If you have a blank check and could write it for whatever you wanted, what would it be? For Bill and Melinda Gates, life affords a rich opportunity to write a lot of blank checks. But for them, it’s not about the next Prada bag, Maserati or waterfront home: it’s about spending the next dollar on health, which they believe is also good for economic sustainability.

Mr. Gates is concerned that after the signing of the Copenhagen accords, the global environmental pact, that developed countries’ funding of health projects will fall in favor of spending on new energy and other green projects.

Gates calculates that if even 1% of global vaccine funding gets siphoned away toward energy programs, then 700,000 children wouldn’t receive vaccinations. The human and economic impact of those poor health citizens not being protected with vaccines is far greater than the 1% spending on the environment could conserve.

Health Populi’s Hot Points: Gates’ interviews in the past few days have been filtering through my health economics lens. I am well-acquainted with the work of Jeffrey Sachs of the Millennium Project (Jeffrey, a high school mate of mine, was impressive back then and was a young economics student at Harvard when he told me how great the subject was — encouraging me to take my first Econ 101 class at U-Michigan — another story for another time, but one of those pivotal life-moments).

Jeffrey wrote the book on the subject of economic development and health, both literally and figuratively: evangelizing on the topic is among his life missions.

I connect the dots between Gates, Sachs and the current health reform debate. Without getting back to the over-arching goal of universal access to health insurance, America’s economic productivity and promise will continue to be compromised. I spent some time with Susannah Fox of the Pew Internet & American Life project today while in DC. We explored data on Americans’ use of the Internet in health care — specifically, what proportion of people with chronic conditions access the Internet for health information, support and counsel versus folks not managing chronic conditions. Suffice it to say, for now, that this is a case of richer getting richer, and poorer, poorer.

Sachs says that health and economic development are mutually reinforcing; check out his many writings and speeches at the Millennium Project’s website. My own studies into the economics of the family, of women, and the microeconomics of health have bolstered this understanding.

We’ve lost sight, in the past year of health reform discussions in the U.S., on the interrelationship between health and economic sustainability. It’s not only true in the developing world; it’s also true in DC, Philly, East L.A., and Minneapolis.

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