We are being ravaged by diseases of despair. We don’t eat well. Our sedentary lifestyles are bad for physical and mental health. But we don’t talk nearly enough about the successes of public health and the advancements of science, which have largely been pushed by agencies, doctors, and research Kennedy and the Trump administration are now attacking. Our food, though more processed, is less contaminated thanks to FDA regulation. Infant mortality has plummeted. Cancer deaths have dropped 34% since 1991. Death rates from childhood leukemia are down six-fold since 1950. Vaccines for measles, polio, hepatitis B, and HPV have saved millions of lives. Smallpox was eliminated. Measles cases are down 99% (despite some recent outbreaks). U.S. life expectancy rose in the 20th century by over 30 years. Cardiovascular disease mortality has fallen about 75% from the 1950s. Even the maternal mortality rates in the U.S. may have been overstated, and new studies show our numbers are much more in line with other developed nations. HIV and AIDS deaths are down 54% since 2010 alone. Overdose deaths fell in 2024 by a whopping 27%. The list goes on and on and on. In short: We’re doing a lot of things right, and doing them in large part because of these agencies, scientific research, new drugs, new vaccines, and new treatment protocols. Quite obviously, these achievements are not enough to warrant burning the entire system down.

headline economic figures have become less and less of a useful guide to how actual families are doing—something repeatedly noted by Democrats during the Obama recovery and the Trump years. Inequality may be declining, but it still skews GDP and income figures, with most gains going to the few, not the many. The obscene cost of health care saps family incomes and government coffers without making anyone feel healthier or wealthier.

To be clear, the headline economic numbers are strong. The gains are real. The reduction in inequality is tremendous, the pickup in wage growth astonishing, particularly if you anchor your expectations to the Barack Obama years, as many Biden staffers do.

During the Biden-Harris years, more granular data pointed to considerable strain. Real median household income fell relative to its pre-COVID peak. The poverty rate ticked up, as did the jobless rate. The number of Americans spending more than 30 percent of their income on rent climbed. The delinquency rate on credit cards surged, as did the share of families struggling to afford enough nutritious food, as did the rate of homelessness.

the White House never passed the permanent care-economy measures it had considered.

the biggest problem, one that voters talked about at any given opportunity, was the unaffordability of American life. The giant run-up in inflation during the Biden administration made everything feel expensive, and the sudden jump in the cost of small-ticket, common purchases (such as fast food and groceries) highlighted how bad the country’s long-standing large-ticket, sticky costs (health care, child care, and housing) had gotten. The cost-of-living crisis became the defining issue of the campaign, and one where the incumbent Democrats’ messaging felt false and weak.

Rather than acknowledging the pain and the trade-offs and the complexity—and rather than running a candidate who could have criticized Biden’s economic plans—Democrats dissembled. They noted that inflation was a global phenomenon, as if that mattered to moms in Ohio and machinists in the Central Valley. They pushed the headline numbers. They insisted that working-class voters were better off, and ran on the threat Trump posed to democracy and rights. But were working-class voters really better off? Why wasn’t anyone listening when they said they weren’t?

Voters do seem to be less likely to vote in their economic self-interest these days, and more likely to vote for a culturally compelling candidate. As my colleague Rogé Karma notes, lower-income white voters are flipping from the Democratic Party to the Republican Party on the basis of identitarian issues. The sharp movement of union voters to Trump seems to confirm the trend. At the same time, high-income voters are becoming bluer in order to vote their cosmopolitan values.

The Biden-Harris administration did make a difference in concrete, specific ways: It failed to address the cost-of-living catastrophe and had little to show for its infrastructure laws, even if it found a lot to talk about. And it dismissed voters who said they hated the pain they felt every time they had to open their wallet.

Why costs are so high: The simplest answer is that schools have had little incentive to control costs, particularly when abundant student loans — both public and private — can make tuition rates appear more affordable than they really are.Moreover, some schools are motivated to spend on high-ticket items like new construction, because that can attract wealthier students (including from overseas) who don't request financial aid. In the end, however, those costs often get passed down to everyone.This is a systemic issue, which explains why most politicians have preferred to play along the easier margins.

There are possible solutions that have been circulating among education experts, not all of which rely on taxpayer largesse like making public college free for lower-income students.One would be to limit loans tied to education at schools that have a demonstrated history of onerous student debt burdens. In other words, if most of a school's students aren't receiving the sort of education that allows them to pay off their loans, cut it off at the source.This could include a gainful employment rule focused on career programs, which is favored by the Biden administration but languishing in Congress.Another would be to deny federal research grants to schools whose tuition rates increase at an unacceptably high level. This would be particularly impactful at large public and private universities.The federal government also could consider revoking the tax-exempt status of schools that exceed tuition inflation limits, although that likely would face court challenges.