Austerity kills: The hidden cost of cutting health care
Brian McArdle had not worked after a stroke left him paralyzed and partially blind. The former security guard, 57, could not eat by himself, but as part of the U.K. austerity campaign, McArdle was assessed, found fit to work and his support was stopped. The following day he died of a heart attack.
Such tragedies form the premise of “The Body Economic: Why Austerity Kills,” a startling new book from epidemiologists David Stuckler and Sanjay Basu. From mining data sets over the past century and across the world, the numbers show the hidden cost of health spending cuts.
“What we learned is that recessions are neutral to health. What matters is how politicians respond,” Stuckler told Metro. “When they make deep cuts to vital social protection systems, it can turn social hardship into severe epidemics.”
No example is starker than Greece, where a 40 percent cut to health spending has allowed HIV infection rates to double. Mosquito-spraying programs were stopped, and malaria returned after being controlled since the 1970s. More than 200 medicines vanished from pharmacies as budgets shrank. “The evidence of a causal link is compelling,” said professor Martin McKee of the London School of Hygiene & Tropical Medicine.
A less visible mental health crisis is also growing. The World Health Organization report a 40 percent rise in suicides in Italy between 2007 and 2010, with local studies attributing most to economic issues. Stuckler’s research found that in the EU and U.S. since 2007, the number of suicides has been 10,000 higher than historic averages.
The author denies that such increases are a normal part of an economic downturn. The book documents how President Franklin Roosevelt’s investment in health after the 1929 depression cut suicide rates and infant mortality, as did the U.K.’s creation of the National Health Service after World War II, when national debt was more than 200 percent of GDP.
“The standard macroeconomic advice is to save in good times and spend in bad,” says Stuckler, adding that public health is one of the biggest “fiscal multipliers” with an average return of $3 for every $1 invested. This is supported by the Harvard School of Public Health, which found the U.S. wastes more than $1 trillion on preventable diseases each year.
Not every country chose austerity, and no health crisis occurred in Iceland, where people voted to keep health care access rather than bail out their failing banks. It also established a body to monitor government responses to economic problems, and Stuckler wants similar accountability in other countries. “If austerity was a treatment, it would never have passed clinical trials. This is a matter of life and death.”
Back in the U.K., the first lawsuits have been served against the government for health cuts that backfired. The policymakers behind austerity could also pay a price.