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Sa ï d Business School

Sa ï d Business School. 1-3 September 2004. The Macro-Economic Context. Professor Gordon L Clark University of Oxford. 2. Oxford Vision 2020. The macro-economic context 1st world & 3rd world futures linked As the OECD countries age, financial burdens loom

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Sa ï d Business School

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  1. Saïd Business School 1-3 September 2004

  2. The Macro-Economic Context Professor Gordon L Clark University of Oxford

  3. 2. Oxford Vision 2020 • The macro-economic context • 1st world & 3rd world futures linked • As the OECD countries age, financial burdens loom • Issues of inter-generational equity and international equity will be more important than ever before.

  4. 3. Oxford Dialogue, 21 May 2004 • Specialists discuss the issues: • Economists, finance specialists, geographers and WHO policy analysts • Goldman Sachs, Harvard MS, the IMF, the Stockholm Institute, Oxford, Novo Nordisk and the Social Investment Forum

  5. 4. OECD Prospects (30 years) • The retirement of the baby-boom generation • Related health costs and long-term care issues • Significance of chronic disease, including diabetes, dementia, and the like • Fiscal burdens on nation-states, given limits on domestic tax rates in the context of globalization • How are we to avoid 19th century poverty?

  6. 5. OECD Prospects (30 years) • Must increase rate of economic growth • Focus upon labour productivity, competitiveness in global markets • Require macro and micro policies aimed at enhanced flexibility and efficiency • Encourage closer linkages between the developed and developing countries

  7. 6. Global Prospects (the BRICs) • Will become the most important consumer markets • Rates of economic growth are remarkable, albeit perhaps not environmentally sustainable • middle-class consumption is rapidly expanding • Suggesting a long-term transformation: instead of the BRICs serving western markets with relatively cheap imports, OECD countries will compete to serve BRIC markets.

  8. 7. Global Prospects (Africa etc) • By contrast, poverty & disease stalk Africa • Perhaps reinforced by global climate change causing many to crop failures etc • Challenging inherited local institutions • In effect, a world of 4 regions (including Latin America as a sphere increasingly tied to NA).

  9. 8. Global Tensions • OECD countries resistant to immigration • Inter-generational competition for resources may impoverish the old OR the young • Flow of OECD financial assets to the rest-of-the-world may not result in a bilateral relationship • Climate change “hot spots” like China and India may introduce competition for food • Lethal combination of income deficits, food deficits, and increased disease load.

  10. 9. USSR Experience Important • Provides a lesson about the health consequences of rapid and profound economic change • Prompting a significant decline in age expectancy and increasing untreated chronic diseases • Highly differentiated in effect—urban v rural, high income v low income etc • In turn, reducing labour productivity and economic growth.

  11. 10. Needed: New Models of Health-care Financing & Delivery • OECD countries may not be able to afford inherited systems of health care delivery • US is an example of a very expensive system WITH high levels of inequality • Prevention rather than treatment of disease may be the only way of avoiding long-term fiscal crisis • But that requires a commitment to PUBLIC HEALTH now, in all its complexity.

  12. 11. Impediments to Global Health • Entrenched interests of medical institutions • Short-term focus of political institutions • Incentives for technological innovation at the margin of common needs • Myopia of people, unwilling to recognize the connection between the SR and the LR • Lack of a “consumer culture” wherein people can initiate their own care and treatment.

  13. 12. Sources & Webpage • Clark, G. L. 2003. European Pensions & Global Finance. Oxford: Oxford University Press • Cutler, D. 2004. Your Money or Your Life. New York: Oxford University Press • Heller, P.S. 2003. Who Will Pay? Washington DC: IMF • Slaughter, A-M. 2004. A New World Order. Princeton: Princeton University Press • http://www.geog.ox.ac.uk/~mseifte/oxfordialogueweb/

  14. Saïd Business School 1-3 September 2004

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