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

Isn’t it funny how socialized healthcare is just so conducive to facilitating health? It’s uncanny!

I’ll be honest, before reading this section, I didn’t really understand exactly how healthcare worked, what the pros and cons were to privatized healthcare versus socialized healthcare, etc. After reading the first chapter of section three, my suspicions that America has a love affair with laissez-faire capitalism are pretty much confirmed. Why? Because they’re applying free-market self-determinism to something as rudimentary as people’s health. This is important because when you have this sort of privatized structure, the people who suffer are the ones who need it the most – the poor, the sick, or both. In fact, what was the most agonizing to read in this chapter, although also very sense-making, was the section that dissected how private insurance companies purged their clients. Those with higher income and less ailments received more attention so that the companies could capitalize on their premiums, and in order to cut costs, they reduced coverage for low-income people. This is austerity. This is also disgusting. This is also American healthcare pre-ACA. It’s saddening to read about how many people died of avoidable causes pre-ACA because insurance companies would discriminate against those with pre-existing conditions.

What is the rationale of conservatives who change an entire population’s living conditions in order to suit their own ideologies? Are conservatives egos really so fragile that they feel compelled to transform the world to fit into their narrow worldview? Wait, why am I asking this question? Of course they are (government shutdown, anyone?) This is why the privatization of the UK’s healthcare is so disheartening to read about. From how the book describes it, this system was working, quite well in fact. It even served to supplement the recovery of the UK’s economy. Apart from aligning the nation to their own conservative views, what purpose was there really for the Tory party to start to privatize healthcare?

ALMP’s seem like a fantastic idea. They’re a stark contrast to the sheer disdain most Americans seem to have towards those living on public assistance. In my opinion, fact that the emphasis is on getting people back to work shows that those who develop it are focused on sustainability. On a small scale, a single person can’t support a family without a job, and, according to statistics, will likely contemplate or attempt suicide. On a large scale, an economy cannot survive if a large amount of people are not working. Thus, it’s in everyone’s best interests to get people back to work.

I hope that the Affordable Care Act heralds a better future for health care in America. I know I’m going to have to sign up for Obamacare once I’m too old for my family’s plan. Hopefully through the ACA I can get decent coverage.

Since we’ve read the whole book now, I was thinking about its purpose and how successful it is in achieving its goals. As far as I can tell, Basu and Stuckler were trying to write a widely accessible book that explained why exactly austerity policies cause public health problems (and to advocate for using innovative, comprehensive public health solutions in place of austerity).

I admit I am a poor judge of “accessible,” because college alters your perception of what is “accessible” and what isn’t, but it seems like the book succeeds on that front. I found this reading much easier than most of what I have to read for school because it doesn’t rely on academic jargon or unnecessarily complicated sentences. Also, it’s a pretty short book, and we all know that size matters.

It seemed that they made a solid case against austerity, as well. I already was pretty sure austerity was a crappy way to not-solve problems, but now I understand why and can articulate it a little better. However, they stated several times that austerity proponents base their arguments on ideology rather than evidence, which is troubling because it also means that evidence doesn’t pose a significant challenge to pro-austerity arguments. Accordingly, I’m not sure how useful this book is in making pro-austerity people question their reasoning. I am again not in a position to judge that.

One feature of the book I would like to draw attention to is its omissions. There are numerous social stratifying institutions and oppressive systems that Stuckler and Basu did not discuss. Medina raised the question of immigrants in the US, for example. They also did not make connections to the prison industrial complex (think The New Jim Crow by Michelle Alexander that we read earlier in the semester) or to disproportionate rates of homelessness among queer and trans people. To be clear, I understand why they did not discuss these or countless other social factors: it’s way too complicated for a single book, especially an “accessible” one. (A less justifiable reason is because advocacy for certain groups of people decreases one’s perceived respectability…but I think the excessive complication factor is enough to cover all the omissions.) This is not criticism, it’s a point of information.

After discussing specific examples of countries that either implemented to rejected austerity principles in Parts I and II of The Body Economic, the authors explore specific social programs that affect health in certain countries. The more austerity measures a country uses, the more they will cut funding to those programs, and this directly affects the health of people in that country.

Most obviously, national healthcare is one program that affects the health of the people. The story of Diane illustrates what is wrong with the healthcare in the US today, and the authors seem to think the same could happen in the UK, with the NHS moving towards a more market-based system. This leaves me to wonder: surely policy-makers in the US realize the countries with national healthcare are the healthiest? I cannot accept that it is simple economics that keeps the US from going the way of Europe. Even “Obamacare,” isn’t exactly the same universal healthcare we keeping hearing people praise in countries like Denmark and Sweden. The US rejects anything like that, and I wonder why, since those countries are generally extremely healthy and (not to be punny) wealthy as well. Is it possible that such a universal system would not work on a country the size of the US? I cannot think of another country with the population of America that maintains a good economy and has a universal healthcare system. I know this isn’t the only piece in this puzzle, but it may play a role.

I also found it incredibly interesting that the foreclosure crisis in the US led to an outbreak of West Nile Virus. I feel like this is something that could have been easily overlooked, as it is not a direct result of forecloses, the way that homelessness and health problems associated with that are. I like the way the authors point out these connections and show us that the ramifications of changes in the economy can be far-reaching and unexpected.