The “Other America”

First things first – this brilliant investigation of the “other America” by the Pulitzer Prize winning husband and wife team of Kristof and WuDunn is an absolute MUST READ.  

Anyone who seeks to understand the causes and effects of severe economic stratification affecting our country; and solutions that can be implemented in order to continue to claim “world’s greatest superpower” status will be captivated by their reporting and storytelling.

These highly acclaimed authors describe the “other America” as a portion of our society that has suffered disproportionately due to the evaporation of good blue-collar jobs, lack of healthcare, the collapse of their community’s previously strong social fabric, and their crumbling family structure.

These factors and other similar challenges have resulted in millions of Americans who are suffering and dying at incredibly high rates from drug and alcohol abuse, suicide, depression, incarceration, and reckless lifestyles lived in a perpetual state of hopelessness.


Wendell Potter founder Wendell Potter

As the publisher of Tarbell, I was particularly interested to examine author’s findings connecting the availability and cost of healthcare and the “other America’s” state of social and economic decline.  Ironically, the first anecdote in Chapter 11 titled “Universal Health Care: One Day, One Town” describes the lifelong work of a dear friend of Wendell Potter (our Chairman and Founder) and me. 

Stan Brock, who introduced the two of us in 2017, founded and managed a non-profit organization called Remote Area Medical or RAM.  RAM takes center stage in TIGHTROPE’s examination of healthcare options for the “other America”.

Stan was the most dedicated and committed human whom I have ever witnessed in their quest to help others.  Unfortunately, the world lost a magical soul when Stan passed away unexpectedly in 2018, but RAM continues today organizing and operating free health clinics more than 70 times per year across America from rural Appalachia to California. 

When RAM sets up camp at various fairgrounds across the country to provide health, vision and dental carefree of charge over a weekend, tens of thousands of uninsured and the underinsured queue up for days ahead of the clinic’s gates opening. 

This scene is not replicated in any other industrialized nation on earth.  Volunteer doctors and dentists are routinely appalled at the health of these patients.  As the authors write, “the United States is an outlier” in the health of our population when compared to peer countries.

America has the highest infant mortality rate in the industrialized world.  While other developed countries have seen their life-expectancies increase, our life expectancy has decreased in each of the last three years for the first time in America’s history – enhanced by the opioid epidemic plaguing the “other America”. 

In no other OECD country do people die on a regular basis from “bad teeth that lead to diabetes to heart disease to death” simply due to the lack of available healthcare.  According to the authors, Universal Health Care is the answer and Tarbell agrees. 

Every other civilized nation has it and we need it.  74 million Americans do not have dental insurance.  Americans spend “nearly one-fifth of national income” on healthcare.  In America “the cost of an appendectomy averages $15,930; in Spain, the cost is $2003”.

A woman is twice as likely to die in pregnancy or childbirth in America as in Britain.  “Today, one of the most dangerous places in the world to become pregnant is the American South”.  A pregnancy related death occurs in America on average twice per day with black women particularly at risk. 

A woman is twice as likely to die in pregnancy or child birth in American than in Britain.

The reason, according to the authors is lack of pre-natal care, lack of reproductive health knowledge, the constant attack on efforts to educate our population on sex and contraception.  None of these challenges exist in the health care and educational systems in the rest of the industrialized world.  The authors start the Chapter with a quote from Walter Cronkite – “America’s health care system is neither healthy, caring, nor a system”. 

Kristof and WuDunn are loud and clear on their recommendations of the need for Universal Health Care in America, as is Tarbell and Wendell Potter in particular.  Wendell, years ago, attended one of Stan Brock’s free medical clinics and it changed his life.  How America gets from the sorry state of affairs now to an affordable, all-inclusive health care system is debatable, but the goal should be written in stone and pursued with the same vigor as Stan summoned when he started RAM. 

TIGHTROPE describes the healthcare problem over a few chapters along with other equally regrettable causes and effects that put so many of our fellow Americans at risk.  But it is a vivid and personable tale of the current state of affairs.  One that can be easily read and universally understood.  Just like Ida Tarbell would have probably written it. 

It is up to publications like Tarbell to take this complex and divisive challenge and put it into terms that can force change and change normally comes from a critical mass who demand change.  Books like TIGHTROPE will help get us there.