"public health is not where top flight thinkers and analysts wind up. it's the scupper that catches the folks washing out of research and development and sucking them into bureaucracy and politics."

It's so true. Many who wash out of the tenure process from the Ivy League go to the NIH and other outfits. Someone I know who's a National Academy of Science member has gone down to the NIH to help with hiring. They were struck by the emphasis on the candidate supporting diversity vs the merits of the candidate's research. The problem is that these top flight people don't, as a result of their experience, speak out about this and the potential of problems. So you have the losers rating the winners regarding grants. How can they not see this problem?

In the past, many of the best did go into public service but, now, with the emphasis on making money, many have eschewed public service with the result that our infrastructure and social capital is greatly eroding. My theory, as a late Baby Boomer, is that there was less competition for everything in the 1950s/1960s because the population ratio compared to land was favorable for the buyers. Immigrant households could buy land in affluent neighborhoods then because it was still cheap. When population increases, the demand skyrockets and becomes unaffordable. It becomes a story of supply and demand.