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on 4 February 2015
Review courtesy of www.subtleillumination.com

The movie The Great Escape tells the story of Allied POWs seeking to escape German prison camps. Some of them make it, and some don’t. Deaton argues this makes a general point: that inequality is an inevitable result of progress, because not everyone can escape at the same time. The key, however, is to make sure that inequality is only temporary: that everyone, to stretch the metaphor, escapes in the end.

Deaton focuses on health and wealth inequality, covering their historical evolution and the current state of affairs, before turning to how we might reduce inequality and particularly foreign aid. He is an interesting mix of idealist and pragmatist: he believes strongly we have a moral obligation to eliminate poverty and improve health for the less well off, but also rejects foreign aid as a failed method of achieving those goals. Aid, he suggests, tends to flow from a desire to be seen to be doing something, rather than actually making a difference, which is why so much money is spent to so little effect. He recommends we invest in things for the developing world, rather than just in the developing world: R&D on malaria and other diseases, improving country capacity in international negotiations, arms control, and other projects.

Deaton has a gift for making complicated concepts clear, and a book that might feel like a dry compendium of statistics works for that reason, though there are times when sections can feel like a litany of graphs and analysis. He is also good at explaining how statistics might mislead or betray our reasoning: the book may be of particular interest to readers without much background in statistics, but want to understand the debates around wealth and inequality. Still, at times the book can be a bit statistics and graph heavy, particularly for a general reader.

The book really comes into its own, however, in the final section. Deaton is passionate and eloquent when it comes to aid, something he feels strongly about. For someone well read in the subject, it won’t add a lot to your understanding (though it will serve as a helpful reminder of the basics), but if you’re willing to do a bit of work to actually understand issues rather than just read results, he’s insightful, interesting, and informative. Worth the read.
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TOP 500 REVIEWERon 1 November 2013
I greatly enjoyed reading this book, which for me as a general reader, achieves just the right balance of readability and learning. Focusing on health and wealth around the world and over time, the author, Angus Deaton (a professor of Economics and International Affairs), provides a clear and interesting account of how the world has become healthier, with people enjoying longer life expectancy pretty much across the globe over the last 75 years, and how this continues to improve. The book shows clearly how China and India continue to contribute so much to the overall improvement in worldwide wellbeing statistics, with over 1 billion people escaping from poverty,with all that such escape brings, in recent times. Today 80% of people around the world are literate - in 1950 the literacy rate was 50%. However, over a billion people still live in abject poverty around the world, and this book explains why this situation remains and explores what might be done to adddres this.

The links between health and wealth are well known, but this book is full of fascinating facts, and delivers clear explanations that greatly help in understanding the roots and consequences of various types of inequality, and of improvement in living standards in absolute as well as relative terms. Illustrated throughout with easy to follow, and clearly explained graphs, this is a very informative and entertaining book indeed.

I would have struggled to believe, for example, that life expectancy in India is today higher than it was in Scotland in 1945 had I not read this book which also explains why such changes have occurred and concludes with well argued ideas about how greater equality around the world could and should be achieved.

Really superb - I have strongly recommended this book to several family members and friends - although I have read so many bits out to them that they may feel they have read it already..
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on 15 October 2015
This book does what it says on the tin. It explains why - as best we know - some but not others have escaped from short lives of ill health to lives of wealth and wellbeing. It then explains why aid does more harm than good.

The most interesting part of the opening chapters comprises graphs showing that whereas it's tempting to conclude that past a certain point, wealth does not bring life satisfaction, the data looks very different if you plot wealth on a logarithmic scale. More money does bring more life satisfaction - it's just that for each step up the ladder, you might need four times as much wealth as you did for the step before. And similarly for life expectancy plotted against GDP per capita on a logarithmic scale.

We don't really know too much about the causes of improvements in life expectancy, but before 1750 in England the aristocracy and others had about the same life expectancy. Then things started to diverge and health started to improve with things like variolation against smallpox, the germ theory of disease and improved sanitation start to impact - particularly on the deaths of babies and young children. Then modern medicine has started winning more against the diseases of old age with smoking cessation impacting on lung cancer and related diseases, water pills as anti-hypertensives to tackle cardiovascular disease, and even some progress on cancer. Meanwhile in poor countries, educating mothers seems to be very important (more so even than GDP growth). Heights are generally improving everywhere (just about) too. But everywhere progress can suffer setbacks - the influenza outbreak of 1918, or HIV/AIDS.

Turning to wealth, the story is harder to understand. Poverty declines across the board in the US for a while, then growth slows and the gains from growth are captured by the one per cent and portions thereof - as the work of Piketty shows. There are also social changes to account for such as the growth in 'power couples' - both big earners, while the fact of having two earners helps a lot with keeping poorer households just on the increase for income, when measured by households.Inequality in the US may matter if the port are effectively driven out of politics by the rich.

When it comes to wealth in countries, there is the interesting phenomenon of 'purchasing parity' - some goods cost the same everywhere (those that are transportable). Some do not. And many services are sold for very different prices in poor countries. The big story is the enormous progress made by China and India in recent times. Perhaps big countries do better because they are big and small countries don't have enough high quality talent to run themselves as well. Or then again, they may have better states - see the book Why States Fail on how 'extractive' regimes at the top deter innovation and growth.

Aid doesn't work because it's paid too much to government or can be appropriated by government in port countries with extractive political regimes. The last thing they need is free money to corrupt their political systems (they also don't need booms in commodity prices for the same reason). Money in fact is not the shortfall - it can always be borrowed if there are good project to invest in. But there has been some good work done to relieve international ill-health. This is because the knowledge transfer involved is not intrinsically corrupting of health economies (thought sometimes these may be influenced in a worse direction). Migration might help, including the temporary migration of students to rich countries.

This is an interesting book from which I learned a great deal - but somehow I did not find it a page-turner - unlike Piketty's work or the book on Why States Fail mentioned above; and both referenced here. It makes interesting new points, though, and draws together the threads of interesting work done by others.
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on 28 December 2015
The Independent People by Halldor Laxness reminds me of the hard work it took just to survive and how leisure (which subsequently sponsors the whole leisure and entertainment industry!) is a relatively recent phenomenon. Leisure was a luxury that our ancestors throughout most of our human history did not enjoy, if one was lucky enough to pass over the threshold of child mortality. The Great Escape tells how we have escaped the dreary of life and the tyranny of nature. It is refreshing to be reminded that our life has not always been and that nothing can guarantee progress can run forever. In fact, the headway that we have made may be reversed as the threats to our lifestyle are encroaching.

While economists can go into the details of a specific topic and get technical, ultimately, I believe, the driving force behind their effort is their concern and interest in the well-being of the human race. In this book, Deaton steps back and takes a panoramic view over time and across countries on how well we have done in raising the overall well-being of people, tracing our path to today, taking stock of what we have achieved, painting where we are today, and looking ahead where we are heading. Human well-being is multi-faceted and material well-being (the subject matter of economics) should not be equated as human well-being. Deaton acknowledges this fact but limits himself to talk about health and wealth in this book.

We can't see progress or the issues without some forms of measurement. Unfortunately we live in an imperfect world, and perfect information is a luxury that we don't have. Inevitably, Deaton has to take us through some of the notorious measurement issues in order to interpret properly the pictures that the imperfect statistics are painting. The reality is that we do not understand the issues on "solid" data because they don't exist! Understanding the limitations of the available data and measurement issues is part and parcel of trying to understand the issues at hand. Deaton has done a marvellous job in making those technical problems accessible.

It is an interesting concept that inequality is a by-product of human progress, which segregates the winners from those who are left behind. As human society is propelled forward by different forces at different times, each round, we have different winners and different groups of people who are left behind. Are inequalities a necessary evil of the market economy which operates on differentials? Why should we be concerned about inequalities? (1) The activities to protect vested interests can block progress and the escape route of those left behind; (2) equality of opportunity and equality of outcome unfortunately are correlated; and (3) wide inequalities tend to undermine the functioning of a democracy.

The discussion on health identifies what really make a significant difference in prolonging the life of the majority, and dispels some of the common preconceptions. Public health is the key, which requires the work of public institutions directed by the advancement in knowledge, especially the germ theory. Today the poor countries and the rich countries face different health issues. A lot of the solutions to the health issues faced by the former are already known. It begs the question why they are not adopted. This points to institutional failures and political paralysis of the poorest countries in the world. On the other hand, the health professionals in the rich countries face different challenges. The focus has been shifted from lowering the mortality rate to improving on morbidity, as the population ages.

Deaton is very blunt on aid and critical about the effort of the rich countries in assisting the poor countries. We may naturally start by asking "what should we do?" He responds by saying that this is the wrong question to ask! For various reasons, he argues strongly and passionately that foreign aid has not be effective; worse, it does more harm than good, even if it comes with good intention. It is eye-opening that the aid workers on the ground, faced with the pressure to discharge aid, focus their effort in damage control. His conclusion is categorical: "Large-scale aid does not work because it cannot work, and attempts to reform it run aground on the same fundamental problems over and over again." (p. 317) "For now, the most urgent task is to undo the work that has been done by those who want more aid and to persuade the citizens of the rich world that much aid is harmful, that more aid would be more harmful still, and that they can best help the poor of the world by not giving them large-scale aid. If we were to succeed in this, and give less aid, what then could we do to discharge our obligation to assist? Doing less harm would be a good start.' (p.318) The actions he suggests that the rich countries can do to help follow along the line of Bhagwati, "it is hard to think of substantial increases in aid being spent effectively in Africa. But it is not so hard to think of more aid being spent productively elsewhere for Africa.' (p.318-319) Following the arguments of the book, I think the recommendations are sound, but even so, it will be difficult to see how the rich countries will break away from their ways of practice.

Finally, the book concludes with our prospects. Can our children expect to do better than us? The answer is that nothing is certain. There are many threats to our well-being that have already emerged: climate change, slowdown in economic growth, polarisation of the labour market, wars, the superbugs that are resistant to all known antibiotics. Our optimism is in the ingenuity of human beings to "overcome setback in the future as they had in the past."

Note that the subject matter is necessarily value laden; and it is impossible to write a book on the subject without the underpinning of a moral standpoint, whether it is made implicit or explicit. Yet this is not a book on the moral debates which are left for the reader to ponder in his own space and time. That said, most of what have been covered in the book can be agreed by the majority, or well argued with supported evidence and reasoning.
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on 7 September 2014
An excellent review of the escape that countries try to make and the difficulties they face with the aid industry and the democratic deficit deficit they face by being accountable to donors and not their own people! A must read for anyone involved in the world of development or people who want to learn about the success or failure of states as they politically develop!
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on 16 May 2016
This book can change the way you think. It's a bit of a mixed bag, with explanations that are clear but that can be long enough to be a little frustrating, combined with a lot of exciting insights into the link between health and wealth. It is gentle in tone but has a powerful logic that is overwhelmingly convincing. This book is well worth reading, this man speaks the truth!
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on 18 December 2015
Angus Deaton like Andro Linklater, Niall Ferguson, Thomas Piketty, Owen Jones, Yuval Noah Harari and Bill Bryson (A Short History of Nearly Everything), has now bridged the gap and enabled persons with poor intellect like myself to grasp a perception of the world that would not before have been possible, I for one am eternally grateful.
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on 30 October 2015
An excoriating indictment of aid and the harm it has done to institutions of government mainly in Africa. Angus Deaton carefully argues and amply illustrates his case. It can be read by non-economists as well as those who belong to the profession
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on 11 December 2014
I have had this book sitting on the shelf since it was first published.

Each time it has come to the front of the queue something else has managed to jump in front of it.

However a number of books, in particular http://www.amazon.co.uk/dp/0670923699/ref=pdp_new_dp_review give it a number of mentions and very favorable one.
So it was time to concrete it as the next read and get stuck in.....

....it was a bit like getting stuck in concrete at first. Part 1 is mainly taken up setting the scene with regards to health and wellbeing, it is all good stuff but just didnt grab my enthusiasm...however it is well worth getting through this scene setting for the glories of part 2 and 3.

A brilliant book on how Money and Wellbeing interact.

buy it...you will enjoy it
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on 19 December 2015
A very accessible book, readable and clear. The issues are sensibly and objectively clarified and I understood much more than before. Great to have an unbiased, factually based, discussion of inequality.
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