Threatening Sovereigns with Downgrades if Healthcare Investment is not Witnessed is Not Helpful
Today, the G20 will be hosting their Global Health Summit in Rome. Before it, the Chair of a World Health Organisation (WHO) panel that wants to set up a new global body that will focus on improving healthcare investment warned that ‘states that invest too little in public health could have their credit ratings cut’. Whilst the sentiment is that the richer nations should be incentivised with a ‘stick’ to invest more in their healthcare programmes, there is am associated problem that has not been addressed.
Mario Monti, the former Italian Prime Minister and the Chair
of the Pan-European Commission on Health and Sustainable Development, argued
that ‘a pandemic like this one poses huge threats not just to financial
stability but to the whole economic and financial system’. This, of course, is
true. To counter against future health-related economic shocks, the panel has
proposed that a ‘Global Health Board’ be established to prevent future
pandemics and coordinate global responses to future crises. The panel cites
research that estimates global losses to be more than $10 trillion from the
pandemic and the associated shutdowns in economic activity. However, the panel
suggest that mere voluntary association from states will not be enough, and
that ‘to
persuade countries to spend more, health threats could be translated into
financial risks, as they have been in climate policy… nations that under-invest
could then face the risk of having their credit ratings cut’. The panel explained
that ‘credit rating agencies could take health preparedness into account in
their assessments’ and that while richer countries could be hit with the ‘stick
of the credit rating’ if they underspend, poorer countries ‘might initially be
helped to spend more with development aid’.
There are a number of issues here. First, the whole
sentiment after the Financial Crisis is to reduce reliance on the credit rating
world and seek differing forms of financial prudency. This, quite obviously,
empowers credit rating agencies further. Perhaps officials are quickly learning
that no matter what legislation or regulation attempts to do, the market will
continue to use credit rating agencies. Yet, the biggest issue is with this
promoting the credit rating agencies to actively penalise countries because of their
healthcare spending. For the richer countries, it makes absolute sense. The
resources are there to be utilised properly and in a preventative manner and,
if they are not, then there should be a consequence. However, the situation
facing poorer countries is nowhere near as simple. Poorer countries are usually
heavily indebted, and with the credit
rating impasse that the CRRI has been focusing on recently, the real
issue is that the credit rating agencies are actively – rightly or wrongly –
standing in the way of meaningful debt renegotiations that could allow for substantial
investment in healthcare infrastructures. Additionally, poorer countries need
to develop and expand, and therefore have to prioritise their spending; is it
the case that poorer countries are now being incentivised to finance preventative
healthcare measures over their own growth so that richer countries do not feel
the effects in the future? Monti suggests that there might be, initially, more
aid provided to poorer countries for this purpose but how much (?), for how
long (?), and with what conditionality? The fear at the moment is that richer
nations are already pulling back from the idea of foreign aid when their own
economies are in shock after the onset of the pandemic, so how realistic is
this suggestion?
There needs to be great care when proposing credit
rating-based solutions to anything, because the level to which they are
intertwined with the financial system dictates that there will always be
consequences later down the line. The proposal from the panel makes sense on
one side, but could be particularly damaging on the other.
Keywords – G20, stick, incentive, poorer countries, development, @C_R_R_I
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