Arguments from analogy and dissimilar countries
We’ve all made the forgivable mistake of comparing apples with oranges. The purpose of that old cliché is to warn us from comparing things that cannot be compared. The reason apples and oranges cannot be compared is because they are more different than they are similar. If we are to stretch and look for their similarities, then we can argue that both are fruits and that they grow on trees. These similarities, however, are not substantial enough to offset the important and more relevant differences between the two fruits. For example, the fact that oranges are orange and apples are red is a more significant difference than the petty similarity that both fruits grown on trees. When comparing the two fruits, color is a more important and relevant metric. Keeping in mind that apples and oranges cannot be compared, then under what circumstances do different countries compare? A more poignant question is; can we expect similar outcomes from countries that are different? The purpose of this post is to show that countries may be similar in one way or another, but in most cases, the fundamental difference between them doesn’t allow comparison or imitation.
Many Kenyans have a good access to the internet and are in a position to know what’s happening in the United States, Britain, China, and pretty much the rest of the world. The easy access to information regarding what’s happening in other countries exerts a lot of pressure on us and our leaders. That pressure pushes us to imitate them and in most cases even exchange notes. We feel the burning desire to develop quick and become wealthy like European countries or the United States. Kenyan leaders even suffer from a bench marking syndrome, where nothing can be done unless a foreign template is used. If we are to circle back to the questions we asked initially, then we would want to know whether Kenya is similar enough to the countries it looks up to that warrants comparison, imitation, or an exchange of templates?
In 2018, President Uhuru defended Kenya’s debt saying that:
The issue of debt is not about incurring debt; it’s about how you are using that debt. Are you using that debt to expand your economy? When you talk about our debt, do you know what the debt of the Japanese’s government is… what is Japan’s debt? Japan’s debt is over 100% of their GDP.
There was a sudden social media uproar as most Kenyans argued that the president was comparing apples with oranges. As my opening paragraph has shown, inasmuch as there might be slight similarities between two countries, the fundamental differences between the two states might constrain the degree of comparisons we make. The president in this case went with the first few similarities he saw and decided to make a comparative analogy. Both Kenya and Japan are countries, and both have debt. If Japan has debt (more of it than Kenya), then it’s also okay for Kenya to have ballooning debt. I’ve second guessed him, but that might as well have been his thought process. However, as you can clearly see, it’s fallacious because the two cases are not parallel or similar.
Mohammed Wehliye, a Kenyan economist showed in clear detail why comparing Kenya to Japan was fallacious. His arguments show that the nature of debt between the two countries cannot be compared. He begins by observing that Japan is a wealthy nation and also one of our creditors. Their 200% debt to GDP ratio is our 50, their debt is mostly in Japanese Yen, they have huge reserves, and more importantly the interest rates to their debt is mostly in the negative. You can read all his arguments HERE.
That relatively simple example allows us to see the peril of comparison. It leads us to the understanding that just because something happens in a different country does not mean we should adopt it or use their template. The president made that error and Kenyans continue to make similar errors. For most Kenyans, comparisons are made for the things we want; free healthcare like the UK, quick growth like Singapore, create a social welfare system like the one in Germany and Scandinavia, and also create exotic urban designs like those in Copenhagen. Add to that mix the fact that we need to lower debt, ensure equity, equality, and social justice within Kenyan boarders, while also eliminating poverty.
Most of these things are good and desirable. Let’s take an example of free healthcare. I believe a health system that allows free and easy access to healthcare is not only desirable but necessary. However, reality does not always conform to our desires. According to Worldometer, the United Kingdom had a total population of 68 million people, slightly higher than Kenya’s 53 million. Britain also has close ties with Kenya considering the colonial past. Most Kenyans even believe that most of our systems and structures are inherently British. Despite failing the English Proficiency Test, Kenya is also one of the best English speaking countries in Africa. Kenya’s land area is almost twice larger than the United Kingdom. Kenya is, therefore, similar to Britain in some ways.
However, if we were to demand free healthcare similar to the UK system, then we have to look clearly and see whether both countries are apples and apples or they’re just another set of apples and oranges. what are the fundamentals of healthcare between the two countries? As we argued earlier, petty similarities between nations is no reason enough to imitate them. The chart below shows a few fundamentals of healthcare in the United Kingdom.
The NHS seems to be a well-resourced healthcare system. In comparison, the number of registered physicians in Kenya totaled 12,090 as of 2019. World Bank data shows that the number of physicians per 1000 people in Kenya was 0.2. In the United Kingdom, the number of physician per 1000 people was 2.8. That’s roughly three doctors for every 1000 people in the UK. In comparison, the US and Canada both had 2.6/1000, while the world average was 1.6 physicians per 1000 people. Kenya is far below the world average to even warrant semblance to the UK.
In terms of nursing staff, the table above shows that the UK’s National Health Service (NHS) had more than 400,000 nurses. On the contrary, Kenya had 58,247 registered nurses in 2019.
We cannot talk about free healthcare without talking about its cost. If Kenya was to have free healthcare, what percentage of GDP would that be? As a proportion of GDP, the United Kingdom spent 9.8% of its GDP in 2017 on healthcare. Health expenditure per head was $3,825, almost similar to the OECD average per capita ($3,854), and the EU average of $3,616. Data also shows that 79% of NHS’ financing was largely sourced from general taxation and insurance contributions.
Kenya’s healthcare spending on the other hand was 5.17% of GDP, which is almost half of what the UK spends as a proportion of GDP. Expenditure per capita was also orders of magnitude lower than that of the UK at $88 as of 2018. The financing of this expenditure mostly comes from general taxation and probably donations. Most recently, Kenya tried to export 300 nurses to the UK for employment. It shows that despite being in dire need of nurses and doctors, Kenya is not in a good financial state to spend more on healthcare and facilitate their absorption into Kenyan hospitals and health facilities.
Is it logical, therefore, for some Kenyans to demand free healthcare similar to that of the United Kingdom, Canada, or Switzerland? Absolutely not. Both healthcare systems are too different to be comparable or to even warrant imitation. In essence, just because something good happens in a different company does not mean that we should reproduce their system. If we are to make comparisons, then we have to sort out the bottom line first. This is not an excuse for mediocrity. Kenya needs cheap, accessible, effective healthcare, but pointing at the UK and saying the NHS is what you want might not be possible currently. Kenyans should focus more on building their healthcare system from the ground up before dreaming about free stuff seen in other countries. On the thread below, I highlight how ironing out non-financial barriers to health access will help us achieve our healthcare fundamentals.
I have also argued before that Kenya’s ambitions to see similar growth milestones like Singapore in the last half a century is deluded. The fact that both Kenya and Singapore got their independence in the same period is what I’ve called petty similarities throughout the essay. The most obvious reason for the disparity in growth trajectories between the two nations is the area in square kilometers of both countries. Singapore is a mere 709 square kilometers while Kenya is approximately half a million square kilometers. Other commentators have also argued that Singapore is largely homogeneous with Han Chinese as the dominant ethnicity. A lot can also be said of the cultural difference between the two nations, which leads to differences in social capital needed to grow a nation. As I have also pointed out here, Singapore’s average IQ of 105 gives it a huge advantage in terms of human capital compared to Kenya’s average IQ of 75.
There’s a lot of examples to give regarding whether countries should adopt similar policies, systems, and structures without deep consideration of fundamental differences between each one of them. Should Kenya legalize marijuana like the Netherlands? should we prioritize social justice in public discourse like the United States? Should we adopt similar climate change policies like European countries? Think of any social problem and there’s a country out there to be compared with. I presume there are some parallel cases where comparisons can still be made, but in most of them, the diversity in the world just doesn’t allow hasty conclusions to be drawn from petty similarities between countries let alone meaningful growth and development.
Reference
Papanicolas, I., Mossialos, E., Gundersen, A., Woskie, L., & Jha, A. K. (2019). Performance of UK National Health Service compared with other high income countries: observational study. bmj, 367.
