To Read: The Poverty Paradox: Understanding Economic Hardship Amid American Prosperity; fPoverty, by America
Unemployment has a disproportionate impact on black workers
Tobias Burns, 9-20, 23, The Hill, Fed faces risks as inflation fight runs into election, https://thehill.com/business/4212209-fed-faces-risks-as-inflation-fight-runs-into-election/
Higher unemployment does not affect all segments of the population equally. The unemployment rate for Black workers, which hit an all-time low of 4.7 percent earlier tis year, is still consistently higher and more volatile than it is for white workers. “I am concerned that we could lose what has become an indicator that the Black community has been really pleased about overall. There was a time in our history when the Black unemployment rate did not go below double digits,” Michelle Holder, an associate professor of economics at John Jay College in New York City, told The Hill. “I absolutely remember what it was like … at that time, where it was just accepted that our community would be dealing with high unemployment — period,” she said.
1:8 kids is poor; 38 million live in poverty
Marcia Chatelain, 8-21, 23, The Nation, Tens of Millions, https://www.thenation.com/article/society/poverty-by-america-matthew-desmond/
The United States, Desmond notes, is “the richest country on earth,” but the problem of poverty is so enormous that it affects Americans across a wide economic spectrum. Not all American poverty looks or feels the same, but the vulnerability of poor people to circumstances outside of their control keeps them from realizing economic security. “If America’s poor founded a country, that country would have a bigger population than Australia or Venezuela,” Desmond writes. “Almost one in nine Americans—including one in eight children—live in poverty. There are more than 38 million people living in the United States who cannot afford basic necessities, and more than 108 million getting by on $55,000 a year or less, many stuck in that space between poverty and security.”\
People won’t use welfare benefits
Marcia Chatelain, 8-21, 23, The Nation, Tens of Millions, https://www.thenation.com/article/society/poverty-by-america-matthew-desmond/
Desmond concludes that one of the real issues with American poverty today is not just that we don’t have the right anti-poverty programs, but that we have marginalized and stigmatized poverty in a way that hinders the poor from getting even the aid that is available. “If you dig into the data,” Desmond writes, “you quickly realize that the problem isn’t welfare dependency but welfare avoidance…simply put, many poor families don’t take advantage of aid that’s available to them.” He cites the fact that only 25 percent of those eligible for Temporary Assistance for Needy Families (TANF) actually apply for it. Senior citizens do not fully take advantage of food stamps, with only 48 percent of those eligible accessing the monthly benefit. Programs that have been heralded for helping relieve poor families—Medicaid, the Children’s Health Insurance Program, and the earned income tax credit—are being used by only “one in five” eligible families. This phenomenon of people opting out of welfare benefits, whether because of social stigma or a lack of information on how to receive them, results in billions of dollars that are not being spent to cover basic needs and therefore are not circulating in the national economy.
Businesses are sustained by the government paying SNAP benefits to their employees
Marcia Chatelain, 8-21, 23, The Nation, Tens of Millions, https://www.thenation.com/article/society/poverty-by-america-matthew-desmond/
Throughout my life, I have heard poor people claim that not taking advantage of welfare benefits was a badge of honor or pride. I could have applied for SNAP. I could have gone to the welfare office. By abstaining from a stigmatized entitlement, they are trying to communicate something about their character. This stigma is even more pronounced because of how poverty is racialized. Racist stereotypes about Black and brown welfare recipients often obscure the scores of white people who access welfare benefits, but it also makes Black and brown people more hesitant to accept any needed entitlement. Meanwhile, many large businesses have come to rely on welfare checks, food stamps, and other benefits to keep their poorly compensated workers fed, housed, and healthy enough to report to their checkout counters, cashier stations, and burger grills. In this way, the federal government is subsidizing these employers, which don’t pay well enough or offer benefits in the first place. One in 17 of North Carolina’s Food Lion grocery workers collected food stamps, as did 1 in 10 of their colleagues at Stop and Shop in Massachusetts, and the same was true of 14 percent of Dollar General’s workers in Oklahoma. Employers in the service industry, despite often taking a pro-business stance and lining the pockets of right-wing candidates, support and benefit from government spending that keeps their workers barely surviving and needing their jobs.
Poverty undermines brain development
Eric Dolan, 8-8, 2023, PsyPost, Home Exclusive Mental Health: Generous anti-poverty programs mitigate impact of low income on child brain development, study finds, https://www.psypost.org/2023/08/generous-anti-poverty-programs-mitigate-impact-of-low-income-on-child-brain-development-study-finds-167484
The researchers conducted this study to understand why adults who grew up in families with lower income tend to have lower educational attainment, more mental and physical health problems, and rely more on public assistance compared to those from higher income families. They wanted to explore whether certain factors, like the cost of living and the generosity of anti-poverty policies, influence the relationship between family income and brain development and mental health in children. “Kids growing up in lower income households tend to have more mental health problems, like depression and anxiety then kids from higher income households,” said study author David G. Weissman, a postdoctoral fellow at Harvard University and an incoming assistant professor at California State University Dominguez Hills. “Many studies have also found poverty or lower family socioeconomic status to be associated with structural differences in the developing brain. The solutions that have the potential for the most widespread impact on these disparities are at the level of state and federal policy, but most neuroscience studies are conducted at a single place and time, where it is not possible to study the impacts of these types of policies. To conduct the study, the researchers used data from a large study called the Adolescent Brain and Cognitive Development (ABCD) Study, which involved children from different states in the United States. They looked at family income, brain structure (specifically the size of the hippocampus), and mental health symptoms of children aged 9 to 11. “The hippocampus is central to memory and learning, and it’s also uniquely sensitive to chronic stress. Animal studies show that consistently elevated stress hormones such as cortisol can reduce the formation of new synapses (or connections between neurons) in this region of the brain,” Weissman told PsyPost. The study included a total of 11,864 youth with data on parent-reported psychopathology and 11,533 youth with brain structure data. The average monthly Earned Income Tax Credit (EITC) and Temporary Assistance for Needy Families (TANF) benefits in each state were used to measure the generosity of anti-poverty policies. Additionally, the researchers used a dichotomous variable to indicate whether each state had expanded Medicaid eligibility through the Affordable Care Act by the end of 2017. “Because the ABCD study collected data from 21 sites in 17 states across the country, we had a unique opportunity that has not been possible with previous studies on this topic,” Weissman explained. “We were able to look at if characteristics of those places, in particular government antipoverty programs, influenced the nature of the associations between poverty and both brain structure and mental health.” The researchers found that lower family income was associated with smaller hippocampal volume and more mental health symptoms in children. Additionally, they discovered that in states with a higher cost of living, the differences in brain structure and mental health between children from high- and low-income families were greater. However, in states with more generous anti-poverty programs, these differences were reduced, meaning that children from low-income families had better brain development and mental health outcomes when they lived in states with more supportive policies. “Many studies have shown that the impacts of poverty are observable in children’s brains,” Weissman told PsyPost. “These results suggest that government antipoverty programs work at reducing those impacts. Therefore, policy decisions on things like Medicaid Expansion and the generosity of cash assistance for families in poverty matter for the brain development and mental health of children from those families in a measurable and significant way.” The researchers suggest that factors like cost of living and anti-poverty policies can either amplify or reduce the impact of low income on brain development and mental health. For example, living in a high-cost-of-living state can put more strain on low-income families, but having access to generous anti-poverty programs can provide more financial resources and support, potentially reducing stress and its negative effects on brain development and mental health. “While the results were more or less what we expected, it is nonetheless striking how consistent the pattern of results were for both the effects of both cash assistant programs and Medicaid expansion on both hippocampal volume and internalizing problems,” Weissman said. The researchers controlled for other state-level social, economic, political, and educational factors that might influence the relationship between family income, brain structure, and mental health. These included population density, unemployment rate, political preferences, and state-funded preschool enrollment. But like all research, the study includes some caveats. “These findings are correlational, and there are other differences between these states that could explain these findings,” Weissman explained. “Experimental evidence, such as from randomized control trials of cash transfer programs like the Baby’s First Years Study at Columbia, can more firmly establish that these types of programs cause differences in brain structure and mental health.” “But we tried to rule as many alternative explanations out as we could by conducting supplemental analyses controlling for a wide array of state characteristics, from the racial and ethnic makeup of the sample within that state to its population density to measures of education equity in those states, and the results held consistently across these analyses.” The study, “State-level macro-economic factors moderate the association of low income with brain structure and mental health in U.S. children“, was authored by David G. Weissman, Mark L. Hatzenbuehler, Mina Cikara, Deanna M. Barch, and Katie A. McLaughlin.
Universal Basic Income improves health
ELIZABETH MEISENZAHL AUGUST 8, 2023, https://prospect.org/economy/2023-08-07-guaranteed-income-gets-new-life/, Guaranteed Income Gets a New Life
Cities around the country are using federal funding from the American Rescue Plan (ARP) to implement pilot universal basic income (UBI) and guaranteed basic income (GBI) programs. Under these programs, residents receive regular cash assistance with no strings attached or requirements for how they spend the money. UBI plans provide cash to all residents without means testing, while GBI programs are more targeted to particular groups in need. In Rochester, a midsized city in western New York, advocates hope that high demand for a new GBI pilot will mean the eventual establishment of a permanent program in a city with extreme need. The Rochester GBI pilot program will provide $500 each month for a year to 351 individuals living at or below 185 percent of the federal poverty level. The number of individuals involved in the pilot is proportionally similar to those in programs offered by larger metropolitan areas, says Jeremy Rosen, director of economic justice at the Shriver Center on Poverty Law. The demand for the program became clear as soon as the application went live on June 22. Within 45 minutes of the application going up, 2,000 city residents applied to be a part of the pilot. The winners will be selected randomly via a lottery. For residents of Rochester and its surrounding area, the immediate demand for the program was no surprise. The city had been a prosperous industrial boomtown along the banks of the Genesee River and Erie Canal, starting in the early 19th century. As mill work declined, it became a new hub of photography and xerography due to the founding of Eastman Kodak and Xerox, respectively. But since then, Rochester has experienced the kind of economic fall common to Rust Belt cities in the Northeast and Midwest. Starting in the 1950s, manufacturing jobs disappeared, and the city’s population started to shrink. By 2010, it was smaller than it had been a century earlier. Some of the economic damage was compensated by new jobs in higher education and health care, both of which have grown rapidly in the 21st century in Rochester. But unlike manufacturing, such jobs typically require lots of education and training. Cities like Rochester now have a widening gap between their highly educated “eds and meds” workers and those who perform low-paying care work, often in poor conditions—and that’s if they have jobs at all. Over the past decade, Rochester has had a significantly higher unemployment rate than the state and country, nearly half its children live in poverty, and the city consistently ranks among the most impoverished compared to similar-sized metropolitan areas. A guaranteed income program is a way to not only put money in the pockets of some of the people with the greatest needs but also to dispel myths about direct cash assistance. Discussions of a GBI program began in and around Rochester over a year before the ARP funding reached the city. In 2020, the city and Monroe County formed the Commission on Racial and Structural Equity to address systemic inequalities within the county. The commission recommended, among other policies, a basic income for pregnant women at risk of maternal mortality. Beginning in the summer of 2021, a new committee focused solely on reparations and UBI began seeking community input. From those discussions, the Rochester-based nonprofit Black Community Focus Fund was selected to work with the city to administer a GBI pilot, which will be the city’s first experiment with a guaranteed income. The required $2.2 million will come from a small portion of the city’s $202 million from ARP. And Rochester is not alone. At least 31 cities are currently undertaking guaranteed income pilot programs, many of them funded at least in part by ARP money. For Damon Wilson, a program director at BCFF who has worked closely with Rochester officials in support of the pilot, a guaranteed income program is a way to not only put money in the pockets of some of the people with the greatest needs in the city, but also to dispel myths about direct cash assistance. “No one has skepticism for people who have wealth and how they spend their money, but when it comes to people who are living in poverty, we want to question everything they do,” Wilson says. “We monitor their every movement because there’s a lack of trust. So I’m hoping that programs like these across the nation will start to dispel some of those fears and those anxieties around people living in poverty.” Wilson’s perspective on the importance of guaranteed income is part of a growing shift in thinking around social welfare benefits, especially on the local level. The COVID-19 pandemic created a window of opportunity for policymakers to push the boundaries of what government’s role is and what kind of assistance it can provide, says associate director of Stanford’s Basic Income Lab Sean Kline. After all, one of the signature features of the CARES Act pandemic relief was the famous $1,200 payment that most Americans received. Combined with the surge of federal funding for cities through ARP, the wave of bolder thinking about benefits in local government has led to a new wave of guaranteed income pilots. On one level, it’s odd to think of this as innovative research. Political philosophers proposed the concept in the 18th century, and theories around it developed throughout the 20th century from intellectuals across the political spectrum. More recently, Democratic presidential candidate Andrew Yang popularized the idea of a federal UBI in his 2020 presidential campaign. But in terms of actual implementation on the city level in the United States, the history of guaranteed income programs is not long. Stockton, California, burst onto the guaranteed income scene in 2019 as an early proponent of local guaranteed income pilots. The program there was a resounding success, and led then-Mayor Michael Tubbs to found Mayors for a Guaranteed Income to spread the policy to cities across the country. The Stockton experiment found that recipients of guaranteed income had improved health outcomes by the end of the study. Rates of full-time employment also increased over the course of the first year. While critics of guaranteed income—or any kind of social welfare program with no-strings-attached cash—argue that aid disincentivizes working and encourages poor spending choices, the results in Stockton showed exactly the opposite. People, especially those living in poverty, knew their needs best, and direct aid allowed them to meet these. The long-term future of these programs, however, is currently unclear, in large part because many pilots are in place for one to two years, and are still under way. Cities like Rochester will use the pilots as a form of research into whether guaranteed income works to reduce poverty among its recipients, although long-term viability would likely require additional state and/or federal funding. Still, advocates are optimistic that the current wave of pilots will mean an expansion of guaranteed income programs—both to new cities and to higher levels of government. City governments are necessarily limited compared to states and especially the federal government, both of which have more money to spend on social welfare programs. Pilots like Rochester’s, Rosen says, have the possibility to show states and the federal government that direct cash assistance programs like UBI and GBI are successful at reducing poverty. “If we have all these pilot programs and we don’t go beyond that, we will have certainly helped people, and that will be great. But we’ll be minimizing our overall impact,” Rosen says. “We really want to see systems of delivering public benefits and cash assistance change in the long term so that we can help many, many more people for many, many years to come.”
Poverty increasing, the social safety net is being cut
DebSitarski, 8-8, 23, Register Herald, What decades of social work taught me about poverty, https://www.register-herald.com/opinion/what-decades-of-social-work-taught-me-about-poverty/article_60e49cf6-35fc-11ee-8f71-bbf9e77fd3f9.html
If my decades of work as a social worker taught me one great lesson, it’s this. Poverty is an entrenched system of political choices by self-serving lawmakers, not a personal failing of ordinary people. Poverty is not, and never has been, a crime. I’ve worked with many economically struggling people. I grew up in meager circumstances myself and well remember the stigma and shame of having to do without. And this I can tell you: Not one person I’ve ever met wants to be poor, sick, disabled, struggling, or on the receiving end of public assistance programs. These programs are vital but often inadequate and difficult to access. Behind each program recipient stands a caseworker responsible for determining eligibility — virtually no one puts themselves on a public program. As a caseworker I often tried to educate the public that taxpayer-supported benefits are earned, not “charity.” In 21st-century America, people have to be in extreme hardship to be eligible for help, even as they sometimes work multiple jobs. Not one mother relishes taking three buses in terrible weather to get to the Women, Infants, and Children (WIC) office to prove her worthiness to get help buying cereal for her toddler’s breakfast. So I’m disgusted when I hear conservative politicians falling over themselves to cut food, health, housing, and disability services for people who are trying to survive in low-wage jobs — a challenge made even tougher by life’s unpredictable circumstances, trauma, and lack of generational wealth. In case that’s not cruel and cynical enough, these same politicians work even harder to get ever-increasing tax breaks for the wealthy and corporations at the expense of the rest of us. Right now, Republicans in Congress are trying to make Trump’s tax cuts for the rich permanent — even as they form a committee to push Social Security cuts for retirees, people on disability, and widows. No one on Social Security receives a benefit for which they do not qualify, yet Congress seems to treat these worker-funded programs as some sort of gift. They are funded by those who paid into them and who meet strict eligibility standards. Unfortunately, lawmakers in many states aren’t much better. Rather than making sure their citizens have good jobs, health care, or a path out of poverty, they focus on passing harsh laws to ban abortion, criminalize LGTBQ people, or flood their states with guns. Poverty is on the rise nationally since the end of pandemic relief programs. During the pandemic, the American Rescue Plan more robustly funded food assistance, provided direct cash assistance, gave small businesses grants, paused student loan payments, and expanded the Child Tax Credit. As a result, hunger fell, savings grew, unemployment dropped to historic lows, and child poverty was cut just about in half. Yet not only are these programs ending, reversing these gains, conservative lawmakers are now fighting hard to cut the safety net even more while passing more tax giveaways to the very wealthy. The explicit purpose of government is to promote the general welfare. This kind of legislating is unsustainable for a society that claims to believe in an American Dream in which hard work allows for a good life. And can’t we agree that should be the goal?
Counterplan/Floating PIC: “Disadvantage” instead of “Poverty”
Edin et all, 8-5, 23, Kathryn J. Edin is the William Church Osborn Professor of Sociology and Public Affairs at Princeton University. She is the co-author of The Injustice of Place: Uncovering the Legacy of Poverty in America., The Atlantic, What the Best Places in America Have in Common, https://www.theatlantic.com/ideas/archive/2023/08/poverty-income-index-deep-disadvantage/674878/
Then president lyndon B. Johnson declared an “unconditional war on poverty” in 1964, the nation didn’t have any method of counting the poor, or even a firm notion of how poverty should be defined. His administration scrambled to come up with a measure to chart progress. The gauge, it was later decided, would be the minimum income needed for a family of three or more to put food on the table multiplied by three (at the time, food constituted a third of the typical family budget). Income is one vital indicator of well-being, but it is not the only one: Things like health outcomes and social mobility matter too. That’s why we should shift our focus from poverty to disadvantage. Disadvantage is a more useful term than poverty because we aren’t just talking about income—we’re trying to capture the complexity of a person’s life chances being hindered by multiple circumstances. Disadvantage is more accurate because it implies an injustice. People are being held back—unfairly. Disadvantage cannot be understood at the individual or family level alone. Thanks to social-science research, we now know that children’s life chances are profoundly affected by their context—not only income and family circumstances but also their community—more so than by their genetic profile or the medical care they receive. With this in mind, we created what we call the Index of Deep Disadvantage, which reflects two traditional measures of income (the poverty rate and the “deep poverty rate,” meaning those with incomes below half the poverty line), two markers of health (birth weight and life expectancy), and the rate of social mobility for children who grow up in low-income families. We used this index to rank the roughly 3,100 counties in the United States along with the 500 most populous cities. Immediately, the rankings revealed a stark geographical pattern. The first surprise—especially for professors who have spent our careers studying urban poverty—was that the most disadvantaged places on our index were primarily rural. But they didn’t fit the stereotypical image of rural America. Though some of these were majority white, most were majority Black or Hispanic. We could see, too, that many places with large Native American populations ranked among the most disadvantaged in the nation. Considerable poverty exists in Chicago, Los Angeles, and New York. But in our apples-to-apples comparison, none of those cities ranked among even the 600 most disadvantaged places in the nation. The only cities on that list were a relatively small number of industrial municipalities such as Cleveland, Detroit, and Rochester. Some might say we should have taken into account the high cost of living in many cities, but this is more complicated than it appears. Although people pay more for housing in some places, they also benefit from good health-care systems, a more generous safety net, public transportation, and higher-quality schools. Those living in the 200 most disadvantaged places on our index were just as likely to have major difficulties paying for housing as those in America’s 500 largest cities. The places that our index identified as the 200 most disadvantaged are concentrated in three regions—Appalachia, South Texas, and the southern Cotton Belt. (Not one county in the West, apart from those with disproportionately large Native American communities, showed up on the list.) These places share a history of intensive resource extraction and human exploitation not seen to the same degree elsewhere in the United States. In each place, this economic pattern emerged (or, in the case of the Cotton Belt, fully flourished) in the late 19th or early 20th century. In each place, one industry came to dominate the economy, a pattern that held, broadly, until the 1960s, when King Cotton, King Tobacco, King Coal, and South Texas agriculture, would bow to the twin forces of automation and global competition. We would have had to be exceedingly dull or stubborn to have missed the fact that these places resembled, well, colonies—internal colonies within the U.S. Using terminology such as nation within a nation or colony to describe the exploitation of communities of color within the United States has a long history among Black scholars and activists. While visiting many of the nation’s most disadvantaged places, we set out to build on this work through historical research, ethnographic observations, and in-depth interviews. In central Appalachia, we drove through the remnants of company towns, many only one or two streets wide, and the hollows—narrow valleys that can stretch for miles between the mountains. We came to Clay County, Kentucky, which before the Civil War was home to both mighty salt barons and a tapestry of subsistence farms. Big Timber and Big Coal took over after the Civil War. Today, the opioid crisis is ravaging the region. Locals in Manchester, the county seat, lament the decline of the movie theater—now a Pentecostal church—and the loss of the bowling alley; numerous bars, cafés, and beauty salons; and a park that has been plowed over for a highway-construction project. People blame the rise of opioid use on the fact that there is now “nothing to do but drugs.” In South Texas, spinach and onion fields were once so enormous that they met the sky’s vanishing point in almost every direction, yielding fabulous profits for those who owned the land. Yet the landless laborers who planted and harvested those crops faced unimaginable hardship. For generations, the appearance of towns in South Texas followed a pattern of social hierarchy: sturdy wood-frame houses, paved streets, and enclosed sewers in the white neighborhoods; shacks, dirt roads, and privies in the Mexican parts of town. Forced to migrate to find work during the off-season, generations of Mexican American children lost their right to a decent education. Even today, adult-illiteracy rates in these places are among the highest in the nation. When we hit the outskirts of the typical Cotton Belt town, fields gave way to a string of gleaming white antebellum homes with large lawns, old-growth trees, and grand entrances framed by columns reaching two or three stories high. These places seem serene on their face, yet in Leflore County, Mississippi, for example, Black residents told us that violence was the No. 1 problem they face. The rate of death due to interpersonal violence there was nearly four times the national average, and well above that of Cook County, Illinois, home to Chicago. As we would soon learn, Leflore County and the larger region it represents—the sprawling Cotton Belt stretching from the Carolinas to eastern Arkansas and Louisiana—are indeed among the most dangerous in the nation. These places have a long tradition of violence, both accepted and sponsored by government. For generations it was the greatest tool at the disposal of the white elite to oppress Black Americans into labor. Throughout these regions, we saw the same themes emerge again and again—unequal schooling, the collapse of social infrastructure, violence, entrenched public corruption, and structural racism embedded in government programs. Exploring the other end of our Index of Deep Disadvantage—the places identified as those of greatest advantage—was also vital to our research. Once again, we were surprised by where the index took us. It was not Manhattan or tech-rich Seattle. Instead, the list pointed us to the upper Midwest: Minnesota, the Dakotas, Wisconsin, Nebraska, and Iowa. Overall, poverty rates in these places are very low, babies are born healthy, people live to a ripe old age, and a low-income child usually has a similar chance of making it into the middle class as any other kid. Counties that rank among those of greatest advantage began as agricultural communities with modestly sized farms, many originally secured through the 1862 Homestead Act that made landownership widely available. Many of these places have built on this history of broad-based wealth by making significant investments in schools, which has contributed to high graduation and college enrollment rates over generations. Using the best data available, we found that they have enjoyed the lowest rates of violent crime, income inequality, and public corruption in the nation. These counties are unusually rich in social capital: Residents are connected to one another through volunteerism, membership in civic organizations, and participation in other community activities. These places are not without their challenges. Local job opportunities for young college graduates are sometimes limited. Yet these communities have been more successful than most in preventing poverty, promoting health, and ensuring a level playing field for their children. One cannot fully understand the benefits enjoyed in America’s most advantaged places without considering the historic (and ongoing) exploitation of migrant labor that has gone on in them, mostly drawn from the U.S. border regions. What’s more, many of these most advantaged places neighbor Native nations, places that often rank among the least advantaged. The histories of these places are deeply and irrevocably intertwined. We visited the Crow Creek reservation in Buffalo County, South Dakota, which ranks as the fourth most disadvantaged place on our index. In 1863, its population was exiled from the rich land of southwestern Minnesota after the bloody U.S.–Dakota War. Native Americans also lost their lives by the hundreds, some in the war but most to starvation after they were forcibly relocated onto land mostly inhospitable to human habitation. The upper Midwest is also overwhelmingly white. When we examined the relationship between whiteness and rank on the index, we found that a higher percentage of white residents is a significant predictor of a place’s rank, which is not at all surprising when one considers that the good schools and the good jobs have long been bestowed liberally on whites while being denied to Hispanic and Black Americans. But race is not as predictive as the level of inequality, the unemployment rate, or the degree of educational attainment. Furthermore, many places that are disproportionately white, in states such as Ohio, Maine, Illinois, Indiana, Montana, Michigan, and Idaho, do not rank even among the top half of advantaged places in America. What makes the communities that are most advantaged unique is their histories as places of broad-based wealth. How different would conditions be in other parts of the country had they followed a similar, equitable course? The lesson is that people seem to thrive—not always in high salaries but in health and life chances—when inequality is low; when landownership is widespread; when social connection is high; and when corruption and violence are rare. The social leveling that is characteristic of communities in the upper Midwest is more than just a quaint cultural feature. It is the foundation of a community’s well-being. Until these regions’ virtues are shared nationwide, poverty and disadvantage will continue to haunt America.
Expanding the child tax credit will reduce poverty
Jesus Torres, 8-2, 23, The effects of the expanded Child Tax Credit on low-income families in the United States, https://equitablegrowth.org/the-effects-of-the-expanded-child-tax-credit-on-low-income-families-in-the-united-states/
Childhood poverty is a stubborn problem in the United States. About 11 million U.S. children lived in poverty prior to the COVID-19 pandemic, accounting for nearly one-third of the impoverished population in one of the wealthiest countries in the world. Upon the expansion of one of the federal government’s most effective anti-poverty programs—the Child Tax Credit—childhood poverty witnessed “a record drop” during the pandemic, according to data compiled by the U.S. Census Bureau in 2020 and 2021. The Census Bureau reported a 46 percent decline in its Supplemental Poverty Measure—which measures poverty levels by calculating net income after payroll taxes, tax credits, and federal anti-poverty assistance such as the Child Tax Credit, housing subsidies, and the Supplemental Nutrition Assistance Program—from 2020 to 2021. A major component of this poverty measure was the increased value of the Child Tax Credit, from $2,000 to $3,600 for children under 6 years old and to $3,000 for children between the ages of 6 and 17, which lifted 2.9 million children out of poverty. These telling results are supported by findings in a 2022 working paper, titled “The Effects of Income on the Economic Wellbeing of Families with Low Incomes: Evidence from the 2021 Expanded Child Tax Credit,” which closely examines the impact of the expansion of the Child Tax Credit on low-income U.S. families. The four researchers at the University of Michigan who co-authored the working paper—Natasha Pilkauskas, Katherine Michelmore, Nicole Kovski, and H. Luke Shaefer—dive deeper into this issue by looking at exactly how these families spent their expanded CTC benefits. Paying monthly bills, such as utilities payments, was the most popular use of these benefits among surveyed recipients of the Child Tax Credit, at 75%. The next most-popular use was the purchase of school supplies or school clothes and uniforms for their children (25 percent) and spending on child necessities, such as diapers and wipes (10 percent). The co-authors also report response rates of between 9 percent and 12 percent for monthly spending of the expanded CTC benefits on mortgage or rent payments. Child care is the least widely used spending of these benefits by families (5 percent to 7 percent), while another 1 percent to 2 percent went into savings accounts. This working paper demonstrates that a distinct majority of families spent their expanded Child Tax Credit on immediate living expenses and child-related expenses. This led the four co-authors to investigate whether the expanded CTC program improved the economic well-being of low-income U.S. households. Using two separate economic models, the researchers find that each additional $100 increase in monthly CTC payments significantly decreases material hardships experienced by the families receiving the benefits. More specifically, the average amount of the Child Tax Credit among those who received it was close to $500. When multiplied by each reported month, the average benefit displayed a reduction in the total number of children living in poverty by about 17 percent. What’s more, food insecurity or food hardships also declined because of an additional $100 in monthly CTC payments. These findings demonstrate that expanding income support programs, such as the Child Tax Credit, are immediately beneficial not only for families with children living in poverty but also for the broader economy of the United States where the families are spending these expanded benefits. Indeed, these findings show that extending the expanded CTC program will help support U.S. families and the broader economy for years to come.
Amount of affordable housing collapsing
NPR, July 12, 2023, Why can’t we stop homelessness? 4 reasons why there’s no end in sight, https://www.npr.org/2023/07/12/1186856463/homelessness-rent-affordable-housing-encampments
When Los Angeles Mayor Karen Bass campaigned last year on reining in homelessness, she laid out bold proposals with a budget of hundreds of millions of dollars. In April, she told NPR she hoped for a “very significant reduction” this year, especially of people living on the street. But on Monday, Bass said it’s become clear that there’s simply no end in sight. “We really need to normalize the fact, unfortunately, that we’re living in a crisis,” she said at a press conference announcing a renewal of her emergency declaration on homelessness. The shift in tone comes after both LA and New York City recently declared a record level of homelessness, and other cities have also seen their numbers continue to climb despite considerable attention and spending to give people shelter. It’s part of a steady rise around the country since 2016, after years of successfully driving down the number of people without housing. So what’s going on? Advocacy groups and researchers say a big driving force is the decline of affordable housing, a problem decades in the making but one that has grown significantly worse in the past few years. Here are a few ways it’s playing out. 1. More people than ever are being housed — but an even higher number are falling into homelessness About a third of the U.S. homeless population is in California, and the state faces mounting questions about why billions of dollars spent in recent years hasn’t reduced the number of people living in cars and encampments. A bipartisan group of lawmakers has asked the state auditor to investigate. A key program in Los Angeles to move people from hotels into permanent housing appears to be struggling. CalMatters reports that officials across the state are asking how they can do better, even traveling to Texas for guidance. And yet, those in California and other places around the country can also argue they are helping more people than ever. The Los Angeles Homeless Services Authority says it has placed more than 20,000 into permanent housing for five years in a row — a significant boost from a decade ago — and that it’s doing this faster than it has in the past. Nationally over that time, the inventory of permanent housing available has increased 26% — and it’s more than doubled since 2007. “We’ve done a lot” to improve how people are placed into housing, says Steve Berg, chief policy officer at the National Alliance to End Homelessness. But he says that’s only half the equation. “The other half is people losing their housing … and we have not had any kind of extensive or organized effort on that,” he says. The upshot is that, in Los Angeles and elsewhere, even as record numbers of people are being housed, a greater number of them are falling into homelessness. Berg says one key reason is that only 1 in 4 Americans who qualify for a federal housing subsidy actually get it, and that’s been the case since he was in law school decades ago. The vast majority of low-income renters must rely on market-rate housing, but the U.S. hasn’t built enough housing for more than a decade, since the market crash of 2008. And the shortage is most acute for the lowest income renters — by more than 7 million units, according to the National Low Income Housing Coalition. That tight market, combined with the worst inflation in a generation last year, has led to double-digit rent spikes in many places around the U.S. 2. Rents are out of reach for many, and millions of affordable places have disappeared A landmark new report surveyed thousands of people in California about how they came to be without housing, and researchers conducted in-depth interviews with hundreds of them. For most, high rental costs were crucial. “People just ran out of the ability to pay, whether it happened quickly or slowly,” says lead investigator Margot Kushel of the University of California, San Francisco. Some said they’d had their work hours cut. Others lost a job because of a health crisis. Many crowded in with relatives or friends, who were also likely to be poor and struggling. “And we found that those relationships, when they fell apart, fell apart quickly,” Kushel says. “People only had one day’s warning” to leave. Even those with their own lease had on average just 10 days to move out. More renters facing eviction have a right to a lawyer. Finding one can be hard NATIONAL More renters facing eviction have a right to a lawyer. Finding one can be hard Their median monthly household income in the six months before they became homeless was $960, she says. The median rent for a one-bedroom apartment in California is $1,700. Around the country, Kushel says, homelessness rates are highest in places where there is both poverty and high housing costs. That gap has been growing for decades, as rents have risen faster than wages. Nationally last year, the share of renters spending at least 30% or 50% of their income on housing reached a record high. And some markets have seen a major share of their low-cost rentals disappear. Sponsor Message Over the past decade, the number of rentals under $600 fell by nearly 4 million, according to an analysis by Harvard’s Joint Center for Housing Studies. The losses happened in every state, because either rents increased, the units were taken off the rental market or buildings were condemned and demolished. Among slightly higher priced rentals, up to $1,000 a month, some 2.5 million more units were lost.
Poverty kills
Oshan Jarow Jul 14, 2023, Poverty is a major public health crisis. Let’s treat it like one, https://www.vox.com/future-perfect/23792854/poverty-mortality-study-public-health-antipoverty-america-deaths-poor-life-expectancy, Vox
“We need a whole new scientific agenda on poverty and mortality,” said David Brady, a professor of public policy at the University of California Riverside, whose recent co-authored study aims to jump-start that agenda by asking just how many Americans die from poverty each year. It’s well established that poverty is bad for your health. But as a public health issue, the US knows less about the direct link between poverty and death than we know about, say, the link between smoking and death. Current estimates suggest smoking kills 480,000 Americans per year. Obesity kills 280,000, and drug overdoses claimed 106,000 American lives in 2021. Together, risk factors and their mortality estimates help motivate public health campaigns and government-funded efforts to save lives. But how many Americans does poverty actually kill? The question has received little attention compared to other mortality risks, and meanwhile, poverty remains prevalent across the country. Brady — alongside sociologist Hui Zheng at Ohio State University and Ulrich Kohler, a professor of empirical social research at the University of Potsdam — published their study in April in the Journal of the American Medical Association. Their results find poverty is America’s fourth-leading risk factor for death, behind only heart disease, cancer, and smoking. A single year of poverty, defined relatively in the study as having less than 50 percent of the US median household income, is associated with 183,000 American deaths per year. Being in “cumulative poverty,” or 10 years or more of uninterrupted poverty, is associated with 295,000 annual deaths Amelia Karraker, a health scientist administrator at the National Institute on Aging, explains that research has shown a variety of pathways that connect poverty and mortality. These range from neighborhood amenities and nutrition down to the impacts of stress on the body: “Being poor is really stressful, which we know from NIH-supported research has implications for what’s actually happening in the body at the cellular level, which ultimately impacts health and mortality,” she said. Crucially, that doesn’t mean you’ll find “poverty” written as the cause on anyone’s death certificate. Risk factors are only correlations that imply an association but not necessarily causation (although new research found that cash transfers to women in low- and middle-income countries cut mortality rates by 20 percent). But proving an association is a necessary step toward deciphering whether poverty might be more than an association. For example, there is an association between the number of Nicolas Cage movies released and the number of people who drown in swimming pools that year. No one is arguing that we should dissuade Cage from releasing films in order to combat drowning. But there is also an association between cigarette smoking and lung cancer. Here, we do believe one causes the other, so we do try and dissuade people from smoking to combat lung cancer deaths. Arguing that poverty is more like the latter elevates the debate from a statistics squabble to one of literal life and death. “We just let all these people die from poverty each year,” Brady said. “What motivated me to think about it in comparison to homicide or other causes of death in America is that people would have to agree that poverty is important if it’s actually associated with anywhere near this quantity of death.” Without a number attached to the relationship, presenting poverty as a serious public health risk falls a little flat. “Poverty and mortality are tightly correlated” isn’t exactly as galvanizing a message as “poverty kills nearly 200,000 Americans a year.” But the key question is what it means to “die from poverty.” As a social determinant of health, the government already recognizes a direct line between economic conditions and health outcomes. Physicians are now going a step further, establishing a movement known as anti-poverty medicine that aims not only to identify poverty as a health risk but develop treatments. Attaching a death toll contributes a new data point — perhaps even a rallying point — to illuminate the ties between poverty and death, and just maybe, it will motivate a more urgent anti-poverty agenda on the grounds that it could save lives. Poverty is more than just another mortality risk Measured in relative terms, poverty in the US is significantly worse than in similarly wealthy countries. Meanwhile, US citizens face a higher mortality rate at almost every age than residents of peer countries, and that disparity is growing. Even according to the US Census Bureau’s supplemental poverty measure (an approach that tries to blend relative methods with absolute ones, while accounting for government programs like SNAP benefits and tax credits), nearly 26 million Americans remained in poverty in 2021. Brady, Zheng, and Kohler analyzed data from 1997–2019, drawing from the Panel Study of Income Dynamics and the Cross-National Equivalent File. Since the data ends before the Covid-19 pandemic began, and poverty likely compounded the pandemic’s death toll, they believe their findings are conservative. In 2019, being in poverty was 10 times more of a mortality risk than murder, 4.7 times more than firearms, and 2.6 times as deadly as drug overdoses. And poor people die younger than others. Their mortality rates begin diverging from the rest around age 40, reaching a peak disparity near 70, and converging back with the rest around 90. The study used a Cox model, a type of statistical analysis commonly used in medical research to isolate the effects of a given variable (often particular drugs, but in this case, poverty) on how long patients survive. But no matter how you analyze it, singling out annual deaths across an entire country from a fuzzy cause like poverty is a statistical nightmare. It’s difficult to imagine how one could untangle all the confounding factors — like the reverse effect of how poor health also affects income — to deliver a plausible number. One of the few previous efforts came from a group of epidemiologists in 2011, who estimated poverty’s death toll at 133,000 per year. And while few prior studies aimed to directly estimate deaths attributable to social factors, there is a decades-long history of wrangling statistical complexities to frame poverty as an actual cause of death. Brady cited a famous 1995 paper by sociologists Bruce Link and Jo Phelan, making the case that over and above mere risk factors, social conditions like poverty should be seen as “fundamental causes of disease” that put you at risk of more proximate risks, like heart disease. Link and Phelan’s paper argued that if you break down a fundamental cause of disease into its more tractable causes of death, like breaking the mortality risks of poverty down into a cocktail of heart disease, lung cancer, and drug overdoses, fundamental causes like poverty get ousted from the picture. Treating individual risk factors alone leaves the underlying social condition intact, and it will continue putting people at risk of other risk factors. Rather than tracing all the different pathways that lead from poverty to mortality and focusing public health-inspired anti-poverty efforts on each one separately, Link and Phelan urged an approach that stays with poverty. “If we wish to alter the effects of these potent determinants of disease, we must do so by directly intervening in ways that change the social conditions themselves,” they write. Nearly three decades later, clinicians are putting these ideas into practice. Physicians are now prescribing anti-poverty as medicine While the use of social determinants of health as a framework is gaining significant traction among physicians, companies, and even the WHO, Lucy Marcil, a pediatrician and associate director for economic mobility in the Center for the Urban Child and Healthy Family at Boston Medical Center, feels they don’t go far enough. She helped coin the idea of anti-poverty medicine in 2021. She explained that “anti-poverty medicine is one step further upstream to the root cause. Social determinants of health are important, but getting someone access to a food pantry doesn’t really address why they’re hungry in the first place.” “I started this work about a decade ago,” Marcil told Vox. “At the time, there was a lot of confusion when I would say that I try to get more people tax credits because it helps their health. Now it’s pretty well established at most major academic medical centers that trying to alleviate economic inequities is an important part of trying to promote health.” Putting a number on poverty’s death count could help build the case for anti-poverty programs embedded within systems of clinical care (like free tax preparation offered in health care systems that already have the community’s trust, an initiative Marcil pioneered). “If I’m able to say to a funder or to a health system, ‘Look, it’s been published in a reputable journal that there are X number of deaths in our country every year due to poverty,’ I have a much stronger case for why they should pay for [anti-poverty] programs,” she said. But physicians can only go so far upstream of poverty. Even before the study positioned long-term poverty as a greater mortality risk than obesity or dementia, public health scholars had been arguing that anti-poverty efforts should play a central role in a national agenda for public health. A national anti-poverty agenda for public health Public health campaigns against poverty face a strange and difficult landscape. One thing Americans seem to dislike more than poverty is welfare. Although 82 percent of Americans reported dissatisfaction with efforts to reduce poverty and homelessness in a 2021 Gallup poll, only 40 percent in a 2019 Pew Research Center survey felt the government should provide more aid to those in need. Even after President Joe Biden’s temporary expansion to the child tax credit (CTC) nearly cut child poverty in half and showed no signs of fostering welfare dependence among recipients, critics were unmoved. The policy expired at the end of 2021, 3.7 million American children fell back into poverty, and we’ve yet to see the program return. Meanwhile, as the Atlantic’s Derek Thompson writes, “a typical American baby is about 1.8 times more likely to die in her first year than the average infant from a group of similarly rich countries,” and child poverty is a major risk factor in all manners of infant mortality. At the federal level, another reason to quantify poverty’s death toll could be to add mortality estimates to the cost-benefit analyses that groups like the Congressional Budget Office (CBO) use to score policies and their impacts. Telling Americans that the expanded CTC almost single-handedly reduced child poverty by half hasn’t yet proved compelling enough to make the changes permanent. If the CBO were to include in their cost estimates that the expanded CTC would save a certain number of American lives per year, or conversely, that letting it expire would cost a certain number of American deaths, maybe the policy discourse would move more urgently. Finding strategies to help support policy implementation is crucial because, ultimately, treating poverty as a public health issue will require a stronger welfare state that benefits low-income Americans. “No country in the history of capitalist democracies has ever accomplished sustainably low poverty without an above-average welfare state,” Brady said. “And so until you get serious about expanding the welfare state in all its forms, you’re not serious about reducing poverty.” Relative to similarly rich countries, the US has high poverty rates, high mortality rates, and a confusing welfare state. It has the second largest welfare state in the world if you include things like subsidies for employer-based health insurance, tax-favored retirement accounts, and homeowner subsidies. These mostly benefit those who are already well-off.
Counterplans to solve poverty
Oshan Jarow Jul 14, 2023, Poverty is a major public health crisis. Let’s treat it like one, https://www.vox.com/future-perfect/23792854/poverty-mortality-study-public-health-antipoverty-america-deaths-poor-life-expectancy, Vox
Instead, if you judge the American safety net based on the share of GDP spent on programs that benefit low-income citizens, it falls well below the average among other rich nations. In other words, poverty is a policy choice, and the US has yet to choose otherwise. As the sociologist Matthew Desmond put it in his recent call for poverty abolitionism, “Ending poverty in America will require both short- and long-term solutions: strategies that stem the bleeding now, alongside more enduring interventions that target the disease and don’t just treat the symptoms.” For starters, the US could revive the expanded CTC and make it permanent, or even combine it with the earned income tax credit into a universal child allowance that would cut child poverty by 64 percent, and reduce deep child poverty by 70 percent (child poverty is one of the largest contributing factors to overall poverty in America). “The biggest movers in the welfare state are pensions and health care, so invest in those as anti-poverty policy,” Brady recommends. Universal pensions and extending “catastrophic coverage” health care to all are a few options. The US could also directly provide homes for the more than 1 million Americans who experience homelessness in the course of a year. If it wanted to go big, it could implement a guaranteed income pegged to the poverty line that would eliminate poverty outright, like the 2021 proposal from scholars at the New School’s Institute on Race and Political Economy. They estimate such a plan would cost $876 billion per year (that’s on par with the annual cost of Medicare, which sat around $900 billion in 2021). Meanwhile, one 2018 estimate places the annual cost of childhood poverty alone at $1.03 trillion per year. “A federal policy with a universal cash transfer could be relatively adequate on its own if there weren’t barriers to receiving it,” Marcil said. But she’s seen firsthand how the implementation of social policy often means jumping through administrative hoops and abominably complex paperwork, with the result that the aid often fails to reach the most vulnerable populations. In her clinic, they help patients who have just given birth apply for Massachusetts’ paid parental leave program. Otherwise, Marcil estimates only one-third of those eligible successfully navigate the bureaucratic gauntlet to claim the benefits. Most of those who get left out are low-income Americans on Medicaid who identify as Black or Hispanic. “In my experience,” Marcil said, “most social policies are written in ways that make it challenging for those who have been historically marginalized to access them.” While big-picture death toll estimates may help bolster the overall motivation for anti-poverty medicine, Marcil argues that data on specific interventions is also crucial to justify the expenditure against the array of alternatives. “Because then you can go to a policymaker and say, ‘Look, someone got paid leave, and they were less likely to show up in the emergency room than this other family who didn’t get paid leave,’” she said. “So it would save Medicaid money to help poor people get access to paid parental leave.” Objections to a new agenda on poverty and mortality will range from moral (unconditional aid undermines the American work ethic) to budgetary (how do you choose between giving nurses a raise or funding an on-site food pantry for food-insecure patients?). But as Brady’s new paper helps establish, the scope of the problem is vast, as is the cost — in terms of American lives — of continuing to treat symptoms of poverty while skimping on treatment for the fundamental cause. Millions of people rely on Future Perfect to understand the most effective ways to create a better world. We focus on the important emerging ideas that are often behind paywalls — things like the future of meat, artificial intelligence, morality, and the biggest threats to society. Financial contributions from readers enable our staff to offer our articles, podcasts, and newsletters for free. Will you consider making a contribution today to help keep Vox and Future Perfect free for all?.
Biden proves government programs reduce poverty
Harold Meyerson, 7-10, 23, American Prospect, Biden’s Unheralded War on Poverty, https://prospect.org/economy/2023-07-10-bidens-unheralded-war-on-poverty/
The Great American Quit Rate (full name: Great American Quit-Your-Stinkin’-Job-for-a-Better-One Rate) has finally subsided. While it lasted, though, it enabled the nation’s low-wage workers to make the first substantial economic gains they’ve made in 40 years. And that the GAQR existed at all was due almost entirely to President Biden’s war on poverty—a war that has gone largely unnoticed by both the public and the media. How sizable were the gains that those low-wage workers made? According to a study by economists David Autor, Arindrajit Dube, and Annie McGrew, so many workers—predominantly young, with no more than high school educations, working overwhelmingly in low-wage service-sector jobs—quit those jobs in 2021 and 2022 for better-paying ones that this collective job switch actually reduced such indices of inequality as the gaps between college-educated and non-college workers, and that between the 90th income percentile and the 10th income percentile, by a full 25 percent. Both those gaps had been steadily widening for the past four decades. So sizable were these gains among low-wage workers that they were the only group of workers over the past two years who have seen wage increases that outpaced the rise in inflation. It was chiefly they who were doing the quitting and moving to better jobs over the past several years; better-paid workers largely stayed put. American Prospect Carousel Jim Jordan Misfires in Attacks on Lina Khan Autor, Dube, and McGrew attribute this entirely unexpected boost to the fortunes of the working poor to the equally unexpected conditions of full employment that followed the economic collapse brought on by the COVID pandemic. It was only under those conditions that the job-quitters could feel assured that they’d find better-paying work. At that point, the study ends, because the question of where that full employment came from is not, strictly speaking, an economic one. It’s a political question. And the answer to the whence-full-employment question is the policies that Biden and the Democratic Congress enacted soon after Biden took office. Specifically, it’s the much maligned $1.9 trillion recovery bill that Congress passed in the late winter of 2021. In classic Keynesian fashion, that bill greatly boosted the public’s purchasing power. It delivered a cash payment to citizens, and a monthly prepayment of a Child Tax Credit to families with children, which reduced the nation’s rate of child poverty by 40 percent. It loaned or gave money to businesses to keep their doors open and their workers employed. And with so much very needed money suddenly traversing the economy, the rate of unemployment dropped quickly to historic lows (it’s currently at 3.6 percent), far faster than in the previous two sluggish recoveries. As a result, workers in jobs that were unrewarding found a host of offers from employers desperate to staff up. Autor, Dube, and McGrew document that the workers who quit their jobs didn’t just quit; they overwhelmingly found new employment that paid better. There aren’t many instances in American history when a relief measure actually changed some of the economy’s contours. Credit for that $1.9 trillion goes not just to Biden, of course, but also to the progressive economists he chose to advise him, very much including Jared Bernstein and Heather Boushey, both members of the president’s Council of Economic Advisers (of which Bernstein recently became chair). They had come to Biden from progressive economic think tanks that had argued strenuously during Obama’s presidency that more stimulus was required to end the Great Recession. As Biden prepared to become president, one of those think tanks, the Economic Policy Institute, assembled a host of economists, unions, and other liberal groups to make the case that recovery from the pandemic collapse required extraordinary measures that would push the economy toward full employment. Within the Biden administration and among Democrats generally, those arguments prevailed. Media coverage of that $1.9 trillion has tended to focus on two different stories: its contribution to inflation, and the difficulty that employers experienced in holding on to their workers unless and until they raised their pay. Coverage of the effect the legislation had on the fortunes of the working poor, much less on the first diminution in economic inequality the nation has seen in 40 years, has been harder to find. Emblematic of that coverage is the attention the media has given to Larry Summers, who complained that the bill would unleash inflationary pressures. (Those pressures have largely subsided here, but are still peaking in European nations that enacted no comparable legislation, raising the distinct possibility that supply chain breakdowns, the Ukraine War, and high corporate profit margins had as much if not more to do with inflation than the Biden bill.) Not incidentally, it was Summers, as President Obama’s chief economic counselor at the start of his presidency, who slashed the opening bid on Obama’s original (and only) stimulus package in 2009 (through backroom intrigues). Having thus delayed that recovery and opposed the current one, Summers is nothing if not consistent. General media myopia when it comes to the world of low-wage work is the chief culprit in their failure to document the positive effects of the current recovery, but there are other factors as well. For one, there aren’t many instances in American history when a relief measure actually changed some of the economy’s contours. Usually, the story has been how the absence of adequate relief measures prolonged a recession—as was certainly the case with the Summers-prolonged recovery following the 2008 financial crash, which dragged on for nearly a decade, stranding millions of millennials in economic purgatory, once the focus of both the Obama administration and Congress turned to debt reduction even as the unemployment rate still hovered near double digits. Another reason was that Biden and congressional Democrats had additional economic priorities on which they themselves focused. These were the three industrial-policy bills that made it through Congress (funding green-energy production, semiconductors, and infrastructure) and the Build Back Better components (a permanent Child Tax Credit, affordable child care, paid sick leave, and free community college) that died at the hands of Sens. Manchin and Sinema. Each of those priorities was more distinct than the catchall stimulus that had passed at the outset of Biden’s presidency, and besides, that catchall was old news, while maneuvering around Build Back Better and the Industrial Three dominated almost all of Biden’s first two years as president. But that temporary relief package looks to have done long-lasting good. While the quit rate has subsided, the move of low-wage workers to better-paying jobs and the wage hikes that employers in that sector have been compelled to make aren’t going away. “There are good reasons to think that at least a chunk of the changes that we’ve seen in the low-wage labor market will prove lasting,” Dube told the Times in a story that ran last Friday. Are there political points that Biden and the Democrats can make by touting the long-lasting good that their legislation did in reducing American poverty? Sadly, probably not. It was the low-wage workforce that benefited most particularly from their policies, and that’s the part of the electorate that’s most difficult to reach with messaging (much less messaging on macroeconomic policies) and through voter mobilization campaigns. Those efforts will be made, of course, and may boost turnout here and there. In the end, however, the fact that Biden’s war on poverty was largely successful may register as a historic achievement—no small thing—but not, in itself, an electoral game changer.
UBI reinscribes capitalism, it doesn’t challenge it
John Bellamy Foster, July 1, 2023, Monthly Review, Monthly Review, Planned Degrowth: Ecosocialism and Sustainable Human Development—An Introduction, https://monthlyreview.org/2023/07/01/planned-degrowth/
Even the most cursory examination of the wider waste and exploitation in the system raises what Morris called the problem of “Useful work versus Useless Toil.”120 The massive economic surplus arising from social labor—measured not simply by profits, interest, and rent, but also the waste, maldistribution, and elementary irrationality of the system—is already many times that which is necessary to carry out the vast changes needed to create a society of sustainable human development. It is capitalism itself that imposes scarcity and austerity on the population in order to compel workers to sacrifice their lives still further for an exploitative system, now threatening a planetary habitability crisis for all of humanity along with innumerable other life forms. Most degrowth strategies, even those promulgated by ecosocialists, defer to the reigning ideology, preferring not to raise the issue of planning, even in the face of the planetary emergency. Indeed, there is a tendency to back off from such obvious measures as nationalization of energy companies and mandatory emissions cuts on corporations. Degrowth theorists instead generally propose a menu of “policy alternatives,” like a Keynesian-style Green New Deal, universal basic income, ecological tax reform, a shortened work week, increased automation, and so on, none of which come into direct conflict with the system, or get close to addressing the enormity of the problem, in what are thought of as nonreformist reforms.121 Proposals for drastically reduced employment, not just shorter working hours, backed up in many degrowth schemes by a guaranteed basic income, seek to adjust the parameters of capitalism, rather than transcend them, in an approach that would generate the kind of dystopian conditions described in Kurt Vonnegut’s novel, Player Piano.122 As Leo Huberman and Sweezy wrote when the notion of a guaranteed basic income was first floated in the 1960s, “our conclusion can only be that the idea of unconditionally guaranteed incomes is not the great revolutionary principle which the authors of ‘The Triple Revolution’ evidently believe it to be. If applied under our present system, it would be, like religion, an opiate of the people tending to strengthen the status quo. And under a socialist system…it would be quite unnecessary and might do more harm than good.”
Socialism needed to prevent capitalist-driven ecological collapse. Another Green New Deal in the capitalist system will fail
John Bellamy Foster, July 1, 2023, Monthly Review, Monthly Review, Planned Degrowth: Ecosocialism and Sustainable Human Development—An Introduction, https://monthlyreview.org/2023/07/01/planned-degrowth/
Today the elemental tragedy of this is all around us. It is now widely perceived that economic growth, based on nonstop capital accumulation, is the main cause of the destruction of the earth as a safe place for humanity. The Earth System crisis is evident in the crossing of planetary boundaries related to climate change, ocean acidification, destruction of the ozone layer, species extinction, disruption of the nitrogen and phosphorus cycles, loss of groundcover (including forests), depletion of fresh water, aerosol loading, and novel entities (such as synthetic chemicals, nuclear radiation, and genetically modified organisms).10 The drive to capital accumulation is thus generating a “habitability crisis” for humanity in this century.11 The world scientific consensus, as represented by the UN Intergovernmental Panel on Climate Change (IPCC), has established that the global average temperature needs to be kept below a 1.5°C increase over pre-industrial levels this century—or else, with a disproportionately higher level of risk, “well below” a 2°C increase—if climate destabilization is not to threaten absolute catastrophe as positive feedback mechanisms come into effect. In the IPCC’s Sixth Assessment Report (AR6, released in its various parts over 2021–23), the most optimistic scenario is one of an end-of-the-century increase in global average temperature over pre-industrial levels of below 1.5°C. This requires that the 1.5°C boundary not be crossed until 2040, rising by a tenth of a degree to 1.6°C, and then falling near the end of the century back down to a 1.4°C increase. All of this is predicated on reaching net zero (in fact, real zero) carbon emissions by 2050, which gives a fifty-fifty chance that the climate-temperature boundary will not be exceeded.12 Yet, according to leading climate scientist Kevin Anderson of the Tyndall Center for Climate Change Research, this scenario is already out of date. It is now necessary, based on the IPCC’s own figures, to reach the zero-carbon dioxide emissions point by 2040, in order to have the same 50 percent chance of avoiding a 1.5°C increase. “Starting now,” Anderson wrote in March 2023, to not exceed 1.5°C of warming requires 11% year-on-year cuts in emissions, falling to nearer 5% for 2°C. However, these global average rates ignore the core concept of equity, central to all UN climate negotiations, which gives “developing country parties” a little longer to decarbonise. Include equity and most “developed” nations need to reach zero CO2 emissions between 2030 and 2035, with developing nations following suit up to a decade later. Any delay will shrink these timelines still further.13 The World Meteorological Organization indicated in May 2023 that there is a 66 percent chance that the annual average near-surface global temperature will temporarily exceed a 1.5°C increase over pre-industrial levels during “at least” one year by 2027.14 Existing IPCC scenarios are part of a conservative process, designed to conform to the prerequisites of the capitalist economy, which builds continued economic growth in the wealthy countries into all scenarios while excluding any substantial changes in social relations. The sole device relied upon in such climate modeling is to assume price-induced shifts in technology. Existing scenarios thus necessarily rely heavily on negative emissions technologies, such as Bioenergy and Carbon Capture and Sequestration (BECCS) and Direct Carbon Air Capture (DAC), that do not presently exist at scale and cannot be instituted within the prescribed timeline, while also presenting enormous ecological hazards in themselves. This emphasis on essentially nonexistent technologies that are themselves environmentally destructive (given their enormous land, water, and energy requirements) has been challenged by scientists within the IPCC itself. Thus, in the original Summary for Policymakers for the mitigation report, part 3 of AR6, the scientists authoring the report agreed that such technologies are not viable in a reasonable time frame and suggested that low-energy solutions based on popular mobilization might offer the best hope of carrying out the massive ecological transformations now required. All of this, however, was excluded from the final published Summary for Policymakers as determined by governments, as part of the normal IPCC process, which allows for censorship of the scientists.15 Price-induced technological solutions, which would allow continued economic growth and the perpetuation of current social relations, do not exist on anything like the required scale and tempo. Hence, major socioeconomic changes in the mode of production and consumption are needed, running counter to the reigning political-economic hegemony. “Three decades of complacency,” Anderson writes, “has meant that technology on its own cannot now cut emissions fast enough.” There is thus a drastic need for low-energy solutions based on changes in relations of production and consumption that also address deep inequalities. The necessary reductions in emissions are “only possible by re-allocating society’s productive capacity away from enabling the private luxury of a few and austerity for everyone else, and toward wider public prosperity and private sufficiency. For most people, tackling climate change will bring multiple benefits, from affordable housing to secure employment. But for those few of us who have disproportionately benefited from the status quo,” Anderson insists, “it means a profound reduction in how much energy we use and stuff we accumulate.”16 A degrowth/deaccumulation approach that challenges accumulative society and the primacy of economic growth is crucial here. Social provisioning for human needs and sharp reductions in inequality are essential parts of a shift to a low-energy transformation in the economy and the elimination of ecologically destructive forms and scales of output. In this way, the lives of most people can be improved both economically and ecologically. Accomplishing this, however, requires going against the logic of capitalism and the mythology of a self-regulating market system. Such a radical transformation can only be achieved by introducing significant levels of economic and social planning, through which, if carried to its fullest, the associated producers would work together in a rational way to regulate the labor and production process governing the social metabolism of humanity and nature as a whole. Classical nineteenth-century socialism in the work of Karl Marx and Frederick Engels saw the need for the institution of collective planning in response to the ecological and social contradictions of capitalism, as well as its economic ones. Engels’s analysis insisted on the need for socialist planning to overcome the ecological rift between town and country, while Marx’s theory of metabolic rift, operating on a more general level, insisted on the need for sustainable human development. Some non-degrowth socialists, confronted with climate change, have succumbed to technology fetishism, proposing dangerous geoengineering measures that would inevitably compound the planetary ecological crisis as a whole.124 There is no doubt that many on the left see the entire solution today as consisting of a Green New Deal that would expand green jobs and green technology, leading to green growth in a seemingly virtuous circle. But since this is usually geared to a Keynesian growth economy and defended in those terms, the assumptions behind it are questionable.125 A more radical proposal, more in line with degrowth, would be a People’s Green New Deal oriented toward socialism and democratic ecological planning.126 Under the monopoly-finance capital of today, whole sectors of the caring profession, education, the arts, and so on are affected by what is known as the “Baumol cost disease,” named after William J. Baumol, who introduced the idea in his 1966 book, Performing Arts: The Economic Dilemma.127 This applies when wages rise and productivity does not. Thus, as Forbes magazine declares, without a trace of irony: “The output of a [string] quartet playing Beethoven has not increased since the 19th century,” although their income has. The Baumol cost disease is seen as applicable mainly to those work areas where notions of quantitative increases in productivity are generally meaningless. Yet, how does one measure the productivity of a nurse treating patients? Certainly not by the number of patients per nurse, regardless of the amount of care each receives and their outcomes. The result of profit-centered goals in the highly financialized economy of today is underinvestment and institutionalization of low wages in precisely those sectors characterized as subject to the so-called Baumol cost disease, simply because they are not directly conducive to capital accumulation. In contrast, in an ecosocialist society, where accumulation of capital is not the primary objective, it would often be those labor-intensive areas in the caring professions, education, the arts, and organic relations to the earth that would be considered most important and built into social planning.128 In an economy geared to sustainability, labor itself might be substituted for fossil-fuel energy, as in small, organic, sustainable farming, which is more efficient in ecological terms.129 Writing in The Political Economy of Growth in 1957, Baran argued that the planned economic surplus might be intentionally reduced in socialist planning, in comparison to what was then possible, in order to ensure the “conservation of human and natural resources.” Here the emphasis would not be simply on economic growth, but on meeting social needs, including decreasing environmental costs; for example, by choosing to cut “coal mining.”130 All of this meant, in effect, prioritizing sustainable human development over destructive forms of economic growth. Today elimination of fossil fuels, even if this means a reduction in the economic surplus generated by society, has become an absolute necessity for the world at large, which is faced by what Noam Chomsky has called “the end of organized humanity.”131 In the words of Engels and Marx, it is necessary to release the “jammed safety-valve” on the capitalist locomotive “racing to ruin.” The choice is one of socialism or exterminism, “ruin or revolution.” 132
Structural racism means inequality and poor health outcomes
Michelle A. Williams is dean of the Faculty at the Harvard T.H. Chan School of Public Health., 6-18, 23, The Hill, Reparations done right can help us close our shameful health gaps, https://thehill.com/opinion/civil-rights/4053493-reparations-done-right-can-help-us-close-our-shameful-health-gaps/
The end of institutionalized slavery led to generations of institutionalized racism in the United States. The shameful results are all around us. Black babies are twice as likely as white babies to die before their first birthday. Black children are four times as likely to live in neighborhoods choked by pollution. Black adults are significantly more likely to have serious conditions including heart disease and Alzheimer’s. And at every age, Blacks are less likely to receive quality health care. Physicians and public health experts point to the insidious effects of structural racism as a driving factor for these disparities and many others.
US poverty increasing and its killing 500 people per day in the US
Baily Schulz, 6-16, 2023, USA Today, As pandemic-era benefits unwind, Poor People’s Campaign wants lawmakers to address poverty, Poor People’s Campaign wants to sound the alarm on death by poverty (usatoday.com)
As COVID-19 case counts dwindle, the United States has been rolling back pandemic-era benefits. But one group argues that a lack of resources for escaping poverty is more than just unjust; it’s deadly. Poor People’s Campaign: A National Call for Moral Revival – a revival of the 1968 movement launched by Martin Luther King Jr. – aims to highlight the dangers of poverty with a three-day congress on Capitol Hill starting Monday. Hundreds of leaders from over 30 states plan to demand elected officials address poverty in the United States, with participants highlighting a recent report that names poverty as one of the country’s leading risk factors related to death. The event comes as pandemic-era provisions meant to help low-income families like the child tax credit and expanded Medicare coverage have reached their expiration dates. “The wrong question keeps being asked: How much does it cost us to address poverty, rather than how much is it (poverty) costing?” said Bishop William Barber II, co-chair of the Poor People’s Campaign. “What we can’t do is just keep burying our loved ones, burying Americans, burying citizens, burying immigrants, who are dying of poverty needlessly.” The federal government took action to shield Americans from slipping into poverty during the height of the pandemic. The child tax credit was expanded to grant eligible families up to $300 per month per child, and the federal government agreed to send billions of dollars in extra Medicaid funding to states to keep people on their rolls. This drove down the uninsured rate to 8%, compared to the previous low of 9% in 2016. Congress failed to renew the expanded child tax credit at the end of 2021, with critics arguing that the program was expensive and would deter parents from working. Child poverty rates saw a dramatic uptick between December 2021 and January 2022, with Columbia University’s Center on Poverty and Social Policy reporting that nearly 4 million more children went into poverty in that time frame. Latino and Black children experienced the largest increase in poverty, at 7.1 percentage points and 5.9 percentage points, respectively. Had the expanded child tax credit continued until 2025, experts predicted that child poverty would leave 4.3 million fewer children in poverty, according to the Urban Institute, a Washington D.C.-based think tank. Meanwhile, states are preparing to remove millions of people from Medicaid coverage as the pandemic-era policy ends. The Biden administration last year said it anticipated 15 million people – about 17% of enrollees – will lose coverage through Medicaid and the Children’s Health Insurance Program. More than 5 million children are expected to lose coverage, and the Biden administration projects nearly 1 in 3 of those predicted to lose coverage will be Latino and 15% Black. People ‘are dying from poverty in the wealthiest nation’ The Poor People’s Campaign plans to discuss a series of measures with lawmakers to help people escape poverty, ranging from child tax credits and healthcare to a higher minimum wage and voting rights. “We connect all of it together. It’s not a separate issue,” Barber said. “We’re going to call on them to put aside the deflection, the culture wars and the partisanship and to focus on the fact that Americans are dying from poverty in the wealthiest nation.” University of California, Riverside professor David Brady, the author of the report citing poverty as one of the leading risk factors tied to death in America, will speak at the event. His research, which published earlier this year in the Journal of the American Medical Association, found there are about 500 deaths per day in the country related to poverty, making it tied for about as many deaths as dementia. The report proposes that poverty should be considered “a major risk factor” for death. “No autopsy says poverty, but maybe it should,” Brady said.
There is currently a welfare state that benefits the rich
Jacob Steimer, 6-15, 23, Mississippi Free Press, 5 Things We Can All Do To Help End Poverty, Mississippi Free Press, https://www.mississippifreepress.org/33834/5-things-we-can-all-do-to-help-end-poverty
“There is so much poverty in America because we benefit from it, and that ‘we’ is a big ‘we,’” he said. Sure, large institutional forces are at play, but, he said, plenty of Memphians profit from poverty, whether by supporting companies that pay low wages or investing in them through the stock market. And the middle and upper classes are the beneficiaries of plenty of government policies that hurt their poor neighbors. “The United States has this imbalanced welfare state, where we give the most to the families that need it the least, especially in the form of tax breaks. … And many of us benefit from these tax breaks,” Desmond said. “That benefiting starves anti-poverty programs.”
Debt limit agreement prohibits new social spending; the plan would have to break that
Dr. Aaron Carroll is the chief health officer of Indiana University and writes often on health policy, 6-14, 23, https://pnhp.org/news/learning-from-other-countries/ New York Times, I Studied Five Countries’ Health Care Systems. We Need to Get More Creative With Ours.
When other countries choose to spend less on their health care systems (and it is a choice), they take the money they save and invest it in programs that benefit their citizens by improving social determinants of health. In the United States, conversely, we argue that the much less resourced programs we already have need to be cut further. The recent debt limit compromise reduces discretionary spending and makes it harder for people to get access to government programs like food stamps
US health care spending currently 2X what other countries spend
Dr. Aaron Carroll is the chief health officer of Indiana University and writes often on health policy, 6-14, 23, https://pnhp.org/news/learning-from-other-countries/ New York Times, I Studied Five Countries’ Health Care Systems. We Need to Get More Creative With Ours..
That is, all of them except the United States. We currently spend about 18 percent of G.D.P. on health care. That’s almost $12,000 per American. It’s about twice what other countries currently spend.
20 million Americans live in persistent poverty
Tanya Khashaul, 6-13, 23, https://www.aol.com/map-us-states-highest-rates-133251571.html, Map: These US states have the highest rates of long-term poverty, Map: These US states have the highest rates of long-term poverty [Video] (aol.com)
Some states are having difficulty shaking off high poverty rates, a new study suggests.
Between 1989 and 2019, 19.4 million people lived in areas of persistent poverty, according to a report by the US Census Bureau. Persistent poverty can be defined as an area that has consistently had poverty rates at 20% or above for a long duration, typically 30 years. According to Craig Benson, co-author of the report and survey statistician at the US Census Bureau, there are several economic variables that correlate with high poverty rates.
Native Americans, Black Americans and Hispanic/Latinos are most likely to be disenfranchised and live in poverty
Tanya Khashaul, 6-13, 23, https://www.aol.com/map-us-states-highest-rates-133251571.html, Map: These US states have the highest rates of long-term poverty, Map: These US states have the highest rates of long-term poverty [Video] (aol.com)
Notably, all states with persistent poverty above 14% are located in the South. Native Americans (24.3%), Black Americans (19.5%), and Hispanic/Latinos (17.1%) are most likely to live below the federal poverty threshold among all ethnic groups, as of 2021. “Some Southern states have historically disenfranchised lower-income populations and created policies that have prevented people in poverty from achieving economic self-sufficiency,” Jaime Rush, senior attorney at the Southern Poverty Law Center (SPLC), told Yahoo Finance. “Some of these policies intentionally targeted Black and Brown communities, and others disproportionately affected these communities.” In Mississippi, 31.1% of Black Americans live in poverty — the third-highest rate for the racial group behind just Iowa and Louisiana.
Poverty is the biggest predictor of poor health outcomes
States with high rates of persistent poverty also tend to be states with high rates of uninsured individuals. For example, Texas — with a 14.6% persistent poverty rate — has the highest rate of uninsured citizens in the US at 18%. “Poverty is a strong driver and predictor of poor health outcomes,” Dr. Omar Escontrías, senior vice president of Equity, Research & Programs at the National Health Council, told Yahoo Finance. “Research indicates that those living below the poverty level face insurmountable barriers to access to care. Indirectly, diagnoses of chronic diseases can go unnoticed or misdiagnosed.” Poorer areas are more likely to have inefficient transportation, which becomes an obstacle for residents needing to travel for healthcare, according to the National Health Council. Similarly, the pandemic revealed that nearly half of low-income communities across the country had no ICU beds available, further underscoring the disproportionate impact of the coronavirus on these communities. Consequently, this impacts life expectancy: Adults whose income falls in the top 1% are expected to live 10.1 to 14.6 years longer than those earning in the bottom 1%, according to the Department of Health and Human Services. “Research has shown that people living in high poverty areas experience barriers to well-being whether they are poor or not,” Benson said. “Many of these areas have a hard time breaking out of the cycle of poverty.”
27 million Americans lack health care coverage
Tanya Khashaul, 6-13, 23, https://www.aol.com/map-us-states-highest-rates-133251571.html, Map: These US states have the highest rates of long-term poverty, Map: These US states have the highest rates of long-term poverty [Video] (aol.com)
While the national uninsured rate declined to 8.6%, there are still roughly 27.2 million Americans without health coverage.
US has one of the highest rates of poverty in the world
Rank, 6-1, 23, Rank is the Herbert S. Hadley Professor of Social Welfare at Washington University in St. Louis. He is the author of The Poverty Paradox: Understanding Economic Hardship Amid American Prosperity, Time, America Looks at Poverty All Wrong, America Looks at Poverty All Wrong | Time,, https://time.com/6283782/america-poverty-all-wrong-essay/
When such events strike, there is very little in the form of a social safety net to protect people from falling into poverty in this country. The U.S. devotes far fewer of its resources to preventing poverty than most other industrialized countries. The result is that we have the highest rates of poverty and inequality among the group of wealthy nations. In America, the poverty-stricken can be found down nearly any street, within any demographic or racial group, and across the entire political and ideological spectrum.
Childhood poverty kills productivity and costs the US economy $1 trillion per year
Rank, 6-1, 23, Rank is the Herbert S. Hadley Professor of Social Welfare at Washington University in St. Louis. He is the author of The Poverty Paradox: Understanding Economic Hardship Amid American Prosperity, Time, America Looks at Poverty All Wrong, America Looks at Poverty All Wrong | Time,, https://time.com/6283782/america-poverty-all-wrong-essay/
As a society, we each pay a hefty price for having such high rates of poverty in our midst, particularly among children. As researchers of poverty and inequality, my colleague Michael McLaughlin and I estimated the annual economic cost of childhood poverty in the United States. We relied on the latest government data and social science research in making our cost estimates. In particular, we examined the effect that childhood poverty has upon future economic productivity, health care, and criminal justice costs, as well as increased outlays as a result of child homelessness and maltreatment. Adding up these expenses resulted in an eye-opening estimate that childhood poverty was costing the U.S. slightly over $1 trillion dollars a year. This represented 28% of the entire federal budget, a jarring estimate. Impoverished children grow up possessing fewer skills and are thus less able to contribute to the productivity of the economy. They are also more likely to experience frequent health care problems and to engage in crime. These costs are borne by the children themselves, but ultimately by the wider society, as well. In this sense, the economic costs of poverty becomes an issue of “us,” rather than “them.” Most of us are familiar with the saying, “An ounce of prevention is worth a pound of cure.” It turns out that this is particularly true in the case of poverty. It is not a question of paying or not paying. Rather, it is a question of how we pay, which then affects the amount we end up spending. In making an investment up front to alleviate poverty, the evidence suggests we will be repaid many times over by lowering the enormous costs associated with a host of interrelated problems.
US poverty rates higher than other developed countries
Cashin 5-21, 23, Sheryll Cashin is a law professor at Georgetown University and author of several books on racial justice and American democracy., Politico, https://www.politico.com/news/magazine/2023/05/21/theres-a-path-out-of-poverty-00097399, Opinion | America’s Poverty Is Built by Design
Many Americans already know that the core of Desmond’s argument is true: that systems are rigged to favor people who are already advantaged. He makes a refreshing, brutally honest case that poverty is pervasive in America by design, to enable the lifestyles of affluent people. U.S. rates of poverty are substantially higher and more extreme than those found in 25 other developed OECD countries, including Australia, Canada, France, Germany, Poland, Portugal and the United Kingdom.
Billions in tax subsidies to the rich
Cashin 5-21, 23, Sheryll Cashin is a law professor at Georgetown University and author of several books on racial justice and American democracy., Politico, https://www.politico.com/news/magazine/2023/05/21/theres-a-path-out-of-poverty-00097399, Opinion | America’s Poverty Is Built by Design
Desmond also shows how the federal government, through the tax code, greatly subsidizes the affluent. In 2021, the U.S. spent $1.8 trillion on tax breaks, forgoing revenue that otherwise would have been paid in taxes, much of it going to very rich people. For example, each year the U.S. loses more than $1 trillion in unpaid taxes because of the tax avoidance strategies of multinational corporations and wealthy families.
20 million Americans live in high poverty areas
Quinoz, 5-17, 23, Jose A. Quinonez is the president of Partners for Rural Transformation, a collective of six community development financial institutions working together to eliminate persistent poverty and advance prosperity and economic justice in rural America., Non Profit Quarterly, Ending Persistent Poverty in Rural America: The Role of CDFIs, https://nonprofitquarterly.org/ending-persistent-poverty-in-rural-america-the-role-of-cdfis/
Perhaps nowhere else in the United States is the structural exclusion by race and place more self-evident than places labeled as persistent poverty areas. Home to over 20 million Americans, these areas are named so because the poverty rate has remained above 20 percent for three consecutive decades. Of these 395 counties and parishes, 80 percent are rural, and 60 percent of residents are people of color. Persistent poverty did not just happen to these areas. Instead, it was policy choices that facilitated the acquisition of wealth and power among a select group through the enslavement of Africans and African Americans in the Mississippi Delta and Black Belt, the taking of land and life from tribal nations and Latinx people throughout the country and along the US-Mexico border, and the extraction of natural resources from Appalachia. This has led to high unemployment, a lack of access to banking services, a lack of affordable housing, and unsafe drinking water. As a result, many of these communities face higher rates of premature death and worse health outcomes than the rest of the country. According to the County Health Rankings, 81 percent fall in the least healthy quartile.
US poverty is structural; it exists because rich people benefit from it
Annie Lowry, 5-14, 23, The Atlantic, The War on Poverty Is Over. Rich People Won., https://www.theatlantic.com/ideas/archive/2023/05/poverty-in-america-book-matthew-desmond-interview/674058/
Why do so many Americans live in poverty? Because so many rich people benefit from it.
This is the thesis of the lauded sociologist Matthew Desmond’s new book, Poverty, by America. The best seller is at once a careful exploration of poverty statistics; a deeply reported depiction of the lived experiences of the poor; an examination of the ways America’s wealthy exploit the masses; and a case for ending poverty. Desmond shows how the country’s employers, financial institutions, and landlords extract money from low-income families while rich families hoard opportunity for themselves. He also demonstrates how America’s safety-net programs are not just too stingy but poorly designed. Desmond is a professor at Princeton. His previous book—Evicted, about the low-income rental market in Milwaukee—won a Pulitzer Prize. We discussed how the ric came to win the War on Poverty and what’s necessary to end poverty.
Desmond continues…
Government programs obviously work. I’ve been with people when they receive a housing voucher. They praise Jesus. They fall on their knees. They pray and weep and cry. We have massive amounts of evidence about the benefits of government spending on anti-poverty programs. But poverty is also about exploitation. We have all these anti-poverty programs that accommodate poverty without disrupting it. They’re not eliminating poverty at the root.
Lowrey: Who benefits from that exploitation? Who benefits from a person being homeless?
Desmond: A lot of us benefit from it. I don’t just mean the guy that’s a little richer than you or a lot richer than you. I mean a lot of us, those who have found security and comfort in America consuming the cheap goods and services that the working class produces for us.
Half of us are invested in the stock market. Many times, we see our savings going up and up and up when someone’s pay is going down and down and down. Those two things are related. Or think about the housing crisis: Many times, it’s not just corporate landowners who are benefiting from high rents. It’s homeowners whose housing values are propped up and kept high by a scarcity of housing that they contribute to.
Banks exploit the poor
Annie Lowry, 5-14, 23, The Atlantic, The War on Poverty Is Over. Rich People Won., https://www.theatlantic.com/ideas/archive/2023/05/poverty-in-america-book-matthew-desmond-interview/674058/
Lowrey: The book points out that our financial institutions, housing markets, and labor market all extract money from low-income families. How does that work for banking, given that wealthy families are the ones with all the money to begin with?
Desmond: By my calculation, financial institutions pull $61 million a day out of the pockets of the poor in fees—just fees, so they can access their money. Often this is just straight-up exploitative. Banks don’t have to charge overdraft fees. That’s not a thing they have to do to keep the lights on. That’s an incredible source of revenue. And people like you and me benefit from it, because we get free checking accounts subsidized by other people’s overdraft fees. Only 9 percent of bank users pay 84 percent of those fees, $11 billion a year. Payday-loan fees and check-cashing fees are part of that, but the overdraft costs are higher. This isn’t just about check-cashing stores with the bright-red signs in the poor neighborhoods. It’s also about the banks that you and I use.
COVID-19 aid proves government aid can reduce poverty
Matthew Desmond, economist, Princeton, May 14, 2023, The Atlantic, The War on Poverty Is Over. Rich People Won., https://www.theatlantic.com/ideas/archive/2023/05/poverty-in-america-book-matthew-desmond-interview/674058/
Desmond: During COVID, we saw this incredible, bold relief, unmatched since the War on Poverty and the Great Society. If you look at the extended child tax credit, it dropped child poverty 46 percent in six months. If you look at emergency rental assistance, eviction rates drop to the lowest on record. If you look at incomes of families in the bottom half of the distribution—after the Great Recession, it took them 10 years to recover. This time, it took a year and a half. Night and day.
I see this as incredible, incredible evidence of what robust government spending can do. But those things are going away. We’re seeing evictions tick up again. We’re seeing the poverty rate tick up again. That should be troubling.
US poverty rate 2X that of Germany and South Korea
Matthew Desmond, economist, Princeton, May 14, 2023, The Atlantic, The War on Poverty Is Over. Rich People Won., https://www.theatlantic.com/ideas/archive/2023/05/poverty-in-america-book-matthew-desmond-interview/674058/
Annie Lowrey: How is poverty different in America than in its peer countries? Matthew Desmond: We have more of it. We have double the child-poverty rate of Germany and South Korea. We have a lot less to go around with, in terms of fighting poverty. We collect a much smaller share of our GDP in taxes every year.
Poverty destroys health
Emma Bascom, May 12, 2023, Healio, https://www.healio.com/news/primary-care/20230512/consistent-poverty-linked-to-higher-mortality-rates, Consistent poverty linked to higher mortality rates
In 2019, 10.5% of U.S. deaths were linked to cumulative poverty. Poverty was associated with 2.6 times as many deaths as drug overdose, 3.9 times as many deaths as suicide and 4.7 times as many deaths as firearms. Poverty should be considered a major risk factor for death in the United States, according to the results of research published in JAMA Internal Medicine. The United States consistently has a poverty rate much higher than similarly wealthy countries, which “presents an enormous challenge to population health, given that considerable research demonstrates that being in poverty is bad for one’s health,” David Brady, PhD, a professor of public policy at University of California, Riverside, and colleagues wrote. Although previous research has offered “valuable contributions” on income and mortality, the researchers wrote that the quantity of mortality connected with U.S. poverty is unknown. So, they conducted a cohort study to estimate the associations between mortality and poverty and quantify the proportion of deaths linked to poverty. Brady and colleagues evaluated the Panel Study of Income Dynamics 1997 to 2019 data merged with the Cross-National Equivalent File, ultimately including 18,995 respondents aged 15 years or older. The survey observed mortality from surviving family members and validated with the National Death Index. When it came to measuring socioeconomic status, the “higher quality household income measure” included all income sources and taxes and was adjusted for household size. Brady and colleagues found that poverty was linked to a greater mortality hazard of 1.42 (95% CI, 1.26-1.6). Consistently being in poverty — referred to as cumulative poverty — was linked to a greater mortality hazard of 1.71 (95% CI, 1.45-2.02). Current poverty was associated with 6.5% of deaths (95% CI, 4.1-9) among those aged 15 years or older in 2019. Among that same demographic, cumulative poverty was linked to 10.5% of deaths (95% CI, 6.9-14.4). Current poverty was connected to higher mortality than major causes like stroke, accidents and lower respiratory diseases, according to the researchers. It was also linked to higher mortality than “far more visible causes,” they wrote. For instance, current poverty mortality was responsible for 2.6 times as many deaths as drug overdose, 3.9 times as many deaths as suicide, 4.7 times as many deaths as firearms and 10 times as many homicides. However, cumulative poverty was linked to approximately 60% greater mortality than current poverty and higher mortality than obesity and dementia. The researchers wrote that the only causes or risks with greater mortality than cumulative poverty were cancer, smoking and heart disease. “Because the U.S. consistently has high poverty rates, these estimates can contribute to understanding why the U.S. has comparatively lower life expectancy,” Brady and colleagues wrote. “Because certain ethnic and racial minority groups are far more likely to be in poverty, our estimates can improve understanding of ethnic and racial inequalities in life expectancy.” Brady and colleagues additionally noted that disparities in survival between those in poverty and those not in poverty begin to emerge at around 40 years of age. The gap peaks around 70 years of age, they wrote, and then begins to converge again. “The mortality associated with poverty is also associated with enormous economic costs,” the researchers wrote. “Therefore, benefit-cost calculations of poverty-reducing social policies should incorporate the benefits of lower mortality.” Brady and colleagues also noted that “poverty likely aggravated the mortality impact of COVID-19, which occurred after our analyses ended in 2019.”
The US economic system makes poverty inevitable
David Smith, May 11, 2023, The Poverty Paradox: why is there still so much economic hardship in the US?, The Guardian, https://www.theguardian.com/books/2023/may/10/poverty-paradox-new-book-mark-rank-us-economic-hardship
Mark Rank thinks about American poverty like a game of musical chairs. “What we’ve done so long is focus on who loses out in the game rather than why the game produces losers in the first place,” the social scientist says in a video call from his office at Washington University in St Louis, Missouri. “We’re playing a game of musical chairs with 10 players and only eight chairs. We can say, OK, who loses out of that game? Well, it’s people that aren’t as quick or they’re in a bad position when the music stops. “But given that there are only eight chairs, then two people are going to lose out regardless of what their character is. That’s a very powerful analogy to use and it does capture what’s been happening in the United States. We focus on individual characteristics rather than saying, hey, there’s something wrong when we don’t have enough jobs that pay a decent wage.” Rank, 67, who has spent decades researching poverty and inequality, is out with a new book, The Poverty Paradox: Understanding Economic Hardship Amid American Prosperity. It brings a much needed sociological method and rigour to an issue too often reduced to political slogans or newspaper snapshots. The paradox in the title has dogged politicians for generations: why does the wealthiest country in the world also have the highest rate of poverty among industrialised nations? This is the land of New York and Los Angeles, of skyscrapers and space rockets, of multibillionaires Jeff Bezos, Warren Buffett, Bill Gates and Elon Musk. Yet one in 10 Americans is officially poor. According to the US Census Bureau, the official poverty rate in 2021 was 11.6%, with 37.9 million people in poverty (an example definition being a family of three with income below $21,559). Rank observes: “You can find poverty in rural areas, in urban areas, in suburban areas, which actually have some of the highest numbers of folks in poverty. In terms of race, it’s a double edged sword. Two thirds of the poor in the United States are white; however, if you’re non-white, you’re at a much greater risk of being in poverty. Both of those things are true. “That’s why I say the reach of poverty is very wide in the United States. I’m looking at the risk of poverty across people’s lives and what’s the risk of poverty in the next 20 or 30 years? If you do that, the vast majority of Americans will experience poverty at some point.” This is because Americans suffer greater economic insecurity than their counterparts in other western industrial nations, Rank argues. Many are in low paying jobs without benefits. If they lose that job or fall ill, there is little to protect them.
“Opportunity” and “individualism” driven by racism and false assumptions about mobility
David Smith, May 11, 2023, The Poverty Paradox: why is there still so much economic hardship in the US?, The Guardian, https://www.theguardian.com/books/2023/may/10/poverty-paradox-new-book-mark-rank-us-economic-hardship
“Our safety net in the United States is very weak and so when these things happen, people are at real risk of falling into poverty. When you think about what can happen to me over the next 20 or 30 years, it’s not unusual to lose a job or to get sick or to have something like this happen and that’s why the rates are so high over a long period of time.” Rank suggests that America’s anaemic welfare state – including an anomalous lack of universal health care – can partly be explained by the interplay of race and poverty. “There’s some interesting research that shows the more homogeneous a society is in terms of race and ethnicity, the more generous their social welfare state. The idea is if you look like me, I’m likely to be more empathetic, I can relate to you more. “Whereas in the United States, we’re very heterogeneous. We’re a large country and we look different and therefore it’s harder to feel that kind of empathy. There has been a lot of backlash against immigrants coming into Scandinavian countries with respect to social safety nets and I’m sure in the UK as well.” This heterogeneity has long been supposed to at least provide the spark for an unrivalled energy, vitality and get-up-and-go entrepreneurial spirit. The American dream – the notion that anyone, regardless of birthplace or class, can attain success – has seduced countless dreamers, not least from overseas. But for every self-made millionaire for whom the streets are paved with gold, there are far more Willy Lomans who fall through the cracks and just keep falling. “In the United States we’re largely about rugged individualism. You do it on your own. You work hard. The idea is that there are opportunities to take advantage of. But the downside is you’re also on your own and, when stuff goes bad, it’s like well, that’s the way it goes. It’s kind of a Faustian bargain that we have here. “‘If I did it, you can do it.’ The problem with that is for every person who really went from rags to riches, there’s 10 other people that didn’t get there at all.” But even the comforting upside of this bargain is now looking tenuous as recent research shows the “land of opportunity” actually offers less economic mobility than many of its counterparts. The American dream has calcified into a myth. “It’s become more rigid in terms of mobility and one way to think about this is not only does the United States lead the OECD countries in poverty but we also have the most income and wealth inequality. What’s happened is that as the income distribution has gotten wider, the rungs on the ladder have gotten further apart, making it more difficult for people to move up.” This trend can be traced to the warp and weft of political ideologies. In 1964, Democratic President Lyndon Johnson declared a war on poverty, telling Congress in his state of the union address: “We shall not rest until that war is won. The richest nation on earth can afford to win it. We cannot afford to lose it.” And while total victory was unattainable, the effort did make strides in poverty reduction. Rank – whose previous books include Living on the Edge: The Realities of Welfare in America and One Nation, Underprivileged: Why American Poverty Affects Us All – notes that wages have stagnated since their peak in 1973, leaving earners no better off today than they were were in real dollars half a century ago. Then came the election of Ronald Reagan, a Republican who declared “We fought a war on poverty, and poverty won.” It was religion of small government, trickle down economics, pull-yourself-up-by-your-bootstraps and the demonisation of “welfare queens”. The tone was set for poverty as individual pathology. Rank adds: “There was very much this backlash that government isn’t the solution, government is the problem, let’s cut back on these programmes and the result is that there’s a very weak safety net to try to protect folks.” The resulting policies, he writes, have been primarily aimed at trying to “improve” individuals on the assumption that causes of poverty lie within their attitudes or behaviour. Approaches include “tough love”, job training and skill development programmes and benign – or not so benign – neglect, premised on the belief that governments do more harm than good. A generation after former Hollywood actor Reagan, there was former reality TV star Donald Trump, who recycled Reagan’s “Make America great again” slogan. The wealthy New Yorker appealed not to the poor but to those who perceived themselves to be economically fragile and caught in a downdraft – and looking for a ready scapegoat. “What has happened is they feel like they are not getting ahead. They feel that other people are getting ahead of them, like African Americans and immigrants, and they’re falling behind. Trump tied into that angst and anxiety and he started talking about that and saying, ‘Hey, these people are getting ahead of you!’ and that resonated.”
Rank supports the plan
David Smith, May 11, 2023, The Poverty Paradox: why is there still so much economic hardship in the US?, The Guardian, https://www.theguardian.com/books/2023/may/10/poverty-paradox-new-book-mark-rank-us-economic-hardship
It took a once-in-a-century crisis to rebuke Reaganism and show what is possible. During the coronavirus pandemic, government stepped in, albeit temporarily, with an expanded child tax credit that reduced child poverty by an estimated 40%. Other safety net expansions included three stimulus cheques, a moratorium on evictions, increased unemployment benefits and more funding for food and housing. Rank comments: “That shows that on a structural level, on a policy level, you can really do something to address poverty. If we take a longer term picture, I think the pendulum will be swinging more towards saying, you know what, there are things we can do to really reduce poverty, particularly child poverty. So although that was short term, it did show the effect that policy can have.” The implication of Rank’s book is that poverty is not inevitable but is a societal choice. His solutions include universal healthcare, which Senator Bernie Sanders has championed but Joe Biden has not. “It’s just ridiculous. We should view healthcare as a human right, not as something that your wallet determines whether you’re able to have that or not. There are certain things that we should put in place that European countries and the UK and others have as well.” Rank would also seek to improve salaries for workers in low paid jobs. “The premise should be if you work full time in the United States you shouldn’t be poor. That just seems wrong. You should at least be a bit above the poverty line and that’s not the case. So I would focus on some social policy things and also on getting a number of those low wage jobs up to a decent level.”
Poverty undermines democracy and the economy
David Smith, May 11, 2023, The Poverty Paradox: why is there still so much economic hardship in the US?, The Guardian, https://www.theguardian.com/books/2023/may/10/poverty-paradox-new-book-mark-rank-us-economic-hardship
In the final third of The Poverty Paradox, the author examines how poverty undermines American values including democracy. He says: “You have a lot of people that are completely disenfranchised. We’re making it harder and harder for people to vote that are either racial minorities or poor and, on the other hand, you’ve got people with enormous resources that are distorting democracy. “They have an undue influence on our policy and in our government. This is getting at more the question of widening inequality: we can point to research that shows that undermines a democracy. Addressing poverty is not only important from a social justice perspective, but it’s also an economic question, because when you disenfranchise a lot of people, when you don’t invest in people, your economy is not going to be as strong as putting your resources into your human capital.” Rank sums up: “One way or another, having this poverty in the United States affects us all here. We pay a price. You can either pay on the on the front end of a problem or on the back end of the problem and we’re paying on the back end, which is always more expensive. The European Union, UK, other places are more likely to pay on the front end by providing good childcare, good healthcare, education and that’s a much better way of addressing this. We need to to shift our thinking about poverty from an issue of them to an issue of us.”
Poverty is the fourth leading cause of death in the US
Brian Contreras, April 23, 2023, https://www.managedhealthcareexecutive.com/view/poverty-is-the-fourth-leading-cause-of-death-in-the-united-states-study-finds, Managed Health Care Executive, Poverty Is the Fourth Leading Cause of Death in the United States, Study Finds
In the United States, poverty was found to be the fourth greatest cause of death. This threat to one’s health is also reported to be far higher in the U.S. compared to other countries. In a recently published research letter in JAMA Network by University of California – Riverside, in 2019 there were roughly 183,000 deaths associated with poverty in the U.S. among people 15 years and older. This is a significant result as the data is from the year prior to the COVID-19 pandemic where death rates skyrocketed. To get a better idea of the association between poverty and death in the U.S., researchers analyzed the Panel Study of Income Dynamics 1997- 2019 data merged with the Cross-National Equivalent File. Deaths reported in surveys were validated in the National Death Index, a database kept by the National Center for Health Statistics, which tracks deaths and their causes in the U.S. Household income was measured by all income sources including cash and near-cash transfers, taxes and tax cred- its and was adjusted for household size. With use of leading standards in international poverty research, poverty was measured relatively as less than 50% of the median income. Current poverty was observed simultaneously in each year, and cumulative poverty was the proportion of the past 10 years. Data shared that broken down, those aged 15 years or older were of the 183,000 deaths associated to current poverty, and 295,431 deaths were associated with cumulative poverty. Current poverty was associated with greater mortality than major causes, such as accidents, lower respiratory diseases, and stroke. Only heart disease, cancer, and smoking were associated with a greater number of deaths than cumulative poverty. Obesity, diabetes, drug overdoses, suicides, firearms, and homicides, among other common causes of death, were less lethal than poverty. “Poverty kills as much as dementia, accidents, stroke, Alzheimer’s, and diabetes,” said David Brady, the study’s lead author and a UCR professor of public policy, in a peer review. “Poverty silently killed 10 times as many people as all the homicides in 2019. And yet, homicide firearms and suicide get vastly more attention.” Another finding is that people living in poverty – those with incomes less than 50% of the U.S. median income — have roughly the same survival rates until they hit their 40s, after which they die at significantly higher rates than people with more adequate incomes and resources. In addition, these findings have major policy implications, the researchers say. “Because certain ethnic and racial minority groups are far more likely to be in poverty, our estimates can improve understanding of ethnic and racial inequalities in life expectancy,” the paper reads. Brady expressed the study shows that poverty should get more attention from policymakers as it not only causes great emotional suffering but also comes at a great cost. “If we had less poverty, there’d be a lot better health and well-being, people could work more, and they could be more productive,” Brady said. “All of those are benefits of investing in people through social policies.” According to a White House brief, over the last three decades, American families have experienced a rise in the costs of many necessities that has made it difficult for them to attain economic security. It was estimated, for example, 80% of families saw the share of budgets dedicated to spending on needs such as housing and healthcare increase by more than 7 percentage points between 1984 and 2014. Further, a 2019 Pew survey found that 37% of Americans worry about the cost of healthcare for themselves and their families.
AI will eliminate 80% of jobs
Eugenia LOGIURATTO, May 8, 2023, Yahoo News, https://news.yahoo.com/ai-could-replace-80-jobs-211900514.html, AI could replace 80% of jobs ‘in next few years’: expert
Artificial intelligence could replace 80 percent of human jobs in the coming years — but that’s a good thing, says US-Brazilian researcher Ben Goertzel, a leading AI guru. Mathematician, cognitive scientist and famed robot-creator Goertzel, 56, is founder and chief executive of SingularityNET, a research group he launched to create “Artificial General Intelligence,” or AGI — artificial intelligence with human cognitive abilities. With his long hair and leopard-print cowboy hat, Goertzel was in provocateur mode last week at Web Summit in Rio de Janeiro, the world’s biggest annual technology conference, where he told AFP in an interview that AGI is just years away and spoke out against recent efforts to curb artificial intelligence research. – ADVERTISEMENT – – As smart as humans? – Q: How far are we from artificial intelligence with human cognitive abilities? “If we want machines to really be as smart as people and to be as agile in dealing with the unknown, then they need to be able to take big leaps beyond their training and programming. And we’re not there yet. But I think there’s reason to believe we’re years rather than decades from getting there.” – AI risk – Q: What do you think of the debate around AI such as ChatGPT and its risks? Should there be a six-month research pause, as some people are advocating? “I don’t think we should pause it because it’s like a dangerous superhuman AI… These are very interesting AI systems, but they’re not capable of becoming like human level general intelligences, because they can’t do complex multi-stage reasoning, like you need to do science. They can’t invent wild new things outside the scope of their training data. “They can also spread misinformation, and people are saying we should pause them because of this. That’s very weird to me. Why haven’t we banned the internet? The internet does exactly this. It gives you way more information at your fingertips. And it spreads bullshit and misinformation. “I think we should have a free society. And just like the internet shouldn’t be banned, we shouldn’t ban this.” – Threat to jobs – Q: Isn’t their potential to replace people’s jobs a threat? “You could probably obsolete maybe 80 percent of jobs that people do, without having an AGI, by my guess. Not with ChatGPT exactly as a product. But with systems of that nature, which are going to follow in the next few years. “I don’t think it’s a threat. I think it’s a benefit. People can find better things to do with their life than work for a living… Pretty much every job involving paperwork should be automatable. “The problem I see is in the interim period, when AIs are obsoleting one human job after another… I don’t know how (to) solve all the social issues.” – AI positives – Q: What can robots do for society today, and what will they be able to do in the future, if AGI is achieved? “You can do a lot of good with AI. “Like Grace, (a robot nurse) we showcased at Web Summit Rio. In the US, a lot of elderly people are sitting lonely in old folks’ homes. And they’re not bad in terms of physical condition — you have medical care and food and big-screen TV — but they’re bad in terms of emotional and social support. So if you inject humanoid robots into it, that will answer your questions, listen to your stories, help you place a call with your kids or order something online, then you’re improving people’s lives. Once you get to an AGI, they’ll be even better companions. “In that case, you’re not eliminating human jobs. Because basically, there’s not enough people who want to do nursing and nursing assistant jobs. “I think education will also be an amazing market for humanoid robots, as well as domestic help.” – Regulation – Q: What regulation do we need for AI to have a positive impact? “What you need is society to be developing these AIs to do good things. And the governance of the AIs to be somehow participatory among the population. All these things are technically possible. The problem is that the companies funding most of the AI research don’t care about doing good things. They care about maximizing shareholder value.”
Medicare for All will save money immediately and over the long-term
Joanne Finnegan, 2020, Fierce Health Care, New study says ‘Medicare for All’ will save the U.S. money with lower healthcare costs, New study says ‘Medicare for All’ will save the U.S. money with lower healthcare costs | Fierce Healthcare
As the debate over how to lower healthcare costs in the U.S. continues, including whether “Medicare for All” is the answer, a new study finds a consensus that a single-payer system would result in savings. A single-payer healthcare system would save money over time—and likely even during the first year—according to a review of 22 analyses of both national and state single-payer proposals made over the past 30 years, according to a study published Wednesday in PLOS Medicine. The study is the first of its kind that reviewed analyses of single-payer proposals and provides strong evidence that Medicare for All would be financially affordable for the U.S., said the study’s first author Christopher Cai, a third-year medical student at the University of California, San Francisco (UCSF), in an interview with FierceHealthcare. To study the consequences of what would happen if the U.S. adopted a single-payer system, researchers from the University of California in San Francisco, Los Angeles and Berkeley examined 22 economic analyses by government, business and academic organizations of national and state-level single-payer plans, including proposals made in Massachusetts, California, Maryland, Vermont, Minnesota, Pennsylvania, New York and Oregon. These analyses were used by policymakers to evaluate the proposals, estimating savings the plans would create through simplified billing and lower drug costs while also taking into account increases in health spending that would arise as newly insured people sought healthcare, the study said. RELATED: Healthcare still a top issue for Iowa, New Hampshire voters as primaries rev up Nineteen of the studies showed the U.S. would save money in the first year of adoption, averaging 3.5% of total healthcare spending, and all of the studies showed healthcare savings in the long term. The greatest source of savings comes from reduced administrative costs, with further savings from lower drug costs, the study found. The models were created by analysts from different political perspectives, and they provided a range of cost estimates in the first year of operation, from 7% higher to 15% lower. In the long term, savings from simplified payment administration and reductions in drug prices and other efficiencies ranged from 3% to 27%, with the largest savings found in plans that lowered drug costs, the study said. Actual costs and savings will depend on features and implementation under a specific proposal. Under proposed single-payer plans, such as Medicare for All, a unified public financing system would replace private insurance, similar to the healthcare system in Canada and many other wealthy countries. A separate study released last week in the Annals of Internal Medicine that compared U.S. administrative healthcare costs with that of neighboring Canada indicated the U.S. would save $600 billion in costs by switching to a single-payer system. Medicare for All has generated discussion in the seven Democratic presidential debates held so far. Candidates Bernie Sanders, a senator from Vermont, and Elizabeth Warren, a senator from Massachusetts, both support Medicare for All proposals, while some other candidates favor building on the Affordable Care Act. The PLOS study could help bolster the argument for Medicare for All. “It’s always our hope that elected officials will spread accurate information. If you watched the [Democratic presidential] debate last night, a lot of people were referencing that Medicare for All will cost more and we can’t afford it. In light of this evidence, I think that’s simply not true,” said Cai, who disclosed as part of the study that he is an executive board member of Students for a National Health Program, a group that supports a single-payer system. “Obviously, I have personal opinions about healthcare reform,” he said, adding that the study included a broad group of authors from both sides of the debate who all made disclosures of any potential conflicts. The study underwent a peer-review process. “The strength of our review is it looked at single-payer proposals in a lot of different contexts and shows a pretty clear consensus. We looked at both studies from conservative-leaning and liberal-leaning think tanks and organizations and all the studies showed savings over time,” he said. Studies authored by those with liberal-leanings were more likely to show more generous savings, but analyses supported by more conservative funders or performed outside of academia still predicted single-payer systems would yield savings. The nonpartisan Congressional Budget Office (CBO) said in a report last year that total spending under a single-payer system might be higher or lower than under the current system depending on the key features of a new system, such as payment rates for hospitals and doctors and whether patients would pay part of the cost of care. The CBO didn’t actually offer up specific cost estimates on any of the Medicare for All proposals floating around, though one estimate put Sanders’ Medicare for All plan at between $32.6 trillion and $38.8 trillion over the first decade. In the PLOS study, researchers estimated longer-term savings by using cost projections made in 10 of the models, which looked as far as 11 years into the future. These studies assumed that savings would grow over time, as the increases in healthcare use by the newly insured leveled off and the global budgets adopted by single-payer systems helped constrain costs. By the tenth year, all modeled single-payer systems would save money, even those that projected costs would initially increase, according to the study. “Even though they start with different single designs and modeling assumptions, the vast majority of these studies all come to the same conclusion,” said study author James Kahn, M.D., a professor in the UCSF Department of Epidemiology and Biostatistics and a member of the Philip R. Lee Health Policy Institute, in an announcement. “This suggests that fears that a single-payer system would increase costs are likely misplaced.” Higher initial costs were associated with plans that had low co-pays or none at all, offered rich benefits or that did not expect savings from lower drug and medical equipment costs, the study found.