Tightrope – Americans reaching for hope by Kristof and WuDunn – book review

Kristof and WuDunn’s book, Tightrope – Americans Reaching for Hope, spent some weeks on bestseller lists. Kristof is a well known reporter and writer for the NYTimes. It centers around the town of Yamhill OR and the people that Kristof grew up among. The stories of industrial decline, increasing inequality, poor education, drug addictions, health problems, family violence and more are well told. The narrative is filled with facts and statistics that illustrate how we came to find ourselves in a country that is fabulously wealthy yet much more than half the population is either poor or economically insecure.A country where middle-age white males without a college degree are dying frequently and earlier each year.

Here are a few snippets of data that are scattered among the personal stories.

“America ranks number 40 in child mortality, according to the Social Progress Index, which is based on research by three Nobel Prize–winning economists and covers 146 countries for which there is reliable data. We rank number 32 in internet access, number 39 in access to clean drinking water, number 50 in personal safety and number 61 in high-school enrollment. Somehow, “We’re number 61!” doesn’t seem so proud a boast. Overall, the Social Progress Index ranks the United States number 25 in well-being of citizens, behind all the other members of the G7 as well as significantly poorer countries like Portugal and Slovenia, and America is one of just a handful of countries that have fallen backward. “Despite spending more on healthcare than any other country in the world, the US has health outcomes comparable to Ecuador, while the US school system is producing results on par with Uzbekistan,” the 2018 Social Progress Index concluded.”


“In the 1970s, the top 1 percent earned a similar share of income, 10 percent, whether in the United States or Europe. That rose modestly in Europe to 12 percent today; in the United States it doubled to 20 percent.”


“In 1965, the average chief executive earned about twenty times as much as the average worker; now the average CEO earns more than three hundred times as much.”


“One study found that the pharmaceutical industry spent an average of $588 per doctor from 2013 through 2015 marketing opioids to 68,000 of them, including paying for meals and trips. That’s a modest sum over three years, but it was effective in increasing both prescriptions and deaths. The study found that the number of payments to doctors in a particular county correlated to overdose deaths from prescription medications in that county a year later.”


“….mass incarceration for drug-related offenses broke up families and meant that millions of boys were raised without the presence of a dad or any other positive male role model, helping transmit the problems to the next generation.”


“Some 74 million people have no dental insurance, more than twice as many as lack health insurance. “Bad teeth lead to diabetes, to heart disease, to death,” Stan noted. “People die from bad teeth in this country.”


“The upshot is that since 1970, life expectancy has improved in the United States, but much less than in other countries. From a bit above the middle of the pack, we’ve tumbled to number 27 out of 35 OECD countries. We’re now behind Chile in life expectancy and just ahead of the Czech Republic and Turkey. Life expectancy in the state of Mississippi, were it a country, would rank second to last, tied with Mexico. Children in America today are 55 percent more likely to die than kids in other affluent countries, according to a peer-reviewed study in Health Affairs. “The U.S. is the most dangerous of wealthy, democratic countries in the world for children,” said Dr. Ashish Thakrar of the Johns Hopkins Hospital, the lead author of the study. ”


“Opponents of universal coverage for all ages protest that it is unaffordable. But we already provide coverage for the most expensive demographic (the elderly) while not for the cheapest (kids); instead of directing money to children, we shower it on drug companies and hospital companies. Xarelto, a drug used to prevent or treat blood clots, costs $292 in the United States for a thirty-day supply; in Switzerland, the figure is $102. Tecfidera, used to treat relapsing multiple sclerosis, costs $5,089 for a thirty-day supply in the United States; in the United Kingdom, it’s $663. An appendectomy averages $15,930 in the United States; in Spain, it’s $2,003. Overall, America actually spends much more on health care than any other country, roughly $10,000 per person per year, nearly one-fifth of national income. That’s almost twice as much as in Europe.”

The disappointing conclusion

With all of this exposition, illustrated with personal stories and hard data, one might expect the book to end with a call to real action. Strangely it ends with a whimpering list of policy suggestions and personal action items -“Ten Steps You Can Take in the Next Ten Minutes to Make a Difference”.

Here is the list of the book’s “big steps”

  1. High-quality early childhood programs
  2. Universal high-school graduation
  3. Universal health coverage
  4. Elimination of unwanted pregnancies
  5. A monthly child allowance
  6. An end to homelessness for children
  7. Baby bonds to help build savings
  8. A right to work

All of these are laudable to be sure. One could easily add others. But this is all beside the point without facing up to the source of the problem. The rich and large corporations own the US and state governments; they deploy the resources, laws and regulations largely to meet their needs. None of the list above nor any other important initiatives to provide Americans with a real opportunity to share in the work and wealth of the country will come about without a sustained and sustainable attack on the privileges of the rich and corporations. The Republican Party is totally corrupt; the Democratic Party is still largely in the thrall of big money from the rich and corporations.

By The Way