A study by the Fraser Institute titled The Effect of Wait Times on Mortality in Canada estimated that “increases in wait times for medically necessary care in Canada between 1993 and 2009 may have resulted in between 25,456 and 63,090 (with a middle value of 44,273) additional deaths among females.” Adjusting for the difference in populations (the US has about 9 times as many people), that middle value inflates to an estimated 400,000 additional deaths among females over a 16 year period. This translates to an estimated 25,000 additional female deaths each year if the American system were to suffer from increased mortality similar to that experienced in Canada due to increases in wait times.
The Declaration of Independence states that all people are endowed with certain unalienable rights, and that among these is the pursuit of happiness. But is happiness available equally to everyone in America today? How about elsewhere in the world? Carol Graham draws on cutting-edge research linking income inequality with well-being to show how the widening prosperity gap has led to rising inequality in people’s beliefs, hopes, and aspirations.
For the United States and other developed countries, the high costs of being poor are most evident not in material deprivation but rather in stress, insecurity, and lack of hope. The result is an optimism gap between rich and poor that, if left unchecked, could lead to an increasingly divided society. Graham reveals how people who do not believe in their own futures are unlikely to invest in them, and how the consequences can range from job instability and poor education to greater mortality rates, failed marriages, and higher rates of incarceration. She describes how the optimism gap is reflected in the very words people use—the wealthy use words that reflect knowledge acquisition and healthy behaviors, while the words of the poor reflect desperation, short-term outlooks, and patchwork solutions. She also explains why the least optimistic people in America are poor whites, not poor blacks or Hispanics.
Happiness for All? highlights the importance of well-being measures in identifying and monitoring trends in life satisfaction and optimism—and misery and despair—and demonstrates how hope and happiness can lead to improved economic outcomes.
All of which is to show that your probability of dying from a range of common conditions is much higher in the UK than here. Perhaps that’s why (with no hint of irony) The Guardian’s write-up of a Commonwealth Fund Report suggesting the UK’s health system was “the best in the world” said “the only serious black mark against the NHS was its poor record on keeping people alive.”
We highlight recent data on stillbirths, discount life expectancy at birth (LEB) for stillbirths, and suggest discounted LEB be used as an element in measuring well-being. Information on stillbirths in all countries has been available since 2006; and that on neonatal and infant mortality since 1990. Using data from The Lancet and World Bank, we redefine stillbirth rate consistently with neonatal and infant mortality, and show its incidence is quite close to neonatal mortality’s; and for high and upper middle income countries, it is higher. Overtime, the reduction in the two rates for low income countries is smaller than for high income from their already very low rates. Recent stillbirth data for all countries has been ignored by economists and social scientists. We suggest stillbirths be estimated annually by the same Inter-Agency Group that estimates neonatal and infant mortality. Almost as many live births do not survive beyond the first day as the intra-partum stillbirths. On grounds that stillbirths lie on a continuum between premature births and neonatal mortality where only the latter are included in the LEB, we suggest a parallel measure, discounted LEB, be developed. Discounting LEB for stillbirths will make it a better measure of health, reduce the neglect of the malaise of stillbirths, show how far the poor countries truly have to travel to capture the perceived low-hanging fruit of catching-up with high income countries’ life expectancy level, and lead to a better beyond GDP measure of well-being.
Social Assistance and Minimum Income Levels and Replacement Rates Dataset by Jinxian Wang, Olaf van Vliet :: SSRNFebruary 9, 2017
The Social Assistance and Minimum Income Levels and Replacement Rates Dataset provides two new indicators for comparisons of social assistance and minimum income benefits across countries and over time, namely real net minimum income benefit levels and net minimum income benefit replacement rates. The dataset contains information for 33 countries for the period 1990–2009. For information on social assistance and minimum income benefits, the dataset draws upon information from Nelson’s (2013) dataset. The minimum income replacement rates are comparable to unemployment replacement rates.
The Canada Health Act (CHA) was adopted in 1984, to shore up a health-care system conceptualized in the 1960s. Under the CHA, universal coverage is limited to “medically necessary” hospital and physician services, to the exclusion of vital goods and services such as outpatient pharmaceuticals, dental care, long-term care, and many mental health services. Inequities resulting from these gaps in public coverage are partly to blame for pushing Canada’s health system to the bottom of recent international rankings. But there is more to modernizing Canada’s health care system, we argue, than filling these gaps in universal coverage. Every major health system review undertaken in Canada over the past decade has ended with a call for greater accountability, and rightly so: accountability is arguably the sine qua non of high-performing health systems. Whereas many countries have established open and rigorous processes for evaluating health goods and services, targeting public spending on those that deliver the biggest bang for buck, Canada’s governance mechanism for defining the medicare basket is passive, opaque and only tenuously evidence-driven. A move to expand medicare’s scope of coverage must be accompanied by improvements in this type of accountability.
Long-Term Growth and Productivity Projections in Advanced Countries by Gilbert Cette, Remy Lecat, Carole Ly-Marin :: SSRNFebruary 7, 2017
In this period of high uncertainty about future economic growth, we have developed a growth projection tool for 13 advanced countries and the euro area at the 2100 horizon. This high uncertainty is reflected in the debate on the possibility of a ‘secular stagnation’, fuelled by the short-lived Information and Communication Technology (ICT) shock and the current low productivity and GDP growth in advanced countries. Our projection tool allows for the modelling of technology shocks, for different speeds of regulation and education convergence, with endogenous capital growth and TFP convergence processes. We illustrate the benefits of this tool through four growth scenarios, crossing the cases of a new technology shock or secular stagnation with those of regulation and education convergence or of absence of reforms. Over the 2015-2100 period, the secular stagnation scenario assumes yearly TFP growth of 0.6% in the US, leading to a 1.5% GDP growth trend. The technology shock scenario assumes that the third technological revolution will, in the US, provide similar TFP gains to electricity during the second industrial revolution, leading to a 1.4% TFP trend, to which we add a TFP growth wave peaking in 2040, and thus to an average GDP growth rate of 3% in the US. In non-US countries, GDP growth will depend on the implementation of regulation reforms, the increase in education and on the distance to the country-specific convergence target, namely the US, as well. Over the period 2015-2060, for the euro area, Japan and the United Kingdom, benefits from regulation and education convergence would amount to a 0.1 to 0.4 pp yearly growth rate depending on the initial degree both of rigidity and the TFP distance to the US.