For end-of-the-year columns, it’s customary to recap the events of the past 12 months, usually highlighting a mix of the good and the bad. Because this year has been dominated by health, in particular COVID-19, and my beat is health, it seems fitting to reflect on where we are. Where we are is not good.

A headline in the Los Angeles Times seemed to sum up the current state of the U.S. health care system: “Bodies pile up, patient care falters as COVID-19 devastates L.A. County hospitals.” In the Times’ story a hospital critical care nurse says, “No one would believe this is the United States.” Indeed, they would not.