Tuesday 26 August 2014

Lancet says austerity is bad for Greeks' health

When your country's problems are so visible that
medical science can see them, you're in bad shape.

These guys even go into the mistake of bailing
banks with money that's needed for health.

What they didn't note was Merkel blackmailing
Greece so that it can spend more on tanks, and
less on health. The Lancet can't do everything.



Checkit:  New scientist
Greek austerity tragedy shows where not to make cuts
    16:23 26 February 2014 by Andy Coghlan
Austerity can be bad for your health. Greece has seen drastic increases in infant mortality, suicide and depression since the government made deep cuts to healthcare and social support services between 2009 and 2012. These fallouts may soon be reprised in other countries that have embarked on tough austerity measures, such as Spain and Portugal.
Following the country's financial crash, Greece cut its hospital budget by 25 per cent cut and slashed funding for mental health problems by 55 per cent. An analysis of health statistics shows that as a result, suicides increased 45 per cent between 2007 and 2011 and, over roughly the same period, cases of depression more than doubled and infant mortality rose by 43 per cent.
Needle-exchange schemes and free condoms for injecting drug users were also cut. By 2012, new HIV cases in this group were 32 times what they had been in 2009.
The country has also had its first cases of locally spread malaria for 40 years.
"The Greek experience shows the serious consequences of withdrawing health spending and social services," says David Stuckler of the University of Oxford, lead author of the analysis.
Spain next?
The worry is that a similar pattern will be seen in Spain, which introduced similarly savage cuts to health budgets in 2012 and 2013. "We think Spain will follow if the cuts are not reversed," says Helena Legido-Quigley of the London School of Hygiene and Tropical Medicine, who last year published a study on how the recession has so far affected health in Spain.
Legido-Quigley says that more recent developments such as the withdrawal of universal access to healthcare from 873,000 non-residents in 2012 could create conditions for epidemics of HIV and TB like those seen when services were withdrawn in Greece. She says there's still time to prevent similar epidemics in Spain, but only by restoring universal healthcare.
False economy

Stuckler says preventing epidemics is far cheaper than controlling them once they've begun. Last year, he produced estimates suggesting that healthcare spending actually boosts the economy, adding more than $4 to the economy for every $1 invested, compared with a drain on the economy of $10 for every $1 invested in defence, for example.
It's a false economy to cut spending on health and welfare, says Stuckler, and both Iceland and Finland survived economic meltdowns without doing so. Instead, they saved public money by not bailing out failed banks, leaving the private sector to pick up the bill.

"Short-term savings gained by drastic austerity measures should be weighed against their long-term costs," says George Slavich of the University of California, Los Angeles, who investigates the long-term effects of stress. "Living in a state of social and economic unpredictability, with inadequate access to healthcare, does not just contribute to short-term illness, it can also set in motion a set of biological processes that greatly affect lifelong health, and which can even lead to premature death," he says.
Journal reference: The Lancet, DOI: 10.1016/S0140-6736(13)62291-6

Proof of Troika fiddling

I'm going to place a text below which is
very good at analysing the politics of
austerity for Greece, and the flaws in
its application.

As this guy sees it, these flaws will mean
the end of the Troika's plans.
He shows how the Troika is acting on
behalf of the banks, and on behalf of
German military contractors and Merkel.

The ballooning military spending was one
clue that politicians were being paid off for
arms that Greece cannot afford and cannot
use. Submarines for example. It shows how
this is still going on now, even with austerity.

And Merkeel feigns innocence, like
"I didn't know Greece was spending so much
money. Schade"

His methodical style is also
very reassuring. He is academically
slicing the Troika and Greek politicians
into tiny pieces.

Let's see what happens next.

checkit: Mainly macro
Greece and denying responsibility
My earlier post making some parallels between attitudes to Greece and attitudes during the Irish potato famine of the 1840s was picked up by others in Ireland and Greece, and has drawn some interesting reactions. Thankfully most understood that, as I wrote: “Of course the Irish famine is different in degree and form to the difficulties being faced by many in some Eurozone economies.” So why did I still want to make the comparison? The trigger was the denial of responsibility highlighted by the Lancet study I referred to, and the common alternative view that all problems were down to a corrupt or inefficient Greek government and economy.
I wanted to make the parallel with the Irish famine for three reasons. First, there seemed to be the same type of deflection of blame going on today as at that time. Second, ideas about what could and couldn’t be done in terms of economic relationships were central. Third, the verdict of history is pretty clear with the Irish famine. The British government did provide some famine relief, but what history remembers is that it was not nearly enough. History remembers the action and inaction of the British government, and not the inefficiencies and inadequacies of Irish agriculture.
One response to my criticisms is that without Troika or IMF support, austerity would have been much more immediate and intense. This is of course true: unable to borrow at all, the Greek government’s primary deficit would have had to fall to zero even if all interest payments on debt had been halted. But as I noted above, the headline from history is not that the famine would have been worse still if the British government had not provided any relief, but rather that it did not provide enough.
Troika assistance to Greece made two major mistakes. First, wishful (at best) thinking about the amount of government debt Greece could support. Second, the Troika imposed a front loaded austerity programme that was far too severe. How much of the subsequent collapse of the economy was due to this is unclear, but few seriously doubt it played a major role. As I noted here, the estimates by the Troika of the impact of austerity that were made at the time ignored basic and widely accepted macroeconomic analysis.
Mistakes get made, particularly in a crisis. When these mistakes become evident, as they did pretty quickly in the case of Greece, there are two possible responses. The first is for those who made these mistakes to admit responsibility, and try and learn the lessons. I think the IMF has to some extent tried to do this, as I noted in this earlier post. The second possible reaction is denial, and to seek to blame others. It is this response that history does not look too kindly upon.
Denial takes many forms. There are many myths. One of the most invidious is that the failure of Greek debt to stabilise is because the Greek government failed to undertake the required austerity. This is simply not true, as this excellent study of all the assistance programmes to Eurozone countries by Pisani-Ferry, Sapir and Wolff documents. (See also the numbers I presented in this post.) The austerity programme was always far too severe, and became more so over time.
Another myth is that workers refused to cut wages, thus preventing the necessary adjustment in competitiveness. To quote the Pisani-Ferry et al study: “It is only for wage-based competitiveness indicators such as unit labour costs that the improvement is noticeable. Thanks mostly to downward wage adjustment, ULCs started to decline already in 2010 and the trend accelerated strongly in 2011-12.” So the image of the stubborn Greek worker refusing to face reality is incorrect.
There is also a denial of the extent to which the Troika promoted its self interest, rather than doing what was good for the Greek people. No doubt part of the failure to recognise the necessary debt write off was wishful thinking, but it is difficult to believe that it had nothing to do with who held that debt. As this Breugel study shows, the term ‘privatisation’ appears ten times more often in Commission programme documents than the word ‘poverty’. When it became possible that Greece might elect a government headed by Syriza, Greece was threatened with exit from the Eurozone not because the Troika believed this prospective government might do more harm to the Greek economy, but because they threatened to suspend interest payments.
A good example of this self interest is defense spending, and German built submarines in particular. Greek defense spending is well above the Eurozone average. An obvious initial austerity measure would have been a complete suspension of Greek spending on overseas produced military hardware. This is one example where austerity could actually be expansionary: Greece benefits from the reduced tax burden, but the demand impact is felt entirely overseas. Any fears about Turkey could have been covered by assurances from other governments. Indeed, given the alternatives, it seems criminal not to have made this a condition of Troika support. But of course this would be to ignore where this hardware was built - mainly in Germany and other Eurozone economies. 
As Merkel is reported as saying: “But we never asked you to spend so much of your GDP on defence”. Yet the Troika has not been afraid to ask for many things. One of the myths is that Troika loans have not involved much conditionality - as Pisani-Ferry et al note, “the Troika has immersed itself more and more in the sector-speciļ¬c regulation of microeconomic behaviour.” The extent of corruption in the procurement of Greek military hardware is immense, but the bribes have been paid by companies in other Eurozone countries, particularly Germany.
It is clearly nonsense to argue that the damage done to the economy and health of the Greek people is all down to corruption and inefficiency within Greece and nothing to do with Troika actions. Denial of responsibility is particularly dangerous if it means not admitting your mistakes but instead repeating them. The tragedy of the Greek political class is not that they failed to enact Troika policies, but that acquiesced to them. The one ray of hope is that now the Greek government is no longer running a primary deficit, so it potentially has much stronger negotiating power. I only hope they use it.