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Our Health Care System Is Organized for the Wealthy -- We Can Change That

We are accustomed to living in a sharply tiered society, but it doesn't have to be that way with health care.

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"This isn't a middle-class country," Reinhardt observed after presenting these numbers. "It's not even a democracy; it's an aristocracy.” 

Wealth and power have become consolidated in the hands of a few because, over the past 29 years, income has been distributed so unevenly, allowing the wealthy to speculate on real estate and high-flying stocks. Since the early 1980s those who could afford to play this high stakes game have bid prices ever higher, and as a consequence, their net worth has soared.   

Despite the stock market crash of 2000, the real estate bubble kept the wealthy afloat: indeed from 1995 to 2004, the wealthiest 25 percent of the nation saw their net worth (assets minus debt) double while the middle class made meager gains.

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At the top of the economic ladder, high salaries gave the affluent the funds they needed to speculate.  According to the Census Bureau, in 2007 the 20 percent who own 85 percent of all wealth also commanded roughly 50 percent of all income while earning an average of $168,000 that year. (Half earned more than $168,000 and half earned somewhere between $100,000 and $168,000.)   

As the table below shows, just one giant step down on a five-step income ladder, upper-middle-class households earned 23 percent of aggregate income, taking home an average of $79,000. On the third and middle step, "middle class" households earned 14.5 percent of the total while receiving an average of $50,000 -- leaving a measly 12 percent of the pie for the 40 percent of the population stuck on the bottom two steps -- where they averaged $29,000 and $11,500 respectively.

  --In 2007, the wealthiest 20 percent earned 50 percent of all  income  

   --Households one step down on a 5-step ladder received 23 percent of all income  

   --Households on the middle step took home 14.5 percent of  all income     

--The bottom 40 percent of the population d divided 12  percent of all income

Some observers point out that the rich pay more in taxes than the rest of us, but even after taxes, the top 20 percent hauled home 45 percent of the nation's earnings.   

Others try to rationalize the consolidation of wealth at the top by arguing that income gaps have widened because education has become much more important. Granted, a college education makes a difference, but the last few decades have hardly created a meritocracy.  The bulk of the divergence in salaries has been among those with comparable levels of education.  High school teachers, nurses and CEOs all spend roughly the same number of years in school, but corporate chieftains earn far more than those responsible for educating our children and caring for the sick.  Even Ph.Ds and those with professional degrees in law and medicine often net much less than MBA's who work in business, real estate or finance.  
Conservatives also like to argue that if you add in the benefits that middle-class workers and poorer Americans have been receiving from employers and government, you will find that all Americans are gaining ground. To test that hypothesis, consider the research done by the Congressional Budget Office. When calculating income, the CBO includes all the standard household revenue streams -- wages, dividends, interest, and the like – plus food stamps, Social Security and employer-paid health benefits.

Using that formula, the CBO discovered that even if you include the health benefits the incomes of America's statistical middle class – the 20 percent in the exact middle of U.S income distribution -- rose only 15 percent over 25 years, or less than 1 percent a year. 

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