Tourism, which is the largest foreign exchange earner, showed improvement as well.

As a consequence, the national health care scheme actually provides a net benefit for the average income earner.

The growth of the tourism sector has become the main foreign exchange earner for Saint Kitts and Nevis.

Tourism was the main export in one third of all developing countries, and a major foreign exchange earner in the least developed countries.

For example, taxing individual rather than family income which in many economies imposes a higher marginal tax on the second earner in households would encourage women to seek employment.

It is a powerful income and employment generator, stimulates the growth of a number of subsidiary industries and is a source of cheap and nutritious food, besides being a foreign exchange earner.

In France, it has been demonstrated that the middle class spends more per capita on its health than the 20 of the poorest French do. As a consequence, the national health care scheme actually provides a net benefit for the average income earner.

With more than 47.7 million tourists a year (2013), Italy is the fifth highest tourist earner, and fifth most visited country in the world, behind France (84.7 million (2013)), United States (69.8 million (2013)), Spain (60.7 million (2013)) and China (55.3 million (2013)).