I was struck by this NY Times piece discussing a recent report by the National Academy of Sciences on longevity in the US and other nations.. I was struck because one could substitute an analogous remark about education for virtually every mention of health care and the report would still ring true. For example:
Over the last 25 years, life expectancy at age 50 in the U.S. has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the U.S. spends more on health care than any other nation
Over the last 25 years, educational achievement in the U.S. has been rising, but at a slower pace than in many other high-income countries . . . This difference is particularly notable given that the U.S. spends more on education than any other nation
Here's the best graph I could find of this trend (the red dots represent the US):
and another example:
With respect to income inequality, it is widely believed that such inequalities are higher in the United States than in other high-income countries . . . Poverty rates also appear to be higher in the United States than in most of the other countries . . .
This combination of factors could result in higher mortality rates among people in the lower socioeconomic brackets in the United States than in other countries, pulling down US life expectancy levels in general
This combination of factors could result in lower achievement rates among people in the lower socioeconomic brackets in the United States than in other countries, pulling down US achievement levels in general
Additionally, we could draw parallels between the success of the highly sophisticated and specialized branches of both health care (e.g. cancer research) that the report lauds and our nation's elite college and university system.
So, what does this all mean? I'd argue that the parallels illustrate two truisms about American education:
1.) Society matters more than any single institutions. While the quality of our doctors and teachers influence how healthy and educated people are, other factors are, cumulatively, far more important. Both are affected by parenting, neighborhood context, diet, exercise, and so on. But while we rush to blame teachers for the failures of American students, I hear very few rushing to blame doctors for the American populace's unhealthy lifestyle.
2.) We excel when we strive for excellence, but place little emphasis on providing excellence for all -- one concoct examples from numerous other fields (e.g. transportation or housing). Whether this is good or bad is largely a value judgment, but it's a fact that the US is more individualist and less collectivist than maybe any nation on Earth.
The end result of these two factors is that our health and education systems are quite similar in many ways (which should surprise no one) and, as such, are likely similarly difficult to reform.