Is This Really One Country?

By Mike Koetting    May 15, 2018

This post relies more on pictures than words.


Gun Ownership

Teach Salary

Repro Rights


While the pattern isn’t perfectly consistent, it is clear enough. The former Confederacy, joined pretty consistently by a band of states up the middle of the country to Canada, Indiana and Arizona have a different set of values than the reminder of the country. (Kansas was a slave state although there were no slaves there, Indiana home to the Ku Klux Klan and Arizona broke away from New Mexico on the idea it would become a slave state.) Wisconsin and a few other Rust Belt states often join them, although their orientations have floated more over time.

I could have come up with another dozen maps on other issues that would have shown the same values spread. At least as far as can be ascertained from state level data, there are two separate value constellations. While at some level this is unsurprising, seeing the degree of consistency across such a range of issues really struck me.

And these differences do make a difference. For instance, Jennifer Montez in the American Journal of Public Health notes that in 1980 the difference between average age at death in New York and Mississippi was 1.6 years. In the years since, during which more latitude has been given to individual states to define their own level of health care and social services, that difference has stretched to 5.5 years.  Longevity in New York is now roughly comparable to Denmark, while Mississippi longevity is similar to Romania. To be sure, New York has become a lot more affluent, so it’s hard to say what way causality flows. But either way, the outcomes are striking.

What, then, does it mean to say this is a “united states”? There’s not that much united. We have a largely common language and share a national creation myth, even if some of the latter is distorted by the difficulty of incorporating the role of Indians and slavery. But beyond that? We haven’t agreed on the meaning of human dignity or the fundamental organizing principles of society—let alone the role of government–since the beginning of the country. (Actually, David Hackett Fischer argues in Albion’s Seed, these divisions go back to England and the different reasons for leaving there to come to America.) Some of the states were willing to fight an actual war over these differences. Nor have they ever accepted the military outcome and have been waging political and social guerilla warfare ever since.

Maybe the United States isn’t quite Belgium, with two quite distinct ethnic groups and two different languages. And, for sure, there are big differences within states. But when one looks at these maps and contemplates the historical consistency of the different value sets—and the amount of energy each expends trying to protect its own values—one has to wonder what it means to say this is a single country. Is there really more here than an historical accident—a momentary convergence to fight against the King of England and, then, expand the country from sea to sea, with no real agreement about what the words of the Declaration of Independence or the Constitution actually mean?  Am I really better off from having had to spend a lifetime arguing the same issues over and over again? From finding at so many turns my ideas about fundamental concepts of humanity thwarted by states that would be happier if they were free to practice Jim Crow without interference?

Of course, the residents of those states are equally unhappy about having to share a country with a bunch of states who don’t share their principles. And it is fair to assume they have the same questions, but framed very differently because they hold their values as tenaciously as I hold mine.

I don’t know what the answer is. Undoing the country isn’t practical, as appealing as it might be in theory. (I followed closely the experience of Catalonia.) Perhaps we can develop a new, really national, ethos over time. History isn’t on the side of such a hope, but, as I suggested in my last post, maybe demography is. Although, as I also noted, the immediate demographic changes are muted by the way we have divided the country into states.

In the interim, it doesn’t seem there is much choice but to accept that my hopes and aspirations for the country will always be watered down by people who live in a different value country. I simply need to hold up my part of the never-ending civil war.

Author: mkbhhw

Mike Koetting’s career has been in health care policy and administration. But it has always been on the fringes of politics. His first job out of graduate school was conducting an evaluation of the Illinois Medicaid program for the Illinois Legislative Budget Office. In the following 40 years, he has been a health care provider, a researcher, a teacher, a regulator, a consultant and a payor. The biggest part of his career was 24 years as Vice President of Planning for the University of Chicago Medical Center. He retired from there in 2008, but in 2010 was asked to implement the ACA Medicaid expansion in Illinois, which kept him busy for another 5 years.

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