By Gregory Acs
The Pew Charitable Trusts, Economic Mobility Project, September 2011
The idea that children will grow up to be better off than their parents is a central component of the American Dream, and sustains American optimism. However, “Downward Mobility from the Middle Class: Waking up from the American Dream” finds that a middle-class upbringing does not guarantee the same status over the course of a lifetime. A third of Americans raised in the middle class — defined here as those between the 30th and 70th percentiles of the income distribution — fall out of the middle as adults.
Comment:
By Don McCanne, MD
Extensive studies have shown that over the past few decades income has dramatically shifted upwards to the wealthiest individuals. This study adds to that data base by showing the impact on the middle class. A third of Americans raised in the middle class have fallen out of the middle (and this was before the economic downturn).
Because health care costs are now so high the middle class can no longer afford to fund an insurance pool that would be adequate to cover their collective health care needs. If the middle class is to receive adequate health care then it is imperative for the wealthy to contribute a greater amount through a progressive financing system (i.e., taxes).
What won’t work is an underfunded welfare program for the poor (Medicaid) and exchanges of low actuarial value under-insurance plans for the middle class, yet this is what the Affordable Care Act is bringing us.
What will work is a single comprehensive risk pool that is equitably funded and includes everyone. If the wealthy were allowed to have a higher standard for themselves with a lower, mediocre standard for everyone else then their support for the health plans serving the “commoners” would diminish. By having a single high standard for everyone, the wealthy would use their influence to see that the health care system met their standards, thereby pulling up the standards for everyone else.
Of course, that is precisely the goal of an improved Medicare for all.