Let us remember now that one fundamental rationale for all economic activity is the satisfaction of human needs for food, clothing, shelter and amusement. The other rationale is the alleviation of human misery. The economic system is supposed to give us pleasure and help us to avoid pain.

This is the basic premise of all economic doctrines and, most especially, the foundation of modern conservative economics. The boys from Chicago tell us that capitalism is good because it is most effective in giving human beings pleasure and alleviating their pain.

So Wonks Anonymous is somewhat surprised when Ms. Rampell of the Tines - who really should know better - tries to prove to us that health expenditures have little or no economic basis. That they must be defended on the grounds of "social welfare" with the emphasis on welfare no doubt.

This because they contribute little or nothing to labor productivity and national output as measured by GDP. I quote the study that forms the basis of her argument:

Our analysis shows that for reasonable parameters, the period before any beneficial effects of an improvement in health are visible in [gross domestic product] per capita can be quite long, on the order of a third of a century. It may take twice that long to achieve most of the long-run gains in income per capita resulting from increasing health. Further, these gains are surprisingly small. An increase in life expectancy at birth from 40 to 60, in our base simulation, raises G.D.P. per capita by roughly 15 percent in the long run…[E]eliminating either malaria or tuberculosis in the typical country in sub-Saharan Africa would raise G.D.P. per capita by only two percent in the long run.

Rampell concludes that perhaps the conclusion would be different if we tweak our measure of economic performance as some social scientists have suggested. Leaving the readers to conclude that this proposed tweak is coming from somewhere in left field and is being made by mere social scientists, sociologists, anthropologists and other fuzzy thinkers.

Well, the discussion of alternatives to GDP has a long history among economists and Wonks Anonymous knows very few economists who are satisfied with this concept as a measure of society's well being. The simple fact is that GDP measures the health of the system of commodity production. GDP would measure human happiness only if all of the components of happiness were bought and sold.

When someone takes a job at McDonald's preparing and serving crap and stops cooking for her family she increases GDP. Services that were once performed in the household have moved to the market to the detriment of national health and family cohesion. But look on the bright side, a major corporation now has the opportunity to turn a profit by supplying this human need.

By this same line of reasoning the HIV virus improved life in San Francisco. Forget the pain and suffering and think about all the health care jobs created and about the new opportunities for profits for drug manufacturers.

Of course we have no way to precisely measure the satisfaction that is not priced by the market. This should not, however lead us to despise it or ignore it. Economics purports to show us how to allocate resources and design policies to improve human welfare. If economists cannot seen the elimination of malaria and tuberculosis as a net plus for human welfare then there is something very wrong here.