Reflections on Poverty, the Party, and Collective Public Intelligence & Leadership

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From an American perspective, now that everyone knows Senator John Edwards has focused on poverty as the underpinning for his revisitation of the "two Americas" divide (see also Barbara Ehrenreich "Nickel and Dimed" and David Shipler's "Working Poor," this book should receive even more attention.

The author is extraordinary, and I take issue with some of the quibbling pot shots (when you are in fact so central to something that both the UN Secretary General and the President of Columbia University want you in the top position, perhaps you just might *be* central).

The most important thing I can say about this book is that the timing is perfect--there is a "correlation of forces" emerging that combines "An Army of Davids" (see my review of that book), "The Left Hand of God (ditto), Collective Intelligence (see my review of Tom Atlee, "The Tao of Democracy,") and a massive public awareness that both the Republican and Democratic parties are corrupt and dysfunctional (see Peter Peterson's "Running on Empty" and Tom Coburn "Breach of Trust"), and that the rampant unilateral evangelical militarism and immoral capitalism that the Bush dynasty has imposed on the earth is in fact a stake in the heart of the American Republic.

It may not be an exaggeration to say that this book represents the pinnacle of "new thinking" in which the public is energized into realizing three great precepts:

1) Republics belong to the people--the government of a Republic can be dissolved by the people when it becomes pathologically dysfunctional.

2) Sovereignty as defined by the Treaty of Westphalia is pass?, in that it supports 44 dictators and massive corruption, censorship, genocide, state crime, and so on. There is a place for sovereignty, but only when certain standards of legitimacy, morality, transparency, and sustainability are present.

3) Poverty is the fulcrum issue for the world, just as democracy is the fulcrum issue for America. If one reads this book in combination with C. K. Prahalad's "The Fortune at the Bottom of the Pyramid," it is crystal clear that a shift of money from militarism to education, health, wireless access, and micro-cash economics will unleash the entrepreneurial innovation of five billion people, and literally save the world.

There are a number of stellar aspects to this book.

The author warms my heart when he slams the International Monetary Fund (IMF) and World Bank for being ignorant and having the wrong economic model. His articulations of the need for "differential diagnosis," and for the development of "clinical economics" are Nobel Prize material. He is right on target when he lambastes the IMF for overlooking "poverty traps, agronomy, climate, disease, transport, gender, and a host of other pathologies." A different take on the IMF and World Bank is provided by John Perkins in "Confessional of an Economic Hit Man" while the contributing delinquency of immoral multinational corporations is addressed by William Grieder in "The Soul of Capitalism" and US insanities are addressed by Clyde Prestowitz in "Rogue Nation."

The author has clearly been influenced by Paul Farmer and his book "The Pathologies of Power," and uses the emergency medicine model to discuss how clinical economics varies from developmental economics. One could say that some nations need to learn to read and feed themselves first, and only after doing so, are they capable of moving up the rung. Lest anyone think the author is over-reaching, he is quite clear on limiting his objective to the elimination of EXTREME poverty, not all poverty.

The bottom line is quite clear: for just 1% of the US GDP, or a 5% surcharge on families making over $200,000 a year, extreme poverty can be eliminated by the year 2025. Anyone familiar with Hans Morgenthau and the "sources of national power" will understand that people rather than geography or resources or military power are the fundamental unit. People can think and share information and innovate. The author clearly discusses how disease destroys labor--including the entire male working class in Africa, and how disease, poverty, and education interact. The checklist for "medical triage" of a country, on page 84, is superb. The "big five" interventions are Agricultural, Health, Education, power-transport-communications, and safe drinking water-sanitation.

The author takes special care to dispel a number of myths, chief among them the myth that African corruption makes foreign aid irrelevant. While there is a great deal to be said for aid mis-management leading to black markets and such (see William Shawcross, "Deliver Us From Evil,") the bottom line is clear: the US Government is both well behind other more enlightened governments in its rate of giving, and downright incompetent at "doing" aid. Indeed, the author can be noted for his general critique of all "official advice" as being generally ignorant.

This is not an ivory tower idealist. He discusses ten examples of global scale success stories from the Green Revolution to cell phones in Bangladesh, and settles on Stabilization, Liberalization, Privatization, Social Safety Net, and Institutional Harmonization as the steps needed to migrate from failed state to stabilized state.

Interestingly, he disassociates himself from the Harvard professors that helped the Russian oligarchs loot the Russian state through predatory privatization, and deliberately slams Professor Andrew Shleifer's role on page 144.

The author appears to be the first person to write a fifteen page plan for migrating a country (Poland) from a socialist economy to a market economy, writing from midnight to dawn due to local time pressures. This book is nothing short of riveting. It will stand the test of time as a prescription that can be explained to the voters, understood by politicians, and enforced by democratic elections.

There is only one small flaw: ending poverty will increase the number of stronger beings jostling for a move up in the pecking order. The program will need to be accompanied by both very strong militaries and police, and by very strong conservation efforts to keep increasingly strong billions from fighting over decresing resources.

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It is very disappointing to see so little information provided by the publisher on this book, not even a table of contents. The time has come for Amazon to demand a higher standard of due diligence by publishers.

For those who wish to immerse themselves on the pros and cons of the debate over poverty, this is an essential intellectual foundation to the current work by Jeffrey Sachs who is both the advisor to the Secretary General of the UN on the Millennium project, and the head of the Columbia Earth Institute.

Thomas Jefferson said that "A Nation's best defense is an educated citizenry." He probably would have agreed to amend that to say an educated, healthy citizenry able to work. A historical appreciation of the phrase "pursuit of happiness" suggests that Jefferson actually meant, in lieu of selfish pleasure, the pursuit of self- actualization.

This book completes a circle with C. K. Prahalad's "The Fortune at the Bottom of the Pyramid," which suggests that there is a four trillion a year marketplace among the five billion poorest, and that unleashing their entrepreneurial initiative could save the world, and the definitive work by Jeffrey Sachs, on how can end poverty for $70 per year per person.

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This is a foundation book, if you have the time, money, and willingness to read broadly. If you want only one book on the cycle of health, human rights, poverty, and violence, buy Jeffrey Sachs' book on "The End of Poverty: Economic Possibilities for Our Time," in which this author, Paul Farmer, is praised, recognized, and clearly valued as a pioneer.

There are two bottom lines in this book:

1) Providing adequate low-cost health care for every human is the non-negotiable first step in eliminating human rights violations writ large (e.g. a year in a Russian prison could be an automatic death sentence from tuberculosis), poverty, and violence among the poor and between the poor and the more affluent.

2) Governments are failing. Here the author is in harmony with Philip Alcott, whose book "The Health of Nations" calls for the over-turning of the Treaty of Westphalia (no more respect for the sovereignty of dictators--as in America, when government become too destructive, the People have the right to abolish the government). The author believes that a larger non-governmental network, and public pressure to force governments to apply more money to health and less money to the military killing machine, will in fact not only end poverty, but unleash sustainable indigenous wealth.

His case studies are of necessity somewhat tedious and can be skimmed if one's mindset is inherently in agreement with his propositions--they do however provide deep documentation for the skeptical.

Another book that might be substituted for this one (especially if buying and reading Sachs) is the pioneering work of Laurie Garrett, "BETRAYAL OF TRUST," which documents the global collapse of public health. A very long book, my Amazon review of it is summative and may suffice.

Dr. Farmer also makes the rather helpful point that doctors doing good can go places where human rights inspectors would be considered intrusive. He praises Cuba, and rightly so. Any country that can put 10,000 medical practitioners into Venezuela, and thereby earn "first call" on Venezuelan oil, is operating at a strategic level of insight that the USA simply does not match today. Readers may not like hearing that the USA is slipping down into the middle ranks of "has been" nations, but that is the reality. On our present course, we are importing poverty, allowing pandemic disease to rear its ugly head through bird flu, mad cow disease and other mutations that will jump to humans, and we have also busted the national piggy bank with the double deficits (trade and debt).

When Dr. Farmer talks about the pathologies of power, he reminds me of Norman Cousin's book by the same title, but does so in a very practical personal way. If human beings are a primary source of national power, then having uneducated human beings subject to disease, poverty, crime, and terror has got to be the single dumbest thing any great power can allow to happen, at home or abroad. Lest anyone dispute my contention on this point, see my reviews of Barbara Ehrenreich, "Nickle and Dimed," and also David Shipler's "The Working Poor: Invisible in America." See my review of Sachs for more detail on the specific topic of global poverty and why it matters to every citizen.

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This book is best appreciated if you have first read C.K. Prahalad's "The Fortune at the Bottom of the Pyramid," William Grieder's "The Soul of Capitalism," and Stuart Hart's "Capitalism at the Crossroads." It is a tactical or foreign neighborhood (both in the Third World and in the immigrant sections of the First World) implementation manual for profiting from sales to the poor.

It makes many obvious points as well as many not so obvious points, and I will not list them here. This is a book that requires patience and careful reading. The author has brought forward a great deal of detail in a very easy to read way.

I will end with thought that the Wharton School's publishing arm has really catalyzed for me with these varied book. The five billion at the bottom of the pyramid are the last remaining super-power on this planet. The good news is that we can profit from enriching them. The bad news is that we still have morons in power that think we can keep them down by using guns. Newsflash: there are not enough guns on the planet to keep the five billion and their off-spring from over-running us. Capitalism, and the rapid nurturing of indigenous self-sustaining wealth that includes the rapid education of women (which leads to saner men, less disease, limited growth) is our only salvation.

This book is one of a handful that could be said to be truly revolutionary in terms of transforming the planet from one beset by poverty, to one inspired by entrepreneurship at the neighborhood level.

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This book complements Barbara Ehrenreich's book "Nickel and Dimed." Ehrenreich's is much easier to read and makes the same broader points. Where this book excels is in the details that in turn lead to policy solutions. I will go so far as to say that if John Kerry and John Edwards do not get hold of an executive summary of this book, and integrate its findings into their campaign as a means of mobilizing the working poor in the forthcoming election, then they will have failed to both excite and serve what the author, David Shipler, calls the "invisible."

Invisible indeed. How America treats its working poor--people working *very* hard and being kept in conditions that border on genocidal labor camps, is our greatest shame.

The most important point made in this book, a point made over and over in relation to a wide variety of "case studies", is that one cannot break out of poverty unless the **entire** system works flawlessly. To hard work one must add public transportation, safe public housing, adequate schooling and child care, effective parenting, effective job training, fundamental budgeting and arithmetic skills, and honest banks, credit card companies and tax preparation brokers, as well as sympathetic or at least observant employers. The author is coherent and compelling in making the point that a break or flaw in any one of these key links in the chain can break a family.

I am personally appalled at the manner in which H&R Block, to name the largest within an industry, and Western Union, to name another, are ripping off the working poor with a wide variety of "surcharges" such that they end up paying 25% of their tax return or their funds transfer back to Mexico. This is both usury and treason if you want to look at it in the largest sense. They are sabotaging the American economy in a time of war.

It surprised me to learn that while hospitals are forced to treat the poor in an emergency, they are also allowed to bill them, and these bills, for an ambulance ride or emergency treatment, often are the straw that breaks a family into destitution. This is outrageous and should not be permitted. Then the author tells us that it costs as much as $900 for a working poor family to declare bankruptcy and obtain the protection of the law from creditors, many of whom are cheats in the larger sense of the world. How can this be?!?!

It did not surprise me, but continues to distress me, to learn that the laws are not enforced. Although laws exist about minimum wage, humane working conditions (and humane living conditions for migrant workers), they are not enforced. The working poor are treated as less than slaves, for they are "used up and thrown out" with no defense against unfair firing. They are forced to work "off the books", to do piece rate work at below minimum wage, this list goes on. In essence, our politicians have passed laws that make us feel good, and then failed to enforce them so as to achieve the desired effects.

The author documents both the jobs leaving the US, and the fact that new jobs pay less. As Paul O'Neil, former Secretary of the Treasury has noted, we have two economies in America: one embraces automation (and kills jobs), the other requires expert labor (not the working poor). We have a double-whammy here that is totally against the lower half of the economic spectrum, and it is being aggravated by an incoherent immigration policy that feeds the beast.

On page 139 the author just blew me away with documentation to the effect that 37 percent of American adults cannot figure a 10% discount on a price, even with a calculator, nor can this same percentage read a bus schedule or write a letter about a credit card error. He goes on, citing the National Adult Literacy Survey from the Department of Education, to note that 14% of adult Americans cannot total a deposit slip, locate an intersection on a map, understand an appliance warranty, or determine the correct dosage of a medicine. I had no idea!!! This reality comprises a "sucking chest wound" in the economic body of America, and it is not a chest wound that can be healed as things now stand.

There are many other daunting "facts of life" in this book about the working poor, and they all add up to a complete failure of both the national and state leaderships to be serious about long-term sustainable economic prosperity.

The author concludes with some suggestions for reform, and here I wish he had actually gone to the trouble of creating a one-page policy paper summing it all up. His most obvious suggestion is wage reform, not just at the bottom, but also at the top. As I read and hear about executives making $5 million to $80 million a year, the norm seeming to be around $20 million, I have to ask myself, have we gone nuts? Are stockholders so stupid as to overlook the fact that capping executive compensation at 100X the pay of the lowest employee ($20,000 low end, $2,000,000 high end) would do *huge* good at the bottom and in the lower middle ranks? The extreme wealthy in America are playing a short-term game that must be brought to an abrupt halt because it is killing the people, the seed corn of the future.

The Earned Income Tax Credit *works* but most of the working poor are afraid to file income tax returns.

The author ends, quite correctly, by pointing out that the ideological debate, removed from the facts, will not alleviate nor eliminate the suffering of the working poor. Right on. It's time for the facts, for a public debate about the facts, and for public policy (and enforcement) based on the facts. This author, already a Pulitzer Prize winner, has rendered a great national service.