Thread to discuss issues around health and social inequalities

And sorry, the insurer is not a private company.

It's the UK National Insurance system, to which I paid premiums called National Insurance stamp to insure against a risk, in this case of being medically unable to work. My payout is called Incapacity Benefit.

The good news for you, LFN, is that the system of your dreams is already in force and has been for years. JobSeekers' Allowance and full Incapacity Benefit/ESA are only available to people with sufficient NI contributions (or seriously disabled from childhood); people without contributions get the much lower Income Support or reduced ESA at Income Support levels.

There! Bet I've made your day!

Is there a link between being poor and being on anti-depressants. I bet there is. And anti-depressants can be awful for you.

Probably boils down to education and aspiration. Having different priorities.

Yes, I have received child benefit. Universal benefits are of course different - personally, I think they shouldn't exist - they are an expensive way of bribing people, with their own money, into an unaffordable welfare state.

You have already said yourself that the insurance company will periodically test eligibility. That in itself could be seen as "too intrusive". Where to draw the line is difficult - but insurance is again different to benefits. Insurance is strictly contributory - you pay premiums to insure against a risk - if that risk occurs, then you get the payoff. Unfortunately, very few benefits these days are contributory. I would be very happy to move to a more or less exclusively contributory benefits system - if someone has worked hard and paid tax for 20 years and then gets made redundant, their contributions should entitle them to more support than someone who has sat at home watching Jeremy Kyle for the last 5 years.

Another Q.

I receive an insurance payout for medical reasons. I support the right of the insurer to send me for regular medical assessments and otherwise assess that I am still eligible.

But in my universe, their rights stop there. As long as I'm eligible, the money is mine to spend how I like.

Is your universe different?

But have you yourself received it? And does this give me, the taxpayer, the right to rifle through your shopping basket?

ThisIsANiceCage The State should have never undertaken the bailouts, in my opinion. Capitalism means that bad risks should result in failure.

I certainly believe there should be far greater transparency on public money spent on MPs and civil servants.

I don't believe in child benefit - at most, it should be strictly limited to 2 children, and means tested.

Some examples of Capitalist countries with relatively low social inequality (and good health outcomes): Greece, Japan, Sweden, Finland, Denmark, Iceland.

I don't accept the premise. It is not desirable to reduce inequality as a political goal.

It's very desirable to reduce inequality and have it as a political goal. Inequality matters.

Executive summary

1. Introduction

Many people, including some on the Left, express doubts about whether
economic inequality matters to public policy. At the same time, Britain has
become one of the most unequal countries in Europe. This pamphlet
explains why this growth in economic inequality should remain a central
political concern.

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1. Inequality and poverty

Inequality and poverty are closely connected: more equal countries have
lower levels of poverty. Britain suffers from high levels of poverty, and poor
people in Britain are substantially poorer than the worst off in more equal
industrialised countries. In the developed world, inequality is more
important than per capita GDP in determining the living standars of the
poor. By ignoring inequality and the growth of incomes at the top of the
distribution the government is compromising its efforts at poverty
reduction.

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Poverty in rich countries is usually defined relative to average incomes. But
despite being richer than in the past, low-income households in Britain
today suffer from serious deprivations that are unnecessary and
unacceptable in a country as rich as Britain. The decision to redistribute
from the rich to the poor is just the decision to put scarce resources to
better use.

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1. Inequality and social justice

The sharp contrast perceived by some between ?equality of opportunity?
and ?equality of outcome? is misguided. Egalitarian social democrats have
always argued that the promotion of equal opportunity will in fact require
greater material equality: for individuals to realise their potential, they will
have to enjoy roughly similar economic and social starting points.

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Empirical evidence shows that Britain is a long way from realising equal
opportunity: the life chances of an individual in Britain today are significantly
influenced by the economic and social position of his or her parents. But
those countries which have succeeded in facilitating greater

?

intergenerational mobility, notably in Scandinavia, have only done so by
promoting greater material equality.

The large inequalities of wealth and income currently found in Britain are
fundamentally unjust, whether one endorses an egalitarian or meritocratic
view of social justice. They cannot plausibly be defended as deserved
rewards for varying talents.

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1. Inequality and social solidarity

Inequality in Britain today undermines social cohesion and causes the
disappearance of a shared public realm. Unequal societies suffer from lower
levels of interpersonal trust, higher levels of violent crime, and the
residential segregation of social classes. High inequality allows the wealthy to
dominate political decision-making and to reduce political support and
funding for public services.

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1. Why not reduce inequality?

It cannot be straightforwardly argued that reducing inequality is a threat to
individual freedom. Economic inequality distributes individual freedom
unequally: the richer you are, the greater ability you have to do as you want
without interference from others.

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There are theoretical arguments both for and against the proposition that
economic inequality is beneficial for economic growth, but the empirical
evidence indicates that there is no relationship either way. Promoting
equality is not bad for the economy.

?

Governments are not powerless before inexorable anti-egalitarian forces.
Many policy tools exist to promote greater equality, and the recent growth
of inequality in Britain is largely due to policy decisions taken by government
during the 1980s. Governments play a large role in the determination of
economic inequality and can choose to reduce it or increase it.

?

1. Conclusion

Economic inequality on the scale now present in Britain presents an
enormous challenge to the core values and policy objectives held by even
the most modern of social democrats. The key political objective of social
democrats must remain to end the gross economic inequality that scars
Britain, and wastes the lives of so many of our fellow citizens.

paulsegal.org/documents/Why_Inequality_Matters.pdf

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Inequality is a very dangerous metric. The last people to start to implement "equal" societies as a matter of course in every aspect of public policy (naturally, with some more equal than the others) were the Communists.

Utter nonsense and a strawman argument. You can have less inequality and still have Capitalism. Most countries in europe are far more equal, and the population are also generally far healthier and happier for it, too.

I had a look at Dental Estimate Board and NHS dentists recently making a slight comeback. Biut there is no doubt dentists have been making a packet.
What i do not like, is that no one seems to care. This is the sad thing. The other night my neighbour moaned about a couple of teenage boys and how he would "just get the police". No more with the cuts. People really need to experience the lack of things first hand, to understand. It is when you try to access them then you find out. Poverty will in the end translate into tragedy for all - desperate people can do anything and they will fetch up on anyone's doorstep - fewer police? all the better

I'm a grammar school beneficiary as well and it was certainly something to aspire to where I grew up. I can see why they were dispensed with because the fall-back, the local secondary modern, was usually rubbish. So if you didn't pass that 11+, tough. And I can see that the ideal of fabulous comprehensive schools with identically amazing standards for every child to flourish in was a good one but they shouldn't have got rid of the grammars until every school was up to scratch. I've just read 'It's Your Time You're Wasting'... a wry look at modern education from the perspective of a teacher... and, even allowing for some comic exaggerations, the problems of low attendance, an 'I don't geddit' culture, poor behaviour and parental disengagement are probably true. If they're stuck in the catchment area of a school like that, even the able children are not going to reach their potential.

Grammar schools often provided the 'spark' although, as I understand things, they are not very popular on mn.

"We're not quite sure where that spark comes from,..."

That's the nub of the problem, I would say. Trying to formulate a policy strategy to create 'spark' is a far more difficult challenge than simply spending more money - the approach to date.

But there are some templates. Very big groups with a good track-record of overcoming the problems of poor housing, low-paid work, limited education and so forth are the Indian subcontinent and Chinese communities. I'm sure there are still health issues but, when it comes to social inequality, they seem to have a knack for helping the next generation progress. Some combination of high expectations & personal standards, a strong work ethic and high importance attached to education as a way of improving yourself seems to be effective.

Longfingernails, do you find your argument that "it's our money, we have right to determine what personal items they spend it on" extends to state-subsidised bankers?

MPs? Civil servants?

Recipients of Child Benefit? (Does this include you?)

On heart attacks, it is true that those in highly pressured, high status professions (like doctors and bankers) often are at risk. Doctors and vets also have high rates of substance misuse and suicide.

BUT that does not disrupt the general trend, which is that the poorer you are, the more likely you are to suffer from a whole range of disease including heart disease, stroke, diabetes etc.

Chil, there has been research done on those people who have resilience and drive that helps them overcome early deprivation. The Department of Health has developed a model for health promotion that segments people using socioeconomic status, life stage etc, but also differentiates those like your mum who not only raise themselves, but can be fantastic leaders and role models for others. They are usually the ones you find running community groups, self-help networks etc. We're not quite sure where that spark comes from, or how it can best be developed and supported, but it is a fantastic and neglected resource.

Your mum sounds just like mine, btw.

I think the group most at risk of heart attacks is actually GPs- hardly known for their lack of income...

Access to dentistry is very difficult in our authority- all the dentists went private a few years ago. DH's denplan is £11 a month, but as HarrietJones says- even that is out of reach for many people, especially as you have to pay for children too.

I think housing has a huge impact on health- many many local authority homes are simply no longer fit to live in. Houses riddled with damp, mould, etc have serious effects on people's health. Lung/chest problems impact on the whole body.

I know a success story. Born with a chronic disability to teenage parents in one of the poorest areas of the country. Father unemployed for long periods. Now a leader in their field earning £160,000 pa.

Just to change tack for a moment, if I was trying to rewrite policy in this area I would be seeking out people who buck the trend and asking them how they did it. People like my mum, for example. Brought up in what can only be described as a slum in a broken by an abusive family with zero money and very low standards, she could have been expected to end up the same way - but didn't. Her brothers and sisters, despite having exactly the same start in life and exactly the same chances, have struggled with marriage break-ups, alcoholism, unemployment, criminality.

I think if we could understand the success stories better it might spark more constructive resolutions.

Income tax isn't the only form of tax. People on benefits pay tax too.

longfingernails - have you read 'The Spirit Level'. Or is that a stupid question?!

These discussions always focus on the lifestyles of the poor, but the most interesting thing about the new evidence on inequalities is what it shows us about how unequal societies affect the health and wellbeing of everyone in them, rich or poor. Rich but unequal countries - like the US - have far worse health outcomes than poorer but more equal countries - like Greece. That is because of the corrosive effects of inequality on social cohestion, stress, safety etc.

In the decade after the fall of communism in the USSR, life expectancy fell by TEN YEARS. That's really fascinating, isn't it?

So it's not just about raising the incomes/reducing the bad habits of the poor (desirable though that may be), it's about creating a more healthy society for everybody. You can only have a more healthy society by having a more equal society. So reducing the gap between rich and poor isn't just a moral or political choice, it's one that will benefit us all.

Denplan quoted me £14 a month, a few years ago. I was a single parent & didn't have that money spare. I would have been paying that for just check ups as I was unlikely to need work(still hVent )

The dental saga: it was v difficult to get NHs dentist for years.Govt shut down/reduced the Dental Estimates board where nhs dentists put in their claims for work done so they had to go for private patients.Thousands have just not gone to the dentist as afraid of expense etc and winging it that nothing will go wrong Our dentist just switched us to Denplan -you pay a monthly fee depending on how bad dentist thinks you teeth are. It covers all the routine stuff but of course if you want implants you still have to pay. These plans include hygienist so idea of this is preventative care etc Good but the hygienist only does 1 day aweek and fully booked ...