On the election, I’d offered the following correspondence to friends; I hope you like it.

 We get all this rubbish (the crappy coverage of the election) because we do not care. Our methods for selecting leadership are a disgrace, and entirely our own fault.

The Presidential Election is a manufactured circus of zingers, gotcha! moments, sass-talking and upstaging. We sit like a numb afternoon TV audience, obligingly issuing an “ooo!” and “yay!” and “boo!” as the scriptwriters trot out banalities to test the response of the voters on the applause-o-meter.

One thing is mandatory every election; that primitive emotions of rage and disgust be tapped into, that people respond to the candidates viscerally after hours of video training. The chore is to down-civilize the body public, to stop the public from voting for agents of desired change, and instead turn into a Pro Wrestling crowd cheering the Hero and booing the Heel. If people do not react viscerally and primitively to the candidates, the media has lost control of the process. But don’t worry, that’s never happened.

We don’t want to watch the program, “Darn that Deficit!” and our eyes glaze over when the news covers the Canadian elections, for God’s sake. Who’s their Prime Minister, what’s their national direction?  Anyone?  But we love to hear the down-deep-and-dirty on the awful people in American office, even if it is absolute nonsense. President Obama has many areas to criticize; but arguing over his birthplace is a pathetic substitute for substantive criticism.

We get this because we love this. Our attention span is taxed when three commercials are run in a row. We are carefully told what to think, and eagerly take to it, even if it is rooted in childish slogans like “Make America Great Again!” When we are confronted by ugly truths, real decisions, we run and hide, change the channel. We have chosen our own Berlusconi. The history of Italy under Berlusconi offers us a script of the next four years, successes and failures. Trump is a bit more isolationist than Berlusconi; but that’s a small difference that will be finagled out of the process.

This cycle, we are offered the simplistic belief that “a wave of globalization (has) gutted the American middle class, sent jobs overseas and brought immigrants.” We pretend that can be stopped by the flick of a switch, as the catastrophe of American healthcare can be fixed by hitting the “rewind” button on Obamacare. We will now trust Government to fix what Government has messed up; surely we aren’t expected to pay much attention to the grimy details of implementation.

“Third Party Candidates” were ignored by the media; they were not invited to the “debates,” these sass-fests, more full of zingers than a popular television show. Yo Mama! rings out nearly every sentence to the excited and lucky spectators attending these events in person. If nobody cares about platform and ideas, and focuses on the barbs being tossed by the spunky lady and the irascible man, who needs extras with speaking roles?

In the APACHE scoring of end-stage countries, the Failed States Index is used to score their ghastly vital signs. Here are some of the measures used in scoring failed states. You can see that the US has a bad case of the sniffles that should not be ignored, although other countries are in the Intensive Care Unit of sovereignty. Read these, and think about what direction we are moving since a half-century ago or so.

Poverty and economic decline: Progressive economic decline of the society as a whole (measurements: per capita income, GNP, economic deficit, unemployment, poverty levels, business failures, and inflation) strains a state’s ability to provide for its citizens, and can create inter-group friction.
• Failure of the state to pay salaries of government employees and armed forces, or to meet other financial obligations to its citizens, such as pension payments.
State legitimacy: Corruption and lack of representativeness undermine the social contract, as citizens lose confidence in state institutions and processes. Measurements include corruption or profiteering by ruling elites, resistance to transparency, level of democracy, illicit economy, and protests/demonstrations.
Public services: Disappearance, or lack of, basic state functions indicate a state’s inability to perform one of its key roles. Measurements include essential services, such as healthcare, education, sanitation, public transportation, police, and infrastructure. Also examined is the use of the state apparatus for agencies that serve ruling elites, such as security forces, executive staff, central bank, diplomatic service, customs and collection agencies.
Human rights and rule of law: The violation or uneven protection of basic rights mark a failure of a state to execute its primary responsibility. Measurements include press freedom and civil liberties, as well as any widespread abuse of legal, political and social rights for individuals, groups, or cultural institutions (e.g., harassment of the press, politicization of the judiciary, internal use of military for political ends, public repression of political opponents, religious or cultural persecution).
Security apparatus: An emergence of elite or praetorian guards that operate with impunity challenges the security apparatus’ monopoly on the use of force, weakening the social contract. Measurements include internal conflict, riots/protests, military coups, rebel activity, and the emergence of state-sponsored or state-supported private militias that terrorize political opponents or civilians seen to be sympathetic to the opposition.
Factionalized elites: A fragmentation of ruling elites and state institutions along group lines undermines public confidence. Measurements include elite power struggles, flawed elections, and use of aggressive nationalistic rhetoric
The last point has definitely shown itself in the last election. See the FSI. [We are hoping to become as successful as Slovenia in the future; we are less of a failure than Slovakia. U!S!A!]

Don’t be daft, and ask me if I am equating the US to Bolivia.  I am not.  Am I comparing them?  Why, yes.  Do I think we are heading Bolivia-ward?  Of course.

We are skylarking about, wagging our finger at “Oh, that HILLARY!” or “Shame on that TRUMP!” as though we were participating in useful discussion. Meanwhile, we race towards the mutually mistrusted and disliked Red Tribe and Blue Tribe, hated for their very essence, not just because of their political inclinations. Nuke them! Throw them in prison! we yell, not seeing that we are sliding towards a culture of a hundred thousand years ago.
What will a Trump Administration mean for Medicine? Who knows? And among the tribes, who cares?