Health Care and Retirement | Twenty-First-Century Issues

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Health-care costs have spiraled out of control. Millions of Americans do not have any health insurance, and those who do are largely not willing to give up what they have in exchange for a more equitable system. For the most part, we believe that we have the best health care in the world, and we want to hang onto it at any cost.

Furthermore, the U.S. population is aging. Our medical care system will be crushed along with the national pension system, called Social Security, unless significant structural reform is achieved. By most estimates, the Social Security system will stop generating a surplus around 2020 and will exhaust its trust fund by the year 2034. Many Americans do not rely on Social Security, depending instead on privately funded pension plans. This means that the poor will by far bear the biggest share of this hardship.

Americans, like many people around the world, have a "love-hate" relationship with globalization. Of course we, like many people, enjoy buying high-quality goods at lower prices. Of course we also object when employers close up manufacturing or, increasingly, high-tech facilities and then move those jobs to countries that hire workers at lower wages. We also do not like to see companies fatten their profits by avoiding environmental or safety regulations when they move to other countries. We like to talk about free trade but overlook our own protections on agricultural and other goods. We have faith in the free market but tend to forget that historically, all major economies, including our own, advanced as a result of stiff tariffs and other means of protecting domestic industries.

The power that corporations are able to exert over the political process is staggering. While some hail the collapse of Enron and the financial scandals of other corporations as evidence that the bad guys do get caught, it is more likely that they represent the tip of the iceberg. Corporate influence on the electoral process, and the resulting access to politicians (of both parties), threatens to undermine our treasured democratic ideals.