The Endangered American Family

How America Has Broken the Social Contracts for Our Children

Trump Administration Republicans are intent on cutting social contracts for middle-class and lower income Americans, by undermining funding, creating negative campaigns about publicly funded programs, and voiding enforcement of current regulations. This article examines these primary expenses for families; healthcare, childcare, housing, and education in the United States, as compared to other industrialized countries.

Healthcare

The cost of U.S. healthcare is higher than anywhere else, yet the benefits and access to care are at the bottom of industrialized countries. As discussed in my 2013, book and many articles over the past decade, this is primarily due to a system which has little cost controls and reimburses healthcare providers on the basis of volume. The Trump Administration has removed the tax penalty for nonexempt families who do not obtain health insurance, which will undermine participation in the ACA insurance exchange programs. Further, the current administration has threatened to remove the tax credits which enable middleclass and lower middleclass Americans to obtain insurance. According to the Kaiser Foundation, the average cost for health insurance for a family is now $18,301 for private plans through employers. (Kaiser Foundation State Health Facts, 2018) Republican plans to lower the cost of health insurance include; reinstating pre-existing conditions for people with health issues, excluding maternity coverage, and absurdly low maximum benefit levels.

Finally, the cost of healthcare, does not mean your insurance payments, it means the total cost of services, administration, out of pocket expenses, and of course the insurance premiums.  This link shows healthcare spending in 2015, using World Economic Forum data. https://www.pgpf.org/chart-archive/0170_international_health_spending_comparison

Childcare

The ability to afford childcare is fundamental to economic mobility. Countries which do not produce enough children have challenges filling jobs, supporting social programs for current beneficiaries of social programs, like Social Security, and maintaining public services. Excluding Monaco, which is primarily a retirement haven for the wealthy, as well as a small French protectorate off the coast of Newfoundland, and Andorra the adorable tax haven situated in the Pyrenees, Japan still leads the pack for the lowest birth rate. For this criterion, the U.S. is in the middle of the pack, ranking 158 out of 226 nations. (CIA Factbook-2017, 2017)  Of the industrialized countries, here are top child producers:

Rank	Industrialized Country	Birth per 1,000
1	India	19.0
2	Venezuela	18.8
3	Mexico	18.3
4	Israel	18.1
5	Argentina	16.7
6	Turkey	15.7
7	North Korea	14.6
8	Brazil and Ireland	14.1
9	Iceland	13.7
10	Chile	13.6
11	New Zealand	13.2
12	United States	12.5

The most expensive childcare is in the U.K., which includes England, Scotland, and Wales. The U.S. has the next most expensive childcare, consuming over 25% of family household incomes. (Organisation for Economic Co-operation and Development, 2016) Currently, the U.S. has no mandatory paid maternity or family medical leave policy. The Family Medical Leave Act, enacted in 1993, required employers with 50 or more employees to provide up to 12 weeks of unpaid leave for an employee or family member engaged in the care of a family member. Employees are entitled to this leave every 12 months. Though 66% of women work during pregnancy, there has been no change in this mandate.

Scandinavian countries provide families with subsidized high-quality childcare, free preschool, and a monthly stipend per child. Parents receive anywhere from 12 to 20 weeks of paid maternity leave. These generous social policies mean that most women are able to work and support themselves while having children, at living wage jobs, including single mothers. Even the UK now provides 15 hours of free childcare for all children (as of 2017). Virtually all European nations provide some type of childcare for working families and in Western Europe this is typically 15 to 30 hours per week. (Janta, 2010)

Home Affordability

In the United States there are many variables to housing costs, depending on a rural or urban location and the availability of employment, which can support housing costs. This is why housing indexes tend to measure housing costs in major metropolitan areas and not the sparsely populated ones. Though housing costs for home buyers tend to be more affordable here than in other nations, for renters, costs are out of control in many regions of the country. That said, housing is a key issue for families so here is a metric illustrating how the U.S. compares to other developed nations with the most expensive listed first. This chart includes data from 2017 for 2018 cost of living values. (Numbeo.com, 2018)

Ranking	City	Multiple of Income   Housing Affordability Ratio
1	Beijing	48.1
2	Shanghai	42.8
3	Hong Kong	41.08
4	Mumbai	28.7
7	Singapore	22.2
8	London	22.19
9	Rio De Janeiro	21.31
10	Rome	20.48
28	Paris	17.68
41	Vancouver, CA	16.02
58	Barcelona	13.99
63	Tokyo	13.68
79	New York	12.34
81	San Francisco	12.31
108	Helsinki	10.99

Rental Housing

However, when viewing housing affordability and rent, a 2015 Harvard study of 11 countries revealed the U.S. was the second most expensive for renters, after Spain. U.S. renters spend 34% of disposable income on housing and low-income households are much more likely to spend 50% of household income on rent (28% of U.S. renters spend >50%). The study found that the degree of income inequality, which is by far greater in the U.S. than these nations and the availability of housing allowances determined the level of affordable rentals. This exhibit shows the housing subsidies provided by European countries compared to the U.S. (Micheal Carliner, 2016)

Percentage of the nation Receiving Housing Allowance	Country	Value of Annual Housing Allowance in USD
55%	France	2,257
46%	United Kingdom	4,988
38%	Netherlands	2,170
20%	Sweden	5,324*
18%	Germany	Not listed
12%	Austria	4,200*
6%	Italy	Not listed
6%	USA	7,200
5%	Spain	2,952*
3%	Switzerland	Local funding
2%	Belgium	Local funding

*These values were drawn from other sources for the 2015 year, due to the way the Harvard article expressed the data. (Organisation for Economic Co-operation and Development, 2016)

Education

Though obtaining a university education is not a goal for all residents, it is considered a measure of upward mobility, not only for the individual but for generations of family members. Since the U.S. has continued to under fund public universities, universities have relied more on user’s fees, tuition increases, and private endowments to pay for higher education. Follow this link to a Forbes article citing the Organisation for Economic Co-operation and Development, which shows U.S. tuition costs compared to the world, based on 2017 data. (Organization for Economic Development, 2018)

https://www.statista.com/chart/11058/the-us-has--the-worlds-highest-tuition-fees/

  

Education policy changes under consideration in the Trump Administration include: eliminating PELL grants for low-income students, cutting back on federally subsidized student loans, eliminating loan forgiveness for those who go into public service roles like nursing or education, and turning loan programs over to for-profit entities, which will raise the costs for students. None of these changes would impact children of the wealthy, whom have already been gifted the biggest tax break under the Trump budget, since Ronald Reagan, only working-class people trying to better themselves.

Anyone with a pulse would conclude the U.S. is not a very easy place to raise children, with the highest rate of mass shootings in the world (the only places that come close are war zones), laws that allow employers to discriminate against working parents, and a nominal social safety net. Not only are these factors impacting highly skilled workers, where out migration has increased since George W. Bush, but the continued efforts by the Republicans to cut social safety-net funding jeopardizes future generations. The U.S. government doesn’t effectively track residents who move to other countries, but maybe it should learn why natives are fleeing the country. The number of Americans who have left the country is anywhere from two to nine million and those legions include retirees, professionals working elsewhere, and those who don’t want to raise their families in the U.S. If Trump wants to make America great again, why doesn’t he look at the adverse policies making it extremely expensive to raise children, who are after all, future tax payers. The proposed federal budget further increases the federal deficit to give tax breaks to the super rich further undermining the nation’s ability to meet Social Security and Medicare/Medicaid obligations. Let’s be clear, these are the only working class social programs for Americans and Trump, Ryan, and Mulvaney would like to get rid of them through program and funding cuts.

This article was written by Roberta Winter, an independent journalist and author of : https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972

For the next three months I will be raising money for the inaugural Russell Ride, an epic 858 mile bicycle ride from Washington to California, in memory of my brother. All proceeds go to the Benaroya Research Institute to cure Type 1 Diabetes. For more information, follow these links:

https://give.everydayhero.com/us/team-roberta-e

https://www.benaroyaresearch.org/

References

Agency, U. S. (2017). CIA Factbook-2017. In C. I. Agency, The World FactBook 2017. Retrieved March 27, 2018, from https://www.cia.gov/library/publications/the-world-factbook/rankorder/2054rank.html

Janta, B. (2010). Caring for Children in Europe-How Childcare, Parental Leave, and Flexible Working Arrangements Interact in Europe. Rand Corporation.org. Rand Corporation-Europe. Retrieved March 28, 2018, from https://www.rand.org/content/dam/rand/pubs/research_reports/RR500/RR554/RAND_RR554.pdf

Kaiser Foundation State Health Facts. (2018, March 28). Kaiser Foundation State Health Facts. Retrieved from Henry J. Kaiser Family Foundation.org: https://www.kff.org/other/state-indicator/family-coverage/?currentTimeframe=0&selectedRows=%7B%22states%22:%7B%22washington%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

Micheal Carliner, E. M. (2016, September 1). Rental Housing-An International Comparison. Harvard University Joint Center For Housing Studies. Retrieved March 28, 2018, from http://www.jchs.harvard.edu/research/publications/rental-housing-international-comparison

Numbeo.com. (2018, March 27). Property Prices Index 2018. Retrieved from Numbeo.com: https://www.numbeo.com/property-investment/rankings.jsp

Organisation for Economic Co-operation and Development. (2016). Affordable Housing Database-Key Characteristics of Housing Allowances. Paris: Organisation for Economic Co-operation and Development (OECD). Retrieved March 28, 2018, from https://www.oecd.org/els/family/PH3-2-Key-characteristics-of-housing-allowances.pdf

Organization for Economic Development. (2016, December 22). These Are The Countries Where The Parents Spend The Most On Childcare. World Economic Forum. Retrieved March 27, 2018, from https://www.weforum.org/agenda/2016/12/childcare-cost-oecd/

Organization for Economic Development. (2018, March 27). Education At A Glance. Retrieved from Organization for Economic Development: https://blogs-images.forbes.com/niallmccarthy/files/2017/09/20170912_Tuition_Fees.jpg