POVERTY AND PUBLIC HEALTH

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Stanley
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POVERTY AND PUBLIC HEALTH

Post by Stanley »

My friend Professor Martha Pass has written this lecture. Though intended for American consumption it is a good argument for the UK as well and flags up universal problems.

Phi Beta Kappa Lecture 2014
Carleton College

Income Inequality and Health Reform:
The Gordian Knot by Professor Martha Paas

It surprises people when I say that the Affordable Care Act has very little to do with health reform. The Act is, in fact, insurance reform and not legislation to reform the way that health care is delivered. The act provides for some fact-finding grants, but it contains no real provision for the implementation of any proposed changes.
So, how should we think about health reform?
The first thing to say is that we have a major philosophical disagreement in this country about the nature of health care. Whether based on some sort of universalist position of natural rights or not, we must first decide whether everyone in the country is entitled to basic health care.
Such a debate has not actually taken place. Americans have a strange aversion to the notion of “entitlement”. We talk more easily about “rights”: to life, liberty and the pursuit of happiness, for example, though it never seems to intrude on our thinking that basic health care is fundamental to all of those things. Instead, we prefer to put health care in the same category as good education or even good food, which some put in the every-man-for-himself category. If we cannot decide that health care is a priority for the nation, then it is hard to know what to say about reforming it.
But let us assume for the moment that we can agree that every US citizen has a right to basic health care. The next obvious thing is that it must be funded. The Affordable Care Act is a beginning, but clearly only that. By insisting that it must be based on markets, we have left ourselves open to endless difficulties. Presumably, the majority of lawmakers believe that a market will produce the greatest output at the least cost, but in fact the market for health care differs from competitive markets in fundamental ways. The economic incentives in the health care market are such that it will ultimately fail to deliver basic health care at an affordable cost to everyone.
We spend more per capita on health can than any other country, but some countries with universal health care manage to deliver it not only at lower costs but also with better results. It is almost heresy to suggest that the US has anything but the best health care in the world, but if we look at any number of measures by which to judge this, we cannot escape the hard truth that for the society as a whole, this just isn’t so. We are wasting our money.

Life Expectancy and Health Expenditure

Life expectancy is a common measure of the quality of health care, but it appears to be unrelated to spending on health care in rich countries. The US. Ranks 40th overall in life expectancy, just below Cuba. Women in the United States, on average, have the lowest life expectancy of women in any of the advanced countries.

Infant Mortality

We have the highest infant mortality in the developed world. In the recently released Social Progress Index, the United States ranked 70th in Health and Wellness, just behind Mali, but ahead of Kuwait. Clearly, something needs to change.
There are many things that should be addressed in health reform, such as tort reform, adoption of best-practice guidelines, the regulation of supplements, the poor pay for surgeons and primary care physicians, the underfunding of the Center for Disease Control and the list goes on.
But the focus of my talk today is the 800 pound gorilla in the room and that is the crisis in mental health care. I will argue that our growing income inequality is closely related to the problem of mental health and that we need to understand this connection in order to find solutions to either.
First, let’s define our terms and look at some data to establish this landscape of inequality:

Who is poor and how many are there? How unequal is income?
The Census Bureau uses the Poverty Threshold as the measure of poverty for federal programs.

Poverty in the United States 2013:
You can see the poverty thresholds on the slide:
Individual $11,670
Two people $15,730
Family of four $23, 850

Using the poverty threshold, there are 49-1/2 million people living in poverty, or a rate of 15%.
Over 6-1/2% of the population --over 20 million people, live in deep poverty, with incomes only half of their poverty threshold.
Another 1/3 of the population – some 106 million people—live close to poverty with incomes less than twice their poverty threshold. This means that almost 50% of Americans live in or close to poverty.
The extent of the inequality can be seen by looking at this graph of income distribution;

Household Income by Percentile, 2011

This inequality is greater than in all the years we have kept records.

Slide 6: Income Inequality US (2007) and England ( 17thc)

Here is an interesting factoid that I find astounding:
Income inequality in the US in 2007 was about what it was in 17th century England. And it has worsened in the US in the last 6 years.
Much has been made in the media of the extraordinarily high income and wealth of the top one-tenth of 1%, but some specific examples may help to make this clearer.

Slide 7: Wall Street Bonuses


It was announced in March that the bonuses on Wall Street at the end of 2013 amounted to $26.7 B, which was $11 B greater than the total income for full-time minimum wage workers in the US. And we are told that these bonuses bear no relationship to how effective these people are—they merely reflect the ability to generate fees for financial trading, whether the clients’ portfolios gain or lose.
In 1950s, the average CEO salary was 20 X that of a typical employee
Today: CEOs of Fortune 500 companies receive 200X as much.
Many do even better: In 2011, Apple’s Tim Cook earned $378,000,000 in salary, stock and other benefits: This is 6,250X the typical Apple employee’s salary
In 2012 the top 40 hedge fund managers and traders were paid a combination of $16.7 B, equivalent to the wages of 400,000 workers making a $43,000, or 2x the poverty level for a family of 4.
Income inequality has been growing for 30 years, but until recently most people were unaware of how dramatic it has become. The fact is that economic growth has not brought with it good jobs for the middle class as it did after World War II, unions have declined, the sort of jobs that used to pay good salaries in manufacturing have been shipped overseas, and minimum wage jobs that used to be for teenagers are now held by heads of households. The minimum wage is so low that a person working full time can barely support herself, let alone a family. While raising the minimum wage will help the poor some in the short run, it is not the solution to the inequality problem.
What of the argument that the rich are the “job creators” and therefore should in fact have their taxes reduced, not raised. The Ryan budget is built around this concept. In fact, much of America’s wealth at the top is the result of rent-seeking—including monopoly profits and excessive compensation of some CEOs and especially those in the finance sector.
In a world of globalization, creating market value has become entirely separated from creating employment. There is no reason to believe that giving money to America’s wealthy would lead to more investment in the United States.
Money goes where returns are highest, which is not at the moment likely to be in the US, and where it is, it seems to be mostly in labor saving machinery designed to replace jobs. Perhaps most disturbing of all is the extent to which it is distorting our politics.
The myth that we should celebrate the wealth of those at the top because we all benefit from it has been used to justify the maintenance of low taxes on capital gains. But most capital gains accrue not from job creation, but from one form of speculation or another. Some of this speculation is destabilizing and played a role in the economic crisis that has cost so many jobs. Moreover, the bottom 90% get less than 10% of all capital gains. Salaries and wages of the top 400 income earners amounts to only 8.8% of their income. The rest is capital gains and dividends and these are taxed at only 15%. Hence Warren Buffet’s claim that he pays a lower tax rate than his cleaning lady.
Corporate taxes accounted for 30% of federal taxes in the mid-50s when the economy was prospering, but only 9% today. If the corporate tax rate were raised to the rate paid in the 50s and if all profits made by American corporations abroad were taxed instead of only the profits they bring back, that would help the deficit and reduce the incentives to export jobs.

Some argue that the growing income inequality is just the result of market forces at work and that it is the price we have to pay for capitalism, democracy and the freedom it affords us, and that eventually the rising tide will lift all boats. We have 30 years of evidence that trickle down economics does not work. In fact, economists now recognize that income inequality has become a drag on the economy.

Slide 8: Inequality : a Drag on the Economy

John Maynard Keynes made this argument in the General Theory in 1936. Many people believe that the argument for more income equality is based on social justice, and certainly there is that. But there is an economic argument against income inequality . Because the wealthy spend only a fraction of their income and save the rest, their income does not multiply demand through the economy to create employment as does the income of the poor and middle classes which is mostly spent. So a worsening income inequality means that demand will fall and unemployment will result and poverty will increase. The IMF recently released research showing that the ever-greater concentration of wealth and income hinders growth worldwide.

Slide 9: Poverty 2012

Over 1 in 5 of all children live in poverty.
14.-1/2 % ( over 17m U.S. households ) are “food insecure”, meaning that at some time during the year they were unable to feed their families with their own resources.
Over 1-1/2 m. children experienced homelessness in a year. Preliminary results show that growing up in a stressful social environment leaves lasting marks on young chromosomes. Telomeres, which are repetitive DNA sequences that protect the ends of chromosomes from fraying over time, are shorter in children from poor and unstable homes than in children from more nurturing families, and this change threatens their long-term health.
One of the realities of poverty in this country is that it is often hidden and hence ignored or denied.
We may see a homeless person on the street panhandling, but we don’t see the family crowded in one room without adequate clothing , heat or food. We don’t see the elderly having to decide whether to buy medicine or food. There is more rural poverty than urban poverty, and that is almost entirely hidden from view. Wealthy individuals increasingly live in separate, sometimes gated, communities and they can carry on their lives without encountering anyone they recognize as poor or indeed anyone whose politics they don’t share. The segregation between homeowners and renters results in starkly different civic environments, including schools. It is easy to understand why the lower income citizens wanted to own a home when mortgages were urged on them by unscrupulous lenders. Home ownership is one of the chief paths out of poverty.
You hear the belief expressed that aid to the poor simply makes them unwilling to work, and therefore that we do them a favor by not letting the “safety net become a hammock” The implication is that the social safely net is the reason why so many Americans remain trapped in poverty. But the evidence shows nothing of the kind.

Slide 10: Income and Social Mobility

If generous aid to the poor perpetuates poverty, then the United States, which treats its poor far more harshly than other rich countries and induces them to work many longer hours, should lead the west in social mobility. In fact it is just the opposite: America has less social mobility than most other advanced countries and it has been worsening as income inequality has grown. We used to pride ourselves on the fact that the vast majority of people on welfare were only there temporarily and soon rose out of poverty. America was the land of opportunity. We saw the generations “on the dole” in Britain and contrasted our experience with theirs. But that is no longer the case. Now we face the real possibility that families will be poor and in need of assistance for 2 or more generations. For all the reasons we have talked about, poverty begets poverty in a land of reduced possibilities.
Now that we have a picture of the extent of income inequality, let’s talk about a major problem in health reform that is bound up with income inequality , and that is the delivery of mental health care for the poor.

Slide 11: Mental Health according to NIMH (National Institute of Mental Health)

NIMH reports that over 26 percent of Americans ages 18 and older , or about 1 in 4 adults, suffer from some sort of diagnosable mental disorder in a year. Consider those people who are incarcerated. The United States has the highest incarceration rate in the world, with over 2 million people behind bars. The estimate is that fully half of all prisoners have at least one mental disorder. Almost weekly the New York Times carries an article about the problem of mental illness in prisons.

Slide 12: Incarcerated Americans

How did this happen? It arose from a series of interrelated developments. First, the discovery of anti-psychotic medication in the 1960s led to a movement to close many psychiatric hospitals. They were supposed to be replaced by community facilities, but in fact most were not. At the same time, health insurers restricted coverage for mental health treatment, and finally the “war on drugs,” begun in the 1980s, increased drug related arrests and brought in mandatory and fixed sentences. More offenders with psychiatric and substance abuse problems, often one and the same thing, were incarcerated for many years without treatment and then released into the the community that had nothing for them: no jobs, no treatment, no housing. This led to drifting homelessness and further mental decline . All over the United States, police officers find themselves playing dual roles as law enforcers and psychiatric social workers. County jails and state prisons have become de facto mental institutions without offering any treatment.
The lack of mental health programs among the incarcerated is a serious national problem, not least because of the especially high recidivism rate among released convicts who have serious disorders. We need to 1) improve mental health care behind bars 2) make sure that all mentally ill inmates are enrolled in Medicaid before they are released, so they have access to care and medication and 3)encourage the growth of an important new program that steers mentally ill people who pose no present danger to the public into mental health programs instead of jail.

Beyond the special problems that the prison system presents, the general problem of lack of mental health care among the poor is more complicated.
Mental illness has always carried a stigma. There is the sense that somehow it is the person’s fault. Even after we began to discover the physiological basis for mental illness, it was not something that people were comfortable talking about. If we consider the problem of depression, which is the most common mental illness, relatively few people talk openly about it. The Carletonian recently reprinted an article by a student from 2011 entitled: Depression: you’re not the Only One, and called for a more open discussion and support on campus for depression.
Mental health professionals tell us that the poor and depressed often have no idea that it is a disease. They know that they have no will to do anything and no energy, but few know that this condition is an illness and has a name.
The Affordable Care Act mandates coverage of mental health by insurance companies, but there are still millions of people who live in states where federal funds for Medicaid have been refused and where the cutoff for Medicaid is a fraction of the poverty level. So millions of the poor continue without health insurance. And there have been closures of many mental health facilities with the worsening of state finances since the downturn, so there is an acute shortage of available care.
Of course depression cuts across class boundaries, but depression treatments do not. This means that most people who are poor and depressed stay poor and depressed. In fact the longer they stay poor and depressed, the more poor and depressed they become. Poverty is depressing and depression is impoverishing, leading as it does to dysfunction and isolation. If someone in the middle class is hit by depression, it is relatively easy to recognize. You are going about your life doing fine and suddenly you begin feeling bad all the time. You can’t function at a high level, you don’t have the will to work and don’t seem to have control over your life. As you become increasingly withdrawn you begin to attract the notice of friends, coworkers and family, who cannot understand why you are giving up so much of what has always given you pleasure. And they urge you to seek help through medication and counseling.
But if you are way down the social ladder, the signs may be less immediately visible. For the miserable and oppressed poor, life has always been hard and they have never felt great about it. They’ve never been able to get or hold a decent job; they have never expected to accomplish anything much, and they have certainly never felt that they had control over their lives. The normal condition of such people has a great deal in common with depression. Though it is common to assume that depression is the natural result of such a life, the reality is frequently just the other way around. If you are depressed, you fail to make anything of your life and remain stranded in the lowest echelon, overwhelmed by the very thought of helping yourself. When pilot programs to diagnose and treat the depressed indigent have been tried, we find this often allows them to discover within themselves ambition, competence and pleasure. And they are then in a position to help themselves.
Depression is a big category, and it is estimated that it occurs more often among people living below the poverty line than it does in an average population. In fact, estimates are that welfare recipients have a rate of depression that is 3X as great as the general population.

We talk about depression among the poor, but in fact the poor have several problems that are interrelated. Economic hardship is only one. They are often in bad relationships with parents, children, boyfriends, girlfriends, husbands or wives. They are not well educated. They do not have easy distractions from their sorrow or suffering, such as satisfying jobs or interesting travel. They do not have the fundamental expectation of good feelings. But depression carries a stigma and people who are depressed, even if they know it, which they probably don’t if they are poor, don’t know where to start to help themselves with mental illness. They turn to alcohol or drugs.
As troubling as all of this is, it gets worse, for poverty perpetuates itself when mental illness is involved. Parents who are depressed cannot care adequately for their children. We are all aware of the heartbreaking pictures of toddlers in slums trying to cook something to eat while their parents are incapacitated by mental illness or its other manifestations. All poor children suffer from the lack of care and stimulation, and we know that what children are exposed to before the age of 3 could have a profound impact on their progress in school. Last spring a study done at Rice University reported that children of professional parents were exposed to 3 million more words than poor children before the age of 3. Parents are encouraged to read to their children, play games and sing to them. Most very poor people do not have the time or the energy to understand what is needed, let alone the means to provide books, toys and good food.
Millions of children in this country do not have access to quality early learning opportunities. It was announced last month that the punishment of children as young as 4 in schools is often very harsh and children are expelled when teachers cannot cope. We all know about the scandal of over-prescribing of drugs for children and young adults thought to suffer from attention deficit disorder. It is no wonder that when these children go to school in classes so large that the teachers cannot be effective, they fall farther behind .To believe that you are not smart enough to succeed in school is depressing and leads to dropping out eventually and all the ills that the poor are exposed to. There is evidence that there is a genetic component to some mental illness, so these poor children are already at a higher risk for developing mental illness as an adult than are more affluent children. And so the cycle continues. Studies have found that well-focused investments in early childhood development yield high public as well as private returns.
How does income inequality and the % of citizens with mental illness compare across countries?

Slide 13 Income inequality and Mental Illness Across Countries

It appears that more people suffer from mental illnesses in more unequal countries.

Slide 14: Income Inequality and Health and Social Problems

It is also clear that health and social problems are more common in more unequal countries.
We also need help for poor patients with limited education and distrust of doctors to navigate their way through obtaining insurance, keeping appointments and following up with care.
In 2012 the American College of Surgeons made patient navigation a standard of care and the Affordable Care Act requires that patient navigators be used to help Americans obtain insurance under the exchanges. But insurance is only a first step toward helping the poor and mentally ill have access to quality health care.
Of course, what is true of mental illness is true of other medical conditions as well, such as obesity and diabetes. While the poor are not more obese than the general population, the causes are somewhat different.

Slide 15: Vulnerability of the Poor

Several factors make it harder for the poor to fight obesity:

1) limited resources with which to make choices
2) lack of access to healthy, affordable foods
3) fewer opportunities for physical activity
4) cycles of food deprivation and overeating
5) high levels of stress
6) greater exposure to marketing of obesity-promoting products.

A large study by the CDC on diabetes recently reported that rates of heart attacks, strokes, kidney failure and amputations from Type 2 diabetes fell sharply over the past two decades, although cases of diabetes continue to rise. Diabetes accounts for $176 B in health costs each year, so progress on this front has important cost containment implications. But this good news did not apply to the poor. The main author of the report said “Really, we have two worlds. The educated patients tend to manage diabetes well. Then we have the other world, which is far more likely to ignore diabetes until its devastating complications set in, maybe because of social issues, language issues, access to health care, and economic issues.”
Without good nutrition, the poor are less able to work, have less resistance to disease, and their babies are more likely to die. The link between income and longevity has been clearly established. Men in the upper ½ of the income spectrum who reach 65 live 6 years longer than they did in the late 70s, but men in the lower incomes only live a little over 1 year longer. Many don’t recognize that this life expectancy gap has policy implications. If Congress decides to increase the retirement age or decrease the cost of living index for Social Security recipients, that will be unfair to those who die considerably earlier.
What is the solution to this Gordian knot of income inequality and health care reform? Do you want the bad news first, or the good news?

Slide 16: Rate of Return of Capital vs. Rate of GDP Growth

Let’s take the bad news first. There is a new book by Thomas Piketty at the Paris School of Economics that promises to be highly influential, which argues that the worsening of income inequality is the inevitable outcome of market capitalism. Piketty demonstrates that the rate of growth of returns to capital which exceeded the rate of growth of GDP for most of history and inspired Marx to predict the eventual overthrow of capitalism by the lower income workers, slowed somewhat in the first half of the 20th century. This ushered in the growth of the middle class in the interwar years and made us expect that capitalism would bring prosperity to everyone in due course.
Indeed, Simon Kuznets, a very influential economist in the 1950s sketched out what came to be known as the “Kuznets Curve”, which shows a widening of the inequality in the transition from preindustrial to industrial civilization and then a stabilization and then a narrowing in the latest phases. This conclusion provided a huge moral lift to capitalism during the Cold War and suggested that the market economy could distribute its fruits equitably without any heavy handed state intervention. And economists pretty much lost interest in the issue of income inequality after that. They assumed that in a balanced economy, wages and profits rose at the same pace and that what really needed attention was taming the business cycle.
Now we are questioning this. Income from wealth usually grows faster than wages, and as returns from capital are reinvested, inherited wealth will grow faster than the economy, concentrating more and more wealth in the hands of a few. The period on which Kuznets based his analysis was an exceptional period in history, when a depression, two world wars and high inflation destroyed a large chunk of the world’s capital stock. Fast growth after World War II and high taxes on the rich, flattened the distribution of income until the 1970s.
But this exceptional period long ago ran its course. Piketty argues that inherited inequality has been lower in the United States because the population has been growing so fast and driving the economic expansion. But the share of national income absorbed by corporate profits is already rising sharply, and the future inequality in the United States will continue to worsen unless we overhaul the tax code.
He argues that the standard recipe—education for all—is no match for the powerful forces driving inherited wealth even higher. And taxes, which could reduce the after-tax return to capital so that it equaled the rate of economic growth, are prey to powerful interests which will oppose them. If we put our trust in the illusion of free markets, things will just get worse. To address the problem of income inequality is to my mind the most urgent economic problem we face. It can be done, but it requires political will.
But there is some good news: there are things we can do now to ease the suffering and address the need for health reform for the poor. Even if the turning of the capitalist ship is a slow process, we can take action now to rescue those who are overboard. A systemic approach to the problem of mental illness is required, including more resources for treatment and community outreach programs.
And we know how to help the children. For a start we can provide free universal Day Care and pre-Kindergarten education and reduce the number of children to no more than 15 per classroom. We can make sure that the poor have access to nutritious food through an extension of food stamps and school breakfasts and lunches. We can invest more in education at every level.
If all of this sounds like academic idealism, that does not make it invalid or less urgent. We seriously need to see beyond the harmonious, maximizing , efficient economic model of textbook capitalism and confront the unjust, polarizing, inefficient, and cruel outcomes which such a system left to its own devices in the real world guarantees. Adam Smith’s point in the Wealth of Nations was that this new market system developing in the wake of the industrial revolution would insure that the economic pie got bigger because of division of labor. Moreover it could be left to its own devices under the invisible hand of self interest . That’s why some people in Washington were wearing Adam Smith ties when Ronald Reagan was elected on the promise of deregulation. But this is not the 18th century. Market outcomes don’t produce the greatest good for the greatest number in a global economy. Somehow we must get beyond that ideology and recognize that a democratically elected government is the only force powerful enough to harness resources for the collective good and that it must use its power to curb the growing inequality that threatens our future.
Sometimes my economic history students say that I act as though the 17th century is “my own personal century”, and I acknowledge that when it comes to caring passionately about a period or an issue that is very important I am guilty as charged. Don’t start packing up. I am not going to launch into the reasons why the 17th century is the most important century in the history of the world. But I cannot emphasize enough that the issues I have raised today are vital to our wellbeing as a society.
My great-grandfather was a doctor in the Confederacy and despite the fact that he was on the losing side, or maybe because of it, he always said that Abraham Lincoln was the greatest man in our nation’s history. Lincoln not only saved the union but he cared about the well being of each citizen who would make up that union, including, and maybe especially, the defeated southerners.
The poor in the United States have become the defeated, but their lives and potential contribution to our society are critical to our union. To fail to address the Gordian knot of worsening income inequality and the crisis in health care which disproportionately affects the poor is not only inefficient and therefore wasteful, but it weakens our social contract. Unless we can regain control of capitalism to ensure that public interests takes priority over private interests, growing income inequality is in danger of radically undermining the meritocratic values on which democratic societies are based. Failure to help those among us who cannot help themselves is the beginning of that process. And, moreover, it is simply not worthy of us as Americans, let alone as human beings.
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Re: POVERTY AND PUBLIC HEALTH

Post by Tripps »

Well - I printed this out today, and gave it two coats of looking at. Bit early to reach any conclusions yet - but it certainly makes you think.. I did a Google search on the author, and she's a very impressive name to have on your speed dial. :smile:

I note that she is entitled to dine at the High Table at Kings College Cambridge six times a year, free of charge, with unlimited wine before and after the meal. I bet they know a thing or two about seven bird roasts there. :smile:
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Re: POVERTY AND PUBLIC HEALTH

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Martha is Wadsworth Professor of Economics at Carleton College and we are close friends because apart from teaching her students in the UK for almost twenty years I have spent a lot of time as guest and paint scraper at the Paas house in Northfield. A good woman and her husband Roger is no slouch!
M sent me this LINK to an article by Paul Krugman (another good man!) in the NY Times. Well worth having a read. The Name Piketty is going to become very well known!
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Re: POVERTY AND PUBLIC HEALTH

Post by Stanley »

I've ordered Piketty's book 'Capital'. I can't do any other, I'm getting so many rave reviews from my friends. (A good 1st edition will be a very valuable book in the future!)
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Re: POVERTY AND PUBLIC HEALTH

Post by Stanley »

Bumped in view of the discussion on the NHS. A very good insight into the American Health system.
(The link to Piketty is still valid and a bit of a goody in hindsight!)
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Re: POVERTY AND PUBLIC HEALTH

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Bumped in the hope that it may get even wider attention.
See THIS Article from the Carleton College 'Voice'. I was the 'salty 50 year old' and yes, Martha was a bit shocked at first but I soon converted her. She even started swearing! I did every Cambridge seminar from 1982 onwards and M and I are still talking to each other!
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Re: POVERTY AND PUBLIC HEALTH

Post by Tripps »

I was in Cambridge this afternoon, and couldn't resist a short detour to look if this memorial plaque was still there. It is - but could do with a good clean up. :smile:
P1000740.JPG
P1000741.JPG
Those steps need a handrail or climbing ropes. :smile:
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Re: POVERTY AND PUBLIC HEALTH

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Brilliant! I shall send it to Martha immediately! (Done)
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Re: POVERTY AND PUBLIC HEALTH

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Martha has replied and says that next time she goes to Cambridge she will take some polish with her. We must keep an eye on her activities David!
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Re: POVERTY AND PUBLIC HEALTH

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Stanley wrote: 19 Apr 2019, 06:30 We must keep an eye on her activities David!
I've done that already. :smile: I have had a print out of the Phi Beta Kappa paper for quite a while now, and I did some revision last night. There's quite a lot of information here

I now know what Kipper und Wipper means. That'll impress her next door. :smile:


There was a time when I'd have volunteered to clean the plaque myself, but being a long time bungalow dweller, the steps with no hand rail gave me the creeps so I won't. :smile:
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Re: POVERTY AND PUBLIC HEALTH

Post by PanBiker »

Our latest registered member is mpaas I wonder if that is Martha?
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Re: POVERTY AND PUBLIC HEALTH

Post by Tripps »

PanBiker wrote: 19 Apr 2019, 11:05 I wonder if that is Martha?

Pretty sure to be I'd guess. :smile:
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Re: POVERTY AND PUBLIC HEALTH

Post by Stanley »

Yes, she re-registered because she couldn't access the site but still failed.
David, could you be persuaded to clean the plaque up a bit. Could get you a dinner at the college...... :biggrin2: :biggrin2:
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Re: POVERTY AND PUBLIC HEALTH

Post by PanBiker »

Stanley wrote: 20 Apr 2019, 02:52 Yes, she re-registered because she couldn't access the site but still failed.
She must have been able to access in order to complete the registration.

Her registration completed correctly, does she get an error message when she tries to access now?
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Re: POVERTY AND PUBLIC HEALTH

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Stanley wrote: 20 Apr 2019, 02:52 David, could you be persuaded to clean the plaque up a bit. Could get you a dinner at the college..
Yes of course, I shall conquer my aversion to heights, and the 'treating' is probably best avoided. I'd probably show myself up. :smile:

I checked 'cleaning plaques' on google and was surprised that the result showed that a company in St Paul - Minnesota came up as the experts. I've taken this as a sign that we are undoubtedly on the right path. Nameplates

Already paying dividends - I'm dining next door tomorrow - I donate the lamb, and they do the cooking - and I've promised them a good story about economics professors and such.. :smile:
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Re: POVERTY AND PUBLIC HEALTH

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Let me know when you have done it and I shall surprise Her Majesty....... :biggrin2:
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Re: POVERTY AND PUBLIC HEALTH

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Stanley wrote: 21 Apr 2019, 02:28 Let me know when you have done it and I shall surprise Her Majesty.
Well - I made an attempt this afternoon, but things didn't go well. I parked up and since a parking attendant was booking someone and taking photos just across the road, I thought it best to actually read the parking notice. Seems it's for residents with permits only. Tried again higher up the road, but same situation.

I had time for a quick closer look and decided that the weathering of the sign is ingrained and that a quick scrub, and brush down would be unlikely to bring about any big improvement. There are about six doorbells, so it's a 'house in multiple occupation' - no point in introducing myself - they'll probably be gone after the exams. The net curtains look as if Keynes himself had put them up. :smile:

So - mission abandoned. Sorry. :sad:
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Re: POVERTY AND PUBLIC HEALTH

Post by Stanley »

What a good man. I have informed M that you tried and encouraged her to post her thanks, if she can't get in the site to do that I will give her your address. I think she's in Sicily at the moment......
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Re: POVERTY AND PUBLIC HEALTH

Post by PanBiker »

Stanley, can you find out why Martha can't get on the site? or if there is an error message?

I find it puzzling as her registration completed fully so there shouldn't be a problem.

I have just tried her account permissions to browse the site and it all works as it should. This admin facility allows me to check the functioning of an individual members account and it all seems good. :smile:

If it's a logon problem it can only really be the password which can be changed if required.
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Re: POVERTY AND PUBLIC HEALTH

Post by mpaas »

David,

Thanks for tracking down the Keynes Plaque!! I shall endeavor to have it cleaned!!!

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Re: POVERTY AND PUBLIC HEALTH

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There we go, proof of the pudding, welcome to the site Martha.
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Re: POVERTY AND PUBLIC HEALTH

Post by Stanley »

Well done M! When you have a spare minute (hollow laugh :biggrin2: ) have a look at other topics. You'll be interested in Forgotten Corners for instance....
(I feel as though we have had a visit by Royalty.....)
You can chalk that one up as an accolade and dine out with the Poet on it David......
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Re: POVERTY AND PUBLIC HEALTH

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Stanley wrote: 28 Apr 2019, 02:47 (I feel as though we have had a visit by Royalty.....)
Must be a VIP to impress Stanley like that :smile: and there have been over 120 views of the pictures of the Keynes plaque - that's impressive, so today I tried again, and Sunday is very different from Friday. I found a parking spot just round the corner and armed with my plaque cleaning kit, tried again.

Two squirts of CIF, a scrub with a brush, a rinse down with cold water, a wipe, and the job's a good 'un.
Plaque after cleaning.JPG

In fact there are twelve doorbells. :smile:
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Re: POVERTY AND PUBLIC HEALTH

Post by Wendyf »

:clap:
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Re: POVERTY AND PUBLIC HEALTH

Post by plaques »

Tripps wrote: 28 Apr 2019, 17:51 Two squirts of CIF, a scrub with a brush, a rinse down with cold water, a wipe, and the job's a good 'un.
Well done Tripps. Did you find CIF was better than Pinkerton's Stain Remover?
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