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Welcome, friends, to another edition of Economic Update, a weekly program devoted to the economic dimensions of our lives and those of our children. I'm your host, Richard Wolff. Before we begin today, I want to remind those of you who are interested that recordings of my latest online course, Marxian Class Analysis with Professor Shahram Azer of Bucknell University, are available for a small donation on our website. This lecture series is designed to help participants learn about our economic system, about our class structure, about the need and the reasons for changing it, and so on. It's to gain a better understanding that will enable every one of you to share that with your friends, coworkers, neighbors, family. That's why we do it. And you can be a partner and extend our reach. We're also having a live question and answer session toward the end of May where you can ask all kinds of questions about Marxian class analysis and other issues too, and get the direct live answer from us. It's part of our way of partnering, as I say with you, to extend the reach of the understandings we're all working to improve. And please remember to like to subscribe and share this video with others. For those of you who have not yet signed up for our Members Only Patreon, by doing so, you can gain access to Members Only content while also supporting our work. You just go to patreon.com democracy@work or you can find the link in the description below. Okay. In today's program, we're going to be dealing with strikes, the history of wealth creation in the United States, electricity costs, and in the second half, a remarkable interview with a guest who's appeared on our program before, Professor Steven Bezruchka of the University of Washington in Seattle talking about his most recent book on illness, Sickness and its Unique Place in American society. I think it'll be an extraordinarily important interview for you to share. Okay, I want to begin with a strike situation that has been developing over recent months and that was supposed to reach its peak on Tuesday 14 April. It was a strike by 85% of the workers in the Los Angeles unified school district. Three unions representing a total of 83,300 workers, teachers, support staff and administrators had set the 14th as a deadline, a tentative agreement having been reached just before that deadline. It is possible by the time you get my report, that the tentative agreement may have become a final agreement. But at the moment I am doing this. That is not yet sure or clear. I'm bringing it up not only because I like to be aware of Large strikes, and this is a huge one, 83,000 plus workers. But because this one is unique, first it's public employees and they've had a particularly hard time recently. And it's important that militancy among them is rising, that public employee unions are showing the backbone and the muscle and the determination to fight back. The second thing that's unique about this situation is that three different unions with different constituents, different contracts expiring at different dates, all got together, overcame the kinds of differences that often prevent unions from working together here. They worked very well together. And the fact that they were not each on their own fighting with the boards of education that were relevant, but that they were fighting as a unified group, threatening a strike at a unified time and date made them all the stronger. And there's a lesson there for all unions everywhere. And the third thing was that they cultivated and got widespread union and non union support. Of particular interest was a rally they held in Grand park on the 16th, or maybe it was the 18th of March of this year. 30,000 people came out for that rally. Well organized, well conducted. This is a good sign for, for unions everywhere that this happened, that this is possible, and that it was successful. My next economic update responds to your questions. A number of you wrote to me saying that electric costs in your area seem to you to be out of control. That was a phrase that was used. So I'm here to do the kind of research, in case you haven't noticed, that you want done and it isn't done for you anywhere near as much as it ought to be. Between 2021 and 2025, the inflation, the general inflation in this country United States, was 21. But the average cost of electricity went up 29%. Now, let me be clear. Electricity grew, the price of it 50% more than average prices of other goods and services we all need. The electric companies are doing very well. Where in America do people have to pay the highest? Well, to explain this, I need to remind you that electricity is considered a kind of monopoly. You typically have in a certain area, one company that generates your electricity, or at least it transmits it. So it's a kind of monopoly. And so over the years, when these companies gouged us as consumers, took advantage of the monopoly to jack up the price way beyond inflation, like they're doing now, There was a reaction in the 19th and early 20th century. Every one of the 50 states therefore has a commission, usually called a utility commission or a public utility commission. And one of the authorities those commissions have is to set Electric rates like they can set the rates for other monopolizable public utilities. So when you're upset about a price of electricity, be it is not just the company that's jacking up the price, but it's the commission, public officials that are permitting that, that are giving these private companies the rates that are hurting us. Well, one of the two worst states in the union in the sense that they've allowed the highest electric rates in the country because each state has their own, because they have their own commission. You might be interested to know that the two worst states out of 50 are Texas and Alabama. That's right. Deep red states where the politicians make a big deal about being helpful to the working man and woman. Yeah, but when you're not looking, they are giving their utility companies in the electricity field the biggest boondoggle of all states. Average home in America uses the following amount of money per year to pay their electric bill. $1,896. That's a lot of money. And the lower you go in the income, the more burdensome it is to pay just shy of $2,000 a year for your electricity. And with artificial intelligence using up electricity, with the war in Iran making the cost of generating electricity out of burning gas or, or oil higher, with more electric rate increases coming, we should be careful, really careful, that we understand that in a capitalist economic system, the private companies, even when you regulate them with a commission of politicians, it's easy to for the regulated electric companies to capture the commissions and get the rates that produce what I just told you. Finally, you've asked me about wealth creation. A number of you citing Elon Musk or Bill Gates or Jeffrey Bezos or any of those folks wanting to know how wealth has changed in the United States in recent years. All right, so I did the research and here are the results. I'm looking at 30 years, or to be actually correct, 35 years. This is the period from 1990 to 2025, the last full year. So that's a total of 35 years. To give you a sense of how wealth has shifted, I'm going to begin with the good news and then the bad news. Here's the good news, if you want to call it that. The share of the net wealth. By net wealth, we mean the value of the land, stocks, bonds that you own, minus any debts you have. So what's your net worth? Okay, the richest 1% of Americans, the richest 1% saw their wealth, their net wealth over those 35 years go from 23% of the total net wealth of America to 30%, a staggering increase. If you're in the 1% over the last 35 years here in America, in the United States, your wealth has soared. That's why you hear about Elon Musk and Jeffrey Beatles over and over again, because they're the poster child. The bottom half of the United States. You know how much wealth the bottom half of our people, 50% of our people. Together they went from 3.5% of the wealth 50% owned, 3.5 in 1990. Last year that was down to 2.5. You know what that means? The rich got richer and the poor got poorer. And then in the middle, the lower middle, that's the people from 50% to 90%, their wealth dropped from 36 to 29. And the top 10%, their wealth dropped from 38 to 36. It's only the 1% who gained a share of the wealth, and they gained a lot of it. This was an unequal Society in 1990, and across the last 35 years, it became radically more unequal. And I want to give credit where credit is. The Democrats, the Republicans, the Trumpers, and not all contributed to that pathetic story. We've come to the end of the first half of today's show. Please stay with us. We will be interviewing Steven Bezruchka when we come back. Before we jump into the second half of today's show, I wanted to thank you for your very generous response to our fundraising efforts this year and in particular in the last couple of months. And in part responding to that, we are extending the availability of our limited edition, linen covered hardcover version of Understanding Capitalism, the book I wrote and that we have been making available now for quite a while. If you are interested, I will be signing copies of that hardcover and they will be available to you as they have been over the last few weeks. Just simply send an email to us@infodemocracyatwork.info and put in the subject line limited edition. We will send you all the information you need to order and receive your copy, signed copy of Understanding Capitalism in its hardback. And thank you again for your kind attention to the fundraising dimension of what we do. Welcome back, friends, to the second half of today's economic update. I am very happy to bring back to our microphones and cameras someone who's been a guest on the show before. He is Stephen Bezruchka. He teaches courses in population health in the School of Public Health at the University of Washington in Seattle. He worked as an emergency physician for 30 years. This is of particular interest to the growing number of my audience that are glued to watching a television program called the Pit that you may know of as well that is bringing attention to emergency room medicine. He also set up a teaching hospital in a remote district in Nepal where he supervised the training of of Nepali doctors. He also has a new book out, which I admit is part of why I wanted to have him on the show again, called Born Sick in the Improving the Health of a Nation. So, first of all, if I may call you, Stephen, thank you very much for your time for joining us to talk about your book. So let me, let me begin. Would you say that sickness is an individual problem or a social problem? When you look at the United States,
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whether you look at the United States or other countries, it's always a social or political problem. Rudolf Virchow, the father of modern cellular pathology, said in 1848, only all diseases have two causes, one biological and the other political. So trying to understand that politics is the most important factor in producing health in a society is quite challenging, especially for Americans.
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All right, let me draw you out. Tell me why that's true. Why is it especially for Americans? Are we A, a sick people and B, is our politics playing a role in creating that situation?
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So as an emergency physician, the easiest diagnosis I could make in the ER was that somebody's dead. Hard to fake. So I filled out a death certificate that was then linked with the birth certificate and we could calculate mortality rates, who died at what age, add them up all together and you get a number called life expectancy. And that's sort of the average length of life if mortality rates stayed the same from year to year. So I like to use this as a measure of health for a country. Basically, you can't be healthy if you're dead. So it's a measure of, of how long people live. So if we look at life expectancy, we have to ask, what's a normal life expectancy? Because if you go to the doctor, they'll take your blood pressure and decide whether it's normal or not for a country. You can take the life expectancy measure and ask, is this normal? Well, normal should be what the best achieve, the best countries achieve. And we're about 7 life expectancy years behind the longest lived country, which has been Japan since 1978. Well, if we. So how important is that seven year difference? You might think of it as a few more years drooling in a nursing home. But in fact, our leading disease killers are number one, heart disease, number two, cancer, and number three, unintentional injuries. Those three will kill roughly half of our population, about 3 million deaths a year. And if we eradicated our three leading killers as a cause of death, we would be right up there with Japan. And in terms of length of life. So taking my measure for length of life, some 50 countries have higher life expectancy than we do now. Then why? The question you asked. Well, medical care. We spend about half of the world's medical care bill in the United states. It's about $7 trillion. It's a sixth our total economy. And we are less healthy than 50 other countries. So just by simple logic, medical care cannot have a big effect. So what else matters? Well, studies show medical care can avert about 10% of mortality in the United States. So that leaves 90% attributed to other factors. But, you know, Americans, when you poll Americans on what's most important for health, they put medical care first, and guess what? They put politics last. So we have to dissect what's going on here. Medical care isn't that important. I have to say that, you know, I worked clinically as a doctor and I taught doctors, and I have to reflect and say, gee, you know, what I did and taught wasn't really that important. So what really matters? Studies show that the amount of inequality in a society is very strongly associated with its health, say, measured by life expectancy. And you were talking earlier about the vast increase in economic inequality in this country. And we are certainly among the rich countries, the most unequal country among them, and we have the worst health among them. And the two are actually linked causally. So mostly we say, well, an association between inequality and health does not imply causation. But if you ask, how do you decide that something causes something else? The relationship I've just mentioned between inequality and health can be proven to be causal. And I use the criteria that the Surgeon General's report in 1968, 1964, linking smoking and bad health. They laid out the criteria for saying smoking caused worst health. And that's what I use to make this link. I make the link, and there are many other researchers that verify that. So inequality kills. How does it do that? Well, inequality produces a lot of stress in society, and we in the United States are one of the most stressed countries in the world. So how do we cope with this stress? Well, not in very healthy ways. I mentioned unintentional injuries being our third leading cause of death. And so we kill ourselves with opioid overdoses. You know, the fentanyl issues that are big time in this country in many other ways. And so that's one way consuming opioids. Another way is, well, there are a lot of dysfunctional ways of trying to cope, some perhaps better than others. Walking the dog gets you out on the street and maybe talking to other people. But so highly stressed society caused by the inequality that we willingly choose. In other words, and this is a tough thing to recognize, we have a so called democracy and so we choose policies. And what you were describing in the previous part of today's session was the inequality. And we seem to have chosen through our political process to have less so the rich can have more. So that makes us responsible for the poor health that we're having. So suppose we decreased inequality, what would we do with the proceeds? Well, besides inequality being so important, the other factor is attention to early life. As we go from the erection to the resurrection. Roughly half of our health as an adult has been programmed between conception and your second birthday. That's called the first thousand days. And studies, many studies show that that period is critical for how healthy you become as an adult. So who's responsible for that period, that first thousand days? Well, we think family values should make the parents responsible for creating healthy conditions for that period. But in fact, A poor family, a family struggling to make ends meet to pay the electricity bill that you described, they're just trying to survive. And if you want them to stay home and raise the child to be healthy, they can't do that. There's only two countries in the world that don't give a working woman who's pregnant paid time off after she has her baby. One is of course the United States. We say we can't afford that. The other country is Papua New guinea, half of a big island north of Australia. So we don't have a national policy of providing time with pay for a woman to, for a mother to spend time with her child. And so our young people, our infants and toddlers are raised in very dysfunctional situations. Take a healthier country, Sweden, you know, there it is mandatory to take 480 days of paid leave, parental leave. The father's got to take some too. And that's at your full pay. So then when your child is put in a, when your child is two or three, you can put them in a daycare center. And in Sweden it costs $160 a month for Swedish daycare that's run by the government. We have nothing like that. So we have chosen because we've decided that it's too expensive for the United States to have to support early life. And so we are, in a sense, making the political choices so we have poor health and die young. I don't think if most Americans really realized that the political choices they make lead to an early death and before dying, much more disease than we should be having, considering we're the richest and most powerful country in world history, although that is fast declining.
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Yeah, it is a lesson that has come from many of my guests over the years. This disconnect that you just mentioned, the lack of an understanding that who you vote for or even if you don't want to focus on elections, who you support, who you favor, has these enormous impacts on your life that you have given up on, so that you think it's somehow fate or something like that that is governing you. Is there anything before we go? Because we have very little time that you would urge on your audience given what you found.
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Well, first of all, decide for yourself whether what I say is true. I always tell students in my class, don't believe a word I said. If it's really important to you, figure out whether it's true or not, and then act upon it. So what does action mean? Well, we have to first of all recognize that our lives are sick and short. And then we have to recognize the importance of inequality and attention to early life. And then we have to make that well known and get people to make an informed choice. So, you know, I teach this in my courses. I suggest, you know, a radical idea is to we're now teaching to the test all the time in grade school and and so on, put questions on the test about how healthy the United States is, and then we'd have to teach that. And I've found that grade five and six students can understand these ideas. So we could certainly put that onto the school curriculum. And once we create the awareness, then we can go on to choose policies that will make us healthier and live longer lives.
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Well, Stephen, I wish we had, of course, more time, but I strongly urge people to get a copy of Born Sick in the usa, where the ideas you've just heard are spelled out and worked out in much more detail. It's a very rich and provocative, in the best sense of the word, book. Thank you again, Stephen, for joining us. And to all my audience, I look forward to speaking with you again next week.
Economic Update with Richard D. Wolff
Episode: Born Sick in the USA: Improving The Health of a Nation
Date: April 21, 2026
In this episode, Richard D. Wolff examines interconnected economic and health issues in the United States. The first half covers recent labor actions, surging electricity costs, and the widening gap in wealth distribution. In the second half, Wolff interviews Dr. Stephen Bezruchka, a physician and public health academic at the University of Washington, about his latest book, Born Sick in the USA: Improving The Health of a Nation. Their conversation spotlights the social and political causes of poor health in American society, focusing on inequality and early childhood.
The episode maintains Richard Wolff’s accessible but incisive style, mixing teaching, critique, and advocacy. Dr. Bezruchka’s contributions blend medical expertise with a call for structural change, urging listeners to question assumptions and see health as a product of social policy.
For a deeper dive, listeners are encouraged to read Dr. Stephen Bezruchka’s book, “Born Sick in the USA: Improving the Health of a Nation.”