Article 43

 

Monday, August 05, 2013

Austerity American Style Part 13 - Austerity Kills

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How Austerity Kills

By David Stuckler and Sanjay Basu
NY Times
May 25, 2013

Early last month, a triple suicide was reported in the seaside town of Civitanova Marche, Italy. A married couple, Anna Maria Sopranzi, 68, and Romeo Dionisi, 62, had been struggling to live on her monthly pension of around 500 euros (about $650), and had fallen behind on rent.

Because the Italian governments austerity budget had raised the retirement age, Mr. Dionisi, a former construction worker, became one of Italy’s esodati (exiled ones) older workers plunged into poverty without a safety net. On April 5, he and his wife left a note on a neighbor’s car asking for forgiveness, then hanged themselves in a storage closet at home. When Ms. Sopranzis brother, Giuseppe Sopranzi, 73, heard the news, he drowned himself in the Adriatic.

The correlation between unemployment and suicide has been observed since the 19th century. People looking for work are about twice as likely to end their lives as those who have jobs.

In the United States, the suicide rate, which had slowly risen since 2000, jumped during and after the 2007-9 recession. In a new book, we estimate that 4,750 “excess suicides” - that is, deaths above what pre-existing trends would predict occurred from 2007 to 2010. Rates of such suicides were significantly greater in the states that experienced the greatest job losses. Deaths from suicide overtook deaths from car crashes in 2009.

If suicides were an unavoidable consequence of economic downturns, this would just be another story about the human toll of the Great Recession. But it isnגt so. Countries that slashed health and social protection budgets, like Greece, Italy and Spain, have seen starkly worse health outcomes than nations like Germany, Iceland and Sweden, which maintained their social safety nets and opted for stimulus over austerity. (Germany preaches the virtues of austerity for others.)

As scholars of public health and political economy, we have watched aghast as politicians endlessly debate debts and deficits with little regard for the human costs of their decisions. Over the past decade, we mined huge data sets from across the globe to understand how economic shocks ח from the Great Depression to the end of the Soviet Union to the Asian financial crisis to the Great Recession affect our health. What weגve found is that people do not inevitably get sick or die because the economy has faltered. Fiscal policy, it turns out, can be a matter of life or death.

At one extreme is Greece, which is in the middle of a public health disaster. The national health budget has been cut by 40 percent since 2008, partly to meet deficit-reduction targets set by the so-called troika the International Monetary Fund, the European Commission and the European Central Bank - as part of a 2010 austerity package. Some 35,000 doctors, nurses and other health workers have lost their jobs. Hospital admissions have soared after Greeks avoided getting routine and preventive treatment because of long wait times and rising drug costs. Infant mortality rose by 40 percent. New H.I.V. infections more than doubled, a result of rising intravenous drug use as the budget for needle-exchange programs was cut. After mosquito-spraying programs were slashed in southern Greece, malaria cases were reported in significant numbers for the first time since the early 1970s.

In contrast, Iceland avoided a public health disaster even though it experienced, in 2008, the largest banking crisis in history, relative to the size of its economy. After three main commercial banks failed, total debt soared, unemployment increased ninefold, and the value of its currency, the krona, collapsed. Iceland became the first European country to seek an I.M.F. bailout since 1976. But instead of bailing out the banks and slashing budgets, as the I.M.F. demanded, Icelandגs politicians took a radical step: they put austerity to a vote. In two referendums, in 2010 and 2011, Icelanders voted overwhelmingly to pay off foreign creditors gradually, rather than all at once through austerity. Icelands economy has largely recovered, while GreeceҒs teeters on collapse. No one lost health care coverage or access to medication, even as the price of imported drugs rose. There was no significant increase in suicide. Last year, the first U.N. World Happiness Report ranked Iceland as one of the worlds happiest nations.

Skeptics will point to structural differences between Greece and Iceland. Greece’s membership in the euro zone made currency devaluation impossible, and it had less political room to reject I.M.F. calls for austerity. But the contrast supports our thesis that an economic crisis does not necessarily have to involve a public health crisis.

Somewhere between these extremes is the United States. Initially, the 2009 stimulus package shored up the safety net. But there are warning signs beyond the higher suicide rate ח that health trends are worsening. Prescriptions for antidepressants have soared. Three-quarters of a million people (particularly out-of-work young men) have turned to binge drinking. Over five million Americans lost access to health care in the recession because they lost their jobs (and either could not afford to extend their insurance under the Cobra law or exhausted their eligibility). Preventive medical visits dropped as people delayed medical care and ended up in emergency rooms. (President Obamas health care law expands coverage, but only gradually.)

The $85 billion “sequester” that began on March 1 will cut nutrition subsidies for approximately 600,000 pregnant women, newborns and infants by year’s end. Public housing budgets will be cut by nearly $2 billion this year, even while 1.4 million homes are in foreclosure. Even the budget of the Centers for Disease Control and Prevention, the nations main defense against epidemics like last year’s fungal meningitis outbreak, is being cut, by $293 million this year.

To test our hypothesis that austerity is deadly, we’ve analyzed data from other regions and eras. After the Soviet Union dissolved, in 1991, Russia’s economy collapsed. Poverty soared and life expectancy dropped, particularly among young, working-age men. But this did not occur everywhere in the former Soviet sphere. Russia, Kazakhstan and the Baltic States (Estonia, Latvia and Lithuania) which adopted economic דshock therapy programs advocated by economists like Jeffrey D. Sachs and Lawrence H. Summers - experienced the worst rises in suicides, heart attacks and alcohol-related deaths.

Countries like Belarus, Poland and Slovenia took a different, gradualist approach, advocated by economists like Joseph E. Stiglitz and the former Soviet leader Mikhail S. Gorbachev. These countries privatized their state-controlled economies in stages and saw much better health outcomes than nearby countries that opted for mass privatizations and layoffs, which caused severe economic and social disruptions.

Like the fall of the Soviet Union, the 1997 Asian financial crisis offers case studies in effect, a natural experiment ח worth examining. Thailand and Indonesia, which submitted to harsh austerity plans imposed by the I.M.F., experienced mass hunger and sharp increases in deaths from infectious disease, while Malaysia, which resisted the I.M.F.s advice, maintained the health of its citizens. In 2012, the I.M.F. formally apologized for its handling of the crisis, estimating that the damage from its recommendations may have been three times greater than previously assumed.

America’s experience of the Depression is also instructive. During the Depression, mortality rates in the United States fell by about 10 percent. The suicide rate actually soared between 1929, when the stock market crashed, and 1932, when Franklin D. Roosevelt was elected president. But the increase in suicides was more than offset by the “epidemiological transition” improvements in hygiene that reduced deaths from infectious diseases like tuberculosis, pneumonia and influenza - and by a sharp drop in fatal traffic accidents, as Americans could not afford to drive. Comparing historical data across states, we estimate that every $100 in New Deal spending per capita was associated with a decline in pneumonia deaths of 18 per 100,000 people; a reduction in infant deaths of 18 per 1,000 live births; and a drop in suicides of 4 per 100,000 people.

OUR research suggests that investing $1 in public health programs can yield as much as $3 in economic growth. Public health investment not only saves lives in a recession, but can help spur economic recovery. These findings suggest that three principles should guide responses to economic crises.

First, do no harm: if austerity were tested like a medication in a clinical trial, it would have been stopped long ago, given its deadly side effects. Each nation should establish a nonpartisan, independent Office of Health Responsibility, staffed by epidemiologists and economists, to evaluate the health effects of fiscal and monetary policies.

Second, treat joblessness like the pandemic it is. Unemployment is a leading cause of depression, anxiety, alcoholism and suicidal thinking. Politicians in Finland and Sweden helped prevent depression and suicides during recessions by investing in active labor-market programs that targeted the newly unemployed and helped them find jobs quickly, with net economic benefits.

Finally, expand investments in public health when times are bad. The clich that an ounce of prevention is worth a pound of cure happens to be true. It is far more expensive to control an epidemic than to prevent one. New York City spent $1 billion in the mid-1990s to control an outbreak of drug-resistant tuberculosis. The drug-resistant strain resulted from the citys failure to ensure that low-income tuberculosis patients completed their regimen of inexpensive generic medications.

One need not be an economic ideologue 钗 we certainly arent - to recognize that the price of austerity can be calculated in human lives. We are not exonerating poor policy decisions of the past or calling for universal debt forgiveness. Its up to policy makers in America and Europe to figure out the right mix of fiscal and monetary policy. What we have found is that austerity - severe, immediate, indiscriminate cuts to social and health spending is not only self-defeating, but fatal.

SOURCE

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Book: The Body Economic
Why Austerity Kills
David Stuckler (Author), Sanjay Basu (Author)
May 2013

Politicians have talked endlessly about the seismic economic and social impacts of the recent financial crisis, but many continue to ignore its disastrous effects on human health - and have even exacerbated them, by adopting harsh austerity measures and cutting key social programs at a time when constituents need them most. The result, as pioneering public health experts David Stuckler and Sanjay Basu reveal in this provocative book, is that many countries have turned their recessions into veritable epidemics, ruining or extinguishing thousands of lives in a misguided attempt to balance budgets and shore up financial markets. Yet sound alternative policies could instead help improve economies and protect public health at the same time.

In The Body Economic, Stuckler and Basu mine data from around the globe and throughout history to show how government policy becomes a matter of life and death during financial crises. In a series of historical case studies stretching from 1930s America, to Russia and Indonesia in the 1990s, to present-day Greece, Britain, Spain, and the U.S., Stuckler and Basu reveal that governmental mismanagement of financial strife has resulted in a grim array of human tragedies, from suicides to HIV infections. Yet people can and do stay healthy, and even get healthier, during downturns. During the Great Depression, U.S. deaths actually plummeted, and today Iceland, Norway, and Japan are happier and healthier than ever, proof that public wellbeing need not be sacrificed for fiscal health.

Full of shocking and counterintuitive revelations and bold policy recommendations, The Body Economic offers an alternative to austerity one that will prevent widespread suffering, both now and in the future.
About the Authors
Dr. David Stuckler is a Senior Research Leader at Oxford University and Honorary Research Fellow at the London School of Hygiene & Tropical Medicine. He lives in Oxford, England.

Dr. Sanjay Basu is an Assistant Professor of Medicine and an epidemiologist at the Prevention Research Center of Stanford University. A former Rhodes Scholar, he lives in San Francisco.

SOURCE

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How to Destroy an Entire Country

By Alan Grayson
December 14, 2013

From a recent 188-page REPORT by the World Health Organization come these ghastly and appalling factoids:

Suicide rates rose 40 percent in the first six months of 2011 alone.

Murder has doubled.

9,100 doctors in Greece, roughly one out of every seven, have been laid off.

Joining those doctors in joblessness are 27.6 percent of the entire Greek labor force. By comparison, in the depths of the Great Depression, unemployment in the United States peaked at a lower percentage than that. Among Greek young adults under 25 years old, unemployment reached an abominable 64.9 percent in May. (Yet the unemployment rate in Greece was as low as 7 percent as recently as 2008.)

I’m sure that my Tea Party friends will blame universal healthcare, paid sick leave and “generous” unemployment benefits for this catastrophe. “If we simply stopped helping people, then they wouldn’t need our help,” they would say. You can see where that “logic” leads. The dead need no help whatsoever, except possibly burial. Sort of like this: “The Republican healthcare plan: Don’t Get Sick. And if you do get sick, Die Quickly."]

Maybe you think that I’m kidding about what my Tea Party friends would do. I’m not. A few years ago here in Florida, we had a children’s health insurance program called KidCare, with a waiting list of over 100,000. The Tea Party Republicans didn’t like that. So they eliminated the waiting list.

But back to Greece. A lot of people blame Greek government debt for the current suffering. According to the Central Intelligence Agency, that most authoritative of all conceivable sources, Greek government debt stands at 160 percent of GDP, which seems like a lot. But Japanese government debt stands at 215 percent of GDP, and the unemployment rate in Japan is only 4 percent.

Moreover, Spain’s unemployment rate is virtually as high as Greece’s, but Spain’s government debt stands at only 85 percent of GDP. That’s less debt than Singapore’s, and Singapore’s unemployment rate is 1.8 percent.

So we cannot properly attribute the catastrophe in Greece to labor protection, nor can we attribute it to government borrowing. What is the cause, then? The World Health Organization has the answer: austerity. “Austerity" is a bloodless term for gross economic mismanagement, animated by heartlessness. That robotic cut-cut-cut mentality that deprives us of jobs, of public services, of safety, of health, of infrastructure, of help for the needy, and—ultimately—of our economic equilibrium and the ability to survive. The mentality that ushers in, and welcomes, a vicious war of all against all. Austerity is destroying an entire country, right before our eyes.

Or, as the World Health Organization put it: “These adverse trends in Greece pose a warning to other countries undergoing significant fiscal austerity, including Spain, Ireland and Italy. It also suggests that ways need to be found for cash-strapped governments to consolidate finances without undermining much-needed investments in health.”

In America, we have a rich and powerful lobby that has the same prescription for every economic malady: austerity. Cut-cut-cut. Cut Social Security and Medicare. Cut teacher and police and firefighter jobs. Cut health care. Cut pay and cut pensions. It all boils down to that one ugly word: austerity. And austerity always brings disarray, disaster, decay and death.

People often ask me my position on various issues. Well, I’m for certain things, and I’m against others. But on one issue, I’m very consistent. I’m against pain and suffering. Especially avoidable pain and suffering. And therefore, I’m against austerity. It begins with seemingly innocuous budget cuts. It then leads inexorably to the destruction of countless lives.

Why am I telling you about Greece? In 1935, Sinclair Lewis wrote a book called It Can’t Happen Here. But it can. And it’s up to us to prevent it.

Courage,

Rep. Alan Grayson

SOURCE

Austerity American Style
[PART 1] - Ending The Safety Net
[PART 2] - Enough Is Enough
[PART 3] - Big, Bad Businessmen
[PART 4] - Big, Bad Banks
[PART 5] - Selling Out The Public
[PART 6] - No Jobs Plan
[PART 7] - Big, Bad Cronies
[PART 8] - Red-State Model
[PART 9] - Inflicting Pain
[PART 10] - The Grand Betrayal
[PART 11] - The Sequester ACT III
[PART 12] - The Sequester ACT IV
[PART 13] - Austerity Kills
[PART 14] - Bail-In Comes To America

Posted by Elvis on 08/05/13 •
Section Dying America • Section Austerity American Style
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