Why focus on the return?
Access to quality healthcare underpins our social cohesion and economic prosperity. Government – as kaitiaki – must make health investments that deliver better health outcomes and improve well-being for more people, and also bolster economies, create jobs and enhance productivity. In other words, make sure investing in the health system delivers both societal and economic outcomes to bolster NZInc's wellbeing.
Health equity can look like early intervention – healthcare may be delayed, but it cannot be avoided – think cancer screening compared to cancer treatment. Kicking the can down the road comes at a human cost and stunts economic and productivity growth.
On the other hand, when labour is healthy, the incentive to develop new skills and knowledge is higher because people expect to enjoy long-term benefits (Boom and Canning et al., 2000). Investing in the health system and early intervention not only saves lives, it is also a crucial investment in the wider economy.
Investing in health has been shown to give economic returns to the health sector, other sectors and the wider economy. It delivers an estimated fourfold return on every dollar invested – an effect described as the "fiscal multiplier" (Reeve et al., 2013) – yet the economic return of health investment has largely been absent from the discussion.
The importance of human capital to economic growth cannot be over emphasised because it serves as a catalyst to economic development. Ill health impairs productivity, hinders job prospects and adversely affects human capital development. There has been a strong political and historical commitment to treating health as a social goal either through legislation or mandating and prioritising expenditure on health.
COVID-19 was an unwelcome reminder of just how much health matters for individuals, society and the global economy. It highlighted the impact of underfunding the health system – quality care cannot occur in the absence of adequate infrastructure. Of course, while infrastructure is critical for high-quality care, it is not a measure of services provided.
Infrastructure allows public health professionals to respond to ongoing health problems, such as chronic disease, and prepare for and respond to emergency health threats, such as natural disasters and disease outbreaks. Without resilient public health infrastructure, deadly disease outbreaks can become even deadlier.
