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2. U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes
- Author:
- Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II
- Publication Date:
- 01-2023
- Content Type:
- Policy Brief
- Institution:
- Commonwealth Fund
- Abstract:
- In the previous edition of U.S. Health Care from a Global Perspective, we reported that people in the United States experience the worst health outcomes overall of any high-income nation.1 Americans are more likely to die younger, and from avoidable causes, than residents of peer countries. Between January 2020 and December 2021, life expectancy dropped in the U.S. and other countries.2 With the pandemic a continuing threat to global health and well-being, we have updated our 2019 cross-national comparison of health care systems to assess U.S. health spending, outcomes, status, and service use relative to Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland, and the United Kingdom. We also compare U.S. health system performance to the OECD average for the 38 high-income countries for which data are available. The data for our analysis come from the Organisation for Economic Co-operation and Development (OECD) and other international sources (see “How We Conducted This Study” for details). For every metric we examine, we used the latest data available. This means that results for certain countries may reflect the height of the COVID-19 pandemic, when mental health conditions were surging, essential health services were disrupted, and patients may not have received the same level of care
- Topic:
- Health, Health Care Policy, Inequality, and Finance
- Political Geography:
- North America and United States of America
3. U.S. and Global Approaches to Financing Long-Term Care: Understanding the Patchwork
- Author:
- Celli Horstman, Evan D. Gumas, and Gretchen Jacobson
- Publication Date:
- 02-2023
- Content Type:
- Policy Brief
- Institution:
- Commonwealth Fund
- Abstract:
- Most United States adults age 65 and older will need long-term care toward the end of their lives.1 Long-term care, provided in the home, community, or in institutional settings like a nursing home, includes medical care as well as personal, nonmedical care for people who are unable to perform activities of daily living, like cooking or bathing. Some services also may support social needs for those unable to perform what are known as instrumental activities of daily living, such as shopping or medication management. In 2018, more than 5 million people in the United States used home health care, including adult day care or home health agency services, and nearly 4 million people resided in nursing homes or residential care communities.2 Despite the widespread need for long-term care, the U.S. has no national program to cover the costs of long-term care. While certain states have implemented their own programs, the resulting patchwork of funding has left many Americans with no sustainable way to pay for the services they require. Other developed countries have comprehensive, national long-term care financing systems featuring broad eligibility and high levels of financial support. In this brief, we analyze data from multiple sources on long-term care costs in the U.S., as well as spending data from the Organisation for Economic Co-operation and Development (OECD), to better understand long-term care financing strategies in 12 high-income countries. In addition to these data, we synthesized initiatives to long-term care funding in these 12 countries. (For details, see “How We Conducted This Study.”) Since the U.S. does not have a national funding strategy, we also focused on individual state approaches. International and U.S. state approaches may provide insights to policymakers seeking to advance comprehensive long-term care funding.
- Topic:
- Health, Health Care Policy, Inequality, and Social Services
- Political Geography:
- Global Focus
4. Gender equality in Europe: a still imperfect model in the world
- Author:
- Stefanie Buzmaniuk
- Publication Date:
- 03-2023
- Content Type:
- Policy Brief
- Institution:
- Robert Schuman Foundation (RSF)
- Abstract:
- In a world where women's rights are once again being challenged from all quarters, Europe remains the place where women live best. Within the Union, however, there have been some setbacks, difficulties persist, and progress is still required in the political, economic and social fields to achieve true gender equality.
- Topic:
- Human Rights, European Union, Women, Inequality, and Gender
- Political Geography:
- Europe
5. Analysis on the Determinants of Labor Share and Its Policy Implications
- Author:
- Yaein Baek, Minsoo Han, Wongi Kim, and Hyunsuk Kim
- Publication Date:
- 02-2023
- Content Type:
- Policy Brief
- Institution:
- Korea Institute for International Economic Policy (KIEP)
- Abstract:
- There has been a significant decline in the global labor share, leading to numerous studies about the cause of this drop. The labor share is used as one of the main indicators of inequality because a decrease in the labor share can lead to aggravation of income inequality. This is because low-skilled workers can be greatly affected by such a decline in the labor share and the main source of in-come for the low-income class, including the self-employed, is labor income. Among various indicators of inequality, this study analyzes the determinants of the change in labor share. Technological changes such as adoption of robots, advancements in information and communications technology (ICT) and the Fourth Industrial Revolution (4IR) are expected to change the labor market. Hence, this study analyzes the impact of technological changes on labor share and suggests policy responses.
- Topic:
- Economics, Science and Technology, Labor Issues, and Inequality
- Political Geography:
- Global Focus
6. Global Inequality in Well‐Being Has Decreased across Many Dimensions: Introducing the Inequality of Human Progress Index
- Author:
- Chelsea Follett and Vincent Geloso
- Publication Date:
- 06-2023
- Content Type:
- Policy Brief
- Institution:
- The Cato Institute
- Abstract:
- The world has seen dramatic, global human progress across a broad range of indicators in recent decades, but have those gains been widely shared? The Inequality of Human Progress Index (IHPI) measures relative gaps in global development. It surveys international inequality across a greater number of dimensions than any prior index. By analyzing inequality in a multidimensional way, the IHPI takes inequality more seriously than those indexes that focus on income inequality alone. The IHPI considers material well‐being and seven additional metrics: lifespan, infant mortality, adequate nutrition, environmental safety, access to opportunity (as measured by education), access to information (as measured by internet access), and political freedom. Across all but two of those dimensions, the world has become more equal since 1990. Globalization and market liberalization over the past few decades have not only raised absolute living standards but also reduced overall inequality.
- Topic:
- Development, Inequality, Economy, and Well-Being
- Political Geography:
- Global Focus
7. A New Horizon in U.S. Trade Policy: Key Developments and Questions for the Biden Administration
- Author:
- Trevor Sutton and Mike Williams
- Publication Date:
- 03-2023
- Content Type:
- Policy Brief
- Institution:
- Center for American Progress - CAP
- Abstract:
- This issue brief examines some of the key trade initiatives pursued by the Biden administration to date. It then sets out key questions facing U.S. trade policy in a global environment defined by volatility and renewed ambition to tackle the great challenges of the 21st century, such as climate change, inequality, and great power competition.
- Topic:
- Foreign Policy, Climate Change, Treaties and Agreements, European Union, Inequality, Economy, Trade Policy, and Strategic Competition
- Political Geography:
- Europe, North America, Asia-Pacific, United States of America, and Americas
8. The Impact of Digital Policy Tools on Local Democracy
- Author:
- Itır Akdoğan
- Publication Date:
- 12-2023
- Content Type:
- Policy Brief
- Institution:
- Turkish Economic and Social Studies Foundation (TESEV)
- Abstract:
- This brief analyses how the digital policy tool My Purple Map, developed by TESEV in cooperation with UN Women Turkey and Eskişehir Metropolitan Municipality, has impacted a local government and puts forward a number of recommendations as to how this impact can be further broadened for a stronger local democracy.
- Topic:
- United Nations, Democracy, Inequality, Digital Policy, and Gender
- Political Geography:
- Turkey and Middle East
9. Achieving Inclusive and Innovative Growth with Competition Policies
- Author:
- Minsoo Han and Subin Kim
- Publication Date:
- 01-2022
- Content Type:
- Policy Brief
- Institution:
- Korea Institute for International Economic Policy (KIEP)
- Abstract:
- In recent years, inequality has grown worse worldwide. Recent studies have pointed out weakening market competition and deepening industrial concentration as one of factors for this phenomenon. Therefore, the role of competition policies in promoting market competition should also be considered as a countermeasure against deepening inequality beyond the traditional view about competition policies. Against this backdrop, we empirically analyze cases of the US, the EU and Korea, and then propose a competition policy direction to achieve inclusive and innovative growth pursued by the Korean government.
- Topic:
- Inequality, Economic Growth, Innovation, Inclusion, and Economic Competition
- Political Geography:
- South Korea, United States of America, and European Union
10. The Effects of Increased Trade with China and Vietnam on Workers’ Earnings and Job Security in Korea
- Author:
- Kyong Hyun Koo
- Publication Date:
- 04-2022
- Content Type:
- Policy Brief
- Institution:
- Korea Institute for International Economic Policy (KIEP)
- Abstract:
- This study empirically demonstrates that changes in trade structure caused by the rise of China and Vietnam over the last 20 years have had a significant impact on the widening of the income and employment stability gap for Korean workers. An important policy goal for Korea, which is heavily reliant on trade, is to ensure that the benefits of trade and openness are distributed evenly to all classes of society while minimizing the harm. In order to achieve the policy goal, the analysis results of this paper show that it is necessary to institutionalize a systematic process for monitoring changes in Korea's trade structure and preparing response policies from a mid- to long-term as well as a short-term perspective. Furthermore, the results indicate that policy efforts are required to identify blind spots where existing trade adjustment assistance policies, employment insurance systems, and vocational training policies do not adequately protect or support workers, and supplement and improve them. More follow-up research is needed to gain a better understanding of the mechanism by which external trade shocks are transmitted to the domestic labor market in order to develop more effective domestic supplementary measures for trade shocks.
- Topic:
- Labor Issues, Employment, Inequality, Economy, Trade, and Wage Income
- Political Geography:
- China, Asia, South Korea, Vietnam, and Southeast Asia
11. Inequality Kills: The unparalleled action needed to combat unprecedented inequality in the wake of COVID-19
- Author:
- Oxfam Publishing
- Publication Date:
- 01-2022
- Content Type:
- Policy Brief
- Institution:
- Oxfam Publishing
- Abstract:
- The wealth of the world’s 10 richest men has doubled since the pandemic began. The incomes of 99% of humanity are worse off because of COVID-19. Widening economic, gender, and racial inequalities—as well as the inequality that exists between countries—are tearing our world apart. This is not by chance, but choice: “economic violence” is perpetrated when structural policy choices are made for the richest and most powerful people. This causes direct harm to us all, and to the poorest people, women and girls, and racialized groups most. Inequality contributes to the death of at least one person every four seconds. But we can radically redesign our economies to be centered on equality. We can claw back extreme wealth through progressive taxation; invest in powerful, proven inequality-busting public measures; and boldly shift power in the economy and society. If we are courageous, and listen to the movements demanding change, we can create an economy in which nobody lives in poverty, nor with unimaginable billionaire wealth—in which inequality no longer kills.
- Topic:
- Health, Inequality, Pandemic, and COVID-19
- Political Geography:
- Global Focus
12. Monetary Policy and Racial Inequality
- Author:
- Alina Bartscher, Moritz Kuhn, Moritz Schularick, and Paul Wachtel
- Publication Date:
- 01-2022
- Content Type:
- Policy Brief
- Institution:
- The Cato Institute
- Abstract:
- The racial tensions that spread across the United States in 2020 have caught the attention of monetary policymakers and focused concern on the size and persistence of the gap between both the income and wealth of black and white households. There is widespread recognition that despite some decline in overt labor market discrimination, gains in educational opportunities, and income growth of black households since the onset of the civil rights movement, the gaps persist and have even grown larger by some measures. According to the 2019 Survey of Consumer Finances (SCF), the median wealth of a white household was $184,390, compared with only $20,730 for the median black household. The typical black household owns only about 11 percent of the wealth of the typical white household. The income gap is smaller but still large; the median income of black households ($38,688) is 58 percent of the median income of white households ($67,196).
- Topic:
- Race, Monetary Policy, Inequality, and Economic Policy
- Political Geography:
- North America and United States of America
13. Why Turkey’s Gender Inequality Matters
- Author:
- Dimitris Tsarouhas
- Publication Date:
- 06-2022
- Content Type:
- Policy Brief
- Institution:
- Hellenic Foundation for European and Foreign Policy (ELIAMEP)
- Abstract:
- Women’s underrepresentation in Turkey’s public life is a persistent and long-lasting phenomenon, despite the socio-economic progress achieved over the last two decades. Some indicators suggest that the problem has been getting worse in recent years, and Turkey’s withdrawal from the Istanbul Convention in 2021 has compounded fears of a further deterioration. Discrimination against women is not only normatively wrong, it is also practically self-defeating, since it deprives the country of resources, talent and expertise it needs to raise prosperity levels. However, women’s organizations in Turkey are numerous, visible and persistent in their demands for genuine equality and an end to discrimination. To address key aspects of the problem, such as record low female employment rates, Turkey needs to return to high-level, sustainable growth and promote female entrepreneurship.
- Topic:
- Women, Inequality, Discrimination, Representation, and Gender
- Political Geography:
- Turkey and Middle East
14. Inequality and the Decline of Small Business
- Author:
- Sebastian Doerr, Thomas Drechsel, and Donggyu Lee
- Publication Date:
- 09-2022
- Content Type:
- Policy Brief
- Institution:
- Economics for Inclusive Prosperity (EfIP)
- Abstract:
- The share of income that goes to top earners has reached levels not seen in over half a century, and addressing inequality has become a central issue for policymakers. Designing policies to alleviate income disparities requires a thorough understanding of how inequality affects the economy. Somewhat surprisingly, while several studies investigate the consequences of rising income inequality for households (Auclert and Rognlie 2017, 2020; Mian et al. 2020), much less is known about how inequality affects firms. In a recent study (Doerr et al. 2022), we examine the important link between income inequality and firms’ job creation. Our analysis of US data reveals that a larger top income share hurts small firms, while benefiting larger firms. The reason is that households’ savings portfolios change with their income level. Higher income inequality leads to more household savings flowing into stocks and bonds – which are mostly used for financing by larger firms – rather than into bank deposits. In turn, as small businesses depend on banks for financing, their funding becomes more costly and they create fewer jobs. Complementing our analysis with a theoretical model, we show that by altering the allocation of household savings, rising income inequality not only hurts small firms, but suppresses overall employment. Income inequality has thereby contributed to two important macroeconomic trends: the decline in small business and the fall in the labor share, i.e., the share of total income that accrues to workers (Decker et al. 2016; Autor et al. 2020).
- Topic:
- Economics, Inequality, Business, and Business Management
- Political Geography:
- North America and United States of America
15. Decentralization and Geographical Inequality in Egypt
- Author:
- Mohamed Abdel Hadi Shantir
- Publication Date:
- 04-2022
- Content Type:
- Policy Brief
- Institution:
- Arab Reform Initiative (ARI)
- Abstract:
- Egypt’s social policies suffer from serious challenges, especially at the spatial level. This is often referred to as the “geographical inequality” gap between the most privileged and less fortunate governorates, or the ones with limited resources. This is in addition to the disparity between different localities within the same governorate. These disparities are due to a highly centralized system of policy-making, resource management, and service distribution – which has been in place since 2014. The issues also include rising corruption rates, which often compromise any potential reforms. According to the 2020 Corruption Perceptions Index issued by Transparency International, Egypt fell by 11 places and ranked 117 among 180 countries, with a score of 33 out of 100 points.[i] Decentralization is considered a requirement that addresses geographical or spatial imbalances in the country, provided that the necessary standards for effective implementation are met. It is an important policy tool for achieving development and promoting democracy. It also helps citizens recognize whether the State is acting in their favor or in favor of monopolizing power and wealth. The effective and integrated implementation of decentralization contributes to increasing the efficiency of local utilities and public services, involving citizens in the management of their local affairs, training the administrative personnel required to implement the vision of local development and to ensure the optimal use of resources, while improving performance in local action. This directly leads to strengthening the quality of life and livelihoods at the local level, promoting a sense of national belonging, and increasing the level of trust between citizens and government.
- Topic:
- Inequality, Decentralization, Geography, and Equality
- Political Geography:
- Africa and Egypt
16. Increasing Vulnerability of Female Labor Force and Deepening Gender Inequalities During The Covid-19 Outbreak
- Author:
- Deniz Beyazbulut
- Publication Date:
- 08-2022
- Content Type:
- Policy Brief
- Institution:
- Turkish Economic and Social Studies Foundation (TESEV)
- Abstract:
- This study aims to examine women’s unemployment and its course during the pandemic period by making use of Turkish Statistical Institute’s (TÜİK’s) Household Labor Force Survey data (HIA), reports prepared by the Research Center of the Confederation of Progressive Trade Unions of Turkey (DİSK-AR) on Unemployment and Employment Outlook, and International Labour Organization’s (ILO) World Employment and Social Outlook: Trends 2021. In the study, gender inequalities, which have intensified with the increase in women’s domestic work and care burdens with the pandemic, will also be discussed.
- Topic:
- Women, Employment, Inequality, COVID-19, and Gender
- Political Geography:
- Turkey and Middle East
17. Rising concern, falling performance: Health-sector challenges evident before and after onset of COVID-19 pandemic
- Author:
- Carolyn Logan and Tosin Salau
- Publication Date:
- 07-2022
- Content Type:
- Policy Brief
- Institution:
- Afrobarometer
- Abstract:
- As Africa and the world begin to regroup now that the worst ravages of the COVID-19 pandemic appear to be past, it is an opportune time to take stock of the state of health care systems on the continent. The pandemic is not over – South Africa is just coming out of its fifth wave of infection (Al Jazeera, 2022), and there may be more to come (Landman, Irfan, & Resnick, 2022). In the meantime, the Africa Centres for Disease Control and Prevention (2022) and national governments continue to scale up their vaccination campaigns. But the war in Ukraine and global economic deterioration have finally supplanted COVID-19 at the top of the news cycle. In the early stages of the pandemic, many assessments warned of the possibly extreme vulnerability of Africans to the pandemic based in part on the many challenges already facing health care systems across much of the continent (Mattes, Logan, Gyimah-Boadi, & Ellison, 2020). While the direst predictions did not come to pass in most countries – South Africa being a notable exception – the pandemic has highlighted gaps in health systems amid the recognition that the next global health crisis could hit harder if improvements and preparations are not made. Taking a longer-term view, the United Nations Sustainable Development Goals (SDGs) also highlight the need to strengthen health systems (United Nations, 2018). SDG#3 focuses on good health and well-being. But Afrobarometer’s SDG Scorecards, based on our most recent data from 34 countries surveyed in Round 8 (2019/2021), show that from the perspective of citizens, only a handful of countries have been making significant progress toward achieving this SDG (Afrobarometer, 2021). Instead, a growing number of Africans report going without medical care, and the share who cite health as one of their country’s most important problems is also on the rise. Even among those who do get care, increasing proportions report finding it difficult, and having to pay bribes, to obtain the medical services they need. Not surprisingly, citizens are also increasingly critical of their governments’ performance in this sector: For the first time in two decades of Afrobarometer polling, a majority of respondents say their governments are performing badly on improving basic health services. Moreover, the evidence suggests that the challenges wrought by the pandemic were not the cause of these increasingly negative reviews: The downward trends were already under way before COVID-19 entered the picture, and in fact, in some cases the trends appear to be somewhat less negative since the onset of the pandemic.
- Topic:
- Health, Inequality, Pandemic, and COVID-19
- Political Geography:
- Africa
18. Profile and determinants of lived poverty in Benin
- Author:
- Romaric Samson and Richard Houessou
- Publication Date:
- 10-2022
- Content Type:
- Policy Brief
- Institution:
- Afrobarometer
- Abstract:
- The 2030 Agenda for Sustainable Development, launched in 2015, outlines global aspirations and priorities through the end of this decade. Prominently, the first two Sustainable Development Goals (SDGs) call for ending poverty “in all its forms everywhere” and for “zero hunger” (United Nations, 2021a). The proportion of the world’s population living in extreme poverty decreased from 36% in 1990 to 16% in 2010 and to 10% in 2015, but the COVID-19 pandemic is likely to have reversed this trend (Sumner, Hoy, & Ortiz-Juarez, 2020). Benin has had one of the fastest-growing economies in sub-Saharan Africa in recent years (Adegoke, 2019), with per-capita gross domestic product (GDP) growth averaging 3.6% between 2017 and 2019 (World Bank, 2020). But the most recent household survey led by the Institut National de la Statistique et de l’Analyse Economique (2018) estimated that 38.5% of citizens still live in poverty. Are GDP gains translating into better lives for ordinary Beninese? According to Afrobarometer survey findings, “lived poverty” – the experience of going without basic life necessities – has worsened significantly over the past decade in Benin. More than three out of four Beninese face moderate or high levels of lived poverty. Many of these citizens continue to have limited access to the electricity grid, water and sanitation services, and other essential development infrastructure. Most importantly, our analysis shows they often lack the education and employment needed to break the poverty cycle.
- Topic:
- Education, Poverty, Infrastructure, Inequality, and Job Creation
- Political Geography:
- Africa and Benin
19. The Impact of Immovable Property Tax on the Macro Economy
- Author:
- Young Sik Jeong, Eunjung Kang, Jinhee Lee, Kyunghun Kim, and Jeehye Kim
- Publication Date:
- 01-2022
- Content Type:
- Policy Brief
- Institution:
- Korea Institute for International Economic Policy (KIEP)
- Abstract:
- Since the 2008 global financial crisis, inequality has been increasing worldwide. In particular, wealth (asset) inequality is getting worse than income inequality. And Korea is no exception. This deepening of inequality is more worrisome in that it leads to inequality of opportunity while suppressing movement between classes, which in turn deepens inequality, creating a vicious cycle of inequality. This is a bigger problem than the inequality itself. The international communities are calling for stronger property taxes, including recurrent taxes on immovable property, as part of mitigating inequality and promoting inclusive growth. In Korea, there is heated discussion on property taxes, such as recurrent taxes on immovable property including the comprehensive real estate tax. Therefore, this study aims to investigate policy directions in international organizations and major countries on immovable property tax and examine the effect of property tax on the macro economy. This study examine international comparisons of immovable property tax burdens using OECD data. Next, this study analyzes the effect of immovable property tax on housing prices, inequality, and economic growth. Finally, we suggest policy implications to Korea through this. Based on our results, we present policy implications for Korea.
- Topic:
- Inequality, Tax Systems, Macroeconomics, and Wealth
- Political Geography:
- Asia and South Korea
20. Our climate future depends on conflict dynamics in Congo
- Author:
- Peer Schouten, Judith Verweijen, and Fergus Simpson
- Publication Date:
- 11-2022
- Content Type:
- Policy Brief
- Institution:
- Danish Institute for International Studies (DIIS)
- Abstract:
- The Congo Basin rainforest – the second largest on earth – absorbs four percent of global CO2 emissions and constitutes a crucial line of defense against cataclysmic climate change. However, a complex mix of illegal resource exploitation and conflict is currently threatening the rainforest. To curb these threats and their global consequenses, we need to understand the interplay between resources, conflict and environmental protection in Congo.
- Topic:
- Agriculture, Climate Change, Development, Environment, Poverty, Food, Non State Actors, Armed Forces, Inequality, Fragile States, Violence, Police, and Justice
- Political Geography:
- Africa and Democratic Republic of the Congo
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