Thorp, John M., Jr. (2015). BJOG Editor's Choice: Dismal Science and BJOG. BJOG: An International Journal of Obstetrics & Gynaecology, 122(9)
The Scottish philosopher Thomas Carlyle in the 19th century labelled economics ‘the dismal science’. His epithet was sticky and persists today. It was prompted by the anti-utopian conclusions of economists that one woman's loss was another's gain so that scarcity made ‘heaven on earth’ a pipedream. Maruthappu et al. extend the dismality of economic thought into obstetrics (page 1216). Using data from the European Union, their modelling shows that a 1% reduction in government health expenditures is associated with a 10% increase in maternal deaths (89 excess deaths). They speculate that the association is mediated by lower government expenditures driving out skilled birth attendants, who care for the most vulnerable women, being the first to lose their jobs. Whether you accept their ‘dismal analyses’ or not, it is interesting to ponder – especially for US readers whose government's stated goal is to ‘bend the rising cost curve’ (spend less) on health care. In a tip of the hat to utopians and those seeking a free lunch, BJOG has made this paper free to view for this issue.
BJOG: An International Journal of Obstetrics & Gynaecology
Thorp, John M., Jr.