Tag Archives: Lower Income

Commentary

Should government promote marriage to lower-income communities?

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Marriage and Poverty
Marriage and Poverty

I found this article by Robert Rector on the The Heritage Foundation web site. It is part of their Poverty and Marriage project.

Excerpt:

The Census data presented so far demonstrate that married couples have dramatically lower poverty rates than single parents. These substantial differences in poverty remain even when married couples are compared to single parents of the same race and level of education. The pattern is almost exactly the same in all 50 states.

However, in the Census comparisons, the married couples and single parents are obviously different (albeit similar) persons. It is therefore possible that much of the difference in poverty between married families and single-parent families might be due to hidden differences between married and single parents as individuals rather than to marriage per se. For example, it is possible that unmarried fathers might have substantially lower earnings than married fathers with the same racial and educational backgrounds. If this were the case, then marriage, for these men, would have a reduced anti-poverty effect.

Fortunately, we have other direct data on poverty and unmarried parents that corroborate the Census analysis. These data are provided by the Fragile Families and Child Well-being Survey conducted jointly by Princeton and Columbia universities.[16] The Fragile Families survey is a representative national sample of parents at the time of a child’s birth, with a heavy emphasis on lower-income unmarried couples. The survey is unusual in collecting information not only on single mothers, but on non-married fathers as well, including (critically) the actual employment and earnings of the father in the year prior to birth.

Because the Fragile Families Survey reports both the mothers’ and fathers’ earnings, it is simple to calculate the poverty rate if the non-married mothers remain single and if each unmarried mother married her child’s father (thereby pooling both parents’ income into a joint family income). The Fragile Families data show that if unmarried mothers remain single, over half (56 percent) of them will be poor. (This high level of poverty will persist for years: Half of all unwed mothers will be poor five years after the child is born.[17]) By contrast, if the single mothers married the actual biological fathers of their children, only 18 percent would remain poor.[18] Thus, marriage would reduce the expected poverty rate of the children by two-thirds.

It is important to note that these results are based on the actual earnings of the biological fathers of the children and not on assumed or hypothetical earnings. Moreover, the non-married fathers in the sample are relatively young. Over time, their earnings will increase and the poverty rate for the married couples will decline farther.

[…]Census data and the Fragile Families survey show that marriage can be extremely effective in reducing child poverty. But the positive effects of married fathers are not limited to income alone. Children raised by married parents have substantially better life outcomes compared to similar children raised in single-parent homes.

When compared to children in intact married homes, children raised by single parents are more likely to have emotional and behavioral problems; be physically abused; smoke, drink, and use drugs; be aggressive; engage in violent, delinquent, and criminal behavior; have poor school performance; be expelled from school; and drop out of high school.[19] Many of these negative outcomes are associated with the higher poverty rates of single mothers. In many cases, however, the improvements in child well-being that are associated with marriage persist even after adjusting for differences in family income. This indicates that the father brings more to his home than just a paycheck.

The effect of married fathers on child outcomes can be quite pronounced. For example, examination of families with the same race and same parental education shows that, when compared to intact married families, children from single-parent homes are:

  • More than twice as likely to be arrested for a juvenile crime;[20]
  • Twice as likely to be treated for emotional and behavioral problems;[21]
  • Roughly twice as likely to be suspended or expelled from school;[22] and
  • A third more likely to drop out before completing high school.[23]

The effects of being raised in a single-parent home continue into adulthood. Comparing families of the same race and similar incomes, children from broken and single-parent homes are three times more likely to end up in jail by the time they reach age 30 than are children raised in intact married families. [24] Compared to girls raised in similar married families, girls from single-parent homes are more than twice as likely to have a child without being married, thereby repeating the negative cycle for another generation.[25]

Finally, the decline of marriage generates poverty in future generations. Children living in single-parent homes are 50 percent more likely to experience poverty as adults when compared to children from intact married homes. This intergenerational poverty effect persists even after adjusting for the original differences in family income and poverty during childhood.[26]

You should definitely click through the article and view all the colorful charts and diagrams. This article should be printed out and used to explain the connection between fiscal conservatism and social conservatism.

I also want to point out that two notable groups on the left act to destroy marriage. First of all, there are the feminists, who oppose the unequal gender roles in marriage. They lobby for feminist policies that destroy marriage, like no-fault divorce. Second, there are the socialists, who favor redistribution of wealth from productive to non-productive people. They lobby for increased welfare for single mothers, causing more single-mother households. Either way, marriage is under attack by the left. I have not even mentioned things like sex education and state-run day care.

What should the government do?

I think that government does have a role in providing financial incentives in the form of tax breaks to married couples who have children and stay married. The government should give bigger and bigger tax breaks as marriages last longer and longer, and have more children. And the biggest tax breaks of all should be given to families where one parent stays at home while the children are not yet in school, during the crucial early years. Sounds crazy, doesn’t it? But if research agrees that marriage is good for children, good for married couples, and good for society, then why aren’t we doing more to inform people about the benefits of marriage, and providing them with financial incentives to marry for the long-term?

Commentary

Cato Institute destroys the myths of inferior health care in the USA

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The article is here by Michael Tanner of the prestigious Cato Institute.

Excerpt:

The Claim: Though we spend more, we get less.

The Facts: America offers the highest quality health care in the world. Most of the world’s top doctors, hospitals and research facilities are located in the United States. Eighteen of the last 25 winners of the Nobel Prize in Medicine either are U.S. citizens or work here. U.S. companies have developed half of all the major new medicines introduced worldwide over the past 20 years. And Americans played a key role in 80 percent of the most important medical advances of the past 30 years.

If you are diagnosed with a serious illness, the United States is the place you want to be. Tens of thousands of patients from around the world come to this country every year for treatment.

Critics of American health care often point out that other countries have higher life expectancies or lower infant mortality rates, but those two indicators are bad ways to measure the quality of a nation’s health-care system. In the United States, very low-birth-weight infants have a much greater chance of being brought to term with the latest medical technologies. Some of those low-birth-weight babies die soon after birth, which boosts our infant mortality rate, but in many other Western countries, those high-risk, low-birth-weight infants are not included when infant mortality is calculated.

Life expectancies are also affected by other factors like violent crime, poverty, obesity, tobacco, and drug use, and other issues unrelated to health care. When you compare the outcome for specific diseases like cancer or heart disease, the United States outperforms the rest of the world.

And one more myth:

The Claim: A government-run health-care system would expand access to care.

The Facts: The one common characteristic of all national health care systems is that they ration care. Sometimes they ration it by denying certain types of treatment altogether. More often, they ration indirectly, imposing cost constraints through budgets, waiting lines, or limited technology. One million Britons are waiting for admission to National Health Service hospitals at any given time, and shortages force the NHS to cancel as many as 100,000 operations each year. Roughly 90,000 New Zealanders are facing similar waits. In Sweden, the wait for heart surgery can be as long as 25 weeks. In Canada more than 800,000 patients are currently on waiting lists for medical procedures.

I wrote about US health care outcomes before in this post from the Hoover Institute at Stanford University.

Excerpt:

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

  • Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).

5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.

Dissenting commenters should be sure to link their assertions to reputable sourcesm, and quote specific passages where the source agrees with their assertion and rebuts some claim made by the Cato Institute or the Hoover Institute. Please don’t cite the New York Times or the United Nations.

Commentary

MUST-READ: How does health care in the USA compare with other countries?

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Story from the Hoover Institute at Stanford University, via ECM.

The article compares American health care to health care in other places like Canada, the UK and Europe.

I am particularly interested in prostate cancer rates, because that is a cancer that will necessarily be neglected by states that have single-payer systems. Why, you ask? Because only men get prostate cancer. And in a welfare state where leftist politicians are always catering to their special interest victim groups, men will definitely be discriminated against.

The full article. I almost never cite the full article, but this is a must read.

MEDICINE AND HEALTH:
Here’s a Second Opinion

By Scott W. Atlas

Ten reasons why America’s health care system is in better condition than you might suppose. By Scott W. Atlas.

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

  • Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).

5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.

Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries.

This essay appeared on the website of the National Center for Policy Analysis on March 24, 2009. An earlier version was published in the Washington Times.

Available from the Hoover Press is Power to the Patient: Selected Health Care Issues and Policy Solutions, edited by Scott W. Atlas. To order, call 800.935.2882 or visit www.hooverpress.org.

Scott W. Atlas is a senior fellow at the Hoover Institution and a professor of radiology and chief of neuroradiology at Stanford University Medical School.

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