Monday, July 17, 2023

Charity that Perpetuates Inequality

Anthem partners with hospitals to create unique health plan | LAist - NPR  News for Southern California - 89.3 FM

Here in Los Angeles, you can drive by some of the most modern medical buildings equipped with expensive, state-of-the-art diagnostic tools and machines including surgical robots, with some of the best doctors in the nation. And the names of the benefactors on some of the largest and most expensive buildings speak to the power of mega-wealth. While many of those benefactors have passed on, it is interesting to note that most of these donations were not testamentary; they were made when the donor was very much alive. How nice and selfless, you might think, but if any of those benefactors were in need of expensive and immediate treatment, you would also realize that the hospital in question would throw every conceivable resource at that medical emergency at a hyper-prioritized level. Expensive healthcare insurance?

I am an indirect beneficiary of such largesse, having had multiple surgeries at more than one of these extraordinary hospitals, but even in a major city like Los Angeles, the disparity among hospitals is massive. Local hospitals have shut down for lack of funding, and critical care is highly differentiated between those ultra-modern hospitals, with every conceivable treatment option, and those older facilities, particularly in and around minority communities, where “you get what we’ve got, and you may have to wait around for it.”

As austerity measures aimed at keeping taxes and regulations for the mega-wealthy at a minimum gained traction since the 1970s, what used to be government-funded has now moved to the private sector. Everything from our space program to education, from cutting-edge medical research to disease control. Public schools in austerity driven states, either for political reasons or simply because the tax base is marginal, are among the worst such schools in the developed world.

Based on globally designed testing, such schools have slipped from first to 19th and below since the 1970s. We are unable to provide high school students with STEM skills sufficient to rise to more sophisticated college and university STEM levels, dropping our competitive edge to dozens of other nations, from China to Germany. Too many of our roughly 13,000 school boards are prioritizing fighting culture wars as opposed to focusing on the best patterns of instruction that are readily available. Adding pressure against immigration, we are woefully short of the STEM expertise we need… with hundreds of thousands of critical jobs unfilled. A competitive disadvantage.

But we’ve never had so many mega-wealthy Americans, even corrected for inflation, as we do today. Philanthropy is a badge of honor among those extraordinarily rich mostly White men, some of whom wield massively disproportionate power, funding extreme political issues and candidates, which and who used to languish as fringe elements with no real access to true power. That has changed dramatically under the horrific “campaign unleashing” of the 2010 Supreme Court ruling in Citizens United vs FEC. Money used to talk; now it screams.

But as Garrett Neiman’s book, Rich White Men, substantiates, even where such donations are not ostensibly political, they still favor incumbent White wealth above a more equitable distribution of money to cover a wider spectrum of need. Perhaps, Neiman argues (in a summary reproduced in the June 20th FastCompany.com): “Even liberal philanthropy typically reproduces inequality. While I’ve often heard rich white men claim that philanthropy is an adequate substitute for government, that’s hardly true. Americans donated $449 billion in 2019—a substantial sum, to be sure—but that’s still just 2% of U.S. GDP. And a significant portion of those funds are earmarked for universities, hospitals, museums, and other large institutions that predominantly serve the wealthy, especially rich white men.

“For example, while many rich white men I know claim that education reform is the best way to advance equal opportunity, 73% of philanthropic giving within education goes to colleges and universities, which half of those who grew up in poverty do not attend. Philanthropists also disproportionately prioritize wealthy universities that serve primarily wealthy students: While UC Berkeley enrolls nearly as many Pell Grant students as the entire Ivy League combined, Ivy League universities received 10 times the donations in 2021. In fact, since the wealthiest 1% get a tax refund worth 29% of their charitable contributions, they actually take more from government coffers with their education donations than they give to K-12 education reform. Focusing on giving totals draws attention away from how little is donated to address poverty.

“Even if the entire $449 billion reached those with incomes below the official poverty line—a long way from the current reality—poverty wouldn’t be eliminated. Since 37 million Americans live below this threshold, only $12,000 in philanthropic giving would reach each person. If workers in the 20 states where the minimum wage is $7.25 instead got a bump to $15 per hour, more money would end up their pockets than if they were granted a slice of the philanthropic pie…

“There’s another problem. Historically, many of the organizations dedicated to fighting poverty take a paternalistic, “blame the victim” approach. For example, my impression is that KIPP—the nation’s largest network of charter schools—was founded with a presumption that children in poverty need alternative schools that enforce high standards, not communities and schools that are as well resourced as those found in white, affluent communities. Similarly, my impression is that Teach for America, which recruits young teachers into high-poverty communities of color, was founded with a belief that what children in poverty need are teachers with elite pedigrees, not access to community wealth and power. Nonprofits like these do have a positive impact on many children’s lives, but they don’t offer America a way out of extreme inequality…

“On the other hand, when those in power are asked about whether they support significant reforms to society—like changing the tax system so that more resources can be invested in high-poverty communities of color—they often retreat into emphasizing that the answer is fixing a single pipe in the pipeline. For example, when I asked a white male president of an elite university what America could do as a society to foster equity, he stressed that what would make the biggest difference are programs that prepare Black people for their first board seats. Other rich white men have told me that early childhood programs are the highest-leverage solution. Still others have told me that the magical elixir may be programs that help underrepresented students access college, succeed in college, get their first jobs, access graduate school, or climb the corporate ladder.” What do you expect from those engaged in massive philanthropic efforts? That they can see what’s needed among masses of disenfranchised? Where would they generate that perspective?

I’m Peter Dekom, we have constructed a nation that works well solely from the perspective of the richest in the land, stripping government of its traditional commitment to all people.

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