Cure health inequality by reducing income inequality

Cure health inequality by reducing income inequality

by | Aug 30, 2017 | Opinion

The relationship between health and social context includes a range of factors influencing overall well-being. Social status, class, lifestyle, education, and environment primarily shape these factors. Age, gender, race, and ethnicity are structural variables of equal importance to health outcomes. Health is being facilitated or inhibited by the socioeconomic, cultural, and political backgrounds, in which one is born and raised. The people that view these data points and makes correlations between socioeconomic status and backgrounds to health issues have an interesting career because they constantly have to adapt to the understanding of new societal groups and focus on why a certain group would make a certain decision, for example.

In the last few decades, we have seen growing income inequality between the poor and rich. Since the 1980’s, the United States of America has seen a shift in wealth from the middle class towards the wealthiest people and transnational companies. The top one-tenth of 1 percent owns as much as the bottom 90 percent. Firebaugh and Beck argued economic growth would automatically benefit the masses, which in hindsight seems questionable.

As health outcomes and life expectations closely liaise to within-country income inequality, policies should aim at finding appropriate actions to address this phenomenon. Meaning, getting basic family urgent care, in terms of medical needs cannot be compromised. Currently, in some countries, those who earn more are able to find medical treatments to treat their injuries or illnesses, whilst those who don’t have as much money are having to cope with their illness or find other treatments. For example, those who suffer from digestive problems would have to pay a significant amount to get their illness looked at, so people on lower incomes will find supplements to help them instead. The bio complete 3 supplement can deliver prominent improvements for people’s digestive systems, so people are able to treat these problems. However, not all problems can be treated with supplements. This is why changes have to be made.

Wilkinson and Pickett found health issues to be strongly correlated to income inequality within a country. To support this finding, they used two different measurement tools. The first index, applied to Western countries, was a ratio of the 20 percent top incomes in relation to the 20 percent of the bottom earners. For different states within the USA they used a second index, the Gini-index, which adopts a different methodology. Where ‘Gini = 0′ represents perfect equality (same income for everyone) and ‘Gini = 1′ is total inequality (if all income goes to one person). The outcome of these results showed that the widening income gap led to an increase of different health issues related to mental disorders, life expectancy, infant mortality, obesity and teenage births. Societal problems that correlated to income inequality included: lower levels of trust, less educational performance, more homicides, higher imprisonment rates and a lack of social mobility. Some authors found Wilkinson and Pickett’s dismissal of poverty in relation to health outcomes incorrect as they did not measure it. On the other hand, research by Beckfield and Bambra confirmed the correlation between life expectancy and health stating that the lagging welfare state in the USA led to an average loss of 3.77 quality life years in comparison to other OECD countries. The USA has an income gap of 8:1 (the average biggest earners have 8 times the wage of those at the other end of the spectrum) leading to a life expectancy of 78.7 years, which is in contrast with Japan reaching an average of 83.0 years with an income gap of 4:1. The same age dependent relation has been found in Scandinavian countries having similar income gaps as Japan.

Goda and Torres Garcia looked at the rise of global inequality and confirmed previous results by stating that within-country inequality is responsible for 70 percent of the global inequality, suggesting 30% is due to in-between country inequality.

Taking national and local figures into account for the UK, the Office for National Statistics observed a life expectancy for new-born baby boys to be 83.3 years in the Kensington and Chelsea area. Meanwhile, the life expectancy for the same cohort in Blackpool is merely 74.7 years. Nationwide, the female life expectancy is 86.6 years in Purbeck and the lowest in Glasgow City with an expectancy of 78.5 years. The authors conclude that inequality has increased over the last two decades despite improvements in these local areas.

Medical technology has improved greatly over the past two decades, with many illnesses that were fatal twenty years ago proving simple to treat now. Simple technological breakthroughs such as RFID labeling and instant messaging have meant that medical practices can be streamlined, saving time and money which can then be invested back into treating patients. With all these improvements in technology, why is there still little improvement in life expectancy in some areas? The answer lies again with income inequality, with areas that suffer from low income also suffering from lower government funding. This directly impacts the access local hospitals have to new technology, meaning they have fewer new technologies to utilise for their patients.

We may assume a strong relation between income inequality and health outcomes on a global scale as Dorling in recent research concludes there are overarching arguments. Dorling (2007) confirmed a strong relation between income inequality and negative health outcomes on a global scale after an observational study performed in 126 countries.

The academic world has provided alternatives to deal with the widening gap between poor and rich. Reformed minimum wages, living wages, basic income or a global ‘fair tax’ and redistribution are only a few austerity counter-proposals to ensure overall well-being by reaching or transcending the poverty line. Minimum wages have proven insufficient and a basic income is still globally debated. An international fair tax may even prove more challenging as this requires global political support.

Minimum wages and living wages have the same aim; raising income for the least fortunate to reduce the impact of a growing income gap. A minimum wage is defined as a minimum market valued income, imposed by law and paid by employers. A living wage is a locally liaised and negotiated pay rate that a fulltime employee needs for a household of four to reach the poverty line. For the latter, societal context is important, as living in a metropolitan area is more expensive than living in the countryside. The Basic Income Earth Network defines basic income as “a periodic cash payment unconditionally delivered to all on an individual basis, without means, test or work requirement”.

A locally implemented living wage project in the UK, facilitated by the General and Municipal Boilermakers Union in 400 councils, has proven to be successful in reducing (health) inequalities as well as being beneficial for government tax income. Awareness within the community influenced policy in a way that living wages became accepted as a benchmark for society. In this regard, a living wage clearly will contribute to individual well-being and social cohesion – both factors improve health within communities.

Proposals for a Universal Basic Income (UBI) are slowly reaching the minds of global policymakers, but this process will take more time in achieving broader support. In developing a short-term response tackling inequality, a living wage appears to be a possible solution for developed countries yet remains a huge challenge for developing countries.

Emerging new technologies will demand economical strategies that are able to cope with less job certainty and keeping up with growing demands in healthcare.

A redistribution of capital, as proposed by Thomas Piketty in his book ‘Capital in the Twenty-First Century’, in combination with a UBI may prove to be the best strategy in the long-run to counter income-related health inequalities on a global scale. We must urge politicians to finally face transnational companies and the top one percent in order to obtain a globally acceptable taxation rate.

About the author:

Sam Brokken hails from Belgium and lives near the city of Leuven. He studied physiotherapy, sports physical therapy and manual therapy practicing these areas for years in private practices within local communities. He lectures in musculoskeletal disorders in relation to manual handling and ergonomics for healthcare service providers.
He is currently engaged in postgraduate work at the Robert Gordon University (Aberdeen – Scotland) within the MSc Public Health and Health Promotion course.

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The Netherlands: ‘Free Money’ at Studium Generale Utrecht University, October 25, 2017

by | Aug 28, 2017 | News

As the social assistance experiments in several Dutch municipalities will begin this fall, Studium Generale of Utrecht University has organized an event dedicated to ‘Free Money‘.

Studium Generale is a university’s public platform for knowledge sharing and reflection by organizing lectures, seminars and other activities aimed at students and the general public. Entrance is always free and accessible without reservation.

In the Netherlands, municipalities are responsible for the provision of tailor-made benefits to anyone who has insufficient means to support him or herself, and for achieving the purpose of the Participation Act, that is, making recipients independent from social assistance. Several municipalities are conducting two-year experiments, in the context of which they have the option of implementing social assistance regulations in an alternative way.

Each experiment will include at least three treatment groups, who are subjected to various regimes, and a control group. The restrictiveness of obligations between the groups will vary, from a group which has fewer obligations imposed on it to a group which is even more intensively supervised. In addition, participants in a third treatment group may retain a limited amount of their income from work on top of their payments. See the links at the bottom of this article for more details.

Researchers of Utrecht University, one of the four universities that will supervise the experiments scientifically, have been critical about the design of the pilots because of its limited scope and complicated nature.

The experiments, as they are proposed now, raise a number of questions, such as: why don’t we all give a basic income? Is it too expensive, or are there any other objections?

Rutger Bregman (The Correspondent) and Professor Ingrid Robeyns (political philosopher and economist at Utrecht University) will address these issues during the “Free Money” event on October 25, 2017.

Rutger Bregman has written several books on ‘Free Money’ — for instance, Utopia for Realists — and was one of the speakers at TED2017 in Vancouver last April.

Ingrid Robeyns holds the chair in Ethics of Institutions. In her teaching she focuses on normative and applied ethics and (normative) political philosophy. She has been teaching about justice theories and economic ethics at the masters level in recent years. In her own research, Robeyns addresses a number of normative issues related to demography, gender, family, and institutional economy. Robeyns writes for the English-language group blog Crooked Timber and occasionally on her own site Buiten Categorie. She will also be one of the speakers during BIEN’s 17th Congress next September in Portugal.

The event will take place on October 25, 2017. The language is Dutch. Those interested are invited to join the discussion on Facebook event. For more details, see here.

Previous information on social assistance experiments in The Netherlands:

Florie Barnhoorn, “The Netherlands: Amsterdam on collision course over social assistance experiments” (August 5, 2017).

Florie Barnhoorn, “The Netherlands: All that’s left is the action. Where do we stand with the experiments?” (June 2, 2017).

Kate McFarland, “The Netherlands: Social Assistance Experiments Under Review” (May 9, 2017).

Florie Barnhoorn, “The Netherlands: Design of BI Experiments Proposed” (October 26, 2016).

Credit Picture Flickr.com CC Ealasaid.
Thanks to Kate McFarland for reviewing this article.

Basic Income: Tradeoffs and Bottom Lines

by | Aug 21, 2017 | Research

This paper represents a massive undertaking by both University of Melbourne Australia faculty and an independent agency called the the Brotherhood of St. Laurence dedicated to social Justice.  It looks at a collection of BI pilot projects, as well as other projects which can be considered close approximations of a BI, from around the world.  Government projects which have been run in the past as well as private and government projects currently being implemented.

The paper provides a number of graphs and and analyses aimed at comparing and contrasting the examined projects while underlining the incredible number of variables affecting both the design and the outcome of any such project that must be attended to.  But the main focus of this paper is to determine how a BI can ensure equity of income, improved efficiency of governance and an end to the stigma of social supports.

While considering the concept of a BI to be attractive for a host of reasons, not the least of which are equity and the automation of the workplace, the paper is decidedly cautious and suggests careful consideration of “… broader issues and the intersecting domains and policies” which one can only assume refers to the social and economic ramifications of such a project. A very bureaucratic summation of some extremely crucial social concerns.

How Many Couch Potatoes Can You Live With?

How Many Couch Potatoes Can You Live With?

by | Aug 16, 2017 | Opinion

I hardly ever respond to anything in writing if I am not remembering it at least a year or so later. The piece I am remembering is an episode of the podcast Freakonomics called “Is The World Ready for A Guaranteed Basic Income?” I recommend it as an introduction.

I am going to give you a quote and then I want you to keep reading.

Sam Altman runs Y Combinator, a technology venture capitalist firm that has had some great successes and is now interested in funding social science research that will include basic income. Here is the quote, which came up during his interview in this podcast episode:

Maybe 90 percent of people will go smoke pot and play video games. But if 10 percent of the people go create new products and services and new wealth, that’s still a huge net win.

We are back to the couch potato. This character appears in a lot of objections to basic income. Altman concedes that there will be couch potatoes. He just thinks that is a good price to pay to get more entrepreneurs, even only a few of them. I appealed earlier for the reader to keep going because most people in my orbit would not like this quote. (If it sounds good to you, then I guess I should still urge you to keep reading.) I will explain why some will push back and why I ultimately do not.

We are starting to see increased support for as well as new sorts of negative reactions to the idea. Not very long ago, basic income advocates were often introducing the idea to specific audiences. This meant one could get away with starting where you thought the listener would react best. If you were talking to someone on the left, you might call it a “strike fund for all”. If someone is more liberal, you would emphasize that a basic income reaches people that welfare is supposed to help. With libertarian types, you start with the efficiency and non-bureaucratic character of a basic income. I have been very impressed by recent writing that emphasizes basic income’s ability to remedy asset inequality for people of color and women.

Now, I am very pleased to see more people who have already heard about basic income from someone. Sometimes they caught the wrong person for them. As we explain basic income, we will need to separate the policy (giving everyone an unconditional cash grant) from the project (which can range from left to right).

A quote like Altman’s can swing a listener in different directions. I know this from my social media work. I imagine people running different movies in their head. Some hear “new products and services and new wealth” and visualize start-ups and think it all sounds great. Others try to imagine a world working well with 90 percent of people not doing anything anyone else wants them to do and they just can’t see that working out well. Others hear this and worry that basic income is part of a larger scheme to organize our lives around Silicon Valley capitalists. To them, Altman seems to overly glorify the tech entrepreneur. Other writers are more desperate in labeling basic income a “neo-liberal plot”, which would make you laugh if you went to one of our Congresses. We would not want to merely swap one set of capitalists for another.

I have not met Sam Altman. His other statements show that he also finds basic income interesting because it directly answers a moral mandate to make sure people are clothed, fed, and sheltered. I highly recommend the rest of the podcast. My objective here is to explain why I think we ought to look at this quote charitably. I will show in what way I think his quote is true. I also want to propose an alteration that makes it much more palatable for those I see reacting negatively.

No One is Saying Ninety Percent of Society Will Hit the Couch

Altman is not talking about a whole society in which only 10 percent work. He is saying that even if we lose some work-time to lame leisure (pot and video games), we will make it back even if only 10 percent start up new enterprises. Nor is he saying that he knows that we will get one successful start-up for every nine lives lost to the coach. He is only saying that losing nine to the couch would be an acceptable price to pay if we gain a start-up, which would offer something someone wants and would also be offering jobs. This is very plausible.

Most people with a basic income will live a lot like they do now. They will have a more stable income. They will worry less about many of their friends and family. They will have a plan if they need to train for a job or pay bills between jobs. This cuts into the number of people who would choose the couch. Work can be a place where we get recognized for our talents and for our cooperativeness. And jobs pay money. In fact, you can still count on a basic income if you take on a job. And you can count on it if you change your mind.

The problem now is that employees have very few options when workplaces go sour. Basic income creates one option (work for no one) and enables people to survive while they search for and train for other options. This will increase pressure on workplaces to improve.

I used to be suspicious of most rhetoric surrounding markets. I think that was because so much of it ended up with a conclusion like “Therefore, government should do less/nothing.” I have come to value markets more and more. Now, I want them for everyone. A basic income secures the capability to participate in markets for everyone. There are many sections of the United States that get very little government or market attention. That would be less likely with a basic income in effect. You will also see more start-ups under a UBI because failing doesn’t risk losing everything. Most entrepreneurs now come from the upper one percent of our society. Whole communities aren’t going to see much startup soon if we wait for the elite to try to make money there.

Add Caregivers and Organizers To The Mix

Someone organizing a non-profit, a political organization, or even an informal social scheme fits under Sam Altman’s phrase of “new products and services and new wealth.” He is not confining his hopes to technological startups.

Robert Putnam’s book Bowling Alone, written in 2000, lays out the loss of social networks and the harm that has caused most Americans. These can be voluntary associations, political clubs, fraternal organizations, or sports leagues. Participation has declined as work-hours per household has increased. This means that many will look for alternative ways to interact with like minded Americans, especially when it comes to sporting events.

There is a strong link between organizational affiliation and many different metrics for happiness or meaningfulness. We also see more affiliation in communities that have more political power and that generate more market activity. (There is likely a causal loop there. Lack of power and lack of market options may often precede losses in organizational depth. And a lack of organizational depth may well often precede losses in money and power.) Social-capital comes hand in hand with capital-capital.

Michael Lewis and Eri Noguchi apply Putnam’s work, and combine it with survey data, to give us strong reasons to think that we would see improvements in civic networks as well. Declines in civic participations can be shown to coincide with an increase in work hours. People who value civic participation will have an option to do so.

If you want to know how a basic income will benefit society, let’s make it clear that we are including “organizers” within our understanding of “entrepreneur”. Our culture is one that has to be reminded of this. Once we expand our understanding, we can look around and see how many people are trying to participate in institutions that organize in pursuit of truth, justice, and beauty.

Examples will help here: church committees, symphony boards, rotary clubs, sports leagues, poetry circles, craft guilds, environmental organizations, identity-based youth groups, identity-based cultural organizations, music bands, theater companies, unions, political organizations, lobbying organizations, etc. This list could go on a very long time.

At this point, I want to share a little bit of what I learned as a community organizer in Arkansas for ACORN. Organizing is difficult. There are many ways in which it is not like entrepreneurship at all. You aren’t selling anything. All organizations have trouble finding this skill set. It is also difficult to get the resources together for full-time organizing. We would often hire someone who loved the mission of the organization but had to leave for pretty small increases in money. It might also prevent the loss of organizers to the for-profit sector.

Please note: I have noticed that a large section of the US internet is trying to malign the very term “community organizer” but my argument includes organization of groups I disagree with.

The ratio of organizers to members goes beyond the one to nine ratio that Altman imagines. About six of us at Arkansas ACORN served around 5,000 households if you are only counting dues payers. The community that responded to our work was larger than that. There were meetings every month. People debated goals and tactics. Political leaders were interviewed or protested. Organizations that despised us did the same things, though often with more funding from fewer people.

Every time I hear the term “couch potato” brought up as some sort of nightmare case for basic income, I remember that I sat on thousands of couches, urging people to get active, to get involved with their community’s decisions. I know that with a basic income, we would have had more organizers and more active members. Rival organizations would have had the same benefit. We will live in a more democratic place.

I am still involved in political work, even though I am not employed to do it. I also have been published as a poet and as a photographer, though not paid. You will find a lot of people working on magazines, readings, and websites in which the true, the good, and the beautiful are debated. A lot of people can see how to raise some money doing cultural, social, or political work but they can’t get to a decent level. A basic income would generate audiences for artists, philosophers, preachers-good and bad. A thriving art world is full of disputed art. A thriving philosophical culture will have disputed philosophical projects. We will live in a more interesting place.

Norman Rockwell “Freedom of Speech”

Finally, we should look at the decision to care for a family like we would a “start-up”. The “caregiver” has started a “career” that works for many people like a vocation. For each caregiver, there is at least one other person, usually more, benefiting in a meaningful way. Economists often do not count care for children and elders unless someone is formally paid to do it. A basic income would enable people to say no to employment if someone they love needs them. We will live in a more caring place.

In fact, Robert Putnam shows us in his research, as do Michael Lewis and Eri Noguchi in theirs, that the “stay-at-home” mom was often a civic association organizer as well.

More markets, more culture, more democracy, more care. This looks to be well worth investing 3% of our GDP and letting a few people stay home.

When I read the comments and notes that come with all basic income articles, I can see that some people would worry about people not working because of basic income. Basic Income enables people not to work. Kate McFarland points out that a basic income enables people to say no to all social useful activity. But we are far away from that. Some people will live incorrectly. Many people live incorrectly now. Basic income is a good bet for increasing socially useful work.

  • More entrepreneurs means more people are offered employment.
  • More organizers mean more people are being invited to venues where what is true, what is good, and what is beautiful are debated and plans are made.
  • More caregivers mean more people are taken care of.

Therefore, most likely, for every couch potato, we will have better reasons than ever to get off the couch.

About the author:

Jason Burke Murphy teaches philosophy and ethics at Elms College in Western Massachusetts. He serves on the board of US Basic Income Guarantee Network and recently presented at their North American Congress. He helps with social media for US Basic Income Guarantee Network. He has written before for Basic Income News. His most read piece so far is “Basic Income as Proposal, as Project, and as Idea.”

US: Stanford’s Basic Income Lab plans new schedule of events

US: Stanford’s Basic Income Lab plans new schedule of events

by | Aug 10, 2017 | News

Launched in February 2017, the Basic Income Lab (BIL) at Stanford University’s McCoy Family Center for Ethics and Society aspires to provide information and advice to researchers, policy makers, and other individuals and groups engaged in the design and implementation of basic income experiments or policies.

Already this year, BIL has held a panel discussion on basic income experiments, in which Joe Huston described the large-scale experiment to be conducted in Kenya by the New York based non-profit GiveDirectly, Elizabeth Rhodes discussed the plans to Silicon Valley’s Y Combinator to run a basic income experiment in the United States, and Guy Standing reviewed the results of a pilot study in eight villages of the Indian state of Madhya Pradesh. It also hosted a presentation by Philippe Van Parijs of his new comprehensive book on basic income, Basic Income: A Radical Proposal for a Free Society and a Sane Economy (with Yannick Vanderborght). Now, BIL is preparing for both public and private events to be held throughout the upcoming academic year.

In September, BIL will co-host the Cities and Universal Basic Income Workshop, working aside the Economic Security Project (ESP), the McCoy Family Center, and the National League of Cities, which recommended investigation of city-level basic income programs in its 2016 report The Future of Work in Cities. This private event aims to inform city leaders and other researchers about the latest developments regarding current and planned basic income experiments, and to investigate the possibility of implementing municipal-level basic income policies. Additionally, BIL has scheduled two co-sponsored public lectures on the relationship of basic income to issues of gender and race: in October, Almaz Zelleke (NYU Shanghai) will visit Stanford to speak about how basic income can impact gender justice; then, in January, Dorian T. Warren (Roosevelt Institute, ESP) will speak about basic income in relation to racial justice.

Juliana Bidadanure in audience at BIL panel

BIL is led by Faculty Director Juliana Bidadanure, a philosophy professor who last year designed and taught a graduate seminar on basic income. Describing the mission of the lab, she states, “There is an increasing need for in-depth academic research on various policy designs for UBI and how to evaluate its implementation – assessing the visions that underpin unconditional cash, the political and economic feasibility of various proposals, as well as its strengths and weaknesses as a measure to alleviate poverty and inequality.”

In addition to her work with BIL, Bidadanure is preparing to teach an undergraduate course on basic income during Stanford’s winter term.

To stay abreast of BIL’s activities, subscribe to its mailing list and follow BIL on Facebook.

Reviewed by Dawn Howard and Juliana Bidadanure

Photos from the Basic Income Lab’s “Experiments in Unconditional Basic Income” panel; credit: Christine Baker (at EthicsSoc).