In my last posting, I referred to parts of America that have been described as “food deserts,” meaning that residents living in those areas do not have access to supermarkets or other food stores or restaurants from which they can purchase affordable healthy food. One of my Pitney Bowes colleagues referred me to a satirical YouTube posting called The Bronx Bodega, which powerfully illustrates what I have noted in a few postings: in many poorer communities with less healthy people, not only is healthy food unavailable at affordable prices, if it is available at all, but the unhealthy food is exceptionally inexpensive and attractively packaged.

But I have learned that the absence of healthy food is just one form of deprivation for low-income communities. They lack four other prerequisites for healthy living:

• Safe outdoor play areas, like parks, to get exercise;
• Primary care clinics for treatment of minor illnesses and injuries, preventive screenings, and immunizations, as well as referral to medical specialists;
• Pharmacies; and
• Information sources. (more…)

Recently, I gave a speech at the American Health Insurance Plans (AHIP) business conference in Chicago on the prerequisites for a workable solution to our health care cost crisis.

One of the main points I made is that convenient and affordable access to healthy foods, prescription and over-the-counter medications, and primary care physicians and nurses for preventive screenings, immunizations, and treatment of minor illnesses and injuries was a more important issue to attack than simply expanding coverage. The more I learn, the more convinced I am that I am right.

This morning, I was listening to an interview on WFAN-New York radio, and the interviewee, a founder of an organization trying to address the issue of hunger in America, referred to “food deserts,” a term I had not heard before. He defined the term as a geographic area in which many people live, but they do not have convenient access to a supermarket or any other food store that carries healthy foods. He said that the entire city of Detroit and major chunks of New York City have no supermarkets. As a result, residents of these communities eat fast food or they go to bodegas or convenience stores that stock inexpensive junk food and nothing else. (more…)

Having recently read a great book called Why Politics Matters by Gerry Stoker, I came to realize why it is so critical to get voting and other forms of citizen engagement right. Without a secure, convenient, reliable voting system and without broad-based citizen participation in some way in the decisions affecting a group of citizens, it is very difficult for elected officials to govern. Their legitimacy would be consistently questioned.

The major question Stoker tackles in his book is why, with all the many ways in which citizens can interact with government today, with the tremendous increase in two-way communications, with higher “responsiveness” by elected officials to citizen demands than ever, citizens today are dissatisfied and alienated from elected officials in democracies than ever before. They have less confidence in their elected officials than ever before.

This is not a phenomenon confined to one country, one political party, one type of leadership, and one set of economic and political circumstances. There is a remarkable uniformity in the intensity and the level of growth in dissatisfaction. Why? (more…)

I find it ironic that not only Americans, but citizens of developed countries all around the world, are more alienated and dissatisfied with their political leaders than at any time in the last 50 years, when politicians, in many respects, are more knowledgeable about public preferences and wants than ever before, and attempt to be more responsive than ever. I know many politicians of both parties. The vast majority of them are great people who care deeply about their constituents, but even they feel trapped in a dysfunctional political system. Why?

I would suggest that there are seven contributing causes:

• Because of the massive growth of the size and reach of government at all levels, the stakes of bad or unpopular decisions are higher than ever, so more people feel the effects of what they perceive to be mistakes.

• Small, militant, well-funded single-interest groups have far more impact on elected officials than a broad public that may want completely the opposite of what the single-interest group wants. That is why our tax code has many subsidies and loopholes built into it. The advocates for these subsidies care far more about them than the broad public that would oppose them. As a result, systems like education and health care, heavily controlled or regulated by the government, are riddled with concessions to special interest groups. A recent blog entry in the Ideas Primary blog discusses the influence of special interest groups over judicial elections. (more…)