A View to a Thrill
Your January 2000 issue is the best I have read
in a long time (even better than November). Thanks for all the great articles.
Deborah Klenotic's "Grand Design: The New Master Plan" was especially
good. The picture of N.U. on pages sixteen and seventeen is great! How
can I get my hands on a copy of this picture without the graphics?
Bob Smith, E'93
Foxborough, Massachusetts
That Dismal Refrain
David Heilbroner's "The Devil's Bargain of a Long Boom" [January]
misses the boat almost completely. He assumes that unequal distribution
is the same as unfair distribution. This is only true if those receiving
smaller shares are receiving less than they have contributed. The increasing
disparities between rich and poor are not the problem. When Bill Gates's
net worth jumps by another $10 billion, none of this money comes from the
poor. When he donates some of that to charity, on the other hand, some
poor people may benefit. The causes of poverty in our society include the
failure of people to maintain two-parent households, failure of some children
to take advantage of educational opportunities, and substance abuse. These
are problems that society must address, but they are in no way caused or
exacerbated by today's prosperity.
In addition, our incarceration rate has not contributed to low unemployment.
The number of jobs created in the justice, security, and penal system is
far smaller than the economic benefit that would accrue to society if the
incarcerated instead had pursued legal and productive endeavors. The claim
that most new service jobs are dead-end "rent-a-jobs" is totally
absurd. I have worked for forty years in the computer field (since starting
as a co-op at N.U.) and have seen temp workers well compensated for saying
"no thanks" to permanent-employee status. Even waiting tables
and serving burgers are entry-level positions. They are not dead-end. They
teach valuable work skills. Both my children entered the work force in
such "dead-end" positions, and both are making their ways quite
nicely.
Finally, I most strongly disagree with the contention that "we
actually are living in an age of diminished expectations." Expectations
have risen so fast that people can only achieve them by taking on excessive
debt. Working-class people spend a small fortune on outfitting their kids
with tennis shoes that cost as much as a prudently chosen entire outfit
might. They spend up to $100 each month on cable television and another
$50 or more for cellular service. Even the poor today have a standard of
living that exceeds what poor people could ever have imagined just a few
short years ago. Never before in the history of the world has there been
a society where poor people, in large numbers, suffered from obesity. I
agree that we need programs for at-risk youth. We need to stop truancy
and improve schools, especially in poor communities. We also need to provide
better health care accessibility for them. These, however, are political
decisions that must be made. The economy has not caused or exacerbated
them. This economy has lifted many out of poverty and can continue to do
so.
There are always those who see anyone's good fortune as a problem, so
long as benefits are not shared by all.
Paul Chandler, LA'63
Falls Church, Virginia
This is in response to David Heilbroner's "The Devil's Bargain
of a Long Boom" article. While it is an indisputable fact that wage
and income inequality have been rising in the U.S. since the 1970s, I'm
doubtful of Barry Bluestone's assessment of the causes of this phenomenon.
He seems to argue that if Alan Greenspan would follow a more expansionary
monetary policy-and create a "huge boom"-then low-income workers'
wages and incomes would rise and income inequality would decrease. I don't
believe that our current economic expansion (or any other) is being powered
by monetary policy. But even if it were, Bluestone's solution doesn't get
at one of the root causes of the income and earnings inequality of the
past thirty years: differences in productivity across individuals. To improve
the wages and incomes of the lower quartiles of the income distribution,
we must invest in human capital-that is, education, health, and job training.
Worker productivity is improved by investing in human capital, and in the
long run wage and income growth are determined by productivity.
I haven't read Professor Bluestone's work, so perhaps this is more a
comment on Heilbroner's reading than Bluestone's work. Oddly enough, I
like sociology professor Thomas Shapiro's proposal for Individual Development
Accounts. Much of the difference in human capital investment across individuals
is in part caused by differences in wealth and constraints on borrowing
to fund investment in human capital such as education.
Kirk White
Durham, North Carolina
White is a graduate student in economics at Duke University.
Doing Much Harm
David T. Gordon's in-depth article in the January issue, "Hippocrates
or Hypocrisy?" highlighted some of the serious contradictions that
are prevalent in our health care system. The plight of consumers, who support
this inefficient, inequitable system, has always been trivialized and ignored
by those in control, which has contributed to the present financial and
ethical problems. Living in a medical mecca and having health coverage
does not ensure that we will receive quality health care, access to services
in a timely manner, options and treatment choices including alternatives,
simplistic and speedy grievance procedures, and inclusion in our health
care decision making. We pay exorbitant fees for insurance and treatment,
have no quality control, oversight, or accountability, and lack access
to the legal system. There is no other area of life where we have such
a lack of control, void of information, and unconscionable human rights
violations.
The business of health care suffers from chronic management problems
and abuses that should have been corrected decades ago. The Institute of
Medicine's recent report on medical errors and negligence as the eighth-leading
cause of death in this country sparked federal and state hearings. Chip
by chip the shroud of secrecy is dismantling. Without accurate and unbiased
information, informed consent cannot be given. Invasive procedures should
not take precedence over viable, less risky alternatives. Consumers should
have the right to decide. Outcome data must be disclosed. It's outrageous
that 99.9 percent of all medical information is communicated to us verbally.
We have a right to privacy concerning our medical histories, but our medical
records should not be so private that the very people they belong to don't
have knowledge or copies of critical information.
The bottom line is that money and profits take precedence over caring
for and about people. Consumers are the heart and soul of the health care
system and our voices should be respected. Yes, Hippocrates or hypocrisy?-that's
the question!
Linda DeBenedictis
Norwood, Massachusetts
DeBenedictis is president of New England Patients' Rights Group.
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