New York, NY, USA May 13 The charging bull of Wall Street has been a staple of the New York Financial district for over 30 years.

The Feminist Political Economy of Health Justice

By Jennifer Cohen

Profit-motivated economic activity conflicts with the realization of population health and health justice.

To work toward health justice, we must recognize health as a function of (1) capitalist economic development processes, including (2) gendered and racialized divisions of labor. Together, these heighten the contradiction between the profit motive and the domestic and global requirements of public health. This contradiction is also evident in the ways (3) markets can misallocate inputs to health (e.g., hand sanitizer, personal protective equipment for medical practitioners) and how most people obtain health (e.g., as “consumers”).

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Symbol of law and justice, banknote of one dollar and United States Flag.

Saving Lives and Decreasing Costs: The Economic Case for Health Justice

By Wendy Netter Epstein

Most proponents of health justice will tell you that health is a fundamental human right. They will say that there is a moral imperative to eliminate health inequities and to give all people equal opportunity to lead a healthy life. And they will be correct. Health justice as a framework is driven by this narrative — the laudable goals of health equity and social justice.

What you aren’t as likely to hear from health justice advocates, however, is that health justice is economically efficient. To the contrary, most health justice advocates see its framework as an alternative to the markets, efficiency, autonomy, and individual responsibility that are the hallmarks of conservative ideology.

Yet, there is no question that health inequities are costly to the individuals that bear them, in higher health care expenses, missed days of work, and fewer years lived. There are also significant costs to society — both direct and indirect. According to one analysis, disparities lead to $93 billion in excess medical care costs and $42 billion in lost productivity per year.

Making the economic case for health justice, and noting how it is inextricably linked to the moral case, is crucial. Because not only is the framework bolstered by notions of both fairness and efficiency, but also, as a practical matter, getting legislative and regulatory buy-in to fund initiatives to address health inequities requires making the economic case.

If health inequities could be ameliorated, government health spending and other safety net spending would be drastically reduced, workforce productivity would increase, and even healthy and wealthy Americans — who are the most likely to oppose the health justice framework — would benefit.

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Bill of health - $100 bill Ben Franklin wearing mask with economic line chart and bar graph going down, pandemic economic crisis, post pandemic economy

Preparing for the Post-Pandemic Economy

By Kareem Caryll, J.D.

The end of the COVID-19 pandemic may be in sight, but how do we prepare for a new economic environment once the health crisis is behind us? The negative economic impact of the health crisis cannot be overstated. In 2020, the domestic economy contracted by 3.5%, the largest decline since World War II. During the year, the unemployment rate reached nearly 15% at its peak as Americans lost 22 million jobs between February and April. Recent data shows that the economy, while slightly improved, remains in a perilous state. There are approximately 9.5 million fewer jobs than in February 2020. While the unemployment rate currently sits at 6.2%, experts suggest that the real rate is closer to 9.5% after accounting for, among other things, the more than 4 million workers who have dropped out the labor force. These facts do not exist in isolation. When individuals lose their jobs, the impact is felt in many facets of their lives. A January 28, 2021 report by the Center on Budget and Policy Priorities revealed that nearly 1 in 6 adults in households with children lacked sufficient food. 21% of adult renters report being behind on rent. 35% of adults report difficulty paying for usual household expenses such as car payments, medical expenses, and student loans.

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A calculator, a stethoscope, and a stack of money rest on a table.

Why Our Health Care Is Incomplete: Review of “Exposed” (Part II)

By: Daniel Aaron

Just last month, Professor Christopher T. Robertson, at the University of Arizona College of Law, released his new book about health care, entitled Exposed: Why Our Health Insurance Is Incomplete and What Can Be Done About It. Part II of this book review offers an analytical discussion of “cost exposure,” the main subject of his book with a focus on solutions. Read Part I here.

Baby solutions

Prof. Robertson writes two chapters on solutions. In the first, titled “Fixes We Could Try,” he offers reforms, from mild to moderate, that would make cost exposure less harmful. The chapter largely retains the analytical nature of the prior chapters, but it comes across like a chapter he might have rather not written. This is evident in the following chapter’s title, “What We Must Do.” It’s also evident because some of the proposals do not seem fully considered, and in some ways appear more controversial than the more comprehensive solution offered later. Read More

A calculator, a stethoscope, and a stack of money rest on a table.

Why Our Health Care Is Incomplete: Review of “Exposed” (Part I)

By: Daniel Aaron

Just last month, Professor Christopher T. Robertson, at the University of Arizona College of Law, released his new book about health care, entitled Exposed: Why Our Health Insurance Is Incomplete and What Can Be Done About It. This book review will offer an analytical discussion of “cost exposure,” the main subject of his book.

What is cost exposure in health care?

Cost exposure is payments people make related to their medical care. There are many ways patients pay – here are a few common ones.

  • Deductible – Patient is responsible for the first, say, $5,000 of their medical care; after this point, the health insurance kicks in. Resets each year.
  • Copay – Patient pays a specific amount, say $25, when having an episode of care.
  • Coinsurance – Patient pays a specified percentage, say 20%, of care.

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Author Q&A: “Association between State Minimum Wages and Suicide Rates in the U.S.”

Alex Gertner, BA
Alex Gertner,  University of North Carolina at Chapel Hill

As the suicide rate increases across the United States, researchers at the UNC Gillings School of Global Public Health approached the issue by considering the financial anxiety caused by low wages. Alex Gertner, Jason Rotter, and Paul Shafer used the LawAtlas minimum wage dataset to explore the associations between state minimum wages and suicide rates in the United States.

Their study was published in the American Journal of Preventive Medicine on March 21, 2019.

Temple University Center for Public Health Law Research spoke with Mr. Gertner about their study.

 

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illustration of abstract ecnomics

The Need for an Economic Bioethics

As the animations of markets increasingly shape the timbre and character of medicine, scholars studying ethical issues in health and medicine must be increasingly attentive to the role of market forces as they shape modern health care.

For those interested in the social, ethical, and conceptual dimensions of contemporary health and medicine, there has been a sustained focus on a key set of important challenges; how do we ensure adequate access to health for marginalized and global populations? What are the social and ethical implications of emergent technologies? How are issues of consent articulated in the everyday interactions of the clinic? What are our obligations to persons in terms of end-of-life care? These longstanding concerns regarding access, new technologies and the rights of patients comprise the major thrusts and foci of bioethics, health care ethics, and associated areas of inquiry.

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