S3 E8: Democracy, Equity and Health Care

Episode 8: Democracy, Equity and Health Care

In this episode, Dr. Eloisa Gordon-Mora discusses the connection between our understandings of democracy, and with respect to equity and health care. From her political science formation, she analyzes the notion of “democracy” itself, addressing its historical evolution and from comparative, global perspectives, as well as myths, assumptions and values that are connected to the notion. She gives a brief overview of how other, high-income, developed nations, and other global examples, compare and contrast to the US, regarding their classifications as full-democracies, as well as in their provisioning of health care access, delivery and quality of care.

Eloisa Gordon-Mora, PhD

Since 2019, Dr. Eloisa Gordon-Mora is the inaugural University Diversity and Inclusion Officer (UDIO) at the University of Nevada, Reno (UNR). She has over 25 years professional experience in the areas of diversity, equity, inclusion, social justice and civic and democratic engagement. Before joining the UNR, she was Dean of the School of Social Science, Humanities and Communication at Universidad Ana G. Méndez (UAGM) and Vice-President for Academic Affairs at Universidad del Sagrado Corazón, both in San Juan, Puerto Rico. Prior to relocating to Puerto Rico, she was Vice-President for Government Affairs at Safe Horizon; the first full-time executive director of the philanthropic organization, Daphne Foundation; and, the executive director of El Barrio Popular Education Program, an academically-recognized, action-based research project of the Center for Puerto Rican Studies, at Hunter College—all based in New York City. On a national level, she was selected as one of 35 Outstanding Women in Higher Education by Diverse in Higher Education in 2020. At the regional level, she is one of two Nevada-wide higher-education representatives of the Northwest Commission of Colleges and Universities’ Equity Council, as well as, Equity Leader, at Nevada Complete College Alliance, at the state-level.  In 2021, she was invited to join the Boards of both, the Community Foundation of Northern Nevada, as well as Northern Nevada Marches Forward, where she currently serves. As an educator and political scientist, she has focused on poverty and globalization, community organizing and urban politics, post-authoritarian/delegative democracies, and politics in Latin America and the Caribbean and has taught at Bates College in Lewiston, ME; Universidad de la Frontera, Temuco, Chile; Marymount Manhattan College and Eugene Lang College of the New School for Social Research, both in New York City, and at UAGM. Her research interests include higher education, diversity and inclusion, democratic theory, social violence, and post-colonial and post-structuralist literature.

Episode Transcript

CASAT Podcast Network

Hello and welcome to season three of CASAT Conversations.

I am your host, heather, Haslem.

This season we will explore the weighty topic of health equity within each conversation.

We will discover insights from researchers, practitioners and experts on this complex and important topic.

We hope you enjoy today’s conversation on today’s episode.

We’re excited to welcome Dr. Eloisa Gordon-Mora.

Dr. Mora is the university diversity and inclusion officer at the University of Nevada, Reno.

Welcome Eloisa, We are so happy to have you here today, it is my great honor.

Thank you so much heather for the invitation.

Looking forward to our conversation.

Me too.

So as we get started, I’d love for you to tell us a little bit about yourself and what inspires you to commit time and effort and resources to health equity.

Yes, I’m a political scientist by training and my research and my focus has always been on democratic theory, critical culture theory, community organizing and postcolonial literature.

So therefore without focus on democracy, healthcare is such a fundamental element of healthy equitable and democratic society that even though my sphere of expertise is not health care itself is so much the way I understand it.

Part of what a robust democratic society ought to be as a political scientist.

I also always describe myself as an activist political scientist, meaning that I have balanced academic intellectual research work with community organizing.

For instance, I was I worked 10 years in New York City and I was focused and work with poor women, Children and mostly African American Latin X, asian LGBTQ+ populations living in poverty, homeless populations.

So first hand, I had to experience the inequities that do exist in our society for certain groups.

Also I before that I was dean before my current position as you and our diversity inclusion officer was dean of social science in Puerto rico and I was at a university that really served a good number of our student population were first generation um, students coming from um either low income or recent immigrant communities and the well being of students is so impacted by other things besides what’s learned in the classroom.

And there, I also experienced uh lack of access to certain groups.

Um, for instance, trans groups, recent immigrant groups, undocumented groups, poor sectors overall to healthcare.

And therefore how for me as a political scientists focus on democracy impacts the fuller possible participation of uh larger sectors of society into the democratic project.


And what drew you to become a political scientist?

Um that’s a good question.

And you know, usually people have some type of moment in their lives that um kind of defines that choice.

Um, maybe out of the experience of being Puerto Rican, I am Puerto Rican and um in Puerto rico, unlike I think in the United States politics is such an everyday part of um the ordinary citizen because of our relationship with the United States unresolved relationship of a territory of a colony that’s so much part of our everyday lives.

So I think that as a party can I was Kind of immediately drawn to the idea of politics and and what is a good society, Puerto Rico is still um greatly a poor society.

Almost 46% of the total population fall under federal definitions of poverty.

So, so the issues of marginalization discrimination were kind of my everyday existence as a Puerto Rican.

Um and then as I mentioned, I worked for many years in New York City, which is this sort of in quintessential um up to a recent time, new Puerto Rican neighborhood in the United States.

Now there are so many Puerto Ricans in the United States, that Florida perhaps is now the quintessential neighborhood Puerto Rican neighborhood, but for instance, my years in in um in el barrio that is East Harlem, that Puerto Rican quintessential neighborhood that I mentioned was traditionally a poor neighborhood and for instance, talking about health care was considered for a long time.

Um Their neighborhood with the highest incidence of asthma in all of New York state.

And essentially a Puerto Rican neighborhood and asthma is so prevalent among Puerto Ricans that there are even epidemiological studies that speak of a Puerto Rican syndrome.

You know that certain characteristics that um asthma has within the Puerto Rican neighborhood.

So again, a real life kind of experience that connected me to my engagement with political science with demography and in this case with how health issues are not universally experience, but I have to do a lot with geography, with identity, with access to resources with incorporation into the societal offerings.

Yeah, it sounds like it’s really been part of the fiber of your being throughout your entire life.

It is, it is.

And even for this job as diversity that could inclusion, I feel the same for me, diversity equity, inclusion.

Social justice are the tools of democracy.

So, so therefore somebody who is so interested in the idea and the advancement of democracy has to be involved in issues of diversity, equity, inclusion, social justice.

So as you speak of, you know, the tools of democracy and the advancement of democracy, I’d love for you to start by just sharing with us really.

What is your definition of democracy?

That is always a question that I say that if there is an elusive term, democracy is one of those because folks tend to think that they know what democracy is and it’s a commonly used term, especially now in the most recent United States experience of challenges to its understanding of democracy.

We hear about democracy often, but I would bet that most people would be hard pressed to give a definition to what is democracy and that’s part of the elusiveness and the challenges of the notion.

And we can go back to the Greeks who originated the term democracy in the 5th and 6th century before the christian era?

And and the word democracy comes from two terms in greek demos, which is the people and practice, which is authority or power.

So, democracy is a notion from millennial old greek definitions is meant to be um briefly uh power of the people and that’s what folks tend to think of democracy.

But immediately off the bad I would say, then we would have to challenge who are the people because the process of democracy has been most certainly a process of gradual incorporation of different sectors of what we call the people.

Even with um the great origins, those that were part of the democratic understanding were only male educated.

Um some levels of wars, adults who were considered valid members of the police and the police being the political society.

So therefore from the very origins of origins of the greek conception of democracy, which is what most Western societies follow as a model that kind of foundation of being for the benefit of male adults educated.

Some level of wealth was created and honestly, that has been the experience of most societies, if not all, in their evolution to democracy.

So, so democracy is never completely universally defined their constructions in political science that for instance, speak of a minimalist definition of democracy in a maximalist definition of democracy.

Many times, many folks in the United States tend to follow when they think of democracy, a minimalist definition and by that it means the reality of a competitive pluralist electoral process.

People tend to think that’s mostly what democracy is about, and most only that’s one of the elements of democracy.

But even if you were to follow the minimalist definition, you would have to ask who has been historically allowed to vote.

Even if if you think that’s only democracy and we know, focusing on the US experience that that process has historically been at the exclusion of African American blacks, indigenous communities, poor sectors, and even white women um received something as basic as the right to vote later than other Western societies, for instance, Finland establish um the vote for women 1906 almost 20 years before the United States as well as Australia, Denmark Canada.

So, so again, if we are to define democracy, it’s among other things in terms of the reality and it’s true to life.

Experience a process of incorporation into that idea of the people.

And then because of that process is that we move into what’s called political science, maximalist definitions of democracy, and that is more um better understanding that beyond the electoral process, there are aspects of social existence that can be procedural, such as the rule of law participation, really establishing broad participation in public decision making, accountability and all these things we know have been challenging the recent United States experience even in electoral procedures, but also questions of civil liberties, economic rights, political rights, equality, and that’s where we move more into the more maximalist definition of democracy and healthcare would follow.

Um clearly on those definitions, but something again to keep in mind because all democracies are not the same.

United States historically has endorsed the idea of civil and political liberties but has been reluctant to endorse social economic cultural rights.

For instance, the United States is signatory to the U.N. Covenant and political and civil rights but not To the one of economic, social and um cultural rights.

And that’s when then we begin to see.

The difference in healthcare provisioning, for instance is Scandinavian countries that offer universal healthcare, universal take to 18 educational access and all that.

That’s when we begin to see the differences in healthcare provisioning as a measure of democracy and as a measure of equality and equity.


Yeah, I’m really struck by the complexity of it all.

And um even just thinking about, you know, how you started talking about democracy being this elusive term and our understanding of it.

Um you know, I’m sure varies across listeners and that’s why, you know, as an educator, I always point out that the important for me um purpose of any educational effort, but most only higher education should be not only to train on professional skills that are very much uh individual needs that have to be addressed but to teach and educate on democracy because the complexity that you point out points out to the fact that democracy is not something you innately know.


Um you know, president of one of my mentors and public science is that democrats, meaning people who believe in democracy and democracy are not born.

They’re made your, you have to be educated into believing in democracy and what we have seen in the world recently is that that actually is uh nut share um value and commitment and and understanding throughout the world and in our nation well.

And you also spoke about to me, it’s like a spectrum of democracy.

It sounds like depending on what country and what measures, So can you share with us some of the measures of democracy?


Um sometimes when we spoke heather I had mentioned that something I follow is the source of research and data’s this world um unit or world organization that measures democracy called the economist intelligence unit and they they’re a nonprofit that measures democracies and understanding of democracy throughout the world.

And they use um five basic indicators and those our electoral process and pluralism, meaning how often does a nation have competitive elections?

Are there truly competitive?

Are they open?

Are the surest the functioning of government?

And we’ll see in the case of the United States has an important one, meaning is government efficient?

Is it overly bureaucratic?

Does it serve population at large?

Does it serve different interests?

Political participation.

And again, we know that in the United States, unlike other countries, that’s not um uh An important element of our democracy, political participation in the United States historically has been under standard of other countries where you have 80% participation for instance Jericho I told you that politics very important 80 something participation.

So that’s also in itself a measure of why is this disengagement from almost half of the population typically?

Um you know the political participation rates in the United States usually around 50 something percent except in the most recent election where it really went out given the circumstances we have been living.

But that speaks then of that kind of lack of commitment or active commitment to the idea of democracy.

So that’s the 3rd and 4th is democratic political culture and that’s actually an area in my work that I’m very much invested because as I was saying earlier um a commitment to democracy is the result of education and therefore the result of fomenting certain values in order to advance democracy.

You have to believe in democracy.

So therefore that speaks of the existence of certain values that support or not the idea of democracy and and values do not necessarily are good things in themselves.

You know, you can have values that support authoritarian systems and we see that throughout the world and finally civil liberties.

So the E.I.U. using research coming from such places as the Pew Center, the World Bank.

Another really recognized research uh institutes their world values survey.

Another important source follows this five measures.

And the importance of of those measures is that if we say that the idea of democracy can be elusive, elusive and abstract?

Those five are measurable um realities.

You can establish what what is the regularity of an electoral process?

What is the the level of participation, What is the type of political culture?

So so that’s why it’s I think such a useful instrument that is used worldwide and importantly in terms of their findings and again, maybe coming as you were mentioning against our common sense.

Um since the index, the E.I.U. Index was created in 2000 and six, what um it has it has established a number of findings.

Number one is that only a fraction of the world lives under way they categorized as full democracy.

Only 8.4% of the world in the last index of 2021 live under what you would call Full democracy as opposed to that 1/3 of the world lives under authoritarian regimes.

So and then in between that the four classifications are full democracies, flawed, democracies, hybrid regimes and authoritarian regimes.

So it says something that we think that democracies such as Um commonly experienced notion such a modern reality and actually um is the rarity even in the 21st century.

Um most people live in authoritarian regimes in hybrid regimes that you should refer to highly corrupt highly irregular societies or flawed democracies that um refer to um kind of weakened Asylum of those 4, 5 measures of democracy?

And so where does the United States rank?

What do you think?

I mean, as I listen, I think, well, we’re probably in flawed.

Democracy would be very good and you know, I say very good because it when I always ask that question, most people are kind of shocked by that.

And again, what’s important of this finding is that it’s not propaganda, ideological kind of comment, but it’s based on on certain measurable realities that democracy should have.

Um importantly, in terms of the United States, um that category of law, democracy um has been ascribed to the United States in over 10 years.

So something to reflect upon is that, you know, a democracy is not simply what political party is in power.

It’s because, you know, um the United States has been classified as such, when different political parties have been in power.

The measures that the IU follows which are the measures that any political scientists would follow are more substantial structural realities.

So, so therefore what those that classification flawed democracy points to is that there are structures in the US experience, meaning, procedures, regulations practices that result in that flaw category, um and other flawed democracies um that the United States would join forces with.

So you have an idea of of what nations were talking about in terms of Western nations, it would be France?

Italy Portugal and ironically Greece the originator democracy.

So what would be full democracies?

And those are societies in which those five measures of democracy are robustly manifested top of of the list.

Finland Norway, Norway has been consistently number one, so I would say maybe we should move to Norway.

Um Norway consistently has been for many years, number one followed by Finland, Sweden, Iceland and Denmark.

So a comment to make about that is that as you know, those are all Scandinavian countries that follow historically, at least even though there have been recent lactation uh form of government that that is highly supportive of not only economic and political rights.

I’m sorry, political and civil rights, but also economic, social and cultural rights is a system of government that normally described as a social democratic government.

So therefore a form of democracy that really embraces the idea of supporting collective and different groups.

For instance, in this society, there’s such thing as a right to work that we don’t have.

There’s universal health care, as I mentioned, there’s universal access to education, K to 18 etcetera.

But also importantly, and then as a comment to how democracy is ought to be understood as always a work in progress and something that we cannot let go, but that we have to consistently engage with.

Is that following that list of the Scandinavian countries the next one is Ireland and and why that is a significant finding is that Ireland way ahead in the list from the U.


From great Britain has achieved a status of full democracy UK also classifies as a full democracy.

But but in in a, you know, lower range than than Ireland.

So Ireland a society that has had a recent history of political violence under the nomination of great Britain for a number for for many centuries.

History of social inequities and poverty for a long time out of an active involvement in advance and democracy has reached this category.

And and something also to remember about Ireland, unlike the United States, is that despite its catholic um possible limitations to to certain practices of inclusion, Ireland has had two female presidents mary Maclean’s and mary Robinson even before the United States has reached that possibility of inclusion.

So other full democracies.

And I’ll just read uh read the list.

I mentioned some of them in the Western hemisphere, but for instance, a nation Austria Australia, Asia full democracies are new Zealand.

Australia and Japan and latin American or Y and Costa rica.

And in sub Saharan Africa, that we also tend to think not a democratic contest, Mauritius is a full democracy.

So above even the United States and I’ll kind of end by saying that things to learn because democracy is always an educational process.

So we also should learn from other example, even though it was an english colony, A plantation economy from early 19th century until 1968 when it achieved its independence.

Now it’s ranked as the most peaceful African country in the by the global peace index, a high income economy by the World Bank and having very high classification of human development of human well being index such as social welfare, universal health care, free education K to 18 free public transportation for students, seniors and disabled citizens.

So again, pointing to with all these examples, what are the characteristics of full democracy and how we can also maybe learn, what are the characters more robust health care system?

Yeah, I’m really struck by the term human well being.

Um and that to me is like, oh, that’s what I would like, that we moved and that was connected with health equity you mentioned for instance?


No, no, I was just gonna say that something that very fortunately because moments of crisis can be also moments of possibilities.

I think that because of the crisis we have been living in the United States and and in the globe recently, but take an example of United States, we now begin to hear more folks speaking of happiness as a human, right?

And and that’s, you know, there are measures to happiness as you’re saying that have to do with human well being and a sick person for instance, cannot be happy.

So, so there’s way of achieving something that could also be elusive, what is happiness, but but there are indicators that can advance it, Sorry to interrupt.

No, you’re good.

I I’m curious You mentioned that this index really started in 2006 and so I’m curious if the United States has ranked differently, you know, from 2006, you know, has it moved on the rankings in any certain direction?

Has it always kind of been in the same space?

Thought well from from this ranking because there are other measures um and indexes that exists in the world.

The United taste tendency has been unfortunately to um decrease its ranking within that flaw democracy um spectrum and as you say, democracies are and you very well pointed out also a spectrum of achievements um you know, I must say that there were lower scores overall for us within um that took place within the last administration and for issues we will know um what those who are about and even impacting basic democratic measures as transparency in the electoral process etcetera.

Um but significantly in this new most recent election, because participation improved for the United States, the numbers ended up being um somewhat better.

Okay, super interesting.

But still within that flaw, um spectrum that is shared by other Western societies that I mentioned and you mentioned that there in order to have democracy, there’s certain values that need to be in place or believed in.

So, can you name some of those values for us?

Well, I think that because there’s no universal definition of democracy.

You know, there are many and the whole theory of democratic evolutions, you know, would would address that.

That democracy in a way is also contextual.

Um There are certain historical realities that um lend themselves more or not to do certain values with uh connected to democracy and or not.

And as I mentioned historically, and we can go to the foundation of the United States nations.

The idea of civil and political liberties as values have been very strongly inscribed in the United States experience um of what is a democracy.

If we take the example of the Scandinavian countries um where unlike most western european nations, unlike the american experience, were societies that did not were not colonial powers, um did not participate in slave trade, did not participate in conquest in um the subjugation of indigenous populations.

So so there there has been some like historical almost um benefit that those societies has had um to to create more of a sense of uh collective share experience and less dramatic moments of clear discrimination, clear oppression which are the challenges of so many societies.

So what I’m trying to say is that I would not say that their values that democracy can be universally established to have.

But if we follow the five measures of something like the E.I.U.

Those are the values um that those five measures also suggest values, you know, something like political participation must have the value of inclusion.

Um Some something like electoral process and pluralism must have the value of of uh equity, accountability, transparency, but something as political culture um that endorses economic, social and cultural rights must have values of um that connect the idea of not having such social class differentiations that we have in this society of creating, which is the way it’s done in social democratic societies, a tax system that prevents those very extreme polarization of wealth that we are not experienced.

That I would say it’s a challenge to democracy because it uh creates real life obstacles to participation.

Two good sectors of society that are still consuming your own survival.

That then democracy does become more than engagement of political elites, which is a challenge also of current US democracies and part of the disengagement, I would say even folks in the left and the right is that they don’t see a level of genuine participation and in the process.

So, so, you know, what I’m trying to say is that we can identify maybe the values for certain forms of democracy uh and ideally we would like to think that most folks would want to advance all the possibilities of democracy, but unfortunately, that’s not necessarily the case.



Uh so how does democracy impact health?

So if we accept the fact that at least for measurable verifiable um sources us is a flawed democracy at this moment.

That implies for me that it’s provisioning of healthcare is also flaw and if we look at more specific evidence for that, um we um and I’ll share some information with you.

Um We know from data that healthcare access delivery, quality of care is not equally experienced by all societal sectors.

There’s widespread evidence documenting how those possibilities are at that firstly experienced by black american sectors, by indigenous americans by people of color, immigrants, undocumented communities and poor communities in general.

Um because there’s not such thing as a universal not privately provided healthcare in the United States access to health care, among other things implies access to a certain income.

So of the bad, there’s a level of unequal participation and benefit and and unequal experiences of quality health care of um the type of treatments that you can then you might need, but that you might or might not be able to um receive medication etcetera.

So from data we know that the United States has high rates of illness and death among certain areas such as diabetes, hypertension, obesity, asthma, heart disease, and that folks of color tends to be impacted by those more than white sectors uh compared to whites.

Um racial and ethnic minorities for sectors are less likely to receive, as I mentioned, preventive health services which therefore lead the way to illness and usually receive as we know, even common sense, likely lower quality of care in terms of again, kind of measuring healthcare and to speak with this about this from data and evidence a source I always use um is something called the commonwealth fund which similar to the E.I.U.

And maybe you’re familiar with it measures healthcare um throughout the globe.

And again they based their research on such uh highly recognized sources as the E.O.E.C.D. The Organization for Economic Cooperation element, the World Bank and so forth.

And again similar to the E.I.U.

And as an academic I think it’s important that we approach these discussions from from evidence.

Um The commonwealth also follows certain measures to establish what is the status of health care and again unfortunately and parallel to its standing in democratic um classifications the out of five measures that they use that I will discuss the U.S.

Rank the lowest in for them when compared to other high income developed nations.

So comparable societies and those measures are access to care that means affordability, timelessness.

We know especially after the pandemic.

You know you can wait a long time to to to achieve care but that has been the reality of of sectors of society that either do not have a level of income that come from underserved communities etcetera.

So that’s the first measure access to care, administrative efficiency.

And by that uh the what that refers to is what is the level of paperwork bureaucracy complications that are entailed to access treatment and how the those negatively impact if it’s too burdensome and cumbersome as we know is our system.

How does that impact the willingness even of patients to want to continue?

Um The other measures healthcare outcomes of course, out of um that access to care, that administrative inefficiency, how much of society’s um sick ill population, how much is it actually serving?

And that can be measured?

And and fourth measures equity, which brings all of those measures together.

So the United States ranks below most developed high income societies in for in those four access to care, administrative efficiency, equity And health care outcomes.

Yet the 5th 1 which for new a surprising which is care process um which generally refers to preventive care.

The US ranks fairly high on that.

However, we have to understand that these are aggregated measures.

What the commonwealth fund is measuring is how society as a whole is serving its general population.

So even in this last measure if we begin to desegregate preventive care by ethnic um racial uh income, um L G B T Q plus trans population.

We know that then those outcomes are not the same.

So again, in terms of classification and I give this listing because there ought to be lessons learned from the example.

Again, Norway scores the eyes scores the highs in healthcare provisioning and in democratic classification and in decreasing order the Netherlands Australia, United Kingdom Germany new Zealand Sweden France.

Switzerland Canada.

And after all of those United States.

Hm So I’m curious what are some of the lessons that we can learn from the countries that do have a more collective approach to well being.

I think that they show that you bring up about values even though it might be difficult and elusive.

It’s an important one.

Um so many of the issues that we’re discussing really are premised on educational pursuits.

We need to educate on what could be a better democratic society, what could be a better health care system.

And there’s a lot of, as we know, one of the unfortunate terms that we hear now all the time.

It’s misinformation, false information.

There’s a lot of untruth around what is, what are the possibilities of democracy as well as what are the possibilities of more equitable precisely and more democratic healthcare system.

And one of the those falsities cost something that it’s externally important out of this um findings is that even though the United States ranks below other comparable Western developed societies in four of the five measures I mentioned, it actually spends more of its gross domestic product that most of those nations.

One things one thing that has been used um as a counter falsity source of information to for something like universal care is that it would be costly and in addition to taxes and what we can learn from these nations is that’s not the case that even though the United States is already spending more of his gross domestic product on health care is not being administratively efficient in the use of those funds.

And that’s one of the measures that the United States does poorly.

And by that means all the cumbersome bureaucracy and meaning all the expenses that paint all those people entail.

More equitable systems are more immediate.

You don’t have to traverse all these procedures and paperwork.

Um, Also, other, more equitable system are supported by public funding as opposed to private insurance companies.

So therefore the taxes are more immediately used to what ought to be the priority, which is the well being of patients as we now in the system that we share because it’s privately managed through insurance company.

In reality, I would say the priorities, the insurance company bottom line and, and, and therefore what is positive about all this reflections is that we don’t need to be stuck with the imperfect system with the inequitable system that we have, but we can think and learn of how is it that other comparable Western capitalist societies, all of them are that, uh, do it in a more efficient way.

I’m remembering.

I had a political science teacher who, um, shared that and I don’t know if this is still true, but that the only two unregulated, um, entities.

I don’t know if that’s not the right word in the United States were baseball and insurance because we were talking about the Cost of insurance.

And so you have, you know, essentially 51 different systems all working, um, that are not regulated by the federal government, which is just really interesting that those were, those were the two that he shared.

Yeah, and you know, and I think that again, because political culture beliefs are important in supporting a type of democratic system or other in the United States, um, we have to recognize that the understanding of a good society is very individualistic base is a strong belief.

Um, we in the United States still have um, to believe on those notions as pulling yourself by the bootstraps and that everybody can do it.

And we continue, we need to continue educating on the evidence based realities, that that’s not the case for all groups.

Um, and, and through that kind of consistent messaging, understanding that the reason why we create government actually, and political society is that we need to organize the collective.

You know, actually, if we lived each of us in an isolated island, then we could only worry about our individual concerns.

But as participants of society, whether we want to believe it or not, we have to work in the benefit of the group.

And I think that’s uh, an understanding that is more challenging in the United States than in other societies.

Even societies like France spain Italy.

Um, they have a more collective tradition.

Um, for instance, union organizing those society is not a crime, it’s a right of workers and another aspects of collective well being, um, are less of a challenge than maybe in the anglo Saxon tradition, but, you know, importantly, even though we inherited those political beliefs from great Britain, even great Britain has absorbed more of that collectivist approach.


Because they understand that the benefit, what benefits to society has to be thought from the groups.


And how how do we shift to more of?

Um you know, I, you talked about the importance of education, um and we have a lot of misinformation and people get bristled with fear with change.

Um and so I’m just really curious your thoughts on how do we move the needle as we really are in this individualistic society to more of a collective society.

Well, um you know, I would not even say that we should move to a more collectivist IQ society because I know that would scare the heck out of a lot of people because it’s miss associated with other notions that that’s not what um the goal ought to be, but more and more consistent.

An active and pervasive and persistent educational process of understanding that there are areas of human existence that are by nature collective.

The educational system is a collective experience.

You know, you cannot benefit uh individual students.

You have to benefit group of students and we have to continue pushing those understanding in areas such as health care, that in this society as you well know, as an expert on these matters, um is a highly contentious area of understanding that, you know, it’s a understanding that precisely because you want to advance your your individual interests, it has to be as part of a group effort because that’s the way it’s actually gonna move ahead.

Um these are times of as we know for the United States, for the globe of enormous level of crisis, in other levels of disengagement of disappointment of cynicism.

But the answer is that also crisis can open, it doesn’t happen all the time, but can open possibilities because we have in crisis proving that certain things are not working and and therefore um it ought to invite to the possibility of rethinking alternatives and you know, ironically the United States is still a young nation when we think of Greece for instance and other examples.

Um so you would think that that spirit that has been so much part of of the American experience of innovation and and the idea of constant evolution that we should in a way go back to those beliefs in a more democratic direction that we don’t need to be stuck in the place that we are and that that’s not all that there is and that is actually a very America way of thinking.

So, so it’s also to, you know, we have that that mentality for for entrepreneurial business proposition.

So so let’s also open ourselves to innovation, creativity, possibilities in other areas of human existence.

Yeah, and I I come from a human development background.

And so I love how you talk about how the United States is a young nation.

And so that actually gives me hope that as we um continue to age that uh hopefully we can develop some wisdom as we reflect on where we are today.

Um and is it time to you know, pivot in other directions or really go back to some of our values that we were founded on?

Yeah, and and the idea and the reality of democracy has to be participatory, that’s one of the actual measures of it.

And by that, I mean not simply participating in electoral process procedures, but but being an active citizen, um that’s where the strength of the people, if we go back to that original notion actually lies.


Well, you’ve given us a lot to think about today.

Um my mind goes in a million directions as you share so much, I feel like we could um I can learn so much from you.

Uh So as we wrap up today, is there anything else that you feel is important for our listeners to know?

I would say just underlining what we have been saying, the importance of the educational process and by that I don’t mean simply higher education.

I mean all educational outlets as active citizens, we should more actively participate in discussions in groups.

Um you know, if we go back to Alexis De toqueville, which was one of the great commentators of the american experience um in the 19th century, what he thought was such a important characteristic of democratic possibilities, of the american experience was that town hall gathering, that those type of smaller groups and and by that he meant, and of course we live in a virtual era now.

So, so it’s not like we can replicate that, but what he meant is the idea of of groups discussing of groups reflecting of groups, proposing that for him was one of the important foundations of what could be the democratic experience for the United States and for other nations.

So, to really embrace that, that is really accessible to any of us.

And also something I always say to my students that political arrangements are human created arrangements, so therefore there’s no law of gravity about them.

That cannot be changed the same way that what we have now is a result of human intervention.

We can also intervene to create something better.

Mm I love that.

I’ve been working a lot with first responders recently and they do a a r so after action reviews and so after, you know, an incident occurs then coming together as a group and discussing how it went, what went well, what needs to be changed and then reflecting on how to move forward for the future.

And so that strikes me from that town hall perspective and that coming together as groups for how are we doing?

Um Exactly.

And of course acting upon those reflections.

That’s that’s another critical piece right?

Sometimes really talking about that’s really where your cross take action.

Oh well, Eloisa, it has been a joy to talk with you today and learn from you.

You just have a wealth of knowledge and really grateful for your time.

Thank you so much.

You have made it so easy.

I was a bit nervous at the beginning, but it really was a great conversation.

Thank you so much.

Thank you.

Thank you very audience.

Thank you for listening to CASAT Conversations.

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This episode features the song “My Tribe” by Ketsa, available under a Creative Commons Attribution-Noncommercial license.

Disclaimer: This podcast is for educational purposes only. Any advice offered on the podcast is an educational context and is not intended as direct medical advice, nor as a replacement for it. If you are experiencing a medical or life emergency, please call 911. If you are experiencing a crisis, please contact the National Suicide Prevention Lifeline at (800) 273 – 8255.  If you are experiencing stress, and would like professional help please contact your insurance company to identify a therapist in your area or contact the organization you work for and ask about an employee assistance program.

CASAT Conversations Season 3 Episode 7 - Human dynamics in healthcarejose l. melendrez, msw