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LPE Originals

The Making of a Caregiving Crisis

A system of employer-based health benefits created not only a fragmented health care financing structure but also an extremely powerful and consolidated industry that now resists changes to that structure.

LPE Originals

The Making of a New Working Class

What happens when the factory is gone and the working class has been rendered dispersed and invisible? In this post, Gabriel Winant kicks off a symposium on his recent book, The Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America.

LPE Originals

How to Vaccinate the World, Part 2

In a previous post, one of us described why we need global cooperation to achieve massively scaled up production of COVID vaccines. The United States must play a key role in this process, because it has the ability to mobilize resources, and powerful leverage over companies that have so far resisted serious participation in global efforts – especially Moderna, Pfizer, and J&J. Some commentators question whether the US has the power to compel this cooperation. Others have doubted the relevance of the demand coming from developing countries to temporarily waive the requirements of the World Trade Organization’s TRIPS Agreement to facilitate more manufacturing. In this post, we explain why existing US law gives the Biden Administration the power to mandate sharing and overcome IP barriers, and how the TRIPS waiver can contribute importantly to efforts to scale up production at a global scale.

LPE Originals

How to Vaccinate the World, Part 1

The shortage of vaccines is a manmade problem, brought on by the false promise of innovation-by-monopoly and by reproduction of colonial dynamics. Our global R&D system layers privatized control and profits for huge firms based in rich countries atop a vast regime of open science and public subsidy. We can scale up production if we force pharma to share.

LPE Originals

Democratizing Governance to Advance Health Justice and Economic Democracy

The inequities and exclusions of the U.S. health care system are well known, but the two prevailing strategies in health law and policy—privatization and technocracy—both fail to address disparities in power that produce health injustices. To advance health justice, we need multiple pathways through which everyday people—acting both as individuals and also as member-led associations of patients, families, health care workers, and members of the public—can meaningfully shape governance and advance accountability by contesting over real levers of power. Many possible legal mechanisms incorporate empowered participatory decision-making and accountability into health governance. Here, I explore five mechanisms that hold especially exciting potential.

LPE Originals

Democratizing Health Systems to Advance Health Justice

The staggeringly disproportionate ravages of the COVID-19 pandemic among people of color, juxtaposed with the summer’s wave of protest against police violence against Black people in the United States, make clear that population health is bound up with existing patterns of social subordination. This reality transcends presidencies and pandemics—even in “normal” times, race, gender, and income play outsize roles in predicting health outcomes in this country. Yet, while the health system is a profoundly important social institution that often determines who lives and who dies, it has rarely been subject to the same level of scrutiny that has been directed at other systems we consider integral to how our democracy functions, such as the justice and electoral systems. In our recent piece, “Democracy and Health: Situating Health Rights within a Republic of Reasons,” we set out the contours of a health system that is grounded in an understanding of entitlements to health (public health and care) as assets of social citizenship. These contours include (1) public participation; (2) fair financing; (3) transparent and fair priority-setting processes; (4) universally acceptable, accessible, and adequate care; and (5) enforceable rights.

LPE Originals

Where Is the Care in the CARES Act?

Two pandemic policy stories have been coming to a head: (1) the push for another relief bill as a key CARES Act unemployment insurance benefit expires on July 31, and (2) the ongoing national child-care crisis as school closures for the fall are announced amidst the virus’ resurgence. What connects them is kids’ needs for care and families’ needs for economic support when they—predominantly mothers, of course—perform that caring labor. A little-noticed feature of the CARES Act supports care for children who must stay home due to school closures.

LPE Originals

Flattening the Curve and Closing the Gap: The Civil Rights of Health During a Global Pandemic

“We’re all in this together” has become a familiar call for strengthening our sense of community and social responsibility during the COVID-19 pandemic. Although this phrase can obscure deep social inequities, this recognition of our interdependence presents an opportunity to connect economic justice and public health. COVID-19 has instilled a new public understanding that our…