2014 Shaping the Future of New York Fridays: 11:00-1:45 Boylan Hall, 2231

Often when we hit times of economic recession, budget cuts are highest or first taken into effect for programs that help those on the lower end of the socio-economic ladder. Budgets can always get “cut” but money that is taken from one sector ends up being spent in another (i.e. NYS cutting higher education funding, while increasing spending on prisons, http://www.prisonpolicy.org/scans/jpi/nysom.pdf). This very well could be the aftermath of austerity tactics within policymaking; however, poor social policy intervention leads to poor health. Most of the time it seems like policy is crafted to mimic other successful social welfare programs, however the cookie cutter method should have already proven its detriment.  As described in “Social Policy Interventions and Health,” Chile, Mexico, and Brazil all managed to launch CCT programs, but in varying ways.

CCT programs in NYC are currently non-existent. Opportunity NYC (designed after the international CCT programs being implemented) would have been better off being reanalyzed and changed to meet its weak points rather than being cut completely. What could be learned however is that social policy intervention should tackle the root of health disparities, allowing for people to live healthier lives while simultaneously enhancing education and social welfare.

Prior the Great Recession, the US healthcare system covered only about two-thirds of Americans. That’s 103 million people uninsured or left to pay for private companies. Within a system that relies heavily on employer-distributed health insurance, it can be expected that both the unemployed, as well as the self-employed will not reap the benefits accept for the small percentage of those who can afford the privatized system. During the Great Recession the United Kingdom’s healthcare system, The National Health Service, moved to closer resembling the US system. This move towards free-market competition among insurance companies should have been known to be risky since the US took steps to reverse the effects of a privatized system during the Great Recession with the passaged of the PPACA or Obamacare.

What does this say about our healthcare system if the providers are the ones being provided for? The insurance companies, hospitals, and drug companies all get the benefit of our healthcare system. Since recessions are connected with increasing unemployment, and receiving health insurance is highly dependent on your employer, harsh austerity reforms during times of recession are detrimental to public health. Unemployment means more depression, anxiety, sleeplessness, and self-harm, which also means more spending on the medication to treat these conditions, as well as the higher government spending that is contributing to more unemployment checks. Reforms should focus on fixing the root of the problem, rather than treating the effects of austerity.

David Stuckler makes a good argument about the detrimental effects of government spending cuts on public health.” When the government cuts spending, it reduces people’s income, leading to less business, more unemployment, and a vicious spiral of slowing down the economy.” The case with Kierren’s dad dying the day after being deemed “fit for work” by Cameron is an example of how budget cuts can lead to slowing down the economy. “During the late 1920s, the US super-rich—the Fords, Vanderbilts, Carnegies, and Rockefellers—were the masters of the country’s financial markets. This top 1 percent of the population held over 40 percent of America’s wealth.” Given that this time was the period right before the stock market crash and the Great Depression, having such a large wealth gap is not economically stimulating. Today’s figure of wealth inequality in the United States is completely analogous to the numbers of the late 1920s. David Stuckler writes, “As public health researchers, we were shocked and concerned at the illogic of the austerity advocates, and the hard data on its human and economic costs. We realized the impact of the Great Recession went far beyond people losing their homes and jobs. It was a full-scale assault on people’s health. At the heart of the argument was the question of what it means to be a society, and what the appropriate role of government is in protecting people.” The initial threat to health was the increased suicide rate after Black Tuesday. Similarly to the Great Recession of recent years, Stucklet finds that the suicide and fall-in traffic death rates have increased. Stuckler compares the New Deal, Shock Therapy in Russia, and the IMF programs in Asian all show how the most vulnerable members of economy feel the worse effects of austerity programs with large budget cuts, intended to improve economic health but actually hurt it while also hurting human public health.