Economic Update: Capitalism's (Uncounted) Health Costs

Summary

Economic Update with Richard D. Wolff Episode: Capitalism's (Uncounted) Health Costs Date: September 7, 2017

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Overview

In this episode, host Richard D. Wolff examines the deep, often hidden connections between capitalist economic systems and detrimental health outcomes, both physical and psychological. The episode opens with timely economic news and transitions into an extensive dialogue with Dr. Harriet Fraad, a New York-based mental health counselor, focusing on rising morbidity and mortality, the opioid crisis, and the mental health costs imposed by economic insecurity and inequality—costs that capitalism systematically ignores.

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Key Discussion Points & Insights

1. Women in the Labor Force and Cultural Shifts

[00:00–05:56]

• Wolff discusses the significant increase in women's participation in the labor force over the last 30 years, referencing the film "Wonder Woman" as a cultural reflection of this shift.
• Quote: “I am the man who can.” – Wonder Woman (as cited by Wolff, 02:37)
• Implications for family life, social relationships, and the economy are profound, highlighting both progress and the strains of adaptation.

2. Religious Critiques of Capitalism

[05:57–09:13]

• Wolff recounts statements by the Archbishop of Canterbury describing the British economic model as "broken," emphasizing the widening gap between the richest and poorest.
• Quote: "Britain stands at a watershed moment, he said, where we need to make fundamental choices about the sort of economy we need." (07:15)

3. Labor Day, the Decline of Unions, and the Importance of Alliances

[09:14–18:56]

• Wolff traces the historic strength of the American labor movement, especially its alliance with socialist and communist parties in the 1930s, which secured lasting social advances (e.g., Social Security, unemployment insurance).
• Current unionization is at its lowest in decades: only 6.5% of private sector workers are union members.
• Wolff stresses that the decline of left-labor alliances after WWII allowed business and conservative interests to dominate:
  • Quote: "Business has gotten richer...in direct proportion that the organized labor movement has gotten weaker." (12:15)
  • Lesson: Labor must rebuild alliances with progressive movements to regain power.

4. Economic Dimensions of Natural Disasters

[18:57–26:03]

• In discussing Hurricane Harvey in Houston, Wolff attributes the exacerbation of such disasters to policy decisions driven by capitalist incentives:
  • Lack of infrastructure (e.g., protective dikes, evacuation routes) is rooted in profit priorities—developers don't want regulations/expenses that cut into profit.
  • Quote: "This is a crisis whose losses are of our own making. The problem of Harvey in Houston was the problem of a system that puts profits first." (24:53)
• Profit motives lead to cycles of destruction and rebuilding—developers profit doubly, while communities repeatedly suffer loss.

5. McDonald’s Strikes in the UK and Wage Inequality

[26:04–29:00]

• UK McDonald’s workers went on strike demanding £10/hour; context given about the U.S. "Fight for $15".
• CEO Steve Easterbrook’s pay (€7,329/hour) is contrasted to workers' meager wage.
  • Quote: “But they can't pay their workers more than what I just told you—it's outrageous.” (28:39)
• Calls attention to corporate tax avoidance and systemic exploitation.

6. Tax Reform: Rhetoric vs. Reality

[29:01–30:00, continued at end of pt.1]

• Wolff characterizes the Trump administration’s “tax reform” as a tax cut for the rich and corporations.
  • Corporate tax cuts from 35% to 15%; rewards for profit offshoring.
  • Over the past 50 years, the tax burden has shifted from businesses to individuals.
  • Quote: “For every dollar the federal government taxes us...it gets 25 cents from taxing corporations.” (28:29)
• Both Republicans and Democrats are implicated in maintaining a system that primarily benefits the wealthy.

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Interview with Dr. Harriet Fraad: The Hidden Health Costs of Capitalism

Introduction

[30:00–31:06]

• Dr. Fraad is introduced as a mental health expert with extensive experience writing and speaking on the psychological effects of economic structures.

1. Surge in Mortality Among White Women

[32:47–38:52]

• 300% increase in mortality for white women in small cities, suburbs, and rural areas since 1999.

  • Root causes include: dissolution of marriage as economic security, increased job precarity, pervasive stress.

  • Stress suppresses immune function, leading to worse health outcomes and increased mortality.

  • Memorable Moment: Fraad explains how constant stress (job insecurity, single parenthood, low pay) leads to health-destructive behaviors—smoking, overeating, drug use.

  • Quote (Dr. Fraad): "When the body is stressed...all non-essential systems are turned off in the body. ... One of those systems is your immune system, so that immunity is turned off if you're under constant stress." (34:20)

2. Opioid Crisis as an Economic Symptom

[36:08–39:32, returns at 52:07–56:14]

• 64,000 Americans died from drug overdoses in 2016—a 22% increase in 2 years. The majority are opioids.
  • Economic pain and lack of prospects lead to substance abuse as solace.
  • Quote (Dr. Fraad): “That's what’s really a killer in the United States. Certainly not ISIS.” (37:09)
• Politicians focus on surface solutions (e.g. more clinics), ignore root economic causes.

3. Insecurity, the Gig Economy, and Health

[41:33–45:14]

• Precarious work (Uber, Lyft, temp jobs) breeds high levels of stress and deteriorating health.

• Case example of a stressed Uber driver underscores instability and risk.

• Service sector workers (e.g. nurse’s aides) face higher stress and more health problems than higher-paid, secure professionals.

  • Quote (Dr. Fraad): "There are no sick days, there are no holidays, there are no vacations. You aren't there performing, you get nothing." (43:03)

4. Inequality Drives Health Gaps—Washington D.C. Life Expectancy

[45:15–49:26]

• In Washington D.C., life expectancy differences between rich and poor neighborhoods can reach 20 years.
  • Education and stable jobs are key determinants; without them, people face stress, unhealthy coping, and early death.
  • Men’s suicides are far higher due to cultural norms around masculinity and emotional expression.

5. Capitalism’s Toll—A System That Kills

[49:27–52:07]

• Economic system produces unnecessary death, widespread anxiety, pain, and isolation.
  • Quote (Wolff): “You're describing an economy that kills people...in a way it doesn't need to.” (49:26)
  • Quote (Dr. Fraad): “Capitalism kills. And in the United States now, all regulations...are porous.” (50:22)
• Comparison to European models (e.g. Denmark’s $24/hr minimum wage, robust social support) demonstrates alternatives with better health outcomes.

6. The Need for Systemic Change and Activism

[53:30–56:14]

• U.S. lacks political engagement, group organizing, and public critique of the capitalist system—key in countries like France.
  • Civic alienation and atomization fuel crisis.
  • Quote (Dr. Fraad): “We need each other. We've got to organize. We've got to stop this together...Not the lone individual. ... No, people together.” (55:23)

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Notable Quotes & Memorable Moments

• "Business has gotten richer...as the organized labor movement has gotten weaker." —Richard D. Wolff [12:15]
• "This is a crisis whose losses are of our own making. The problem of Harvey in Houston was the problem of a system that puts profits first." —Richard D. Wolff [24:53]
• "When the body is stressed...your immune system is turned off if you're under constant stress." —Dr. Harriet Fraad [34:20]
• "Capitalism kills." —Dr. Harriet Fraad [50:22]
• "You’re describing an economy that kills people...in a way it doesn't need to." —Richard D. Wolff [49:26]
• "We need each other. We've got to organize. We've got to stop this together… No, people together. And that's a tradition we need to rebuild." —Dr. Harriet Fraad [55:23]

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Timestamps for Key Segments

• 00:00–05:56 — Women’s expanded role in the labor force, cultural and economic consequences
• 05:57–09:13 — Archbishop of Canterbury on the broken British economic model
• 09:14–18:55 — Decline of labor movement, need for alliances, history of labor-socialist/communist coalitions
• 18:56–26:03 — Capitalism and economic mismanagement of disasters (Harvey, Houston)
• 26:04–29:00 — McDonald’s strikes, CEO-worker wage gap
• 29:01–30:00 — Rhetoric vs. reality of "tax reform"
• 31:06–38:52 — Dr. Fraad interview, women’s health crisis, stress, and mortality
• 41:33–45:14 — Gig economy, work insecurity, and health outcomes
• 45:15–49:26 — Inequality and life expectancy, suicide, educational divides
• 49:27–52:07 — Capitalism’s health toll, comparison to Europe
• 53:30–56:14 — Social atomization, need for organizing, collective solutions

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Conclusion

Wolff and Fraad’s central message is that the health costs of capitalism are real, sweeping, and unaccounted for in mainstream economic reckoning. These costs are evident in everything from the opioid epidemic to declining life expectancies, magnified by economic insecurity and inequality, but largely ignored by policy makers. The solution, both argue, lies in rebuilding social and political alliances to challenge capitalism’s dominance, learning from international examples, and demanding that economic systems be judged by their human outcomes—not profits.

For further engagement: Visit democracyatwork.info or rdwolff.com for more resources.

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Transcript

[A]

Sam. Sa. Welcome, friends, to another edition of ECONOMIC update, a weekly program devoted to the economic dimensions of our lives, our jobs, our incomes, our debts, those coming down the road for us and for our children. I'm your host, Richard Wolff. I've been a professor of economics all of my adult life. And so I'm ready to talk about what's been going on in our economy since last we met. I want to begin by talking about something everybody knows about. The last 30 years have been a time when women have entered the American labor force in a way they never had before. Oh, sure, lower income women have always had to work in regular jobs alongside the men, but millions of women weren't required to do that in the way American culture developed. But all that changed over the last 30 years as women have entered the labor force and really taken up the position that in many of us was theirs all along and should have never been denied to them. But of course, it's hard. It's hard on the family. It's hard on the relationships those women have had with one another, with their spouses, their children, their parents and all the rest. And so it's a cultural as well as economic adjustment to have women a regular part of the paid labor force. And nowhere was that brought home more clearly to me than in the blockbuster film, one of the few that the film industry had over the last few months, namely Wonder Woman, this remarkable film, and in it there's a moment that captures so much of the entry of American women, particularly white women, into the paid labor force. The male protagonist, Steve, turns to Diana, the Wonder Woman speaking about World War I, that she's been called in to intervene with and cope with. And he says the this war is a great big mess and there's not a whole lot you and I can do about that. I mean, we can get back to London and try to get the men who can. At which point Wonder Woman turns to him and says, I am the man who can. Welcome to the world of work and women's position now in it. Remarkable capture of that moment. I want to turn next in another update to a leader of a major religion in the world. Yes, I think many of you know I occasionally quote Pope Francis because of his criticisms of capitalism. But today I want to quote Archbishop of Canterbury Justin Welby, head of the British Anglican Church, and that's the most important church religious group in the United Kingdom. And he became important in yet another way this last week when as part of a report issued by the Institute for Public Policy Research, a report he helped to write. He reached a number of conclusions which said, among other things, that the British economic model is broken. Notice he didn't say this or that detail of the British economy was in trouble. The British economic model is broken. And just in case anyone was unclear, he explained what he meant. The gap between the richest and poorest parts of the UK Widens. He expanded it further. Britain stands at a watershed moment, he said, where we need to make fundamental choices about the sort of economy we need. We are failing those who will grow up into a world where the gap between the richest and the poorest parts of the country is significant and destabilizing. It is interesting when leaders of the religions of the world increasingly share with those of us who have been critics of a capitalist system spinning out of control the sense that we are coming to a historic turning point. We cannot continue in the way we have developed, and the leaders of capitalism don't want to face it, and they certainly don't want to do much about it, but they have to. And the leaders of the church want to be out front explaining why. I want to also now talk to you briefly about the holiday just passed, Labor Day, the day in the United States, anyway, that we celebrate labor and organizations of working people. The unions in other countries, they do that on May 1st, but that's another story. We do it the first Monday in September. And I want to be honest, I like to celebrate Labor Day. I feel that I am part of the working people of this society, as I assume most of you are, And I'm honestly proud of the labor movement, of all it has achieved. It's very clear to me as an economist that the wages we enjoy, those of us who still do, the social benefits, the government programs, the conditions on our jobs would have been and used to be much worse than they are today. And the credit for that goes to the labor movement. But honesty requires me to look into the bad news, too. And the bad news is that the labor movement is weaker today than it has been at any time in the last half century or more. The decline of the labor movement is epic in its dimensions. Less than six and a half percent of the workers in the private sector of the American economy are members of or represented by a labor union. A few decades ago, a third of such workers were represented by unions. Now not even 6.5%. Anyone who speaks as though the labor movement is a fitting alternative or a serious antagonist of big business doesn't know what he or she is talking about. Business has gotten richer. Business has gotten Stronger business has gotten more powerful in our society in direct proportion that the organized labor movement has gotten weaker. And to pretend otherwise does nobody any favors. And I want to spend two minutes exploring what this means and what the lessons are. Let's go back to when the labor movement was strongest in America. The late 1930s, 40s and 50s, the heyday. The labor movement was never that strong before and it's never been that strong since. What was that about? Quick reminder, quick history lesson, if you like. During the 1930s, the greatest collapse of capitalism so far in its history, millions of Americans joined labor movements, labor unions. They did so for a simple the devastating depression all around them, threatening them. Well, their answer was the let's join a union. In union there is some strength. In union we'll be able to weather this economic storm better than if we try to do it all by ourselves. So they joined unions. Millions of Americans who had never been in a union, whose parents had never been in a union, who knew very little about unions. They did it out of an act of solidarity. But it's important to remember that the union movement had helped. It had a powerful alliance. It allied with two socialist parties and a communist party. And while we might like to pretend that those institutions were never part of the American scene, that is not true. In the 1930s, the socialist parties, two of them, and the communist party were very powerful. And they were allied with the cio, the thrusting union movement that mobilized most people to join unions. And in the 1930s, and that alliance, communists, socialists and the labor movement became very strong. And that's why we got in the 1930s, the unemployment compensation law that gives people money for a year or two to tide them over when they lose a job because of economic downturn and no fault of their own. That's why we have Social Security. That's why we have a minimum wage. That was passed at that time with the support of a powerful labor movement. That's why we had public jobs, millions of them, when no other jobs were available, when the private sector couldn't provide work for the millions of Americans who wanted it. And those days of a powerful labor movement are what created the well paid, secure job. The government supports everything that goes nowadays by the name vanishing middle class. And why vanishing? Because there's no organized support for it. You got it with organization and you're losing it because you don't have those organizations anymore. And why not? Because after the war, the business community in America was very upset that the unions had formed, that they were so strong that they were so militant partly because of that alliance with the socialists and the communists. And so they set about to destroy that powerful coalition, the coalition of labor socialists and communists. They demonized the communists, they demonized the socialists, and they went after the labor movement. We barely have a communist party. It has little or no influence. We barely have socialist parties. They have little, but not no influence. And the labor movement, as I said, has been declining for 50 years. In other words, the business community got what it wanted. And what is the lesson? The business community had allies. It formed those allies with conservative social movements, with fundamentalist religious movements to support the business agenda in exchange for support from business. The unions could have done likewise with the left wing in America, with the progressive social forces, but it didn't. It allowed the anti communism, the anti socialism, the anti progressivism to split those folks from the CIO, from the labor movement. Well, then the outcome was easy to see. Business had a good alliance going with the conservative part of America. Labor unions had no alliance going with the left, the part of America that resurfaced recently around Bernie Sanders, for example, or around Occupy Wall street, for example. A strong alliance on the right and no alliance on the left gives you American politics right up to President Trump, doesn't it? And it explains why on this Labor Day, while we celebrate what labor was and what labor could be, the lesson that labor has to learn, rebuild the alliances with the movements to your left. It's your best shot to avoid disappearing altogether from the American political scene, which the other side still has. And as its basic agenda. Let me turn next to the hurricanes. Harvey in Houston, Irma in Florida, and let me talk to you a little bit about the economics of these cataclysmic disasters in which we are now talking about hundreds of of billions of dollars of lost wages, lost productivity, lost wealth. I mean, it is staggering. I'm not going to talk about nature. That's not what this program's about. And this was partly a natural occurrence, as all hurricanes are. I want to talk to you about the economic dimensions of such catastrophes. And I'm here speaking more about the Houston catastrophe because it happened sooner and we can have a better sense now of what its consequences are than we can about Irma in Florida. Here's the catastrophe. Economically, a great deal of the lost wealth could have and should have been avoided in order to avoid catastrophic losses from storms. You have to spend money. And what do you have to spend money on? Mechanisms of protection so that the damage is minimized, mechanisms of evacuation so that human beings are removed from danger zones in a timely, efficient way, and mechanisms of rescue for those who aren't either protected or. Or evacuated. They all know this. This is elementary. This was not done in Houston. It wasn't done by the city of Houston, it wasn't done adequately by the state of Texas, and it wasn't done by the federal government either. At one startling moment in the middle of the Houston disaster, the governor was asked, why in the world did you not order and facilitate an evacuation of Houston as the fourth largest city in the United States? And his answer was stupefying. He said that would make no sense because the way the roads are built, they would be immediately filled with cars and nobody could move. This is a none too subtle way of saying, well, we have no evacuation plan. We never had one. And don't ask me to evacuate anybody because we can't do it. And we've known that we can't do it given the way we've organized things. I sat there looking at the television as I heard these sentences uttered, and I didn't literally know what to do. What an amazing admission. Why in the world would the fourth largest city low lying right by a body of water that has had repeated major storms for at least the last 50 years of recorded history? Why in the world would they not do that? And then my economics kicks in, and of course I know the answer, and I want to share it with you. Capitalism is a system in which everything is done for profit. The profitable thing to do in Houston over the last 40 years has been A, to invest in oil and oil related businesses, and B, to be what we call, in a euphemism, a developer, one of those people who builds houses or shopping malls or industrial centers. And those people want to build those things because it's profitable to do so. Since the oil business is a booming business. They don't want to be held back by rules. They don't want to be held back by being told that the soil around Houston is like a sponge. It's porous, and if you pour a lot of water in, it holds only so much. And then the water has nowhere to go anymore, which the soil specialists will tell you now. They don't want to create big ways for traffic to get out of the city in a crisis because that uses up valuable land where profits can be made, just like using that soil. That's inappropriate. That's why money isn't spent to build protective dikes. Why? Because the city would have to raise taxes or the state would have to raise taxes. And the private profit people don't want to pay the taxes. You see the picture. This is a crisis whose losses are of our own making. The problem of Harvey in Houston was the problem of a system that puts profits first. The developers made their money. Once the houses and the highways and the shopping malls went up, that they went up in a disastrous place. It was not their concern. They weren't worried about it. In fact, you know now from the stock market that many of them are seeing profits again in rebuilding what the storm destroyed. They're going to make money twice and they're not going to do it any better next time than they did last time. At least if history is any guide. Capitalism is a system whose costs, if they were honestly calculated, would have long ago convinced rational people. We need a better system than this to live with. I also want to talk to you in the time that remains about two other items. The first is brief. My attention was caught when I read that on September 4th of this year, workers at the McDonald's hamburger stands in a number of British locations went on strike. Why? Well, we've had an important movement in America, the fight for 15, it's called in many parts of the country to help people like McDonald's workers get $15 an hour for the work that they do. Not that that's enough to live much beyond the poverty level, but it's more than they're getting now, and that's unconscionable. And they have had demonstrations, they've done a number of things. They've even walked out off the job. They haven't quite gotten to the point of having a strike. So I thought it would be interesting to all of you that in Britain there is a strike. McDonald workers have gone on strike. They're demanding £10 an hour, or roughly a $13 an hour. It's not as much as the fight for 15, but then again, 17 year olds in England are allowed to be paid $6 an hour for when they work at McDonald's. Regular workers get $11 an hour. Jobs and hours are notably insecure. And as the workers like to point out, the CEO of McDonald's, Steve Easterbrook, gets 5,684 pounds per hour. That's compared to the average worker getting 8 pounds per hour. So I did the math so I can tell you what. CEO of McDonald's, Steve Easterbrook, gets his 5,684 pounds an hour works out to $7,329 per hour. But they can't pay their workers more than What I just told you, it's outrageous. The British are investigating McDonald's for cheating the government out of a billion dollars in taxes. I could go on. But you know all of this, even if you don't know the details, because it's the way our system works. That's why it produces these kinds of stories over and over. I want to remind you, lest I forget, that we maintain websites and we maintain an option for you to see this program as a television program, both on YouTube and I'm proud to say that you can find a video version as well on patreon.com P A T R E O N. I want to remind you that we maintain two websites where you can also see much more of the kind of work that we Rdwolff with two Fs.com and democracyatwork.info that's all one word, democracyatwork.info. for the final economic update in this first half of the program, I want to talk to you about the big item in Washington these days, and that is tax reform. Now, I use the word reform with triple quotation marks around it because reform is not really what it is. It's a tax cut. Mr. Trump and the Republican Party have a tax cut in mind. It's a tax cut for wealthy people. Oh, of course, they wouldn't say that. That's not good politics in America. So they talk a large bit of nonsense about cutting taxes for poor people and working people and middle class people. They use those phrases every chance they get. It's nice. The words. They really are nice. I appreciate the words. The problem is when you look at the proposals and they've been short on specifics, but they give you a general idea. Here's what it amounts to. Number one, the big tax cuts go to businesses, not individuals. And here's the big they want to cut the corporate profits tax. The tax companies have to pay on their profits. That is what they earn less. Their costs. They want to reduce that from 35% to 15%. That's a whopping big tax cut for businesses. The second thing they want to do is to say to companies who haven't paid any tax on their profits because they keep them abroad and therefore they don't have to, that if they bring them home, we'll give them a real good break and they'll only have to pay 5 or 10 or 15%, a kind of incentive to bring that money back into the United States. And what does the incentive amount to? An enormous tax cut. These people avoided taxes in a way that was unpatriotic and burdened the rest of us with making up the difference. And now we're going to give them, in effect, a reward for not having paid for as long as they got away with it by keeping the money abroad. These are wonderful big gifts to business. I want you to keep in mind a little fact of history. Fifty years ago, for every dollar the federal government raised by taxing individuals, it raised $1.50 by taxing corporations. Today, for every dollar the federal government taxes us as individuals, it gets 25 cents from taxing corporations. The last 50 years have seen a shift of taxes off of business onto individuals. And all that Mr. Trump and the GOP are doing is more of the same. It hasn't solved our economic problems. It hasn't gotten our economy bubbling, quite the opposite. But for them, who cares? Because that's who they serve and that's what this tax reform is really about. But we're not done when it comes to individuals, the proposal so far would be much more valuable the higher your income. It's again, a tax reform that gives small cuts to folks in the middle and the bottom in the hopes that they won't notice the huge cuts that are given to the people at the top. If you listen to the Republicans and the president, you'll get the impression we're all getting a tax cut, because that's the game. But I'm here to tell you that if you look at the concrete realities that as many other than myself are also doing, what you're getting is same old, same old tax cuts for those at the top, the business top and the individual top. And for the rest, nothing, nothing significant, nothing that will change the basic contours of your life. And for those of you that voted either for the Republicans or for Mr. Trump in the hope that a big tax change would come down the pike and alter the circumstances of your life. You have been betrayed. No other way to put it. And if you expect anything fundamentally different from the Democrats, don't. The leader in the Senate, Mr. Schumer from New York, Senator Schumer was quoted this last week as the millionaires and the billionaires are doing fine in America, and there's nothing wrong with that, bless them. My goodness. If that's what the best of the Democrats can do, if that's what the leader of the Democrats can do, well, I've never seen more evidence that the changes we need in this country, economically speaking, go far beyond what Republicans or Democrats in the main are able to think about let alone to do. We've come to the end of the first half of this program. Please stay with me. We will be back in a very short time. La.

[B]

Dance me to your beauty with a burning violin Dance me through the panic Till I'm gathered safely in Lift me like an olive branch and be my homeward dove Dance me to the end of love Dance me to the end.

[A]

Of love.

[B]

Oh, let me see your beauty when the witnesses are gone Let me feel the moving like they do in Babylon show me slowly what I only.

[A]

Welcome back, friends, to the second half of Economic Update. I'm very pleased that we are once again at the beginning of a month, this time September 2017. And that means that I have my usual beginning of the month guest, Dr. Harriet Fraad. She is, as I think many of you now know, a mental health counselor and hypnotherapist in private practice in New York City. She also writes for a variety of outlets, including Truth out, the International Psychohistory Journal, the blog for democracyatwork.info where you can find her writings as well as mine. And she has her own website, harrietfraud.com and I'll spell that for you. H A R R I E T F R a a d harrietfraud.com so without more ado, let me turn and speak with Dr. Frad.

[C]

Hi.

[A]

Hi. Good to see you again.

[C]

Good to be here.

[A]

I want to talk to you today about something that I, as an economist, have always understood, since a good teacher of mine explained it. The health conditions of a population, physical health, mental health, are as good a measure of how well an economy is serving its people as any other. And that economy and economics needs to understand the importance of looking at health as a way to gauge an economic system and its performance. And that's what I want to talk with you about. Since I know you are interested in that topic and you study it, I would like to focus, if we could, today, on two or three key statistics in health and ask you to tell us what you think is the connection between the economics of our world today and these realities of health. So let me begin. Here's a statistic which I know you are aware of, indeed you brought to my attention. The rate of mortality, the death of white women has increased 300% since 1999. In other words, an extraordinary explosion of death, which is the ultimate health problem for white women. What's going on? What is this about? How do you account for this sort of thing?

[C]

Well, first of all, it's very much what you were saying, how it relates to economics, it isn't all white women. It's white women in cities of less than a million people, White women in suburbs and rural white women. And the way I would account for it is that one of the things people desperately need in life is some control over their lives. Not total control, of course, but knowing what will happen the next day or the next week. And as marriage, marriages don't any longer hold up. People don't get married. And if they do, half of them get divorced and many more, half of them get legally divorced and many more just call it quits and don't fight over assets. So marriage has basically disappeared. And the economics of the old marriage, where a man supported his wife and children is over. About 29% of women, actually 29% are the higher wage earners. The majority of women are single. And what's happened to women in smaller cities and rural and suburban is they're the sole support of their families. They have no financial security. They live with the precarity of people whose jobs can go any minute and under huge stress. And stress is a particular thing to pay attention to. Everyone talks about it. But when the body is stressed and the mind is stressed, we go back to a primitive mechanism which is in order to escape the stress, all non essential systems are turned off in the body. In the body, that's why. And in the mind. That's why in a forest fire, rabbits run next to foxes and neither bother. You know, the fox minds his own business to get out of the fire, so does a rabbit. They're going straight out of that fire because all that's an emergency. And in that emergency all non essential systems besides survival are turned off. Well, one of those systems is your immune system, so that immunity is turned off if you're under constant stress. And women are under constant stress of dissolving relationships, dissolving support, and being still emotionally and physically in charge of holding together a family that can't hold together and taking care of children and in addition working at jobs which are precarious.

[A]

And that don't pay well and don't pay well.

[C]

They're always insufficient. And so that what happens is women turn to whatever they can to give them relief. They turn to smoking. There's a woman who told me that they want to take away my cigarettes. It's my only breather in my whole life where I can take a moment out and just inhale. I'm not going to give up my cigarettes. But of course that means cancer and Heart disease. They also comfort themselves with food, women, because that's what's around.

[A]

And it's relatively inexpensive, Cheap, especially non.

[C]

Healthy food is cheap. And so that they become obese, which leads to heart disease, cardiovascular problems, problems on every level, because exercise is good for you, respiratory problems, and also to drugs, because legal and illegal, legal and illegal, if they have pain, they often go to a doctor who gives them a legal drug. Then when it runs out, that drug on the market, on the illegal market, which is where you'd have to go, is too expensive. So they turn to an opioid from the street, or heroin, which are cheaper. And that's what's really a killer in the United States. Certainly not ISIS or anything like that. 64,000 people died of overdoses in 2016, just in one year. 64,000, which is a 22% increase from the two years before.

[A]

Wow.

[C]

And the opioids become more and more powerful and people need some powerful relief. So that's the killer.

[A]

I'm really struck because if there were a rational way of measuring an economic act, for example, lowering wages for workers in a factory or a store, or changing the working conditions, or going from week to week giving workers different amounts of hours and different hours of the day, if you measured that properly, what were the costs of doing that and the benefit, on the benefit side, it would make more profits for the business. That's why it's happening. We know that. But on the cost side, you would really have to weigh the impact on the stresses and in turn on the behaviors of not only the women affected, but all the people who depend on that woman. The children, the elderly, in the house, the husband. And if you looked at the medical and physical costs associated, it would not be a rational act to do it because the costs would outweigh the, the profit gain. But in our economic capitalist system, it's the profit that makes the decision. And the costs are not taken account of and they're not even paid attention to. But you're saying that they literally include life and death.

[C]

They include life and death. And in the overall statistics they don't even show because people who are more prosperous and live in bigger cities live longer. So it gets fudged. You have to look at particular groups.

[A]

You have to break down income levels.

[C]

And the inequality to understand the statistics. And there are reports from the Centers for Disease Control and from Princeton and so on that verify this. This isn't a figment of anyone's imagination. Also, people should understand that other nations, for example Sweden has a Rule, if you want to close your plant and outsource it, you have to get an equivalent job for every single employee. So most of those factories, if they stop making one thing, they start making another, because they have those employees for which they're responsible no matter what.

[A]

They also mean job loss is not a stressor for those workers.

[C]

That's right. They do not have a precarious terror of always losing their jobs. It also should be noted that in the studies they show that people who are actually fired, gotten their pink slip, unemployed, have less stress than the people who think they're going to be unemployed and who are afraid. Not that both groups aren't stressed, but there's even greater stress in the terror of what's going to happen of how precarious your life is. Also, in a country like Sweden, 90 women who are single mothers earn 98% of what men learn so that they know they're secure. And they have clothing allowances and support after school programs that are free and all the other things. So that as parents and as workers, they are all right, they have some control over their lives. Because control, some sense of anticipating what will be next is as important as the basic five things. Food, water and sleep and rest and restorative, sleep, temperature control and ability to move. You know, they're just. They're all very powerful things. And so that. And without a sense of. And temperature regulation. I think I probably forgot to mention that. But in order to understand how important it is to have some anticipation of what's going to happen to you, control is right in there. You have to know that you're not going to. Suddenly, if you're a child, suddenly a parent is gone, suddenly your house is gone. You know, these are traumatic things that are constant for people.

[A]

Well, let me continue this for a moment. What you're saying, if I understand you, is that the change over the last 20 years, something called the gig economy sometimes, or the sharing economy. But the bottom line is jobs that are temporary, jobs that are insecure, jobs where the hours or the tasks you're asked to do change from moment to moment. These things have been justified on the grounds that they're more proud, profitable, or more quote, unquote, efficient. But that doesn't take into account the enormous cost you're telling us this has on the health, the psychological balance, the relationships of society.

[C]

Absolutely. Because, look, I have a couple of clients who are taxi workers. You know, taxi drivers, they never know how much they'll make. The ones from Uber and Lyft and those Places they don't know when they'll get a call or when they won't. One of them was waiting at the airport. He got a call that he was needed at the airport. The cop wouldn't let him stop, and he kept circling. And the woman just said, I cancel it. I'm getting in a yellow cab. So he lost $70, and he couldn't stand to get another. He couldn't stay there to get another fare. That there was too big, there was no space. And that's just because it rained and the lot was soggy, so they couldn't stop. And although he tried to plead with the cop, the cop said, you know, get out of here. And he knew he better. Also, there are no sick days. There are no holidays, there are no vacations. You aren't there performing, you get nothing. And when you do perform on the job, you don't know what you'll get at the end of the day.

[A]

So the interesting thing then is that what the unions. Because in the earlier part of the show, we talked what the unions were able to get in the 30s, 40s, and 50s, jobs in which the contract covered the job. You knew your hours, you knew your tasks, you knew what you would get paid. All of that gave you a security which is now being removed with noise made about technology, efficiency and profits and whatever the truth of those stories are. Profits, profits for who?

[C]

Right?

[A]

No one has counted the real cost in physical and mental health that you're talking about, which questions the whole rationale and the rationality of this change.

[C]

Well, a perfect example is the hospital structure. People think that doctors and hospital administrators have more stress. They have much less stress than nurses aides who are on swing shifts, who don't know if they'll keep their job. Whose job is different every day a doctor knows he'll make a mint. The hospital privileges. Doctors and Doctors make over $100,000 a year as a median.

[B]

Easily.

[C]

Yes, yeah, easily, as you know, and many, much more. Whereas nurses aides are in constant precarity. So it's a perfect example. And they have the greater stress and they have the greater disability rates, and they have the greater reaching out for some comfort and in ways that endanger their lives.

[A]

So they have every one of these costs greater, but they earn much less.

[C]

Much less.

[A]

Okay, let me turn to that, to the inequality. Another statistic about health that is as dramatic as any runs as follows. That if you go from one end of the city of Washington, D.C. to the other, the life expectancy at the poorest end of the city is 20 years less than the life expectancy in the richest neighborhoods. So within one city, depending on your income and the overall financial security of your situation, you can live on average 20 years longer than people who may be servants of yours and live in another part of town. Tell us a little bit about this kind of inequality and its connection to the economy and its impact and so on.

[C]

Well, people who have not graduated from high school or graduated with only have a high school degree, have a formal, formally a 17% unemployment rate. So they're going to have to scrabble a living that's highly stressful and difficult. And being told when you apply for a job that no one wants you is a huge blow to people. Also, the kind of jobs that you can have, you know, if you want to be, let's say, a venture capital person in a very poor, downtrodden neighborhood, you got to go into selling drugs or being a protector of other people, which means that you're going to likely get shot, that you have very few and dangerous options. And so you're more likely to be disabled because you're more likely to look for solace in terrible ways like drugs or tobacco or alcohol, which erode your body and make you disabled before your early death. Whereas someone who has more control over her or his life doesn't have that and has a steady job with a recognition, there will be a job. That's one of the things that has changed radically since the 1970s, where even if you didn't love your job, you knew you'd get a job, particularly if you were white and male. But even if you were female or African American or Hispanic, there would be a job and you could count on going to that job and that it would be there, rather than unpredictable income source on which you utterly depend. So that what you have is, as you drive through the neighborhoods in Washington, D.C. you go from the wealthier neighborhoods into the poorer neighborhoods, and as you go into Virginia, where the estates are for the wealthier politicians, then you get richer and richer. So that's why people are dying. Also, I should mention that there's that 300% increase in white women dying. There's also a big difference in suicide. Now, men tend to die more of suicide relative to women, relative to women, because when women want to commit suicide, they take an overdose of medication or something, which means they could be revived or call out to someone if they change their mind. Men tend to shoot themselves, which is much less reversible. And 121 people commit suicide in the United States every day, 93% of those are men whose despair and inability to ever talk about it or relate, ask for help within a macho stereotype leads them to kill themselves.

[A]

But you're describing then, because again, I'm going to play the role of economist, you're describing an economy that kills people. Absolutely, in a way it doesn't need to, that distributes wealth and income in such a way that provides large numbers of people with a shorter lifespan and all the anxiety and emotional pain that an early death entails, not just for you, but for people who depend on you and so on. This is an economy who, if you measure its results in these inequalities that you've described and in this level of physical and psychological pain, is an economic system that ought to be questioned in a daily way because its inadequacy for what we need as a human species is obvious. Am I missing something here?

[C]

No. Capitalism kills. And in the United States now, are all regulations like the eight hour day that used to be existing are porous. Yes, porous. And even where they do have them, they aren't enforced. And so that you have. And under Trump, they're being even lessened from the lesser degree they had before in the United States versus Europe. I mean, in Denmark, if you work at McDonald's, you make $24 an hour. That's a livable wage. They still make a profit. Also, they have all their social benefits that they can count on, the free child care and after school care and elder care and all the rest of it. And they also have a maximum wage, after which your money is hugely taxed, and a high minimum wage, $24 an hour.

[A]

So it goes together with the research recently that shows that the less inequality, the better the physical, mental health, longevity and all the rest, the less the rest. You know, the evidence is really accumulating that by using health, mental and physical as a measure, the kind of private capitalism that is touted in the United States, Britain and so forth is really not showing up real well. I want to. I don't want to end the program without going back to this number you gave the 64,000 people who in 2016 died of overdoses of drugs, of drugs, legal and illegal. The opioids, the opiates. Opiates.

[C]

And also 2/3 of them are opiates or opioids. A third are things like crystal method and also speed and cocaine. But that's 2/3, 1/3.

[A]

Okay, the number is staggering.

[C]

64,000.

[A]

64,000. It dwarfs what we lose in wars it dwarfs what we lose on the highways are big killers in this society.

[C]

The combined things. It's more than highways and shootings in the United States.

[A]

So granted, I know politicians are now talking about it. It's, it's a kind of thing you're supposed to talk about. But how did we get to a system that works this badly, killing 64,000 people a year from something which is a reflection, as you've pointed out, of the difficulties of an economic and political and cultural system, but particularly an economic system. Why has it not led to questioning that system? All I hear, when I hear politicians talk about these opioid and opiate deaths is oh, we should have more treatment or oh, we should have more clinics. In other words, not dealing with the causes but simply with the bad result, leaving the system that produces this untouched by criticism. How do you respond to that?

[C]

Well, we don't have in AmeriCorps. We lost in the, in the 50s with the anti communist assault of McCarthy and so on. An awareness that politics matters, that the economic system, that every system should be questioned. Not only the communist systems should be questioned, definitely, but also capitalist systems should be questioned. That was off the table. So people didn't think that way and they're starting to begin to think that way now because these deaths are clearly economically different depending on where you are. And I think what has happened and.

[A]

How well the economy performs for you.

[C]

Exactly. And what has happened in America is there were two basic things that held Americans up. One of them was steady jobs, which was particularly true of white Americans. African Americans and other minorities had less good jobs, but they could have steady jobs and a sense of a stable home. They've both fallen apart, so there's nothing to hold onto. There's no idea that I can count on. I can count on this marriage, I can count on this home, I can count on a salary that will support these things. And so that people are utterly without the support. And they haven't learned the way people like the French do. They're not connected. We still have fewer groups of any kind than were in bowling leagues alone in 1970. If you look at France, the retirees in every quarter every year around Ismain, every area like every big zip code, have a retirees or have retirees organizations that meet and look after their interests and entertain them and all the rest. So do young parents. Everyone is politicized so that when Macron threat, the new president threatens to take away their job security by changing the labor laws, 1.2 million people are out in the street. That's different. We're not used to saying we need each other. We've got to organize. We've got to stop this together. Not the lone individual. Clint Eastwood shoots up the town in righteous upset and rides into the sunset. No people together. And that's a tradition we need to rebuild.

[A]

Well, as often happens, we've run out of time, but I really want to thank you for making as clear as these statistics and your discussion have done what this link is between an economic system and these enormous human costs, including life and death itself, that haven't but ought to have been factored in to what we believe about this system and its desirability. So I look forward to resuming our conversation at the beginning of October.

[C]

Thank you.

[A]

And to all of you, I want to thank you again for participating in this program. I want to ask you to be a partner, as we often do. Use our websites, rdwolff, with two f's.com and democracy @ Work. Share what you find on there with others. I want to thank partners we already have, like truthout.org, that remarkable independent source of news and analysis. But beyond that, I want to thank you for your partnership past, present and future. And I look forward to speaking with you again next week. My time, my time, babe. They ain't gonna change. Thing gonna change.

[B]

Yes, Sam.