Guest Editorial > The Body Economic – Why Austerity Kills by David Stuckler and Sanjay Basu Simic
The Body Economic – Why Austerity Kills by David Stuckler and Sanjay Basu Simic | Roger Steer
What's the relationship between austerity policies and public health? And how are we doing compared with others? Roger Steer reviews
The authors, as relatively young American public health academics, are characteristically brisk, to the point and cover a great deal of territory in drawing public health lessons from the Great Depression of the 1930’s, the Great Recession of the last five years and how various governments in various countries have dealt with economic difficulties more or less effectively.
The good news is that the UK and the NHS stand up well.
The bad news is that our government and other governments around the world seem strangely reluctant to let the facts intrude into public health policy and continue to dabble with “austerity” policies that are known to be disastrous for public health, likely to undermine the economy and to serve no other purpose than reinforcing rigid economic theories similarly open to question.
The authors though obviously of an American “liberal” persuasion or a British left wing leaning do not explore the implicit political issues but fill their book with the medical evidence on the impact of the relative effect within states of the USA who implemented the Roosevelt New Deal to various degrees; within the countries of the old USSR and soviet bloc who moved to rapid privatisation or more gradual economic reform; to countries in Asia having different policy responses to the economic crisis of the late nineties; and to the action being taken in European countries and Iceland to the most recent economic depression.
Despite having an eye for all these matters they constantly revealed to me new and startling evidence supporting the case for supporting access to healthcare and the consequences for not doing so.
The most interesting to me was they presented evidence that in recent years one in five Americans access to healthcare had reduced; access in France and Germany had reduced but far less (7% and 4% respectively and attributable to the effect of co-payments) but access had increased in the UK by 0.3%.
They quote Aneurin Bevan approvingly as saying “we ought to take pride in the fact that; despite our financial and economic anxieties, we are still able to do the most civilised thing in the world, put the welfare of the sick before every other consideration”.
Bevan was talking post WW2 at a time of genuine hardship. It is now sad to read constantly of the £20bn NHS saving imperative designed to free resources to invest in the same American Healthcare multinationals who made $12.2bn in profits in 2009 (see p101) and who “invested” another billion or so in lobbying to water down Obamacare.
For those of us in the UK therefore we would have liked more on the specifics of the UK threats to public health and the authors’ hatchet job on the Health and Social Care Act 2012 is perfunctory. Nonetheless it is invigorating to have your prejudices confirmed and good to have at your fingertips the evidence and copious sources with which to wage future battles.
Buy this book and note the quote at the front of the book “politics is nothing but medicine on a grand scale” Rudolph Vischow (1848). I hadn’t heard of him either but I think I know what they mean.
The Body Economic – Why Austerity Kills by David Stuckler and Sanjay Basu Simic is published by Allen Lane London 2013