Recently, an old friend, a retired doctor who volunteers at the free clinic in Providence, Rhode Island, described the anger of many of the patients he sees. It’s by now a familiar story, but his images of people who put off medical procedures they fear they can’t afford gave it a new urgency. Feeling abandoned by the system, they are afraid as well as angry, bewildered at how completely the American dream, at least for them, has disappeared.

And then another old friend sent me information that gives some context to what is happening to the lives of the patients in Providence. Wealth inequality is also a familiar story in America these days, but for so many of us, it remains a set of numbers, no matter how staggering. And they are staggering: the 20 richest Americans now own more than the 152 million people in the bottom half of the population. Such discrepancies are growing rapidly: the richest 0.1% owned 7% of the country’s household wealth 40 years ago; 15% 20 years ago; 22% today, with the result that the vast majority of Americans now face a combination of stagnant incomes and accelerating debt.

Never, to paraphrase Winston Churchill, was so much owed by so many to so few.

Unsurprisingly, the newfound wealth has found its way into politics, where it tends to look out for its own.

A third old friend sent me a book called (honestly) Ratf**ked, in which David Daley describes one way it does so, and about which I will write next time.

* From “Harlem” by Langston Hughes