Greek tragedy and medical hybris

Dr. Carlos Javier Regazzoni. MD, PhD.FundaciónPensar. Former Vice-Minister of Social Development, Government of the City of Buenos Aires. As the tenth anniversary of the 2001 Argentine economic crisis approaches, lessons learned warn us that Greece’splight, if unattended,could become a health tragedy for its society. Argentine’s recovery from the crisis has been acknowledged, providing arguments to those who minimize the consequences of a sovereign debt default.. Nevertheless, the sudden impoverishment that took place in 2001continues tothreaten the health of the Argentine population. This experience, together with other examples,such as the former Soviet Union during the 90’ crisis, makes a medical catastrophe for the Aegean,a plausible future as well. In Argentina, rate of reduction of child mortality was 32% during the 90’, butonly 27% during the decade that followed 2001. After 2001, child mortality reduction has been even weaker in the north of the country, were economic turmoil was more severe, almost 68% of the population fallingbelow the poverty lineby 2002. Mortality for adults too, suffered a similar disappointing course. Mortality diminished 14% for people ages 45-55 during the 90’, but that rate of improvement fell to 10% after the crisis, mainly due to high mortality of cardiovascular disease in the country. Maternal mortality provides another example of a health parameter that did not improve during the last decade, albeit a strong effort on the part of the government. All these health indicators still characterize our health statistics, ten years after the crisis and despite impressive economic growth since 2003. In fact, at the current pace, the country is not going to attain the Millennium Development Goals in health. According to present official estimates, 40% of children below the age of 15are poor. Parents of these children are young poor adults, 55% of whomhave not attainted secondary school;nearly 50% don’t hold a formal job, and their health status is far from good. 52% of women in the poorest sector do not undergo mammogram screening, even when the Government provides it freely, and undetected (and untreated) hypertension is rampant among adult men of working age. Life expectancy in Argentina is currently 75 years of age, but it falls to 60 when only poor sectors are considered, with technically little improvement during the last decade. Plainly speaking, it means that poor people, living in impoverished neighborhoods, are exposed to a greater risk of premature death. Many epidemiological studies have pointed out the striking relationship between economic crisis and health of the population. Notwithstanding the Government has doubled National Health Expenditure, health of a great part of Argentine population continues to fall below ante crisis standards. The World Bank had warned in 2002 about the long lasting impact of the economic crisis on the health of the Argentine population. The forecast proved to be true. A similar concern shouldbe raised over the future of Greece. In Greece, life expectancy at birth is currently 79,5, and infant mortality is 3,6 deaths before the age of 1 year per 1,000 births, with aremarkable record of health achievements during the last two decades. This social capital will certainly be

decimated if default occurs, a large part of the society suddenly impoverishes, and, most of all, hopes vanish. In classical tragedy, the Hybris (Hubris) was the insolence that hastened the definitive fall of human being into discord, infuriating gods and subsuming everything into irremediable disaster. The only force able to stop it was sophrosyne,it is: temperance and prudence. Probably nothing characterizes better the medical thinking that temperance and prudence. The Argentine experience teaches thatwhen analysts argue for a default they need to look beyond finance;and towards the suffering that is surely going to follow from it.It would be wiser, therefore, to appeal to sophrosyne.