It is interesting that in the United States, the belief system has been
manipulated (insurance, privatization, keep people in fear from various
scenarios) to illustrate consistently that Government Programs do not work.

They so easily forget that the elderly were once 30% in poverty, but are
now among the wealthiest

They love Kennedy's Man to the Moon speech, ignore the first 9 sections
about economics, emerging nations, and infrastructure (people, programs,
national focus) allowing the nation to address what was needed to get to
the moon, including reigning in greed and corruption.

They forget about family medicine, created by a partnership of medical
educators, needs of the public, and a number of federal and state funding
efforts.

Family medicine, like all of the above, also depends upon people and
government efforts
1. lower and middle income origin medical students gaining admission,
difficult in today's education policies
2. broader admissions focused on people skills lasting 10 or 20 years
rather than scores that measure 1 year of performance
training focus
3. health policy supporting the patients outside of major medical centers
in rural, lower income, and middle income areas
Family physician studies involve all of these areas and confirm the
national changes. Family medicine choice in US medical students is a
particularly sensitive indicator of health policy.

Service oriented professionals such as teachers and nurses also have the
same difficulties and have been ignored since the 1970s with only $100 -
$300 per year in real income gain. Public servants on the front lines
providing security are also in this group. Recently forms of primary care
have reached this level of disrespect.

People and government work best when they work together and when the front
lines communicate back and forth between the people and government.

Spiritual infrastructure - do we believe in the government, the leaders,
the nation, religion or higher purpose (all potentially bad or good, used
or abused)  Are the people, the front lines professions, and government all
on the same page.

Human potential infrastructure - do we work to facilitate greater
opportunity for children such that they engage in education and society and
self invest - child development, education, health, security (never a bad
choice)

Physical plant infrastructure - do we have the ability to make our lives
and works more efficient and effective (rarely a bad choice unless
impinging on human potential)

It is very difficult with low belief in leadership, in the nation, and in
religion or higher purpose; with lower opportunity for children, and with
failure to improve or maintain physical infrastructure (schools, colleges,
transportation). Other nations have different situations and solutions.

Child well being is an interesting overall measure of these areas and a
measure of the true priorities of government.

Robert C. Bowman, M.D.
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