Excerpt: Nobel winners Abhijit Banerjee and Esther Duflo on decisions poor make

The poor seem to be trapped by the same kind of problems that afflict the rest of us—lack of information, weak beliefs and procrastination among them. It is true that we who are not poor are somewhat better educated and informed, but the difference is small because, in the end, we actually know very little, and almost surely less than we imagine.

Our real advantage comes from the many things that we take as given. We live in houses where clean water gets piped in. The sewage goes away on its own. We can (mostly) trust our doctors to do the best they can and can trust the public health system. We have no choice but to get our children immunised—public schools will not take them if they aren’t. And perhaps most important, most of us do not have to worry where our next meal will come from. We rarely need to draw upon our limited endowment of self-control and decisiveness, while the poor are constantly being required to do so.

We should recognise that no one is wise, patient, or knowledgeable enough to be fully responsible for making the right decisions for his or her own health. For the same reason that those who live in rich countries live a life surrounded by invisible nudges, the primary goal of health care policy in poor countries should be to make it as easy as possible for the poor to obtain preventive care, while at the same time regulating the quality of treatment that people can get.

All this sounds paternalistic, and in a way, it certainly is. But then it is easy, too easy, to sermonise about the dangers of paternalism and the need to take responsibility for our own lives, from the comfort of our couch in our safe and sanitary home. Aren’t we, those who live in the rich world, the constant beneficiaries of a paternalism now so thoroughly embedded into the system that we hardly notice it? This does not absolve us of the responsibility of educating people about public health. We owe everyone, the poor included, as clear an explanation as possible of why immunisation is important and why they have to complete their course of antibiotics. But we should recognise—indeed assume—that information alone will not do the trick.

Excerpted from Poor Economic: Rethinking poverty & the ways to end it, by Abhijit Banerjee and Esther Duflo, published by Penguin Random House India