Amartya Sen on Quality of Life in India and China

In the New York Review of Books, Amartya Sen describes several ways we can assess the differences in quality of life in China and India. He points to China’s economic and public goods strength, but argues that other values, including freedom of expression and democracy, should be considered in the comparison. Sen argues that democracy and pluralism need not inhibit economic growth, and that GNP growth should not be the sole indicator of improving conditions.

Here, some interesting points, one on China’s strength in health care compared with China (striking for those of us who hear more about China’s health failings), and another on the value of freedom of expression (emphasis added in both). Below, a quibble.

For example, government expenditure on health care in China is nearly five times that in India. China does, of course, have a larger population and a higher per capita income than India, but even in relative terms, while the Chinese government spends nearly 2 percent of GDP (1.9 percent) on health care, the proportion is only a little above one percent (1.1 percent) in India.


Freedom of expression has its own value as a potentially important instrument for democratic politics, but also as something that people enjoy and treasure. Even the poorest parts of the population want to participate in social and political life, and in India they can do so. There is a contrast as well in the use of trial and punishment, including capital punishment. China often executes more people in a week than India has executed since independence in 1947. If our focus is on a comprehensive comparison of the quality of life in India and China, we have to look well beyond the traditional social indicators, and many of these comparisons are not to China’s advantage.

I agree that any reasonable account of welfare across countries (or among other groups of people) should include factors apart from economic growth and production. This is probably unsurprising for most non-economists or those outside the discourses of development, but it’s an important point nonetheless.

Sen is weakest, however, in underplaying the role of pressure from “below” on China’s leadership. He is right to say that there is “very little democratic pressure from below,” but this is not the same as saying there is very little pressure from below. Indeed, the very precariousness of authoritarianism that Sen points out is based in the challenge of handling pressures from below, above, outside, and every which way. Just as democracy is not necessarily incompatible with rapid economic growth, China’s form of government is not necessarily incompatible with responsiveness to broad interests in the population.

No country has a perfect government, but any persistent government short of a thoroughgoing coercive and repressive state will be responsive in some way. In its period of rapid development especially, China has had various forms of non-democratic “input institutions,” that Andrew Nathan argues have contributed to an “authoritarian resilience.” The puzzle of how to assess material and non-material welfare remains.





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