Éloi Laurent


On his book Measuring Tomorrow: Accounting for Well-Being, Resilience, and Sustainability in the Twenty-First Century

Cover Interview of January 29, 2018

A close-up

I think the chapter on health is the perfect introduction for any reader interested in what goes on in our contemporary societies and wondering how this book would change her/his vision.

The most striking fact about the fate of humanity in the twentieth century concerns health, not growth: we have seen a greater improvement in human health in the second half of the twentieth century than at any moment in all human history, i.e., the last seven million years. Life expectancy skyrocketed between 1900 and 2000; a century described (and rightly so) as eminently violent and destructive. According to historical data gathered by the late Angus Maddison, during the twentieth century, life expectancy increased, on average, five times more than in the millennium that preceded it.

Moreover, simple metrics such as life expectancy or mortality rates tell us a whole different story about what has happened in a given country in the last thirty years than just growth. Take the United States. The recent discovery by economists Angus Deaton and Anne Case of very high mortality rates among middle-aged whites in the U.S., all the while GDP was growing, is proof that health status must be studied and measured regardless of a nation’s perceived wealth status. How is it that the richest country in the world in terms of average income per capita, a country that devotes more of its wealth to health than any other, comes close to last in the rankings with comparable countries in terms of health outcomes? Use different indicators, as I do in the chapter devoted to health, and the solution to the American health puzzle quickly becomes apparent: the ballooning of inefficient private spending has led to a system where the costs are huge compared to its performance. The healthcare reform initiated by Barack Obama in 2009 can actually be explained by the desire to amend a health system in which the human and economic cost has become unbearable. If this reform was to be destroyed, the cost would no doubt skyrocket again.