“We are tied together in the single garment of destiny, caught in an inescapable network of mutuality. And whatever affects one directly affects all indirectly.” - Martin Luther King, Jr.
The thesis of this post is simple and, I hope, provocative: that if you care deeply about a particular social or environmental issue, then you must at least be familiar with many other social or environmental issues. This is due to the increasingly unavoidable link between seemingly disparate challenges, be they economic growth and climate change, health care spending and hunger, or defense spending and education.
I was inspired to write this after reading a phenomenal article in the most recent edition of Time. The article, titled ‘Bitter Pill: Why Medical Bills Are Killing Us,’ is one of the best pieces of journalism I’ve read in a while. But more importantly, it highlights the fact that the way in which medical products and services--hospital stays, prescription medications, etc.--are priced is egregiously, if not criminally, disconnected from the cost of providing them. In fact, the content of the article is so galling that I found myself unable to read it more than a few paragraphs at a time before my stomach would begin churning and I had to take a break.
Okay, so ‘Bitter Pill’ is a profoundly important article that sheds light on the rising cost of medical care in America. But Capital Good Fund is focused on financial services for the poor, not health care reform. So a key question arises: to what extent is this article, and the issues it raises, related to the work of my organization? At first, my thinking was that, well, this is all well and good, but it’s time to get back to underwriting loans, developing our Financial Coaching program, raising funds, and so on.
However, I just couldn’t get the article out of my mind. As I read back through it, some critical pieces of information stuck out at me; I’d like to share just two of these quotes and then explain how they have changed my thinking:
"When you crunch data compiled by McKinsey and other researchers, the big picture looks like this: We’re likely to spend $2.8 trillion this year on health care. That $2.8 trillion is likely to be $750 billion, or 27%, more than we would spend if we spent the same per capita as other developed countries, even after adjusting for the relatively high per capita income in the U.S. vs. those other countries...This is what’s increasingly burdening businesses that pay for their employees’ health insurance and forcing individuals to pay so much in out-of-pocket expenses." (Page 1)
"More than $280 billion will be spent this year on prescription drugs in the U.S. If we paid what other countries did for the same products, we would save about $94 billion a year." (Page 8)
So here’s why you should care about this whether your primary focus is homelessness, recidivism, climate change, education or practically any other social issue: solving the vast majority of problems requires funding, yet how can we secure the needed funding when over $800 billion /year in being wasted in our health care system alone? Every dollar that is wasted in our health care system or elsewhere is a dollar that is not spent on poverty, on environment...What’s worse, the recent obsession with deficit reduction in general, and the sequester in particular, are being driven by a growing national debt that is, in turn, being driven by defense and health spending.
In other words, it’s not much of a logical leap to go from caring about a particular issue to recognizing that addressing it requires funding, to seeing that funding is being siphoned away from it by an unjust health system (among other things). And when the public is blissfully unaware of how much money is wasted in our health system, we get trapped in the our current sophie’s choice: we are told that we must either cut programs for the poor and raise taxes, or grow the national deficit. Sorry, but that’s not true--we can eradicate hunger in America (where, by the way, 1 out 6 Americans are food insecure, an appalling statistic in the wealthiest country in the world) without growing the deficit. In fact, aside from the highly potent moral imperative for ending hunger, there is no doubt that hungry families are less able to participate in society, be it politically, economically or educationally. Put another way, if we actually reformed the health care system (this isn’t the place to discuss it, but we should be clear that though the Affordable Care Act does a lot of good things, is does virtually nothing to address the problems raised in ‘Bitter Pill’), we could use the savings to end hunger and make other critical investments in our country.
So here’s the bottom line: if you care about one issue of justice, you must be aware of other issues. There is no shortage of examples...Climate change can’t be solved so long as we are focused on creating jobs, and so long as we believe that tackling the one negatively impacts the other. So what to do? Well, climate change activists should also be advocates for policies that will stimulate the economy--stimulus spending, settlements that force the big banks to restructure mortgages, and so on. Or let’s take the example of Capital Good Fund. No amount of one-on-one service provision to the poor will achieve our mission in the absence of public policies that actually enable hardworking people to move out of poverty. After all, we can help a family budget and build credit and increase savings, but to what end if there are no jobs, no access to affordable loans...?
Yes, I run Capital Good Fund, and we are in the business of using a particular tool--financial services--to empower our clients. Yes, I can’t be aware of or interested in every social/environmental issue. Yes, I must be focused. But at the same time, no one’s work occurs in a vacuum: we are all affected by public policy, by funding decisions, and by public opinion and attitudes. If we do not see, understand and find effective ways of taking action on issues that directly or indirectly affect our focus areas, then we will be severely limited in our ability to bring to fruition the society we seek.