It will not be enough for health systems to simply offer the wealth-building opportunities we have outlined. Rather, they need to make it as frictionless as possible for staff and patients to take advantage of such services. All eligible employees could be granted time during normal working hours, and as part of their normal duties, to take part in wealth-building activities. Similarly, health systems that facilitate savings opportunities using 401(k) or 403(b) retirement accounts could not only expand these programs to all employees, but also take steps to ensure uptake by making enrollment easy (e.g., by using behavioral economics approaches, such as opt-out systems). As work by Chetty and colleagues makes clear, a neighborhood-based approach to this effort is important: opportunities and resources need not be hoarded, since “a rising tide lifts all boats,” and healthier, wealthier neighborhoods mean greater chances of economic mobility for all inhabitants.40
Other scholars and commentators have proposed reparations as a public health strategy for ending Black–White health disparities.2,3 Health systems have a choice to make: continue with the status quo or reposition themselves as essential actors in closing the racial wealth gap. We believe that large, sustained societal investments such as reparations are in fact the only way to address the gap and that health systems have a moral obligation to join the movement.
I wonder if this will affect the esteem in which doctors are held? I wonder if this will affect regular Americans attitude towards medical instruction?
Obamacare was a $2 trillion transfer from people who work to those who don’t. If a working man goes to the ER, he gets financially raped on behalf of those who don’t pay a cent.
If a man gets married in the current system, he has a good chance of getting raped by his disenchanted ex-wife.
How long can we go on subsidizing dysfunctional choices and penalizing productive choices?
