More than 660,000 Americans have already died of covid-19 — more than in any other country — and another 100,000 may perish by Dec. 1. How is this possible when we have enough vaccine doses for the whole population? The problem is that nearly 80 million eligible Americans stubbornly, stupidly refuse to get vaccinated — and there is almost no way to force them to do the right thing. With just 63 percent of the U.S. population having received at least one dose, we now lag behind every Group of Seven country in vaccination rates. We have even fallen behind countries such as Brazil, Mongolia and Cambodia, which are nowhere near as wealthy.

President Biden has said repeatedly that he believes that the onus is on the United States to show that democracy can work better than autocracy. But that’s not quite right. Other developed democracies work just fine. It’s not a question of democracy vs. autocracy. It’s more a question of the United States vs. the rest of the democratic world. Look at Canada: Its covid-19 death rate is one-third of ours and its vaccination rate is 12 percentage points higher. We have a uniquely dysfunctional political system — and it’s not clear that it can be fixed.

Our failure to manage the pandemic is of a piece with our failures to manage many other endemic ills. We have the weakest gun regulations among wealthy democracies and the highest level of gun violence. We are the only advanced democracy without universal health care — and our infant mortality rate is higher than in comparable countries. We have the weakest welfare state and the highest income inequality and poverty among G-7 countries. No wonder Europeans’ life expectancy is increasing while ours is declining.

Americans liked to think we live in an “exceptional” nation, but in recent years we have been exceptional primarily in the scale of our public-policy failures. Biden is doing his best to catch up, but our sclerotic political system may not allow him to achieve what other advanced democracies take for granted.

Biden has proposed a $3.5 trillion plan that would provide more money for, among other urgent priorities, child care, elder care, family leave, pre-K education and clean energy — but it may not pass in the Senate. Biden wants to impose tougher controls on guns, but he just had to pull his nominee to head the Bureau of Alcohol, Tobacco, Firearms and Explosives because the gun lobby controls Congress. Biden has done an excellent job of rolling out vaccines, but red-state governors are trying to block vaccine and mask mandates that could save lives.

Why is it so much harder to enact sensible policies in the United States than in other democracies? Part of our problem is the flip side of our strengths: Love of liberty and distrust of authority run amok when a quarter of the eligible population will not accept lifesaving vaccines in the middle of a terrible pandemic.

We are also paying the price for a political system that was brilliantly designed for 1787 but has failed in 2021. In 1790, the largest state, Pennsylvania, had six times the population of the smallest, Rhode Island. Today, the largest state, California, has 68 times the population of the smallest, Wyoming. Yet California and Wyoming have the same number of U.S. senators.

Imagine how differently our politics would look if the Senate were elected based on population regardless of state lines. California would have 12 senators, and Wyoming, North Dakota, South Dakota and Montana would all share one. That should make it much easier to enact policies such as universal medical care and a ban on assault rifles that are unthinkable today. The overrepresentation of rural, conservative interests in the Senate is stunning: The 50 Republican senators represent nearly 40 million fewer voters than the 50 Democrats. Ending the filibuster can ameliorate this inequity, but there is no way to end it when just 13 states can block any constitutional amendment.

Even when it’s possible to implement sensible initiatives in Washington — which these days increasingly means via executive order — the system of federalism enshrined in the Constitution allows extremists at the state level to go their own way. Biden reflects the views of the pro-choice majority in America, but Texas just effectively outlawed abortion — and a Supreme Court packed with Republican-appointed justices refused to intervene. Biden could never impose the kind of vaccine passports that are now required in Italy and France for entry into public places — and that have boosted their vaccination rates above ours.

It was once common to venerate the Founding Fathers as demigods. These days, they are often assailed as enslaving racists. But while slavery has been outlawed, the fundamental structure of the government they created remains not only unchanged but is effectively unchangeable. That, I fear, consigns America to more frustration and failure in the future. There’s a good reason why a country that was once a model to emulate has become for much of the world a case study in what not to do. Ultimately, if you want to blame anyone for our current dysfunction, we need to look to the men who created our country.