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Austerity Kills: Crippling Economic Policies Causing Global Health Crisis

Economist David Stuckler and physician Sanjay Basu examine the health impacts of austerity across the globe in their new book.

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Amy Goodman: That’s CDC Director Thomas Frieden on PBS. We’re joined by David Stuckler and Sanjay Basu. They are authors of The Body Economic: Why Austerity Kills. David Stuckler is a senior research leader at Oxford University, and Sanjay Basu is an assistant professor of medicine and epidemiologist at Stanford University. If you could respond, Dr. Basu, to Dr. Frieden’s comment?

Dr. Sanjay Basu: Yeah, I certainly agree with Dr. Frieden’s comment. And what we have found in our research is that these suicide rate spikes seem to correspond quite closely to state-level unemployment rates. And in particular, when we do these long-term studies that track individuals before the recession, during the recession and after, we can control for their pre-existing mental health statistically, and we find that it’s the new unemployment that seems to trigger new onset of depression and suicide, particularly among our most vulnerable, adults over 50, who, when they lose a job, are often discriminated against or have a very hard time finding new work. There’s a great deal of shame, and also it’s quite hard for our healthcare system to access those individuals, given the degree of barriers that they have, social barriers, to accessing mental healthcare.

Amy Goodman: I mean, the point for people to understand in this country is, what’s unusual for us, compared to other countries, is that when we lose our jobs, we lose our health insurance.

Dr. Sanjay Basu: Absolutely. And we do have some safety nets in the form of Medicaid, Medicare, but it’s quite true that there are some large holes in that system, as has been repeated time and time again.

Amy Goodman:  During an interview on Fox News in February, Republican Senator Lindsey Graham of South Carolina suggested slashing healthcare to stop scheduled sequester cuts from, quote, "destroying the military."

Sen. Lindsey Graham: The commander-in-chief thought—came up with the idea of sequestration, destroying the military and putting a lot of good programs at risk. Here’s my belief. Let’s take "Obamacare" and put it on the table. You can make $86,000 a year in income and still get a government subsidy under "Obamacare." "Obamacare" is destroying healthcare in this country. People are leaving the private sector because their companies can’t afford to offer "Obamacare." If you want to look at ways to find $1.2 trillion in savings over the next decade, let’s look at "Obamacare." Let’s don’t destroy the military and just cut blindly across the board.

Amy Goodman: David Stuckler, can you respond to Senator Graham?

David Stuckler: Austerity in health is a false economy. The cliché, an ounce of prevention is worth a pound of cure, is really true. New York City officials learned this the hard way in the early 1990s, when they cut TB prevention programs by $120 million but ended up with a drug-resistant TB outbreak that cost more than $1.2 billion to control. What we found is that smart investments in public health can have a return on investment, for each dollar, of up to $3.

Amy Goodman: So, talk about the healthcare system, Dr. Sanjay Basu, how sequester fits in, and also just what Lindsey Graham was talking about, "Obamacare."

Dr. Sanjay Basu: So, I’m not a politician and—but I do analyze data. And I think, in looking comparatively among OECD countries, you see a lot of false claims about the U.S. health system. Why is it that we cost so much more and seem to be getting less? I think comparing our country to other OECD stations provides some sense of what—

Amy Goodman: You’re talking about European countries?

Dr. Sanjay Basu: European, as well as Japan, Australia and so forth. And you can see a lot of the myths by just looking at the data. So, what are the theories? The theory is, for example, maybe it’s just American obesity. Well, actually, the costs started well before American obesity and doesn’t seem to correspond actually statistically to obesity. Maybe it’s that we have an older population, but not so. Switzerland actually pays more in nursing home care. Japan has an older population, yet they still pay less while getting more in terms of health. Maybe it’s just technology. We do a lot of research and development. But, in fact, if you look at the Securities and Exchange Commission data, the R&D pharmaceutical industry, while making—

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