The Third Way: Can a healthy economy be an economy for health?

Canadian work has shown that, if the poorest 20 per cent of the population had the same health status as the wealthiest 40 per cent, they would enjoy 13 more years of disability-free life: whereas, if heart disease and cancer were eliminated for the poorest 20 per cent, they would experience only 2 to 5 more years disability-free life.

The Canadian 1997 National Forum on Health was clear: the bottom line is that distributing money and power is the same as distributing health status.

If this is the case, then it seems unlikely that an economy that is based on fostering economic growth can be health enhancing, but some Third Way-ers seem content to see a wide gap between rich and poor. The issue, they say, isn't whether the very richest person ends up becoming richer. The issue is whether the poorest person is given the chance that they don't otherwise have. (Quite how they can argue this when the 500 or so billionaires in the world control wealth equal to that controlled by countries which make up 45 per cent of the world's population eludes me, but they do.)

If our economy were structured so as to promote the health of our population then what would be its parameters?

• Its fundamental organising principle would be to nurture and protect its children;
• Wealth would be defined in terms of the quality of social (including economic) interactions;
• It would be co-operative in the way it worked, and would make sure that everyone wins;
• It would tilt the playing field to assist the disadvantaged - i.e. it would focus on (perhaps insist on) equality of outcomes;
• It would celebrate wealth creation (as defined above) and equal sharing of the wealth;
• It would be oriented primarily at the level of neighbourhood, however defined. It would encourage ethical trade between global neighbourhoods;
• It would value and reward collective processes, where the widest possible participation occurred;
• It would avoid inequality, recognising that inequality is the most serious of the non-communicable diseases;
• It would focuses on maximising social inclusion to promote stability; and,
• It would be oriented towards sustainable development at the neighbourhood and global levels.

Some would argue that giving any group primacy would infringe the rights of other groups. In my view, it is right to focus on children because they are the most vulnerable of groups. In creating a society in which they can prosper, we create a society in which all vulnerable people can prosper.

Let's acknowledge too, that it is never right to give advantage to one’s own children at the expense of someone else’s children. If, as the American Constitution says “all men are created equal”, then it is never better that someone else’s child starves rather than your own; never better that someone else’s child has to live in fear; nor that they have less chance to be educated.

So let's sit the two sets of parameters together. At all points they are diametrically opposed. 

In an economy for health, anything we wanted to do would have to pass the double-sided test - “will this harm children?” (If so, we don't do it.) And “will it benefit them?” (If so, we do it.) If its impact on children is going to be neutral or benign, we would need to agree on what are the second-order criteria.

So what would be the implications of running an economy for health? How would you demonstrate the benefit to children of television advertising? Perhaps the most valued occupations would be those involved in the nurture and protection of children - healing, education, policing, child care (including parenting). Certainly, though, we would value people on the basis of who they are, not what they do. We would not value playing the stock or other money markets unless the rewards were shared equally among the world’s children. We would reduce the volume of motorised traffic in areas that children live, on both road safety and air quality grounds. And so on …

That kind of world sounds attractive to me.