Nagra Blog Post 12

 

In chapter two of his work, Development as Freedom, Amartya Sen develops nuances in the relationship between various factors we commonly hear about, such as GDP and life expectancy and the broader term of development. He delineates certain interconnected and core rights as paramount to growth. These include political freedoms, economic freedoms, social opportunities, transparency guarantees, and protective security. He develops the importance of all of these freedoms and their impact on health outcomes. Sen’s adamance about the importance of freedom of life through public and private healthcare, while correct, lacks a fundamental connection to the broader spectrum of scientific and medical research. I do not point this out to devalue Sen’s theory of interconnectedness but to provide an additional perspective to the incentivization of social freedom to health. Later I will describe my contentions with the India-China example of democratic health outcomes. 

The development of an economically stable and thriving research market, while often against market behavior, is essential to the growth of sound social freedom of healthcare. Beginning with my original definition, it is necessary to affirm that medical research, while sometimes profitable, is seldom pushed by the “invisible hand.” Entry costs are incredibly high, and the market lacks a guarantee to turn a profit or even have a successful intervention. State and central forces reverse this flow, offering patents, funding, and approvals. A thriving research field is therefore even more interconnected with economic freedom but in a slightly different way. It is not that anyone can simply enter into market transactions by picking up a lab coat and shelving some acid. A research market presupposes economic restrictions, not increased economic freedoms. Perhaps this is a point of tradeoff for Sen. It is obviously (or maybe you believe it not to be so obvious) challenging to achieve a utopia of freedom, health, and economic individualism. Sen would agree. Where he missteps is a characterization that these fundamental areas of freedom reinforce each other when they are widespread and positive. A correct approach would be that these freedoms interact in complex ways, with restrictions and freedom affecting other limits and privileges. 

Later Sen states that many of the problems in China, a state with a centralized government, come from its lack of representative democracy. He says, “this is particularly so when it comes to flexibility of economic policy and the responsiveness of public action to social crisis and unforeseen disasters” (43). He cites that China is prone to famine while India, a democracy, has not had one since democratization. This statement is false on two grounds. While India has not had many mass famines and has successfully prevented at least one, it is a global center for undernourishment, with 194 million underfed people every year. In the last two decades, per capita income has more than tripled while food intake has halved. 

Sen also lacks the insight the pandemic has given us. Through a centralized response, China curved the spread of the virus in record-breaking times and constructed hospitals to decrease ICU and hospital bed load in a matter of days. A centralized power can be dangerous, but it can be highly effective in the realm of public and individual health.