Why Incentives Matter in Human Development
By Paul Sullivan, Georgetown University
August 22 (UB Post) Mongolia has a real chance to be a wealthy country. Its people have a real chance to be much healthier, happier, more educated, and better trained. They could live longer and have higher quality lives and more. They have serious chances to be entrepreneurs, inventors, leaders and more.
The future cities, towns and villages of Mongolia could be examples of very high quality of life areas for the world to admire. Imagine a city where Mongolians could walk easily to their markets, their relatives and friends, entertainment, schools, clubs, hospitals and clinics, post offices, government offices and more. Think about Mongolian cities, towns and villages that have very clean air, water, and land.
Mongolians have a real chance to make a model Mongolia. This could all be happening in a fairly short time period. With the massive wealth in the ground that could be extracted sold, processed, improved, and traded the average Mongolian really has a right, and even a responsibility, to dream of the model Mongolia.
However, with fortune come great challenges. How does Mongolia give the right incentives to its people, its leaders, its business people and others to help Mongolia move toward this better future?
One of the curses of quick and massive wealth to some countries is the increased obesity of its people. They get lazy, have others do the work for them, and they eat "modern foods". I remember being in one of the newly massively wealthy countries in the Middle East passing by the new diabetes hospital for children. Just outside the hospital there was a big post advertisement for ice cream. The little girl in the poster was holding an ice cream with 15 scoops of different flavors.
Of course, the children of this country could easily afford these 15 scoops. 40 years ago they could barely afford stale bread. Now they are importing sweets by the tons from Switzerland, meats from New Zealand, and lobsters from Maine in the United States (which is half way around the world from them).
This country and others like them now see the health problems that spoiling their people have wrought. They are now investing in cures, medicines and more, but are they investing in incentives to get their people out exercising, working at physical labor and more. It does not seem that way. However, as the health problems spread I suspect such incentives would happen.
The health care in this country is free of charge to its citizens. So there is no real cost, except a shorter and lower quality life, for bad behavior, such as overeating, smoking, etc.
The U.S. has a growing obesity epidemic. Many children have grown fat on fast foods, sugary drinks, massive carbohydrate-loaded meals, fatty foods and more. U.S. children are far wealthier, but clearly not healthier in many ways than their parents and certainly their grandparents. The incidence of various forms of diabetes in children, even very young children has gone way up in the United States.
The incentives for Americans to live healthier lives are quite weak. Most of the costs of health care are paid for by either the government, through private insurance agreements with employers, or by other third-party insurers and payers. Most Americans don't have a clue how much their health care costs them. They never see the bills.
Those without health care insurance see the bills. They also tend to stay away from taking care of themselves until the worst occurs. Dental problems become catastrophes and chronic health issues are neglected until it is almost too late to deal with them. There are some very healthy people without health insurance in the U.S., but they will get older. With age come the inevitable health issues.
The President's health plan and other plans are supposed to deal with these warped incentives, but they do not.
TV, video games, and the sedentary lifestyles of wealthier people all add up to not more health, but less.
For both the country in the Middle East and the U.S. one of the best ways to deal with this is to give proper incentives to the people to exercise more, eat less, eat better and do a lot more on preventive healthcare. Doctors have told me on many occasions that what they often see is a fat person who has neglected himself asking to be repaired.
So, is wealth a gift or a curse?
For the health of a population it can be both. Many examples can be found worldwide. I have seen children from Tanzania running 10 kilometers to school and back in bare feet. A couple of generations ago in the U.S. children often walked to school. Some even ran, especially if they were late rising teenagers fearing the cursed detention from being tardy. (I can vouch for that from my own experience.)
I often see parents driving their children short distances to school in the morning in my U.S. neighborhood. In that Middle Eastern country during the 2 weeks of my last visit I did not see a single child walking to school or really walking anywhere. Their South Asian drivers brought them to wherever they wanted to go often.
It would be so easy for yet another country that has a chance at great wealth to spoil its children of the future. However, Mongolia has a chance to turn that curse around by giving the right incentives for healthier lives and by building healthier cities, towns and villages.
It is not that hard given the wealth that could be coming. However, it is sadly very easy to fall right into the trap of unhealthy, yet wealthy people. I hope that will not be the case for Mongolia.
Things Mongolia could do? Well, money talks. Businesses and the government could give cash incentives for losing weight, getting blood sugar down, having better health reports for their employees and their families. Schools could have built in incentives programs to have national and local competitions in aerobic and challenging sports. Towns, villages and neighborhoods could have health competitions. Fatty and sugary foods could be taxed. Alcohol and cigarettes could be taxed more heavily.
There are many things that could be done. However, I am an outsider. Mongolia will need to decide based on its culture, its people-to-people relations, and its traditions what is its best way. However, it would help if those in leadership looked at the rest of the world and saw how quick and gigantic wealth has affected the health of people of many countries.
Now it is time to get out of my basement office and talk a long walk on the treadmill and think how I can improve my health. One must practice what one is preaching. I have a long way to go to the optimal health that I would like. Part of the issue with health incentives is that they need to be over the long run. They have to be planned and directed in creative ways to keep them interesting and useful.
Maybe I can plan to train to run long distances for the next time I am in Ulaanbaatar? (I used to run 10K races and marathons years ago and it would be nice to do that again.) However, I hope the air is cleaner to do that. Incentive could be set up for that issue as well.
August 22 (UB Post) Mongolia has a real chance to be a wealthy country. Its people have a real chance to be much healthier, happier, more educated, and better trained. They could live longer and have higher quality lives and more. They have serious chances to be entrepreneurs, inventors, leaders and more.
The future cities, towns and villages of Mongolia could be examples of very high quality of life areas for the world to admire. Imagine a city where Mongolians could walk easily to their markets, their relatives and friends, entertainment, schools, clubs, hospitals and clinics, post offices, government offices and more. Think about Mongolian cities, towns and villages that have very clean air, water, and land.
Mongolians have a real chance to make a model Mongolia. This could all be happening in a fairly short time period. With the massive wealth in the ground that could be extracted sold, processed, improved, and traded the average Mongolian really has a right, and even a responsibility, to dream of the model Mongolia.
However, with fortune come great challenges. How does Mongolia give the right incentives to its people, its leaders, its business people and others to help Mongolia move toward this better future?
One of the curses of quick and massive wealth to some countries is the increased obesity of its people. They get lazy, have others do the work for them, and they eat "modern foods". I remember being in one of the newly massively wealthy countries in the Middle East passing by the new diabetes hospital for children. Just outside the hospital there was a big post advertisement for ice cream. The little girl in the poster was holding an ice cream with 15 scoops of different flavors.
Of course, the children of this country could easily afford these 15 scoops. 40 years ago they could barely afford stale bread. Now they are importing sweets by the tons from Switzerland, meats from New Zealand, and lobsters from Maine in the United States (which is half way around the world from them).
This country and others like them now see the health problems that spoiling their people have wrought. They are now investing in cures, medicines and more, but are they investing in incentives to get their people out exercising, working at physical labor and more. It does not seem that way. However, as the health problems spread I suspect such incentives would happen.
The health care in this country is free of charge to its citizens. So there is no real cost, except a shorter and lower quality life, for bad behavior, such as overeating, smoking, etc.
The U.S. has a growing obesity epidemic. Many children have grown fat on fast foods, sugary drinks, massive carbohydrate-loaded meals, fatty foods and more. U.S. children are far wealthier, but clearly not healthier in many ways than their parents and certainly their grandparents. The incidence of various forms of diabetes in children, even very young children has gone way up in the United States.
The incentives for Americans to live healthier lives are quite weak. Most of the costs of health care are paid for by either the government, through private insurance agreements with employers, or by other third-party insurers and payers. Most Americans don't have a clue how much their health care costs them. They never see the bills.
Those without health care insurance see the bills. They also tend to stay away from taking care of themselves until the worst occurs. Dental problems become catastrophes and chronic health issues are neglected until it is almost too late to deal with them. There are some very healthy people without health insurance in the U.S., but they will get older. With age come the inevitable health issues.
The President's health plan and other plans are supposed to deal with these warped incentives, but they do not.
TV, video games, and the sedentary lifestyles of wealthier people all add up to not more health, but less.
For both the country in the Middle East and the U.S. one of the best ways to deal with this is to give proper incentives to the people to exercise more, eat less, eat better and do a lot more on preventive healthcare. Doctors have told me on many occasions that what they often see is a fat person who has neglected himself asking to be repaired.
So, is wealth a gift or a curse?
For the health of a population it can be both. Many examples can be found worldwide. I have seen children from Tanzania running 10 kilometers to school and back in bare feet. A couple of generations ago in the U.S. children often walked to school. Some even ran, especially if they were late rising teenagers fearing the cursed detention from being tardy. (I can vouch for that from my own experience.)
I often see parents driving their children short distances to school in the morning in my U.S. neighborhood. In that Middle Eastern country during the 2 weeks of my last visit I did not see a single child walking to school or really walking anywhere. Their South Asian drivers brought them to wherever they wanted to go often.
It would be so easy for yet another country that has a chance at great wealth to spoil its children of the future. However, Mongolia has a chance to turn that curse around by giving the right incentives for healthier lives and by building healthier cities, towns and villages.
It is not that hard given the wealth that could be coming. However, it is sadly very easy to fall right into the trap of unhealthy, yet wealthy people. I hope that will not be the case for Mongolia.
Things Mongolia could do? Well, money talks. Businesses and the government could give cash incentives for losing weight, getting blood sugar down, having better health reports for their employees and their families. Schools could have built in incentives programs to have national and local competitions in aerobic and challenging sports. Towns, villages and neighborhoods could have health competitions. Fatty and sugary foods could be taxed. Alcohol and cigarettes could be taxed more heavily.
There are many things that could be done. However, I am an outsider. Mongolia will need to decide based on its culture, its people-to-people relations, and its traditions what is its best way. However, it would help if those in leadership looked at the rest of the world and saw how quick and gigantic wealth has affected the health of people of many countries.
Now it is time to get out of my basement office and talk a long walk on the treadmill and think how I can improve my health. One must practice what one is preaching. I have a long way to go to the optimal health that I would like. Part of the issue with health incentives is that they need to be over the long run. They have to be planned and directed in creative ways to keep them interesting and useful.
Maybe I can plan to train to run long distances for the next time I am in Ulaanbaatar? (I used to run 10K races and marathons years ago and it would be nice to do that again.) However, I hope the air is cleaner to do that. Incentive could be set up for that issue as well.
Comments
Post a Comment