Does it ever seem to you as if the United States, having grown in relative domestic peace and stability since 1945, is now choking on itself like an old lilac bush that nobody trims? I am trying to avoid a medical cliché, but surely we are clogging our arteries, letting toxins build in our organs; softening, sagging, and losing our will.

For example, our major manufacturing industries cannot generate decent jobs, in part because they seem unable to innovate, and in part because they are carrying the expense of health insurance for their workers and retirees. For all our firms and households, the health system is amazingly expensive, yet it is riddled with inefficiency, error, and inequality. The technology is impressive; the incentives are perverse.

We choose where we live on the basis of the quality of the schools, which (in turn) is mostly a function of the affluence of the people who live around them. We thus sort ourselves by privilege and leave a substantial minority with dismal prospects.

The neighborhoods with the failing schools are often dominated by the sale of illegal drugs. Perhaps our drug policies reduce the tonnage of narcotics that we consume as a people, but at the cost of violence and rampant incarceration in the very places that begin with the fewest resources.

Our colleges and universities serve mainly to sort people by social class and to confer advantages on the already advantaged. As a side business, they run quasi-professional football and basketball teams.

Our congressional districts are “rotten boroughs,” gerrymandered to prevent competition. Our very land is planted with corn and soybeans that are turned into artificial products, all because our taxes subsidize particular crops while funding agribusinesses to lobby to preserve their advantages. Our bodies are glutted with the refined sugars that the land yields at our expense. While we chew, we sit and watch screens on which tawdry spectacles are interrupted only by incessant advertising for disposable goods that pile up in landfills. We borrow from abroad, burn mountains of carbon, send our young overseas to fight in lost causes, and toss away a trillion dollars on an optional war.

These times demand serious work from all of us, and leaders who call for us to contribute.