Debate with Matt on India, China, Cuba, Korea, etc.

Below I quote the lengthy exchange I had with Matt on India, China, Cuba, South Korea, etc. in the comments section of another blog. Since our debate was off-topic, Matt and I have agreed to move it here. My latest reply to Matt is contained in the separate blogpost, “Ideology & Human Development“. Note : Matt had already been arguing with others about something else, so below I merely extract that part of the debate relevant to ours.


…Kerala has been studied a lot. Read Amartya Sen, for example. The (proximate) reason Kerala has high HDI for its income class is that it has had a strong Marxist party in electoral politics which caused the state to invest more in health & education than other states. In independent countries Marxist regimes normally nationalised private property and redistributed incomes to things like health and education. So, on average, other poor non-communist countries with comparable levels of income will usually have lower HDI. Now, I say this is “proximate” because the real question is why Kerala has such a strong Marxist party. Emmanuel Todd argues in several books it’s about the family structure.


I’m aware of Sen’s work, and I agree with his/your explanation for this. My point in bringing up Kerala was that to show that even polities with high levels of diversity can have robust, effective social democracy if the government is competent, treats each group fairly, and is dedicated to improving social conditions (see the Bo Rothstein article in my comment above for more details). Diversity is not necessarily incompatible with social cohesion or a welfare state.

Sen also does a good job of explaining why Maoist China, for all its many evils, did much better than India at raising life expectancy over the same period. Short answer: because China was Marxist. See, e.g., “Indian Development: Lessons and Nonlessons,” Daedalus Vol. 118, No.4, 1989….


…I actually don’t believe the Marxist explanation for Kerala in any deep sense. After all West Bengal has also had a strong communist party and its HDI scores are abysmal… Which is also why Sen’s assertions about China are ultimately shallow : East Asia in general stresses education, health and egalitarian growth much more than other countries.

This shows up in land reform. Many have observed that Japan’s land redistribution in 1946, which created a large class of small proprietor-farmers out of what had been closer to a Latin-America-like latifundist system, was the work of the Americans. That is true. However, the very similar land reforms in South Korea and Taiwan were not the work of the Americans. [Note : I meant, these were not compelled by the Americans, as with Japan.] More importantly, all three succeeded. And China has also succeeded with small-holder agriculture since decollectivisation. But the record of land reform in most other places is truly abysmal.

Democratic India in the 1950s and 1960s had a “zamindari abolition commission” yet the number of small holders in India is still fairly low because the process was strangulated by bureaucratic delays, corruption, repartition into smaller within-family plots, etc. There’s more going on here than mere redistribution of wealth. Well, I think you know what I’m getting at : even if we allow that certain political regimes will invest more in people all things equal, redistribution still requires a certain amount of social competence that is not uniformly distributed in the world. Some people appear to do better under socialism and communism than others.

[Emmanuel Todd argues] that Kerala is an extreme example of the matrilineal family system found in the South in general which produces better HDI than the north. Todd explains the unusual predilection for Marxism in Kerala as a reaction to the slow erosion of that family structure. I think Todd supplies good descriptions, but not very good explanations…


Sen also points to Sri Lanka (“Indian Development,” p. 376), which although non-Communist, carried out similar investment in education, health and welfare, and now has an HDI of 0.715. Sen (ibid, p. 380-82) also mentions post-1975 Communist Vietnam (current HDI 0.617; higher than India (0.554), higher than Cambodia and Laos (both 0.553); I also think we need to account for the impact of the war in these countries).

I would also point to Cuba, with an HDI of 0.780, close to Kerala’s and well above the demographically similar Dominican Republic (0.702). Also the Seychelles, another diverse Marxist country with the highest HDI score in Africa (0.806, even above Kerala).

But I think Sen’s argument is strongest when he points to differences within China over time. Thus, life expectancy in China underwent a sharp downturn following the market-based reforms of Deng Xiaoping in the late 1970s (ibid., pp. 385-87).

This was because the breakup of the communal farms dismantled the system of healthcare provision in place. Sen explains here (p. 2):

“[T]he economic reforms of 1979 greatly improved the working and efficiency of Chinese agriculture and industry; but the Chinese government also eliminated, at the same time, the entitlement of all to public medical care (which was often administered through the communes). Most people were then required to buy their own health insurance, drastically reducing the proportion of the population with guaranteed health care….

…The change sharply reduced the progress of longevity in China. Its large lead over India in life expectancy dwindled during the following two decades—falling from a fourteen-year lead to one of just seven years.

The Chinese authorities, however, eventually realized what had been lost, and from 2004 they rapidly started reintroducing the right to medical care. China now has a considerably higher proportion of people with guaranteed health care than does India. The gap in life expectancy in China’s favor has been rising again, and it is now around nine years; and the degree of coverage is clearly central to the difference.”

HBD doesn’t do a very good job of explaining these changes.


You misunderstand me. I have no problem with the view that, all else equal (such as demographic characteristics), a redistributionist political regime in a poor country is more likely to improve HDI than a non-redistributionist one. That was my point about East Asia. The [sociobiological] angle would address who is more likely to adopt redistributionist policies, and who is more competent at them once they are adopted.

So I think that easily covers Cuba vs [the Dominican Republic] (fairly similar demographics) — though you do not consider that Soviet subsidies to Cuba were on the order of 1/3 of GDP (via purchase of inflated price of sugar) and that helped a lot in Cuba’s human development… In fact most of your examples are pretty bad. The Seychelles compared with the rest of Africa ? Why ? The Seychelles are a mixed-race Franco-East-African country with about 80,000 people and a GDP per capita comparable with the Czech Republic. I should hope they would have decent HDI !

As for China and life expectancy, see the chart I’ve uploaded here :


Don’t see any big drop. The rate of increase slowed, but that’s normal especially in a country like China with a big divide between the coasts and the interior. Besides, life expectancy is not strongly correlated with access to medical care in the broadest first-world sense, and only weakly correlated with income. (You don’t need huge jumps in income to improve HDI.) The post-war global increase in life expectancy (as well as the global fall in infant mortality) is best explained by greater food availability, more balanced micronutrient intake, innoculations, public health measures (such as sanitation), etc. Most of these measures don’t require high incomes.


Re: Cuba.

It’s been [23] years since Cuba received those subsidies, and the DR still hasn’t caught up. Also, we have to factor in the embargo against Cuba from 1959. Remember, from 1964 until 1975, that embargo wasn’t just from the United States, it was from the entire Organization of American States, except Mexico. There’s also the fact that Cuba needed to divert spending to its military in order to deter the very real threat of an American invasion (which happened of course in 1961) and the near-constant terrorism directed from Miami and Langley. Finally, if we’re going to look at subsidies, we’d also have to look at the massive U.S. subsidies to South Korea during the Cold War.

Re: China

I’ll quote Sen directly:

“While the gross value of agricultural output doubled between 1979 and 1986, the death rate firmly rose after 1979, and by 1983 reached a peak of being 14 percent higher than in 1979 (in rural areas, the increase was even sharper: 20 percent). The death rates have come down somewhat since then, but they remain higher than before the reforms were launched” (“Indian Development,” p. 385).

See also the chart on p. 383 of “Indian Development” and p. 26 of Sen’s “Hunger and Entitlements.” He takes the Chinese part of the chart from Judith Banister’s “An Analysis of Recent Data on the Population of China,” Population and Development Review, 10 (1984). It shows a noticeable drop from 1979.

Bannister (ibid., 254) says that China’s life expectancy, after having risen every year from 1960 to 1978, fell from 65.1 to 64.7 from 1978-1982. The Google chart (which says it came from World Bank data) says that life expectancy rose from 66.51 to 67.57 during the same years. I don’t know why the discrepancy exists.

Sen repeats his claim about the China-India gap falling from 14 to 7 from 1979 to the early 2000s, then rising from 7 to 9 after 2004 (when the Chinese reinstituted the public health system) in “The Art of Medicine: Learning from Others,” The Lancet, Vol 377 (2011), but he doesn’t give a source.

What do you think about Sri Lanka?

P.S. Sen also mentions this paper by Athar Hussain and Nicholas Stern, and his own paper “Food and Freedom.” See Table 5 on p. 16 for data on the rise in the death rate from 1979, and Table 6 on p. 17 for data on the decline in the number of “barefoot doctors” from 1980.


Why do you keep talking about the Dominican Republic ? I have already agreed with you that redistributionist policies are more likely to result in better HDI than otherwise.

However, you are looking at it the wrong way. Cuba had to expropriate nearly all private assets and receive large external subsidies to get it done. The Dominican Republic didn’t exproproriate and its foreign assistance was much more limited, but its HDI score today is not that much lower than Cuba’s…

No need to “factor” in [the US & OAS embargo] at all [in the case of Cuba]. What ever Cuba lost via the embargo, it was much more than made up for by sugar purchases by the Soviet Union and the rest of the East bloc at inflated prices — especially after 1972, when the Soviet Union agreed to pay not the international price, but nearly four times the international price.

Also, Cuba never lost export markets for sugar outside the East bloc. At any given time between 1960 and 1990, exports to non-communist countries were between 20% to 50% of the total volume. Western Europe and Japan never observed any embargo against Cuba.

By the way, the OAS dropped its embargo in 1975. Besides, that never stopped anyone from having trade relations unilaterally with Cuba if they wanted, like Argentina before 1976…

Castro built up the Cuban armed forces to such an extent that he could send thousands of troops to Angola, Ethiopia, Mozambique, etc. Now you can say this was tit-for-tat against US support of the opposing side, but these luxury foreign adventures belie the claim of Castro’s “having” to divert spending anywhere.

[Re South Korea] At the peak of US aid to South Korea in the late 1950s and early 1960s, it amounted to less than 5% of South Korean GDP. [Note : This was intended as net of military assistance, I will address this later.] This was not trivial but never approached the vicinity of Cuba’s dependence on the Soviet Union in the 1970s and 1980s. Besides, no sensible person believes South Korea’s explosive growth has much to do with external assistance.

As for Sen, I’ve looked into his claims a little more, and, yes, there was a drop in Chinese life expectancy after 1979 which gets reversed in the late 1980s. But in the Bannister data the drop is trivial. Hussein & Stern’s argument is more interesting : the life expectancy data appear to be driven by rising infant mortality in the first half of the 1980s, which are substantial enough to be interesting. But there must be more happening than is implied by Sen’s argument, because China’s crude death rate hit its low in 1979 and still remains higher than then… So the age-structure effects of the population must be important — something Hussein & Stern do not discount.

Matt [sent to me by email]

I think you’re understating the disparity [between Cuba’s and the Dominican Republic’s HDI scores].

First of all, the difference between the two countries’ HDI is 0.078, which is 10% of Cuba’s score. If we add 10% to Cuba’s score, we almost get to Greece (0.860; not the best place in the world, but better than Cuba). If we subtract 10% from the DR’s score, we get Honduras (0.632; one of the worst places in Latin America), and a little worse than Botswana (0.634; one of the best places in sub-Saharan Africa). If we subtract 10% from the U.S.’s score of 0.937, we somewhere between Slovakia (0.840) and Andorra (0.846).

Secondly, if we look at non-income HDI (which we should be able to, given that Cuba’s and DR’s per capita GDPs are comparable), we find that Cuba’s is 0.894 and DR’s is 0.726, a difference of 0.168. Cuba not only does much better than DR on this measure, it actually scores within the same range as the UK (0.886) and Hong Kong (0.907), despite far lower per capita income.

Next, we should look at the Inequality-Adjusted HDI values. When adjusted for inequality, DR’s score drops to 0.510 (a fall of 27.3%), putting it with Tajikistan and Guyana. I can’t imagine that Cuba’s IHDI score falls further than DR’s, but unfortunately, we have no data on Cuba’s total IHDI value. However, we do have Cuba’s Inequality-adjusted Life Expectancy Index (LEI) value, which is 0.882 (a drop of 5.4%). This not only puts Cuba far above DR (0.708, a drop of 16% and a difference with Cuba of 0.174), it actually makes Cuba almost exactly the same as Denmark on this measure (ILEI 0.887). That’s remarkable. If Cuba’s Inequality-Adjusted LEI gives us any indication of its overall Inequality-Adjusted HDI, then the latter should be within the range of the developed world, and of course far above the DR.

And again, it has been a quarter-century since the Soviet spigot was shut off. I suppose Soviet aid has been to some extent replaced by Venezuelan aid, but it’s still not even close.

[I also forgot to mention something: about 10% of Cuba’s population left the island in the decades following the Revolution, encouraged by, among other things, special privileges granted to them in the US immigration system. These emigres are wealthier and more educated than the average Cuban. Nothing remotely comparable holds for the Dominican Republic; if anything, emigration from the DR has been disproportionately unskilled.]

[Quoting PE] Castro built up the Cuban armed forces to such an extent that he could send thousands of troops to Angola, Ethiopia, Mozambique, etc.

He never actually sent combat troops to Mozambique; only a few hundred advisors. By that standard, you could say that the U.S. “sent troops” to El Salvador in the 1980s, or is “sending troops” to Iraq again today. Cuba did, however, send a few thousand troops to Syria during the Yom Kippur War, and engaged in at least some combat with the Israelis.

 [Quoting PE] Now you can say this was tit-for-tat against US support of the opposing side, but these luxury foreign adventures belie the claim of Castro’s “having” to divert spending anywhere

At least in the case of Angola, Cuba was engaging in collective self-defense (which is a guaranteed right in Article 51 of the U.N. Charter) against a South African/Zairean attack. Ethiopia, too, was attacked by Somalia, though you could make the argument that the regime in Ethiopia was so heinous that it would have been better had Cuba stayed out of it. With the Yom Kippur War, the situation was more complicated, since, unlike in 1967 and virtually every other Arab-Israeli war, the Arabs actually fired the first shot that time, though they were only trying reacquire their own conquered territory (Sinai and Golan). In any case, Cuban intervention in that war wasn’t very consequential.

So in the two major cases of Cuban intervention, the Cubans could argue that they were only exercising their right of collective self-defense in accordance with the U.N. Charter, and that they needed to do this in order to deter American aggression and interventionism which could very easily have turned its sights on Cuba (and did, in fact). The United States has similarly exercised (what it described as) “collective self-defense” in Korea, Vietnam, Laos, Cambodia, and Kuwait, all of which cases were at least as complicated as Cuba’s interventions in Angola, Ethiopia, and Syria (and, I would argue, much more so, in each case).

But let’s examine the presuppositions of your argument. Imagine we were having a discussion about the distortions to South Korea’s development caused by South Korea’s military spending, needed in order to deter a North Korean/Chinese invasion, which of course happened in 1950). [Leave aside the fact that this war was far more complicated than it appears from how it is usually discussed (it followed frequent border clashes, most of which were initiated by the South; not to mention a virtual civil war from 1945-50 within the South, for example on Jeju)]. Clearly there’s something to this: South Korea’s actual performance has been impressive, but it would have been arguably better in the absence of the North Korean threat. But imagine I were to respond by saying:

“The South Korean generals built up the South Korean armed forces to such an extent that they could send thousands of troops to Vietnam. Now you can say this was tit-for-tat against Soviet/Chinese/North Korean support of the opposing side, but these luxury foreign adventures belie the claim of South Korea’s ‘having’ to divert spending anywhere.”

Clearly this isn’t a good response.

Even if you think that Cuba didn’t “have” to intervene in Angola, etc., that doesn’t mean that they weren’t driven to spend on their military by the very real threat of U.S. attack. After 9/11, we invaded Iraq, which we <i>definitely</i> didn’t need to do. But it wouldn’t have happened if it weren’t for 9/11. Cheney, Wolfowitz, et al may still have <i>wanted</i> to do it, but they wouldn’t have gotten away with it. Now imagine that this country experienced <i>multiple</i> 9/11s (which is the equivalent of what we’ve done to Cuba over the years once you control for population size). Imagine that Al Qaeda tried to kill the president dozens, maybe hundreds of times. Imagine that there was a Taliban-backed rebellion in the interior of the U.S. How ape-shit do you think we would have gone? How much would we have diverted away from health, education, and welfare to spend on war, the military and the national security state?

[Quoting PE] At the peak of US aid to South Korea in the late 1950s and early 1960s, it amounted to less than 5% of South Korean GDP.

Actually, at its peak in 1957, total foreign aid (most of it from the US) to South Korea hit 16% of GNP, and averaged 8-9 percent from 1959-1962. See the following article by Susan M. Collins and Won-Am Park:

The following paper by Marcus Noland says that foreign aid reached over 20% of GDP, and over 80% of imports, at its peak (see Figure 2, p. 36):

However, as Collins and Park point out (p. 178), this is a significant underestimation, because it does not include subsidized loans from the US and Japan, which continued well after aid had slowed.

Also see Figure 3 (p. 37) of Noland’s paper, which shows that in the early 60’s, US aid financed almost all of South Korea’s investment, since domestic savings net of aid was near 0.

Going back to your post on Kerala/West Bengal/East Asia/Land reform, I noticed that you ran together two slightly different topics: HDI and land reform. It’s true that West Bengal has abysmal HDI, but it actually did very well compared with the rest of India in terms of land reform. According to Maitreesh Ghatak and Sanchari Roy, West Bengal and Kerala

“accounted for 11.75 and 22.88 per cent, respectively, of the total number of tenants conferred ownership rights (or protected rights) up to 2000, despite being only [7.05] and 2.31 per cent of India’s population, respectively…. West Bengal’s share of total surplus land distributed was almost 20 per cent of the all-India figure… although the state accounts for only about 3 per cent of India’s land resources…..” (p. 253).

I don’t know why West Bengal seems to have done well with land reform and poorly with HDI. Any ideas?

Pseudoerasmus [responding re China only]

In my last reply to Matt, I conceded his/Sen’s argument that China’s market reforms of 1979 may have disrupted or undermined the “barefoot doctors” programme, which could have had adverse consequences for Chinese infant mortality. However, Matt’s own source points out the increase in China’s infant mortality started before the market reforms of 1979 :


[Hussain & Stern] click to enlarge

Moreover, the above analysis is powered by scepticism about China’s official statistics for 1979-1989. The World Bank’s data on infant mortality at birth and child mortality under age 5, which are based on official statistics, do not show a deterioration in either indicator for the years at issue.  (There is, however, a general discrepancy between the World Bank’s and the WHO’s data, although the latter only go back to 1990. But the World Bank and the UN are consistent.) Nonetheless, the PRC’s current infant mortality rate is considerably higher than that of the rich countries (and Cuba’s), although at least according to official statistics, that appears to be in large part because of the divide between the cities and the rural interior.

The rest of my reply is contained in the separate blogpost, Ideology & Human Development. Please post any comments regarding the above over there.

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