Health and Wealth Inequality in America
House Budget, Health and Wealth Inequality in America: How COVID-19 Makes Clear the Need for Change, June 23, 2020
There are two factors of concern on minority health care: the general health of the population and access to primary care.
The general health of communities of color among the working and beneficiary classes is sub-optimal, often by design. Diets provided by low wages or inadequate benefits lead to health conditions which include obesity, hypertension and diabetes. Urban air is more polluted, so asthma may be a factor, especially in children. Emergency room-based care means less of a long-term relationship than available to patients with primary care physicians. I mention these factors because they are well covered and likely will be mentioned by the scheduled witnesses.
The second factor shows that the work of healthcare reform is not yet complete. Communities of color have had higher reported cases because they still must seek care in hospitals. Those who work in low-end jobs with no sick leave must seek care outside of normal business hours.
They are often called “essential workers” but are not paid a wage that reflects how essential they really are. Because primary care physicians generally have offices outside their neighborhoods and during normal business hours, they have no choice but to go to the emergency room. Higher exposure may be an artifact of the availability of testing at hospitals compared to doctor’s offices available to upper-middle class populations.
Media coverage of emergency rooms makes it less likely that patients who are sick rely on them will seek care until it is almost too late (which may be the case with the all populations). In the beginning of the pandemic, people who were not badly ill were sent home. Many were likely not anxious to go back.
This may be the second round for minority patients. If they brought their children for care at the beginning of their local outbreak, crowded conditions may have led to exposure they would not otherwise have received. Again, they come back very sick.
The question is, how do we fix these problems?
The most obvious solution is mandatory sick leave, especially for essential workers. Higher minimum wages are necessary because this will increase wages for all but the very wealthy. The CEO class, because they are under-taxed, have an incentive to seek economic rent by cutting worker wages. Higher taxes marginally decrease these incentives. A return to the tax rates of the fifties and early sixties would eliminate them, but the political will to go that far is not there. Too many donors on both sides assure that it will not be any time soon.
The benefit of more money, especially for people of color, is economic advancement and a generally better lifestyle. Workers with more money seek more education. Paid education for displaced workers at higher minimum wage level to meet their opportunity costs will enable career advancement. Those essential, lower wage workers, will benefit from having a smaller labor pool, forcing employers to raise wages even higher. Evidence shows that more money is the answer to poverty.
The contention that giving people more money will cause indolence. The truth is that social policies that assume that workers will not spend money well have their origins in the reactionary desire to maintain a pool of low wage workers to do the jobs that others would not due, save for poverty and racism.
The tax reform advanced by the Center (see the attached plan), particularly the high salary surtax and the asset value added tax will decrease incentives to rent seek by keeping wages lower (some would call that stealing – we certainly do). The subtraction VAT will raise more money for human services, such as Medicare for All.
The SVAT will also give employers the incentive to pay families a higher wage via an increased child tax credit at median income levels, to offer superior quality health insurance or direct care in the workplace, as well as both healthy and sick daycare and to provide an additional credit for paid training for employees from ESL and GED to Associates degrees and beyond.
Improving the lives of the working class, particularly for families of color, will lead to a healthier population that is more resistant to disease outbreaks in the future. We only need to abandon the notion that keeping people poor will make them seek a better life through work. This is a sick joke designed to guarantee a supply of low wage labor, particularly by people of color, so that they will be forced to work jobs that no one else wants.
Immigration reform is also part of the equation. Our illegal economy (not the workers, but the working conditions, lack of union representation and low pay) forces undocumented workers to come to work sick or face a call to the Department of Homeland Security. The government is actively engaged in what amounts to human trafficking. Reform will end this.
Attachment - Tax Reform, Center for Fiscal Equity, February 21, 2020
Ways and Means, Disproportionate Impact of COVID-19 on Communities of Color, May 27, 2020
There are two factors of concern on minority health care: the general health of the population and access to primary care.
The general health of communities of color among the working and beneficiary classes is sub-optimal, often by design. Diets provided by low wages or inadequate benefits lead to health conditions which include obesity, hypertension and diabetes. Urban air is more polluted, so asthma may be a factor, especially in children. Emergency room-based care means less of a long-term relationship than available to patients with primary care physicians. I mention these factors because they are well covered and likely will be mentioned by the scheduled witnesses.
The second factor shows that the work of healthcare reform is not yet complete. Communities of color have had higher reported cases because they still must seek care in hospitals. Those who work in low-end jobs with no sick leave must seek care outside of normal business hours.
They are often called “essential workers” but are not paid a wage that reflects how essential they really are. Because primary care physicians generally have offices outside their neighborhoods and during normal business hours, they have no choice but to go to the emergency room. Higher exposure may be an artifact of the availability of testing at hospitals compared to doctor’s offices available to upper-middle class populations.
Media coverage of emergency rooms makes it less likely that patients who are sick rely on them will seek care until it is almost too late (which may be the case with the all populations). In the beginning of the pandemic, people who were not badly ill were sent home. Many were likely not anxious to go back.
This may be the second round for minority patients. If they brought their children for care at the beginning of their local outbreak, crowded conditions may have led to exposure they would not otherwise have received. Again, they come back very sick.
The question is, how do we fix these problems?
The most obvious solution is mandatory sick leave, especially for essential workers. Higher minimum wages are necessary because this will increase wages for all but the very wealthy. The CEO class, because they are under-taxed, have an incentive to seek economic rent by cutting worker wages. Higher taxes marginally decrease these incentives. A return to the tax rates of the fifties and early sixties would eliminate them, but the political will to go that far is not there. Too many donors on both sides assure that it will not be any time soon.
The benefit of more money, especially for people of color, is economic advancement and a generally better lifestyle. Workers with more money seek more education. Paid education for displaced workers at higher minimum wage level to meet their opportunity costs will enable career advancement. Those essential, lower wage workers, will benefit from having a smaller labor pool, forcing employers to raise wages even higher. Evidence shows that more money is the answer to poverty.
The contention that giving people more money will cause indolence. The truth is that social policies that assume that workers will not spend money well have their origins in the reactionary desire to maintain a pool of low wage workers to do the jobs that others would not due, save for poverty and racism.
The tax reform advanced by the Center (see the attached plan), particularly the high salary surtax and the asset value added tax will decrease incentives to rent seek by keeping wages lower (some would call that stealing – we certainly do). The subtraction VAT will raise more money for human services, such as Medicare for All.
The SVAT will also give employers the incentive to pay families a higher wage via an increased child tax credit at median income levels, to offer superior quality health insurance or direct care in the workplace, as well as both healthy and sick daycare and to provide an additional credit for paid training for employees from ESL and GED to Associates degrees and beyond.
Improving the lives of the working class, particularly for families of color, will lead to a healthier population that is more resistant to disease outbreaks in the future. We only need to abandon the notion that keeping people poor will make them seek a better life through work. This is a sick joke designed to guarantee a supply of low wage labor, particularly by people of color, so that they will be forced to work jobs that no one else wants.
Immigration reform is also part of the equation. Our illegal economy (not the workers, but the working conditions, lack of union representation and low pay) forces undocumented workers to come to work sick or face a call to the Department of Homeland Security. The government is actively engaged in what amounts to human trafficking. Reform will end this.
Attachment - Tax Reform, Center for Fiscal Equity, February 21, 2020
posted by Michael Bindner at 2:30 PM
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