World Happiness Report 2023 21 Human beings do not spring into the world fully formed, like mushrooms, as Hobbes once suggested. Nor do they have tastes and values which can be taken as given, as the economists Becker and Stigler once suggested.15 Their characters, habits, and values are formed by the social institutions where they live and the norms which they absorb from them. For example, the Nordic countries have the highest well-being, though they are not richer than many other countries. But they do have higher levels of trust and of mutual respect and support.16 Thus, the well-being revolution will depend on the performance of the social institutions in each country. The objective of every institution should be to contribute what it can to human well-being. From our existing knowledge, we can already see many of the key things that institutions have to do. Let us take these institutions in turn. Governments and NGOs Thomas Jefferson once said, “The care of human life and happiness is the only legitimate object of good government”.17 This echoes Aristotle’s belief that politics should aim to promote eudaimonia. The overarching objective of a government must be to create conditions for the greatest possible well-being and, especially, the least misery in the population. (Fortunately, as we show later, it is also in the electoral interest of the government to increase happiness since this makes it more likely that the government will be re-elected). Thus, all policies on expenditure, tax and regulation need to be assessed in terms of their impact on well-being. Total expenditure will probably be determined by political forces, but which policies attract money should depend on their likely effect on well-being per dollar spent.18 We already have rough estimates of some of these effects and what follows reflects this evidence. Policy choices should always take proper account of future generations (“sustainability”) and the need to preserve basic human rights. The fight against climate change is, of course, international, and each government should play its proper role in this inescapable commitment. There is evidence that other things being equal, countries with higher levels of government social expenditure (but not military expenditure), backed by the revenues to pay for them, have higher well-being.19 Social expenditure leads to higher happiness, especially in countries with trusted and effective governments (see Chapter 3). This is more than coincidence, as where social and institutional trust are deservedly higher, people are more prepared to pay for social programs, and governments are more able to deliver them efficiently. But, whatever the scope of government, there is always a key role for charitable, voluntary organisations (NGOs) – in almost every sphere of human activity. The rationale for an NGO is its contribution to well-being, and every NGO would naturally evaluate its alternative options against this criterion. Health Services and Social Care Many health services already evaluate their spending options by their impact per dollar on the number of Quality-of-life-Adjusted Life Years (QALYs) – a procedure similar to that needed for all government expenditure. Since resources are limited, this is the only approach that can be justified. One clear finding is that much more needs to be spent on mental healthcare and public health. For example, modern evidence-based psychological therapy for depression and anxiety disorders has been shown to save more money than it costs. (The savings are on reduced disability benefits, increased tax payments and reduced physical healthcare costs).20 Even more proactive than providing mental health care, a focus on mental health promotion – or promoting the conditions for good mental health and preventing the onset of mental illness – has been shown to be cost effective.21 Many problems of mental and physical health can be prevented by better lifestyles (e.g., more Human beings do not spring into the world fully formed, like mushrooms, as Hobbes once suggested.
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