IT is said that economics is concentrated politics. By this is meant that regardless of the political or ideological posturing of any society, at the end of the day it is the extent to which governments can satisfy the economic and cultural needs of their citizenry that ultimately determines the efficacy of the system. I propose in this article to focus on the ideology of health care.

No where is the politicization of health care delivery more pronounced than that of the United States of America where there is currently a big debate raging over the role of the state in the provision of health care delivery.

The Obama administration, true to their manifesto promises to the American people, is in the process of taking legislative action to make health care more accessible to all Americans, in particular the poor and the underprivileged especially those not covered by health care insurance. Some 50 million Americans are likely to benefit from this new dispensation when it becomes operational, hopefully soon.

The move is bitterly opposed by the Republicans who wanted the status quo to continue on the grounds that it will expand the role and influence of the state in the provision of medical care and in the process increase the budgetary deficit which is already alarmingly high.

One would have thought that the United States, being one of the richest countries in the world, would have recognized the wisdom, if not the imperative of providing each and every American with health care delivery. This is all the more relevant in view of the fact that some of the less developed economies including some that are considered by the US administration as “failed states” have been successful in providing medical care to all of their citizens, free of cost.

Take Cuba as an example. The Cuban government is providing free health care of a fairly decent quality to all of its people, despite the fact of the embargo placed on Cuba by the United States and other western nations which have had devastating effects on the Cuban economy.

The same is true of education delivery which is on par with that provided by any country in the developed or developing world. In fact Cuba is ranked high on the human development index when it comes to the delivery of health and education services to its citizens.

Guyana is also one of those countries that has been aggressively pursuing an approach to development that puts people at the centre of all development activities. Development for this current PPP/C administration is about people. That is why immediately upon its assumption to office on October 1992, it began to pursue a development path in which there is a human face to development. This approach to development was manifested in a reconfiguration of the structure of the national budget which saw the lion share of the budget going into the social sectors in particular education, health, housing and water.

Noteworthy was the fact that under the previous administration, especially during the latter part of the life of the administration, housing and water were de-emphasized in favour of the military and para- military, the foreign service and the Office of the President.

The fact is that the provision of services to the people in any country is influenced to a large extent by the political or ideological underpinnings of that country. The United States for example is influenced by an ethos that says basically that the state should not get involved in the provision of goods and services, except in those areas where the incentive for private entrepreneurs to make money is negligible.

These include spending on national security and infrastructure development such as the construction of roads and bridges where returns on investment can be extremely long.

The role of the state is relegated only to provide an enabling environment for the private sector to generate wealth, the distribution of which is highly skewed in favour of capital and entrepreneurship at the expense of labour.

The recent economic and financial crisis that rocked the United States and the western world has resulted in a re-think on the role of the state especially in light of the fact that the countries that escaped relatively unscathed from the crisis are those where the state is playing a leading role in the development processes. China for example not only escaped the negative fallout from the crisis but in some ways has managed to turn the crisis to its own advantage as reflected in soaring growth rates and a sound balance of payments position.

Ironically, the crisis has put a severe dent not only on the financial status of the United States but also with respect to some of the other bigger economies such as Japan which is today experiencing one of the highest debt-to-revenue ratio in its history.

The same is true of the United States of America which is today the leading debtor nation in the world with a significant portion of the debt being owed to China which, as mentioned before, has been able to build up huge foreign exchange reserves at the expense of the United States and other western economies.

If the current trends continue, the problem of debt burden which has stagnated growth and development of the underdeveloped world could now apply to the developed world.