As we reach the final days of National Minority Health Month, one Healthcare Executive article recently caught my eye.  In John Buell’s, “Equity of Care”, the author stipulates that healthcare systems must focus on six key elements in order to truly achieve quality care.  In absence of efficiency, effectiveness, safety, timeliness, patient-centeredness or equity, Buell contends that institutions are not meeting the mark.  While progress is being made on the first five ingredients, equity is described as, “the last fundamental piece that many hospitals have struggled to achieve but one with which some clear progress is being made.”

According to the author, “equity is achieved by providing care that does not vary in quality on the basis of patients’ personal characteristics such as ethnicity, gender, geographic location and socioeconomic status.”   With the diabetes-related death rate of blacks in the U.S. almost twice that of whites, Dr. Joseph R. Betancourt, Associate Professor of Medicine at Harvard and Director, the Disparities Solutions Center at Massachusetts General Hospital, asserts that social determinants and access to care are the leading contributors to racial and ethnic disparities.  Dr. Betancourt also points out that, “hospitals are not purposefully treating patients differently, but it may mean that hospitals are not doing the extra things to meet the needs of the diverse populations.”

So, what can be done to reverse this trend?  The Disparities Solutions Center provides the following recommendations:

• Create a disparities committee or task force – multidisciplinary team charged with what is being done to identify and address disparities, including whether or not patients’ race and ethnicity are being collected.
• Build a foundation to address disparities, including data collection and stratification of quality measures
  • Develop medical policies
  • Finalize a strategic plan with one, three and five year goals
  • Assign leadership and raise awareness with internal and external constituencies
  • Create a dashboard for monitoring assigned measures and standardize processes
  • Develop pilots to address disparities
  • Evaluate, share and re-engineer

While not explicitly addressed at this level, it also remains critical to note that a multicultural workforce  provides a sense of community for prospective patients and resource for creative recommendations to better serve their brethren.  Engaging patients beyond the hospital walls to educate and empower them for better health also holds great promise.  With 45% of the fastest growing segment of the population owning smartphones, are we harnessing this engine to effectively reach Hispanics regarding their significant predisposition to diabetes…and the means to avoid it?  For that matter, is the U.S. taking serious note of the innovative preventive and service delivery measures that less developed countries are employing?  Last but not least, technology is merely an enabler and achieving true equity demands fundamental reassessment of ‘health’ in the community, as well as, the healthcare system.

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On April 14 student leaders from the Southside Solidarity Network (SSN) at the University of Chicago, a founding member of the IIRON Student Network, joined a 99% Spring training hosted by SOUL. At this training we learned about the economic and political  history of the United States. We learned about how we came to this moment where large corporations and the ultra-rich have taken over the economy and political system, and are now implementing austerity measures which undermine public education, social services, and the common good. And we studied the strategy and tactics of non-violent direct action, and considered how we might use these tactics to confront the power of organized money which stands in the way of the emerging movement to construct a better, more humane, and sustainable future which will reflect our shared values.

For SSN, the timing of the training was serendipitous. As readers of this blog may already know, on Thursday April 12 (two days before the training) the Mental Health Movement began an occupation at the Woodlawn Mental Health Clinic, located at 63rd and Woodlawn, just a few blocks south of our campus at the University of Chicago. This clinic is one of the six city-run mental health clinics which Mayor Rahm Emanuel has targeted for closure by the end of the month, a move which will cut the number of clinics in the city in half. Prior to the occupation the Mental Health Movement had appealed repeatedly to the Mayor, Chicago’s Aldermen, and the press. The decision to occupy the clinic was made in the face of consistent refusal on the part of the Mayor to speak openly and honestly with the movement.

SSN leaders have maintained a presence at the occupation since the beginning. So when we attended the 99% Spring training, the subject matter was concrete and immediate, not abstract or hypothetical. The clinic occupation is a non-violent direct action (or a series of connected actions), and prior to the training we had already stood, linked arms, sung, chanted, and borne witness as 23 consumers and allies were arrested on the night of the first day of the occupation. Two days later, the 99% Spring training helped prepare each member of SSN to decide for themselves how they wished to proceed as the police pursued increasingly aggressive (and, by some accounts, illegal) tactics in their attempt to break up the ongoing occupation. In some cases (but by no means all), students have firmly decided to engage in actions which they recognize as involving a risk of arrest.

The clinic closures are a tangible, local example of the austerity measures being inflicted on the 99% in the United States and countries across the globe. They are a clear demonstration of the injustice and irrationality of austerity. Austerity is justified in terms of budget crises, and the city of Chicago is undeniably in a budget crisis. But the closures will reportedly save the city only $2.3 million. This is a fraction of the $15 million in TIF dollars which Mayor Emanuel attempted to hand over to his former colleagues at the Chicago Mercantile Exchange (they thankfully turned down the money after a public outcry); a fraction of the costs for the NATO summit; a fraction of the unaccountable $7 billion “trust fund” which the Mayor wants to create. We are told that these cuts are necessary because the city is broke, but the truer explanation is that the Mayor’s priorities are broken. And even if you happen to share his disregard for the welfare of the current clients of the clinics, you still ought to worry that this just might be a false economy, as reduced access to care leads to much greater costs down the line, in the form of increased visits to ERs, or “treatment” in jail cells.

At the Woodlawn occupation, SSN’s students leaders join mental health consumers, community members, and allied activists of all stripes, in a miniature image of the forms of solidarity that will be required to prevent “the 99% percent” from becoming an empty slogan. For we must always be conscious of the very real and problematic lines of oppression and privilege within ”the 99%”. And these lines are drawn clearly between the University community and the neighborhood of Woodlawn. For many students at the University of Chicago, the Woodlawn clinic and the University campus might as well exist in different universes. The campus is located in the relatively affluent and racially diverse neighborhood of Hyde Park, while the clinic is located in the predominantly black and relatively disadvantaged neighborhood of Woodlawn. For its part, the University, expressing concerns about student safety (justified to an extent, but also shot through with a predictable mix of classism and racism), works hard to maintain a barrier between the two neighborhoods, to form a protective bubble around University students. At SSN we seek to overcome this barrier and pierce the bubble. This is not to deny the very real differences between the two neighborhoods, nor the enormous privileges enjoyed by the students at the University of Chicago in comparison to the residents of Woodlawn. But we believe in building bridges of solidarity across these divisions, through shared shoulder-to-shoulder struggle and the methods of community organizing techniques practiced by SOUL and IIRON. As we, the 99%, join together and organize across all these lines which have been constructed in order to divide us, the Mayor and all those like him will come to see that, truly, the people are unstoppable.

This morning, at 10 am outside the Chicago Department of Public Health, the Mental Health Movement held a press conference urging the CDPH and Mayor Emanuel to change course.  Occupiers at the tent city across from the health clinic will remain there until the Mayor agrees to: 1) keep all the city’s mental health clinics open, fully staffed and fully funded 2) back on privatization plans for neighborhood health centers 3) hire more nurses, doctors, therapists, social workers 4) reinstate drug assistance program 5) expand mental health public safety net to cover unmet needs.

Despite two nights of wind and rain, the tent city has held up strong!  As of 2 pm this afternoon, occupiers were stabilizing the camp to combat high winds by securing canopy shelters and tents with guide lines, zip ties, and stakes.  The forecast shows tonight as mostly clear and tomorrow as sunny, so stop by 6337 S. Woodlawn and show your support!  Food and supplies are always welcome.

Sitting outside the clinic, around 9 pm Thursday

On Thursday around 4pm, 23 brave mental health consumers and organizers barricaded themselves into the clinic at 6337 S Woodlawn, and stayed there until the CPD buzz-sawed through chains, bike locks, and a chair or two, and arrested all of the occupants.

SSNers Aija Nemer-Aanerud, Sophia Kortchmar, Dasha Polzik, and Patrick Dexter sitting in front of the clinic at 6337 Woodlawn around 10pm on Thursday.

Some spent up to 14 hours in lockup before being released after being manhandled and denied medication. On Saturday, arrestees and supporters, including lots of SSNers and allies, showed up for a second stand-off with police that ended with lots of OccupyChicago allies arriving and the CPD allowing us to stay the night.

This is going to be an ongoing occupation, and it will be crucial, over the next week or so, to keep public attention in order to make sure that the city of Chicago actually addresses the issue of the clinic closures. Please feel free to contact the Mental Health Movement at 773-340-9598 or head down to 6337 S Woodlawn…keep the party going! Peace.

Press: Chicago Maroon, Chicago Tribune, care2, CBS, NBC

Come support consumers of mental health services at the Woodlawn Mental Health Clinic, scheduled to be closed next week, at a big party on THURSDAY. There will be music, activities, and lots of testimonies on the importance of mental health services.

Come to 6337 S Woodlawn Ave (right behind Robust Cafe) at 3pm on Thursday to stand in solidarity with our ally organization STOP, and to tell Rahm to save our clinics!

#1.
Communities join,
Fighting for health equity.
Life supporting work.

2.
What’s a body need?
Real food water shelter love,
Healthy Abundance.

With thanks to my coworkers, Renee and Owen, who contributed to the writing of these short odes to the work that we love. To read more health-related haiku, search Twitter with #HAWMC.  And if you have your own health-related haiku or poem, please share it here!

Shivaun Nestor,
Go Folic! Project Coordinator

_____________________________

*For those who are unfamiliar, Haiku is a Japanese poetry form – 3 lines of 5 syllables, 7 syllables and 5 syllables.

This space has been designed for students from SFU’s Masters in Public Health Program to continue discussions and share information regarding health inequality.

Please feel free to share posts, links, and resources that address health inequality in Canada or globally.

It is one thing to educate ourselves and discuss inequality, but what can we do about it?

Let’s help each other find out how…

Related articles

• Looking at Health Inequity through the Eyes of UK Counterparts (centerforhealthmediapolicy.com)
• National News: Inequality ‘hits child development’ (coventrytelegraph.net)

Speakers for the day will be:

• Janine Anzalota, Program Director at the Boston Public Health Commission
• Jessamyn West, author, community technology librarian and community manager of the massive group blog MetaFilter.com
• Gary L. Kreps, University Distinguished Professor and Chair of the Department of Communication at George Mason University in Fairfax, VA

The program is free, but seating is limited and registration IS required. For more information and to register, visit the NER’s website.

While the causes of health disparities are complex (OMH, 2011), lack of equity in health typically affects groups who have systematically experienced discrimination (HHS, 2011c).  Many of the differences in the presence of disease, health outcomes, quality of health care, and access to health care services are due to differences in the social determinants of health (OMH, 2011), including race and ethnicity, age, socioeconomic status, gender, sexual identity and orientation, physical and mental health status, and geographic location (HHS, 2011b).  Factors contributing to these disparities include biological predispositions, behavioral lifestyle, psychological characteristics, environmental and psychosocial factors, and variables within the health care system (Myers & Hwang, 2003).

For example, the utilization of health care is strongly age dependent (Alemayehu & Warner, 2004).  Health-related conditions affected by age-based disparities include the health of women before and during pregnancy, child and adolescent care (e.g., immunizations), adult health behaviors (e.g., high risk behaviors), and geriatric care (e.g., chronic conditions).  Eliminating health disparities across the lifespan requires acknowledging these age-based disparities (Cheng & Jenkins, 2009).  Eliminating age-based health disparities also requires acknowledging condition-specific health literacy issues (Bennett, Chen, Soroui, & White, 2009), especially among the geriatric population (Cutilli, 2007).

Empowering the U.S. society toward achieving health equity involves combining an understanding of the social determinants of health with increasing the health literacy skills of disadvantaged individuals (Mogford, Gould, & DeVoght, 2010).  Addressing the fundamental causes of disparities in health and reducing or eliminating the disparities in health care that are based on a person’s social, economic, and/or environmental disadvantages should achieve a fundamental right¾ the highest level of health for all people.

References

Alemayehu, B., & Warner, K. E. (2004). The lifetime distribution of health care costs. Health Services Research, 39, 627-642. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Bennett, I. M., Chen, J., Soroui, J. S., & White, S. (2009). The contribution of health literacy to disparities in self-rated health status and preventive health behaviors in older adults. Annals of Family Medicine, 7, 204-211. Abstract retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19433837

Cheng, T. L., & Jenkins, R. R. (2009). Health disparities across the lifespan: Where are the children? The Journal of the American Medical Association, 301, 2491-2492. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974843/

Cutilli, C. C. (2007). Health literacy in geriatric patients: An integrative review of the literature. Orthopaedic Nursing, 26, 43-48.

Mogford, E., Gould, L., & DeVoght, A. (2010). Teaching critical health literacy in the US as a means to action on the social determinants of health. Health Promotion International, 26, 4-13. Abstract retrieved from http://heapro.oxfordjournals.org/content/26/1/4.abstract

Myers, H. F. & Hwang, W-C. (2003). Ethnocultural issues in behavioral medicine. The Health Psychology Handbook. SAGE Publications. Retrieved from http://sage-ereference.com/view/hdbk_healthpsych/n23.xml

U. S. Department of Health and Human Services (HHS). (2011a). Foundation Health Measures. Retrieved from http://www.healthypeople.gov/2020/about/tracking.aspx

U. S. Department of Health and Human Services (HHS). (2011b). Lesbian, gay, bisexual, and transgender health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25

U.S. Department of Health and Human Services Office of Minority Health (OMH). (2011). National stakeholder strategy for achieving health equity. Retrieved from http://www.minorityhealth.hhs.gov/npa/files/Plans/NSS/NSSExecSum.pdf

]]> http://dralfoldman.com/2012/03/04/how-do-you-reduce-health-inequalities-john-redwood-mp/ Sun, 04 Mar 2012 07:48:30 +0000 dralfoldman http://dralfoldman.com/2012/03/04/how-do-you-reduce-health-inequalities-john-redwood-mp/ http://equityjusticeaccess.wordpress.com/2012/02/06/the-worlds-housing-bubble/ Mon, 06 Feb 2012 21:38:39 +0000 equityjusticeaccess http://equityjusticeaccess.wordpress.com/2012/02/06/the-worlds-housing-bubble/ http://thirdworlddd.wordpress.com/2012/02/01/163/ Wed, 01 Feb 2012 03:01:43 +0000 rrosemahoney http://thirdworlddd.wordpress.com/2012/02/01/163/ Rachel Mahoney

“The history of trade follows that of larger world orders.  Following years of exploiting their former colonies, rich countries ordered trade to their own advantage and have maintained unequal orders ever since.  Although they no longer extract mineral, oil, and timber with the barrel of a gun, they now use tariffs, subsidies, and import quotas.  One order of exploitation has given way to a subtler but equally lethal version” (O’neil, 149)

One salient example of subtle contemporary imperialism is the coca-colonization of many developing economies.  Coca-colonization, a term coined as the result of rising neoliberalism, occurs when powerful multi-national corporations (Coca-Cola) and lending institutions (International Monetary Fund) take steps to “modernize” and “integrate” indigenous agricultural economies, instead spurning these markets to ineffective peripheral positions in the global balance of power  (Leatherman & Goodman, Coca-colonization of diets in the Yucatan).  

As students of public health and human rights — and more importantly, as active global citizens — it is our duty to consider each angle of the claims made about global health; we must understand the complex and dynamic ways institutions, governments, and corporations around the world affect the health and status of everyone.  Joyce A. Millen, former Director of the Institute for Health and Social Justice at Partners In Health and professor of Social Medicine at Harvard Medical School, echoes this need for critical skepticism of health statistics: “…many of the significant health improvements made over the last 50 years are marred by growing health disparities between the world’s wealthy and the world’s poor” … “the ‘winners’ and ‘losers’ amidst the global balance of power and wealth.  Millen goes on to caution that “aggregate statistics mask” the unevenness of health improvements worldwide, by failing to mention that “equally dramatic losses” of many development strategies (Millen et al., 4 and 5).

Included in the “equally dramatic losses” alluded to above, are the 10 million children under five-years-old who died in 2007.  What is more, is that 97% of these children died in developing countries that lack the resources to treat and prevent their predominantly preventable deaths. How different might the fates of these children be if they had won the proverbial “birth lottery”?  Alas, they, along with billions more babies, are born in countries with infant mortality rates sixteen times higher than the Global North (Millen et al., 5).

Millen and her colleagues make clear the disparities that prevent raw economic growth from benefitting everyone equally.  A myriad of intersecting factors like colonialism, political and structural violence, malnourishment, and corporation-dominated global financial flows have only worsened the lives of the world’s poorest citizens: “specific growth-oriented policies have not only failed to improve the living standards and health outcomes among the poor, but also have inflicted additional suffering on disenfranchised and vulnerable populations” (Millen et al., 7).

An anti-neoliberalism cartoon symbolizing the corporate imperialism it perpetuates around the world.

That’s why SHE created a petition to University of Chicago Medical Center Board of Directors, which says:

“We, members of the University of Chicago community, support a public study conducted by an unbiased third party to assess the feasibility of offering level 1 adult trauma care at the UCMC. The UCMC receives $58.6 million annually in tax benefits to cover its costs,  and it is about time to formally consider the introduction of such care in an area where penetrative trauma is so common.”

Sign the Petition: “UCMC: Run a Feasibility Study on Trauma Care on the South Side“

Renata’s post can be found on HEI’s Health Equity Exchange.

The rationale

In theory, international banking, just like other forms of international trade, should help spur economic well-being. That would be true if the world of trade followed Ricardo’s “theory of comparative advantage“, which tells us that if two populations each specialize in what they produce (like China producing electronics and the French making wine), then they will both be better off trading between each other (focusing all of their production on their area of specialty) rather than trying to both make electronics and wine domestically. But like any economic theory, Ricardo’s theory–which has been the basis of free trade arguments for decades–is based on a series of assumptions, many of which are violated in today’s modern trading environment. Ricardo assumed that capital did not move between countries (oops), that trade would take place just between companies (not within companies, double oops), and that markets are totally competitive (triple oops in today’s political work of subsidies, trade sanctions and oligopolies).

Perhaps more serious are the inherent limits of the idea that economic prices adequately reflect the value of goods or services for humans. Market prices often fail to reflect the downstream health or environmental costs of a given product or activity, thereby sending misleading signals about the benefits and risks of a particular economic decision. And those companies conducting the activities that damage public health or the environment do not have to pay the consequences of the damage, leaving the cleanup job to the rest of society.

Some of today’s international banking transactions appear particularly problematic to public health. There is increasing evidence, for example, that banks speculating on basic food commodities (like wheat or rice) have sparked another famine in the Horn of Africa and elsewhere. Many people blamed increasing consumption from India and China for the spike in food prices that has taken place, or the subsidization of biofuels (diverting staples like corn into oil production rather than food). Those factors may lead to gradual increases in food prices due to higher of demand, but can’t explain sudden spikes. In addition, both aggregate and per capita consumption of grain have actually fallen in India and China, and the population growth and total demand from those countries can’t numerically explain the food price spikes. Natural disasters related to global warming also don’t seem to fully explain the sudden spikes in prices that have lead to the famine.

Some component of these spikes seems to be the result of a new form of “speculation” from banks. Speculation wasn’t always a negative force (and could be a positive one in some circumstances); here’s how it used to work:  farmers protected themselves against natural disasters or other risks by “hedging”, or agreeing to sell their crop in advance of the harvest to a trader. This guaranteed the farmers a reasonable price for the crop (even if lower than a future price that the trader might get), and allowed the farmer to plan ahead and invest in infrastructure for the future. Some years, farmers get a better profit than they would have otherwise, while in other years, traders get a higher profit. Under tight regulations, this process might even help stabilize the food market, and the process is controlled by real forces of supply and demand.

That form of speculation was dramatically altered in the mid-1990s. After heavy lobbying, numerous regulations on commodity markets were removed. Contracts to buy and sell foods were turned into “derivatives” that could be bought and sold among traders who had nothing to do with agriculture, producing a sort of “unreal” or false market so that food could be sold like corporate stocks and oil, bundled into complex financial packages and traded to make small profit markets off of market volatility (sounds like the mortgage crisis, no?). When the US sub-prime mortgage disaster happened in 2006, the  banks and traders moved billions of dollars from pension funds and equities into “safe” commodities,  especially foods. The resulting spike in demand for these commodities caused prices to skyrocket, precipitating massive suffering among people of the world who could no longer afford wheat or rice or other basic foods. The UN report on speculation and the banks has captured the problem in great detail, as have further reports from The Oakland Institute and others. A global campaign to curb food speculation has begun.

But while the relationship between speculation and food prices remains controversial in some economic circles, it is more clear that banks also affect public health in a number of other ways. There is increasing evidence that numerous people have lost health insurance in the economic recession that was incontrovertibly started by bank misbehavior (in particular, by doing with mortgages what they are now doing with food), and the subsequent unemployment and health insurance losses have led to increases in morbidity and mortality. The corporate tax subsidies and cuts negotiated by the banks also relate to the budgetary shortfalls at the state and country level, resulting in cuts to social welfare and social protection services that are a critical determinant of public health outcomes.

The question is: what can we possibly do about it?

The proposal

The “Robin Hood Tax” is a type of financial transactions tax (FTT) that is  essentially derived from Nobel Prize-winning economist James Tobin, who proposed years ago to tax foreign currency exchanges. The Robin Hood Tax would go further to place a 0.05% tax (that’s right, very small) on the purchase and sale of certain types of stocks, bonds, commodities, unit trusts, mutual funds, and derivatives such as futures and options. It’s been endorsed by everyone from French President Sarkozy to economist Paul Krugman (another Nobel Prize winner, accompanied by 1000 other economists including Joseph Stiglitz, Ha-Joon Chang, Jeff Sachs and Dani Rodrik), but how and why would it work?

The group of non-governmental organizations who collectively proposed and endorsed the Robin Hood Tax idea in 2010 suggested that it be placed on financial commodities that are most related to volatile international transactions–the kind of transactions that banks make money from by buying and selling commodities with each rise or fall of the stock market, but that destabilize the rest of the economy and that don’t usually constitute meaningful long-term investments.  The idea was to split the tax evenly between domestic social welfare program (e.g., food stamps, among countries collecting from their own domestic banking industry) and international aid. The best estimates suggest that around $400 billion would be collected from such a tax each year. The idea is that the small tax would not accumulate among long-term investors who are truly interested in putting their money into real goods and services, but would accumulate upon and therefore discourage the high-frequency traders who are speculating on derivatives and trying to make a quick buck off of market volatility (probably reducing such trades by about 14% according to recent estimates).

Naturally, the idea has garnered criticism–mostly that it will adversely impact the banking industry, negatively impact overall employment by depressing the economy, and be a “stealth tax” that is transferred over to consumers rather than really being paid by the bankers. Few people are terribly concerned about the impact on the banking industry, given that it is 26 times more profitable than the average business and continues to doll out expensive bonuses for its executives. The consequences for other sectors of the economy have been highly controversial, as arguments have been made about whether sectors of the economy that are dependent on high-frequency trading are really producing meaningful goods and services, or simply employing e-traders and i-bankers who have negative consequences on the rest of us. Some calculations suggest that at the 0.05% rate, the tax is unlikely to affect retail banking, which includes savings and mortgages. It will instead introduce a micro-tax on short-term, casino-style trading which employs a small number of highly paid bankers in a few urban centers (New York, London), not the tens of thousands employed in main street financial services. It may be a stealth tax on consumers, but mostly on consumers who are involved in high-frequency trades, which we wish to discourage anyway. And bankers would not receive commissions and other profits from that kind of trading, creating further incentives for more value-driven investments. In fact, studies of who ends up paying transaction taxes have concluded the Robin Hood Tax would in all likelihood be “highly progressive”, meaning it would fall on the richest institutions and individuals in society, in a similar way to capital gains tax (in contrast to VAT, which falls disproportionately on the poorest people).

There are also alternatives to the Robin Hood financial transactions Tax. The two most common are a bank levy and a FAT tax. A bank levy involves a flat-rate charge imposed on large financial institutions (which is currently employed ni the UK, France and Germany).  But at the rates they have used, these levies haven’t raised much money (being commonly offset by reduced income taxes to the banking sector) and don’t seem to discourage the heighest-risk transactions. The financial activities tax, or FAT tax, is equivalent to a VAT tax on the financial sector; it may work but might be easier to circumvent and cheat than a financial transactions tax.

Progress on implementation

Is the tax just a pie-in-the-sky idea, or does it have political promise?  In the middle of this year, the European Commission reversed its earlier opposition to the Robin Hood Tax, proposing an EU financial transaction tax be adopted within the 27 member states of the European Union. In August, French President Sarkozy and German Chancellor Merkel affirmed their support for the proposed European implementation. Great Britain’s prime minister Cameron remains opposed to the tax unless it can be implemented globally, meaning that a European implementation would likely have to be confined to the Eurozone not the whole EU. The White House also remains opposed. But in September, Bill Gates endorsed the tax the 2011 IMF and World Bank meeting and suggested that the tax apply to the entire G20, which would raise between $48 and $250 billion per year. His endorsement was followed by one from the Pope, but we haven’t heard further yet from the White House about whether Obama will reconsider his position. 

While it may seem critical for a financial transactions tax to be implemented globally, as banks could hide in the Cayman Islands. But surprisingly, while the UK hasn’t implemented the full Robin Hood Tax, it has put in place a stamp duty of 0.5% on all share transactions, and this did not precipitate a run from London.  The UK’s major competitors do not have this duty but the UK raises around £5 billion pounds each year from it. There’s further interest into whether this duty was sufficient to discourage riskier transactions, but it certainly seemed that London life was attractive enough for bankers that few would want to live or work elsewhere simply because of a less than 1% tax. Regardless, once the major set of European countries are on board, most commodities will end up having the tax applied to them, as it would be hard to stay in business as a bank while ignoring mainland Europe (as the banks involved in Greece can testify to).

Whatever happens next to the Robin Hood Tax proposal, it’s important to look back on this year and recognize that the campaigners for the Robin Hood Tax proposal have made incredible strides in just 12 months: moving from an idea on paper to a real proposal being debated by world leaders, hitting headlines across the globe, and gaining endorsements from the most powerful economists and public figures. Let’s hope the momentum continues into the New Year…

Oh, by the way, the average Australian driver has the intellect of an 11-year-old, gender not specified…