Health Is Wealth!

Without health it is difficult to have fun, pleasure, wealth, freedom and drive for reason and responsibility. At times in pursuit of above mentioned things we lose our focus on health and lose health! This is true at individual and country level.

Which country has the best health care system?
Does spending more on healthcare ensure better health?
What is the optimum funding for healthcare?
How health is a linear and non-linear function?

The above questions require research and data collection and analysis. And it will always be a work in progress. Three articles published in Lancet throw some light and make us ponder on health.

Wealth But Not Health In USA The article speaks about the now well known fact that US spends more on health care per person than other G7 countries.
Americans especially American women are having declining health for 30 years.  Americans fare badly not only at life span but also at infant mortality, low birth weight, injuries and homicides, teenage pregnancies and sexually transmitted infections, drug-related deaths!, obesity, diabetes and heart disease, chronic lung disease, HIV/AIDS prevalence.  The data if segregated according to region and economic level will be more revealing about the disparity in health condition.
I suspect there is a great inequality in health care access and outcome within US. This despite the fact that US spends 18% of its GDP on health. The leading European countries range between 9.5 to 12 %. And they have better metrics to show. One thing which i dare to conclude without digging into the data  is that probably the level of inequality is less as of today. It will be interesting to note the metrics 5 and 10 years from now as austerity measures get implemented.

Cuba spends on healthcare and has results to show for it also.

What are the lessons for other countries? What model should one follow? How should the government intervene or give incentives for better health. This especially true for young nations like India and China which will have its major population moving above 50 years in coming decade or two.

The Lancet article mentions the following remedies for US.

"Why are Americans at a health disadvantage compared with those in other countries? The fragmented US health-care system, and, in particular, poor access to health care and to primary care, are partly to blame. Lack of insurance, or inadequate insurance, restricts access to health care for many Americans. But the system is not the only problem. Unhealthy behaviours abound in the USA, particularly overeating, drug abuse, and other risk-taking activities such as not wearing motorcycle helmets, drinking and driving, and using firearms. Social and economic conditions in the USA contribute to high incomes for some, but to high poverty and income inequality for others, and to low standards of education. Welfare safety nets are not as robust as they are in other countries. Moreover, cities in the USA are often built around car use, which discourages physical activity and contributes to obesity."

Also it seeks implementation of National Prevention Strategy.

The report mentions the following things:

The Strategy’s seven Priorities are designed to improve health and 
wellness for the entire U.S. population, including those groups 
disproportionately affected by disease and injury. 
• Tobacco Free Living
• Preventing Drug Abuse and Excessive Alcohol Use 
• Healthy Eating
• Active Living
• Injury and Violence Free Living
• Reproductive and Sexual Health
• Mental and Emotional Well-Being


My opinion:

1. Behaviors are difficult to change. People who fight fires are normally the heroes and not the one's who prevent fires! We need to glorify fire prev-enters.
2. Corporate's, government, schools, colleges should stress on healthy living. Incentives and recognition should be given to healthy people. Ideal Blood pressure individuals in different age groups, Best Glycemic control in a particular quarter, Best Aerobic capacity person, etc etc.
3. Role of viruses in causing infections, chronic diseases and cancers should be highlighted. Vaccinations should be explained.

We need not have to wait to implement these strategies in Emerging Countries. Every nation stands to benefit by rewarding healthy living.

Other articles to read:
1. Guardian
2. UC Atlas
3. PBS Newshour-How US Compares

A slightly different view!

So what are you going to do to stay healthy?

'Globalization, Development and Inequality' by Joseph Stiglitz, Ravi Kanbur and Robert Wade

Notes and other points from

APU Public Lecture: 'Globalization, Development and Inequality' by Joseph Stiglitz, Ravi Kanbur and Robert Wade

Why is inequality rising? What are the costs and consequences of inequality? Can governments worldwide intervene and regulate to decrease/eliminate inequality? The government policies, laws and structure are built in such a fashion that the rich get richer and poor become poorer. How the recent economic crisis has deepened this divide. Joseph Stiglitz with few stories brought the above points into consideration. The discussion with his colleagues from Cornell and London School of Economics did stimulate a few grey cells and roused emotions.
In US the bankruptcy laws are lenient on banks and corporate while  they will  not budge in case of educational loans. The political system is also responsible for fostering this inequality. As the rich and super rich donate the election campaigns, the subsequent government form laws and structures more lucrative to their well being.
Ravi Kanbur highlighted with series of case studies the role of government in Taiwan, China, Ghana in addressing the issue of inequality. Land reforms formed a starting point in Taiwan for equitable growth. The same holds true in case of South Korea. In Ghana the divide between north and south is stark because of geographical vagary. The south grows products which can be exported and this raised the inequality after the exports boomed. So the parameters measured may show that Ghana has grown and inequality is decreasing but the divide between North and South has grown larger. This is actively being addressed by the government of Ghana.
In China the first 15 years of growth saw reduction of inequality because of agricultural growth. As the country relied more on export oriented growth the inequality started widening. The difference between coastal and heartland china is something which Chinese government is trying to rectify by increasing investments in mainland china.
Between inflation and unemployment governments normally tend to address inflation. This according to the panelists helps the larger organizations and raises inequality.
 They also mentioned that GDP may not be the right metric to measure economic progress.

The lecture and discussion was interesting with few anecdotes thrown in by Robert Wade but all panelists agreed in their views and belonged to the same school of thought. It would have been interesting and illuminating to have the opposite view with serious debate. Hope Azim Premji University will address this point. The question and answer session had its own Indian flavor. More of it in next post.