Although there is much more I could say about health, I have decided to move on to the second part of the formula and for the next few entries discuss the questions surrounding wealth.
In the Wealth of Nations, Adam Smith divides nations into three categories, wealthy, medium, and poor. As examples of each he uses China, England, and "the Colonies" or what is soon to me the US, respectively. But it is clear from his discussion that he is really discussing opportunity as well as wealth. They seemed to him to be inversely related. China, I suspect, he listed as being wealthy, or at least as wealthy as its traditions, government, laws, etc, would allow it to become, because of the huge government supperstructure. The impressive "Forbidden City", the vast network of government bureaucrats, the ornate buildings and colorful costumes of the wealthy. But the inverse was the lack of opportunity. Unwanted or unprovided children were simply killed. The rate of infanticide among the poor was high. Indeed, if a man died leaving a widow and orphans, if no provision could be made for them by extended family they were all simply "eliminated". In England, while not quite so impressive in government and bureaucracy, the opportunity was not quite so dismal. There if a man died leaving widow and orphan they were placed in a poor house or on some kind of minimum subsistance dole, so at least, they were not eliminated. But most interesting was the US. The colonies, as he knew them (the US declared independence a few months after his book was published), were poor. They had no impressive buildings of any kind, certainly no large cathederals or impressive palaces or government buildings. The streets and other "public works" were primitive. But what America did have was opportunity. There, according to Smith, if a man died leaving a widow and orphans, she almost immediately had offers for remarriage, even if she were poor, but men wanted to raise the children. Children, indeed, people in general were viewed as the most important wealth. They were for our founding fathers, long before Julian Simons invented the term, the"ultimate resource".
Historians and economists in our day, most of whom are really bureaucrats themselves, at least, in the sense that their incomes are indirectly, or increasingly, directly dependent upon some level of government, attribute this opportunity to ready availability of land. The people themselves who lived at the time attributed it, more correctly, in my opinion, to the reduction in tyranny, reduced when compared to Europe. They were very sensitive to the fact that it was always rearing its ugly head.
To be subject to tyranny of any kind is very discouraging enervating. It is probably the chief reason that poverty is so widespread in the world and throughout human history. The question then becomes why is it tolerated? To understand that I am going to refer to one of my favorite plays, "The Barretts of Wimpole Street". The play is the story of Robert and Elizabeth Browning's courtship. Elizabeth Barrett was the daughter of a wealthy man who had a very large family. He had 12 children, 9 of whom survived into adulthood. Mr. Barrett was a very strong-and self-willed man who decided, probably after reading Malthus's book on population or similar nonsense, that none of his children should marry. In the play, of course, Elizabeth defies her father and marries Robert Browning, and one other daughter does likewise. Eventually, another of his children follows suit. Mr. Browning would have nothing to do with the three who married. He not only disinherited them, but he even refused to open any correspondence from or about them. Why would six adults put up with that kind of tyranny? The answer, of course, is in his wealth. They were afraid to loose material comforts and status in society if they went against "Papa's" wishes. In addition, he would be become angry and vengeful if anyone went counter to his will.
Of course, Mr. Barrett is an example of a family tyrant. The bureaucratic tyrant, however, uses exactly the same carrot-and-stick tactic. And unlike Mr. Barrett, whose motives are not precisely known, at least, to the sources I have read, the bureaucrat, the politician exercise tyranny for a combination of wealth and power. The result is, of course, general loss of wealth, in the fullest sense of the word. But some wealth and usually a great deal of power is transferred to those exercising the tyranny.