Health and Economics
Out of 33 countries considered to possess a “developed” economy, there is one that does not have universal health coverage.
That country is the US.
Historians argue why we are such an outlier. Not only do we not possess universal health care coverage, but national policies rarely reward health as the goal of health care.
The results are known to most of you. The U.S. ranks 50th in the world in expected longevity at birth – according to our C.I.A. Our costs per capita are about double those of the developed countries we compete with – like Germany and Britain.
Countries with strong public health systems have healthier populations. Healthier workers cost employers and taxpayers less money, and become more economically productive.
And other people figured this out a long time ago. We need to turn to the master of “Blood and Iron” – the creator of the German Empire, Otto von Bismarck.
Bismarck, Health and the Nation
Bismarck can hardly be called a “socialist” hero. He was a conservative land owner who implicity believed in the separation of social classes.
But he wanted a strong, economically powerful country.
In the early 1880’s, Bismarck set up landmark social legislation, including worker and employer bought health insurance, accident and disability insurance, and government supported long term care for the elderly. He argued that workers needed security in order to work productively – and their health and safety were crucial to national goals.
He also needed effective soldiers and workers for the Empire – healthy soldiers and workers.
Many projects were produced to protect public health in Bismarck’s time. His new health policies also worked to help save economic productivity.
German workers had been leaving in large numbers for the U.S., where wages were higher than in the Empire. However, when they saw some of the benefits of German social spending – as on health care and old age pensions – many decided to stay home. Bismarck firmly declared that national health care systems were necessary for economic productivity and national strength.
The numbers bore him out.
World War I
Americans flocked to enlistment stations when Woodrow Wilson declared for war in Europe. Doctors quickly become shocked at the “quality” of the enlistees.
Many suffered from basic lack of vitamins – with illnesses like beri beri and rickets. Many others were infected with chronic illnesses.
When all was said and done, the large majority of potential enlistees were found unfit to serve.
The U.S. became much more interested in public health work at that time. Researchers also started thinking about social health.
Social animals – like humans – often help get each other well.
Learning from the Ants
Ants are also heavily social animals. As reported today by Sindya Bhanoo in the April 10th New York Times, ants infected by pathogens are approached by other ants. Rather than move away, they lick the pathogen off their infected comrades.
And some of them die.
Yet the rates of death are far less than the increased immune strength of the ant population. Two per cent may die, but 60% will see their immunity enhanced.
That is how the community is saved from pandemic infection.
Health operates in similar ways in human communities. Vaccines allow societies to avoid immensely destructive epidemics – but only if enough people partake to make the immunity community-wide.
Health care is similar. To make health care work, you do what most of the world does – you pool risk over the entire population. Thus the fortunate pay for the unfortunate.
And there are other benefits. National systems can pay attention to protecting the health of the entire nation. They can look to public health measures – like green space, education, pollution control, education, vaccination, sanitation, and national nutritional issues. All these factors can markedly improve national health – making much of the population healthier.
Because health is an issue of broad significance. It’s not just a matter of avoiding epidemics, but of national economic productivity, well-being, fairness and social cohesion.
In harsh economic times, you want a healthy population that can conceive new ways – and new forms of frugal innovation – to push the country forward.
A healthy population can regenerate its sense of purpose and its economy. And improve the potential well-being of everyone within it.
Health is always a societal concern. And that’s how it must be addressed – on the national level – so that all can benefit.
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