تاثیر سیستم بهداشت و درمان در رشد اقتصادی مطلوب

This paper analyzes the impact of health system in the economic growth, based upon three macroeconomic models. The first one considers the economy with only one sector, but with morbidity; in the others the economy is divided in two sectors, the productive sector and the health sector, considering it intensive in labor and after intensive in capital. The results show that the presence of the health system increases the life expectancy and the aggregate product, but does not modify the per capita product.

This paper presents an introductory study of the macroeconomic impacts of the inclusion of the healthcare sector in the neoclassical model of optimal economic growth. Studies in economics regarding the healthcare sector – usually referred to as the economics of health – are well established in the literature (Arrow, 1963 and Grossman, 1972). Some studies deal with the issue from a microeconomic standpoint, focusing more intensively on the public sector (Blomqvist and Léger, 2005, Østerdal, 2005 and Buchumuller, 2006). Others discuss the importance of health for economic growth (Aguayo-Rico et al., 2005, Bloom and Canning, 2005, Ainsworth and Over, 1993, Sorkin, 1997, Howitt, 2005, Aguayo-Rico et al., 2005, Bloom and Canning, 2005, Bloom and Canning, 2005, Howitt, 2005, Aguayo-Rico et al., 2005, Bloom and Canning, 2005, Muskhin, 1964, Taylor and Hall, 1967, Ainsworth and Over, 1993, Sorkin, 1997, Howitt, 2005, Aguayo-Rico et al., 2005, Bloom and Canning, 2005, Sorkin, 1997, Howitt, 2005, Aguayo-Rico et al., 2005, Bloom and Canning, 2005, Taylor and Hall, 1967, Ainsworth and Over, 1993, Sorkin, 1997, Howitt, 2005, Aguayo-Rico et al., 2005, Bloom and Canning, 2005, Winslow, 1951, Muskhin, 1964, Taylor and Hall, 1967, Ainsworth and Over, 1993, Sorkin, 1997, Howitt, 2005, Aguayo-Rico et al., 2005 and Bloom and Canning, 2005), but they tend to be qualitative analyses without a well-established theoretical basis, that is, a basic mathematical model. Besides, most studies deal with health in the context of the practice of healthy habits, diet, leisure, education, etc. (Schultz, 1991, Becker, 1962 and Bloom et al., 2004), and not with the healthcare sector as an intermediary productive sector that deploys technology, capital, and labor with impacts in the recovery of the workforce. In order to attempt to measure the effects of the healthcare sector on economic growth it is necessary to adequately insert such sector in a theoretical model capable of predicting the impacts caused by its presence. The empirical aspect has already been adequately addressed by Acemoglu and Johnson (2007). Thus, the goal of the present paper is to evaluate what is the adequate policy for the allocation of resources for the optimal economic growth given the explicit presence of the healthcare sector in the economy. It also attempts to answer the question of whether there are economic advantages for society in opting for the healthcare sector in its economy. The main contribution is to discuss the optimal economic growth in an economy not only with the existence of morbidity, but also with a healthcare sector, that needs to solve the problem of the tradeoffs between capital and labor for production versus capital and labor for the recovery of the sick or ailed workforce. This article was divided into four sections beyond this introduction. The first one presents the model of an economy with a single sector – the productive sector – in the presence of morbidity which affects labor by reducing the workforce, that is to say, the amount of hours available for production. The second section is dedicated to the explanation and to the empirical measures of the recovery effort function, which is the function that gives the production of the healthcare sector in terms of the recovery of the hours of work available for production that were subtracted due to the existence of morbidity (representing the activity of recovering the sick or ailed workforce and returning it to the productive sector). The third one is where the economy is divided into two sectors – productive and healthcare – and where, for simplicity of analysis, two types of healthcare sector are considered, one being labor-intensive and the other capital-intensive. Finally, in the fourth section the main conclusions and some comments are presented.

The model in which the economy has only one sector brings results similar to the economic growth models with exhaustible resources. In this model, it was found that the existence of a BGP is assured as long as it is true that n > m or, if that does not happen, it is necessary that g > β(m − n). The insertion of the healthcare sector immediately modifies the labor movement equation that now begins to decay into a smaller rate, that is, the presence of the healthcare sector increases people's life expectancy, but this increase in life expectancy does not change the growth rate of the per capita consumption, View the MathML sourceg∗=g1−α, that depends, with or without the healthcare sector, on the rate of technology of the productive system and on the elasticity of the product in relation to the capital (or of the product in relation to the labor, given that 1 − α = β). This result does not change whether the effort function of the healthcare sector is labor-intensive or capital-intensive, and this can suggest some level of inoperance for the healthcare sector, however, the theoretical result obtained here is corroborated by the empirical results found by Acemoglu and Johnson (2007) who studied the impact of illness on economic development and, using a regression analysis, showed that there is no evidence that the increase in life expectancy, the main result of the healthcare sector, had any influence over the growth in per capita income. One of the results of the work is to highlight that the healthcare sector increases society's well-being because the aggregated product is greater than the aggregate product of an economy with morbidity and without a healthcare system. Therefore, one obtains a result contrary to that of Thomas Malthus (1798), who advocated the positive control of the population suggesting the construction of houses close to mangroves and the narrowing of streets in order to provoke the return of plagues, saying that: … but above all we must repudiate specific medicine for overwhelming diseases …. Ehrlich and Lui (1997), referring to Malthus, said: “Malthus dramatized the idea by identifying population as potentially detrimental to growth. Since that time, work on growth and development has been inextricably linked with population economics”. The authors trace the evolution of the literature on population growth until the recent endogenous growth theory and development and propose a model of dynasty. The results are important, but the approach is different from ours. Here we show that the health system as a productive sector of the economy, has no impact on the increase in per capita income, but it is of fundamental importance in social welfare because it contributes to the increase in life expectancy of people. The models presented here show that Malthus was wrong, for, even if the healthcare sector approaches the effect of snake oil, it brings positive results for the economic system. The present work does not deal with an effort function based simultaneously on capital and labor, due to the initial difficulty in expressing a functional form for the healthcare sector that can be both of the Cobb–Douglas and of the fixed proportions type, allowing for some level of substitution between factors. It also does not consider the randomness of the illness, a fact that would force an analysis in light of dynamic programming. Finally, the endogenization of technology is not done, in spite of the importance of technology for the existence of BGP.