The biggest surrogate indicator of them all

A headline from the current Economist: 

Do vaccine mandates actually work? The Canadian and European experiences suggest they do

How does the Economist define 'work'? In its view, the mandates work in that more people are or 'nudged' or coerced into being jabbed. It's unfortunate, then, that the link between proportion of the population jabbed and health of that population is tenuous. (See for instance here, here and here.)

My approach is different. I think that, for a health intervention to 'work', it must improve people's health, as shown by measurable, meaningful, objectively verifiable health improvements. Definitely not surrogate indicators, such as cholesterol levels or numbers of people receiving jabs. 

My starting point would be to define and reward the achievement of society's health goal, so that the structures and activities of the sectors that support that goal would be entirely subordinated to that goal rather than, as now, the other way round. On a national level, physical health could be defined as a range of long-term targets, all of which would have to be reached and sustained before we can say we have achieved our goal, at which point Social Policy Bonds targeting health could be redeemed. My suggestion is that our goal would include such targets as: longevity, Quality Adjusted Life Years, and infant mortality. There would be others, to be decided by experts in consultation with ordinary citizens.

That would be the first step. The second would be to put in place a system whereby people are rewarded for bringing about such improvements in health. Not for  jabbing, screening, or curing or treating disease, nor for selling drugs or health insurance. Those are indirect means to an end, rather than ends in themselves and the results are lamentable: pills that are no better than placebo (see here and here). Or incentives to over-diagnose and over-treat. Or to falsify or otherwise manipulate the results of drug trials.

Applying the Social Policy Bond concept to health would change all that. All the activity they stimulate and reward would be entirely subordinate to society's long-term health goal. There would be a market for the bonds, but it would be society's servant, not its master. The Social Policy Bond principle uses the market as a means to society's goals. It doesn't view the market as an end in itself. Under a Health Bond regime, the the end that the market serves under a bond regime will be society's health, as defined and targeted by society itself. The goals of those working in any field impinging on society's health would be exactly congruent with those of ordinary citizens: to improve society's health as quickly and efficiently as possible. I have described how applying the Social Policy Bond idea to health would work here, or in a lot more detail here.