I like “steelmanning”, so thanks for sharing that.
Sin taxes & behavioural nudges seem to support my point rather than work against it. The US banned alcohol and discovered many people kept on drinking anyway, so now limits itself to talking a good game and collecting the extra tax income. Most health professionals are very clear that alcohol is bad, and many claim if it were invented today governments would ban it like so many other drugs. Yet no government I know says “We’ve looked at the scientific evidence, this is a clear example of people making bad choices, so we’re going to force them to make a good choice”.
I know almost nothing about the DRC government. My best guess is that it makes OK spending choices. More than a quarter of government spending is on health, about half as much again on education. (3.3% and 1.5% of GDP, out of a total spend of 11.9%.) That seems reasonable. High level statistics on health & education have been improving over the last 20 years despite there being a civil war for a lot of that time. Turning it around, if we think the DRC government, health administrators, doctors and nurses make bad spending decisions then that seems like a much better opportunity to improve things.
Ok prohibition didn’t work but I don’t think we know of alcohol and tobacco taxes etc are having good or ill effects.
I agree the overall shares look ok on DRC spending but that doesn’t tell the whole story obviously. According to a quick Wikipedia dig and my memory of reading DRC is known for tremendous corruption.
Another data point against “locals know there own interests best”?:
The 2013–2014 DHS survey (pp. 299) found that 74.8% of women agreed that a husband is justified in beating his wife in certain circumstances.
On this point:
Turning it around, if we think the DRC government, health administrators, doctors and nurses make bad spending decisions then that seems like a much better opportunity to improve things.
What intervention/opportunity would you propose to address this?
I don’t have a specific intervention/opportunity in mind for the scenario where health spending is broken.
I’m reminded of a survey of several poor countries which revealed many were not following best practice for treating complications in pregnancy and childbirth despite the treatments being cheap and well-known. Digging into it showed there wasn’t a single reason for this, so no single intervention would change things everywhere.
If the underlying reality is locals make bad choices, as normal individuals and health practitioners and policiticians, I don’t think distributing nets for free is going to make much difference. The moral argument for intervening seems to be a lot weaker too. In that set-up we have replaced Singer’s drowning child with an adult who refuses swimming lessons and ignores all advice to stay out of the water.
I like “steelmanning”, so thanks for sharing that.
Sin taxes & behavioural nudges seem to support my point rather than work against it. The US banned alcohol and discovered many people kept on drinking anyway, so now limits itself to talking a good game and collecting the extra tax income. Most health professionals are very clear that alcohol is bad, and many claim if it were invented today governments would ban it like so many other drugs. Yet no government I know says “We’ve looked at the scientific evidence, this is a clear example of people making bad choices, so we’re going to force them to make a good choice”.
I know almost nothing about the DRC government. My best guess is that it makes OK spending choices. More than a quarter of government spending is on health, about half as much again on education. (3.3% and 1.5% of GDP, out of a total spend of 11.9%.) That seems reasonable. High level statistics on health & education have been improving over the last 20 years despite there being a civil war for a lot of that time. Turning it around, if we think the DRC government, health administrators, doctors and nurses make bad spending decisions then that seems like a much better opportunity to improve things.
Ok prohibition didn’t work but I don’t think we know of alcohol and tobacco taxes etc are having good or ill effects.
I agree the overall shares look ok on DRC spending but that doesn’t tell the whole story obviously. According to a quick Wikipedia dig and my memory of reading DRC is known for tremendous corruption.
Another data point against “locals know there own interests best”?:
On this point:
What intervention/opportunity would you propose to address this?
I don’t have a specific intervention/opportunity in mind for the scenario where health spending is broken.
I’m reminded of a survey of several poor countries which revealed many were not following best practice for treating complications in pregnancy and childbirth despite the treatments being cheap and well-known. Digging into it showed there wasn’t a single reason for this, so no single intervention would change things everywhere.
If the underlying reality is locals make bad choices, as normal individuals and health practitioners and policiticians, I don’t think distributing nets for free is going to make much difference. The moral argument for intervening seems to be a lot weaker too. In that set-up we have replaced Singer’s drowning child with an adult who refuses swimming lessons and ignores all advice to stay out of the water.