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The Body Economic: Why Austerity Kills Kindle Edition
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The book starts by saying that we are all part of a clinical trial. This sounds cute at first but becomes more chilling as you read along. The book looks at populations around the world (Iceland, Greece, historical and contemporary United States, the UK, Sweden, Thailand, post-Soviet Nations etc) and how they fared based on which decisions their governments made (cut spending or maintain social programs). The results are unequivocal and will threaten the ideologues on the right but can actually change their minds, if they give data a chance.
This book has the passion of "Pathologies of Power", but takes a more direct look at the economic determinants of health. It has the empathy and global reach of "Development as Freedom" but has a remarkably accessible language, especially given that the authors are academicians (sorry Amartya Sen, you are a brilliant economist but you work faster than Ambien for the average Jane). It has the data-driven approach of "Poor Economics" but it is unapologetic in its conclusion that austerity kills.
The last point is sure to ruffle some feathers. Academics who make conclusions that are backed by politically-neutral data often take a cautious approach in their language, perhaps in an attempt to engage those who might be turned off by a subtitle as seemingly polarizing as "Why Austerity Kills". However, The Body Economic is unapologetic and strongly backed by solid data. Kudos to the authors for using something like 60 pages for notes and references so that you can look at the primary sources if you wanted to (also made for a faster read!) And these aren't your bogus speeches/opinions/whatnot that are referenced as some scholarly work (I am looking at you, NYT best-selling author Glenn Beck). The papers that this book is based on are published in some of the most prestigious journals in the world (The Lancet, BMJ etc), meaning they have undergone a very critical review process that peruses data and rips apart conclusions that have no empirical backing. I didn't recognize all the journals (that doesn't mean much) but it is hard to ignore a book that is based on data and statistical methods that were closely scrutinized. Like I said, a refreshing change in the wordpress era where everyone is an expert on anything.
I did start the book by being slightly turned off by the unapologetic tone that bashes austerity from page one (or actually, the cover). However after reading the book, I can see why the authors chose to place the central focus on the logical conclusion that cutting down critical services in the name of "tightening the belt" makes people sick and kills them, at a rate much higher than what happened in other places where the belt wasn't tightened, despite the overwhelming forces trying to make them cut back.
My other gripe about the book is its focus -as is apparent in its subtitle- on just deaths. This risks giving the impression that they have ignored the other very important measure of illness: disability. Upon closer reading, there is a lot dedicated to the effect of economic policies not just on mortality but also on disability (perhaps "Why Austerity Kills... and causes Disability" is not as catchy?) It is also possible that mortality data were easier to access and compare across countries vs. data on disability-adjusted life-years (DALYs) from physical and neuropsychiatric conditions.
Overall, a good read that is pertinent to the heated discussions on government spending. It shows a clear way forward by presenting cases from around the world. Liberals will have an easier time relating to and agreeing with the book. So will fiscal conservatives, as long as they are willing to get past the rhetoric and look at the hard data that the authors have compiled.
But even if you still want to hold onto austerity as a policy preference, you'll have to deal with Basu and Stuckler's book. The science here has been peer reviewed. Unless you're also hanging onto conspiracy theories about the Lancet and the British Medical Journal being under the control of some modern version of the Freemasons or the Illuminati, in hanging onto austerity as a creed, you'll have to take on the consequences of your policy preferences as well. Basu and Stuckler go through the data step by step and show that infectious disease deaths and deaths due to mental illness and substance use spike under austerity; it's not bad economic times that are bad for your health, it's how your government responds to recessions and depressions. If safety net programs are cut, the facts show that people die in greater numbers than in places where key social programs remain intact or are enhanced during crises.
If you want to argue with the data, go to the original papers and critique the methodology used to derive the conclusions made in the book. You don't get to make ad hominem arguments or change the subject to something more to your liking.
Basu and Stuckler's book will end up as a classic. They've made a direct connection between the reigning economic ideology of the early 21st century and excess mortality and morbidity and have indeed shown that austerity kills. The saddest thing is that European and American politicians will likely ignore their findings and turn a blind eye to the suffering of millions. All in a day's work for the bureaucrats of Washington DC, Brussels and Berlin I suppose.
What we can hope is that future leaders will learn from our mistakes in 2013. Ordinary Greeks, Spaniards, Italians, Americans are paying with their lives for what our governments have done in our names in this most inauspicious of beginnings to a new century.
New Haven, CT
It reinforces my belief that more for the many, rather than a few, benefits everyone in the long run.