European leaders slicing away at national budgets are keen to persuade voters that healthcare is sacrosanct, but they will struggle to escape the truth that cutting spending elsewhere also eventually costs lives.
If a government’s first priority is to protect the lives of its people, then ring fencing health spending while cutting other budgets and trying to drive down the cost of medicines — policies being pursued in Europe — seem sensible options.
Yet experts say the planned cuts in welfare and other state programs will hit everything from pensions to housing to playgrounds, all of which also affect the health of nations.
If unemployment rises, as predicted in countries such as Britain and Spain, the consequences could be hazardous. In short, there is more to health than healthcare.
“These cuts will result in significant harm to people’s health,” David Stuckler of the Department of Sociology at Oxford University said. “It’s not just about doctors and medicines to care for the sick — social care and support are vital to prevent people from becoming ill.”
In a study published in the British Medical Journal (BMJ) last week, Stuckler and his colleagues calculated that for approximately every 80 euros (US$107) cut from social welfare spending per person, alcohol-related deaths would rise by about 2.8 percent and heart disease deaths by about 1.2 percent.
Britain has just set out a punishing round of public spending cuts, while Greece, Spain, Portugal and Italy are all planning drastic deficit reductions. Even Germany, Europe’s largest and arguably healthiest economy, is targeting 80 billion euros of budget savings over the next four years.
“So far the discussion about radical budget cuts has largely focused on improving the economy, but ... these cuts will have a major adverse impact on the lives of ordinary people,” Stuckler said.
“If we can remind policymakers that these cuts will cause real suffering ... perhaps the decades of pain and austerity that are being contemplated will come with a human face,” he said.
Previous studies have found that unemployment rates have an almost immediate impact on mental health and suicide rates.
“It’s an incredibly difficult thing to link what happens this year or next year in welfare budgets and what happens some way down the line with people’s health, but what we do know, from every study that has ever been done on it, is that unemployment is not good for people’s health,” said John Appleby, chief economist at the King’s Fund health think tank in London.
“So yes, there will be at the margins a small proportion who will suffer catastrophically — in other words they’ll die,” he said.
Politicians trying to distance themselves from the idea that spending cuts may lead to higher death rates could seek to blame the recession itself.
Scientists have found a strong correlation between higher economic growth and lower mortality rates, but Stuckler said evidence also shows that this link can be all but broken if social spending is kept up during tough times — and conversely made more direct if social support systems are pared down by austerity measures.
He pointed to Russia in the early 1990s where “shock therapy” tactics to force the country into a capitalist system also stripped away many of the social welfare functions for workers, families and children.
“Those rapid economic changes and strict austerity programs led to a devastating mortality crisis, an immediate rise in suicides, heart attacks and alcohol related deaths, as well as an inability to control rises in HIV, tuberculosis and their drug-resistant forms, and we are still dealing with the consequences of those policies today,” he said.
On the other hand, the effects of the Great Depression on rates of premature death and chronic disease in the US in the 1930s were mitigated, he said, partly because they coincided with the birth of the US welfare system.
Martin McKee of the WHO’s European Observatory on Health Systems and Policies, who worked on the BMJ study, said the full impact of austerity measures on death and disease may not be felt for some time.
There can be decades-long lag times between government austerity measures and consequences such as deaths from obesity or heart disease caused by poor diets in families which have been forced by joblessness and a lack of welfare support to buy cheap, low quality food, for example.
“Scientific research can only demonstrate the short-term impacts, but everything we know tells us it is highly likely this will have significant long-term effects,” McKee said.
Appleby reckons the time lag provides a smoke screen for policymakers who can shelter behind the fact that pressure applied now may not hurt until 10, 20 or 30 years later.
“We’re talking statistical lives, in a way, which I suppose makes it easier to bear, and of course somebody else will be in power then,” he said.
There is much evidence that the Chinese Communist Party (CCP) is sending soldiers from the People’s Liberation Army (PLA) to support Russia’s invasion of Ukraine — and is learning lessons for a future war against Taiwan. Until now, the CCP has claimed that they have not sent PLA personnel to support Russian aggression. On 18 April, Ukrainian President Volodymyr Zelinskiy announced that the CCP is supplying war supplies such as gunpowder, artillery, and weapons subcomponents to Russia. When Zelinskiy announced on 9 April that the Ukrainian Army had captured two Chinese nationals fighting with Russians on the front line with details
On a quiet lane in Taipei’s central Daan District (大安), an otherwise unremarkable high-rise is marked by a police guard and a tawdry A4 printout from the Ministry of Foreign Affairs indicating an “embassy area.” Keen observers would see the emblem of the Holy See, one of Taiwan’s 12 so-called “diplomatic allies.” Unlike Taipei’s other embassies and quasi-consulates, no national flag flies there, nor is there a plaque indicating what country’s embassy this is. Visitors hoping to sign a condolence book for the late Pope Francis would instead have to visit the Italian Trade Office, adjacent to Taipei 101. The death of
The Chinese Nationalist Party (KMT), joined by the Taiwan People’s Party (TPP), held a protest on Saturday on Ketagalan Boulevard in Taipei. They were essentially standing for the Chinese Communist Party (CCP), which is anxious about the mass recall campaign against KMT legislators. President William Lai (賴清德) said that if the opposition parties truly wanted to fight dictatorship, they should do so in Tiananmen Square — and at the very least, refrain from groveling to Chinese officials during their visits to China, alluding to meetings between KMT members and Chinese authorities. Now that China has been defined as a foreign hostile force,
On April 19, former president Chen Shui-bian (陳水扁) gave a public speech, his first in about 17 years. During the address at the Ketagalan Institute in Taipei, Chen’s words were vague and his tone was sour. He said that democracy should not be used as an echo chamber for a single politician, that people must be tolerant of other views, that the president should not act as a dictator and that the judiciary should not get involved in politics. He then went on to say that others with different opinions should not be criticized as “XX fellow travelers,” in reference to
RSS