ajfortin.com

Image by ~C4Chaos via Flickr

(Cross-posted at the World Health Care Blog)

Fareed Zakaria argues in his new book “The Post-American World“, that the problem America faces in the new emerging international sphere is not so much domestic decline, but rather more “the rise of the rest.” By this he means that countries all over the world “have been experiencing rates of economic growth that were once unthinkable.” This is resulting in shifting of the balance of power, the movement from a unipower world with America at the center, to a world of “many actors, state and non-state” where there is no center. The challenge in such a world, according to Zakaria, is “how to stop the forces of global growth from turning into the forces of global disorder and disintegration.”

In this new “Post-American World”, Zakaria asks “will international life be substantially different in a world in which the non-Western powers have enormous weight?” Will Washington be able to “adjust and adapt to a world in which others have moved up?” And can we thrive in a world we cannot dominate? In America, “new thinking about the world is sorely lacking” and our isolationism has left us quite unaware of the world beyond our borders.

We also suffer from a “dysfunctional politics”, Zakaria writes, one characterized by gridlock and partisanship, which prevents us from beginning “a generous effort to engage the world.” The future is already here.

The task for today is to construct a new approach for a new era, one that responds to a global system in which power is far more diffuse than ever before and in which everyone feels empowered.

And organizing coalitions has become a primary form of power. Real solutions require,

creating a much broader coalition that includes the private sector, nongovernmental groups, cities and localities, and the media. In a globalized, democratized, and decentralized world, we need to get individuals to alter their behavior.

Now here is where health care begins to enter into the “Post-American” picture.

While Zakaria complains that health care costs “have risen to  point that there is a significant competitive disadvantage to hiring American workers,” — and will not be an easy fix — he strongly believes that “America will remain a vital, vibrant economy, at the forefront of the next revolution in science, technology and industry — as long as it can embrace and adjust to the challenges confronting it.” The United States “has been and can be the world’s most important continuing source of new ideas, big and small, technical and creative, economic and political.”

In fact two of the industries he cites as examples are nanotechnology and biotechnology.

So where does Zakaria’s analysis leave those of us in health care. Here are a few thoughts.

• Health care reform in the US is not just a domestic priority but an international one as well. It is both part of the problem and part of the solution to America’s future position in international affairs.
• As I have argued a number of times before( here, here, and here ) American health care can become a stronger component of our international ‘soft power’ because it is a valuable and desired center around which international coalitions can be formed.
• The world (and the US) has yet to full advantage of the emergence and development of Health 2.0. What an opportunity for a technology which emphasizes social networks to bring the world a bit closer together around a major concern of all countries– health care.
• The time to bring America’s involvement in world health care to the next level is now.

Health care can help to renew America’s legitimacy to act, in Zakaria’s words as an “honest broker’ in world affairs. It is time for US health activists to think global and take leadership in this important challenge.