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Computer Model Reveals Escape Plan From Poverty's Vicious Circle

KentuckyFC writes "Infectious disease condemns poor countries to an endless cycle of ill health and poverty. Now a powerful new model of the link between disease and economic growth has revealed why some escape plans work while others just make matters worse. The problem is that when workers suffer from poor health, economic output goes down. And if economic output goes down, there is less to spend on healthcare. And if spending on healthcare drops, workers become less healthy. And so on. So an obvious solution is for a country to spend more on healthcare. But the new model says governments must take care since the cost to a poor country can send the economy spiraling into long term decline. By contrast, an injection of capital from outside the country allows spending on healthcare to increase without any drop in economic output. 'We find that a large influx of capital is successful in escaping the poverty trap, but increasing health spending alone is not,' say the authors. And the amount required is relatively little. The model suggests that long-term investment needs only to be more than 15 per cent of the cost of healthcare. But anything less than this cannot prevent the vicious circle of decline."

30 of 356 comments (clear)

  1. Healthcare by ledow · · Score: 5, Insightful

    Keep your people healthy and they'll live longer, work longer and pay more tax.

    What kind of idiot hasn't realised this yet? (obviously, America)

    1. Re:Healthcare by ganjadude · · Score: 4, Interesting

      'We find that a large influx of capital is successful in escaping the poverty trap, but increasing health spending alone is not,

      Pretty much, we spend more money on HC in america than any other country yet our care is no where near good by any stretch of the imagination. Throwing more money at it like the current admin wants to do, according to this study anyway seems to be a waste of money

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    2. Re:Healthcare by ColdWetDog · · Score: 5, Interesting

      Oh we're quite 'healthy' - not at the highest level but more than healthy enough to be able to weather serious disease as best as possible. TFA is talking about real malnutrition / lack of clean water / lack of vaccines level healthy.

      Now, how we go about spending money on 'health' is another topic that we've attacked numerous times and is much more complex. But, barring small pockets of severe poverty, we're pretty healthy.

      Going back to TFA

      How much cash does a country need to escape a poverty trap? Goerg and co say their model suggests that the money should be equivalent to halving the cost of disease treatment and prevention.

      But this level of investment is not needed in the long term. Goerg and co say the same outcome can be guaranteed if the long term investment is equivalent to only 15 per cent of this cost.

      I wonder if they're talking about nutrition / basic sanitation in theses costs. While not terribly high dollar, it's often hard to get levels of basic nutrition and clean water to really poverty stricken places and create the infrastructure to keep the resources up over time. That might be more expensive. Still and all it gives groups like the IMF a spread sheet number that they can plug in to force countries to do something other than create a mega dam for the Chinese.

      --
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    3. Re:Healthcare by Anonymous Coward · · Score: 5, Insightful

      Throwing more money at it like the current admin wants to do, according to this study anyway seems to be a waste of money

      It's not the money you spend, it's how you spend it.

      The US healthcare system is mired in being a for-profit operation controlled by large multi-nationals and insurance companies.

      They have no interest whatsoever in providing good health care, they care about maximizing corporate profits.

      Basically, America's system can't ever work, and never really will except for the rich. Everybody else is expendable and 'surplus population'.

    4. Re:Healthcare by ledow · · Score: 5, Insightful

      Spending money on cosmetic surgery, and the amount of money you literally PISS AWAY into insurers and intermediaries is the cause of your problem.

      You're not spending money on making people better. You're spending money on keeping huge pharmaceutical companies in their monopoly on ineffective treatments.

      How much do you think it *really* costs to diagnose and treat a broken leg? Now find out how much your insurers pay (who aren't "insuring", because they only charge you for your own personal expense, at great "middle-man" profit).

      Stop pissing about, through out this "private" medical practice with insurers and so many middle-men, and put in place a national health service who offer any treatment that is effective and extends life / quality of life, which everyone contributes to from taxation, and everything else you pay for out of your own pocket.

      You'll pay less tax. You'll never pay health insurance again unless you want to for something cosmetic. And you'll be healthier.

      Come join the rest of the fucking first- and third-world.

    5. Re:Healthcare by Grishnakh · · Score: 5, Informative

      Spending money on cosmetic surgery

      Huh? That's not part of the US's problem at all. Cosmetic surgery isn't covered by insurance, it's at-will and paid directly by those who want it. It's totally irrelevant to the problems in the healthcare industry in America. In fact, if anything, it's probably more cost-effective and efficient because it cuts the insurance companies out of the equation.

      and everything else you pay for out of your own pocket.

      Yes, that's already how we do it for cosmetic surgery. It's everything else that's a disaster.

    6. Re:Healthcare by Anonymous Coward · · Score: 5, Insightful

      In a for profit health care system like the US has profit is maximized by having sick people paying for care. Profit is mimimized by having a healthy population that does not need the care.
      Guess where the economic factors are going to push the health of the population?

    7. Re:Healthcare by torkus · · Score: 5, Interesting

      Very true. Talk to people in the healthcare field and they'll be able to list tons of examples of wasted money. Any patient on medicaid/medicare gets more treatments, pills, devices, etc. because the hospital, dr, or specialist can bill for it.

      Example: 80-something comatose man in the final stages of lung cancer being given a colonoscopy ... just in case he might have ass cancer too. Seriously.

      Healthcare is for-profit and must-CYA. Those are the two primary factors 90+% of the time. That's not to say there aren't doctors who care. Many do. But they're stuck working in a system that leaves them little choice but to go along if they want to continue practicing medicine (and paying off their insane student loans).

       

      --
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    8. Re:Healthcare by mcrbids · · Score: 5, Informative

      Pay less? I doubt it, especially over the long term. It doesn't matter if we overpay the insurance companies or the state..both are experts at wasting other people's money.

      The USA Spends more per capita (by far) than any other nation on earth. Yet our actual life expectancy is just 33rd.

      Doubt all you want. I prefer to get some facts and base my opinions on them rather than "gut feelings".

      --
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    9. Re:Healthcare by Anonymous Coward · · Score: 5, Insightful

      The US healthcare system is mired in being a for-profit operation controlled by large multi-nationals and insurance companies.

      I want to add "not-profit hospitals turning huge profits" and "chargemasters" to this list of reasons why healthcare is so screwed up. Time magazine again exposed this problem very well earlier this year. Total BS...

    10. Re:Healthcare by znrt · · Score: 4, Insightful

      It's not the money you spend, it's how you spend it.

      this, and it's not just medical resources. it's education too, to a great extent.

      and regarding the article, I would like to point out that injection of money from the outside would in most (or possibly all) cases not be even necessary: just get the rich in the country to pay their fair share of taxes, that would be more than enough.

    11. Re:Healthcare by Solandri · · Score: 4, Interesting

      Actually, the U.S. already spends more public money per capita on health care (via Medicare/Medicaid) than Canada does. So the problem cannot be attributed entirely to private health insurance.

      I'm fairly certain the problem is the combination of private + public money used to pay for health care. If you go with completely public health care, there is just one payer. When you go with completely private health care, there is also just one payer (the person/insurer paying for a procedure). When you combine private + public, there are two payers. And just like government subsidized school loans end up driving up the cost of tuition, having two payers drives up the cost of health care. (I'm only "fairly certain" because the two conflate through a complicated mix of different patients paying different amounts for the same procedure, and doctors/hospitals cost-shifting in the accounting books to even everything out).

    12. Re:Healthcare by denzacar · · Score: 3, Interesting

      Basically, America's system can't ever work, and never really will except for the rich.

      Doesn't that actually imply that simply throwing money at the problem actually works?

      US health system is built to accommodate most those who can afford it - clearly it works splendidly for that purpose.
      Keep your rich healthy and they'll live longer, work longer and grow richer.

      --
      Mit der Dummheit kämpfen Götter selbst vergebens
    13. Re:Healthcare by compro01 · · Score: 4, Insightful

      put the right controls in place to insure that corporate interests align with the patients interests.

      At which point is is no longer the American system.

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    14. Re:Healthcare by sg_oneill · · Score: 5, Interesting

      I live in Australia which has a hybrid UHC/Private system. Basically everyone pays for "medicare" (Which I guess would be called "medicaid" in the US) as a small addition to tax. Totally transparent, its just part of income tax and the contribution is income dependent. On top of that we have a private health system where you can get private health cover AS WELL which gives access to private hospitals (although in my experience the private hospitals are inferior to the excellent government ones, especially in emergency care). You have a choice here, but the govt system is largely excellent, however there might be waiting times to see specialists , sometimes in the months range for non essential stuff, and thats where private health cover is advisable. Fortunately private health insurance is well regulated and the doctor, not the health insurance companies , have final say in approving treatments.

      Anyway, as you can imagine, when we have progressive governments, funding for the public system increases, and when you get conservative governments, that funding decreases.

      But it backfires horribly to defund it, and ironically the actual costs increase.

      I can giive an example. Under state labor, my local hospital had the 4 hour rule. In emergency, you would be seen within 15 minutes of ariving (or less if its urgent) , and within 4 hours either be seen by a doctor and sent home (maybe with medication or bandages or whatever) or admitted to hospital. In the case of borderline cases like Influensa, a patient would be sent to an Accute observation ward for overnight assessment. Its a great system that works brilliantly.

      However in the last few years our state has had a conservative government that has systematically tried to defund the hospital. The end result is that waiting times have blown out to be multiple hours for non trauma cases in the emergency ward, and doctors are increasingly overworked and stressed out.

      Last time I was admitted to emergency ward I was in with internal bleeding. Because I didn't *look* unhealthy it took 3 hours to see and diagnose me. This happened when I finally vomited blood and collapsed in the waiting room unconscious. I required surgery and a few weeks recovery. The doctor told me that if I had been diagnosed within half an hour of being admitted, it would have been a simple procedure and I would have been home within a day. As a result of underfunding, I cost the government *vastly more* in treatment costs then had I not. This is not a case of malpractice, the reality was the hospital was overworked and it took 3 hours to see me because thats how long it took to free up a doctor from all the other emergency cases.

      It might seem paradoxical that properly funding universal healthcare is cheaper than not properly funding it, but it actually makes sense when you remember that prompt adequate treatment is almost always cheaper than trying to patch up some poor sod who's condition has been made worse by not treating it.

      --
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    15. Re:Healthcare by TheRealMindChild · · Score: 5, Informative

      Any patient on medicaid/medicare gets more treatments, pills, devices, etc. because the hospital, dr, or specialist can bill for it.

      You grossly overestimate how much medicare (and medicaid) provide, and ignore the cost of what you receive. Being on medicare, a chunk of your Social Security income is taken for part A. For me, that amount is almost $200 a month. I only get an allowance of ~$630 dollars a month to spend on the hospital/PCP/specialist. A trip to the hospital, and I owe out of pocket. If I visit my PCP (primary care physician) AND have a psychiatrist appointment, or a physical therapy appointment in the same month, I owe out of pocket. Essentially, I get a "free" ~$430 to throw at my medical care and the rest is up to me to cover.

      Medicare Part B (drugs) is optional. It can cost anywhere from $120 to $300+ dollars a month, depending on what and how much you want. It is only beneficial to have if you are on a regimen of costly drugs that would normally go above what you would pay without it. Even if you opt to purchase part B, not everything is covered, and you have a varying copay.

      --

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    16. Re:Healthcare by fahrbot-bot · · Score: 3, Insightful

      Most misquoted line of the election. The whole thing makes the Democrats look worse than the Republicans.

      Misquoted as in quoted directly from the video?

      --
      It must have been something you assimilated. . . .
    17. Re:Healthcare by Anonymous Coward · · Score: 5, Insightful

      Actually, the U.S. already spends more public money per capita on health care (via Medicare/Medicaid) than Canada does. So the problem cannot be attributed entirely to private health insurance.

      Sure it can.

      Because likely around half (or more) of every dollar being spent is simply lining the pockets of the insurance companies and the middle-men. There's simply no room to get savings from economies of scale, and the vendors can just gouge for every piece as they go. Because if those vendors don't show a steady (and unrealistic) profit, they will be punished by the speculative investors running the stock markets.

      As it exists, your system is hugely wasteful because every asshole in the middle is taking his cut and contributing absolutely NOTHING to patient care.

      Everything in the middle is just mark-up and waste -- which is why your system as it stands can never actually work for everyone.

      The US health-care system is the economic equivalent of trying to build a car by purchasing all of the parts directly from car dealers, and then paying a bunch of mechanics to do the assembly. All you're doing is throwing money into the gaping maws of the middle-men.

      The cost of your procedures and case is so high because you need to offset the sheer quantity of money you've been bilked out of in the process. And then all of those other absurd line-items in the bill amount to "because we fucking can".

      Essentially, your system is designed to be ineffective and wasteful, because that's how the private companies want it. When insurance companies decide on the 'appropriate' level of medical care, it's a sucker's game from there.

      The fact that you spend more money per capita mostly means you are wasting more on the structural problems in your health care system.

    18. Re:Healthcare by Pope · · Score: 4, Insightful

      However in the last few years our state has had a conservative government that has systematically tried to defund the hospital. The end result is that waiting times have blown out to be multiple hours for non trauma cases in the emergency ward, and doctors are increasingly overworked and stressed out.

      That's a typical Tory/neo-conservative power play: defund the public option, then in a few years gripe how terrible the public option is, and how great the private is!

      --
      It doesn't mean much now, it's built for the future.
    19. Re:Healthcare by nbauman · · Score: 4, Informative

      many of us have a serious issue with the portion of this country that consumes far more from the fed then it pays in taxes.

      You mean the southern red states + Alaska?
      http://www.slate.com/blogs/the_reckoning/2012/10/25/blue_state_red_face_guess_who_benefits_more_from_your_taxes.html

    20. Re:Healthcare by fahrbot-bot · · Score: 4, Informative

      many of us have a serious issue with the portion of this country that consumes far more from the fed then it pays in taxes.

      To be clear, that's only federal income taxes. They still pay state/local taxes, SSI/Medicare and sales taxes. In addition, that 47% includes SSI/Medicare disabled, retirees. From The 47%: Who They Are, Where They Live... (with graphs and charts):

      Who They Are:
      In 2011, 47% of Americans paid no federal income taxes. Within that group, two-thirds still pay payroll taxes. The rest are almost all either (a) old and retired folks collecting Social Security or (b) households earning less than $20,000. Overall, four out of five households not owing federal income tax earn less than $30,000, according to the Tax Policy Center.

      There are some not-so-poor outliers, like the 7,000 millionaires who paid no federal income taxes in 2011. But for the most part, when you hear "The 47%" you should think "old retired folks and poor working families."

      Where They Live
      The ten states with the highest share of "non-payers" are in the states colored red. Most are in southern (and Republican) states. Meanwhile, the 13 states with the smallest share of "non-payers" are in blue. Most are northeastern (and Democratic) states.

      Why the Meme Matters
      The 47% aren't lucky ducks cheating the system. They're mostly poor working families getting pilloried by the political party that wrote the rules they're following. If the 47% are the monster here, then Republicans helped play the role of Dr. Frankenstein. "Non-payers" have grown in the last 30 years because of marginal tax rate cuts and credits like the EITC passed under Republican presidents and continued by both parties in Congress.

      --
      It must have been something you assimilated. . . .
    21. Re:Healthcare by nbauman · · Score: 3, Interesting

      Private evil this private evil that.. look, insurance companies are manipulative and profit seeking, but having the state manage it is no better.

      It should be obvious that a well-managed state will run a well-managed health care system, and a poorly-managed state will run a poorly-managed health care system. In fact, a poorly-managed state will have a poorly-managed private health care system.

      Our government, run by the Republicans and their Democratic neocon equivalents, will manage it badly.

      The problem is that in our political system, whoever has the most money for TV attack ads wins (most of the time), and corporate billionaires are the ones who can donate the most money to the two parties as a quid pro quo for advancing their interests. (In other countries that would be considered illegal bribery.) That's the main problem with the health care system. The health care industry poured hundreds of millions of dollars into the political campaigns.

      Other countries -- every other country in the world -- pay far less per capita for their health care system. Some of them, like Canada, are pretty much like ours except they cost half as much and don't have a health insurance industry. The Australian and British health care systems are about as good as ours except that they cost roughly half as much as ours.

      The Supreme Court case of Citizens United vs. FEC was designed to make it impossible to have electoral reform, and to insure that the 1% of billionaires will keep running this country for the indefinite future. I don't see any way out.

      Unless you're making at least $100,000 a year, or have a million dollars invested cautiously, you'd probably be better off moving to another country.

      Or you could stay here and fight.

    22. Re:Healthcare by TheNastyInThePasty · · Score: 4, Informative

      What? How? Explain the context to me then. I've watched the entire video and the line means exactly what you'd expect.

      There are 47 percent of the people who will vote for the president no matter what...who are dependent upon government, who believe that they are victims. ...These are people who pay no income tax. ...and so my job is not to worry about those people. I'll never convince them that they should take personal responsibility and care for their lives.

      Also, did you forget about the "You didn't build that" misquote? The line in context CLEARLY meant "You didn't build that infrastructure." Yet, the Republicans used the misquote as the theme of their damn national convention!

      --
      The best thing about UDP jokes is I don't care if you get them or not
    23. Re:Healthcare by Gavagai80 · · Score: 3

      It is of course completely false both in implication and fact. The implication is that the poorest 47% don't pay income tax, which is blatantly false as even people below the federal poverty line pay federal income tax (I know, I was one last year, there was still a few hundred in federal tax and no I'm not confusing it with the separate social security tax). If 47% don't pay, it must be mostly wealthy people. But in fact, everyone pays sales tax and wealthy people pay property tax so there's nobody not paying any kind of tax into the system, from the homeless to Bill Gates.

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      This space intentionally left blank
    24. Re:Healthcare by PopeRatzo · · Score: 3, Insightful

      If you think about it for a minute. "Insurance" is about the dumbest way possible to pay for a society's health care. It's based on giving a load of money to some corporations and them paying less than that amount for your care. Care which they get to approve.

      For goodness sake, it's clearly more efficient to have all basic and catastrophic health care paid directly by society via taxes. If there are years where society uses less health care, there could be a tax rebate, giving financial incentive for people to remain healthy.

      Nobody bringing a family member to a hospital for life-saving care should be worrying about losing their home if the insurance company decides to be shitty.

      --
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    25. Re:Healthcare by AK+Marc · · Score: 4, Insightful

      The red states don't want it, but vote in representatives who will fight for it, not representatives who will turn it down because it shouldn't be spent. No, I don't believe you. The red states believe the "deserve" it more than the blue states who pay more for it.

    26. Re:Healthcare by Anonymous Coward · · Score: 4, Insightful

      Err, yes he was wrong. Even in the most literal sense: the poorest pay tax -- disproportionatey so, in fact. Income tax is not the only kind of tax there is, although someone with Romney's income (but not his position) might be forgiven for thinking so. Even if you ignore payroll tax, sales tax, bus fares, inflation of rent due to property tax, and so on, those that don't pay income tax aren't "putting nothing into the system." Many of them are working their asses off for sub-poverty wages (44% of the 47%). Others are children, elderly, or housewives who would not be expected to pay income tax in any system (30% of the 47%).

      He was dead wrong, and from the looks of the google results, most major networks called him out on it in precise detail. Maybe Fox forgot?

      http://www.cbsnews.com/news/fact-checking-romneys-47-percent-comment/

      http://www.newrepublic.com/article/108817/anatomy-47-percent

  2. sending aid doesn't help, stop raiding countries by dutchwhizzman · · Score: 5, Insightful

    Most "poor" countries to which we send aid, are being plundered just as hard, or even harder. Every time we send food aid to some poor African or central American country, the local farmers get no money for the little food they produce and the local market is ruined, stopping local production of food instead of encouraging it.

    Every time we demand the lowest price for all the stuff we import from those countries, we make them find ways to produce even cheaper, lowering the standard of life there. This results in pricing that is so low that our own economy can't compete and we put import taxes on these goods. This results in the foreign producers being forced to lower their prices even more, again ruining their economy and health.

    Instead of "sending aid" every time a famine or natural disaster strikes one of these countries, we should stop plundering them. Micro credits for local businesses there have helped a lot, investing in farming for local food supply helps. These people are perfectly capable of helping themselves, given half a chance.

    --
    I was promised a flying car. Where is my flying car?
  3. Escape Plan From Social Science's Vicious Cycle by Baldrson · · Score: 4, Insightful
    This study is just more social pseudo-science. Social science is incapable of effectively dealing with the "correlation doesn't imply causation" trope we've all been taught in statistics 102.

    In real science control groups are required to establish causality.

    Social scientists are as terrified of real control groups testing causal hypotheses in human ecology as were the Jesuits of independent interpretations of the Bible. This is because social science is essentially a pre-enlightenment theocratic discipline:

    If the powers-that-be oppose your social "science" then no matter how much data you gather, some variant of "correlation doesn't imply causation" will be trotted out to ignore it.

    If the powers-that-be like your social "science" then the NYT will take one data point -- perhaps even one anecdote about one person at some point in history and base public policy on it. With the mass media holding mass and preaching said sermons the pious slaves to intellectual fashion, generally those with college degrees from the seminaries known as "colleges", and and with IQs below 140 who like to pretend to be morally superior "thought leaders" (knowing they have safety in numbers from hearing sermons at "mass") will then to the dirty work on the street.

    Moreover, this theocratic sophistry, imposing social theories on unwilling human subjects, locks into place powerful interests that oppose any truth-discovery.

    From Machiavelli's "The Prince" chapter 6:

    "It ought to be remembered that there is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things. Because the innovator has for enemies all those who have done well under the old conditions, and lukewarm defenders in those who may do well under the new. This coolness arises partly from fear of the opponents, who have the laws on their side, and partly from the incredulity of men, who do not readily believe in new things until they have had a long experience of them."

    If we are ever to escape this vicious cycle driven by the social sciences, the Enlightenment must penetrate them through Sortocracy:

    Sorting proponents of social theories into governments that test them.

    Fortunately, like the Protestant movement's impetus to independently interpret the Bible due to the Gutenberg press, the Internet is now letting people have direct access to and independent interpretation of data about human ecologies -- and the demand for freedom from imposition of social theories on unwilling human subjects will increase until freedom from theocratic forms of government -- and their social scientist theologians -- will win the day.

    In the process, as with the wars for freedom of religion that lasted over a century, we cannot expect this penetration of Enlightenment values into the social sciences to take place without a struggle.

  4. Spending on Prevention always more cost effective by acroyear · · Score: 4, Insightful

    So long as we just focus on *treatment* of the sick, costs will continue to spiral.

    A general influx of cash doesn't just focus on treatment of those sick - it starts to alleviate the issues that allow disease to spread in the first place (lack of hygene, lack of vaccination, lack of clean water, lack of balanced food (and complete meals), and lack of general preventive care, and lack of birth control - ALL things people in poverty already lack).

    Health care costs get under control when the focus is on prevention rather than treatment: you spend FAR less money when fewer people get sick. When you use the capital to address the causes of disease rather than just treating it, you spend much less on treating the ones that got away.

    Relatedly, this is why insurance companies love birth control - a pill a day and a box full of condoms is far cheaper to them than the thousands of dollars for examinations, the birth, emergency natal care, and having to cover the kid for the next 26 years.

    --
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