Q: Could you please briefly explain the concept of investing in health?
Dean Jamison: I think we all have an idea of what an investment is. You make a commitment now, in terms of putting down money, or time, or effort, to reap the rewards in future. And I think the essence of good healthcare, both at the personal and national level, is to take care of our population now and expect returns in the future.
Q: And why do you think this topic ranks as one of the most important healthcare issues in the world today? Why is it included in WISH?
Dean Jamison: So many countries are experiencing slowed economic growth, meaning there’s much more competition for public, as well as private, resources than in the past. So though thinking hard about how to invest well in health has always been important, it’s become even more so now. And my sense is that that’s a lot of why it’s on the WISH agenda.
Q: Your report makes the case for the economic case for investing in health; why is it important for healthcare investment to benefit the economy?
Dean Jamison: Well, one important part of the argument certainly is that an investment in health is an investment in a better economy. Kids learn more, they learn faster, workers are at work more, they don’t retire as early, they don’t die before they should die—all of these things lead to higher output of the things that we enjoy and want. Those are instrumental reasons for doing health investments well.
Q: Could you please speak a little bit about the intrinsic value of health?
Dean Jamison: We have a basic set of national income accounts that all countries in the world use. These national income accounts are what tell us how many cars, houses, banking services and all those other things the economy produces and consumes. However, some important things are left out, such as environmental degradation, resource depletion, women’s time in the household, increases of leisure time such as that in Europe. Those are not part of national income, whereas improvements in health conditions, or reductions in mortality rates, are probably the biggest areas that must be included in national income accounts but are not. There’s nothing in the national income accounts that captures that intrinsic value of better health, so trying to measure that dimension is one of the things that economists have been working on for a long time.
Q: Does investing in health contribute to individual income wealth, national income wealth or both?
Dean Jamison: Both. There can be effects at the national level that are not captured at the individual level. A prominent economist, Jeffrey Sachs, has pointed out how getting rid of or greatly reducing malaria in African countries has an effect that, in some ways, is much more than the sum of the local effect on the economy. Every producer of yams, for example, in a given country might be able to produce a few more yams per year because they don’t have malaria, and that would be captured in national accounts as the sum of those individual gains. However, Jeff would argue that’s not really what’s important. What’s important is, now that it’s a healthy environment, some Taiwanese textile company is going to come in and create a whole set of new jobs so people don’t have to be producing yams at all; they can be producing something better. So improved health conditions created a different climate at the national level that is not captured just by looking at individual productivity.
Q: So one of the things about the WISH research forum is that it’s not just about research, but it is coming up with actionable policies. Could you please take me through the highlights of what you are recommending to policy-makers based on the research you have been doing over the past year?
Dean Jamison: What we are arguing in particular is that by focusing too much on the national income accounts as a measure of productivity and not measuring and accounting for the very large intrinsic value of better health, you run the risk of underestimating the value of successful investment in health to a society. So the heart of the argument is to improve the balance of government investment across the necessary sectors.
Q: So overall then to conclude just a couple of questions, what kind of impact do you hope your research will have, and what kind of overall difference you want to make?
Dean Jamison: Well, I would like to see a more deliberate discussion in public policy—in the academic side of public policy and in analytic parts of governments—of the true value of health improvements and how that should impact the public sector’s decision-making, particularly in the health sector.
Q: So what is the significance of your being able to further this research in this forum and elevate your research to a global level, and how does WISH help you achieve that?
Dean Jamison: My team and I have learning about some of the other WISH activities, what they’re concluding, and I think that’s been a valuable input into our thought process as well, and I hope it continues into our fall meeting during WISH 2016.