Our grandparents used to tell us, “if it ain’t broke, don’t fix it”.

Management gurus, in their race to the finish line have turned this sentiment on its head by telling us that, if it ain’t broke now, it will be soon, and if you do not fix it before it breaks, you will be behind the competition. This sentiment drives the annual corporate reorganization at every corporation that I or any of my friends has worked at, and puts millions of dollars into these gurus’ bank accounts.

Politicians have adopted this philosophy as well, to much detriment to the citizens. I live in the rural and much neglected Western part of the state of Massachusetts. We like being neglected by the State House in Boston; we are used to it and we like it. What we do NOT like is paying disproportionate taxes for fewer services than our friends East of I-495 get.

One pearl of our Western MA civic life is our libraries: they are so much more than a place to get a book. They are community centers, places for people to meet and discuss current events, for local poets and artists to show their wares, for children to learn the responsibility of civic engagement through volunteering. In the economic downturn, where else can an unemployed person find employment and training resources for free? Where else can someone without access to the internet come and use a computer without spending $4 on a cup of coffee? Libraries are what makes our communities what they are.

So, how ironic is it that the MA Library system, the very system that is working remarkably well on a shoe-string budget, is under the damocles sword in the budget planning process? The very system that ain’t broke is about to get quite a fix. And we, the citizens along with it.

So, you ask, what does this have to do with healthcare or health? A lot! Personally, I am sick of ever-increasing taxes buying ever-decreasing services. Yes, there is inflation, and what a convenient excuse! This all falls for me in the same bucket as the travesty of our educational system, our healthcare system, and, in general, the quackery of the trickle-down economic theory.

Let’s take education. The first things to be cut perennially are arts and gym. What does this do? A lot! Do we really think that the obesity epidemic is somehow not related to devaluing physical activity in the schools? Of course it is, and I do not need a randomized controlled trial, or even a cohort study, to recognize this. Do we really think that art is not an essential component of educational foundation? Just because it will not lend you a corporate job in the future does not mean that it is unimportant. And schools are but a sample of the society at large.

Look where we are as a nation: addicted to consumption of trash, creation of trash, assimilation of trash. We are more miserable and demoralized than we have ever been before, we work harder than ever before for less money than ever before, and we pray to the god of the free market more ardently than our ancestors prayed to the god of rain ever before. We have created more disease than we had ever thought possible, and along with it a $2-trillion godzilla of a healthcare “system”, only too happy to treat anything and everything under the sun. Like an out-of-control cartoon bulldozer, we are razing our earth, our children’s future and our own sanity.

Of course, I am not saying that all of these ills can be fixed by reintroducing art and phys ed back to our schools, but it sure would be a start. But, indeed, we have been manipulated, duped, sold a bill of goods, taken for a ride. Our market-focused utilitarianism as the single raison d’etre has brought us here, and it has to go; we need to find our way out of this spiritual isolationism and regain our sense of community.

Nurses, physicians and other healthcare providers, I call on you to start addressing the civic health of our communities. Get involved in your local politics, and not just because you are interested in maximizing your Medicare reimbursements. The time to act is now. You can start at your local library: have a discussion about how to maintain and improve your community’s health, physical, mental and spiritual. It may not be fiscally expedient. But most important stuff in life never is.

Marya Zilberberg is founder and CEO of EviMed Research Group and blogs at Healthcare, etc.

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