Street art in Bogotá, Colombia,
by artists Ericailcane and Bastardilla.
Photo by #bogotástreetart
Street art in Bogotá, Colombia,
by artists Ericailcane and Bastardilla.
Photo by #bogotástreetart
Subterranean Fire: A History of Working-Class Radicalism in the United States, takes a closer look at the income statistics everyone is celebrating., author of
HAS THE economic recovery finally filtered down to the U.S. working class, more than seven years after the official end of the Great Recession? The U.S. Census Bureau says yes, based on the results of its Current Population Surveyreleased on September 13.
According to the Census Bureau, all sectors of the population–be their incomes high or low, their ages old or young, their regions East, West, North or South–experienced sizeable income gains between 2014 and 2015. In fact, as MSNBC reported, income grew the fastest for the poorest people: “[T]he income growth was widespread across every…racial/ethnic demographic, with Americans at the bottom seeing the largest percentage increase.”
But the Census Bureau’s findings are highly suspect, mainly due the mountain of economic data they ignore.
Who could trust a meteorologist, for example, who reports cheerfully: “The recent heat wave has given way to cooler, more pleasant temperatures,” yet doesn’t mention a tropical storm presently whipping through the region?
The Current Population Survey has a similar problem, reporting on pre-tax cash income increases without regard to the spiraling expenses necessary to survive in today’s world.
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THE SURVEY showed that median U.S. household income rose a whopping 5.2 percent to $56,516 last year–not only the first increase since before the recession began in 2008, but also the fastest income growth in nearly 50 years.
It also found that 3.5 million people climbed out of poverty in 2015, lowering the poverty rate from 14.8 percent to 13.5 percent–the sharpest annual drop in poverty since the late 1960s. In addition, the percentage of Americans with health insurance for at least part of 2015 reached 90.9 percent–the highest ever recorded.
With such upbeat news arriving less than two months before the election, it was almost possible to hear the corks popping over at Democratic Party headquarters. After all, records were broken in 2015! Obamacare is working! People are working!
Corporate media giants broadcast this ostensibly magnificent news with headlines such as “Median incomes are up and poverty rate is down, surprisingly strong census figures show” (Los Angeles Times) and “Poverty goes down, coverage goes up, and America gets a raise” (MSNBC).
The Washington Post editorial board used the report as an opportunity to ridicule both Bernie Sanders and Donald Trump (as if they were two peas in a pod) for their “bombardment of negativity about the U.S. economy” on the campaign trail–claiming the Census Bureau data proved that “the entire time candidates such as Mr. Sanders and Mr. Trump were out on the stump, the U.S. economy was performing contrary to their respective tales of woe.”
But headlines such as “America Gets a Raise” imply that wages have risen significantly when they have not.
To be sure, roughly 2.4 million more people found full-time, year-round jobs in 2015 compared with the year before. But wages rose much less than 5.2 percent last year. Higher median household income reflects more hours worked rather than a substantial hike in pay.
And even by the Census Bureau’s own measurement, in 2015 median household income (which is the level at which 50 percent of the population makes more and the other 50 percent makes less–was still lower than in 2007, and lower still than the all-time high in 1999.
Further examination also reveals that people in rural areas didn’t share in the increase, but rather experienced a 2 percent decrease in median income last year–which fell to just $44,657 for these households, far below the national median.
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THE CENSUS Bureau generalizations about median income dramatically downplay the deep concentrations of poverty that exist across the country. For example, North Dakota had the nation’s biggest drop in child poverty between 2011 and 2016, but the poverty rate for Native American children, the majority living on reservations, is five times higher than for the rest of the state’s children.
Likewise, buried within a Detroit Free Press article headlined “Michigan posts its largest income gain since the recession” is the admission that the majority Black cities of:
Flint and Detroit continue to have some of the highest poverty rates in the U.S., at 40.8 percent and 39.8 percent, respectively. The child poverty rate is higher–more than half of the children who lived in Detroit and Flint last year lived in poverty, 57.6 percent and 58.3 percent, respectively.
The Census Bureau figures also ignore the enormous income disparities, often along racial lines, within individual cities. According to the Census Bureau, Washington, D.C.’s median household income rose to $75,600 in 2015, but that breaks down to $120,000 for white households compared to just $41,000 for Black households. The poverty rate for the city’s Black population is 27 percent–and 75 percent of all D.C. residents living in poverty are Black.
There is yet another way that the Census Bureau’s poverty statistics skew lower while its median income figures skew higher.
In the introduction to its Current Population Survey, the bureau makes the following caveat about its “sample” population: “People in institutions, such as prisons, long-term care hospitals and nursing homes, are not eligible to be interviewed in the CPS…[P]eople who are homeless and not living in shelters are not included in the sample.” The list of those excluded from the survey thus includes millions of the most impoverished people in the U.S.
Despite the flaws in the Census Bureau’s findings, they still show roughly one in four African Americans and Native Americans and more than one in five Latinos living under the official poverty line. One in five children are living in poverty by official standards, and 10 percent of U.S. households are trying to survive on less than $13,300 a year.
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BUT THE most glaring problem with the Census Bureau’s methodology is its appallingly low poverty threshold. If the poverty line were scaled upward to a more accurate level, the official poverty rate of the U.S. population would certainly skyrocket statistically.
The Social Security Administration developed the current poverty measure back in 1963, adopting a formula based on the minimum amount of money necessary to buy a subsistence level of food, using data from the 1955 Household Food Consumption Survey. On the assumption that food expenditures made up one-third of what a family of four needed to survive at the time, that amount was then multiplied by three to define the poverty line.
This definition, using obsolete 50-year-old consumption patterns and even more antiquated 60-year-old prices (adjusted annually based on the consumer price index), is still in use today.
If that formula (food expenses times three) was ever adequate for survival–and it most certainly wasn’t in the era of Eisenhower–it is completely preposterous today. In 2015, the poverty threshold was set at just at $24,250 for a family of four and $11,770 for an individual.
Even the Census Bureau recognizes some of the shortcomings of its formula. Since 2010, it has issued a “Supplemental Poverty Measure,” adding income from sources such as Social Security, tax credits and food stamps, while subtracting some expenses, such as work costs, medical care and child-support payments.
In 2015, this statistic showed the rate of poverty at a (slightly) more realistic 14.3 percent, compared to the Consumer Population Survey’s 13.5 percent.
But the Supplemental Poverty Measure is an exercise in futility, however well meaning its proponents’ intentions. It does nothing to actually improve the lives of impoverished people because the government relies only on the Current Population Survey to determine eligibility for government poverty programs such as food stamps.
And while those cloistered in the bubble of the federal bureaucracy seem to find its poverty threshold adequate for survival, anyone with at least one foot in the real world is aware that no family of four can make ends meet on $24,250 a year.
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JUST AS every household needs a budget measuring its income in relation to expenses, we should examine the actual cost of just a few major household necessities to give a cursory sense of whether that 5.2 percent rise in median household income last year actually made a dent in falling working-class living standards:
— Rent: According to apartmentlist.com, using Census data from 1960 to 2014, median rent has risen by 64 percent after adjusting for inflation, while real household income only increased by 18 percent. Between 2000 and 2010, rents rose by 18 percent while household income fell by 7 percent.
As Apartmentlist.com concluded, “As a result, the share of cost-burdened renters [households spending more than one-third of their income on rent] nationwide more than doubled, from 24 percent in 1960 to 49 percent in 2014.”
If anything, the pace is accelerating: In the last year alone, median rents rose by 2.3 percent to $1,120 per month for a 1-bedroom apartment and $1,300 for a 2-bedroom.
— Child care: The cost of child care has nearly doubled since the 1980s–yet it is not considered a necessary household expenditure, even though 75 percent of mothers with children six to 17 years old are in the labor force, as are 61 percent of mothers with children under 3 years old.
In 2015, the average child care cost rose to over $143 a week. As a result, fewer working parents can afford to pay for it and end up keeping children with relatives or trading off child care shifts while the other parent, if they have one, is at their job.
Whereas 42 percent of parents paid for child care in 1997, only 32 percent did so by 2011.The poorest families spend the largest proportion–one-third of their incomes–on child care.
— Health care: The Supplemental Poverty Measure for 2015 showed that with medical expenses–including insurance premiums, co-pays, co-insurance, prescription drug costs and other uncovered medical expenses–factored in, 11.2 million (or 3.5 percent) more people are living in poverty than the Census Bureau’s Current Population Survey acknowledges.
And we can expect next year’s statistics to be even worse, as employers continue to push more insurance costs onto their employees. More and more employers are turning to plans with higher co-pays and so-called “high-deductible” plans, offering premiums workers can barely afford and deductibles of $1,000 or $2,000 a year–meaning workers have to pay these amounts before insurance kicks in even a penny toward their medical care.
This year, deductibles alone are rising nearly six times faster than wages, according to the 2016 Employer Health Benefits Survey of the Kaiser Family Foundation.
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A NEW Georgetown University study on job creation shows that workers with a high school diploma or less have lost the most income during the recovery, as more jobs go to those with at least some post-secondary education–perhaps reflecting a glut of “over-educated” applicants for low wage jobs.
“Of the 7.2 million jobs lost in the recession,” the Georgetown study states, “5.6 million were jobs for workers with a high school diploma or less…On net, there are now more than 5.5 million fewer jobs for individuals with a high school education or less than there were in December 2007.”
This downward trend began well before the Great Recession. A report by the Hamilton Project of the Brookings Institution found that between 1990 and 2003, real median wages had already fallen by 20 percent for male workers without a high school diplomaage 30 to 45, and by 12 percent for women in the same category.
As the New York Times, citing the report, concluded: “Less-educated Americans, especially men, are shifting away from manufacturing and other jobs that once offered higher pay, and a higher share are now working in lower-paying food service, cleaning and groundskeeping jobs.”
But this decline in wages is tied to more than the decline in manufacturing jobs. As theTimes article added, “[P]ay levels are declining in almost all of the fields that employ less-educated workers, so even those who have held onto jobs as manufacturers, operators and laborers are making less than they would have a generation ago.” Inflation-adjusted annual pay for manufacturing jobs fell from $33,600 in 1990 to $28,000 in 2013.
While much media attention today is devoted to labeling the so-called “millennial” generation the best-educated in history, fully two-thirds of those between the ages of 25 and 32 have no bachelor’s degree–a figure that is virtually identical to the baby-boomer generation.
But the earnings shortfall for young people without a bachelor’s degree compared to those with a four-year degree has fallen from 77 percent in 1979 to just 62 percent today. And with student debt averaging $35,000 per college grad, a bachelor’s degree is simply out of reach for most low-income young adults.
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THE LONG-term decline in wages is not an accident, nor an unfortunate consequence of factors beyond the control of U.S. policymakers. On the contrary, it has been a long time in the making.
Since the late 1970s, both Democratic and Republican policymakers joined with the rest of the corporate class in a strategy intended to drive down working-class living standards in order to raise corporate profits. This comprehensive set of policies–which involved legal green lights for union busting, wage and benefit cuts, dismantling social welfare subsidies, and privatizing formerly public services in order to shift costs onto consumers–has more recently become known as “neoliberalism.”
The greatest damage from neoliberalism was done early on, from the late 1970s through the early 1990s. The average real hourly wages of production and nonsupervisory workers fell by 15 percent between 1973 and the mid-1990s, lowering the ceiling for working-class wages ever since. Wages briefly rose during the economic boom of the late 1990s–only to be derailed by the early 2000s when wages began to stagnate again. The Great Recession once again accelerated the decline.
The claims of the 2015 Current Population Survey should be viewed in this historical context. Since 1979, the vast majority of U.S. workers have seen their wages bouncing back and forth between decline and stagnation, while the wealthiest few have enjoyed massive gains in income. Even the Census Bureau’s statistics showed that the enormous degree of income inequality in 2015 was “not statistically significant” from the year (or years) before.
So a more appropriate headline for the articles about the Census Bureau report would be, “Neoliberalism continues to slash working-class living standards, with no end in sight (until workers fight back).”
Amid mounting public threats that the US is preparing an escalation of its military intervention in Syria, the New York Times Thursday published a lead editorial branding Russia as an “outlaw state.”
This ratcheting up of rhetoric that has grown increasingly hysterical in regard to Russia is a response to the debacle suffered by US imperialism in its over five-year-long proxy war for regime change in Syria. Syrian government forces, backed by Russian air power, appear to be on the brink of retaking all of the eastern portion of Aleppo, the last major bastion of the US-backed “rebels,” composed principally of Al Qaeda-affiliated Islamist militias.
Secretary of State John Kerry issued an ultimatum to his Russian counterpart Sergei Lavrov Wednesday: either Russia grounds both its own and the Syrian government’s warplanes, or Washington will break off all negotiations with Moscow on Syria.
The significance of this threat was further spelled out in a press briefing by State Department spokesman John Kirby, who told reporters that as a consequence of Russia failing to bow to US demands, “extremists and extremist groups will continue to…expand their operations, which will include, no question, attacks against Russian interests, perhaps even Russian cities, and Russia will continue to send troops home in body bags, and they will continue to lose resources—even, perhaps, more aircraft.”
The provocative and utterly reckless character of Kirby’s remarks was no accident. That Washington intended to communicate a threat to unleash CIA-sponsored terrorism against Russia was underscored by a Washington Postcolumn by Philip Gordon, who until last year was the White House coordinator for the Middle East, North Africa and the Gulf. The piece, which warned in its headline that “Russia will pay the price,” used almost identical language, stating that continued Russian action in Syria “could very well result in terrorist attacks against Russia.”
Gordon went on to warn that the Obama administration could take actions to “increase costs on Russia,” adding, “Arming the opposition with shoulder-fired missiles capable of hitting Russian and Syrian planes over Aleppo is among the options.”
The ex-White House aide finally cautioned Moscow that if “Hillary Clinton becomes the next U.S. president, Putin could be facing a U.S. leader who has long supported a no-fly zone in Syria and robust support for the opposition, has expressed skepticism about Russia’s intentions in Syria, and will be looking to more clearly reassert American leadership in the Middle East.”
It is evident, however, that the question of whether an escalation of the US intervention in Syria can wait until after the US election of November 8 has become the subject of heated debate within the US ruling establishment.
The Reuters news agency cited unnamed senior officials as saying that the Obama administration is considering “tougher responses to the Russian-backed Syrian government assault, including military options,” including the provision of heavier weaponry to the Al Qaeda-linked “rebels” and air strikes on Syrian government positions. (This second option was already put into practice with the September 17 US bombing that killed and wounded close to 200 Syrian troops near Deir Ezzor, which Washington claimed was an accident.)
With its editorial denunciation of Russia as an “outlaw state,” the New York Times is effectively weighing in on the debate within America ruling circles over the US intervention in Syria. It wants a military escalation and it wants it now—against Russia.
The Times writes: “President Obama has long refused to approve direct military intervention in Syria. And Mr. Putin may be assuming that Mr. Obama is unlikely to confront Russia in his final months and with an American election season in full swing. But with the rebel stronghold in Aleppo under threat of falling to the government, administration officials said that such a response is again under consideration.”
To bolster its case, the Times throws in unsubstantiated charges made in an investigation driven entirely by “evidence” supplied by the Ukrainian secret police that Russia was responsible for the July 2014 shootdown of a Malaysia Airline jet over the war-torn Donbass region.
Putin, the newspaper declares, is guilty of “butchering civilians in Syria and Ukraine, annexing Crimea, computer-hacking American government agencies,” and “crushing dissent at home.”
Putin’s government represents Russia’s ruling oligarchy, which enriched itself through the theft of state property during the dissolution of the Soviet Union and the restoration of capitalism. Its intervention in Syria, though of a defensive character, in response to US attempts to encircle and isolate Russia, represents the interests of this oligarchy and provides no progressive solution to the catastrophe unleashed by imperialism on Syria and the broader Middle East.
That being said, the crimes of Putin pale in the face of those carried out by successive US administrations, all of them with the complicity and propaganda support of the New York Times.
The US government is responsible for over a million deaths in Iraq and hundreds of thousands more from Afghanistan to Libya and Yemen. It instigated the regime-change operations in both Ukraine and Syria that gave rise to the “butchery” in those countries, much of it inflicted with weapons supplied by the CIA.
Moreover, even as the Times attacked the Russians’ “butchery” in Syria, the Pentagon announced that it is sending another 600 US troops to Iraq to prepare for a siege of Mosul, which, like the previous assaults on Fallujah and Ramadi, will entail massive crimes against the civilian population.
As for Russian computer hacking, the Times speaks on behalf of the US government, which, through the NSA, engages in the most massive spying operation the world has ever seen. And as for “crushing dissent at home,” the US, it should be recalled, is a country where the police murder over 1,000 people every year and the so-called “justice system” keeps some 2 million people behind bars. In brief, the Times editorial is a piece of war propaganda.
The term “outlaw state” was first put into official use by Ronald Reagan. It was later rendered as “rogue state” under Bill Clinton and, then, under George W. Bush, became the “axis of evil.” Invariably, these terms were used to describe oppressed, semi-colonial countries targeted by US imperialism for war and conquest: Nicaragua, Grenada, Iraq, Libya, Somalia, Sudan, North Korea, Iran, etc.
Now, in the pages of the New York Times, the term is used to describe Russia, a country of 146 million people armed with nuclear weapons. The implications could not be more ominous.
While the motivations of the Times editors may include short-term political considerations—the possibility of an “October surprise” in Syria boosting the prospects of Democratic presidential candidate Hillary Clinton—the anti-Russia propaganda campaign that the newspaper is leading has far deeper roots in the crisis of American capitalism and the protracted drive by US imperialism to overcome its historic decline through the instrument of militarism.
If words have any meaning, the Times editorial is a warning: behind the backs of the people of the United States and the entire planet, the preparations for a third world war are advancing rapidly.
Bill Van Auken
Street art in Puebla, Mexico,
by artists Fest Crew.
Photo by streetartpuebla
Reports issued this week by the World Trade Organisation (WTO) and the International Monetary Fund (IMF) point to worsening stagnation in the global economy and a consequent rise of nationalist tensions.
The WTO forecast that global trade would grow by only 1.7 percent this year, compared to the already low rate of 2.8 percent it had predicted in April. In the analytic chapters of its latest “World Economic Outlook” (WEO) report, the IMF warned that “broad-based” low inflation and outright deflation could lead to a full-blown deflationary cycle in which lower prices, combined with falling investment, lead to a further economic contraction.
“Disinflation has been taking place across a broad range of countries and regions,” the report stated. “By 2015 inflation rates were below medium-term expectations in more than 85 percent of a broad sample of 120 economies—20 percent of which were actually experiencing outright deflation.”
The WTO report focused on the rapid downturn in global trade, particularly over the past three years. Since the 1980s, world trade has grown at a rate 1.5 to 2 times faster than the growth in global gross domestic product. This year, the trade growth rate will only be 80 percent of GDP, the first time trade growth has dipped below GDP growth since 2001 and only the second time since 1982.
“The dramatic slowing of trade growth is serious and should serve as a wake-up call,” said WTO Director-General Roberto Azevêdo. Having earlier pointed to the rise of protectionist measures, especially by major countries, the WTO again raised its concerns over this issue. It was necessary to ensure that the slowdown did not “translate into misguided policies that could make the situation much worse, not only from the perspective of trade but also for job creation and economic growth and development.”
“This is a moment to heed the lessons of history and recommit to openness in trade, which can help to spur economic growth,” Azevêdo said.
The reference to the “lessons of history” was an allusion to the experience of the Great Depression of the 1930s, when all of the major economic powers reacted to a contraction in world markets by imposing increased tariff barriers and forming currency blocs, further exacerbating the downward spiral and contributing to the conflicts that erupted in 1939 in the Second World War.
His remarks were echoed in a speech delivered by IMF Managing Director Christine Lagarde in Chicago yesterday. She said the world economy faced the danger of constrictions on trade and increased protectionism.
“Restricting trade is a clear case of economic malpractice,” she said. Limiting economic openness was “sure to worsen the growth outlook for the world,” and it was necessary to “reverse the trend toward protectionism and restore a climate that supports a rebound in trade.”
The IMF drew attention to the slowdown of trade in its WEO report, noting that it was a symptom of sluggish growth. “Empirical analysis suggested that up to three-fourths of the shortfall in real trade growth since 2012 compared with 2003-2007 can be traced to globally weaker economic growth, notably subdued investment.”
The decline in investment is particularly significant because investment is the driving force of economic expansion in the capitalist economy. Investment is carried out in the expectation of future profits, leading in turn to higher employment and greater demand for raw materials and industrial goods, thereby promoting broader economic expansion. But as profit expectations decline, investment falls, bringing about economic contraction and a turn to financial speculation and manipulation to boost profits.
The IMF warned that the “quantitative easing” measures of central banks, carried out with the rationale that low interest rates will lift inflation and stimulate investment in the real economy, but in reality only boosting speculation, were reaching their limit. It said “bold policy actions” were needed to avoid the risk of chronically undershooting inflation targets and eroding the credibility of monetary policy, especially in the advanced economies.
The IMF has been calling for some time for increased government spending on infrastructure programs in order to provide an economic boost.
This call was repeated by Lagarde in her Chicago speech. She said governments with so-called fiscal space, such as Canada, Germany and South Korea, had to more aggressively pursue government spending. She also called for greater coordination among major countries. The IMF has been regularly making such calls at meetings of the G20 in the recent period, but has failed to elicit any concrete action.
“No doubt, the current situation is different from the 2008 crisis, which required a prompt, massive and coordinated fiscal response,” Lagarde said. “But as our ‘new mediocre’ is less acute, it is also more divisive and subtle than a full-blown crisis, and it could prove just as toxic as the recovery has so far proven elusive.”
She said if all countries worked to stimulate their own growth, this would bring “positive spillovers” that would “reinforce each other” and benefit the world economy as a whole. While such an approach might appear to be in accord with logic and reason, however, it runs into the objective obstacle of the division of the world into rival great powers with conflicting interests. All the major powers are in favour of such action, provided someone else does it.
The US, for example, wants to see increased spending by Germany to boost the European economy, thereby benefiting American exporters and investors. Germany, on the other hand, fears that such measures will weaken its financial position to the benefit of US banks and investment houses.
Consequently, rather than increased collaboration, the world economy is marked by increased national tensions and rivalries. The rise of protectionist measures—initiated in the main by the advanced economies—is accompanied by outright economic warfare, expressed most sharply in the European Union’s demand for a €13 billion back tax payment from Apple, the sinking of the US-based Transatlantic Trade and Investment Partnership by Germany and France, and the US Justice Department’s $14 billion fine against Deutsche Bank, which threatens to send the German banking giant into bankruptcy.
The intractable contradictions gripping the world economy were highlighted in another part of the IMF’s WEO analysis, where it called for China to pull back from “unsustainably high growth targets” by reining in credit growth. China has responded to the global economic slowdown by increasing credit by 13 percent this year—the fastest expansion since the 2008 financial crisis.
But with the country’s debt-to-GDP ratio at 250 percent and rising, these measures could set off a financial crisis. The IMF called for a comprehensive plan to address “vulnerabilities” in the financial sector. “A disorderly deleveraging … could trigger contagion in emerging market financial markets,” it said.
Thus, while calling for increased global growth, the IMF wants the world’s second largest economy, where the growth rate of 6.5 percent is far higher than most of the rest of the world, to cut back on stimulus lest this set off a financial crisis with global repercussions.
The remarks by both Lagarde and Azevêdo point to fears in policy-making circles that the world economy is increasingly riven by nationalist tensions which, despite their warnings, they are unable to reduce.
There are other, related concerns, generally referred to somewhat euphemistically as a “backlash” against globalisation. At heart, this is a reference to mounting social opposition to the growth of social inequality and hostility to the entire political and corporate establishment, a phenomenon reflected in contradictory ways in the support for Bernie Sanders in the US presidential race, the Brexit vote in the UK, the crisis of the traditional ruling parties and rise of right-wing populist parties in Europe, and the elevation of Donald Trump as the Republican presidential candidate in the US.
Fear is mounting within the international capitalist class of this opposition taking the form of a conscious struggle by the working class on the basis of a socialist perspective. Some of what is being discussed behind closed doors was revealed in an editorial published earlier this month by the BritishEconomist magazine, which warned that the present economic climate bore a striking similarity to the “backlash” that led to the Russian Revolution.
A century later, the Economist wrote, what may be taking place is a return to “1917 and all that.”
Half of U.S. physicians are “disengaged, burned out, and demoralized and plan to either retire, cut back on work hours, or seek non-clinical roles,” reports MedPage Today, citing a new nationwide survey commissioned by The Physicians Foundation.
“Many physicians are dissatisfied with the current state of the medical practice environment and they are opting out of traditional patient care roles,” said Walker Ray, MD, president of The Physicians Foundation, in remarks that appeared with the survey.
“The implications of evolving physician practice patterns for both patient access and the implementation of healthcare reform are profound.”
MedPage Today reports:
The majority of the 17,236 physicians surveyed (54%) describe their morale as somewhat or very negative, 63% are pessimistic about the future of the medical profession, 49% always or often experience feelings of burn-out, and 49% would not recommend medicine as a career to their children, according to the survey.
Physicians identified regulatory/paperwork burdens and loss of clinical autonomy as their primary sources of dissatisfaction. They spend 21% of their time on non-clinical paper work duties, according to the survey, while only 14% said they have the time they need to provide the highest standards of care. About two-thirds (72%) said third-party intrusions detract from the quality of care. …
The survey indicates that only 33% of physicians now identify as private practice owners, down from 49% in 2012, while 58% identify as employees, up from 44% in 2012.
Physicians also indicated that “they’re disengaged from key initiatives of healthcare reform,” MedPage Today reports.
Only 43% said their compensation is tied to value. Of these, the majority (77%) have 20% or less of their compensation tied to value. Only 20% are familiar with the Medicare Access and CHIP Reauthorization Act (MACRA) which will greatly accelerate value-based payments to physicians.
While 36% of physicians participate in accountable care organizations (ACOs), only 11% believe ACOs are likely to enhance quality while decreasing costs. Physicians also are dubious about hospital employment of doctors, another mechanism for achieving healthcare reform.
Two-thirds (66%) do not believe hospital employment will enhance quality of care or decrease costs. Even 50% of physicians who are themselves employed by hospitals, do not see hospital employment as a positive trend.
The survey additionally found:
* 80% of physicians are overextended or are at capacity, with no time to see additional patients
* 48% of physicians said their time with patients is always or often limited
* Employed physicians see 19% fewer patients than practice owners
* 46.8% of physicians plan to accelerate their retirement plans
* 20% of physicians practice in groups of 101 doctors or more, up from 12% in 2012
* Only 17% of physicians are in solo practice, down from 25% in 2012
* 27% of physicians do not see Medicare patients, or limit the number they see
* 36% of physicians do not see Medicaid patients, or limit the number they see
One Truthdig reader said of the findings:
One should compare what’s happened in the medical profession with what’s happened in the nation’s universities—greed and ideologically driven (rather than empirically based) business modeling turned control of persons educated to perform the profession’s real work over to hordes of bean counting ‘administrators’ whose policies and actions deprive doctors and professors of autonomy, reduce both time to perform and fair reward for their work, and slash due respect for their hard acquired skills and the developed judgment needed to effectively use them with patients and students.
These results follow from privatization, which is a form of theft consisting of the capitalist practice of plundering employees and reducing services to the public in order to leach wealth for owners, managers or both—workers, humanity and Earth’s future be damned.
Update: Via email, Truthdig reader Lawrence Raines, recently retired from a career in healthcare, adds to the findings and the preceding comment:
I was an independent General Surgeon who retired (after 31 years in same location) in August 2013 because of the relentless, oppressive intrusion of Corporatised Medicine which is nicely described by the above quote from one of your readers. There are myriad reasons that led to my retirement but using my long acquired and honed skills to care for my patients was not one of them. I loved being a doctor but my professional life was literally sucked out of me and according to the article and conversations with former colleagues it has continued to get worse, “much worse.” I don’t think this is unique to healthcare and I have grave concerns about what type of society will exist for my grandchildren. Greed and Power and the associated Immorality are corrupting the world.
—Posted by Alexander Reed Kelly
Street art in West Harlem, NYC, USA,
by artist Alexander Keto (for #NotACrime in collaboration with Street Art Anarchy).
Photo by Jaime Rojo (bsa).