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	Economics as if health mattered by Michael Marmot The Lancet   Review: The Body Economic: Why Austerity Kills, by David Stuckler, Sanjay Basu.   Were the economies of the UK, most countries of Europe, and the USA patients, we might diagnose anaemia or worse. Prognosis? If we did nothing there are three possibilities for the short to medium term: the patient would remain ill, she would recover, or she would die. The government in charge at the time could either claim the credit, or attract the blame, even if they did nothing at all. And in the long run? Remember, John Maynard Keynes said that in the long run we are all dead. Perhaps anticipating current debates as to what to do about our ailing economies, Keynes went on: economists set themselves too easy, too useless a task if in tempestuous seasons they can only tell us that when the storm is past the ocean is flat again.   In today"s tempestuous seasons, faced with sick economies, economists and politicians seem to have taken up one of two positions. On one side, expansionary austerians think we have to reduce the debt to get economic growth; on the other, Keynesians believe that we have to get economic growth in order to reduce the debt. Paul Krugman, Nobel Prize winning Keynesian, characterises expansionary austerianism as belief in the confidence fairies. Austerians sneer that the Keynesian solution to high debt is more debt.   Before asking who"s right, it is worth noting that views about the correct economic remedy seem to be correlated with positions on the political spectrum: austerians to the right, Keynesians to the left. It is an interesting intellectual question as to why this should be the case. Naively, one might have thought that it was an empirical question as to which policy “worked”. It is likely, however, that austerians tend to be more suspicious of government solutions and less concerned with distributive effects of policies—harming the poor. The Keynesians have a readier acceptance of the importance of government policies and practice, and are more concerned with inequality. Because of this political alignment, it is difficult to have an informed debate about the evidence. As so often, what should be a debate about evidence is a none-too-veiled debate about prior political beliefs.   It is difficult for a non-economist to penetrate the argument and form an independent judgment. It can be noted that the intellectual case for austerity has suffered a couple of recent blows. Austerians have cited, among others, Harvard economists Carmen Reinhart and Kenneth Rogoff who “showed” that when national debt climbs above 90% of gross domestic product (GDP), economic growth slows. They “showed” it, except that a graduate student checking their figures found elementary errors that cast doubt on their conclusions. Quite apart from the question of causation, which has parallels in epidemiology: does slow growth lead to high debt, or does high debt lead to slow growth. The International Monetary Fund (IMF) has published new estimates that austerity has a bigger effect on slowing economic growth than they previously thought. In the UK, the Office for Budget Responsibility says that it subscribes to the widely held assumption that fiscal contraction damages growth. The intellectual argument is under threat, but austerians are still winning the political and public relations argument across Europe and in the USA.   There is another objection to this debate: the main criterion of success of economic policy appears to be growth of GDP. But what if we had a wider set of considerations—we want economic and social policy to do more than deliver economic growth. Policies should also be evaluated for their effects on people"s lives. An important way of doing that is to look at the health impacts of policy. This is the approach David Stuckler and Sanjay Basu have taken in their book, The Body Economic: Why Austerity Kills. Pursuing the analogy of seeking proven remedies for a sick patient, the authors suggest that we are all unwitting participants in a controlled trial of stimulus versus austerity. Stuckler and Basu"s clear conclusion is that the austerity remedy doesn"t work and may be harmful, particularly for mental health. To make the case they go back to the Great Depression in the USA during the 1930s, to the East Asian currency crisis, to the collapse of the Soviet Union, to Greece, Iceland, California, and the UK.   The Great Depression is intriguing. If the crash of 1929 summons up images of stockbrokers jumping off buildings your recollection is at least partly accurate. As Stuckler and Basu explain, suicide was rising before 1929 and peaked in 1932, and was more common in states that had more bank failures. Even so, my guess is that soup kitchens might have been a better place to look for suicides than financial institutions. But, despite the rise in suicides, overall mortality in the USA declined. There were fewer traffic deaths, and the decline in infectious disease mortality continued. Alcohol-related deaths were low, but this was Prohibition time in the USA. Prohibition was lifted in 1933, after which deaths linked to alcohol climbed steeply. Prohibition is not a policy option that any sane person wants to pursue for alcohol—although many sane people want to pursue it for drugs—but it is of interest that restricting availability does lead to fewer alcohol-related deaths.   Economic and social policies rarely provide neat experiments. At first blush a comparison between Iceland, a North Atlantic island of some 320 000 people, and the Behemoth that is Russia might give pause. That said, Stuckler and Basu do draw interesting contrasts. When the Soviet Union collapsed, Russia followed a policy of rapid privatisation and erosion of social safety nets. GDP went down, economic inequality increased, poverty increased, and life expectancy plummeted, in sharp contrast to some other countries of the former Soviet bloc. Iceland is altogether different. It went from being a well-organised society based on fishing and huge supplies of natural energy to housing three private banks that represent just what reckless cowboys can do when let loose on the global economy, and that"s being unkind to cowboys.   The debate about Reinhart and Rogoff is what happens when debt exceeds 90% of GDP. At its peak, Iceland"s debt was 850% of GDP. Icelandic banks bought assets around the world, as though all curves go ever upwards without a day of reckoning. The butterfly that flapped its wings might have been the collapse of subprime mortgages in the USA, but it caused a hurricane in Iceland and, predictably, the castles in the air were reduced to rubble. Iceland appealed to the IMF, which offered help in return for their usual policies of stringent austerity. The general population of Iceland were asked to pay off the debts of a few bankers. In a referendum, they refused, and spending on social safety nets and health care were maintained. That, and a high degree of social solidarity were, in Stuckler and Basu"s account, the reason why Iceland did not see adverse health effects. Stuckler and Basu find the evidence to be plain.   If austerity means cutting vital social expenditure it will add to the pain of recession. The authors conclude: “The lessons of history—the New Deal, Shock therapy in Russia, and the IMF programs in the Asian Financial Crisis—are clear…Will we continue to balance budgets on the backs of the most vulnerable members of society. Will tens of millions…have to suffer for misbegotten austerity programs?” Those of us who argue for evaluating all policies for their likely impact on health equity should welcome this important contribution to the debate. Visit the related web page
	Ten U.S. Cities Commit to pursue Fossil Fuel Divestment by Bill McKibben, Desmond Tutu USA 350.org / Climate Commission   “Divestment is just one of the steps we can take to address the climate crisis,” says Seattle Mayor Mike McGinn. This is the warning 10 cities across the U.S. are issuing to the fossil fuel industry as the campaign to divest from the industry wreaking havoc on the planet gains steam.   Seattle Mayor Mike McGinn joined climate group 350.org and the Mayors Innovation Projectin officially launching their city and state fossil fuel divestment campaign, cheering the 10 cities that have already joined and urging other cities to commit to the climate action as well.   “Divestment is just one of the steps we can take to address the climate crisis,” said Seattle Mayor Mike McGinn. “Cities that do so will be leaders in creating a new model for quality of life, environmental sustainability and economic success. We’ve got a head start on that here in Seattle, but there’s a lot more work to do.”   According to 350.org, Seattle joins Madison, Wis., Bayfield, Wis, Ithaca, NY, Boulder, Colo., State College, Pa, Eugene, Ore., Richmond, Calif., Berkeley, Calif., and San Francisco in divesting from the top 200 fossil fuel companies.   Today’s announcement sends a powerful message to the fossil fuel industry: if you’re going to try and take away our planet, we’re going to try and take away your money. We’re no longer just playing defense against dirty projects like the Keystone XL pipeline, we’re going on offense, too.   The group,says it is sending the message that if it’s wrong to wreck the planet, then it’s also wrong to profit from that wreckage.   In addition to the 10 cities already committed to the divestment, 350.org says 100 other cities and states also have divestment petitions in the works.   College campuses were leaders in pushing fossil fuel divestment, with Unity College in Maine and Hampshire College in Massachusetts pledging to divest their endowments from oil, gas and coal companies. 350.org reports that Sterling College and College of the Atlantic have also agreed to divestment, and the efforts are gaining traction at hundreds of other college campuses.   “It"s so fitting that American cities are taking the lead in the fight to weaken the fossil fuel industry"s political power,” Bill McKibben, noted environmentalist, author and founder of 350.org, said in a statement. “Since every city public works department is already spending scads of cash to deal with the gathering storms and rising seas climate change is bringing, it"s clear it makes no sense for them to also prop up the industries that make it necessary.”   As the fossil fuel divestment campaign is modeled after the anti-apartheid divestment campaigns of the 1980s, the message Nobel Prize-winner Archbishop Desmond Tutu gave 350.org at the start of their own divestment campaign is powerful:   The divestment movement played a key role in helping liberate South Africa. The corporations understood the logics of money even when they weren’t swayed by the dictates of morality. Climate change is a deeply moral issue too, of course...Once again, we can join together as a world and put pressure where it counts. http://neweconomyworkinggroup.org/blog/divest-or-not-divest   http://www.themonthly.com.au/video/2013/07/24/1374649328/global-warming-do-math-bill-mckibben   The Critical Decade: The Climate Commission (Australia)   Over many decades thousands of scientists have painted an unambiguous picture: the global climate is changing and humanity is almost surely the dominant cause. The risks have never been clearer and the case for action has never been more urgent.   Our Earth’s surface is warming rapidly and we can already see social, economic and environmental impacts in Australia.   Failing to take sufficient action today entails potentially huge risks to our economy, society and way of life into the future. This is the critical decade for action.   The following points highlight the key messages arising from the accompanying report The Critical Decade:   1. There is no doubt that the climate is changing. The evidence is overwhelming and clear.   The atmosphere is warming, the ocean is warming, ice is being lost from glaciers and ice caps and sea levels are rising. The biological world is changing in response to a warming world.   Global surface temperature is rising fast; the last decade was the hottest on record.   2. We are already seeing the social, economic and environmental impacts of a changing climate.   With less than 1 degree of warming globally the impacts are already being felt in Australia.   In the last 50 years the number of record hot days in Australia has more than doubled. This has increased the risk of heatwaves and associated deaths, as well as extreme bush fire weather in South Eastern and South Western Australia.   Sea level has risen by 20 cm globally since the late 1800s, impacting many coastal communities. Another 20 cm increase by 2050, which is feasible at current projections, would more than double the risk of coastal flooding.   The Great Barrier Reef has suffered from nine bleaching events in the past 31 years. This iconic natural ecosystem, and the economy that depends upon it, face serious risks from climate change.   3. It is beyond reasonable doubt that human activities – the burning of fossil fuels and deforestation – are triggering the changes we are witnessing in the global climate.   A very large body of observations, experiments, analyses, and physical theory points to increasing greenhouse gases in the atmosphere – with carbon dioxide being the most important – as the primary cause of the observed warming.   Increasing carbon dioxide emissions are primarily produced by the burning of fossil fuels, such as coal and oil, as well as deforestation.   Natural factors, like changes in the Earth’s orbit or solar activity, cannot explain the world-wide warming trend.   4. This is the critical decade. Decisions we make from now to 2020 will determine the severity of climate change our children and grandchildren experience.   Without strong and rapid action there is a significant risk that climate change will undermine our society’s prosperity, health, stability and way of life.   To minimise this risk, we must decarbonise our economy and move to clean energy sources by 2050. That means carbon emissions must peak within the next few years and then strongly decline.   Unless effective action is taken, the global climate may be so irreversibly altered we will struggle to maintain our present way of life. The choices we make this decade will shape the long-term climate future for our children and grandchildren.   Carbon dioxide concentrations are at the highest level in over one million years. Despite global efforts they continue to increase at a rate much faster than at any other time on the recent geological record.   Most nations of the world, including Australia, have agreed that the risks of a changing climate beyond 2°C are unacceptably high. The temperature rise is already approaching 1°C degrees Celsius above pre-industrial, nearly halfway to the 2°C limit. The best chance for staying below the 2°C limit requires global emissions to begin declining as soon as possible and by 2020 at the latest. Emissions need to be reduced to nearly zero by 2050.   Stabilising the climate within the 2°C limit remains possible provided that we redouble our efforts this decade and beyond.   5. Most of the available fossil fuels cannot be burnt if we are to stabilise the climate this century.   The burning of fossil fuels represents the most significant contributor to climate change.   From today until 2050 we can emit no more than 600 billion tonnes of carbon dioxide to have a good chance of staying within the 2°C limit.   Based on estimates by the International Energy Agency, emissions from using all the world’s fossil fuel reserves would be around five times this budget. Burning all fossil fuels reserves would lead to unprecedented changes in climate so severe that they will challenge the existence of our society as we know it today.   It is clear that most fossil fuels must be left in the ground and cannot be burned.   Storing carbon in soils and vegetation is part of the solution but cannot substitute for reducing fossil fuel emissions.   http://climatecommission.gov.au/report/the-critical-decade-2013/ Visit the related web page
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