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ACKNOWLEDGMENTS
We are deeply indebted to our many colleagues who have worked with us over the years and provided unparalleled support and guidance, offering their critical eyes and vast repositories of wisdom to review this book as it came together. First of these, we are indebted to Martin McKee, our dear friend and close colleague who worked with us tirelessly in this research and continues to prove himself a paragon of integrity and virtue in public health. We also appreciate our many collaborators, without whose support the research that went into this book would not be as well-developed: Adam Coutts, Christopher Meissner, Marc Suhrcke, Price Fishback, David Taylor-Robinson, Benjamin Barr, Alexander Kentikelenis, Irene Papanicolas, Michael Marmot, Roberto De Vogli, Marina Karanikolos, Alexey Bessudnov, Johan Mackenbach, Lawrence King, Jose Martin-Moreno, Vicente Navarro, Michael Harhay, Jacob Bor, Karen Siegel, Chris McClure, Margalida Gili, Miquel Roca, David McDaid, David Gunnell, Shu-Sen Chang, Jan Semenza, Gauden Galea, Aaron Reeves, Patrick Hamm, and Ben Cave. Additionally we appreciate the time and energy of those who provided constructive comments, criticisms, and advice at various stages of the book’s development, including Vladimir Shkolnikov, Sigur Sigurgeirsdottir, Shah Ebrahim, Ron Labonte, John Thompson, Margaret Whitehead, and Bo Burgstrom. Inevitably, we are unable to thank by name all the peer-reviewers who have contributed anonymous feedback that helped strengthen our analysis. Peer-review is a thankless task, and for those who contributed, we are ever grateful.
A special thanks goes to Molly Crockett for her extraordinary assistance in editing and revising the manuscript. We are also grateful to Michelle Spring for introducing us to the world of trade publishing and helping us to craft the initial book proposal. We are particularly thankful to Shah Ebrahim and Fiona Taylor for giving us refuge in Delhi during the final stages of this writing.
David would additionally like to thank his parents, Danny and Margit, and his sister, Michelle, for their unwavering support. His research has benefited from the insights and direction of Mary Ridgway, Lowell Levin, Mark Schlesinger, Larry King, Paul Schultz, Christopher Meissner, and especially Martin McKee. Thanks to the continued support and friendship of Chris Lockamy, Elizabeth Rush, and Louis Caron.
Sanjay would also like to thank his parents for always encouraging him to “read, read, read, read everything” (as per Faulkner), and his mentors Christine Balone for teaching him to write, Lee Marek for the gift of science, Rudolph Tanzi for the experimental spirit, and Noam Chomsky for being the quintessence of the public intellectual. Special thanks to Paul Farmer for always humbly bestowing on him the lessons of social justice; Jim Yong Kim for teaching him how to pick the right battles; Joseph Dumit for insights on academia; and Anita Desai, Alan Lightman, and Jean Jackson for the gift of the pen. For their mentorship in medicine and epidemiology, thanks to Rick Altice, R. Douglas Bruce, Gerald Friedland, Edward Kaplan, Sharad Jain, Stanton Glantz, Robert Lustig and Jack Farquhar. Thanks to John Ioannidis for role-modeling the ideal of a critical scientist, and for everyone at the Stanford Prevention Research Center for their family spirit and passion in the pursuit of public health. Thanks to the continued support and friendship of Jason Andrews, C. Brandon Ogbunagafor, Jay Varellas, Russell Bither-Terry, Sandeep Kishore, Amy Kapczynski, Gregg Gonsalves, Duncan Smith-Rohrberg Mar
u and the Nyaya Health team. For their encouragement and constructive criticism in writing, thanks as well to Sandy Close, Viji Sundaram, Richard Rodriguez and the folks at New America Media. And thanks most of all to Palav Babaria, the love of my life, who forgave many sleepless nights, and who always provides a critical lifeline of grounded insight, encouragement and partnership.
This book would not have been possible without the dedication of an incredible editorial team. Thanks to Lara Heimert at Basic Books for her “fierce but loving” edits to strengthen our manuscript, to Norman MacAfee for his indelible camaraderie and eleventh-hour marathon editing sessions, and to Thomas Penn at Penguin for his intellectual spirit, vast historical knowledge, and keen eye for detail. We are very grateful for support from Katy O’Donnell and the team at Basic at every step of the book’s development; Karen Browning and the team at Penguin for their support to produce the book; and Iris Tupholme and the HarperCollins crew for their coordination and wisdom. Thanks finally to Patrick Walsh and his team at Conville and Walsh for being the most supportive agency a new pair of authors could hope for.
INDEX
Alcohol consumption, xvii, 18–19, 70–71, 130
Alcohol-related deaths, 13–14, 19, 25–27, 36
Aliber, Robert, 60
ALMP (Active Labor Market Program) protective effect, 114–121, 144
American Recovery and Reinvestment Act, 126, 142
Arrow, Kenneth, 101
Assumed fiscal multiplier errors, 64–65, 92
Austerity
defined, ix
the democratic option to, 66–67, 71, 74, 93, 142–143
failure of, 140
Great Recession experiment in, ix–x, 140
New New Deal program response, 143–145
personal impact, stories of, xvii–xviii, 3–4, 91, 94, 97–98, 110
Bahr, Daniel, 93
Bakersfield, 123–125, 126, 137, 145
Baltic states recession (1990s), 118–119
Belarus post-Soviet gradualist policy, 31, 32–33, 35, 36
Bevan, Aneurin, 108
Beveridge, William, 141
Body economic, xx–xxi, 139, 142–143
Body politic, defined, 139
Braly, Angela, 101
Brown, Gordon, 69
Bush, George W., 136
Byrne, Peter, 112
California, 97–98, 123–125
California Encephalitis Project (CEP), 124, 136–137, 145
Cameron, David, ix, 3, 5, 19, 106, 140
Campaniello, Giuseppe, 109–110
Canada, xiv, xix, 104
Cardiovascular disease, 25–26, 36, 68
Centers for Disease Control and Prevention, 124, 136, 144
Children, impact of austerity on, 50, 129
China, 40
Christoulas, Dimitris, xvii–xviii, 94
Clegg, Nick, 106
Corruption, 27–28, 33–34, 85
Czech Republic post-Soviet gradualist policy, 28, 33
Deming, W., 142
the democratic option, 66–67, 71, 74, 93, 142–143
Denmark, 119
Depression, 69, 112–114, 115, 127
Donovan, Neil, 128–129
Dublin, Louis, 7
East Asia economic growth (1980s), 42–44
East Asian crisis (1990s)
economic impacts of austerity, 43, 46, 48
health impacts of austerity, 46, 48–50
IMF austerity requirements, 45
roots of, 43
social impacts, 44, 142
welfare protection countries, impacts on, 46–47, 50–53
Eastern Europe recession 1990s, 118–119
Economic impacts
of foreclosure threat, 127–128
of gradual vs. rapid privatization, 22, 32–35, 37, 40
of Shock Therapy, 32, 35
of stimulus, xii–xiii, 46, 52, 140–142
Economic impacts of austerity
deficit reduction and recovery, xii–xiii, 5–6, 88, 93
globally, 140–141
homelessness, costs of, 126–127, 132–134
medical care for individuals, 3–4, 48, 98
poverty, 43, 46, 47
public health budget cuts, 78, 85–89, 91–92, 107
unemployment, 81, 87, 120
Estonia, 28
European Central Bank, 78, 80, 92
European Commission, 78
European financial crisis, 4–5, 58
Federal Emergency Relief Act, 15
Felixson, Helgi, 62, 73
Finland, 111, 115, 118–119, 121, 135
Fischer, Stanley, 29, 47
Food Stamp Program, 15
Ford Hunger March/Massacre, 14–15, 142
Foreclosure crisis. See also Great Recession (US, 2007–2009)
United Kingdom, 131–134
United States, 123–131, 136–137
Former Soviet Union (FSU) countries, 28–29, 31–35
France, 104, 105
Friedman, Milton, 30, 37, 67
Friedman, Samuel R., 89
Gaddafi, Muammar, 69, 88
Gaidar, Yegor, 29
Galbraith, James, 93
Germany, 84, 93–94, 104, 105
Gkezerva, Zoi, 91
God Bless Iceland (Felixson), 62, 73
Gorbachev, Mikhail, 25–26, 29, 31, 37
Gradual privatization policy effects, 28, 32–36, 40
Great Depression, 6–16
Great Recession (US, 2007–2009). See also New Deal
austerity response, xvii, 100, 142
banking sector rescue packages, 4–5
deferral of essential medical care, due to inability to pay, 97–101, 127
foreclosure crisis, 123–131, 136–137
health insurance company profits, 101–102
Medicaid enrollment growth, 100
mental health, 112–113
mortality rates, xix, 18–19, 99, 103
personal stories, x–xi, xvii
roots of, 6
suicide rates, xix, 12, 110–111, 112
Greece
corruption, pre-crisis, 81, 84
economic recovery, 75
economy, pre-crisis, 79–81
financial crisis roots of, 79–81
IMF recovery plan, 84–85
suicides, pre-crisis, xix
Greece, financial crisis austerity response
bailout funds, misuse of, 92
corruption and the, 85
democracy, suspension of, 78, 83, 87–88
economic impacts, 78, 81–82, 85–89, 91–92, 107
Germany’s insistence on, 94
health impacts, xiv, xvii–xviii, xix, 77–78, 83–91
homelessness and the, 78, 135
homicide rates, xiv, 78
IMF loan requirements, 78, 81–82
personal impact, stories of, xvii–xviii, 94
public protests, xvii–xviii, 78, 82–83, 91–92, 94
social impacts, xvii–xviii, 78, 82–83, 89, 91–92, 94
Grímsson, Ólafur Ragnar, 74
Gripiotis, Jannis, 89–90
Haarde, Geir Hilmar, 57, 58, 66, 69, 75
Happiness, 59, 69–70
Healthcare
cost benefit, 119
Germany, 104
human right to, non-US countries, 103–104
market-based system, 101–102, 103, 106
United States, 99–105
Health impacts
foreclosure crisis (US), 123–129, 136–137
of gradual privatization, 28, 35–36, 40
of homelessness, 126, 127, 129–130, 132–133, 134
of rapid privatization, 21, 23–29, 36, 39
of unemployment, 18–19, 87, 109–110, 111, 112–114, 115, 116–121
Health impacts of austerity
to children, 50
deferral of essential medical care, 48, 85, 90, 97–101, 127–128
disability benefits, 3–4, 91
emergency relief programs for, 89
illegal drug use, 86–87
infant mortality/mother malnutrition, 46, 51, 89–90
infectious disease rates, xiv, 48–50, 77–78, 86–91, 134
mental health, 86, 112–113
mortality rates, xix, 19, 51, 90
New New Deal program proposal, 143
personal impact, stories of, x–xi, xvii, 83–84, 91
quality of care, 102–104, 106–107
suicide rates, xiv, xvii–xviii, xix, 46, 86, 88, 109–111, 119–121
violence, xiv
Health improvements
Great Depression, 7–12
New Deal era stimulus, 15–18
recessions and, xiii–xiv, xviii–xx, 51, 68–71
social welfare spending and, 15–18, 50–51, 53
HIV, xiv, 48–51, 77–78, 86–91, 135
Homelessness
economic impacts, 130, 131
foreclosure crisis and, 126, 128–130, 132–134, 136
Greece’s austerity response and, 78, 135
health impacts, 126, 129–130, 134
mortality rates, 127, 129, 132–133
prevention programs (US), 130–131, 133
statistics, globally, 135
UK austerity response and, 126–127, 132–134
UK vs. US statistics, 132
Homelessness Prevention and Rapid Re-Housing Program, 130, 133
Home Owner’s Loan Corporation, 15
Homicide rates, xiv, 78
Hoover, Herbert, 4, 7, 14
Housing crisis. See also foreclosure crisis
UK/austerity response, 131–134
US/austerity response, 135–136
US/stimulus response, 128–131
Housing First, 130–131, 135
Huppert, Felicia, 69
Iceland
constitution, 74
economy, pre-crisis, 59–61
happiness in, 59, 69–70
social welfare spending, xiv, xix, 71–75
wealth gap, 62–63, 73
Iceland, financial crisis in
austerity plan
debate over, 54–65
the democratic option, 66–67, 71, 74, 93, 142
health impacts, planning for, 58, 63–66
protests against, 62, 63, 88
economic impacts, 61, 62, 65
economic recovery, 71–75
extent of, 57–58
health improvements, xiv, 68–71
roots of, 59–61, 73
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