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At the end of 2019, political and policy concerns about three social insurance issues - access to and the cost of health care; the solvency of Social Security, and the underfunding of large public pension funds - were all making the news.
Other systemic problems, including the erosion of the rural economy; student debt; educational achievement gaps; workforce shortages; and income disparity were also in the headlines. None of these issues were addressed, let alone resolved, in the first quarter of 2020. And, when the COVID-19 pandemic has run its course, all of these issues will have been exacerbated, which is why it is necessary to consider what, if anything, can be done to continue the work that was being done and to alert policy makers and pandemic managers to the need to be sensitive to how their decisions affect these concerns.
“About 76% of promised benefits will be payable from payroll taxes after the trust funds are exhausted. In 2021, the total annual income of the program is expected to be less than the annual cost for the first time since 1982. That gap is expected to continue for the next 75 years, which is the maximum period the trustees forecast.” Forbes, April 22, 2020
“Between 2008 and 2016, Medicaid costs increased from $0.55 to $0.67 of every federal dollar going to states and local governments. The demand on state revenues increased as well and now claims about 20% of all state revenues collected. These increases affected state and local spending on other priorities including education and infrastructure.” CAG
Just to put the relevance of this exercise in context, it is worth noting that policy makers around the globe were warned regularly for at least the past two years by respected organizations, institutions and individuals that they needed to prepare for an “apocalyptic pandemic.”
Leveraging Existing Informational Resources:
Over the past decade, individuals, groups, organizations and governments have spent a great deal of time and money exploring how best to address the social insurance and other issues that adversely affect public and economic wellbeing. At a minimum, some effort should be made to encourage the leaders of these various initiatives to collaborate on an effort to make their major findings and recommendations more visible and accessible to policy makers and other relevant audiences.
“Prices for crops this year are expected to drop by as much as 10% and prices of livestock by as much as 12% as a result of the coronavirus pandemic, according to a report from the Food and Agricultural Policy Research Institute at the University of Missouri. The net income for farmers is expected to decline $20 billion. “In the past month, it’s become probably one of the worst years in history for agriculture,” says Edelburg. Time. April 21, 2020
At a minimum, some effort should be made to encourage the leaders of these various initiatives to collaborate on an effort to make the public more aware of their major findings and recommendations. More to the point, current pandemic experience makes painfully and expensively clear that concern, expertise, study, publication and even media coverage, while essential, don’t get the job done. Consequently, the interested, affected and concerned need to concentrate not just on making their work more visible and accessible, but also considerably more urgent and economically and politically relevant to policy makers and other relevant audiences.
Avoiding Further Damage:
Most crisis management experts believe that the best emergency management is the management that takes place before a crisis occurs, that is the identification, mitigation and/or hazard management of risks. That opportunity with the corona virus has passed.
Boom-and-bust federal funding after 9/11 undercut hospitals’ preparedness for pandemics, Washington Post, May 2, 2020
Here's How The Small Business Loan Program Went Wrong In Just 4 Weeks, NPR, May 4, 2020
Most elected officials don’t make policy mistakes because they are stupid, evil or uncaring. Like most people, they make mistakes when they’re operating under pressure and lack the experience, information and/or time they need to make good decisions. Right now our elected officials are experiencing unprecedented pressure and grappling with an information deluge plagued by a lack of information and uncertainty about the information that is available. In tis sort of environment, they will act and they will make mistakes. Given all of that, we must make sure that those grappling with the day to day tactical demands of the pandemic - elected officials and others - are alerted to what NOT TO DO in terms of these critical issues.
Finding the Resources to Fund Critical Change:
Addressing major systemic issues will require funding. Money - governmental, personal, corporate and philanthropic - will be short everywhere as the nation comes out of the pandemic. Consequently, the identification of opportunities to recognize and monetize the value of changes in behavior will become an essential tool in the efforts to move forward.
Were Keynes alive today, he would have much to say not just about what to spend on what but about how to manage the financial burden efficiently and fairly.
In the world we live in today, changed almost beyond recognition by scientific breakthroughs, unprecedented technological advances, demographic shifts and now threatened by a global pandemic and vast economic challenges and dislocations, certain conclusions are inescapable. First, the economic, health and social wellbeing of our citizens is at risk. Second, what we’ve been doing is has not proved sufficient to deal with the challenges we face. Third, we need to find new ways forward. And fourth, time is not on our side. If helping societies and people thrive and prosper is the goal. Defining, finding, quantifying, expanding on and increasing accessibility to “value” is one of the most important new ways forward to that goal.
Hospitals and health systems have an array of non-clinical assets—from their ability to make loans to expertise in real estate, financial, and project management to significant property holdings—that can be leveraged not only for the benefit of the community but for their own benefit as well.