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Social Determinants of Health

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Subject:
From:
Dennis Raphael <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Sat, 10 Sep 2005 06:43:16 -0400
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"Unfortunately, America's most significant problems aren't as easy to
recognize, don't have the same media appeal and defy clear resolutions. For
instance, America, the wealthiest nation in the world, is simultaneously
experiencing an increase in poverty and a decline in wages for 80 percent
of its workers, while the economy grows! More than 45 million Americans
don't have health insurance. The United States ranks a woeful 43rd in the
world in infant mortality rates."

http://www.suntimes.com/output/martire/cst-edt-mart10.html
http://tinyurl.com/a85uh
-------------------------------------
Katrina illustrates folly of starving Uncle Sam

September 10, 2005

BY RALPH MARTIRE
The grim events of the last week have had a profound, devastating impact on
millions. Family members, loved ones, friends and acquaintances all were
lost as Hurricane Katrina ravaged the Gulf Coast. Americans, being the
resilient folks we are, will rebound from this disaster. We always do. But
if something really positive is to emerge from Katrina's wake, the storm
must claim one more victim.

The casualty won't involve the tragic loss of innocent life. Instead, it
will be the end of a pernicious philosophy that simultaneously distracts
Americans from our nation's real problems while driving wedges between
segments of society. Simply put, Katrina should shatter the belief that
government, as an institution, is the enemy. Grover Norquist, one of this
ideology's most ardent champions, summarized it best in a 1998 interview:
''[When] I got out of college in 1978 there were two threats to American
liberty: the Soviet Union and Washington, D.C. One of those is finished. .
. . We now have the opportunity to turn our attention from fighting the
Soviet Union to reducing the size and scope of the federal government,
which is the other threat to our civil liberties.''

The preferred way to destroy the enemy that is our own government is
simple: Starve the beast. In 2003, Norquist made this clear when he
maintained the objective is ''to reduce the size and scope of government in
half over the next 25 years,'' so that ultimately it is small enough ''to
drown in a bathtub.'' In this world view, government threatens, rather than
protects, civil liberties. Somehow, the size rather than function of
government is what matters. ''Big government'' equates with ''bad
government.''

I wonder if the millions who desperately need federal aid after Katrina
agree. To the contrary, evacuees' main complaint is government isn't quite
big enough. The Federal Emergency Management Agency was understaffed and
deprioritized, military and National Guard units that could have made a
difference were deployed in Iraq, and our nation didn't have the capacity
to replace them.

The big government/small government debate misses the point entirely. It's
not government's size in an abstract sense that matters, but rather whether
government is adequately equipped to deliver needed services and perform
essential functions. Certainly, having the capacity to respond to natural
disasters is an easy example of a societal function that requires ''big''
government. Large-scale disasters are easily recognized, the media cover
them extensively, and eventually, a clear resolution is reached.

Unfortunately, America's most significant problems aren't as easy to
recognize, don't have the same media appeal and defy clear resolutions. For
instance, America, the wealthiest nation in the world, is simultaneously
experiencing an increase in poverty and a decline in wages for 80 percent
of its workers, while the economy grows! More than 45 million Americans
don't have health insurance. The United States ranks a woeful 43rd in the
world in infant mortality rates.

Meanwhile, Congress is considering policy options straight out of the
''starve the beast'' playbook. These include cutting around $35 billion in
funding for: Medicaid (despite the growing ranks of uninsured Americans);
food stamps, housing and cash assistance for poor families (despite the
growth in poverty); and student loan programs (despite census data making
it clear that a college education is the only ticket to a growing income).

Big government didn't cause any of these big problems, but it can and
should play a role in countering them. In many cases, it does. Government
programs like Medicaid, Social Security and food stamps help alleviate many
societal ills, while creating a fairer, more just America for all.
''Starving the beast'' ignores this reality, while incapacitating
government's ability to play its role in making America great. The real
issue isn't ''big'' government vs. ''small.'' It's competent, adequately
financed government vs. incompetent, unprepared and incapacitated
government. For the wealthiest nation in the world, the choice should be
obvious.

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