In the modern world today, it can be postulated with strong claims that democracy is a positive driver for health because it permits stronger representation of the poor and their interests in policies that affect them. This, of course, includes health policies. One could also argue that since the floor of participation in everyday politics is getting more accessible across countries in the world, and autocratic regimes are being replaced with more democratic ones (at least in theory), the income and thereby accessibility to health services might also increase.
If you think that this is a realizable utopian journey that the world has embarked upon, I am sorry to disappoint you because not everyone shares the same opinion. There are certain quarters in our world where people still hold the opinion that people would have better access to health services under the “universal basic services” arrangement of communist and socialist regimes.
Let’s examine some basic facts about this question together. According to the World Economic Forum, democracy is spreading like a wildfire (on a cosmic scale) amidst global concerns for its future and it continues to garner strong public support. It is quite a clear fact that since World War II, more countries have become democratic. To elucidate better, as, at the end of 2016, 58% of countries with populations of over 500 000 were democracies while 26% exhibited characteristics of a mixed system and only 13% were autocracies. This is poised to continue to change in favor of democratic systems with the influence of readily available access to information.
One indicator that is usually used as a proxy to evaluate the general access to health services in a country is the child mortality index. When considered separately and evaluated across countries, child mortality has also been dropping dramatically in the decades after World War II. And this is exciting news. But it is not happening everywhere. This drop is happening in regions of the world that are less autocratic and tend more or less towards a liberal state; where freedom of expression and basic human rights are guaranteed. In a practical sense, as I mentioned earlier, active citizens are able to pressure their governments to prioritize healthcare spending in the national budget and the relative availability of opportunities in the free market ensures that people have choices when it comes to choosing a health care provider which increases competition thereby improving the quality of the health systems.
In their study published in the Lancet, Dr Hannah Pieters et al analyzed 33 democratic transitions that took place in the last four decades. They discovered that political reforms lead to declines in child mortality and that the effect rises over time. They observed significant declines in nine countries including Nigeria, Senegal, Bangladesh, Philippines, Bolivia, Guatemala, Nicaragua, Honduras, and Mexico. But before you get all excited, it is worth noting that their finding comes with a caveat: the greatest effect of this relationship is experienced where health is an important concern for the population or country. This clearly means that even if you have democracy safely tucked in your pocket, you still have to consider health a priority. This will drive you to advocate and demand better health care services for yourself, your family and others.
So if you ask me, I will always say it as it is. Democracy guarantees freedom of expression, liberty, freedom of association and our basic human rights. The beautiful thing about it is that democracy also guarantees you a healthier life if you are able to demand for it.
Sources
- https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30104-8/fulltext
- https://www.weforum.org/agenda/2017/12/more-countries-are-now-democratic-than-at-any-point-since-world-war-two/
