- Jim Armitage discusses how the privatization of public services in the UK is being mashed up with the principles behind subprime lending and debt bundling - leading to a bubble which promises to take down investors and the public alike.
- Dylan Matthews offers what would seem to be a natural conclusion about the simplest, most effective answer to poverty:
As solutions to global poverty go, "just give poor people money" is pretty rock solid. A recent randomized trial found that Kenyans who received no-strings attached cash from the charity GiveDirectly built more assets, bought more goods, were less hungry, and were all-around happier than those who didn't get cash.- Ellen Lawton and Megan Sandel discuss the value of dealing with poverty and other social determinants of health at the outset, rather than placing undue demands on our health care system:
But voters and politicians generally prefer giving people specific goods — like housing, food, or health care — rather than plain old cash, for fear that the cash might get misused by unscrupulous poor people. Maybe the recipients will just blow the cash drinking! This particular concern comes up both in domestic and global poverty conversations; Fox News is obsessed with the possibility of people using federal government benefits like food stamps to buy fancy seafood or hang out at strip clubs, but mainstream global development experts often express these concerns too. As Paul Niehaus, the founder of GiveDirectly, once put it, "It is pretty ironic the number of conversations I have had with development people about the poor and their drinking—over drinks."
"We have investigated evidence from around the developing world, including Latin America, Africa, and Asia," Evans and Popova conclude. "There is clear evidence that transfers are not consistently used for alcohol or tobacco in any of these environments. This is particularly true when relying on randomized trials."
We're starting to understand that poverty causes illness, not just for individuals, but for whole communities. Yet we talk about the effects of substandard housing, poor nutrition, and violence in a vacuum separate from the laws and policies that create and perpetuate these problems in the first place. And then we ask health care to clean up the mess.- Meanwhile, Kelsey Johnson reports on the NDP's national food strategy - which should serve as a reminder of what could be accomplished by a government which actually saw the public good as something worth pursuing.
Health care has long been in the business of treating the negative health effects of bad social policy. When there isn't enough safe affordable housing, when sanitary codes are unenforced and when cuts are made to housing voucher programs, doctors treat people for the injuries and asthma that ensue. When people live in food deserts without access to healthy food, or their SNAP applications are wrongfully denied, nurses help patients manage the low blood sugar episodes for diabetics who are hungry. And health care spends a lot of money doing it.
Now more than ever, with the prevention mandates of health reform, we are asking health care to be in the business of preventing illness. That's a tall order when so much of what makes people sick are underenforced laws and policies, underfunded public programs and ill-conceived public policies way outside the scope of what health care professionals are trained to do. Indeed research shows that only about fifteen percent of preventable illness can be improved with access to better medical care alone.
Health care providers should screen patients regularly for "social vital signs" -- problems with housing, hunger and domestic violence -- all of which are equal predictors of poor health as any vital sign taken for blood pressure or heartbeat. But we cannot ask nurses and doctors to write prescriptions for healthy housing or food when those "pharmacies" are empty.
- Stephen Maher and Glen McGregor have been reporting on Michael Sona's trial - featuring the revelation that Con highers-up including Andrew Prescott saw Robocon as a national scheme. And Karl Nerenberg highlights some of what remains to be answered about Robocon, while Alison takes a look for herself.
- Finally, speaking of the Cons' standards for public service, Bruce Carson - he of the open door to the Prime Minister's office - is headed to trial for influence peddling. And Tim Naumetz reports on Benjamin Perrin's curious departure from the PMO just a day after Mike Duffy received his hush money from Nigel Wright.