If the Ebola scare has done nothing else, it has heightened our awareness of global risks—in general—and the seriousness of health risks as an attendant feature of globalization. Globalization has increased our exposure to so-called “contagion risks,” which are broadly defined as risks that are not confined by conventional barriers and boundaries (geographic and political), and are further defined by the relative ease of transmission. We think of things like Ebola, but contagion risks also adhere to our global financial system, our planetary environment, and even things like communication technology.
Like most global risks, there are significant issues in health risk management that affect our ability to effectively respond. Notably, global governance infrastructure does not align with the scope and depth of such risks. Individual countries can develop approaches to addressing the risk, but absent a holistic risk management effort by all countries, the effects will be limited. Further, as economists have long told us, spillover effects (benefits and costs) and the inability to capture and appropriately distribute the costs and benefits lead to free-riding, moral hazard, and adverse selection problems. Or to put it more simply, enormous ‘fairness’ problems arise. Who pays? Who benefits? Why should we care?
I would expect the Opus College of Business to make contributions to the discussion about global health risks in a number of different ways. Importantly, our health care programming puts us in the forefront of modern thinking about the financing and delivery of health care here and abroad. Additionally, the Center for Ethical Business Cultures has undertaken work in the advancement of ethical thinking in health care, and—of course—the Blanch Risk Leadership Initiative is, to a significant degree—focused on the challenges of addressing global risks. Finally, our emerging emphasis on globalization is likely to lead us down the road toward engagement in the subject of global health.
Our just-completed elections offer the promise of a return to the debate over health care delivery and financing in the US, and it is clear that very different views exist on the role the federal government should play within the health and health care market. Changes to the Affordable Care Act will be debated though it is difficult to determine where those debates will take us. However, what will be interesting to note is the ways in which the ‘contagion’ issue is addressed. Although politically, it may be possible to argue that everyone is on his/her own when it comes to health (and therefore the government should have little or no role), that argument weakens considerably when we think about communicable disease.
In some senses we are only as strong as our weakest point, so living in a community where children are not immunized, or living in a world where one region (Africa) is suffering immensely from a transmittable disease, means that we all are compromised, regardless of the individual steps we may try to take to protect ourselves. When it comes to contagion risks, no man (or woman) is an island.