health

University of Washington