Anorexia is a nasty eating disorder, and although in the prosperous West there seems to be more fretting about obesity than the other extreme, there is no doubt that people who, for whatever reason, don't eat enough to protect their health, represent a serious health issue. But as ever, I get irritated at the "victim culture" that is sometimes wittingly or unwittingly promoted in public discussions of the issue. Case in point was earlier this week on the BBC.

The state broadcaster's morning current affairs show featured a young woman who had almost died as a result of this condition, and some shocking photos were shown. During the course of the discussion with the presenters, the argument from the woman (I did not get the name) was that she had been strongly influenced into her under-eating by a desire to look like the models and actresses seen in glossy magazines and on TV and movies. Such pictures are often enhanced, ergo, such enhancement is evil and there should be a law against such activity so as to prevent impressionable people from being led astray, etc.

At no point did either presenter, or another woman who was representing the modeling industry, say something like this:

"I am very glad you have recovered your health and are eating a proper diet and don't feel a need to starve yourself to `look good'". The fact that photos of such supermodels/actresses or whoever might appear to show that it is acceptable to be very thin does not, and should not undercut your own responsibility for your health. You have a mind, so use it. You have free will; you are not a piece of clay in the hands of the advertising industry, the movie business, or modelling agencies. You are an attractive young person who can, and should, think for yourself. Finally, curves on women are fabulous, and anyone who thinks for a second that the opposite sex is turned on by skeletons needs their head examined. So take charge of your life, and don't expect the State to censor things because you lacked self-control earlier in your life. Thanks for appearing on our show and now let's go over to Carole for the weather forecast."

But they didn't say that. Pity.

From the Radio Times, about a programme this evening on BBC3 TV, entitled I Woke Up Gay:

Documentary about Chris Birch, who used to be a rugby-playing lad with a girlfriend and a job in a bank. However, his life was radically changed by a stroke when he was just 21, and he is now a gay hairdresser with an interest in fashion and interior décor.

The question I ask with my title is of course an attempt to get a smile, if not a lol, but it is also serious. Has anyone gay suffered a stroke and emerged from it straight, with the overwhelming desire to ditch the hairdressing and instead to get a girlfriend and a job in a bank and to take up rugby? Either way, I think the answer would be interesting. Seriously, is this kind of thing a one way street, or can it work in both directions?

Neither answer would obey the gods of Political Correctness. If a stroke can turn you gay, but not make you straight, that would suggest that gays are, at least in some sense, the result of something a lot like brain damage. They are, sort of, a mistake. If a stroke can turn you straight, then maybe those crazy Christians who say that they can straighten out gays may after all be onto something.

A relative of mine recently had a stroke. He lost his peripheral vision and can no longer drive, but otherwise no change. Still no interest in fashion, or not that anyone in the family has heard about.

All this reminds me of that Woody Allen movie (I can't recall which - they're all a blur) where someone gets a smack on the head and wakes up right wing.

I entirely realise that strokes are frequently very unfunny. I'm sure we all know about friends or relatives who were not as lucky as my relative, or as Chris Birch was, kind of. I certainly do.

The programme airs at 9pm, and is repeated at 12.30pm in the very small hours of tomorrow morning. I will record it.

In one of my many jobs I had to look over thousands upon thousands of staff records. I learnt many things. Among them was that plenty of those staff who had had significant time off for stress or other mental problems not only returned to their old jobs and performed satisfactorily but went on to success and promotion. Before this I had believed in my heart of hearts that a month off for stress was about the limit. Anything more than that and the person was a write-off in terms of doing any useful work ever again, although it might not be politic to admit it.

Perhaps not by coincidence a month off for stress was about the limit of what had befallen anyone I knew well enough to be told about it. Since I began to think more deeply about this issue I have twigged that other people I know have almost certainly had bouts of mental illness they did not make public. My impression is that the libertarian and intellectual types likely to be reading this are more likely than average to have experienced mental illness.

There is a lot to agree with in what the Mental Health Foundation says about mental illness - it is common, most people who experience it either get better or can manage it, it need not be a barrier to success in many fields, public fear of the mentally ill is out of all proportion to the risk they actually present.

I just wish they wouldn't over-egg the pudding. These words from the Mental Health Foundation article I linked to above are typically evasive:

Many people believe that people with mental ill health are violent and dangerous, when in fact they are more at risk of being attacked or harming themselves than harming other people.

Pardon me, but the fact that the mentally ill are more at risk of being attacked or harming themselves than of harming other people says nothing whatsoever about the absolute level of risk that they will harm other people.

Annoyingly, the Mental Health Foundation didn't have to raise my hackles by indulging in this common evasion. The absolute risk that a mentally ill person will attack you is very low. It is higher than the risk that a non-mentally ill person will attack you, but only slightly. I don't have the numbers to hand, but I have seen them and that is the position. Why the Mental Health Foundation cannot just show some confidence in their own position and give the numbers I do not know, unless it is that to acknowledge the obvious truth that, yes, a very small minority of mentally ill people really can be dangerous would mess up their nice simple victimhood and "anti-discrimination" agenda.

As a libertarian, I think all forms of discrimination should be legal, including those I find irrational or even morally abhorrent, but put that aside. The link correctly says,

The Equality Act 2010 makes it illegal to discriminate directly or indirectly against people with mental health problems in public services and functions, access to premises, work, education, associations and transport.

It is not illegal to discriminate against people with mental health problems when appointing someone to a job, promoting them, or firing them. There is a movement afoot that it ought to be. Many compassionate people, correctly perceiving that discrimination against those who are suffering or have suffered mental illness is often irrational and hard-hearted, are being edged towards supporting a move to make it a crime.

That movement had a setback the other day. A JetBlue pilot suffered a meltdown and had to be restrained by passengers at the request of the co-pilot, who had locked him out of the cabin. Scary. Also memorable and quotable in debate.

Wishing the pilot well for the future is not incompatible with a firm belief that it would be irresponsible to allow him back at the controls of an airliner. There are also a good many less dramatic situations in which an employee being mentally ill ought justly to be grounds for reassignment or dismissal. A pretence this is not so harms the interests of mentally ill people. There is little an organisation fears more than taking on an employee who turns out to be "trouble" and there are good reasons for this fear. That was another thing I learnt from my thousands upon thousands of personnel records. One came to dread the thick files; the ones trailing stapled-on appendices and confidential notes directing you to yet other files; files that bulged with long, messy, sad stories of warnings and final warnings and appeals and getting the union involved and even the union giving up and offloading the troublemaker onto some other department only for it all to start up again.

If ever discrimination on the grounds of mental illness does become illegal, or even publicly unacceptable, be sure it will continue to be practised in secret - and the secrecy will make it more unfair. Instead of basing their assessment of suitability on the plain answers to plain questions in application forms, they will go by code words, or a quiet (and often slanderous) word in confidence at the canteen.

I used to know a little girl with severe mental and physical disabilities. She had to be lifted and moved dozens of times a day as she was unable to walk or crawl. It was a source of great worry to her parents how they would cope when she grew up and could no longer be lifted easily. More distant, but greater, was their fear concerning she how would be cared for when they died. Their fears did not come to pass for the saddest of reasons; she herself died when she was still quite small.

I thought of that family when I read about Ashley. Ashley is another little girl with severe mental and physical disabilities; even more deeply disabled than the child I once knew. Ashley is fourteen, but is described as having the cognitive abilities of a three month old baby - in truth, if the description of what she can and cannot do is correct, a three month old baby is better able to communicate than she is. Her parents share the same fears as those of the parents of the girl I knew. They have taken drastic action: they have had her treated surgically and with hormones so as to ensure, within the limits of the technology, that she remains a child for the remainder of her life.

"It was carried out in the belief that her quality of life would improve as it would save her from physical discomfort and pain", reports the Telegraph. The Guardian, which ran opposing comment articles on Ashley's case, suggests that another motive was to reduce the effort of lifting her and hence extend the time for which her parents could care for her. I wonder if an unmentioned further reason - one that sounds ghastly but might make sense given human nature - was to try to ensure better care for Ashley when her parents are gone by keeping her cuter. It is a sad fact that many people will find their protective instincts aroused by the sight of a mentally disabled child (or apparent child), yet flinch at the sight of a mentally disabled adult.

Ashley cannot consent and cannot withold consent. This procedure might help - no, it very likely will help to give her the best quality of life possible, for as long as possible in the care of those who love her. Yet the potential for abuse is horrible. Her body is being irrevocably altered for the convenience of those who care for her (but that convenience is no small thing, and convenience is too weak a word; whether they can cope is a major determinant of her quality of life.) If we can do this to Ashley, what else can we do to future Ashleys? More severe modifications to more severely disabled people? To less severely disabled people? To any people?

... to save the NHS, says Ed Miliband.

My first thought was, gosh, that's nice, three months in which to kill it. I suspect that I am in a minority: the outpouring of love, loyalty and vows to defend the NHS unto death coming from the Guardian commenters to this report and to Miliband's own article resemble nothing so much as the frenzied cries of "Deus vult!" that greeted Pope Urban II when he declared the First Crusade. I further suspect that when it comes to this issue the knights of the Guardian would indeed get support from the peasants of the Sun and the Daily Mail.

Heigh-ho. Just for the record, I shall repost an article that is now more than ten years old. It is by Anthony Browne, once Health Editor of the Guardian's Sunday sister, the Observer, and at one time a passionate supporter of the NHS:

Even as you read this, in almost every hospital in the country, there will be elderly, vulnerable people left for hours and sometimes days on trolleys. Each year, thousands of British people - the young, the old, the rich, the poor - die unnecessarily from lack of diagnosis, lack of treatment and lack of drugs. They die and suffer unnecessarily for different reasons, but there is just one root cause: the blind faith the Government has in the ideology of the National Health Service, and our unwillingness to accept not just that it doesn't work, but that it can never work.

This morning I was prodded by the scourge of epidemiocracy, Chris Snowden, to read this piece by Theodore Dalrymple. What most struck me was not the main argument (I find predictable agreement almost as wearing as disagreement) but this piece of supplementary information:

A higher proportion of the Dutch population smokes than average for a developed country (27 percent), and fewer Dutch people are aware of secondhand, or second-lung, smoke — that breathed in from other people’s tobacco — than any other comparable country.

Why should that be? I think it demands an explanation. Certainly the Dutch population cannot easily be classed as ill-educated or poorly-informed. (I have been sworn at by a drunk tramp on an Amsterdam tram who switched instantly to English invective when he realised that it was going to be more effective in my case.) My mind leapfrogged towards ideas about the Dutch liberal tradition. They choose not to know, because they do not like to hassle people about their private behaviour, perhaps...

Unfortunately there are no sources quoted. When I looked for stats and background info, I found something even odder. That remarkable factoid contains no truth.

The OECD statistical library agrees with that 27% average - if it is actually daily smoking for males 15 and over. But it places The Netherlands fractionally below average, equal with Germany and slightly above Belgium for the proportion of males who smoke (26%), with slightly more women than either (20%).

How about "awareness of second-hand smoke". The points in the article about "relatively high" Dutch smokishness appear in less critical articles such as this one in Salon. (Which itself hints that it relies as a source on one Lies Van Gennip, director of the national tobacco control center.) Here we have a hint of the source for the "awareness" figure.

In a global survey on smokers’ awareness, only 61 percent of Dutch smokers agreed second-hand smoke was dangerous to non-smokers — much lower than smokers elsewhere, including Mauritius, China, Brazil and Mexico.

“Dutch smokers are among the least informed about the harms of smoking and second-hand smoke,” said Geoff Fong, at the University of Waterloo in Canada, who heads a program that monitors smoking policies worldwide.

Note the built-in interpretation: failure to agree counts as being ill-informed. I googled down the global survey mentioned. It appears in the BMJ for 4 April 2011 under the headline "Dutch smokers are "alarmingly" ignorant of harms of passive smoking, study finds." The original findings do indeed appear under the aegis of the University of Waterloo here (pdf) But are published on behalf of 'The International Tobacco Control Policy Evaluation Project: ITC Netherlands Survey' — the presentation of which suggests it is intended to drive Dutch policy, and the naming of which suggests we should worry about that 'global survey' point. Some (more) cherry-picking, perhaps?

Inspecting a bit further suggests there is reason to worry. See here. The ITCPEP doesn't do a global survey. It surveys different countries at different times using different methods. The most recent French survey (2009) was a telephone poll with respondents reimbursed; the most recent Dutch one (2011) was an online survey. The critical common question is not "Do you think your smoking harms others?" but "How often, in the last month have you thought about the harm your smoking might be doing to other people?" In both surveys, the critical question is preceded by questions about respondents' attempts to give up and their degree of addiction, but in the Dutch survey that is the beginning. In the French survey there is much prequalification apparatus including emphasis of the importance of the survey itself, and information sought about the individual respondent's household. Longitudinal comparisons on a single country might make sense if individual surveys are consistent; but comparing attitudes in two countries on this basis does not.

We know nothing from the ITCPEP about the beliefs of either Dutch or French smokers concerning the dangers of environmental tobacco smoke. They were not asked. But we cannot even compare their relative preoccupation with whether they may be harming others—what they were asked—because they were asked at different times, in different ways, in different contexts.

The only reason for making the comparison in the first place was to condemn Dutch views as "ignorance", but even the variance in views is a pseudo-statistical phantom, if you can be bothered to look into the detail.

I am interested in variation in public attitudes and in political culture and their relationship to policy. But it is devilish hard to find out about those relationships when even critical discussion, such as Dr Dalrymple's, is predicated on 'facts' whose selection and interpretation is determined by the attitudes of interested researchers. Even specialist commentators are seldom suspicious enough to do more than re-word the press release and cast it in the light of their own attitudes.

Even as supplied by an unscrupulous underground market and taken blind by consumers in a variety of unsuitable ways, they really aren't very dangerous:

According to the ONS data, in 2010 there were more helium deaths [32] than cannabis, ecstasy, mephedrone and GHB related deaths put together.

'Helium?' you may ask... It's classed as a drug but no, it doesn't do anything. But it is so hard to buy anything reliably lethal in the UK that helium is a sophisticated means of self-asphyxiation for suicide. So even those 32 cases should not be classed under malign side effect of drug-use. Death in those cases was a positive result.

Say what you will about the environmentalist and Guardian columnist Mr George Monbiot - not, apparently, the prototypical moonbat but merely a moonbat - he does have integrity. I have no doubt his recent conversion to a belief in the benefits of nuclear power cost him many friends in the green movement.

This article will not win them back. In it Mr Monbiot and Justin McCurry write that

The Green party's former science and technology spokesman is promoting anti-radiation pills to people in Japan affected by the Fukushima nuclear disaster, that leading scientists have condemned as "useless".

Dr Christopher Busby, a visiting professor at the University of Ulster, is championing a series of expensive products and services which, he claims, will protect people in Japan from the effects of radiation. Among them are mineral supplements on sale for ￥5,800 (£48) a bottle, urine tests for radioactive contaminants for ￥98,000 (£808) and food tests for ￥108,000 (£891).

and

Launching the products and tests, Busby warns in his video of a public health catastrophe in Japan caused by the Fukushima explosions, and claims that radioactive caesium will destroy the heart muscles of Japanese children.

He also alleges that the Japanese government is trucking radioactive material from the Fukushima site all over Japan, in order to "increase the cancer rate in the whole of Japan so that there will be no control group" of children unaffected by the disaster, in order to help the Japanese government prevent potential lawsuits from people whose health may have been affected by the radiation. The pills, he claims, will stop radioactive contaminants attaching themselves to the DNA of Japanese children.

Regarding that claim, Monbiot and McCurry write:

Gerry Thomas, professor of molecular pathology at the department of surgery and cancer at Imperial College, London, describes his statements about heart disease caused by caesium as "ludicrous". She says that radioactive elements do not bind to DNA. "This shows how little he understands about basic radiobiology." Of the products and services being offered, she says, "none of these are useful at all. Dr Busby should be ashamed of himself."

UPDATE: George Monbiot has also put up a blog post on Christopher Busby in the Guardian Environment section. There is fierce debate in the comments between pro-and anti-nuclear Guardianistas. Meanwhile the Green Party have made no statement on all this that I can see.

So, a company notes that its natural food product has scientifically documented positive health effects... and a bunch of underhanded bureaucrats underhandedly silences them:

Quote of the Day: "Experience should teach us to be most on our guard to protect liberty when the Government's purposes are beneficent." - Justice Louis D. Brandeis

Only an organization as evil as the FDA could manage to harm public health, free speech, and due process, with a single action.

The sample letter to Congress below explains how the FDA accomplished these things in the name of protecting you from . . .

Wait for it . . .

Walnuts!

But hey, is that not what we pay them for via our voluntary tax system?

“One curious and unintended consequence of the aeroplane ban [on smoking] was that airlines began to save money by changing the air in the cabin less frequently. Traditionally, this was done every two minutes and old air was never recirculated, but with no tobacco smoke to draw attention to the quality of air, the carriers reduced air changes to once every twenty minutes. This led to a musty aroma on board and, according to a report in The Lancet, contributed to the appearance of Deep Vein Thrombosis, a disease unknown in airline passengers until the 1990s.”

Page 163 of Velvet Glove, Iron Fist: A history of anti-smoking. By Christopher Snowdon.

Entirely selfishly, I am delighted that I travel in a smoke-free airline industry, although it is a shame that this change came about through the coercion of the state and not in reaction to consumer choice via a market. After all, there are many irritations involved in flying that might be amenable to a market solution, if it was available, such as screaming young children or patronising and idiotic flight attendants.

“Hitler remained closely involved with the crusade against tobacco to the very end. He banned smoking at his Austrian base, the Wolf’s Lair, and in the Fuhrerbunker in Berlin. In 1942, he voiced regret that he had ever allowed his troops a tobacco ration; a ration he would soon be forced to increase to boost morale when the war went from bad to worse. In 1943 he made it illegal for persons under the age of 18 to smoke in public places. A year later, with the Third Reich crumbling around him, Hitler personally ordered smoking to be banned on city trains and to protect female staff from second-hand smoke.”

“Hitler committed suicide in April 1945 and, after burning his body, SS troops lit cigarettes in the Fuhrerbunker for the first time. Within weeks, cigarettes became the unofficial currency of Germany, with a value of fifty US cents each. Hitler ultimately, if inadvertently, succeeded in reducing smoking in Germany but only by bringing the country to its knees.”

Pages 76 to 76 of Velvet Glove, Iron Fist: A History of Anti-Smoking, by Christopher Snowdon.

In Italy last week, where I holidayed, I also attended the ISIL conference with a great bunch of fellow libertarian conspirators, such as Kevin Dowd, Tom Palmer and Detlev Schlichter. One of the talks was by Mary Ruwart, who has worked for many years in the medical field and has first-hand knowledge of the destructive power of the US Food and Drugs Administration. She argued that the cost to life in terms of drugs and treatments that never got approved runs to several million people, far outweighing the likely number of deaths from drugs that might have dangerous side-effects.

As Ruwart said, one of the issues that comes up in any discussion about drugs are patents. She disapproves of them - she called the process of getting a patent a "game"; but at the same time she pointed out that if drug firms have no certainty of being able to recoup some of their research costs due to a patent, and those research costs are inflated by the FDA and other regulators, then abolishing patents without first removing such regulators would be bad. In my view, it would be disastrous.

I thought about her talk when I came across this rather lame article by the Economist, in which the publication wonders why US drugs are so expensive and why production of them has slowed. Wow, I wonder why that can be?

Update: the FDA has been carrying out an absurd attempt to hammer dietary supplements. US citizens who want to stop this nonsense can register their views at this site.

Felicity Lawrence. Describing her as a health dominatrix doesn't really work; some people find that fun. In this article, Why the new McDonald's menu won't make us thin, she writes:

The coalition government has chosen to cast public health as a matter of personal responsibility. It takes the classical liberal view that individuals should make their own choices, free from state intrusion. Nudging us to healthier choices is OK, but regulating is not.

On this liberal reading, the fact that your risk of being obese relates closely to your socio-economic status is not a question of social justice but a problem of the feckless poor being too ignorant or spineless to make good choices.

This is a dangerous misrepresentation. It conflates the right of the individual to freedom from interference with the right of business to the same freedom from government constraint. It ignores the fact that business intrudes on our choices constantly with its powerful marketing and sales strategies.

The part where she is projecting is the part I have put in bold type. It is Felicity Lawrence, not the supporters of a belief that individuals should make their own choices, who is conflating the right of the individual to freedom from interference with the right of business to the same freedom from government constraint. She is conflating the two rights so as to get her Guardian audience, generally hostile to business, to give up their residual hippy belief in freedom to do what one likes with one's own body in return for the quick thrill of an anti-business sugar rush.

Those who believe that individuals should be able to do what they like with their own bodies may also believe that businesses should be free from government constraint. I do. They are both freedoms. They are not the same freedom. I would say that the freedom to do what you like with your own body, and mind, and life, is the fundamental freedom - is, in fact, freedom. The specific freedom of businesses is merely an application of that to certain uses of your time and applied to specific types of groups.

I am a sarcastic cow, I am used to being a sarcastic cow and I am comfortable being a sarcastic cow. When the time comes to simply recommend an article in the Guardian my non-sarcastic mooing sounds all funny in my own ears. But, here goes: I recommend you read 'Freedom of information is for businesses too' by Heather Brooke.

A request by tobacco giant Philip Morris International has reignited concern about the use of freedom of information laws. The data it was interested in was collected as part of a survey of teenagers and smoking carried out by the university's Centre for Tobacco Control Research.

The UK's FoI law is meant to be applicant blind. This means anyone can ask a public body for official information and there should be no discrimination based on the identity of the person asking. In the case of scientific research conducted and funded in the public's name, there is a strong argument that the underlying data and methodology should be disclosed. It is precisely this transparency that grants research reports their status as robust investigations.

Taking a break from life in riot-torn London, I came across this item at the FT about some of the implications of longer lifespans. It is a mixed situation. Excerpt:

"Maxmin admits there are no miraculous solutions to the problems of a fast-ageing society. We will all have to work longer, save more and pay more in tax to cover the costs of a world with a greyer population. Even so, he thinks models like Elder Power can have a much wider application. Perhaps moments like the collapse of Southern Cross, he tells me, could (in the right hands) become moments of opportunity. More generally, models like Beacon Hill Village, ITNAmerica and Elder Power show glimpses of a future in which more elderly people can stay in their homes for longer. All three use innovative technology, make use of assets in their local community and bring together the resources of local businesses, volunteers and the state to solve problems none could have solved individually, at reasonable cost."

How we deal with ageing, and the issue of longer lifespans, is of course intertwined with the current fiscal breakdown of many developed economies. Healthcare costs are skyrocketing. And in that Greg Lindsay and John Kasarda book I have been linking to lately, about the impact of mass aviation, there is a segment on how said aviation can be used to dramatically reshape healthcare, such as by flying people with problems to cheaper, but arguably better run, hospitals in Asia. It struck me while reading this book that while automobiles and consumer electronics have been propelled by their Henry Fords, Michael Dells and Steve Jobses, we haven't really had, in healthcare, a similar set of individuals to drive innovation and push things sharply down the price curve. The dynamics of Silicon Valley, allied with cheap Chinese manufacturing and just-in-time stock inventory systems, hardly touches healthcare at all, although this is starting to change, perhaps. Of course, much of this is caused by how healthcare is seen, wrongly in my view, as somehow "different" from such vulgar things as selling flatscreen TVs or cars. Healthcare is political. That's the problem.

A few days ago Phlip Davies MP suggested that disabled workers or those with mental health problems could get work more easily if they had the right to voluntarily opt out of the minimum wage.

He said,

"Given that some of those people with a learning disability clearly, by definition, can't be as productive in their work as somebody who hasn't got a disability of that nature, then it was inevitable that given that the employer was going to have to pay them both the same they were going to take on the person who was going to be more productive, less of a risk, and that was doing those people a huge disservice."

Within hours so much outraged commentary flowed out of newspaper columnists, charity representatives and politicians of all parties, including Mr Davies' own, that you'd think there'd been an outbreak of indignation dysentery.

Let us look at a few of the responses.

"A lower minimum wage if you're disabled? Not acceptable, sorry," says Lucy Glennon in the Guardian.

"It is a preposterous suggestion," MIND spokeswoman Sophie Corlett was quoted as saying in the Yorkshire Post, "that someone who has a mental health problem should be prepared to accept less than the minimum wage to get their foot in the door with an employer.

"People with mental health problems should not be considered a source of cheap labour and should be paid appropriately for the jobs they do."

"Philip Davies's comments are another obstacle to disabled workers being treated as equal," said Paul Farmer, chief executive of MIND, writing in the Telegraph. He added, "He has caused offence to many people who work with a mental health problem and those who want to work on an equal footing, yet struggle to overcome the stigma they face."

Jody McIntyre in the Independent was also outraged. His suggestion that Members of Parliament should work for less than minimum wage was not bad, though. Of the mentally disabled, he said "A strong test of any progressive society is how it’s most vulnerable people are valued for their worth, rather than pitied for their faults. Philip Davies clearly places little value on the role of people with learning difficulties in our society; instead of celebrating their diversity, he chooses to reinforce the discriminatory myth that people with learning difficulties are more of a risk to employers."

There was more, much more. After reading loads of responses I noticed something that they all had in common... as not having.

Not one response of all the many I read even tried to argue that Mr Davies was factually wrong. They were outraged, disgusted. They asserted what no one denies: that mentally disabled people are equal citizens and often prove to be hardworking employees, valued by their employers. But I could not find one article that argued that Davies' description of the way things go when a person with an IQ of 60 or a history of insanity seeks a job was inaccurate, or gave reasons to believe his proposal would not increase their chances of landing one.

"Philip Davies is right, of course," says Tim Worstall. "But so profoundly unfashionable that no one will say so". He then goes on to argue that Davies is right. His views will not be purist enough for some libertarians, but the novelty of reading someone bother to put forward a chain of reasoning when talking about this topic is a bit of a thrill. The fact that he bothers to think about what will actually happen to disabled people, particularly mentally disabled people, under various scenarios shows a thousand times more compassion than the people whose response is mostly concerned with their own emotions.

A quote from Charles Murray: "It seems that those who legislate and administer and write about social policy can tolerate any increase in actual suffering so long as the system does not explicitly permit it."

Though a World Health Organization study concluded cell phones may cause cancer, some are wondering why, if their truly is a link, there not been a significant worldwide increase in brain cancers.

Go figure. But of course providing excuses for more regulations, and more funding for further studies, is the reason bodies such as the World Health Organisation exist.

The gradual but inexorable illegalisation of smoking is arriving at its end-game, as many bloggers of the sort I like have been complaining about, and no doubt as many bloggers of the sort I don't like have been celebrating.

Here is the Radio Times, describing a show done by Panorama last Monday (March 7th) entitled Smoking and the Bandits:

Criminal gangs are believed to be supplying half of all hand-rolled tobacco and in five cigarettes in the United Kingdom. ... their products are also up to 30 times more toxic than ordinary cigarettes.

I saw that coming in 1987. Under the bit in that pamphlet entitled THE BENEFITS OF ADVERTISING, AND OF PROPERTY (page 3) I wrote about how gangsters would, if the illegalisation process I was writing about even then continued, soon be running the tobacco business, supplying "these now genuinely lethal products". Not that I was alone in possessing these prophetic powers. Just about every libertarian then writing saw this coming. Illegality equals toxicity. You merely had to apply what everyone already knew about other drugs markets that already were, even then, illegal, or for that matter acquaint yourself with a one page summary of the story of Prohibition, and the pattern of future events, if they insisted on continue to bear down on smoking with the force of law.

But going back to that bit in the Radio Times, where I put "…" above, it also says this:

However, not only are the criminals depriving British taxpayers of £4 billion in revenue, ...

That's right, there goes the exact same warped logic as Natalie Solent noted in her posting earlier today, immediately below this one. No, Radio Times, depriving taxpayers is what you do when you tax them. These "bandits" are thriving because, unlike our tyrannical government, they are not doing that.

It seems that the commenter quoted by Natalie is mistaken. It is not "only in the mind of Ms Lucas" that such warped thinking is being thought.

I believe I am the senior Samizdatista, in years if not in eloquence or influence. And one of the privileges of advancing years is the right to inflict upon strangers the details of one's various medical infirmities and experiences. I can't, yet, quite manage the truly, Platonically essential, shameless way of doing this, which is: in a very loud voice on the top deck of a double-decker bus. But, a blog is a satisfactory next best, so here goes. Stop whatever else you may be doing or trying to do, stop talking amongst yourselves, and listen to me.

A few months ago, a crown that had been attached to one of my disintegrating British teeth started to loosen, and about one month ago, this crown fell off. My non-British dentist advised that what remained of the real tooth was now useless and that it all should go. This was not a wisdom tooth; those are long gone. It was the next one in, top left. But I wouldn't miss it, said my dentist. If I did, an "implant" could be contrived.

So, a week ago now, the tooth was duly removed. The NHS had been asked to do something about all this, as soon as the crown had become loose. But not a peep was heard from the NHS in three months (apparently a whole clutch of letters due to go out had been delayed for some obscure reason – waiting lists?), so when the crown finally did fall off, I decided to go private. Had I been content to lie about how much it was hurting (in reality it only started hurting after the tooth had been removed), the emergency bit of the NHS might have obliged. But, forced to choose, I preferred buying to lying, and so, for £150, the date was fixed and the deed was done.

Local anaesthetics do away with almost all pain, but I can't get used to the notion that all that grinding and sawing is not hurting, and I love it when it ends. But taking out a tooth involves flesh, not just teeth. I had supposed that once the tooth had gone, any discomfort involved would end, but gouging out a tooth does damage. It does less damage if all of the tooth comes out in one go, but mine did not. After most of the tooth had been removed, a long, thin root remained, and further damage was done to my gum while that was dug out. So, not surprisingly when I actually thought about it, it was only when the local anaesthetic started to wear off that the serious discomfort began. The pain has by no means been unbearable, but it started out quite bad, and has still not truly abated. For a couple of days all but the smallest mouthful, the shallowest spoonful, involved a painfully slow wrenching open of the jaw. I am still chewing only with the other side of my mouth, not least because the hole takes time to fill itself in. Further dentistry may be required to this end.

Okay, so much for the shouting on a bus bit. Now it gets a little more officially Samizdata-esque.

Just before yanking my tooth out, the specialist tooth yanker who was about to do it handed me a bit of paper, which he asked me to read and then sign. It said that Tooth Yanker:

... has fully explained to me the purpose of the procedure(s) and has also informed me of the expected benefits and complications (from known and unknown causes), attendant discomforts and risks that may arise, as well as possible alternatives to the proposed treatment, including no treatment. The attendant risks of no treatment have also been discussed. I have been given an opportunity to ask questions, and all my questions have been answered fully and satisfactorily. I acknowledge that no guarantees or assurances have been made to me concerning the results intended from the procedure(s) which the above-named dentist or his/her associates may consider necessary.

I also understand the financial obligation attached to this procedure and
agree to comply as listed below.

Total amount due £................ ("150" filled in by hand)

I understand that I am responsible for all fees. I also understand that as treatment progresses the above fees may have to be adjusted, but that I will be informed of these adjustments and how they will affect my payment plan. In the event that my payments are not received by their due date I agree to pay all costs, including, but not limited to, reasonable agency/solicitors
fees.

I confirm that I have read and fully understand the above and that all blank spaces have been completed prior to my signing.

I hereby consent to the proposed dental treatment.

All of which was so, and I duly signed.

Underneath, there was a shorter declaration from Tooth Yanker, saying that he had done his bit, in terms of explaining everything and supplying any required answers.

Really just to make conversation, what with Tooth Yanker being young and Irish and the sort who seemed to want to make "relaxing" conversation, I asked him when this form first started happening. Because, I'd never come across this before. When those original crowns were put on the remains of my British teeth, which was much more complicated and surely just as hazardous, I don't recall signing any consent form. How long have these forms been around?

Tooth Yanker's answer surprised me. They have, he said, been around for about one week! This was only the second time that he had deployed such a thing.

Some "guidelines" had apparently been issued, and they were the kind of guidelines that, if you are a low-on-the-dental-pecking-order tooth yanker, you are firmly guided by.

It reminded me of a weird conversation I had with an unfamiliar doctor just after my mother died, asking me if I thought there was anything untoward about the care she had been receiving. At first I thought he was accusing us of having murdered our mother. But it turned out that he was just checking to make sure that her regular doctor had not murdered her. Doctor Shipman, you see. More guidelines.

Please do not get me wrong. I am not complaining, just reporting. This form was clearly intended to protect honest dentists against dishonest patients, and honest patients from dishonest or incompetent, or even evil, dentists. I certainly had no problem about signing it.

However, I can't help feeling that all this tells us something about the way that British dentistry is now heading, and perhaps British life generally.

It is becoming more private sector. This all coincided, remember, with me going private to have my tooth out, the NHS having ignored me. I'm guessing that the NHS is protected by all purpose laws which say that the NHS can do no wrong, not even if it does do wrong, in fact especially if it does do wrong. But the evil private sector? Well, patients must be positively encouraged to sue those evil people, mustn't they? These guidelines are the latest defence against this new atmosphere. I don't know, I'm just guessing. But that is my guess.

I connect this form in my mind with the rash of television adverts there have recently been about how, if you have been careless at work and had an accident (like: you slipped on a slippery floor), then instead of just suffering like an old fashioned person of the sort who Won The War, you can instead blame someone else for your foolishness and ruin their life too.

I connect this form with the big signs that you now see, wherever there is a slippery floor.

More generally, I connect this form with the signs that you now see on building sites, like this one, listing all the many foolish things that you ought not to do on a building site.

You miss the point if you think that these signs are merely there to alter your behaviour. They are also, surely, legal documents. I have started particularly photographing such signs (and signs in general), because signs are, I think, and especially now, signs of the times that we live in.

One can perhaps sum all this up by saying that British dentistry, and British life in general, is becoming more Americanised. As in: less socialistic, but much more inclined to litigate and hence frightened of the litiginousness of others. And although I think it rather harsh to blame America for the annoyingness of lawyers everywhere, such an observation does suggest one particular thing that may get seriously underway in Britain. In the short run, changes like those alluded to in this posting probably mean a lot of turmoil, grief and added expense (they certainly meant added expense for me). But, in the longer run, does all this spell the demise of British teeth? Will British teeth in two or three decades time all be immaculate and sparkling? Maybe so.

The NHS traditionally has been rather indifferent to demands for mere beauty. But if customers are going to have to get used to paying, that means that dentists will be spending more time doing what customers actually want. And one of the things that more and more customers want is not just functioning teeth but pretty teeth. All of this will be too late for me, but it is surely one of the ways all this is heading.

About half way through this, I stopped shouting, but then started rambling, which is the other talking privilege of advancing years. I have, in particular, rather muddled together the increased litigation thing with the way that British dentistry is now being denationalised. But actually, I think, the two things do go together. Both are about dental customers moving from a world in which they take what they are given and suffer, should suffering be involved, in silence, to a world in which they demand, sometimes rather nastily and expensively, what they want. In the past, you trusted, and hoped for the best. Now, you distrust, and demand it.

As with so many discussions of clashing interests, not least those of lawyers, form printers and sign makers, this one makes me think yet again of the point made by Leon Louw in this publication (now over two decades old, linking to ancient things being another privilege of advancing years) that the society in which everyone's rights and interests are taken seriously is the most difficult to legislate and litigate about.

"The struggle for definition is veritably the struggle for life itself. In the typical Western two men fight desperately for the possession of a gun that has been thrown to the ground: whoever reaches the weapon first shoots and lives; his adversary is shot and dies. In ordinary life, the struggle is not for guns but for words; whoever first defines the situation is the victor; his adversary, the victim. For example, in the family, husband and wife, mother and child do not get along; who defines whom as troublesome or mentally sick?...[the one] who first seizes the word imposes reality on the other; [the one] who defines thus dominates and lives; and [the one] who is defined is subjugated and may be killed."

The quote is from Thomas Szasz, psychiatrist and libertarian. The race to get your side's definition in first perfectly describes the frenzy of the left wing media establishment to link the murders carried out by Jared Loughner to the right, the Tea Party, and Sarah Palin. I posted about the contrast between Guardian columnist Michael Tomasky's haste to explain Loughner's murders and his reluctance to explain Nidal Hassan's murders here.

Over the last few days further evidence has emerged that Loughner was (a) simply a drug-addled madman, judging from his strange pseudo-logical screeds on YouTube and (b) had began to fix his mad rage on Gabrielle Giffords in 2007, after she gave what he regarded as an inadequate answer to his question, "What is government if words have no meaning?" At that time Palin was barely known outside Alaska.

A prescient remark from Thomas Szasz, then. Yet anyone who knows anything of his work and writings will have predicted that I am about to say that an apt quote is not his only relevance to this situation. Szasz is famous for opposing the many authoritarian crimes of the psychiatric profession: among them imprisonment without trial or appeal, assaults under the name of "treatment" (such as lobotomies, electric shocks, injections of drugs against the patient's will), and collusion with the state to define dissent and eccentricity as mental ills. All very great dangers and he was right to oppose them, as he was right to oppose the prohibition of drugs.

And yet - there is Jared Loughner and the lengthening list of those like him. Lougher was is (Why do I keep saying was? He is alive and in custody!) a drug-addled madman who killed six people. "He should have been locked up before this" does not seem an unreasonable thing to think.

Clayton Cramer is a former libertarian. His article Mental illness and mass murder contains food for thought. This 2007 post by Brian Micklethwait is also relevant. I would welcome your opinions.

WikiLeaks: Cuba banned Sicko for depicting 'mythical' healthcare system.

According to the Guardian (!):

Cuba banned Michael Moore's 2007 documentary, Sicko, because it painted such a "mythically" favourable picture of Cuba's healthcare system that the authorities feared it could lead to a "popular backlash", according to US diplomats in Havana.

The revelation, contained in a confidential US embassy cable released by WikiLeaks , is surprising, given that the film attempted to discredit the US healthcare system by highlighting what it claimed was the excellence of the Cuban system.

But the memo reveals that when the film was shown to a group of Cuban doctors, some became so "disturbed at the blatant misrepresentation of healthcare in Cuba that they left the room".

Castro's government apparently went on to ban the film because, the leaked cable claims, it "knows the film is a myth and does not want to risk a popular backlash by showing to Cubans facilities that are clearly not available to the vast majority of them."

Back in 2007 I mentioned a milder version of the same reaction among British people to Moore's depiction of "empty waiting rooms and happy, care-free health workers" in the NHS.

UPDATE: Hat tips to commenters Jock and Alisa. The Guardian story has now been corrected to say that Sicko was shown in Cuba, confirmed on Michael Moore's own website. Pity. That was a fun meme while it lasted, but truth must prevail. Moore says that the cable was purely a lie. Not necessarily: indecision as to the "line to take" is not exactly unknown in totalitarian regimes. Both showing the film and forbidding it have their dangers from the point of view of the Cuban rulers.

This round to Michael Moore, but I shall defiantly repeat something I said in 2008:

When the history of Fidel Castro's rule in Cuba comes to be written all that stuff about the excellence of the healthcare system will turn out to be lies but the claim of high literacy rates will be more or less true.

Communist education gets results because force is near to the surface. I acknowledge but do not approve ... A further advantage of communist education is that the wishes of the teachers are given almost as short a shrift as those of the pupils.

Force works well in education because the forcers can look at the forcees all the time they are doing the forcing. It works less well in healthcare and very badly indeed in agriculture.

My id always said that an article by a Freudian therapist would be a sloppy half-cooked pizza of generalities and buzzwords, and this one in the Guardian by Darian Leader is much as expected:

Therapy occupies a unique space in the modern world. In a culture obsessed with surface and statistics, it allows the detail and narrative of a human life to be explored. Where society tells us what to be, therapy allows us to reflect critically on the imperatives that shape us. Challenging received notions of wellbeing and happiness, we can try to find out what is really important to us, often with life-changing consequences. It offers a system of values freed from the moral judgments of social authorities.

Then he whinges away about how his woo is going to be regulated, and throws in a couple of digs at the "market-led vision of human life" for good measure. While complaining about being regulated. Boo Woo Hoo.

There is only one thing stopping me having a really good laugh. His complaint is just. His concern is justified.

(And, unusually, Tim Worstall, whose blog is linked to by the word "woo" above, is wrong.)

If people, for reasons that seem good to them, want to pay to spend time with a therapist, what right does the Health Professions Council have to force the interaction into a tidy format of input and output? Who asked them to the party?

There seems to be a growing belief among our dear protectors that whenever money changes hands then their guiding presence is necessary. They generously allow us to speak more or less as we choose to our friends, lovers, and random blokes on the Clapham omnibus, but as soon as a cheque is written, they say, away flew an invisible invitation to make a threesome: me, you, and the government.

I see no logical justification for this. Some people might end up paying for therapy and then feeling they had wasted their money. That is sad. It is also sad that in my time I have wasted good money on dresses that looked bad on me, plays that I left during the interval, and exercise machines.

Come to think of it, money you can get back. Time is irrecoverable. I am still traumatized by the fact that in 1978 I watched 17 episodes of the original Battlestar Galactica thinking something interesting might happen. Some people who have experienced therapy say it was a waste of time; others say it saved their sanity. My only opinion on the matter is that the Health Professions Council has no right to an opinion on the matter. Certain clear categories of abuse or fraud by therapists have long been forbidden in law. If someone's beef with their therapist is big enough for them to sue, then the State might just have a role. Other than that, the bureaucrat should not intrude.

David Lucas, commenting on a posting at my place sparked by the fact that a relative of mine by marriage is celebrating her hundredth birthday today, pours cold water on the likelihood of serious life extension much beyond a hundred:

I believe increased life expectancy is due to decreased rates of death, initially in childhood, later on in mid-life and now in tackling old-age diseases. There is remarkably little growth in people living significantly beyond 100-110.

The future pattern is likely to be most people living to around 100 and then dying of multiple organ failure.

Which I find bleak, but convincing. You read about occasional people of long, long ago living into very old age even by our standards, even as you wince at the tales of multiple infant death, then and later. The statistics of how medicine and food and hygiene have affected life expectancy until now are surely just as Lucas says.

But does that mean that it will always be like this? Maybe, but maybe not. Maybe medical magic will trundle slowly onwards, from stopping half the babies dying, to stopping half the surviving adults dying with the onset of middle age, to stopping three quarters of the wrinklies from dying well before they are a hundred, to keeping everyone alive even longer, by means now not known about. Or perhaps now known about but not yet widely bothered about, because now too difficult and expensive, and crucially (to use a morbidly appropriate adverb), too uncomfortable.

In other words, the reason nobody now lives beyond about a hundred and ten is basically the same reason that nobody, two hundred years ago, ever travelled faster than a galloping horse. The techies just hadn't got around to repealing this seemingly fixed law of nature. And then, one day - puff-puff - the techies got that sorted, and a few people did start travelling at twenty, thirty, forty, a hundred, two hundred, three hundred, five hundred miles per hour, quickly followed by nearly everybody else who could afford it.

We'll see. Well, I probably won't see, but we as in humanity as a whole may.

And if people ever do routinely live to be four hundred or more, what will be the results of that? A crate of Tesco Viagra for whoever can come up with the most surprising yet likely consequence of mass super-longevity.

Doctor Zero:

ObamaCare is the most powerful job-killing force unleashed against our economy in decades. It dramatically increases the cost of labor, and applies huge fines against companies that resist its mandates. Companies such as Caterpillar, John Deere, Prudential, and AT&T responded by announcing thousands of layoffs. This is a perfectly rational reaction to a bill that dramatically increases the cost of labor, especially when the legislation keeps mutating and producing expensive new horrors, such as the nationalization of student loans that wiped out thousands of jobs at Sallie Mae.

I sort of get much of that, although I would definitely have to follow the second link to see how ObamaCare is nationalising student loans, and to find out what on earth "Sallie Mae" might be. But, speaking more generally about this huge furore, I have a real problem with ObamaCare. Not in the sense that it is causing me to lay off hundreds of my employees, but in the sense that I am finding the arguments about it very hard to follow. Mountains of verbiage have already been written about ObamaCare and many more will follow. But I am afraid I missed the early bits, where the actual blow-by-blow damage that ObamaCare will unleash (is now unleashing) was itemised, briefly and punchily. Anti-ObamaCare writers tend now merely to allude to the assumed harm of it, rather than yet again itemising it. Much is made by critics of ObamaCare of the immense length and complexity of the relevant legislation, which it seems most US politicians have no more read right through than I have. But what, approximately speaking, does it all say?

I suspect I am not the only Brit who feels this way. Not that long ago, for instance, I heard those comedians on Mock The Week take it in turns to denounce Americans for not welcoming ObamaCare, and I knew they were talking out of their smug and self-satisfied arses (especially that little bald one who is smug self-satisfaction personified, if you don't happen to agree with something he is saying). Death panels? No. It's free healthcare for those who can't now afford it, you obese God-frazzled morons. What could possibly be wrong with that?!? Do you all want to die prematurely of terrible diseases and accidents that the British health service cures immediately at no cost?

But had I been on the panel, trying to resist (in particular) the Smug Dwarf's relentless leftery, I don't think I would have done a very good job. Most Brits watching, if my reaction is anything to go by, either agreed that all American opponents of ObamaCare are indeed morons, or that they perhaps have their reasons for not wanting it, but that these reasons will for ever be a mystery, probably involving some Americanised version of God.

So, commenters, please fill me (us) in. Please help us Brits - this particular Brit especially - to wrap our brains around ObamaCare. What, briefly, are those "mandates" that Doctor Zero refers to? How are student loans involved? And what else is being inflicted?

I would like to be able to concoct a further posting entitled something like: "A brief but pretty much complete explanation for confused Brits of why ObamaCare is a really bad idea and why so many Americans are right to hate it". And maybe, with your help, I will be able to do that.

One particular request. What concerns me is not to dig deeply into any particular harm that ObamaCare is doing. What I seek is completeness, combined with as much brevity as can be contrived. In the event that I do manage that follow-up posting that I can now only dream of, I want an American to be able to wizz through it, and say something like: "Yup, that about covers it. That's why so many of us hate it. I actually don't think number three is quite as bad as your short description of it implies, and I think number five is far worse even than you say. But, nothing major is missing from that list. Good job."

Maybe such a posting already exists, and I need only read it, and link to it.

Or maybe (I've just been following the links in the quote above, just to check that they work), my question is wrong. Maybe what I really want is a brief guillotine-blow-by-guillotine-blow guide to the entire Obama legislative "achievement", of which "ObamaCare" is only a part.

Anyway, whatever help anyone can offer along these approximate lines would be most welcome.

Can anyone offer any confirmation or contradiction of this observation, which is one of the comments on this posting about the rights and wrongs of smoking bans:

One of the things I learned when going through insurance sales training was that life and health insurance companies do not take exposure to secondhand smoke into account at all when determining risk categories. Insurance companies have all sorts of super-detailed actuarial information for use in setting rates. None of this information shows any health risks associated with secondhand smoke.

I am actually a bit surprised if that is true. One of the reasons why there has been so much talk of "passive smoking" is that it makes such perfect sense that if smoking is very bad for you, smoke near you day after day would also be somewhat bad for you. This suggests no badness for you at all. Can that really be right?

This comment concerns the USA. I assume there is no particular arrangement there which actually forbids "passive smoking" being inquired into by insurance companies.

LATER: As I should have included in the above, the author of that comment also has a blog.

I used to be a matron but as a patient I was treated worse than an animal. That was one of the headlines in yesterday's Sun. I do mean headlines, too. Jean Emblen's account was not top story but it was right up there among the footballers' wives. The editor of the Sun thought the readers would go for a story criticising nurses.

When did that happen? When I was a kid everyone was all soppy over nurses. It was considered quite shocking when a 1970s BBC soap opera called, tellingly, Angels depicted them as less than angelic.

We can't simply attribute this loss in esteem to the NHS. For round about the first half century of the existence of the National Health Service, nurses continued to be loved by all (it is only fair to say there are plenty of people, including those with recent experience of the NHS, for whom that has not changed; a huge amount depends on the individual hospital). So what has caused it? Does it reflect reality - are nurses really not as good as they used to be - or is it just fashion, a last ripple from the wave that knocked politicians over in the 1960s and teachers in the 1970s?

One possible explanation is that nurses are no longer paid that badly. There is nothing like low pay for calling forth guilty affection. Once the pay improved people no longer felt they needed to make up the shortfall with love.

However my impression is that the downward trend on the nurse popularity graph best tracks the increasing moves for the nursing profession to become more... professional. It's all "nurse practitioners" and degrees these days, and being more like doctors. No one ever had any trouble hating doctors, once the thermometer went down. People think that nurses these days think themselves too grand to change a bedpan.

Is this charge fair? Lucky me: I don't know. You tell me. All I can say is that it would not surprise me if there was a tendency for both human contact and the dirty but necessary jobs to be de-emphasised in modern nursing, and maybe I can find a way to blame the NHS after all. It is what I would expect to see from an old command economy. Compared to most command economies, the NHS in its early years had a huge amount going for it: a sense of mission was in its collective blood. But as time as passed the blood has thinned, or done something else old and dry and sad that I lack the medical knowledge to build into my metaphor. (The blood of armies dries up in the same way, but then a war comes along and de-mummifies them. Or replaces them. ) An old and somewhat ossified organisation instinctively prefers its staff to have measurable, academic and relatively high status skills rather than unquantifiable, physical and and traditionally low-status ones. But no one was ever loved for academic skills.

In the US, I learn, there has been a similar move from plain old nurses to nurse practitioners, but if the American equivalent of the Sun has started on the anti-nurse stories then I had not heard about it. This might be because US healthcare is, for the moment, not provided by the taxpayer. At least, a lot of it is, but not so visibly. My impression is that the extravagant love for nurses in the past and the extravagant annoyance with them now are both British phenomena.

A simply astonishing story from Alex Deane of Big Brother Watch: Smokers harrassed - with the encouragement of a school, and the co-operation of the police

On one perfectly reasonable reading of this story, "harrassed" is too mild a term. The correct word is "assaulted". I am no lawyer, but this looks to me as though it could involve multiple crimes - not just assault but also theft, and encouraging minors to commit assault and theft, if those are separate charges.

Outrageously the fagins here are not underworld characters but the Hundred of Hoo Comprehensive School in Medway (cute name, shame about the Special Measures), Kent Police, and something called "A Better Medway", described as "a joint initiative between the council and NHS Medway that encourages healthy living". "A Better Medway" part-funded the project, paying for filming equipment.

According to This is Kent, quoted by Alex Deane, the first few filmed attacks featured stooges and then they went on to "other people". I can't quite figure out whether or not the"other people" were members of the public who participated voluntarily as "extras" in an admitted fiction or whether they were real victims. My spidey-senses are a-tingle with the suspicion of some hasty re-writing of history after hostile attention; the comments to the sycophantic This is Kent piece are gratifyingly hostile. Also, the video admiringly profiled in Kent Online has now been removed by the user.

Irrespective of whether the videos are real or fake, videos that show apparent assaults in an approving manner incite others to commit similar assaults on smokers for real.

Indeed, they incite others to commit any other type of assault that the attackers may deem is good for the victims. The law, of course, forbids people to rip the veils off Muslim women who go about swathed - though at least as many people the veils offensive as find cigarettes offensive, and there is a reasonable case to be made - as reasonable as the case for doing good by force being made by the Ciggy Busters - that having their veils ripped off might do them good in the end and help them kick the masking habit. The law also forbids incitement to such assaults. If I were to make a "burqa busters" video the police would be round in an instant, and the defence that everyone involved was only acting would cut no ice with the Crown Prosecution Service.

Why should not that law also apply in this case?

... so I would advise anyone of an even vaguely libertarian inclination who gets stressed easily to read no further.

This article by Felicity Lawrence, Nanny does know best, Andrew Lansley, displays the ideology of the Nanny State in an unusually pure and unapologetic form:

Can it be too that Lansley is not aware of all the literature about how individuals' "free choices" are shaped by marketing and advertising. Perhaps we should recommend some urgent remedial reading for his homework, starting with...

The Andrew Lansley for whom Felicity Lawrence is setting homework is the Secretary of State for Health. The fact that he consents to hold this position means that he too must be something of a statist, but nonetheless he recently said, "If we are constantly lecturing people and trying to tell them what to do, we will actually find that we undermine and are counterproductive in the results that we achieve." It is a measure of how deeply Nanny's rule has been accepted that even this pragmatic, rather than principled, objection to government health lectures aroused fury.

Now I am usually harsh in my criticism of the National Health Service and indeed I wish to see it abolished entirely... but credit where credit is due. This was a very, er, uplifting example of 'Enterprise Thinking' by the NHS.

Carry on, Doctor!

I am going to say naathing specific about this, but the best response to this sort of thing is for everyone to immediately make private copies of all the associated information and stash them somewhere.

The Internet is Forever, but some folk are just too dense to figure it out.

A quick entry from me: take a look at this item via Reason TV spot about the monster of a healthcare bill that passed at the weekend in the US. (I love the Incredibles-style music in it, by the way). As Gillespie puts it, the government underestimates of spending on things like health is not a bug, but a feature. The message that comes through, of course, is one that applies to governments worldwide. Do we honestly expect that politicians who are capable of the sort of accounting tricks surrounding building projects like the Olympic Games in London can be trusted to give accurate, costed predictions on things like healthcare spending, or education, or defence procurement?

Bear that in mind as we read the latest performance by UK finance minister, Alistair Darling, today.

"Congratulations, Democrats. Beginning now, you own the health-care system in America. Every hiccup. Every complaint. Every long line. All yours."

- Kathryn Jean-Lopez.

I wish that were true. Here in Britain, where filthy wards in NHS hospitals, for example, have been a regular staple of the UK newspapers, the standard response is usually to demand even more money, more rules, and so forth. If you challenge the model of tax-funded healthcare free at the point of delivery, then you are political dogfood. And Mr Obama and his allies know that. As Mark Steyn has been putting since before Mr Obama's election, Mr O. is counting on what the UK politician Sir Keith Joseph once dubbed the "ratchet effect": ratchet socialism a little more, and make it harder and harder for anyone to push back.

Of course, sometimes this argument will be proven wrong. I do get the impression that a lot of Americans, including those middle-of-the-road voters who gave Obama a chance in 2008, are now very alarmed at the huge debt that his administration seems to be encouraging. So it may be that Mr Obama is a one-term POTUS. But his legacy might take a lot longer to reverse.

On a more philosophical line, here is what I wrote a while back about the bogus nature of healthcare "rights".

Policy Exchange has just published a "research note" purporting to show that the tax on cigarettes in the UK should be increased, and that "that every single cigarette smoked costs the country money - 6.5 pence each time someone lights up."

If you read the paper [pdf], you will find it is an astonishingly dodgy dossier. Here is how the figure is made up:

Taxation of tobacco contributes £10 billion to HM Treasury annually; however, we calculate that the costs to society from smoking are much greater at £13.74 billion. Every cigarette smoked is costing us money. These societal costs comprise not only the cost of treating smokers on the NHS (£2.7 billion) but also the loss in productivity from smoking breaks (£2.9 billion) and increased absenteeism (£2.5 billion); the cost of cleaning up cigarette butts (£342 million); the cost of smoking related house fires (£507 million), and also the loss in economic output from the deaths of smokers (£4.1 billion) and passive smokers (£713 million).

The notion of "cost to society" is a pretty weird one.

Leave that aside for a moment. Add up costs and revenues to the state, which might be one semi-logical way of determining whether the smoking in some sense "runs a deficit", and using Policy Exchange's own figures you get a big surplus for the Treasury. Even if you assume all house fire costs are borne by the state and not partially by insurers and householders, and there are no errors in the headline figures, then you can only get to £3,549 million. (Have you noticed how public policy research generally involves implausible numbers of significant digits, and at the same time utter absence of error estimates?) On that basis smokers are contributing roughly £6Bn annually towards public spending.

But what are we to make of the suggestion that counting "lost output" is meaningful? To my mind the idea that an economic aggregate represents a collective wealth that may be politically attributed and redistributed is repulsive even if it is coherent (which I doubt). The state's royal We, which Policy Echange is channelling here, may in turn choose to impersonate you and me and everyone else, but it only controls the taxed margin of other's outputs. Output and taxation are apples and oranges. It is meaningless to add them together. Unless you want (or deserve) a punch.

And even were it not meaningless, there's an accounting fraud here. If you count output putatively lost to smoking, then you must also count the gains. There is the output of the tobacco industry, distribution and retailing in the UK to consider. Imperial Tobacco alone had a gross profit for the year ending September 2009 of approximately £5.3 billion. The CTC industry consists of tens of thousands of small shops. Honest research, however dubious its theoretical basis, would attempt to estimate the value-added, too. It would also be clear - without referring to a paper cited in the footnotes we cannot tell whether the cost-of-illness measure used in determining those "lost outputs" also includes the gains to third parties in pensions unpaid and public services unused by people dying early. If you are going to add apples and oranges, you should also tell us explicitly whether you have subtracted pears.

But what set me off on this chase was actually just one of those headline figures. Most of the margin of costs over gains in this strange sum is covered by the £2.9 billion allocated to the "output lost to cigarette breaks". How do they know? "[A] number of studies have investigated workers taking breaks in order to smoke, and have tried to quantify this time at between £915 million and £3.2 billion per annum." Hm.

Read through to p13, and you discover that the number of studies was... two. Er, no. It was one... Or some sort of strange interpolative hybrid... I cannot decide. Make your own mind up:

McGuire et al. estimated that £915 million annually is lost on the basis that average smokers spend tenminutes a day smoking, while light smokers and part-time workers would use approximately half of this time. The Royal College of Physicians (RCP) used similar initial assumptions on average smoking time to calculate that some £2.6 billion would be saved through the introduction of smoke-free legislation. Using McGuire’s estimates of 5.2 million working smokers, with the RCP’s estimates of ten minutes a day smoking reveals an intermediary figure of £2.9 billion.

I think that is 'intermediary' in the sense that a magician is an intermediary between a rabbit and a hat.

However they get there, if someone thinks that cigarette breaks ought to be a determining factor in public policy, rather than a matter for negotiation between employer and employee, then I suggest that it would be a good idea if they are kept as far as possible from the levers of power. This lot are said to be influential on the presumptively incoming Cameron team. Oh dear.

The new enemy is salt. Here is an interesting example at an early stage of how calls for legislation leap from study to implementation. A survey has looked at salt.

In the paper, Kirsten Bibbins-Domingo and colleagues, from the University of California, San Francisco, USA, undertook a computer simulation showing the effects of population wide reductions of dietary salt intakes in all adults aged 35 to 85 years in the USA. Reducing dietary salt intake by 3 g per day (1200mg less sodium per day) could result in 60,000 to 120,000 fewer cases of heart disease , 32,000 to 66,000 fewer strokes and 54,000 to 100,000 fewer heart attacks.

Just one study and even then, dietary recommendations are notorious for lack of reliability. But the recommendation follows like day after night:

A reduction in dietary salt of 3g per day, the authors went on to say, would have approximately the same effect on reducing cardiac events as a 50 % reduction in tobacco use, a 5% reduction in body mass index among obese adults or the use of statins to treat people at low or intermediate risk for CHD events. Furthermore, reducing dietary salt intakes by 3g per day would save $10 billion to $ 24 billion in annual health care costs

Precise, costed benefits that bear little resemblance to reality, but a comparison with the other devils of public health is utilised to define a 'collective benefit'. Thus the call for legislation by the European Society of Cardiology:

While individuals may use salt sparingly at home, around 75 % of the salt we eat is already in the food we buy. This, says the ESC, underlines the need for legislation to lay down guidelines. "The reality of international food production in Europe means that such public health initiatives need to be tackled on a European wide basis, rather than an individual country basis," said [Professor Frank] Ruschitzka.

Throw in a publicity week and the NGO for good measure:

Salt will again be on the agenda with World Salt Awareness Week 2010 , which runs from February 1- 7 (3). The week is being run by World Action on Salt and Health (WASH), a global group that works with governments to highlight the need for widespread introduction of population based salt reduction strategies

Add salt!

Helen Evans, who runs Nurses for Reform, a campaigning organisation dedicated to free-market options for healthcare in the UK, got to meet Conservative Party leader David Cameron a couple of weeks ago. The Daily Mirror [here, here and here] and the Daily Telegraph found out about the meeting and offered their own take on it.

Broadly, I agree that the proposals are in the right direction, although I have concerns about some of the tactics suggested and their formulation, which I deal with later. The bit that was not previously familiar to me was the idea that a barrier to entry should be at least lowered, by amending local planning rules to make it easier to open a new healthcare facility. I'm told the Conservative Party already favours this for schools, so the extension to clinics should not be difficult.

Having read the briefing document presented to the Leader of the Opposition, I disagree with one element of the strategy being proposed, specifically this passage: "the [National Health Service] NHS should be renamed the National Health SYSTEM and that under its auspices patients should benefit from a universal right to independent hospital care and treatment."

A "universal right" is something that a government could be justified in declaring war to defend, like "freedom from slavery" or freedom from the use of confessions extracted under torture in criminal trials. It could certainly be a pretext for new taxes, a new bureaucracy, more regulations, and the restriction of other "non-universal" rights. Sadly, this call for declaring that privately-provided healthcare is a right could become the very instrument for imposing regulations (such as US Medicare-style price controls, or French-style government control on where doctors can practise [link in French]) that violate patient and physician freedom. To give a specific example: could a private clinic be fined for not providing 24-hour accident and emergency access? I would expect a government agency to do just that. Meanwhile, of course, government facilities which operate "in the public interest" would be excused.

A second concern comes in a later paragraph: "health censorship must be outlawed and patients must be empowered with greater access to information." Outlawed? Must be empowered? By what agency, regulation, funded by what taxes or levies, with what powers of inspection and control?

These may seem like quibbles, but the law of intended consequences suggests that the wording of reforms can be as important as their spirit. Consider the US Constitution's First Amendment:

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

Does it say that Congress cannot give money to the Food and Drug Administration to hunt down anyone making claims about the alleged benefits to cancer patients of drinking grapefruit juice? No it does not. It means it, I think, but can I prove it to the US Supreme Court? Probably not.

It might be more boring to do, but the best way to remove censorship would be to revoke the clauses of those laws and regulations that allow it. As for "empowerment," if this comes from the government it will mean a Department of Truth in Advertising demand for a quarterly report from all private providers as to how they inform the public, with fines for not reaching a wide enough audience.

On the positive side, Nurses for Reform finds that the ownership by a government department of most of the UK's hospitals is a potential conflict of interest. There is the temptation to hide problems, to restrict information about alternative (often newer) treatments, the cozy relationship between the government employees in the NHS and those of the Department of Health who are supposed to watch them.

Dr Evans is therefore absolutely right to suggest the immediate transfer of ownership of NHS hospitals out of "public ownership," and she is also correct that the "Secretary of State for Health must no longer have any say over when or where hospitals are built, opened or closed."

On the issue of advertising, or freedom to communicate with the public in general, the major benefit would be that people could get an idea of which were the better brands (either cheapest, or best quality, or best balance between the two). If we think of how Aldi and Lidl can co-exist with ASDA, Tesco, Sainsbury, Waitrose and independent grocers, we can see how variety of branding can lead to beneficial competition: new treatments, more options and probably less queues.

Personally, I see no point whatsoever in delaying the reform of NHS funding: it merely prolongs unnecessary suffering and provides more opportunities for opponents of change to mobilise, like Gorbachev's "perestroika" versus the liquidation of the soviet system. Having little expectation of any progress under a new Conservative Party government this coming year, it would be a pleasant surprise if Dr Evans' proposals came to fruition. But at least no one can now claim that the case was not made.

[UPDATE: corrected link for Daily Telegraph article]

As FA Hayek pointed out many years ago in his masterpiece, The Constitution of Liberty, if healthcare is paid for out of general taxation and delivered free at the point of delivery, then in a world of scarce resources - and healthcare is always constrained at any time by the supply of doctors, drugs, etc - then such care must be rationed by some form of bureaucratic/political rule. As Dr Hayek presciently warned at the time (1950s), any such rationing will put doctors, politicians or other people in power in the position of a god, in having the decision about who gets treatment for what, or whether life A is more "worth saving" than life B. For example, one such utiltarian consideration might be that it is more "cost-efficient" to save the life of a young kid with his whole life ahead than an 90-year-old. That is what happens when socialised medicine is established. It transfers key powers to people in ways that raise disturbing issues of accountability and control.

Now a socialist might respond that it is still better for health care to be rationed by some rule they consider to be "fair" than by the supposed lottery of the market, although in fact, as I would respond, there is, due to the benefits of competition and entrepreneurship, far greater chance that all but the poorest will get better healthcare under a genuine free market in health than under the system of centralised, state-provided healthcare. Also, if the possession of a large fortune is partly a matter of luck, then luck, being blind, cannot be either just or unjust. It just is. Some folk have access to better dentists or whatever because they are richer. That may annoy someone who cannot afford the whitest teeth, but that is not proof of unfairness, as such. To prove it, one would have to construct an ethical theory that says that humans have an apriori claim on their fellows to receive a certain amount of healthcare/watever as a "right". But such "rights" are abuses of the term: one cannot have a right to X that requires that another be forced to provide X, such as forcing folk to train as doctors to serve the sick, and so on.

I was led to think about the latest twist in the US healthcare debate by reading an article by the US writer, Nat Hentoff. He totally bypasses the issue of how to deal with scarcity under socialism in ways that are fair. He rightly worries about the sort of brutal choices that state-rationed healthcare provides, but then does not see that any system of state-run, and socialised medicine, makes such issues of rationing unavoidable. Rationing by such tests of age, "need" and so forth is a feature of socialised medicine, not a bug.

(H/T: The Corner).

According to Radio Free Europe,

Rovshan Nasirli, a young Eurovision [song contest] fan living in the Azerbaijani capital Baku, says he was summoned this week to the country's National Security Ministry -- to explain why he had voted for Armenia during this year's competition in May.

"They wanted an explanation for why I voted for Armenia. They said it was a matter of national security,” Nasirli said. “They were trying to put psychological pressure on me, saying things like, 'You have no sense of ethnic pride. How come you voted for Armenia?' They made me write out an explanation, and then they let me go."

(Hat tip to Gene of Harry's Place and Robert Wright of the The Daily Dish.)

In other news, Health Secretary Andy Burnham has accused Tory MEP Daniel Hannan who said on US TV that the US healthcare system was generally better than the NHS of being unpatriotic. Senior figures from both the Labour and Conservative parties have denounced Hannan and demanded an explanation.

Here is a story suggesting that employees might use the outbreak of swine flu as an excuse to extend their summer holidays. I guess this is inevitable, given that some people will try anything on, although in a recession, it does seem rather dumb for staff to risk a disciplinary warning or outright sacking to lie about their health in this way.

Talking of holidays, in a few days' time, yours truly is heading off to Normandy, northern France, for a week's holiday with family, including, I am very happy to say, my father, who has recently made a recovery from a serious illness.

There will be lots of Calvados consumed. My blogging is likely to be slow next week.

I had to read the headline twice. Then I read the article twice. I still don't get it.

What I first thought it said was,

International development minister urges firms to pool HIV patients

Weird, obscure line, but no weirder than a lot of things that come out of the international development department, and potentially a lot more sensible. I suppose it might make sense for the big southern African companies, especially, to combine their employee health programmes. But if it were more effective, wouldn't they already be doing it? Wouldn't the South African government, in any case (now they have got rid of that barking health minister), be the one doing the urging?

What it actually said was,

International development minister urges firms to pool HIV patents

Now that makes a lot less sense. It is quite up to the standard we have come to expect from DFID, a real candidate for economic illiteracy of the day.

[Mike Foster MP] wants companies to contribute to a "patent pool", which the international drug-purchasing facility, Unitaid – set up by a number of donor countries, including the UK – is trying to establish.

"While it is absolutely vital that we work to reduce the human cost of HIV by focusing our efforts on preventing new infections, we must also face up to the stark reality of the treatment challenge we face. The pharmaceutical industry has an opportunity to act now to help prevent future human catastrophe. It is time for them to state their clear commitment to make new HIV medicines affordable to those who need them most."

According to the all-party report, if HIV patents are put in a pool, generics companies – which make the cheap combinations now used in Africa – will be permitted to make low-cost copies of newer drugs and devise new combinations in a single pill, which is important for people living in poverty.

What can this possibly mean? There's no real explanation here of how a 'patent pool' might work. It sounds like pharmaceuticals companies are being offered to the opportunity to swap an unstable legal monopoly for an internationally approved cartel, and to pose as humanitarians while doing so. Would that really lower the cost of HIV medication, and improve its effectiveness in general? It is far from obvious why that should be the case. Would medicines that are both cheaper and more effective be permitted to flow back to Western countries? I doubt it.

Which points up the weirdness of the whole exercise. In order to be economic in Western countries, HIV medicines have to be very expensive to buy there. That is not just because they are expensive to develop, but because the absolute numbers of people who need them are small. In the West, just as in poorer parts of the world almost no individual can afford to pay for their own treatment. So there's a different sort of cartel effect maintaining the oligopolistic market. Government protects the patentees; and government subsidies end up paying for the consequences.

You don't have to be a believer in the efficacy of beetroot and garlic as anti-virals to notice that the difference between the scale of the epidemic in parts of Africa and the richest parts of the world is not a consequence of the availabilty of drugs - or at least not the availabilty of anti-retrovirals. We have fewer people getting the disease in the first place. But we have fewer people with all sorts of infectious diseases. Malaria and dengue are not more treatable than they were when they were endemic in Europe, and the US, less than a century ago. The difference is better living conditions that everyone will work for if they have the chance.

Patent pooling, it seems to me, is no better than patent farming, in that it seeks to exploit artifical restrictions on innovation that just happen to be there for the benefit of a restricted interest group. It is an exercise in dinosaur husbandry, with little real relevance to improving the lives of us mammals. A reconfiguration of corporarate welfare, with its concentration on subsidising treatment of a particular disease, and bureaucrats swapping targets with bureaucrats, is a distraction from the less collectively 'manageable' task of avoiding the spread of infection, which is the invisible part of the virtuous circle of the people who are not sick getting better general health and more comfortable lives. That isn't going to come from government drug programmes. I suspect it might come from "people living in poverty" having a bit more access to the non-patent and never-patent - but still restricted - technologies of choosing their own priorities and exploiting their own comparative advantages.

A friend (you know who you are) informed me that the Economist magazine was "getting better", for example it had a lead story denouncing government debt. Of course this was the government debt that the Economist had urged government to take on (to bail out banks and other corporations and then to "stimulate the economy"), but it was good that it was denouncing the debt.

So I decided to give the Economist a chance and read their article ("editorial") on American health care. After drinking a bottle of cider to recover (what a nice new bottle shape Henry Westons have produced) these on my thoughts upon that article:

It starts with a lie - Barack Obama was elected in part because of his plans to "fix American health care".

In reality it was Hillary Clinton who stressed her health care plan during the Democrat primary campaign (Barack Obama just attacked her plan and made vague noises about his own). And during the general election campaign it was John McCain who came out with a specific health care plan, allowing people to buy health cover over State lines and switching the tax deductibility of buying health care cover from employers to individuals, whereas Barack Obama just (dishonestly) attacked the McCain plan and was vague about his own.

Barack Obama was elected President of the United States for several reasons (white guilt about mistreatment of black people, the total ideological devotion of the education system and the mainstream media, the insane judgement by John McCain to back the bank bailouts...), but stressing some specific plan to "fix American health care" was not one of them.

Still the Economist does not let the truth stand in the way of its articles, so it then outlines its position.

"Starting from scratch their would be a good case for a mostly publicly funded system" even for a magazine "as economically liberal as this one".

This is a standard Economist trick - propose some form of statism and defend it by saying even we, the free market ones (the European meaning of "economically liberal"), are in favour of this statism. Of course the Economist never actually produces any evidence that it is pro-free market - but it is at trick it has been using since Walter Bagehot (the second editor, the first editor actually was a free market man) so I suppose it is a lie hollowed by history.

However, we are not "starting from scratch" so the Economist reluctantly concedes that some little freedom (about half of American health care is already government funded and the rest is tied up in regulations - facts that the Economist avoids, see later) must remain for awhile - it suggests five years.

The first step, according to the Economist, must be to make everyone buy health cover by statute with the poor being subsidized by the government "as is done already in Massachusetts". That the Massachusetts "reform", introduced by Governor Romney, has turned out rather badly is a fact that the Economist article neglects to mention - even though the percentage of "uncovered" in Massachusetts was very low compared to other States so if this "reform" was going to work anywhere it would have worked in Massachusetts.

Of course, says the Economist, insurance companies must not be allowed to exploit government subsides for the poor. They must provide "affordable" plans (no prices are suggested - it is all left vague), and must not be allowed to exclude the old or the already sick from their plans.

In short - lower prices and covering high cost groups. As (contrary to the propaganda) American health insurance is already not a high profit margin industry, these "reforms" should be enough to bankrupt the insurance companies - even before the five year period comes to an end and the government plan the Economist suggests takes over.

However, just in case the private health companies are not bankrupted, the Economist also suggests that "anti trust" be introduced into the area. As the late Ayn Rand (and so many others) have pointed out, there are no clear principles (things that can be clearly defined in advance) in "anti trust" or "competition policy" in fact the whole thing is an excuse for arbitrary power for the government working with the politically connected. But the Economist either does not know, or does not care, about this point - and loves "anti trust".

Almost needless to say the Economist does not mean getting rid of regulation (such as the licensing regulations for doctors - exposed as a racket by Milton Friedman 60 years ago,. or the F.D.A. and its price inflating and new medical adavance preventing "health and safety" regulations). On the contrary the Economist means yet more regulations on top of all the ones that exist already.

Of course the Economist does not mention the real problems of American health care. Neither the ones I have mentioned already or the others. It does not mention how Medicare and Medicaid and SCHIP have vastly inflated prices (just as the subsidies for higher education have had the effect of inflating tuition fees over the decades) or how the vast web of Federal and State regulations prevent much of a real "market" in health care at all, or how American hospitals are forced to provide free ER cover in spite of the fact that an expensive (although terrible - rather like some British NHS hospitals in fact)) network of government "county hospitals" already exists, or... But of course it does not - because it wishes to add subsidy schemes and regulations, not get rid of them.

Lastly I must mention one other policy suggestion of the Economist.

It suggests abolishing the tax deductibility of employer health care provision - not to switch the tax deductibility to individuals to buy health cover themselves, but because the lower taxes "cost the government" lots of money (all money belongs to the government it seems - although it should kindly allow people to buy toys, not important things like health care).

This massive tax increase is something that even Barack Obama is wary about talking about (although it would only pay for a fraction of the costs of his plans), but have no fear the Economist will hold his hand - it is all about "The Renewal of America" to quote one of the most vile magazine front covers I have ever seen.

As for the Obama plan of one and half TRILLION Dollars (according the Congressional budget office in reality it will grow to far more than that, entitlement programs always do) that will only cover a fraction of the people he says it will. Well if the Economist is truly "economically liberal" it will help lead the fight against this evil - but judging by this article...

Of course it could be claimed that I am being unfair - that the American coverage of the Economist is the worst element in the magazine. Although I have not noticed the Economist denouncing the move to income support schemes and government health cover in India (in spite of the ever growing fiscal deficit) in India - or indeed in any country.

Be that as it may, it is the United States where the alternative of a free market current affairs magazine is most needed - an alternative to the statism of Time and Newsweek and the rest of the mainstream media. And the Economist utterly fails to provide this alternative.

So, friend (again you know who you are), do not ask me to give the Economist a chance again - to do so is not good for my liver.

All the existing [medical care] schemes, including the present American mixed corporatist/socialist model, represent a transfer from the young and healthy to the old and chronically sick (and to the medical cartel, of course). The way it's used in practice, the phrase "having health insurance" means having the right to place oneself on the receiving end of these transfers. No honest discussion of the situation is possible until the entirely false and misleading concept of "health insurance" is dropped.

- Commenter Ivan

Millions and millions of Americans support Obama's desire to even more massively intervene in the market for medical care than the US state already does. And of course Obama's moves are just the opening salvo in a desire to eventually end up with fully socialist healthcare, along the lines of Britain's ghastly National Health Service, which has intermittently tried to kill me over the years.

I have tried pointing Americans at the British example to show them what an appalling idea it is to have the state directing any industry, let alone medical care. But alas it is very hard to overcome that special kind of insular American optimism that does not think what happens in another advanced first world nation can teach them anything, because in the USA things will be different.

Well yes, it will be different... in that the control obsessed Obama's of this world will find new, innovative and oh so wholesome American ways to end up with a third rate health care system much like Britain has today.

This might be a good time for Americans to invest their money in Swiss medical clinics as I suspect in the coming years expatriated medical care will be a serious growth industry... plus it has the added benefit of getting your money out of the USA and US dollar.

"It is rare that governments successfully cut costs by first spending more money."

- Tyler Cowen. He was talking about Mr Obama's plans to socialise US medicine. I am sure that when the NHS was set up here in the UK, the advocates of said argued that it would "save" money in the long run. Meanwhile, here is some useful commentary from Arnold Kling.

Oh dear... seems the EU is being beastly to us again.

I wonder if I can buy brain futures or it is just pork bellies?

As here, for instance. Via Liberty Alone, I learn of a remarkable new recruit to the ranks of those who are panicking about the pandemic. Yes, it is none other than the US Libertarian Party. They have just issued a press release reprimanding the US state for not being statist enough about this medically trivial event, which is in any case only being plugged up in order to divert attention away from other governmental blunders and to excuse further governmental usurpations, despite all the blunders. Why can't they see that? Or don't they care about such things any more? One can imagine a true "pandemic" that really did need measures like draconian border controls to defend against it (sickness is the health of the state), but if this trivial flu variant is it, then, to put it mildly, an explanation to that effect should have been added.

The UK Libertarian Party should treat this pandemic pandering as an awful warning of what happens to small parties - parties "of principle" - who become gripped by the desire to pile up lots of mere votes, and who forget what they were started to accomplish. First they pick a regular politician to lead them, and he then picks more regular politicians to help him, and before you know it, they are behaving like regular politicians.

But it is more fundamental than that, I fear. Start a political party, and before you know it, it is behaving like a political party. LPUK beware.

One of the beauties of the blogs, I find, is that the link-rich medium enables you to fly off on all manner of tangents and think through issues that might otherwise not arise or come into one's head so fast. The recent posting on Samizdata about Ayn Rand - which seemed to trigger a rather bad-tempered and long comment thread - led me to a site put together by this fellow, who wrote a rather rude comment about Rand - nothing very new there - and I decided to take a look at his own blog. This is what I found. James Hooper is a socialist who once, apparently, was a "teenage libertarian". I guess one does not come across many libertarians who imbibed their Hayeks, Rands, or Rothbards and later decided that what the world really needed, in fact, was lots of collectivism, progressive taxes, and the rest of it. I suppose John Gray fits a similar path, although as Brian Micklethwait has noted, Gray is consistent in his pathological gloomsterism.

Anway, back to James Hooper. In his latest post, he writes this:

"Healthcare is an area where the market has proven utterly inadequate, indeed it’s hard to find any pure market approach outside of the Third World (company insurance is decided by CEO boards and unions, state insurance by governments), although I’d imagine that those who have died in America owing to lack of insurance didn’t rate the distinction that much."

Now it seems to me that there is something very wrong about this statement. Human beings require health care, just as they require food. Now, in the West, food is - mostly - produced by the free market, although as a libertarian I'd be the first to note that there is a lot of regulatory control over food production (ask any farmer, slaughterhouse owner, food retailer, etc) and a lot of subsidies, such as under the EU's Common Agricultural Policy. But by and large, the process by which we get our fruit, veg, meat and carbs is via capitalism. This seems to work tolerably well. It could work a heck of a lot better, of course, but in general, you don't see people, even the very poor, starving in the streets as happened under communism in Russia (1930s) or Mao's China (1950s, 60s), or see the sort of state-induced disasters in Zimbabwe, etc. So clearly, something as basic as food seems to work best when left to the market.

So what is so different about health care that it can only - according to various statists, including many right Tories - be provided by a mixture of private/public operations or even, only by state monopolies, such as the UK's National Health Service? For sure, some people, such as the very poor, will not be able to afford all the healthcare they want, but then the same issue applies to very poor people who cannot get all the food or housing that they want. Their problem is poverty, not something peculiar about food or housing. I understand that healthcare purchases tend to be less frequent than purchases of food; there may be inefficiencies or supply-demand issues that perhaps don't let a market in health care function as well as in say, baked beans. But even so, for a person to state as a bald fact that a market in health care does not work seems, well, to be a case of ideology trumping experience and elementary logic. This article by Ronald Bailey lays out a good argument for a free market in health.

Of course, if, like Marx, Mr Hooper believes that a socialist society will be based on the "From each according to his abilities, to each according to his needs", then that of course begs all kind of momentous questions of interest to defenders of liberty and prosperity. As I have pointed out before, if you say, for example, that I have a "right" to "free" healthcare, what that really means, in practice, is that I have a right to coerce someone who is able to work as a doctor/nurse/lab technician to give me what I want. In short, the Marxian "from each according to his abilities" presumably means that the state must have the power to decide what are the "abilities" that Johnathan Pearce, or James Hooper, etc, actually have, and then have the power to harness those abilities to fullfill the needs, as the state has defined them. In short, the Marxian formulation requires conscription of abilities.

There is a word for this state of affairs. It is called totalitarianism.

This story is bizarre: China is ordering folk to smoke to boost the economy? Maybe the Chinese authorities figure that with air pollution already so bad, what could be any worse?

It goes without saying that being a good liberal that I am, I consider it as outrageous for a government to encourage smoking as to use invasions of property rights and censorship of things like adverts to stop it. This sort of issue cuts both ways. What next: forcing folk to get hammered every evening?

What is the worst case scenario for swine flu cases in the United States? About 1,700.

This is not a pandemic, and the ballet of institutional panic in government combined irresponsible media coverage over the last few days has been instrumental in ticking public health as another area where contemporary alarmism, fanned by governments, signposts higher mortality when a crisis finally arrives.

Reported by Lucy Bannerman in today's Times:

Fire kills child, 3, and parents as police prevent neighbours from trying to rescue them

A pregnant woman, her husband and their three-year-old son were killed in a house fire early yesterday as police who arrived before the fire brigade prevented neighbours from trying to save them. The woman screamed: “Please save my kids” from a bedroom window and neighbours tried to help but were beaten back by flames and were told by police not to attempt a rescue.

By the time firefighters got into the house in Doncaster, Michelle Colly, 25, her husband, Mark, 29, and son, Louis, 3, were dead. Their daughter, Sophie, 5, was taken to hospital and believed to be critically ill.

Davey Davis, 38, a friend of the family, said: “It was the most harrowing thing I have ever witnessed. Michelle was at the bedroom window yelling, ‘Please save my kids’ and we wanted to help but the police were pushing us back and not allowing us near. We were willing to risk our lives to save those kiddies but the police wouldn’t let us.

“Tempers were running very high, particularly with the women who were there, but the police were just saying we have to wait for the fire brigade because of health and safety.

“There were four or five police officers. They were here before the fire brigade. We heard the sirens and we came across to help but they wouldn’t let us.

“I thought the police were there to protect lives. At one time they would have have gone inside themselves to try and rescue them.

“When a family is burning to death in front of your eyes, rules should go out of the window – especially with kids. Everybody wanted to try and help.”

In a previous post about loss of nerve in our public services I said, referring to instances in which firemen and policemen had "broken procedure" to save life, that despite their personal courage "institutional gutlessness surrounded them, was embarrassed by them, and will kill off their like eventually. Poisoned soil does not long give forth good fruit."

Seems like the poison has worked its way well in. Note: I do not know whether the Colly family could have been saved had the attempt been made while Mrs Colly was still alive to scream for someone to save her kids. A spokeswoman for the South Yorkshire Police said, “The senior officer in charge is confident we handled this incident as professionally as possible. In a situation like that you could end up with more deceased bodies than you had in the first place.”

One of the lesser known sights of London is the Watts Memorial in Postman's Park. I gather it featured in the film Closer, starring Natalie Portman and Jude Law. No, I am not being funny, suddenly veering off into a travelogue in the middle of a post about the deaths of a family. I wish there were something to laugh about. The memorial was set up by a Victorian artist, George Frederick Watts, to commemorate those who died saving others. It consists of hand made plaques each bearing the name of a person who sacrificed his or her life and a brief citation. Very quaint they are, with their crowded lettering with the extra-large initial capitals and little swirly plant motifs and curlicues in the corners. Even the names are quaint, laboriously given in full. Police Constables Percy Edwin Cook, Edward George Brown Greenoff, Harold Frank Ricketts and George Stephen Funnell are among them. I wonder what PC Percy Edwin Cook, for instance, who perished when he "Voluntarily descended high tension chamber at Kensington to rescue two workmen overcome by poisonous gas" would have made of his successors in the South Yorkshire force.

Perhaps the police spokeswoman was right. Perhaps if health and safety had been less comprehensively assured and the Colly incident handled rather less professionally, we would have ended up with more than the three "deceased bodies" - no, make that four, when you count the child expected to be born in two weeks - that we did end up with. Still, more than four dead bodies is quite a lot and quite unlikely, I cannot help thinking. And I also cannot help thinking that there is more to this than just counting the dead under different scenarios. If the critically injured five year old girl does survive she will be burdened by more than just the fact that her family died. She will eventually have to know that those who might have answered her mother's last desperate appeal were held back on grounds of "health and safety." Not theirs, obviously.

UPDATE: Other accounts give the spelling of the family name as "Colley". They confirm that the police actively prevented rescue attempts.

FURTHER UPDATE: There is a thoughtful discussion in the comments regarding several moral and practical questions, and whether the press accounts are to be trusted. Quite possibly not. Yet I must add that if the South Yorkshire police are trying to convince me that they are not abdicating responsibility in order to follow rote "health and safety" procedure (as commenter "sjv" put it), then best not claim, as they appeared to in the Mail report linked to in the word "other", that the reason they will not tell us exactly how long elapsed between the arrival of the police and the arrival of the firemen is "'data protection' rules."

There is no stated national consensus that as a country we should substantially reduce overall masturbation, but such a reduction would benefit the health of many who wank – and those affected by passive wanking- the concept I invented a few sentences ago and am now treating as a genuine problem.

In 2006, 180,000 people died from pornographic-related causes. Wanking has a major impact on individual wanker's health: it causes cancers of the liver, bowel, breast, throat, mouth, larynx and oesophagus; it causes blindness, hairy palms, a pale pallor and insanity ...

Some point to the potential benefits of self-pleasuring, but these tend to be greatly overstated.

Despite its known harms, one-quarter of the adult population – about 10 million people – now wank above the recommended low-risk levels. I made this figure up but as the Chief Medical Officer I can cite myself because I am in a position of authority.

Here is a graph to illustrate how many people are killed by masturbation. It actually represents something completely different, possibly cat food sales, but I'm guessing that most of you are actually too stupid to actually look at the graph in any detail ...

- some Unenlightened Commentary sadly not actually supplied by Sir Liam Donaldson (with thanks to Obnoxio the Clown)

The blogger Slugger O'Toole expresses a very sensible view, in my opinion, about the recent case of a NHS nurse who was disciplined for offering to pray for a patient. I am all in favour of the separation of church and state, but then would reflect that this case shows just what happens when hospitals are part of the state and not part of the non-state sector, where they can be run by secular or religious groups without such issues arising. If a hospital is run by a church or has an endowment froma religiously-minded gazillionaire, and staff want to pray with its patients and the patients are okay with that, what exactly is the problem? Many UK hospitals, as their names often suggest - such as St Thomas's Hospital in London - were founded by churches and religious orders. For all that I am not a religious person, I can greatly admire the spirit of compassion that motivated many religious believers to work in or endow hospitals with funds. Many of Britain's greatest hospitals were started by churches and their history goes back hundreds of years.

This is wonderful, funny and true.

Via Radley Balko.

More support comes from the medical profession that regular, moderate intakes of red wine is good for health. (Via this blog).

This makes me happy.

Random link-chasing brought me here. "Leg-iron" writes:

I have a pack of tobacco with no hideous picture. Instead it has a phone number and the words:

Choose freedom. We'll help you get help to stop smoking.

Freedom? Really? That would be nice. I don't have the freedom to smoke in a bar, at a bus stop, bus station or on the open platform of a railway station.

There is more, please do read it. I should explain for foreign readers that British cigarette packets must by law bear an anti-smoking slogan such as "smoking kills" or "smoking causes impotence" and often, these days, a repulsive picture showing the bad consequences of smoking. I do not smoke so I do not often need to look at these pictures, but nothing about their appearance repels me as much as the fact that our laws force people to publish material designed to humiliate themselves. Truly, that does repel me. I neither like nor dislike cigarette manufacturers or those who work for them as a category, but when I imagine whichever bureaucrat thinks up these rotating slogans sneeringly transmitting the latest one to some servile flack in a cigarette company along with orders to start the print run - then I feel a faint echo of the shame someone living in Mao's China must have felt at the sight of a wretch bearing a placard saying "I am an enemy of the people."

I scrolled down Leg-iron's blog and found another good post on the same topic:

On the first one I bought was one of those pictures that are supposed to terrify us into stopping smoking. This one shows a pair of eighty-year-old hands with the slogan 'Smoking causes ageing of the skin'.

Interesting. I was under the impression that ageing was the main cause of ageing of the skin.

After ruminating on the lameness of these propaganda efforts, Leg-iron writes that it is almost

...as if ASH have realised that, should we all give up smoking, they'd have nobody left to torment and they'd all be out of a job.

ASH refers to a body called "Action on Smoking and Health." It is a fake charity - in fact, I learn, it is the original fake charity - receiving just 2% of its money from voluntary contributions. The rest of its money is paid to it by the government. It exists in order to allow the government (I should say "the State" since it has been the tool of several successive governments of both major parties) to pretend that when enacting new forms of repression it is merely responding to popular demand; in other words, it pretends to be servant the better to be master. There are many such. Some call themselves charities, others "NGOs". As the EU Serf asked years ago, "I always thought that NGO meant Non Governmental Organisation. How come any of them get money from the state?" Some are funded by the British government, some by the European Union, although trying to to establish the extent, if any, to which the former category is not a subset of the latter, would not be a good use of anyone's time.

Devil's Kitchen is sick of fake charities. He has put forward a modest proposal, and has registered the domain name http://fakecharities.org/ in order to put it into practice. His co-blogger, "The Filthy Smoker" wrote about the staggering dishonesty and corruption that the existence of these shills brought to a Department of Health "consultation process" here.

All these lies and deceptions spread out and reinforce each other - until we come to a stage where someone can force someone else to publish the words "choose freedom" and feel no shame.

I suppose it is a sign of advancing years, and having lost some close friends to cancer or having been scared by a close relative's condition that the notion of a cure for the gremlin should weigh on my mind a bit more than it used to. (You are definitely getting old, Ed). I cannot help noticing, when reading Instapundit as I do every day that Glenn Reynolds has been putting up regular links to the growing use of nanotechnology in delivering cancer-busting chemicals to the body with incredible accuracy. Here's another one. The more accurate the delivery of the drug, so the reasoning goes, the fewer the unpleasant side-effects associated with things like chemo treatments, and the greater chances of beating the cancer. The steady trickle of news items and articles has yet to become a flood, but I have this sense that the flood may be pretty close.

When I read Engines of Creation by Eric Drexler back whenever it was, the idea of tiny nanobots being used to treat cancer was, then, still on the edge of what folk thought might be possible. There is a way to go yet but it is a mark of how certain stories get below the radar of current events that nano-medicine has crept up on us so quickly, rather as the internet did about 20-odd years ago.

Faster please!

These pictures are pretty cleverly done. (Via Andy Ross).

We are sometimes told by its defenders that the National Health Service is the envy of the world. Well, I wonder if all those countries yearning for socialised medicine are dreaming of this?

I used to visit the South of France as a kid and one day, walking down the beach in St Tropez, yours truly, then a pretty wet-behind-the-ears lad from Suffolk, espied a whole row of lovely French women lying on the beach with nary a stitch on. Mon dieu! After my silly childish embarrassment wore off, I thought nothing of it after a while.

It appears that for health and fashion reason, though, that the lovelies of Europe are covering up. One of the main factors may be a concern about skin cancer. Also, I notice that in France, a lot of the men and women's skin gets very lined and aged if they sit out a lot in the sun, so for reasons of vanity or beauty - depending on your point of view - it makes sense to cover up. I have to watch it in the sun as I am pretty fair-skinned.

I did sort of half wonder whether any of this story from France has something to do with the large Muslim immigrant population in the South of France that takes a dim view of baring any female flesh at all. It does make one wonder. I hope not.

Last night, flicking through the TV channels after watching Andy Murray get pulverised by Nadal, the muscle-bound Spaniard, in the tennis, I watched in bemused fascination as ITV and the BBC both devoted quite a lot of air time to celebrating - that word was used repeatedly - the 60th anniversary of the National Health Service. There has even been a church service, attended by Prince Charles and the Prime Minister, Gordon Brown, to mark the anniversary of Britain's monopoly provider of health care, an essentially socialist creation that is hardly emulated anywhere else in the world, and for good reason. None of the major objections to health care that is provided via tax and distributed "free" at the point of use were mentioned. Last night's stories gave no balancing comments from skeptics or opponents of the NHS to counter the general feel-good presentations.

At the Institute of Economic Affairs, here is a rather more sober treatment of the NHS. As the US writer PJ O'Rourke once warned his countrymen about socialised medical care, if you think US private sector healthcare is expensive, just wait until it is "free".

Here is a great new book to cheer libertarians as we draw close to the sixtieth anniversary of the National Health Service. Written by the director of Nurses for Reform, Dr. Helen Evans, and published by the Institute of Economic Affairs, ‘Sixty Years On: Who Cares for the NHS?’ not only shows that the country’s top 100 health opinion formers no longer actually believe in nationalised healthcare but, gloriously, this book fundamentally challenges the medical monopoly inherent in all health systems around the world.

Citing a huge array of free marketeers the work is awash with glorious quotes like this one from David Friedman:

Both barbers and physicians are licensed; both professions have for decades used licensing to keep their numbers down and their salaries up. Government regulation of barbers makes haircuts more expensive; one result, presumably, is that we have fewer haircuts and longer hair. Government regulation of physicians makes medical care more expensive; one result, presumably, is that we have less medical care and shorter lives. Given the choice of deregulating one profession or the other, I would choose the physicians.

Quoting our own Brian Micklethwait we again read:

Far from being obvious to me that a truly free medical market would be disastrous, I believe on the contrary that such arrangements would be of huge benefit to mankind, and that the sooner medicine is done this way the better.

Things would not, inevitably, be perfect. Some fools would make crass blunders, by ignoring manifestly superior medical services for the most frivolous of reasons, and by patronising the most notoriously incompetent. Some such fools would perish from their foolishness. Others would merely be unlucky. No law can prevent either stupidity or bad luck, although the world is now filled with the particular stupidity which consists of refusing to face this truth, and with the many luckless victims of this stupidity.

Powerfully, he concludes:

Given that for most people the avoidance of suicide rather than suicide is the objective, a truly free medical market would enable them, for the first time ever, to purchase steadily improving medical advice and medical help, and at a steadily diminishing price.

One of the most pernicious restrictions on medicine imposed by the current medical regime is the restriction on advertising. In a free market rival medical procedures, rival medical 'philosophies', rival views on the relative importance of confidentiality, hygiene, speed of treatment, riskiness of treatment, and so forth, would all battle it out in the market place. 'Alternative' therapists would be allowed to prescribe potentially dangerous drugs, as only government favoured therapists may now. It would be up to the patients to pick therapists who seemed to know what they were doing and their look out if they chose badly. The already thriving medical periodical press would assist with voluminous comparative advice, praise and criticism.

In such a free market, any number of different medical styles could be practised, and patients would make their choices.

Evans’s book is a must read for libertarians. It is also a tonic for the period of NHS propaganda we will no doubt endure over the next couple of weeks.

Looking for a real boost in the morning? Someday you may be able to do better than coffee. According to New Scientist (via the Foresight Institute):

Human cells could have their metabolisms upgraded without altering their genes by inserting tiny plastic packages of enzymes, Swiss researchers have shown. They hope the technique could allow advanced cancer therapies, or even upgrade a person’s metabolism.

I can hardly begin to imagine the applications. With this technique you could correct chronic genetically caused disorders. It makes drugs old hat. You could boost athletic performance from inside the cell and really give the luddite sports crowd something to worry about.

Imagine the battlefield applications! It could keep the 21st century soldier alert despite little sleep; alive when injured; fed from sunlight or other external energy sources and performance enhanced when under threat.

Over at ConservativeHome there's a survey suggesting the social conservatives are doing the Guardian's work for it by trying to make one's position on abortion a party-political issue in Britain. The next generation of Conservative MPs support a lower time limit for abortions says an email questionnaire to 225 candidates, answered by just under half. I'm as irritated by this sort of spinning of some very doubtful evidence as I am by the contrary stuff - to the same effect - from the Guardian, which has recently started to suggest (as a measure of its desperation) that no-one who favours abortion choice should vote Conservative.

What really winds me up, though, is the mendacious presentation of their position by the proponents of this staged debate. The legal position of abortion in Britain is the sort of muddy compromise people with a clear ideas about the question are quite right to resent. But the approach of many abortion-banners (as they actually are) is anything but frank, and reminiscent of the step-by-step strategy of the anti-smoking lobby. For every principled (usually religiously principled) pro-lifer, there is someone who secretly shares their conviction, but makes the case for just a little cut in the time-limit now "because science tells us that babies of that age can now survive outside the womb".

It's nonsense. Without a lot of help a two-year-old can't survive outside the womb. And the prospect of those few born at the limit of current paediatric technology surviving uncrippled to live a normal life is tiny even with a massive input of medical and nursing resources. But worse, it is mendacious nonsense - they don't care about "viability" in the slightest. What they want is a plausible excuse to cut the availability of abortion just a bit.

So I have a test to flush them out. It is provided by that ghastly muddy compromise. Britain doesn't in law permit women to choose abortion, unlike most rich countries. It is an extraordinary construct of bureaucratic paternalism.

What British (mainland) law does is to permit pregnant women to petition doctors to give them permission to abort on the grounds that it will be bad for their well-being to carry the baby to term. With two doctors assenting to this opinion in writing (that is, as the doctors' professional opinion - the woman's view doesn't matter in law), you may have an abortion. Where the 'time-limit' comes in is that those two doctors can only approve an abortion to preserving the patient's social or mental well-being before a certain point. After that terminations may only occur where there is a substantial risk to life or health, or in cases of severe foetal abnormality.

So in practice, in the UK you have a choice only if you approach the right doctor armed with the right argument. A naive or poorly educated, woman who seeks help from her GP when the GP happens to oppose abortion, or who mistakenly calls a pro-life charity canvassing itself as offering help to the unexpectedly pregnant (as opposed to one of the pro-choice groups who do the same thing) may never find out how to get an abortion, or at least not until it is too late. The late abortions themselves aren't occuring as a lifestyle choice - which is another mendacious narrative element in the pseudo-debate.

My test is this: Next time anyone says they want the time-limit for abortion cut to because "science shows" the baby can survive outside the womb after X weeks. Say, "And of course you support changing the law to allow abortion on demand before that date, don't you?" Then watch them flounder.

I am interested in this story as I am one of many people for whom the hopefully sunnier weather of summer is accompanied by the irritation of hayfever. I do not suffer from it as badly as when I was a child but it is still unpleasant sometimes. I once played in a cricket match and my symptoms - streaming eyes and sneezing - got so bad that I could hardly continue to play the game.

Anyway, it may be soon be possible to significantly nail the problem with a vaccine.

Belatedly, I joined the craze and had a go on one of my friend's Wii games the other weekend. Terrific stuff: I played the golf, tennis, ten-pin bowling and shooter games. Bloody marvellous. You do need to get a large-enough television to make it work; unfortunately, I don't really want to mess up my sitting room by putting a huge plasma screen on the wall, but some of my friends seem to be less squeamish.

The main downside, I find, is that if you are playing this game and have not stretched and warmed up properly first, you can actually do a bit of damage. The next morning, when I woke up, the left side of my back was quite painful. This is what happens to a 41-year-old wealth management geek who has not spent enough time doing sport for real. Time to turn off the technology and put on the training shoes.

A link to some Wii-related injuries. I wait for the first politician to try and bleat about the "Wii menace".

William H. Stoddard of San Diego, California has some interesting commentary on the state of the debate between Clinton and Obama on what they want for US health care policy

Health care policy is a major issue in the Democratic Party's choice of a presidential candidate. The final debate between Hillary Clinton and Barack Obama, in Ohio, spent a reported 15 minutes on it. Yet the mainstream news media in the United States consistently report that there are only very minor differences between the positions of the two candidates. Given this, the argument looks like little more than semantic quibbling over the meaning of the word "universal," all too typical of Clinton's struggle to contest Obama's unexpected rivalry for the nomination.

But the mainstream news media have it wrong. There is, in fact, a vitally important difference between the two positions, though one that their worldview makes them ill equipped to recognize. The difference is that Clinton would compel everyone to purchase health insurance; Obama would not. The standard label for this difference in health policy debates is "mandate," for what Clinton wants.

Clinton has been evasive about exactly how she would compel the purchase of insurance - which is not surprising, as talking about punishing voters is not a good selling point in an election. The state of Massachusetts, which has a mandate, imposes fines on adults who do not have health insurance. Clinton has not talked about fines, but has suggested garnishing wages or making enrollment compulsory on admission to any hospital.

Of course, Clinton promises to make health insurance affordable to everyone, through subsidies and through massive new regulation of the insurance industry. So does Obama. But what if their plans do not work out? Under Obama's plan, adults who thought even subsidized health insurance cost more than they could pay would remain uninsured, and at least be no worse off. Under Clinton's plan, they would be forced to sign up, or penalized for not doing so - and either way they would be hurt. And given that Clinton predicts that fifteen million Americans would remain uncovered under Obama's voluntary plan, it seems that she anticipates that fifteen million people would have to be hurt financially to make her plan viable - or, perhaps, simply to justify her in calling it "universal."

Obama, in fact, has fairly clearly called attention to this difference. In the debate, he said, "We still do not know how Senator Clinton intends to enforce a mandate, and if we don’t know the level of subsidies that she’s going to provide, then you can have a situation, which we are seeing right now in the state of Massachusetts, where people are being fined for not having purchased health care but choose to accept the fine because they still can’t afford it, even with the subsidies..."

For libertarians, of course, which plan is less bad is a fairly straightforward question: the one that allows a measure of free choice is a lesser evil than the one based on coercive social engineering. And a non-trivial part of the electorate may feel the same way; where hard-core Democrats often favour Clinton's views, independent voters are reported as less supportive of mandates.

But there are hard questions about mandates even from the perspective of the Democratic Party itself. On one hand, people between fifty and sixty-five (where Medicare comes into effect) consume substantially more health services than younger people. Younger people are more likely to decide their low health risks do not justify paying for insurance. So forced enrolment would compel many younger people to pay for insurance they would not purchase voluntarily - but the benefit of enlarging the pool and lowering insurance costs would go disproportionately to older people. And on the other hand, those same older people are much more likely to own houses, to have savings and investments, and in general to be able to afford health care. So what Clinton is proposing is a regressive redistribution of wealth, from the worse off to the better off. It is hard to see how this makes sense within the publicly announced ideology of the Democratic Party.

It does make a kind of sense, though, within a different framework - the version of class analysis propounded by the libertarian economist Murray Rothbard, which emphasized conflict between the people who pay for taxes and redistributive schemes, and people who benefit from them.

Who supported the two candidates? Leaving aside the obvious "identity" politics (blacks favoured Obama; women favored Clinton; Hispanics, a group often in conflict with blacks, favoured Clinton), Obama had unusually strong support from younger voters, and Clinton from older voters; that is, Obama from Democrats who would be hurt from Clinton's scheme, and Clinton from Democrats who would profit from it. And Obama was favoured by Democrats with incomes above $100,000 a year, Clinton by Democrats with incomes below $50,000 a year. This is less obvious, but higher income people are more likely to be self-insured (so that forcing them to buy insurance would be to their disadvantage as they see it). So it looks rather as if Obama has managed to put together an insurance proposal that is more favourable to the very people who have been voting for him all along, and Clinton one that similarly appeals to her base. And the conflict between the two is a struggle between net victims and net beneficiaries of Clinton's redistributive scheme.

Whether Clinton and Obama recognize this is not clear. Of course, neither of them discusses such issues in their speeches; they both have to present their ideas as being best for everybody. Health policy theorists certainly do not see any conflict - and most of them favour Clinton's approach. But Obama's statements suggest that he is aware that mandatory health insurance could hurt some of the worst off people in American society; that he thinks this is a bad idea; and that he is prepared to make an issue of it. In a small way, this seems to make him the lesser evil as far as health care is concerned. If nothing else, he does not seem to cherish the idea of forcing everyone into a comprehensive administrative scheme for its own sake, regardless of the cost to the people it claims to help. Health care policy experts seem to feel otherwise - and so does Clinton. This is, of course, the core position of the established Democratic Party, the authoritarian liberal party of American politics. Obama's support might represent a realignment of less authoritarian voters increasingly unhappy with the Republican Party's fall into militarism, theocracy, and big government. The Democrats could only be improved by playing for their continued support.

What is innovation? A difficult question but would this effort modestly fit?

The Inter-Faith Gown is a new hospital gown for patients who would like to be more modestly clothed....

The Problem

Some people may be reluctant to be admitted into hospital due to the revealing nature of traditional patient gowns.

The Solution

The Inter-Faith Gown is designed to preserve the modesty of patients whose culture or religion requires them to be more modestly clothed.

It is made up of five pieces – three head garments, a gown and trousers. These elements can be mixed-and-matched to enable the patient to obtain the required degree of coverage. The sleeves of the gown have elasticated cuffs to cover the patients' arms.

Pictures are added in a tasteful jade green. Is this really what our taxes should be spent on?

This article is in the LA Times titled Doctors balk at request for data:

The state's largest for-profit health insurer is asking California physicians to look for conditions it can use to cancel their new patients' medical coverage. Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," including "pre-existing pregnancies".

Firstly all aspects of medical care, including insurance, are regulated to bits in the United States (especially in California), and it is the government regulations and subsidy programs (such as Medicare and Medicaid - but in recent years SCHIP as well) that are at the root of the high price of medical cover. But to turn to the specific question:

If someone lies about their medical history when filling out a contract, in order to get less expensive medical cover, they are guilty of fraud. In an alternative world, which I am not saying I would support, they would not only be dropped by their insurance company when their fraud was exposed - they would also be prosecuted.

Of course, in our world, they will not be prosecuted and would not be convicted if they were prosecuted. It is much the same with all the political talk about "fraudulent lending" in the mortgage market. There has been vastly more fraudulent borrowing, but I doubt that the vast number of people who lied on their mortgage applications (for example claiming to have an income much greater than they really have) will be prosecuted.

However, in an alternative world (which, again, I am not saying I support) prosecution and conviction would solve the problems of customers guilty of fraud - medical cover and a roof over their heads.

Prison provides both.

Considering how many health-scare news items there are these days, it makes me want to smile in a wry way when I also read about the supposed problems caused by an ageing, greying, population. The first and obvious question is: if we are all at such risk from obesity, drugs, booze, stress, pollution or the angst of watching Jonathan Ross, why are we living so much longer than our parents or grandparents? If this is what happens when the sky is supposedly always about to fall in, then what must a healthy population be like? And yet there is something in the human psyche, or our culture, that rebels against the happy prospect of a longer life. We are told, or at least have until recently accepted, that three-score years and ten is Man's rightful due (perhaps a tad longer for women); it is almost a hangover from religion to believe that it is impious, even blasphemous, to want to live for much longer. Andrew O'Hagan, writing in the Daily Telegraph today in a moan about how the elderly are treated in Britain - a valid subject - makes this point:

Growing old is now considered more of an option than an inevitability, something to beat rather than be resigned to, something that is thought to take away from one's individuality rather than deepen it.

I don't really know how death, or its inevitability, adds to one's individuality. I think I know what O'Hagan is trying to say: We are unique, precisely because we are mortal. We cannot be replaced, or copied.

The trouble, though, is that I don't see how one's uniqueness is somehow reduced by living for 200 years rather than say, 100, or 50, or 30. Were the ancient Romans - average lifespan about 35 - more individualistic and unique than a 21st Century Brit? How on earth can one measure this? Also, the desire to keep the Grim Reaper at bay surely attests to a love of life, not a denial of its value; if one believed in a craven acceptance of the inevitable, then why do we have doctors and hospitals?. I value my life rather a lot and am in no hurry to see my hair go all grey, my face resemble tree bark, and my limbs to seize up. Sorry, Mr O'Hagan, but I'd rather not suffer that fate any time soon. I go to the gym and try to keep fit despite my enjoyment of red wine. I have not signed up for cryonic suspension or anything like that but I keep an eye on life extension research and have been greatly impressed by the work of people such as Aubrey de Grey, among others. (Don't be put off by the immense beard, he's not a nutter). I lost a good friend and intellectual mentor, Chris Tame, nearly two years ago to the horror of bone cancer - he was in his mid-50s - and I am pretty sure this most unique of people could and should have been around for many more decades among us. (I particularly miss his outrageous jokes).

I remain to be convinced of the idea that to value one's life, it must be short, or that we should resign ourselves to it meekly. Meekness did not build the space rocket, the Aston Martin DB9 or even produce modern dental surgery.

Update: Glenn Reynolds has interesting thoughts on this subject. He's been writing on this for some time. Ronald Bailey, whom I met over a year ago during a book tour of London, is also well worth reading on this and related topics. I read this Peter Hamilton novel which touches on rejuvination; it is not one of his best tales, unfortunately (the Amazon.co.uk book reviews are not very flattering).

Via the excellent engadget blog, here is a nifty item to put on the wall for all you health-freaks out there. Perhaps I should strap my arm to one of the controls the next time I read about the Archbishop of Canterbury, the eco-Leninist thoughts of Madeleine Bunting, or watch the English rugby/cricket/football team give up a lead?.

Or maybe I should stop doing all these things for a longer, happier life.

On some, if not all issues, Rod Liddle is a man of sound views. He loathes the nanny state; he is unconvinced that we need to crack down on freedom of speech in order to avoid giving offence to religious groups. He is a patriot. In this week's edition of the Spectator, where other authors rant away splendidly, Liddle rails against the six-month-old government ban on smoking in all public buildings, including privately owned ones (apart from private homes), such as pubs and restaurants. He makes a good case and some of his paragraphs are cheer-out-loud material:

Of course, one shouldn’t drop a policy simply because the pubs are having a rather hard time of it as a result. But in which case, don’t bother to pretend that they’re not, that actually there are queues all down the street consisting of shiny, happy people who wish nothing more than to drink in a new, healthy, smoke-free environment. Stop lying. Say, instead, that the smoke ban is putting pubs out of business but actually we couldn’t give a toss. Truth is, the government — and the health charities — are caught by their previous, gerrymandered poll findings which purported to suggest that the entire country was in favour of a complete ban on smoking everywhere, when — and again, do a quick vox pop if you doubt this — the reverse was true. People would like to see genuinely smoke-free areas of restaurants and pubs, for sure — but only chose a complete ban on smoking when the alternative on the poll sheet was ‘or would you like your testicles sawn off?’.

Or this:

Perhaps it is true, though, that because of the ban, I shall live for ever, for which many thanks, Dawn. But I doubt it; we will have recourse to one or another means of killing ourselves, such as driving a car (4,000 deaths per year), drinking more (40,000 deaths per year) or visiting a doctor (30,000 deaths per year through negligence or incompetence: never forget that figure. It exceeds the numbers killed through smoking-related illness. And it really, really hacks off the doctors).

But as always with Mr Liddle, the carelessness with which he chucks around numbers makes me wonder if any reader will want to get past his first paragraph:

I am still not sure what I hate the most about this government: its decision to invade Iraq and thus either effect or facilitate the murder of 500,000 Iraqis, or its decision to stop me from smoking in pubs and restaurants.

500,000 Iraqis? Is that correct? Liddle gives no source for this or attempts to do so later in the piece. Now Rod may be right to suggest that the overthrow of a power-mad, dangerous dictator was even worse than letting him stay in power (I occasionally wonder why a certain type of right-winger is so indulgent towards evil men like Saddam). But if he is going to make an argument with statistics as part of his core argument, it is probably not a great idea to kick off an argument with a massive figure based on, whatever.

Oh, in case anyone asks, I don't smoke, except on National No Smoking Day.

The European Union has its uses. While rootling around for stuff to link to from CNE Competition, I came across this:

Left-wing Labour MPs are girding themselves for a rebellion over a European Union plan which they say could spell the end of the National Health Service.

When left wing Labour MPs rebel, I at least hope for possible goodness.

The European Commission will publish its health directive next week and it is meant to make it easier for people to travel to get specific medical treatment in another EU country.

Ah, the age-old dilemma of the EUrosceptic. What do you think if the EU imposes something sensible?

British diplomats say that this is NOT the same as making sure that if you fall sick in Slovakia or have an accident in Austria you can get treatment straight away.

When British diplomats say that something is NOT something else, it means that they have been told to say that by their political masters and that the small print of their argument will be about a very small difference. The feathers on the other something will definitely NOT be the exact same colour, but the other something will otherwise waddle and quack in an identical fashion to the original something, and will in fact be just another duck. For "NOT", read " ", in other words.

It is what some people call "health tourism" and both critics and fans say it will allow people to shop around for health care.

Sounds great. So what if it is just a plan to sell Eurostar tickets; I still like it.

In the end, there is nothing like people preferring something else to whatever bogus nirvana is being peddled by the bogus nirvana peddlers. The one argument against the much vaunted Soviet Communist nirvana that the vaunters could never wriggle free from was the fact - for fact it was - that this was a nirvana that millions wanted to escape from, through minefields if need be, and with only the clothes they were wearing at the time of their escape if that was all they could take with them. A similar process is now under way with Britain's similarly vaunted NHS, the best healthcare system in the world except for all the others.

A story on the UK news last night gave statistics on trauma patients. Those are the seriously injured who must be transported from an accident site to a trauma centre. The percentages of trauma patients who die are:

UK - 43%
US - 16%

Draw your own conclusions.

I happened to be near a TV last night and was so stunned by the numbers that I pulled out my clipboard and wrote them down. The news feature also noted that ambulance first responders were insufficiently trained and often did not carry out measures such as clearing air passages. It also discussed the idea of having specialist regional trauma centre's. If any one else was watching last night, their inputs on this TV report and the data behind it are welcome. The only thing I have found so far on the net is this

The smoking ban was a mere tasty morsel. It has roused the appetite of the beast without bedding it back down again. The hungry beast has drawn blood and it wants more:

Government ministers should shrug off media accusations that they are running a nanny state and introduce tougher public health measures, experts say.

The Nuffield Council on Bioethics said the time had come to consider a whole host of interventions in the UK after the introduction of a smoking ban.

Its proposes raising alcohol prices, restricting pub opening hours and better food labelling to fight obesity....

The report by the panel of experts, which include scientists, lawyers and philosophers, said there was a balance to be struck between individual freedom and wider public protection.

Welcome to the latest phase of the old 'public choice' paradigm. You have to choose between freedom and prosperity. You have to choose between freedom and fairness. You have to choose between freedom and safety. And the wheels of the world turn round and round to the music of the rhythm of history.

Okay. let's gird our loins, saddle up and prepare for battle again but, this time, let's make sure that we don't go charging off in the wrong direction. It would be easy to lose this stage of the war and, as always, the odds are stacked against us. But lose we will for sure if attempt to fight it on the enemy's ground and what I mean by that is accepting that there is a such a thing as a choice between freedom and health and then attempting to persuade people to choose freedom and to hell with their health. If the public believes that this is the choice they must make, then they will choose to be healthy and, before we know it, we're standing around scratching our arses and wondering what went wrong while the triumphant, braying beast tramples everything in its path.

We must not make the mistake of arguing that health does not matter. It does matter. As every exhortatory elderly relative has croaked at one time or another, health is the most important thing. But that is exactly why we need more freedom and less compulsion. The healthiest societies are the the most liberal and prosperous ones, while the unhealthiest are invariably the poorest and most statist and centrally planned prescriptions for health will be no more successful than centrally planned prescriptions for the economy. The public must hear, again and again, that the "choice" being presented to them by the likes of the Nuffield Council on Bioethics is vexatious, counterfactual and perverse.

The beast will not stop. It will not change its mind, grow tired, get distracted or give up. The stakes are too high. But that is not the same as saying that it is unstoppable. We just have to make sure that we shoot its legs from under it. Nothing less will do.

Who'd'a thought we'd see two shout-outs to King Canute in as many days in the health care arena? Yet there he is, popping up again in Business Week in the service of opposing more government intervention in health care.

According to legend, King Canute of Denmark facetiously tried to stop the rising tide by simply raising his hand and commanding the waters to roll back. The tide, of course, kept rising. Yet policymakers throughout history have followed Canute's lead. From Hillary Clinton and John Edwards to Mitt Romney and Arnold Schwarzenegger, politicians across the spectrum have tried or vowed to solve America's health-care woes by enacting an individual mandate - a law requiring every adult to purchase health insurance. Despite its bipartisan support, the individual mandate is bad policy, a vain attempt to command a better result while doing nothing to achieve it.

An excellent discussion of the folly of individual mandates follows. Of some interest is the way the estimate of the size of the problem meshes with that made below.

According to an Urban Institute study released in 2003, uncompensated care for the uninsured constitutes less than 3% of all health expenditures. Even if the individual mandate works exactly as planned, that's the effective upper boundary on the mandate's impact.

If you do the math, I think you will find that Mark Steyn's number of the poor uninsured comes out to about 3% of the population.

More importantly, Whitman points out the major flaws in the individual mandate proposal - it would not work (people will still refuse to buy health insurance), and it will make the problem worse by driving costs even higher.

Even now, every state has a list of benefits that any health-insurance policy must cover - from contraception to psychotherapy to chiropractic to hair transplants. All states together have created nearly 1,900 mandated benefits. Of course, more generous benefits make insurance more expensive. A 2007 study estimates existing mandates boost premiums by more than 20%.

If interest groups have found it worthwhile to lobby 50 state legislatures for laws affecting only voluntarily purchased insurance policies, they will surely redouble their efforts to affect the contents of a federally mandated insurance plan. Consequently, even more people will find themselves unable to afford insurance. Others will buy insurance, but only via public subsidies. Isn't that just what the doctor didn't order?

His prescription for incremental policy reform strikes me as being pretty sound, as the fundamental shift that needs to be made in health care insurance is away from first dollar coverage, low deductibles and copays, etc. and toward catastrophic insurance. First dollar coverage has proven to distort if not destroy any semblance of financial responsibility on both sides of the health care transaction, and is one of the primary drivers of high costs. Catastrophic coverage fulfils the true function of insurance - protection against risks you can not afford - without creating the disastrously misaligned incentives that our current system has.

Our theme for today comes from George W Bush: "Freedom is the desire of every human heart."

Whether or not freedom is the desire of every heart, I think it is abundantly clear that most people are indifferent or hostile to their neighbor's freedom, which is why a mere democracy, unencumbered by principles of limited government, is assured of devolving into some sort of Total State in short order. But the inimitable Mr. Steyn is not content with observing that most people think of freedom as "fine for me, but not for thee." No, he has in mind the apparent eagerness of so many to give up their own freedom.

A year ago, I wrote that, "The story of the western world since 1945 is that, invited to choose between freedom and government ‘security,' large numbers of people vote to dump freedom — the freedom to make your own decisions about health care, education, property rights, seat belts and a ton of other stuff."

This is what makes being a small-government libertarian so frustrating. Our patron saint should be King Canute, for it often seems like we are standing on the shore, trying to stop the tide. The reply to Mr. Steyn, if it is not couched in shallow democratism ("we are just giving the people what they want") is usually couched in terms that imply that freedom is not possible, or at least can not be enjoyed, without material security provided by the State. This inversion of real freedom (the freedom of self-ownership) was perhaps best catechized by FDR, the man most responsible for freeing demagogic democracy from the strictures of the constitutional republic, as "freedom from want."

FDR's heir is Hillary Clinton, and she is pushing (again) for nationalized health care in America. The battlecry this time is that there are "45 million uninsured" (or whatever spurious number is trotted out).

My first response is "so what?" Anyone in America can get health care simply by walking into the nearest hospital, as all hospitals are required to give an exam and emergency treatment regardless of ability to pay.

But, as always, one should not let the factual assertions of the advocates of the Total State go unexamined. Mr. Steyn continues:

So, out of 45 million uninsured Americans, nine million aren't American, nine million are insured, 18 million are young and healthy. And the rest of these poor helpless waifs trapped in Uninsured Hell waiting for Hillary to rescue them are, in fact, wealthier than the general population. According to the Census Bureau's August 2006 report on "Income, Poverty and Health Insurance Coverage," 37% of those without health insurance - that's 17 million people - come from households earning more than $50,000. Nineteen percent - 8.7 million people - of those downtrodden paupers crushed by the brutal inequities of capitalism come from households earning more than $75,000.

In other words, if they fall off the roof, they can write a check. Indeed, the so-called "explosion" of the uninsured has been driven almost entirely by wealthy households opting out of health insurance. In the decade after 1995 — i.e., since the last round of coercive health reform — the proportion of the uninsured earning less than 25,000 has fallen by 20% and the proportion earning more than 75 grand has increased by 155%. The story of the last decade is that the poor are getting sucked into the maw of "coverage" and the rich are fleeing it.

At a conference on health law last week, I predicted (only half in jest) that Hillary would be signing the bill nationalizing health care at the beginning of her second term. The more I think about it, the more likely it seems. The tide of the Total State never sleeps.

Edward Paul Brown was a premature baby whose birth and death took place within minutes of each other on February 23rd 2007 in a lavatory in Queen's Hospital, Romford.

Eighteen weeks into her pregnancy, his mother, Catherine Brown, was told that there was no amniotic fluid surrounding the baby in her womb. This meant that the baby's chances of survival were minimal and her own life was threatened. Catherine Brown took the "devastating" decision to abort. Even those (such as I) who generally oppose abortion, will see this as a hard case - and I hope that any comments do not get sidetracked onto that issue.

So. We have a woman in hospital waiting for the procedure that will abort her baby, a child she had wanted to bear and raise. Not a pleasant situation at any time, but what followed next was disconcerting to read about even for those who have grown weary of NHS "war stories".

I first saw this in the Times (Baby's birth and death in lavatory of hospital with no trained staff), but there is a considerably more detailed account in This Is London (Mother forced to give birth alone in toilet of 'flagship' NHS hospital) (A very similar account appeared in the Daily Mail.)

Both headlines understate the peculiarly modern horror of what happened. The reader gets a picture of nurses trying to help, but out of their depth because Queen's Hospital did not at that time have a proper maternity unit. That picture is wrong. The part of it that is wrong is the "trying to help." The nurses declined to help.

This Is London quotes Catherine Brown's mother, Sheila Keeling, who was present as her daughter went into labour:

"I was running around frantically trying to find gas and air for her and pleaded with nurses, who seemed very matter of fact, to assist," she said.

"The staff I did find told me they did not have the training to help. Catherine was left to deliver the baby alone with just me for help before cleaning herself up and going back to bed. It was horrific."

(Emphasis addded.)

Not just could not help, would not. Would not even be present, as far as I can see. Modern nursing has moved on, you know, since the days when the role of the nurse was to hold your hand and wipe the sweat from your brow. They don't do that any more!

What caused these nurses to hang back from offering the ordinary, unskilled comfort that would once have been seen as the heart of their calling? I am tempted to simply blame it on the NHS. Certainly this case is something to set against all those stories we hear from those benighted lands where healthcare is not financed by taxation. Of course I do blame the NHS for the dreary catalogue of delays and mismanagement that Catherine Brown suffered before the birth; the wait for a scan, the further wait for pain relief, and the fact that she had to lie in a mixed sex ward and the fact that they nearly dumped Edward's dead body. But that is old hat. Things were no different a decade and a half ago when I was in labour in another hospital in Essex and the midwife was obliged to run out into the corridor and yell "Where's the fucking obstetrician?" And my would-be epidural man popped his head round the door and announced that he was ready to begin twenty minutes after the birth. I did not hold it against them. It was a difficult day, lots of births happening at the same time. At least they tried. In Queen's Hospital as Catherine Brown crouched over the support bar of a disabled person's lavatory to deliver her doomed child, they felt themselves unqualified to try. More than their jobs were worth.

No, this gutlessness is new, and although I do see it as yet another consequence of the command economy of the National Health Service, to add to the melancholy consequences we knew about already, I seek a more specific explanation as well. One major factor might well be fear of getting sued. Yet that, too, does not wholly explain it. The nurses concerned must have known that their chances of being held personally liable were tiny and they must also have known that the chances of their hospital getting sued for neglect of duty were significant. (None of the reports I have read in the press say whether this happened, although clearly some official inquisition took place and reached the verdict that press has been reporting over the last few days.)

The loss of nerve is not just seen in hospitals. One can see it in the other public services too.

Looking at the fire service, fireman Tam Brown nearly drowned saving a woman's life in the River Tay - and was rewarded by being threatened with disciplinary action by Tayside Fire and Rescue, on the grounds that he had "broken procedure" by entering the water. He was meant to use the correct ropes and poles and since his crew did not have the correct ropes and poles he was meant to watch her die. Possibly he was meant to put the down time to good use by filling in a safety report on the incident. As it happens he not only got away with his archaic belief that that was not what he had joined the fire service to do, but was belatedly praised for it by his superiors - but, make no mistake, as Squander Two says, that will be because of the publicity.

Looking at the police - Julia Pemberton was murdered along with her son by her estranged husband. She called the police as he rampaged with a shotgun through the house. You can read the transcript of her last 999 call here. "Officers are on the way," says the operator. That was moderately close to being true and the fact that the police could not even find the address of a woman whose house they had fitted with a panic button is not really relevant to this post. They got there in the end and saw the son, William, lying on the drive. At this point three unarmed officers vainly but creditably attempted to help him. Guess what? They were breaking procedure. In the words of Julia Drown MP,

However, the irony is that the officers who stand out as having done everything, and more, that the family could have expected from the police, were the ones who breached the police's policy.

What Julia needed was a firearms response, but it was more than one hour after she picked up the phone before the first armed response arrived outside the grounds. Armed units did not enter the house for almost seven hours, despite the fact that no sounds from it had been heard for more than six hours. Instead of going directly to the house, armed units were sent to a remote rendezvous point, and further problems were caused by poor communication among the police. The wrong silver commander was initially called, with the correct one not called for more than an hour after the start of the 999 call. When the silver commander finally arrived, he moved the rendezvous point and did not take command until three hours and 26 minutes after the call started.

During that time, it was not known whether Julia was dead or alive. The police priority was to preserve the lives of officers rather than the lives of victims.

The police did not actually go into the house for hours. Goodness, no. There might have been a violent criminal in there! Probably it made no difference. The victims were already dead. But for all the police knew Julia Pemberton could have been alive but desperately wounded and praying for help. Time was when the ordinary village policeman, unarmed as he was, would have gone in.

Let me say (before someone says it for me) that I do not claim that I would have the courage to go into a house where a killer might lie in wait, or that I would have jumped in the bitter, fast flowing waters of the Tay to save some stupid woman who wanted to top herself. But such were the traditions that were honoured in the police and fire services. In fact, when I talk about "gutlessness" and "loss of nerve" here I am not talking about individual physical courage. Fireman Tam Brown showed great courage. At least three of the policemen in the Pemberton murders did as well and all of them showed more guts than I would. But institutional gutlessness surrounded them, was embarrassed by them, and will kill off their like eventually. Poisoned soil does not long give forth good fruit.

Going back to the Queen's Hospital example, I do not have the personal qualities to be a good nurse, though I do think I could have bestirred myself to help in this case, when even standing around being useless because untrained would not have been useless and was clearly what the patient wanted. All the training nurses have these days appears to have trained the initiative and compassion right out.

I keep asking myself why anyone wants the new way?

Perhaps, in the case of those who will not act because unqualified in that speciality, it is a fear of finally having to be the real thing. When your whole life has been one long rehersal the raising of the curtain for the First Night is not always a welcome event. So Nurse Smith listens to the howling through the lavatory door rather than act wrongly and Constable Jones watches the stripy tape flutter around the perimeter of the silent house and waits for the Armed Response Team.

Perhaps, in the case of those who make these regulations, it is a peverted delicacy. Some are offended by the eruption of death or violence into their paper world, by the bloody evidence that not everything is covered by their rules. Below that delicacy, deeper and colder than mere personal malice, is a hatred of efficacy.

How do we get our nerve back?

In his defence of classical liberalism and critique of 20th Century state welfarism, F.A. Hayek argued that one of the dangers of socialised medicine (Michael Moore, please note) is that if health care is not rationed by price and expanded by the freely chosen actions of patients and doctors, then some other means of allocating scarce resources, and making them hopefully less scarce, will be needed. That "other" way is state coercion and control. Because healthcare is delivered in Britain free at the point of use - of course it is not free at all - the individual patient does not directly see the price of the health care he or she receives, such as in the form of an insurance premium. There is no price incentive, therefore, for a person to, say, cut out smoking, cut the beer and the beef burgers, get in shape by frequenting a gym, etc.

I wrote some time ago about the scarcity of human organs such as kidneys and livers, and how much of the western world suffers from a strange form or hypocrisy: we say it is great that people volunteer to donate organs (the libertarian writer Virginia Postrel has done just that by donating a kidney to a friend) but we recoil in horror at the idea that a person might ever be persuaded to sell an organ or be paid for such a donation, even though there is, in some countries, a commercial market in the business of using such organs and the related human tissue. (There is some legitimate worry that very poor people who do not realise the health implications might undergo surgery to sell their body parts, to be fair).

I thought again about such mixed attitudes when I saw the front page of the Sunday Times this morning:

THE chief medical officer wants everyone to be treated as organ donors after death unless they explicitly opt out of the scheme.

Sir Liam Donaldson believes the shortage of kidneys, livers and hearts is so acute that the country needs a donation system that will presume patients have given consent for their body parts to be transplanted.

Those who wanted to opt out would have to register in a similar way to those who now carry organ donor cards. This could be done through a central NHS database or through other documentation, such as driving licences.

But ranting away about the presumptious tendencies of a state doctor is all very well for relieving a bit of blood pressure, but there clearly is a problem with shortages of organs and how to save the lives of people in desperate need. Donation, either for no money or for a payment (with safeguards, if need be), can work only so far. We need to encourage biotechnological fixes: and a good place to see what sort of fixes might be out there is this interesting study by Ronald Bailey.

The doctors are right to highlight that there is a problem, but how less depressing would it be if they could think about ways of solving it without recourse to asuming that your body belongs to the collective, just for once.

This comment was left by a person calling herself Jasmine, responding to Sam Leith's fine piece bemoaning the attitude of mind that led to the UK smoking ban in privately-owned places:

Has it occured to you that this is a nanny state because we need nannying? I don't think anyone can dispute that smoking is not good for you. I read somewhere that having a smoking "section" is like having a peeing "section" in a swimming pool. It's just not enough to have a partial ban and wait for the natural goodness of people who simply don't know any better, to stop. They need to be forced to stop.

A question I would put to this woman, and quite a few of the other control-freaks out there is this: what gives you the right to tell an adult that he or she should adjust their habits for "their own good"? Does Jasmine think of herself as being some sort of god? Has it never occurred to these people that their obsessive desire to regulate all aspects of existence is in fact a sign of a deep psychological problem, which needs to be fixed?

Those idiots want health. But what we need is more life.

- Tattooed Marie, a Parisian barmaid, quoted à propos smoking bans on Spiked.

"If Michael (Moore) thinks healthcare is expensive now, just wait when it's free."

P.J. O'Rourke, in a remark attributed to him in this nice takedown of Moore's latest "documentary", Sicko, a film making the case that we would all be better off in having tax-funded healthcare free at the point of use, like the magnificent British National Health Service that is the envy of the world (cue sarcasm alert, sounds of hollow laughter).

Arnold Kling has thoughts on the movie. Here is what I wrote about some of the issues arising when people want healthcare free at the point of use (ie, they want someone else to pay for it).

Do not misunderstand me: private healthcare in some countries, such as the US, is far from perfect. For a start, it does not have a lot to do with unfettered laissez faire capitalism, as anyone who has encountered the powerful American Medical Association will point out. The insurance system in the US encourages inflated prices for treatment, and there are other regulatory and legal costs which have become a lot worse in recent years. But if Moore thinks British cinema audiences will be wowed by his paean of praise for Britain's Soviet model of healthcare, he needs to have his head examined.

Mind you, I have often wondered whether Moore is for real, or a sort of performance artist secretly working for Dick Cheney.

(Update: further thoughts on whether Moore is a clown damaging the already-weak case for socialised medicine can be seen here.)

When Perry referred to the recent comments of US Presidential hopeful Barak Obama, we had another example in the ensuing comment thread of how people lazily refer to the idea that healthcare should be 'free'. Of course, unless Obama is a total idiot - and I doubt that - he realises that health care, like roads, clean water, defence or food is not free in any sense at all that matters in a world of scarce resources that have alternate uses (such scarcity and the fact they have alternate uses is a classic element of what economics is). Healthcare is not free - it must be paid for, paid out of the time and trouble of other people. The problem, however, is that a lot of people, not just socialists, think that some things in life 'ought' to be free although one often finds they are at a loss to say why. Indeed, if you challenge a person by asking, "Why should health, clean water or defence be free"? they will either change the subject, or go bright red with anger, or fail to understand the question at all.

To attack the idea that certain services and resources should be 'free' is not, alas, all that easy in today's politically dumb climate. However, I think I have a partial solution in how to frame the point. If you ever encounter a person who says that healthcare should be free at the point of use, and it should be a 'right', then point out that this means that someone else has a corresponding duty to be a doctor, a nurse, a hospital orderly or an administrator. Unless people can be forced to perform these roles, then all talk of health as something that ought to be free is meaningless. Of course, at this point the socialist will blather on about incentives and so on, but what if no one wants to be a doctor or a nurse, regardless of pay? Does this mean that anyone who shows an inclination to like medicine should, at an early age, be conscripted into a hospital like a draft for the Army?

I ask these rhetorical questions because I think that when we try to frame our arguments, it is sometimes easy to lose sight of the fact that actual flesh and blood human beings are involved in talk about "the right to free health care". Most people these days oppose the idea of military conscription so it ought to be possible to make the case against medical conscription. If we can point out that medical conscription would be a bad thing, then it would be a step in nailing the nonsense that healthcare is a 'right'.

Here is a book I highly recommend about the whole noxious doctrine of 'welfare rights' and how they erode respect for the original, far more coherent rights doctrine of classical liberalism.

I just saw Barack Obama on television saying that he would introduce Universal Socialist Medical Care in the USA and for people who already have insurance policies, the only difference would be such people would pay less in premiums... everything else would be just as good. Yes, you too in the USA can have something as 'wonderful' as our decrepit National Health Service. You lucky, lucky people.

And presumably this conjuring act of creating wealth out of nothing with government impositions will come to pass purely via the Triumph of Barack Obama's will.

Talk about delusional.

He [Michael Moore] travels to London to show off the beauty and brilliance of the British National Health Service. He talks to an unstressed doctor who has a four bedroom house in Greenwich and a £100,000 salary from the NHS. He films empty waiting rooms and happy, care-free health workers. He even talks to Tony Benn about how this wonderful marvel came into existence in 1948.

What he hasn’t done is lie in a corridor all night at the Royal Free watching his severed toe disintegrate in a plastic cup of melted ice. I have.

- James Christopher, reviewing Michael Moore's film Sicko in the Times.

Continuing in movie-talk vein, one force that has swept through the western film industry to greater and lesser degrees is the current hatred of tobacco and the tobacco industry. The Michael Mann film, The Insider, starring Russell Crowe and Al Pacino - with a fine performance also by Christopher Plummer - is a good example. All the pieces are in place: a big, evil ciggie firm makes its products more addictive by dark scientific means; Crowe, who plays a scientist, leaves said evil organisation and blows the whistle on its practices. He is hounded, threatened, his marriage and career collapses. Pacino, as the hero-journalist, tries to expose all this, and in the process gets leant on by his big-bucks media empire bosses. The viewer comes away from the production in no doubt that cigarette companies are just a few inches short of being Nazis.

If you take a random look at any major Hollywood production these days, you seldom see stars light up a cigarette, except possibly some of the more dubious or "troubled" characters. When I watched Steve Martin's hilarious spoof film of 1940s film noir, Dead Men Don't Wear Plaid, I was reminded of how in the movies of the time, everyone smoked. Even the pet dogs would have smoked, given half a chance. And the cinema audiences smoked like chimneys as well. This is now a distant memory. The modern James Bond in Casino Royale does not smoke his Morland Specials, whereas Connery smoked and of course 007's creator, Ian Fleming, puffed away heroically. Bogart got through several packs of Luckies in a movie, and so did the various hot dames who acted with him. Spencer Tracy was unusual in that he did not smoke. Can you imagine Hugh Grant smoking, or George Clooney?

Of course, there is a bit of a backlash from time to time, creating wonderful satire. Thankyou for Smoking, the film based on the humorous novel by Christopher Buckley, is one such. And the great Denis Leary tries to keep the flag flying. But for real defiance of the health-obsessives, the French cannot be beaten. Last night I watched the French cop film 36, starring the usual roster of craggy-faced Jules and Jacques with their Galoises and Gitanes attached permanently to their lower lips. I counted, or tried to count, the number of cigarettes smoked in the film and gave up at about the 200 mark.

If Sarkozy is to be a great president of France, he needs to smoke.

In the beginning God covered the earth with broccoli, cauliflower and spinach, with green, yellow and red vegetables of all kinds so Man and Woman would live long and healthy lives.

Then Satan created Dairy Ice Cream and Magnums. And Satan said, "You want hot fudge with that?
And Man said, "Yes!" And Woman said, "I'll have one too with chocolate chips".
And lo, they gained 10 pounds.

And God created the healthy yoghurt that Woman might keep the figure that Man found so fair.
Satan brought forth white flour from the wheat and sugar from the cane and combined them.
And Woman went from size 12 to size 14.

So God said, "Try my fresh green salad".
And Satan presented Blue Cheese dressing and garlic croutons on the side.
And Man and Woman unfastened their belts following the repast.

God then said, "I have sent you healthy vegetables and olive oil in which to cook them".
And Satan brought forth deep fried coconut king prawns, butter-dipped lobster chunks and chicken fried steak, so big it needed its own platter.
And Man's cholesterol went through the roof.

Then God brought forth the potato, naturally low in fat and brimming with potassium and good nutrition.
Then Satan peeled off the healthy skin and sliced the starchy centre into chips and deep fried them in animal fats adding copious quantities of salt.
And Man put on more pounds.

God then brought forth running shoes so that his Children might lose those extra pounds.
And Satan came forth with cable T.V. with remote control so Man would not have to toil changing the channels.
And Man and Woman laughed and cried before the flickering light and started wearing stretch jogging suits.

Then God gave lean beef so that Man might consume fewer calories and still satisfy his appetite.
And Satan created McDonalds and the 99p double cheeseburger.
Then Satan said, "You want fries with that?" and Man replied, "Yes, and super size 'em".
And Satan said, "It is good."

And Man and Woman went into cardiac arrest.
God sighed. And created quadruple by-pass surgery.
And then Satan chuckled, and created the National Health Service.

Some people get disgusted - I guess it is the 'yuck!' factor - at the idea that a person can sell his or her own kidney for money, for example. We seem to live in an era of warped values about the donation and use of human body parts, as this article in Reason makes clear. It appears that in some jurisdictions, just about everyone is allowed to make money from the business of using human tissue and bone for medical purposes - except the people from whom the tissue and bone is taken (I think we can take it as read at a liberal blog like this that killing people for their body parts is wrong).

Virginia Postrel, the US-based writer, underwent surgery to give one of her own kidneys to a friend and made sure said friend is alive today (what a great woman Virginia is). As a classical free marketeer, Postrel does not understand why it is so terrible that such acts should be done for financial gain. She has a long and typically thoughtful piece on the subject here. She responds to those who fear that poor or gullible people might be led into selling their body parts out of financial desperation, but that is an argument about curbing poverty, not reducing human freedom. Ultimately, I own my body, and not the state, not the rest of the UK population, not Tony Blair, not god or the Great Cheese Monster in the sky. Of course, a "market in organs" may attract shysters and unscrupulous doctors, but as the Reason article I alluded to makes clear, there are plenty of shysters in the system now.

Of course, in a country like Britain where a lot of the population drink like fish, it is debatable whether anyone would want to buy our kidneys, or even take them for free.

There is a class of drugs called 'cognitive enhancers' that could potentially raise the intelligence, skills and productivity of users. Pharmocological enhancement is an anticipated bonus of the information revolution, and has been welcomed by many in the transhumanist community. These issues are now cognitive blips on the unenhanced specialist offices that civil services establish to monitor that horrible outcome of progress known as the Future.

When governments begin to understand that people could use a new set of drugs for improvement, they grasp for an improper P word, Prohibition. Their Puritanical wish to maintain a level playing field between themselves and the Populace demands that these substances be controlled, classified, prescribed, monitored and hopefully banned. Enhancement is a dirty word, but if these drugs have to be accepted, then they will make sure that we will use them on their terms:

Foresight, a Government think-tank, believes that "cognitive enhancers" could be "as common as coffee" within a couple of decades to help a person think faster, relax and sleep more efficiently....

The Department of Health has become so concerned about these drugs that it has asked the Academy of Medical Sciences (AMS) to assess the potential impact of the substances, some of which are licensed in Britain to treat narcolepsy or acute tiredness.

They are already being bought illegally over the internet in the US by people who think they will enhance their performance in the classroom and in the office.

Government attention in these drugs is unwelcome, since the report of Foresight or the Academy of Medical Sciences speculate about social problems as an excuse for regulation. One argument raised is that the pharmaceutical industry could abandon research into mental health and switch to 'cognitive enhancers' because of greater demand.

All of the evidence indicates that civil servants, politicians, and public sector professionals would not benefit from 'cognitive enhancers', since their increased intelligence would be expressed in greater fiscal and regulatory complexity. These classes should be prohibited from employing cognitive enhancement.

As if the threat of being bullied and labelled a fattie is not enough, there is now the risk that the state and its agents will take a child into care if that child is deemed "obese". Over the last few days, the press has carried reports of how a young boy, weighing in at a powerful 14-stone (196 lbs/ 89 kg), narrowly avoided such a fate.

My first instinctive belief is that the state has no business telling us about what should be the shape of our butts. In the case of children, responsibility lies with the parents, and there has to be real and sustained proof of neglect and abuse to trigger any form of intervention. In nearly all cases, my view is that the "cure" of taking an "obese" child into care will far worse than the supposed problem. Yes, extreme obesity, as measured in terms of excess fat vis a vis overall body shape, is not something to laugh at or dismiss. Although I have been lucky and born with a slim physique, I still try to build on that good fortune by keeping fit. There's no doubt that many people in Britain are unhealthily overweight. Lack of exercise, sedentary lifestyles and the demise of hard, physical labour all have an effect. But while I would encourage folk to look after themselves, ultimately, what people choose to do with their lives is their business, not mine. In the case of this youngster, realising that he is overweight should be incentive enough to do something about it. His parents may not be the brightest lights in the harbour, but from what I have read, they plainly adore their son, although they probably could exert rather a stricter control over his diet.

As we have also found in so many cases, paternalistic state actions often start to "protect the kids" and end up spreading towards adults as well. I hope this young man learns to take pride in his own health and can look back in future to this time in his life as one where he learned to control his appetite and also realise how dangerous the state has become. There are plenty worse things than having a large tummy, that is for sure.

If water were not so obviously essential, I wonder if it would now be even allowed:

If you drink too much water, eventually the kidneys will not be able to work fast enough to remove sufficient amounts from the body, so the blood becomes more dilute with low salt concentrations. "If you drink too much water it lowers the concentration of salt in your blood so that it is lower than the concentration of salt in cells," says Professor Robert Forrest, a consultant in clinical chemistry and forensic toxicology at the Royal Hallamshire Hospital in Sheffield.

Professor Forrest continues:

"When the brain swells, it is inside a bony box so has nowhere to go," he says. "The pressure increases in the skull and you may get a headache. As the brain is squeezed it compresses vital regions regulating functions such as breathing."

Eventually these functions will be impaired and you are likely to stop breathing and die. Warning signs included confusion and headaches.

No sniggering. This is exactly what happened to a Californian lady after she had taken part in a water drinking contest (a sport which should obviously be banned forthwith).

A government task force is clearly needed to keep a constant eye on the water threat. Once that happens, health warnings on water bottles are only a matter of time. "Water can seriously damage your kidneys", and so on. "Big Water" will be accused of peddling scaremongering stories about the alleged need for water, and the alleged benefits of water, and even nonsense about how, if you don't regularly wash with it, that might be a danger to your health.

Some time ago, I recall someone translating "water" into "hydrogen oxide" or "oxygen di-hydride" or some such thing, and listing all the dangers of this profoundly dangerous fluid, such as the definite danger of contracting cancer if you drank, say, forty gallons of the stuff at one sitting, and quite a few safety nazis fell for it. Well, now such anti-water campaigners have some hard evidence to work with.

Professor Aziz Sheikh has called for the National Health Service to provide separate (privileged?) services for Muslims to take account of their religious requirements. The Professor is of Muslim orientation and has written an article for the British Journal of Medicine, giving reasons for his argument:

Writing in the British Medical Journal, he said the NHS should record patients’ religion as well as their ethnic grouping. “It is absurd that we do not, for example, know the perinatal mortality or smoking prevalence among Muslims,” he said. Male infant circumcision should be available throughout the NHS, he added. Although some NHS trusts do offer circumcision, most parents are forced into the poorly regulated private sector, he said.

Aziz Sheikh is conflating two issues here: matters of health provision and providing specialised services for particular communities. Whilst there may be problems amongst Muslim communities in terms of infant mortality and chronic illness, it is unclear why their status as Muslims should predispose them to these. Indeed, habits of smoking, an inability to speak English in the United Kingdom as an immigrant and living in relative poverty are better indicators for life expectancy and health. Therefore, these arguments may demonstrate that Muslims suffer from these problems, but that the causes are not specific to Muslims in particular, but are generally prevalent amongst the poor and immigrant communities.

It is not absurd that we do not gather statistics on the basis of faith, as faith is not a primary indicator for health, unlike social class, education or the country of origin for your family. Aziz Sheikh has cited this argument to add ballast to his call for discrimination in favour of Muslims on the NHS. This points the article away from a public health agenda towards a medical version of the 'identity politics' that has hindered the effectiveness of other governmental institutions.

The NHS should be more accommodating to the religious needs of Muslims. Many Muslims would prefer to see a same-sex doctor for reasons of modesty, but this was often not possible, despite the increasing number of female doctors in the NHS. More information about drug ingredients should also be available to allow Muslim patients to avoid porcine and alcohol-derived drugs.

If a patient who is Muslim wishes to receive treatment that is compatible with his religious inclinations, the National Health Service is unlikely to meet their requirements. The rationing of healthcare is resolved in a mediocrity of outcomes based upon the equality of all - though contact with NHS personnel or class will often result in a better quality of care.

Aziz Sheikh's call for services in line with the Muslim faith could be interpreted as the natural demands of a community that has found its feet and started to request personalised treatment, in line with the oft-quoted rise of consumer expectations in health. Some could also see this as the further development of separatism within the Muslim community, demanding special treatment for itself.

The common factor is the state monopoly in health. It encourages communal responses to health issues, allowing professional leaders to make calls for particular treatment, with the corresponding balkanisation and backlash that we would expect from those who perceive that they have been missed out in any sharing of the tax spoils. Hence, the unedifying advance of 'white welfarism' in the leafy suburbs.

This would not be reported if health was a choice of individuals purchasing their requirements in a free market. The particular institutions would cater for those who wished to apply these requirements, and one would expect multi-faith alliances to obtain the critical mass that health provision often requires.

The problem is not Islam, it is the National Health Service.

It is a reflexive tic among libertarian types to describe Britain's NHS as 'Stalinist', in reference to its vast monolithic structure and institutional preference for central state planning. Now some indications that the parallels run a little deeper.

The Department of Health's first reaction to the campaign for people to opt out of the "Spine" medical records database, that I mentioned a couple of days ago, is not to attack it as 'irresponsible' as I was expecting. It is to demand that doctors report any patients who try to the authorities. "Let us deal with them," it appears to be saying.

The Guardian reported yesterday:

The Department of Health provoked uproar among doctors yesterday by asking GPs in England to send in correspondence from objectors who do not want their confidential medical records placed on the Spine, a national NHS database.

Sir Liam Donaldson, the chief medical officer, said letters from patients who want to keep their private medical details out of the government's reach should be sent to Patricia Hewitt, the health secretary, for "full consideration".

You will recall that such suggested letters were personal communications with doctors, asking them personally to do something: to code patients records so that they would not be uploaded to the Spine. That's something that can only (as I understand it) be done locally. "Consideration" by the Secretary of State defeats it.

It also seems to me that it would be a fundamental breach of confidentiality, and if the letter were posted, possibly a criminal offence contrary to the Postal Services Act 2000, for the letter to be forwarded to the Secretary of State without patient consent.

But neither law nor morals may stand in the way of the great plan.

...

BBC Radio 4 had another example this evening. Its File on 4 programme considered endemic MRSA and other antibiotic resistant bacteria in NHS hospitals. It interviewed a couple of epidemiological specialists who said with the current control regime slow progress was to be expected and the government target of 50% reduction in MRSA infections by 2008 is unrealistic. Andy Burnham MP, usually characterised as one of the brightest and best of the Primrose Hill group of New Labour heirs presumptive, was asked to comment. He said the complacency and defeatism of the clinical scientists was unacceptable: there was a target and the Health Service would meet it.

The CNE Health blog reports that Pfizer is to take UK's National Institute for Clinical Excellence (NICE) to court because of its refusal to allow tax money to be spent on its new drug for Alzheimer's disease. In a perfect system, NICE would not exist. But given our socialist healthcare system, I do not really like the idea of companies like Pfizer expecting that taxpayers must cough up the cash regardless of whether a treatment offers value for money. And to be fair, under a social insurance system or other private system, insurance companies would still make NICE-type decisions about whether something delivers value.

Meanwhile, Pfizer continues to lobby for taxpayers to pay more for pharmaceuticals by arguing for the end of the free trade in pharmaceuticals in Europe.

Take my advice, never trust a politician. When a politician tells you they are going to look after your child’s education, it's perhaps time to go private - or even to home educate. When a politician tells you they are going to ban guns – expect vast increases in gun crime. When a politician tells you they are going to ban dangerous drugs – watch out for your community being awash with these substances. My heart sinks when politicians get involved in anything. Invariably, they promise the earth, coercively tax you out of your hard earned money, and then they deliver bugger all when you really need the service.

- Helen Evans in the Nurses for Reform blog today (I thought it might liven up)

I particularly like it when blogging is being done, or is about to be done, by people whom I know quite well. And my friend Helen Evans has just this very day started a blog about nursing, called the Nurses For Reform blog.

That said, the prose style so far is rather corporate and armour-plated for my taste. However, despite the rather baffling word "contestability" - which is presumably some kind of Blairite code-word, for something or other - I think it is reasonably clear what is intended by the following:

NFR rejects bland egalitarianism in favour of contestability. Above all else we believe that greater partnership with the private sector is to be actively welcomed and that this sector’s contributions are good news for patients and healthcare professionals alike.

That suggests to me something quite like free market medicine, and of course I am totally for that. This next bit is definitely about free market medicine:

NFR believes in fundamental change. It believes that only by putting patients and consumers interests first will healthcare improve. It is only when healthcare is opened up to real consumers and trusted brands that nurses will find themselves working in a sustainable environment and with the incentives, resources and encouragement to deliver a responsive, popular and truly high quality service.

This says stuff I agree with, but in the manner of a corporate mission statement, and I loath and detest nearly every corporate mission statement that I have ever encountered.

Wouldn't it be fun one day to read one of these things starting with something like: "We believe only in superficial change. Fundamentally, things should stay pretty much as they are." And how about someone just occasionally admitting that he aims to supply an "unresponsive, unpopular" product or service? Many splendid tradespersons do just that and are richly rewarded.

However, since this is a corporate mission statement, I really ought not to carp. And since this is medicine and nursing care in Britain that is being talked about, well, I admit it, I do believe in "fundamental change". Nor can I reasonably object to the ambition that nurses should work, if at all possible, in a "sustainable environment", nor to them delivering a "responsive, popular and truly high quality service".

To be more serious, I have quite often heard Helen Evans say, in the plainest of English, that one of the many problems of Britain's National Health Service is that its nurses do not now have a proper career path in front of them. As soon as they get really good at their job, they tend to leave. The NHS has lost many of what would now be its NCOs, so to speak, good and experienced senior nurses being to hospitals what good and experienced sergeants are to armies. And where have they all gone? To get married, or to the private sector.

When the postings at this new blog get more specific and personal, as I am sure many of them will, I will surely read them with interest and pleasure. There will be more links from here to there in the future, I promise you.

I came out of hospital yesterday. La Belle Dame is in America making money (one of us has to) so Dave picked me up and steered me home. I live quite close to the Chelsea & Westminster and needed some air to clear my head so we walked back. I felt surprisingly well considering I have been under a general anaesthetic and had quite a few squishy bits from inside lopped off me. In fact I felt amazingly well.

The journey back home was interesting. The colours were so very bright and someone seems to have turned up the contrast. Sometimes when I looked closely as the things written on the back of people's tee-shirts whilst walking down King's Road, the words seemed to suddenly zoom away from me towards some vanishing point.

Getting home and having a nice shower was a transcendent experience but the thing that really kept me captivated was the way the water fell down, coming from hundreds of feet above my head and travelling downwards towards the gleaming ceramic floor perhaps three yards below. I could feel the vibration of the water spiralling down the plughole and the strange flute-like sound it made.

I looked forward to getting some good food as being chopped up had not dented my appetite and the hospital food was moderately dreadful. When it came time to eat, for some reason Dave would not let me near the hot stove. The smell of bacon was almost erotic.

Dave and I work together and I had been struck by some really good creative ideas whilst pacing back and forth in the ward the night before last, waiting for the frigging painkillers to actually do something. The ideas kept pouring out of me and Dave just absorbed them like the 185 IQ colossus he is. For a while at least.

But then I noticed that I was having to force the ideas out through clenched teeth and they kept bouncing off Dave's head rather than going in. To make matters worse although the bacon surrendered to me willingly, the sausages were staring at me with ill concealed contempt. I stabbed a couple to death as punishment and gave the rest to Dave.

Today I find the internet in front of me and deep throbbing pains from within. Be prepared from some bad tempered blogging over the next few days when I can drag my fingers to the mouse. Tramadol, Co-Codamol and Diclofenac are pallid impostors. Sister Morphine is a fickle lover and she would not come home with me.

The threats to liberty in Britain are too numerous to keep track of. Thanks to Josie Appleton on Spiked! for this, which I had entirely missed before now:

The Safeguarding Vulnerable Groups Bill, due to return to the House of Commons next week, will mean that 9.5million adults - one third of the adult working population - will be subject to ongoing criminal checks.

It is a House of Lords Bill, but has Government backing.

The Bill would create an Independent Barring Board (IBB), which would maintain "barred lists" preventing listed individuals from engaging in "regulated activities". "In respect of an individual who is included in a barred list, IBB must keep other information of such description as is prescribed." [cl.2(5)]

As the Bill was originally presented, you would have no right to damages if you were mistakenly or maliciously included in a barred list, and nor would anyone else. And the IBB would have been an absolute finder of fact, with appeal allowed only on a point of law. So among the things the IBB would have been independent of is responsibility for its actions.

Now things are slightly better, but there's a cunning pseudo-compromise. You can sue. And you can now appeal the facts. But the criteria applied in the application of policy to an individual case - the core of what the IBB would do - is expressly (with a shade of Guantanamo) deemed not to be a matter of law or fact, and are therefore not to be subject to examination by the courts [cl.4(3)].

The schedule of "regulated activity" is 5 pages long in the printed copy. So you'll have to look it up yourselves if you are interested.

The practical effect? Well, as an example, as I understand it, if the Bill were currently law, I would be committing a criminal offence in paying someone I trust to look after my elderly mother, who is currently convalescing from an operation, without both of us being made subject to official monitoring first.

Once it is in force, if you wish to be self sufficient - even if you don't value your privacy, and are confident that theree's nothing about you to which an official could possibly have objected in the past, and that you might not be confused with anyone else - you'll need to know if a family member is going to be ill in sufficient time to fill in all the forms and wait for them to be processed. Better leave it to the state - which is of course always perfect.

The obesity crisis, epidemic, or whatever (is fatness contagious?) continues to keep the chattering classes busy. In the Daily Telegraph today, Andrew O'Hagan, of whom I was blissfully unaware until about a month ago when he sprung to the defence of Mel Gibson after he made his anti-Jewish rant, argues for stuff like taxing "junk food" and encouraging a whole cultural battle to get the moronic lower orders off their dietary habits. It is an article reeking of disdain for vast swathes of the UK population. Perhaps it is deserved. Many Britons are disgusting people, I suppose, but being the wild-eyed libertarian that I am, do not consider it my business to nag them into eating better by a mixture of state exhortation, punitive taxes and compulsory five-mile runs.

I am not entirely sure what to make of Mr O'Hagan, or indeed the decision of the right-leaning Telegraph to hire him. I thought his article on Gibson was a terrible piece, both patronising towards Jews, other groups, and offensive but perhaps a one-off lapse, one which might not be repeated. But pretty much everything he has written since seems to be entirely lacking in humour, grace or wit. I fear that paper is in one of its down-cycles. O'Hagan may perhaps fit in nicely into the modern Conservative Party.

For a related article on obesity, diet and the nanny state, read this by Jacob Sullum.

Scientists have observed that smoking pot may stave off Alzheimer's Disease. Hmm. I am not a medical expert, but this is not the first time that people have claimed medicinal benefits for smoking this substance. There appears to be quite a steady drumbeat of support for the idea that marihuana may beneficial and that some of the scare stories are just that - scares. Of course, there are certain downsides to a "spot of blow": such as a desire to suddenly consume the entire contents of one's fridge (I speak from
experience over several years' ago).

The War on Drugs is a disaster on many levels. Besides the encouragement to organised crime, the corruption of the legal system, and the obvious assaults on individual liberty, one of the stupidest aspects of said war has been the way in which substances like pot, which might have useful properties in dealing with certain conditions, are ruled off-limits by the law. It is high time ('scuse the pun), that the law was changed.

Remember, when was the last time you heard of a bunch of young British youths getting into a fight because of lighting up a large bong as opposed to being blind drunk?

Last month, it was this:

A report published by the government predicts more than 12m adults and one million children will be obese by 2010 if nothing is done.

And this month, there is this:

Culture Secretary Tessa Jowell has called for "stick-thin" models to be banned from the catwalks during London Fashion Week...

Ms Jowell said "stick-thin" models pressurised girls to starve themselves.

Damn these wretched sheep! Can they not get anything right? One minute, they are stuffing their ovine faces with calories and the next minute they are starving themselves. Have they no pity for the suffering of the Nagging Classes?

That the BBC can earnestly report, almost simultaneously, two flagrantly contradictory agenda-driven hysterias is symptomatic of the fact that we have too many paid worriers with too little to worry about.

I am sure that ours is not the first civilisation to undergo spasms of a sociological St. Vitus' Dance nor will it be the last. But have there ever been so many popular hobgoblins surrounding the subject of food and eating? Could it have something to do with the fact that ours is possibly the first (or maybe second) generation that is more than one rainy season away from famine? Is it all just a part of the struggle to find a cultural narrative within which to fit this apparently easy abundance?

Who can say? But the sheep will graze on regardless.

This seems like a good idea

The Financial Services Authority (FSA) is to hold a six-week exercise to test the resilience of the UK's financial institutions to an avian flu pandemic.

Starting on 13 October, some 60 banks, insurance firms and other financial businesses will take part.

The exercise will look at a number of factors including how firms could cope with a greatly reduced workforce

Yes, I know that we free market purists might argue as to why we need a big regulator like Britain's FSA to set this up, but even in the absence of such a body, smart businesses would be looking to stress-test their systems against a potential serious problem like avian flu. And it is serious. Naysayers may jest about how much effort was expended on the Y2K technology issue (remember that?) but I am encouraged that these sorts of issues are taken seriously. The health of the London-centred financial system is critical, not just to the British economy, but to the wider trading system as well.

Tyler Cowen, hardly a scaremonger, has thoughts about possible preparations that should be taken.

The journey from environmentalism to sanity may not be so far after all:

The World Health Organization (WHO) has reversed a 30-year policy by endorsing the use of DDT for malaria control.

The chemical is sprayed inside houses to kill malaria-carrying mosquitoes.

And about bloody time too! The prohibition of DTT was a product of wrong-headed, fashionable green dogma and Lord only knows how many people in the developing world have paid for it with their lives. Just how many neural transmitters do you have shut down in order to hand-wring about poverty and premature death in the developing world while simultaneously campaigning against everything and anything that stands a chance of tackling them?

I sincerely hope that the greenslimers are seething with thwarted rage. In fact, I hope their blood boils until they have a collective stroke. I wish a pox on them (before they unleash a pox on the rest of us).

London calling! London calling! Reports are coming in of growing resistance to the brutal occupation of the Food Nazis:

Pupils at a South Yorkshire school are being fed fish and chips through the gates by parents who say the canteen is not providing what their children want...

The move is being seen as a backlash against TV chef Jamie Oliver's campaign for healthy school dinners..

"We aim to provide good quality food which is within government healthy eating guidelines and helps the children's learning in the afternoon "...

"The food that these parents are handing out is not part of a healthy eating diet and on top of that I have to question the morality of delivering it from the grounds of a cemetery."

Smuggling food into prisoners is a time-honoured practice but I have to admit that the cemetery angle is cool. They may need to start digging tunnels though.

Hopefully, this is a 'line in the sand'; a message from the public to the ruling class paternalists and busybodies that their food fascism is an intervention too far.

British government scientists claim that Britain faces a growing crisis of obesity. And of course such predictions, which carry all the usual credibility of such things, are accompanied by calls on the powers-that-be to "do something" about it, including the likes of bans on advertising for sinful foods, funding for sports and so on.

First point: even our waistlines are expanding, is it any of the state's business? At present, one might argue that because we have socialised medicine in the form of the National Health Service, taxpayers, both slim, chubby and positively enormous, have to pay for the consequences of bad health habits. So the neo-puritans will argue for controls on how we all live to reduce the tax cost of bad habits, which is an example of what economists might call a 'negative externality'. Surely though, the approach that would encourage good habits and treat citizens like adults is one based on private medical insurance. If people want to cut their insurance premiums, then they will have a strong market-driven incentive to do so. In a private sector model, there may be much more encouragement from health providers to get in shape and give up the triple cheeseburgers. Of course, there will always be feckless people who do not give a damn and end up demanding some kind of handout when things go wrong, but I do not see why the liberties of the majority of us should be tossed away to deal with people who are too weak willed or plain stupid to act differently. In any event, I imagine that as in the days before the NHS came along, there will be health care available for those who cannot afford it - as James Bartholomew pointed out in his book - provided through charitable means. I actually think that a charity which supports doctors might, for example, insist that if a poor person wants to get medical care for his or her obesity-related problems, then as part of any treatment, that person has to do something about their problem.

Such an approach may, at first sight, appear to be 'unaring' or harsh, but I think there is no greater respect that one can give to one's fellows than to accord them the ability to act like adults.

Goodness, all this venting has made me hungry. Anyway, as I head towards the kitchen, may I recommend this collection of articles by Reason magazine on the obesity issue.

Bon appetit!

The British Medical Association's response to a proposal by the British government to allow optometrists more leeway to prescribe medication for eye problems.

"In order to safeguard patient care, the BMA's ophthalmic committee can only envisage extremely limited opportunities for optometrists to make therapeutic interventions."

I wonder whose interests are really being 'safeguarded' here.

It seems there is a shortage of certain drugs in Britain's National Health Service.

Joe Fortescue from Alfreton, Derbyshire wants the government to provide more diamorphine, which has been in short supply since 2004. He said his 49-year-old ex-wife from Nottingham was screaming in pain in the days before her death because it was not available.

Horrendous. We are not talking about sophisticated and costly cutting edge drugs here, just a strong painkiller. As someone personally currently gobbling none-too-effective codeine painkillers every four hours after a close encounter with the NHS yesterday, dare I say I 'feel the pain' of those relying on the NHS in their time of need.

Perhaps the ex-husband of the hapless woman who died in agony for want of the correct drugs should have just scored some himself, available to anyone driving slowly with their windows open in the crappier parts of most large British towns and cities. Diamorphine is essentially just heroin after all and needless to say the 'free market' in heroin has no difficulty supplying public demand. Only the state could be inept enough to be unable to find heroin for a dying woman.

Truly the state is not your friend.

The NHS is now being instructed to turn its back on 'alternative' treatments such as homeopathy. This is a very good beginning... now all we need is for it to turn its back on non-alternative treatments too and Britain can start to allow a First World healthcare system to develop.

I recently had a very interesting chat with my good friend, Steve Edwards, who is currently without his own blog - although probably not for much longer. He is a regular at libertarian.org.au, however. In the course of our conversation, he informed me that HIV risk-of-transmission rates are not nearly as high as I previously thought. Consider this - for every 10 000 exposures to an HIV-infected source, it is estimated 5 will contract HIV via insertive penile-vaginal intercourse. 10 will contract HIV via receptive penile-vaginal intercourse. These figures assume no use of a condom. Click the link for the risk via other routes of exposure.

This got us both thinking about the HIV/AIDS epidemic epicentre of Sub-Saharan Africa. Given the very low rate of HIV transmission through sexual intercourse, is it really feasible that a country like Botswana has an infection rate of 30%+? If the ratio mentioned above is correct, an African male with an average number of vaginal sexual encounters can have unprotected sex with only HIV positive partners for a lifetime and still stand a reasonable chance of not contracting the virus. How could a virus that difficult to catch spread through a population so comprehensively?

I am not saying that HIV/AIDS is not an enormous problem in Africa - of course it is. And I do not discount the anecdotal evidence of health professionals who report a multitude of AIDS orphans and hospitals groaning with AIDS-riddled patients. I am sure this is the case, however from the limited perspective of a person's experiences, how could they possibly tell if this casualty rate represents 30% of a population of several million or 3%? 10% or 1%? Sick people do tend to cluster in hospitals, and health professionals go where the need is great. Given this working environment for doctors and nurses treating HIV in Africa, they could be forgiven for believing an inflated number. Conversely, if a foreign doctor spent a month in the wealthier parts of Nairobi, they would probably report to the folks back home that they saw no signs of HIV/AIDS at all.

I do not doubt that there is a large amount of research that has gone into producing the figures commonly cited when detailing the scope of the HIV outbreak in Africa. I would, however, ask sceptics to ponder the beneficiaries of an inflated threat of this disease. The NGOs, university teams and (most) African governments are in accord regarding the magnitude of the AIDS threat. To use the old saying; well - they would be, wouldn't they? This issue is a magnet for foreign aid and grant money. After all, African despots need to keep their wives in the style they've become accustomed to. Not to mention one's stooges who require regular buying off. NGOs need to run their fleets of SUVs, hold their conferences in five star hotels and generously employ their "support staff". University professors need grants to carry out their research. I should not forget the UN - regarding that sprawling organisation's potential conflicts of interest, the mind boggles. These people all have a stake in talking up the HIV/AIDS problem. These are also the people who provide us with data concerning HIV rates in Africa.

I am not a scientist, and I have no specific expertise in this field. I could be omitting important variables that make the scale of the HIV/AIDS problem in Africa that we're told about more tenable. However, when considering the far lower than popularly believed HIV contraction rates, I smell a rat. What makes me even more suspicious is the fact that the beneficiaries of an overinflated HIV threat in Africa appear to be African governments, NGOs and foreign researchers. Even in rich nations, resources are scarce. We need accurate information to distribute them in optimal fashion. Please set me straight if I am wrong to question, but are we being lied to about the scope of the HIV/AIDS problem in Africa?

Life is far more fun when you have a really good book on the go, and the only thing wrong with mine just now is that it weighs too much to be lugged about comfortably on my pedestrian journeyings around London. It is The Lives & Times of the Great Composers by Michael Steen. For me, this book is perfect. I know what most of the music that the great composers composed sounds like. But I am enjoying hugely learning more about the circumstances in which this wonderful music was composed and first listened to.

After an Italian prelude, the first big name composer Steen deals with is Handel, the German who ended up living in London for most of his life.

Handel's London was an exciting place (p. 39 of my unwieldy paperback):

The year before Handel arrived, Sir Christopher Wren's St Paul's Cathedral had been completed at a cost of £1,167,474 paid for largely by the import duty on coal. Sir Isaac Newton, the great scientist was still at work. London, with its sounds of wheels rumbling on cobbles and cries from the street vendors, was well into a century of commercial and cultural prosperity: the country's population grew by 71 per cent over the century; its merchant fleet more than doubled in tonnage between 1702 and 1776.

London, in other words, then as now, was making lots of progress. Perhaps because music itself can be such an otherworldy thing, even when composed by such a worldly figure as the energetically entrepreneurial Handel, Steen chooses in this book to emphasise the material aspect of things when describing the world in which this music was created.

The kind of people who enjoy the fruits of material progress, but who enjoy them more than they think about how they were first devised and are now cultivated, often dismiss progress as a small thing, perhaps because they dislike the kind of people who are needed to make it, and the methods they must be allowed to use. (Basically: commerce. And insofar as "public spending" is involved, someone has to make that money first before it can be spent.) Such people should ponder pieces of writing such as what Michael Steen says next about Handel's London:

Behind its superficial prosperity and elegance, London was overcrowded, squalid and full of beggars. People had fleas, lice and few teeth. Most people defecated in nooks and crannies, or used public lavatories built over rivers such as the Fleet. For the more refined, with a small fee, the 'human lavatory' would provide a pail and extend its large cape as a screen. Lavatory paper did not exist, the alternatives ranged from a sponge on a stick in a container of salt water, to stones, shells and bunches of herbs.

Delightful.

But the most chilling observation Steen makes about the trials and tribulations of material life in the early eighteenth century - instead of the early twenty-first, say – is this, a couple of paragraphs later:

The political outlook was uncertain.

So? When was it not? But now, hear the reason:

Queen Anne, who was in her late 40s, had borne seventeen children; mostly still-born, none had survived.

Let an anti-progress person of now read that, and then try telling us that material progress of is no great importance, or of no "spiritual" significance, that it is merely a matter of brute, animal comfort. The Queen of England, no less - who presumably enjoyed, if that is the word, the very best medical attention then available - scored zero out of seventeen in the deadly game of childbirth and child-rearing; which meant that there was no obvious royal heir, which meant that the political outlook was uncertain. Poor, poor woman.

Later (p. 54), Michael Steen throws light on another kind of material progress, of a sort that is far more widely and deliberately scorned than progress in things like plumbing or medicine (which is often merely forgotten about), namely cosmetics. Steen has this to tell us about the way that the sort of women Handel often had dealings with - such as the highly paid and outrageously indulged and pampered opera singers whom he supplied tunes for, the crazy rock stars of their day – tried to beautify themselves:

Their faces were painted with compounds of white lead, rice and flour, with washes of quicksilver boiled in water with bismuth.

Suddenly, the progress made in female adornment, which has put incomparably more convenient and healthy – to say nothing of far more visually appealing - methods of adornment into the hands of any modern woman with a few quid to spare who wants them, appears almost as impressive as progress in plumbing, medicine, nutrition, travel, civil engineering, electronic entertainment, or even the wondrous progress that was about to be made in the two centuries after Handel, in music.

Many moral questions are tricky, requiring complex theories and difficult judgements... but many more moral issues are really very simple when you look at them clearly. Manditory mass medication is one of those simple issues. I am as keen as anyone else to not see epidemics of infectious disease and in the case of such, I take the view that it is rather like why you have states to fight against foreign armies: a collective threat to everyone can sometimes only be faced by a government acting collectively. However very few things fall into this category, but infectious disease is one which indeed does - a collective threat that can only be defeated collectively. So yes, I am all for property rights but that does not include having a malarial breeding swamp on your property next to mine or infecting everyone's water supply with some nasty bug.

Birth defects on the other hand, are not a 'collective threat' and so taking folic acid to avoid certain birth defects is the responsibility of anyone who does things likely to get them pregnant. So when Max Pemperton writes an article in the Telegraph opposing government plans to force bakers to add folic acid to bread, you would think I would be supportive of him, right? Well no.

In his article Folic acid is not the best thing since sliced bread he goes into a great song and dance about the pros and cons to various groups in the population of adding folic acid and whilst he does talk about civil liberties, he is mostly just making a utilitarian argument of net-benefit. He ends with saying "It's certainly a complex moral dilemma"... and that completely fogs the issue.

No, it is actually a very simply moral dilemma: does anyone have the right to alter my body chemistry to benefit other people when my body chemistry poses no threat to anyone else (unlike if I have smallpox, for example). The question (does the state have this right?) and the answer (no) are not complex at all. If women want to avoid neural tube defects in their children, they should take folic acid. Making me take it as well will not help and is none of anyone elses damn business.

Few things are as impermanent as medical theories of 'what is best', so the utilitarian argument is utterly irrelevant. As it happens I take folic acid pills for a medical condition so I have nothing against the stuff myself but that does not change the fact the state has NO moral right to medicate me in such a way and anyone who trusts the state to pick 'what is best' for your health and make it a force backed law really needs to take a look at the state's history of screw-ups and ask themselves is this is an institution which should have the right to mess with your personal body chemistry.

Fans of the great Stanley Kubrick satire, Dr Strangelove, will struggle to suppress a wry smile over this story:

Fluoride in drinking water - long controversial in the United States when it is deliberately added to strengthen teeth - can damage bones and teeth, and federal standards fail to guard against this, the National Academy of Sciences reported on Wednesday.

The vast majority of Americans - including those whose water supply has fluoride added -- drink water that is well below the limit for fluoride levels set by the U.S. Environmental Protection Agency (EPA)

Maybe all that stuff about flouride in the water being a crazy Commie plot may not have been so nuts after all. On the other hand...

This story about advances in creation of artificial limbs and muscles caught my attention:

Scientists have developed artificial, super-strength muscles which are powered by alcohol and hydrogen. And they could eventually be used to make more advanced prosthetic limbs, say researchers at University of Texas.

Writing in Science, they say these artificial muscles are 100 times more powerful than the body's own. They said they could even be used in "exoskeletons" to give superhuman strength to certain professions such as firefighters, soldiers and astronauts.

As we ponder the flow of day-to-day news, it is easy to overlook the tremendous advances going on in fields like this. As the article mentions, applications of such medical technologies apply not just to repairing existing injuries or coping with the terrible effects of losing a limb (a sobering reality for victims of terror, car accidents, conflicts, etc), but even for perfectly healthy people looking to augment their physical strength.

The story demonstrates how blurred the boundaries now are between medical technologies that can be used to repair or heal injuries and those used to make what we have picked up in Darwin's great lottery draw even better. The genetic fatalists will decry all this for tampering with God's Will or whatever, but I don't see any difference between this and say, laser surgery for the eye, or technologies to make it possible to vastly increase our hearing strength, or enhance our cognitive capacity, and so forth.

Mind you, it makes me wonder how this technology, if it really works, is going to affect sport. At the moment the sporting authorities controlling events like the Tour de France cycling event, say, or the Olympic Games, treat any form of human augmentation or performance enhancement as off-limits. I guess so long as participants agree in advance not to use such techniques, then they cannot complain if they are caught breaking the rules. But in some occupations like those mentioned in the story, such as astronauts experiencing the effects of zero-gravity environments, this sort of stuff might be a basic necessity rather than a luxury.

Meanwhile, here is an interesting story about nanotech and possible cures for blindness. And I can recommend this book by Ronald Bailey.

Makes a change from writing about Tony Blair, anyway.

Exhibit A from the United States. That 100 pattie burger looks tasty...

(Spotted on Marginal Revolution)

Exhibit B from the United Kingdom - wait a few seconds to be diverted.

Both sites for the epicureans amongst us, most certainly.

I have come across a press release from Britain's National Health Service. The NHS is currently trying to prevent obese people from having hip replacement operations as they do not "deserve" to have such treatment, despite the little matter of their having been taxpayers like the rest of us.

"The NHS, like any proud creation of a socialist, inclusive Britain, has to operate under certain priorities. Indeed its founder, the great Soviet leader Nye Bevan, stated that socialism is about priorities. Well, there is no place and certainly no priority to treat people, who, by laziness, sloth and lack of intelligence, choose to make themselves ill or incapacitated. In fact ill people are a positive nuisance. It is the fit, able-bodied and alert people of Britain who deserve to be treated by the Greatest Health Service Devised by Mankind. No more obese people. No more smokers. No more drinkers. No more red meat eaters and chocolate fans. Such habits have no place in a socialist Britain. Let such vile habits wither away."

I am still trying to vouch for the authenticity of this release. Looks plausible to me.

As Christmas is almost upon us, it is a pleasure to read a nice article by a doughty basher of nanny-state puritanism, Jacob Sullum. Sullum states what many of us probably instinctively know to be true - a bit of what you fancy is good for you. Dark chocolate (yeh!), red wine (yeh again!) and even red meat (thrice yeh!).

So in the interests of good health, I am now eyeing a bottle of fine Rhone red wine sitting on the rack in the kitchen.

I have long gotten a laugh from Dilbert, the socially inept engineer comic created by Scott Adams. Usually, Dilbert is harmless, but occasionally he causes real damage. Last Sunday's cartoon, which features Dilbert's mother in an excessive shopping adventure that ends with organ harvesting struck me as rather amusing, but according to Scott Adams' blog, dozens of people failed to see the humour in it:

Recently I killed thousands more people. I don�t have exact numbers yet. The problem stems from my comic that ran on 11-20-05, implying that retail stores might harvest organs from bad customers and sell them on eBay. I�ve received dozens of letters (long ones!) from very angry people who assure me that the Dilbert comic will reduce the number of organ donors. The concern is that people will think their parts will end up on eBay and so they won�t be inspired to donate.

This would only have an impact on exceptionally dumb potential organ donors. But as you know, that�s a large block of the general population. Now I have to wonder how many people are smart enough to read an entire Dilbert comic and still dumb enough to think that the first person on the scene of an accident might be there just to harvest organs for eBay. It can�t be more than 1%. Let�s see, we estimate 150 million people read Dilbert, so 1% would be 1.5 million. And only 10% of them might have donated an organ anyway, so I�m probably killing 150,000 people.

It�s times like this when �oops� doesn�t seem sufficient.

I bet you did not know that cartoonists could be so dangerous. If you ever meet Scott Adams, approach with extreme caution.

One of the concerns appearing on the radar is the impact of a flu pandemic upon Africa, where a rudimentary infrastructure for health is combined with the largest number of individuals with HIV and AIDs. A common mistake is to view this latter group as the most vulnerable to a flu pandemic, with a potentially catastrophic death rate.

Recent comments by Dr. Robert Webster, at an avian-influenza conference, organised by the Council for Foreign Relations, in New York, theorised that HIV positive patients and those suffering from cancer could act as incubators for the virus, leading to more virulent strains. However, there is evidence to support the view that immunologically compromised individuals will not facilitate the spread of the pandemic:

Stephen Wolinsky, chief of the infectious diseases division at the Feinberg School of Medicine, concurred that prolonged shedding of the virus was a definite problem but referred to a study published earlier this week that stated that immunodeficiency may in fact be a benefit in the face of avian influenza.

The study, published in the journal Respiratory Research, indicated that the young and healthy may be those most seriously affected by avian influenza, as the body's immuno-response was to produce a storm of cytokines that can lead to respiratory difficulties.

Wolinsky opined that, for Africa, the lack of access to doctors and hospitals may prove to be a greater concern in the fight against avian influenza than the continent's HIV/AIDS epidemic.

This region has been identified as a potential outbreak region for the pandemic. Farming practices that bring farmers into close proximity with poultry, are compounded by non-existent public health schemes and a large proportion of the population suffering from ill-health and malnutrition.

The H5N1 virus overstimulates the immune system, and many of its powerful effects are caused by what medical expert call a "cytokine storm", after the immune molecules excited by the disease.

It was the cytokine storm that overwhelmed so many victims of the 1918 flu pandemic. Aids patients may be spared that fate.

But equally possible, with their immune defences down, they could succumb easily to the disease.

"In that situation," said Laurie Garrett, "vast populations of HIV positive people could be obliterated by the pandemic flu."

Laurie Garrett, senior fellow for global health at the Council of Foreign Relations, was identifying the worst case scenario.

Alexia Harriton, an Australian woman who is deaf, blind, physically and mentally disabled and requires round-the-clock care, is suing a doctor for allowing her to be born, with the full support by her mother. Never mind that rubella during pregnancy does not guarantee what happened to Ms. Harriton.

I have a better idea. If she is competent to sue the doctor, she is competent to tell the people giving her round-the-clock medical care to get lost and let nature take its course. Hell, she could tell one of them to leave a nice sharp knife or a cup of water and a bottle of sleeping pills within reach if she wants to expedite things and if she cannot manage that, well seeing as how her mother is so supportive...

Why should a doctor be liable for an 'act of God'? So he did not diagnose how thing would shake out correctly. Too bad, no one is perfect.

Seems to me that Alexia Harriton and her mother were born moral and emotional cripples too. Nature dealt them a seriously crap hand and that is truly tragic but it is no one's fault. It happens. Deal with it, but please, deal with it yourself. Think I am being a little harsh? Well I do not think so and I have my reasons.

A study claims that the long-term effects of smoking tobacco can impair mental functions. My goodness, what other horrors can the dreaded weed be held responsible for? I don't smoke and dislike the pong of cigarette smoke in my clothes after visiting a pub, but is there no limit to the ways in which our blessed medical profession want to condemn smoking? The claim rings false to me (I am not a scientist mind so if this can be verified in a peer-reviewed journal, I'll stand corrected). There have been lots of brainy smokers over the years, surely.

I wonder how many members of Mensa have been smokers?

Just as the NHS is the darling of the British people, it will come as no surprise that its failures are increasingly covered by the tabloids, who have found that the crisis in health provision is a concern to those who have to rely on the state through no fault of their own. High taxes and expensive private health care denies choice to the majority of the population.

One of the latest (and incredible) stories to emerge is a lack of mops in Victoria Infirmary in Glasgow:

PATIENTS spent two days in "grotty" wards - after a hospital ran out of mops.

Cleaners at the Victoria Infirmary in Glasgow were left stunned after bosses told them of the shortage. And it took two working days for the hospital to replace all the mops.

A source at the closure-threatened hospital said: "We knew things were bad here but this takes the biscuit. Cleaners went to work on Wednesday and were told there were no mops and nothing could be done about it

Only scenes such as these could be caused by a state monopoly of health:

After replacement mops arrived on Thursday, a source revealed that hospital staff celebrated.

The insider revealed: "People were dancing around the boxes, singing and chanting, 'We have mops.' " The source added: "No wonder our hospitals are riddled with MRSA superbugs and such like if they can't get something as simple as this right."

Only the NHS could ration health and mops!

"Organic farming has been put forward as one of the major pillars of a new, more-sustainable human society that would be "kinder to the earth". Unfortunately, organic farming cannot deliver on that promise. In fact, organic farming is an imminent danger to the world's wildlife and hazard to the health of its own consumers."

Dennis Avery, quoted in Fearing Food, (page 3) by Roger Bate and Julian Morris.

Something for George Moonbat to ponder, I reckon.

The pharmaceutical industry has been running an ad campaign in the United States saying that reimportation of drugs from Canada were allowed, those drugs might be counterfeit, unregulated and unsafe. This is simple propaganda and nothing more.

Pfizer's Chief Executive Officer Dr Hank McKinnell has come out and contradicted his industry's advertising. On page 69 of his new book, he says that: "Drugs from Canadian pharmacies are as safe as drugs from pharmacies in the United States." Pfizer vice-president Dr Peter Rost says that drug company lobbyists "know full well" that drug reimportation has "been done safely and cost-effectively... in Europe, for over twenty years... The German Federal Health Ministry has verified that not one single confirmed case of a counterfeit medicine has ever come through the parallel trade chain. The UK regulatory authority has described the level of pharmaceutical counterfeiting as 'virtually undetectable'."

They were not speaking on behalf of their employer.

Dr Rost's view is confirmed by Donald MacArthur of the European Association of Euro-Pharmaceutical Companies who in November 2003 testified at a US Senate committee. MacArthur said: "As far as can be ascertained there has never been a single, proven case of a counterfeit medicine leaving the parallel trade supply chain in Europe. Certainly, none has been reported in the two largest markets for incoming parallel trade - the UK and Germany; in the case of the latter, the government has recently verified this fact".

In the US, where reimportation is illegal, counterfeiting is on the rise. The ban on reimportation has led many people who cannot afford the cost of drugs from their local pharmacy to use online shops they have never heard of to illegally get cheap drugs. Some of these websites, which are marketed through spam e-mail, claim to be in Canada but are based in developing countries and fail to deliver anything or supply counterfeit drugs.

If the US wants to fight counterfeit drugs, it should follow the European model and let legitimate, properly-regulated businesses, which consumers can trust, safely and securely reimport pharmaceuticals. That way, the drugs get imported from legitimate wholesalers in Canada and Europe. Contrary to claims of pharma's lobbyists, it is America's ban on reimportation that promotes counterfeiting. The US government should adopt free trade in pharmaceuticals not just to reduce prices but to reduce counterfeiting, too.

Crossposted from the Globalisation Institute Blog.

Last summer, I went on very public record with my opinon that the überhyped and screechingly hysterical 'obesity epidemic' was nothing but a crock of shit, cooked up (in this country at least) by grasping public sector vested interests and amplified by their MSM handmaidens.

While I will continue to do whatever is in my power to undermine this whole wicked, mendacious plot over here, I am pleased to note that there is also some serious fightback going on over on the gun-toting side of the Atlantic:

One would be forgiven for thinking CDC stands for Center for Damage Control. Just a year after its widely-publicized and exceedingly controversial announcement that excess weight kills 400,000 Americans annually, the agency is rumbling, bumbling, stumbling toward an explanation for a new study that says the real figure is just 26,000.

Unfortunately, trial lawyers who see dollar signs where the rest of us see dinner have seized on the CDC's 400,000 deaths number to justify their frivolous crusades.

Now word comes from experts within the CDC that excess weight is about one-fifteenth as dangerous as previously thought, and has a lower death toll than diseases like septicemia and nephritis. Each death is of course tragic. But has anyone heard of the septicemia "epidemic" or the nephritis "tsunami"?

It's said that a lie can travel halfway round the world while the truth is putting on its shoes. Well, the truth about obesity is finally lacing up. And that's bad news for trial lawyers pursuing obesity lawsuits against food and beverage companies as well as the self-appointed diet dictators seeking extra taxes on foods they don't like.

Not that that will stop them, mind. Truth has little currency when compared to the value of a well-forged career-path or the tantalising lure of brimming public coffers. (By the way, the link above is to the website of an American organisation called the 'Center for Consumer Freedom'. Not only do they appear to be on the side of the Angels but their website looks like an excellent activist resource that is well worth a bookmark).

Still, the backlash has to begin somewhere, somehow and debunking the fraudulently inflated statistics is an important part of that process. However, it is equally important to maintain the principle that, even if all the har'em-scar'em statistics were true (which they clearly are not) then the responsibility for and solution to the problem of obesity lies with the obese themselves and not with judicial system or the apparatus of tax-collection.

Story here that says that far from being a bad thing, sitting outside in the sun for at least 15 minutes a day is good for you, latest medical findings suggest. It certainly is a bit of a change from the period, I well recall, in the 1990s, when it appeared to be the case that any exposure to sun was fraught with danger as a result of the supposed hole in the ozone layer. I recall the constant worries, fuelled in the press and elsewhere, about skin cancer and the dangers of overdoing the sunshine.

Sometimes you have to just laugh. Of course being exposed to the sun is good for you in moderation! Mankind was not meant to sit indoors or conceal every aspect of the body all the time. Anyone I know who spends the vast majority of his or her time indoors looks, well, unwell, in my opinion. I always make the effort to break out of my office at lunchtime to get what passes for sunshine in this damp country of ours. It is not rocket science.

Coming next: medical experts reveal that regular exercise, eating vegetables and playing sports can do you some good.

The steady advances in cloning technology holds a great deal of hope the future of the species and the news from Korea and Britain has been pretty damn encouraging over the last few years. It now looks like we could be on the brink of being able to mass produce stem cells and that, boys and girls, could be the gateway to a new era of medical possibilities.

�This is really the destruction of the National Health Service."

- Professor Vincent Marks of the University of Surrey on the Today programme this morning discussing the modest government announcement to allow more private involvement in the National Health Service.

It takes some nerve to announce this on the day of a General Election. Mind you, I doubt very much that it would at all influence the outcome:

Patients should be refused treatment because of their age in some cases, government advisers have proposed.

Where age can affect the benefits or risks of treatment, discrimination is appropriate, the National Institute for Health and Clinical Excellence said.

Charities representing older people said the recommendations were outrageous and sent out mixed messages.

Wrong. The message is quite clear and will gradually become more acceptable. Within five years, people over 75 will be offered euthanasia when they get sick. Within 10 years it will be mandatory.

The fine U.S. blogger and libertarian scholar, Tyler Cowen, who's blog Marginal Revolution is well worth a visit (as if I did not have enough things to read, aarrgghh, Ed) has started a specialist blog devoted to tracking developments and medical research surrounding avian flu. Tyler is clearly worried about the spread of new and more powerful viruses and the threat this poses to the health to millions of people around the world.

Rather interesting, I think, that the Internet, which helps to spread ideas with the speed of a virus, is now spawning blogs which are devoted to actual, existing viruses.

Terri Schiavo died this morning.

I hope that her husband and family can find some peace, if not with each other, than at least within themselves.

Now that the emotional flash point of the debate is gone, I hope that we can have a more considered policy discussion over who should make medical decisions for non-decisional patients, and under what restrictions.

Nobody is willing to take the position (at least in public) that a person should not be able to refuse medical care in person, on their own behalf. However, many of those now engaged in the struggle over end-of-life health care are, wittingly or not, arguing that some health care decisions should be removed from private hands and made by the state.

The current baseline rule is that your personal autonomy with respect to consenting to or refusing to consent to medical care is pretty much absolute (I am discussing medical care, not mental health care, which operates in a parallel universe on these issues). I note that there are some second-order restrictions on what kind of care is actually available to you, arising from various licensing and regulatory regimes, but leave those aside for now. You can refuse any and all kinds of care, ranging from the most extreme life support to the most mundane blood transfusion, and people do all the time, even when the refusal puts their life at risk.

Things get more complicated when you are unable to decide for yourself (or, what amounts to the same thing, unable to communicate your decision). Someone has to decide what care you will be given. Your ability to make such decisions in advance will, sooner or later, be outrun by the unforeseeable complexities and irreducible detail of your medical care. If nothing else, someone will have to interpret your written instructions and apply them to the messy clinical realities. At the end of the day, if you are not "decisional" you will have a surrogate decision-maker. That decision-maker will either be a private individual or the state.

The current system very rarely results in the state directly taking custody of a medical patient who is not decisional, and is very heavily biased toward leaving health care decisions in private hands, with a fairly limited "reserved" power in the state to hear disputes about who the private decision-maker should be. So far, so good.

Although reasonable people can disagree on whether, for example, Michael Schiavo should be Terri Schiavo's surrogate or one of her parents should be, this dispute is over the proper issue of which private party should make decisions. It is very difficult, I think, to argue that this issue hasn't been fairly and adequately processed by the courts.

However, we are seeing increasing pressure to restrict the decisions that the surrogate can make. This is where it gets tricky, because legal restrictions on the decisions that a private decision-maker can make mean that the state is making that decision. If there is a law on the books that prohibits your surrogate from consenting to experimental treatments, then the state is making the decision that you will not receive that treatment. If there is a law on the books that prohibits your surrogate from withdrawing a feeding tube, then the state is making the decision that you will be fed through a feeding tube.

The current mantra that "if there is any doubt, err on the side of life" is a TV-friendly sound-bite in the service of expanding the control that the state has over your medical care, because this "principle" removes from your surrogate the ability to make health care decisions, and is functionally equivalent to the state ordering that medical care be provided regardless of your wishes. For your own good, of course.

Similarly, the endless agitation for more appeals amounts to agitation for more state review and oversight of a nominally private decision. For your own good, naturally.

In short, to the extent any coherent public policy is being advanced by the people who want the feeding tube re-inserted into Ms. Schiavo, it is a public policy that shrinks the decision-making powers of private decision-makers, and necessarily transfers those decisions from private hands to those of the state.

The over-riding principle that is cited in favor of this transfer of power to the state is the protection of life. However, the protection of life is not an absolute trump card; indeed, when it comes to medical care, personal autonomy overrides protection of life; otherwise, the law would require that life-saving health care be provided to you over your objections.

Nobody is willing to take that step, so advocates for the transfer of power to the state are left in the position of arguing that some decisions that you can make for yourself should never be made by your surrogate, but should be made by the state instead. Those are the only two choices on offer - either the state makes decisions about your end-of-life medical care by prohibiting your surrogate from deciding, or your surrogate decision-maker does.

I think you know where my instincts are when faced with a choice between preserving the private sphere and expanding state control.

On The Voice of Reason (slogan: "A penny saved is a government oversight"), there is a pretty clear headed little essay of what I think is most the reasonable position on this absurdly emotive case.

For an excellent overview of the Schiavo case, written by someone with a better work ethic than me (she links to her sources, I just kind of remember their gist), go to Majikthise.

Out of the morass of purely case-specific issues in this case, perhaps the most legitimate policy argument raised by the Schiavo trainwreck has to do with the withdrawal of food and water.

Let's be clear on Schiavo's condition and treatment here: she is being fed and hydrated through a tube in her stomach. She is not feeding herself, and is presumably not capable of taking food and water orally, or the tube would never have been inserted. This kind of feeding and hydration is just as much a medical treatment as having a glucose or saline IV inserted into your arm.

No one attempts to deny that Terri (or anyone else) would be permitted to refuse this treatment for themselves; a law mandating that you receive a given medical treatment against your will would be widely regarded as an abomination.

Similarly, no one seems to be seriously arguing that if Terri were on a ventilator or some other form of artificial "life support", that her guardian should be permitted to withdraw the life support, even though there is no written evidence of what Terri's wishes were in that regard.

This leaves many of the folks who are now arguing for federal intervention into Terri Schiavo's medical treatment in the rather uncomfortable position admitting that (a) she could refuse to consent to being fed through a tube in her stomach, and (b) that her guardian could withdraw other forms of life support, but nonetheless that (c) her guardian cannot refuse consent to her being fed through a tube in her stomach.

Thus, the policy question being posed by this case seems to be whether a surrogate decisionmaker should be compelled by law to "consent" to their ward being fed through a tube in her stomach, unless he can produce written evidence that is what the patient would have wanted.

The case against such a legal mandate boils down to the argument that denying the right to consent or refuse consent to the surrogate is the same as denying it to the patient herself. Of course, the surrogate is not, in fact, the patient, and there may be legitimate boundaries placed on the decisions the guardian can make on behalf of their ward. The question is whether withdrawal of nutrition and hydration is outside of those boundaries, and if so why.

The case for a legal mandate that nutrition and hydration be given over the objections of the legal guardian rests comes down to the argument that, where there is any doubt as to what the patient would want, we should err on the side of keeping them alive. This argument, however, founders on a couple of points. Logically, it cannot be limited to nutrition and hydration, and thus requires that we keep all life support, no matter how extraordinary, in place. Further, it begs the question of how much certainty is enough. Even where a written living will exists, the question can be raised about whether the patient changed her mind.

Because we cold-hearted libertarians care about such things, Terri Schiavo's care is being paid for by taxpayer money through the Medicaid program. Even though her parents have noisily pledged to take all financial responsibility for her care, they have not yet done so, even though the trust fund established out of the proceeds of her malpractice case to pay for her care is nearly exhausted. The annual cost is probably around $80,000 per year.

Various precincts of the US body politic are obsessed with Terri Schiavo, a young woman who has been at the center of an ongoing familial, legal, and now, sadly, political dogfight.

In very broad terms, Terri Schiavo is unable to make decisions for herself. She is apparently brain damaged, and has been in some degree of coma or "persistent vegetative state" for years. Her husband wants to withdraw artificial life support and let nature take its course. Her parents want her kept on life support indefinitely in the hopes that some day she will make some degree of recovery. As ever, you can find a medical expert to present just about any side of this that you want. This situation is, sadly, all too common.

The uproar around Terri Schiavo illustrates rather nicely the key distinction between libertarians and, well, everyone else. For libertarians, the critical question is "who decides?", based on their belief that you should be able to make your own decisions in life. Most other folks, it seems, don't care "who decides" nearly as much as they care about "what decision is made," and particularly, "whatever decision is made, it damn will better be one I approve of."

In Terri's case, this means that all sorts of folks who you think would know better than to invite the state to participate in medical decision-making are doing exactly that, because Terri's husband has made a decision that they do not approve of.

So, not only have we been treated the spectacle of the Governor of Florida, Jeb Bush, trying to elbow his way to Terri's bedside so he can dictate what care she will receive, we also have various Florida legislators trying to insert the State of Florida into the mix. Now the US Congress, apparently not satisfied with embarrassing itself* in its ongoing investigation into steroid use in major league baseball, is preparing to abuse its subpoena power to block the decision made by Terri's husband.

A fundamental principle of health care law, and one dear to the hearts of libertarians, is that you must give informed consent to any treatment before it is administered to you (with an exception in cases of emergency when you are unable to communicate, in which case the caregivers are allowed to assume you want life-saving treatment). A doctor who treats you without your consent has committed assault and battery. It is your right to refuse any treatment at all, even if it will mean your death, and so long as you are a competent adult no court or legislature can intervene to force treatment on you.

When the patient is not a decisional adult, someone who will make decisions on their behalf must be located. You can appoint your own surrogate decision-maker, via a health care power of attorney (which I strongly recommend). Some states have lists of "deemed" surrogate decision-makers on the statute books, such as spouses, parents, siblings, etc., in rank order so everyone knows who has authority in a given case. As a last resort, a court will appoint a guardian.

The whole process is focused on the proper issue of identifying "who will decide." Once the decision-maker is identified/appointed, they stand in the shoes of the patient. The state retains (or should retain) only the most limited role, to ensure that the decision-maker does not abuse their power. Clearly, the decision to withdraw life support is a decision that Terri Schiavo could make for herself. Indeed, my wife has told me that if she were in Terri's position, that is exactly what she would want. Her husband's decision to make it in her stead is by no means an abuse of his power as her surrogate decision-maker - such decisions are made routinely, every single day, across the country by people charged with the heavy burden of making health care decisions for someone else.

What we have in the Schaivo case, then, is the legally appointed and recognized decision-maker making a choice that is well within his purview. Multiple court reviews have concluded that he is the right person to make the call, and his decision should be honored. To this libertarian, that is the end of the matter, because the very essence of being a libertarian is respecting the decisions of others even when you might decide otherwise. To a broad spectrum of conservatives, however, the fact that medical decision-making should be private is of no concern when the decisions made are decisions they disagree with.

*While at the gym yesterday, I caught a few minutes of the steroid hearings. It was painfully embarassing to see the solons of American governance earnestly seeking noted idiot Jose Canseco's advice on public policy. A quick survey of the fellows in the locker room revealed that this latest Congressional exercise in nannying competent adults and chasing headlines is not being well-received by the public. The universal sentiment was, "Don't they have anything better to do?"

Stephen Pollard, a former member of Britain's Young Conservatives who is now a New Labour guru, has an article in the Times called: My easy ride in the Senate seat.

Life after his easy ride is getting a little more tricky, with a savaging from Global Growth, the free-market NGO.

The Centers for Disease Control released new life expectancy figures for the USA today. Average life expectancy is up to 77.6 years, up three tenths in a mere two years. Also remarkable is the rapidly closing gap between the life expectancies of men and women. It was a 7.8 year gap in 1978 and is now down to 5.3 years.

When I was in my twenties I told friends my life's goal was to go downhill skiing on Ganymede at age 120. If the technological exponential keeps going as I expect -- and I am 'lucky' enough not to draw the Ace of Spades -- I might just do it.

See you on the slopes!

For more information, see Space.com's Live Science article.

Leon Trotsky's views on the role of arts were well known. He argued that art in all its forms existed to convey political messages to the masses and that any other use of the arts was bourgeois nonsense. The idea that it was acceptable for the arts exist to express the personal views of some artist or to simply 'entertain' in a non-political sense (not that anything is really non-political to a statist) was just preposterous to Trotsky. Thus if the state wished to advocate or depreciate something, it was the role of the arts to assist with that process. A modern day example of this would be, say, the relentless demonization of smoking.

Which brings us to the views of the Orwellian sounding Centre for Tobacco Control. This group of lobbyists is infuriated that their calls for smoking to be censored by the British Board of Film Classification (who were once simply known as the Film Censors) has been rejected.

The board's cautious mention of smoking for the first time falls far short of demands that smoking scenes, particularly in any film likely to be seen by children, should be banned in Britain and consigned to the cutting room floor. Professor Gerard Hastings, director of cancer research at the UK's Centre for Tobacco Control, said: "If the BBFC doesn't accept its moral responsibility, it might as well pack up and go home."

And so we discover that this lobby thinks is the 'moral responsibility' of the state to impose standards on entertainment to make them more in accordance with the wishes of our technocratic betters (them, of course). Not only do they wish to make it as difficult as possible for you to make your own non-coerced choices as to what stresses and chemicals you expose your body to, they wish to prevent you seeing images which do not conform to the message they wish to indoctrinate you with. I would be curious to know if Professor Hastings also supports forcing people to take favoured chemicals?

Remember this?

The sun's rays, which are called ultraviolet A and ultraviolet B rays (UVA and UVB rays) damage your skin. This leads to early wrinkles, skin cancer and other skin problems.

Being in the sun often over time, even if you don't burn, can lead to skin cancer. A tan is the body's desperate attempt to protect itself from the sun's harmful rays.

Well, forget that. Now learn this:

Sunshine might stop certain cancers from growing, including skin cancers, according to two new studies.

One found it helped beat the deadly skin cancer malignant melanoma. The other found the sun helped with non-Hodgkin lymphoma.

Tobacco is also known to prevent cancer. So get out that sunbed and a packet of cigarettes now. It's for your own good.

One of the unspoken benefits of globalisation is the use that professionals make of the new instruments and techniques that are publicised over the internet or through the wider dissemination of networks to newly emerging economies, such as India. However, as one example demonstrates, medical professionals in India read or learn about new developments from the West in their specialism but are unable to apply them because they are too expensive or the instruments cannot be imported or the patients are not rich enough to afford them. This is providing a spur to entrepreneurial and philanthropic activity.

Narayana Hrudayalaya is a medical foundation established in India by Mother Teresa's cardiologist, Davi Prasad Shetty. Acknowledging the dilemma faced by all professionals in poorer countries, Shetty aimed to pioneer low-cost cardiac surgery that would prove affordable, with charitable supplements and insurance for even the Bengali peasantry and textile workers inhabiting the countryside around Kolkata.

In an interview with New Scientist, Shetty understood that governments and international bureaucracies were a hindrance, not a benefit.

If there is one organisation that can be squarely blamed it is the WHO. Headquartered in Geneva, separated from reality, it runs its global activities with help from government representatives who are mostly bureaucrats. In the countries I travel to, bureaucrats are a class of people who are experts in nothing but authorities on everything. They are not best-suited to guide planning at the WHO. One of the WHO declarations was "Health for all by 2000". How can a global body make that kind of statement when a country like Zambia does not have an echo-Doppler, without which you cannot detect any heart problem, or when one cannot find a single functioning ECG machine in many African countries?

Apart from the WHO, I have stopped blaming the politicians and bureaucrats. We are better placed to bring about changes by being outsiders, not by being a part of the system. All that the government can do is to stop being an obstacle. If it decides to be a bystander, things will fall in place. My belief is that within ten years, the government healthcare systems in all Third World countries will fold up. The government will not be able to pay even salaries, never mind offering healthcare. In that situation, organisations like ours should come forward to take over and manage it in a professional manner.

Whilst Shetty describes himself as a social worker as a libertarian, he has recognised that governments cannot provide the resources to meet his objectives and that it is best if they stand aside or collapse. When the state is no longer a factor, the economics or healthcare starts to add up.

Yes, it's very different. In Western hospitals, about 60 per cent of the revenue is spent on salaries, while in government hospitals in India, 90 per cent goes on salaries. By contrast, in our hospital only 12 to 13 per cent is spent on salaries. That doesn't mean our doctors are being exploited. Since their output is ten times more, unit operating costs are very low. To earn a given salary in another hospital, a doctor would have to perform one operation a day. With us he might have to operate on five patients. We also work with zero inventory, so the burden lies with the supplier. And since we are the largest consumers of medical disposables, we procure them at a discount of 30 to 35 per cent.

Increasingly, for the pragmatists of the world, freedom provides the answers that the state is unable to.

Peter Cuthbertson has some pretty clear views about those who would control us for 'our own good'

Any Brit who turns their television on to ITV or Channels 4 or 5 now will sooner or later see a vile new National Health Service advertisement, funded by their own tax money. Showing a young man running around bars and shopping centres spraying foul smells into the air and onto the clothes of others, it literally urges people that just as they would not tolerate anyone who does that, they should fight against the freedom of smokers to light up in bars and pubs. An obvious prelude to the government's campaign to stop restauranteurs and landlords from allowing smoking on their own property, it is no doubt hoped the advertisement will edge public opinion in the nannying direction.

It is difficult to fathom the petty, narrow mind of the sort of otherwise unemployable bureaucrat who came up with this one. But one comes to understand the idea of people feeling aliens in their own country when one sees such things. What a profoundly un-British little broadcast it was. What a sickening way to impose the morality of the elite's stateless global citizen onto a country whose famous tolerance and fair-mindedness is probably what left-liberal nannies feel necessitates such propaganda - sorry, such a campaign of public education - in the first place. One can only hope enough independently-minded people are emboldened by such spiteful nonsense to take stands on behalf of smoking, one of the few remaining mass activities that genuinely is not in some way anti-social, in an age where it seems few Britons can enjoy themselves in a group without being obnoxious to others.

Somehow worse than this, however, one sees explicit use of taxpayers' money to campaign for one side on politically controversial areas, over behaviour that is perfectly legal and normal. This is a precedent that should worry everybody.

In any reporting on a quasi-tyranny, the state's control and use of the media is usually cited to show that a country cannot be a genuine liberal democracy. Chile's slide into dictatorship in the early 1970s is exemplified by Salvador Allende's decision to eliminate criticism of his regime by nationalising the press. Today's Russia is now widely described with the euphemism 'managed democracy' to a considerable degree because so much of its television is under state control: the elections themselves are free, but the state-run television stations campaigned strongly for Vladimir Putin in advance of last March's Presidential election.

It's because the use by the state of the media to advertise its own virtues and ideals is so symbolic of a wider lack of freedom that it is such a good indicator of the health of a society. The state is effectively limitless in its power to take by taxation anything people earn and produce. When it also feels free to use that money to take political stands, often stands opposed by the very people who pay these taxes, that is a signal of an overmighty government, wherever it exists.

When the state, as distinct from any political party, takes on the role of encouraging people to have the correct views and oppose the right habits, the liberty of everyone is made immediately more precarious. There is a very great supply of petty nannies with a favoured cause, and altogether more dangerous authoritarians and social engineeers with their own pet projects, who would love to get their hands on the power the NHS is now abusing. Rest assured, they will find ways of doing so if the precedent now being set is not reversed.

As the unrelieved gloom surrounding freedom in the UK becomes too much to bear, here is a recommendation for all of those who wish to celebrate the diversity of snackdom before the health fascists force us all to eat lentils and turnips.

Visit snackspot and track down all of those arcane foods such as Gummi Zone Gummi Pizza before they are banned by the edict of Nanny Blair.

According to Dutch health investigators, going to church can cause lung cancer and other respiratory problems, because of the carcinogenic effects of candles and incense. Dr Theo de Kok, says that it is "very worrying". With Christmas approaching, levels of pollutants would be expected to rise.

The solution is obvious. The European Union must immediately ban church-going for all children, impose a tax on adult church-goers, put health warning signs on the outside of all churches and copies of the Bible.

Oh, and ban Christmas.

Obviously, the EU must also impose diplomatic and economic sanctions on any country that does not comply with this (the USA).

In dreaming up appropriate health warnings for church-going, I like the following:

God kills!
Do not worship God in the presence of children
and cutest of all:
God can seriously damage your unborn child

Last month a British panel of the Great and Good issued a thumpingly big report on the state of Britain's pensions system covering both the private and state networks of provision. In short, the report said that we are living longer, have fewer children, and hence pensions systems which were constructed in the middle of the last century are buckling under the strain. It is all now a fairly familiar story and likely to prove one of the most ticklish political domestic issues in Europe and north America for the next few years.

But consider this - if we are living longer and able to live healthier lives for longer, and this is causing certain strains to emerge in pension provision, then how do the doomongers square that with the claim that we face all manner of threats to our health? One can barely open the pages of a newspaper or turn on the television without being regaled about all the horrible risks out there, obesity being the latest issue, but by no means the last.

Well, for all our supposed problems, something wonderful has happened to the health of most people in modern industrial nations these past few decades. (Clues: modern medicine, drugs, decline of heavy manual labour, greater awareness of healthy diet, dangers of tobacco, etc). I appreciate that stating such a thing in today's culture of gloom is unfashionable, even reckless, but there it is.

Business enterprises are often attacked for selling people 'junk food' and not telling them about the health benefits of vegetables.

Well recently ASDA (the British arm of Walmart) labelled its vegetables, explaining that people who eat certain types of vegetable have a lower chance of developing certain forms of cancer.

ASDA was promptly prosecuted and punished. It seems that 'making health claims' is not legal in Britain.

Oh well, back to selling junk. The state is not your friend.

Via Catallarchy, here is something you do not hear every day from a legislator:

Folks have got to take personal responsibility for their actions.

So said Michigan Representative David Palsrok, sponsor of a bill signed into law today in that state by Democratic Governor Jennifer Granholm - a law which bans people suing food companies and restaurants for 'making' them fat.

And here is another quotation from the same article which is not quite as much of a shocker:

The Legislature and society should focus on preventing the sale of fatty, sugar-laden products in our nations [sic] schools or requiring that fast food manufacturers provide nutritional information on the food they sell.

Says who? The Michigan Trial Lawyers' Association, of course.

BBC Radio Four (indeed any part of the B.B.C.) is not where one would expect to find support for liberty, but a few a days ago I heard, on the Radio 4 Today Program, a report on medical care.

According to the report private hospitals in India (including in Calcutta) offer British people medical care at least as good as that provided by the NHS, and in wonderful conditions (marble floors, everything clean rather than the dirt, and decay one finds in British government hospitals - thousands of people die every year in Britain from infections they pick up whilst in government hospitals) and at a small fraction of the cost of the (highly regulated) British private hospitals.

The Labour MP Frank Field (a man known for his honesty - hard to believe in a politician, but it is true in his case) came on to the program and claimed that a constituent of his was being left to go blind by the NHS, people are normally left to rot for long periods of time by the government medical service, but his sight was saved by sending him to an Indian hospital.

The price of his medical care (not including the cost of flying to India, I admit) was £50 - in Britain the medical care would have cost (according to Mr Field) £3000.

So the choices were - go to a highly regulated British private hospital (if you happen to have £3000), rely on government medical care (and go blind), or go overseas.

Being a Labour MP Mr Field wanted the NHS to pay to send people to private hospitals in India (they put administrative barriers in the way of this ["it is too far"] - although they are willing to spend far more money sending people to European hospitals), but this was the closest I have ever come to hearing both the BBC and a Labour MP condemn statism in health care.

Discussing nationalised healthcare with those of a leftist frame of mind, it occurs to me that one is put at a disadvantage in attempting to demonstrate the merits of a private healthcare system if one restricts the options to a public health system versus private health system. This tends to conflate the separate benefits a private system would provide. Nationalised healthcare systems are wasteful and ruinously expensive but there are actually two separate phenomena contributing to this.

1. Any business which is run by the government will have priorities unrelated to those of the customers of that business and will tend to provide the product or service it wants to provide, in the quantities it wants to produce as opposed to providing the product according to the customer's demand. This leads inexorably to unsatisfied customers, gluts, rationing and shortages.
2. 'Free' healthcare is a problem similar to the tragedy of the commons. If there is no cost to be borne by availing of 'free' healthcare, there is no corrective against frivolous use of this service. The phenomena of bored pensioners visiting the doctor for a chat is solely that of a system where that doctor's time is paid by the taxpayer and not the loquacious geriatric. Hypochondria, held in check by a pay-as-you-go system is positively rewarded by free healthcare.

One is further disadvantaged by conflating nationalised health with redistributionism per se. Thus, if the matter for discussion is simply nationalised health versus private, one must not only convince the sceptic of the benefits of the market but also to abandon a, perhaps cherished, redistributionist outlook. Yet, it is not necessary to do so if these issues are separated. In agreeing to set aside the issue of redistribution in the first place it ought to be possible to agree with the leftist interlocutor that the government does a lousy job of running the health system. An ardent supporter of cradle to grave healthcare, if intellectually honest, may be persuaded to concede that, so long as the government still pays for it, healthcare would be better provided by the private sector. If this step is accepted, such an intellectually honest leftist might also note the role of incentives when healthcare is provided on a no-cost basis. In an alternative system, an individual might be provided with health vouchers or subsidised insurance, perhaps a no claims bonus might apply or a policy excess. In such a system, the government still picks up the tab but there is at least some incentive for the user to modify his consumption.

By separating the issues it may be possible to reach wider agreement on privatising health than would be possible with the issues lumped together. It is probably worth adopting such an incrementalist approach in lieu of the 'greedy' approach of the absolutist. For most of the issues which concern libertarians, a step in the right direction is not only useful in getting closer to one's goal, it may also offer a noticeable improvement in its own right.

Whenever we touch on the issue of state controlled health system versus private healthcare, we get a smattering of outraged readers who cannot understand why we attack that venerable (in their eyes, not ours) dinosaur, the NHS. It's free and for everybody they screech, you heartless capitalists... would you let your parents/grandparents/children die without treatment and care, if they couldn't afford to go private?!.

The fact is that those I care about are more likely to be in need of treatment and care, as a result of coming into contact with the NHS. I want them to stay away from the NHS, and the government to give them back their money taken to support the giant leech known as national healthcare.

Many people are now frightened that they could pick up a dangerous infection if they go into hospital. It is hardly surprising. More and more of us know someone who has been infected with the superbug, MRSA (methicillin resistant Staphylococcus aureus). Marjorie Evans has been infected with it on eight occasions at the same hospital in Swansea. Now wheelchair-bound as a result, she says: "I'd rather go abroad and trust foreigners."

As James Bartholomew writes in the Telegraph opinion section one is vastly safer in a private hospital and the danger of getting MRSA is a risk affecting patients of the NHS.

The NHS both is the most state-controlled hospital system in the advanced world and has the worst record in Europe. At a practical level, it is because of things like ministers driving hospitals at full capacity to reduce waiting lists, with the result that patients with MRSA cannot always be isolated.

But at a more profound level, the MRSA crisis is because the NHS is a state monopoly. Ministers are always making hospitals respond to the latest newspaper headlines rather than doing what is best in the overall interest of patients; hospital workers - like many employees of state industries - are demoralised and their pay rates are unresponsive, thus causing the local shortages. The state has also closed too many hospitals. The list of ways in which it has increased the risk is endless.

This is a result of the fundamental dynamics (or statics) of the public sector, not any lack of funding. There is no legitimate role for the state in healthcare, education and many other sectors that it appropriated for perpetration of what is so misleading called 'public services'.

The dynamics of the private sector, meanwhile, are simpler and more effective. If you don't treat your customers well, you go out of business.

Indeed, unless you take their money first and then help yourself to it...

This used to be the state of Britain in the 1970s; a reference to the relative economic decline that accompanied the imperial scuttle. Now, we should use the term in another sense: the transition of the National Health Service from modernity to the Middle Ages.

If you enter a National Health Service hospital, there is a high risk of contracting an infection caused by a dugs resistant bacteria called MRSA (methicillin-resistant Staphylococcus aureus), which the tabloids have dubbed "superbug". There are numerous stories of patients, who have no choice but to use state provision, due to its monopolistic powers, and have contracted this infection as a consequence. There is one poor unfortunate who has been MRSA positive eight times.

A grandmother who has contracted the MRSA superbug eight times is refusing to return to hospital for a vital operation.

Doctors warned Marjorie Evans, 69, she could die or be bedridden for the rest of her life if she is hit by the infection again. She plans to travel abroad for her hip replacement rather than trust a British hospital. Mrs Evans has caught MRSA during inpatient stays at Morriston Hospital in Swansea since 1992.

One of the major causes of these infections is the inability of NHS hospitals to maintain minimum levels of cleanliness, such as insisting all visitors wash their hands. Once drugs-resistant bacteria have taken hold, they are difficult to eradicate. However, there is an alternative, the private sector:

BMI Healthcare is one of the biggest private hospital groups in the UK, with 47 hospitals. During the course of a year, the group has a quarter of a million in-patients and three-quarters of a million out-patient visits. How many patients in BMI hospitals have acquired MRSA in the blood? None. In fact, over the years, the company has "never" had such a case.

If you do come to Britain, avoid the NHS. For if they do manage to kill you, a task they achieve with ease, you may still not be given last rites as the religious affiliation of your dying husk cannot be disclosed under the Data Protection Act.

The Hospital Chaplaincies Council has criticised several NHS Trusts for their "hysterical" refusal to disclose the religious backgrounds of their patients. The trusts claim that such information is "too sensitive" to share with chaplains.

Candida Moss, writing in the Spectator, suggests that 'presumed consent' ought to apply for donating organs. On the basis that my comments my not appear in the magazine, here's what I wrote:

Presumed consent is not consent. If it were, then minors or people suffering from dementia might not enjoy the protection from sexual assault that they do at present. Sexual predators could no doubt claim "presumed consent" for their crimes.

There is a difference between medical expedience and morality. There can be no doubt that there would be enormous medical benefits from performing vivisection on human beings, instead of on animals: dosages, differences in metabolic rates etc. would be far easier to calculate.

Rightly, we abhor this and consider controvertial using the results of Nazi experiments on Jews, because it can be considered the partial condoning of horrific actions.

Is it Candida Moss's wish that the state (probably at EU level) ought to nationalize our bodies and redistribute organs according to need? At least Gordon Brown only wants my money.

I might add that the issue of designer babies giving their own consent to being used as experimental animals is another current topic. It seems pretty sick to me.

Some time ago President Bush offered 15 billion dollars of American taxpayers money for 'the fight against AIDS' in various nations.

Yesterday the Secretary General of the UN denounced the United States for not spending enough money. Now this anger could be dismissed as the Secretary General being upset that so much of the money was going to be spent 'direct' in the nations concerned rather than put through the UN (where the Secretary General's son and his friends could steal some of the money), however this does not explain all the anger directed against the United States at the AIDS conference in Bangkok.

I think the explanation for the anger is very simple - people are never grateful for loot.

Everyone knows that President Bush is not giving his own money when he hands out the 15 billion dollars (assuming that Congress goes along with this idea), he is just taking (by the threat of violence) money from the taxpayers and dishing it out.

Why should anyone be grateful to him? He is not making a sacrifice; he is just handing out the money of the taxpayers. Why should he give 15 billion dollars to the third world, why not 50 billion or 500 hundred billion? It is not costing him anything.

So the various political activists feel no reason to thank President Bush.

It is the old story of 'conservatives' and government spending. No matter how much they spend the activists will always think they can get more money from the 'progressive' politicians and so will shout and scream and stamp their feet.

I am going to have to find some new term to adequately describe the condition of ignorance that renders its sufferers unable to comprehend the inevitable truth that state-control means political control.

A shining example of this tragically far-too-common form of myopia can be found in one of today's letters to the UK Times [note: link may not work for non-UK readers]:

Sir, Once again the NHS is set fair to become the filling in the Labour and Conservative policy sandwiches, and yet neither party recognises that the biggest problem besetting the service is the very political control each espouses.

Health, like broadcasting, is too important to be the political football of major parties during the first skirmishes of an impending general election. The NHS needs a charter, it needs sensitive management, it needs to value and cherish its long-suffering staff and, above all, it needs to be isolated from the political process.

The man who wrote this letter is a doctor and is, therefore, unlikely to be either dim-witted or uneducated. Yet, he passionately demands (and no doubt expects) a government-run health service that is somehow 'isolated from the political process'.

I have penned a letter of response to the Times pointing out that the only way to get politics out of healthcare is to de-nationalise it and allow provision to be bought and sold on the free market. However, I do not expect the editors of the Times will be inclined to publicise such heretical and 'extreme' views.

The great canard of the collectivists holds that a free-market in healthcare will assuredly result in healthcare providers hungrily pursuing maximum profits while abandoning the poor, the elderly and the vulnerable to a wretched and untreated fate.

So often and so passionately has this big lie been repeated that it is now accepted by most people in this country as an incontrovertibe truth. Nationalised healthcare, they say, puts people's needs at the top of the agenda where there is no room for ugly money-grubbing.

Only they forgot about ugly bed-grubbing:

A nurse has been jailed for five years for trying to kill two elderly patients at a Cheshire hospital.

Barbara Salisbury, 47, was found guilty of trying to kill them to free up more beds at Leighton Hospital, in Crewe.

Rationed resources require desperate measures. In fact, and given the governmental obsession with reducing waiting times for hospital treatment, I am a little surprised that the Department of Health has not pinned a medal on this woman.

When she finally emerges from her time in stir, Ms Salisbury may well find herself being offered a job back in the NHS as a senior consultant.

It is strangely comforting to see that the 'class war' instincts of old Labour are not entirely dead yet:

John Reid, the Health Secretary, yesterday dismissed the demand for a blanket ban on smoking as "an obsession of the learned middle class".

Speaking at a Labour Party event, he said he was reluctant to use compulsion to outlaw something that was a source of pleasure, particularly to working class people.

That Mr. Reid has to fight the corner of working-class people at a Labour Party event speaks volumes about the evolutionary path of the modern left.

Earlier, Mr Reid expressed his views even more bluntly when he took part in a round-table discussion with some of those invited to contribute to the consultation.

Told that they were discussing a smoking ban, Mr Reid said: "Let me play devil's advocate. What enjoyment does a 21-year-old mother of three living on a sink estate get? The only enjoyment sometimes they get is having a cigarette."

One participant objected quite strongly, telling Mr Reid her mother died of lung cancer.

But Mr Reid, a former chain smoker who has now given up, said it was best to provide people with information and let them decide what to do for themselves.

Now, perhaps, Mr. Reid can take the next logical step and denounce the levels of tax that working people have to pony up in order to enjoy their smoking habit. Then the bien-pensant can safely re-classify him as a 'right-winger'.

Compared to the length of time it took to hike up the taxes on tobacco, alcohol and petroleum, the great 'junk food' shakedown has been completed in remarkably quick time. HMG is clearly honing its modus operandi down to a fine art: [note: link to UK Times may not be available to readers based outside the UK]

BRITAIN�S biggest food companies are to be told by the government to pay an �anti-obesity� levy to fund new sports centres or face punitive laws restricting advertising, marketing and labelling.

Firms such as McDonald�s, Walkers and Cadbury Schweppes are to be asked to contribute tens of millions of pounds towards the sports facilities. The government is set to provide £1m for the scheme for every £3m pledged by the food industry. It will be used to build sports centres, gyms, football pitches and tennis courts.

The food industry confirmed this weekend that it was preparing to co-operate with ministers and could provide hundreds of millions of pounds to fend off regulation.

Of course, I knew this was coming but not even I was prepared for the ugly truth to be revealed quite this rapidly. The Treasury must be desperate for the cash.

Yes, it really was only a few short weeks ago that I noticed the wave of 'shock, horror' articles about an 'obesity crisis' ripple right through the Fourth Estate like an electro-magnetic pulse. From out of the blue, every single news organ in the land was suddenly brimming with distraught editorials about how fat all 'our children' were becoming and what could be done about it. Some blamed the food industry, some blamed the public, some blamed advertising, some blamed George Bush, everyone blamed 'rampant capitalism' (as if we have even a faint prospect of such a thing) and former Tory cabinet minister, Norman Tebbit, brought a twitch to everyone's jowls by blaming it on homosexuals.

It all felt far too co-ordinated to be either genuine or the mere manifestation of some form of mass hysteria. In fact, it was neither. It was a deliberate, well-planned and professionally executed 'softening up' operation designed to smooth the political path for the pay-off of a 'junk food' levy.

There is no 'obesity crisis'. It is, and always has been, a fictional hobgoblin to be exploited for maximum fiscal effect and now that endgame has been achieved, press coverage of the 'obesity crisis will suddenly vanish as quickly and mysteriously as it appeared. Job done (at least until such time as an increase in the tax is required).

But even if 'our children' were as dumpy as has been so mischieviously claimed, they are going to get thinner now for sure. The tax on the profits of food producers will be passed onto consumers who will now have to pay significantly higher prices for their weekly shopping. As with all such extortions, it is those on fixed or low incomes who will be hit the hardest.

Nor are they to be compensated by the appearance of any brand, spanking new sports facilities which, I predict, will never materialise. A few crumbs of the cash will go to the appointment of some Real Sports Advisers as a Potemkin show, but the lion's share of the money will simply be poured into the great, sucking black-hole of the public sector and lost. That is how it goes in Britain.

So now that our wonderful, caring government has finally solved the 'obesity crisis', all that remains is for us to speculate as to what private sector industry is next on the list for a shakedown. At a rough guess, I'd say telecommunications. There is an awful lot of money sloshing around in that sector right now and that makes it a very tempting target. I do not yet know what pretext will be employed but I am in no doubt whatsoever that it will somehow involve 'our children'.

Growing up in the 1970's I recall being rather spooked by dire warnings of an impending ice age and the threat that I would spend my adult life shivering in a cave. Some twenty years later that apocalypse vision had been melted clean away by the dire (and considerably shriller) warnings about global warming and, according to everyone who is anyone, I now face the threat of spending what remains of my adult life sizzling like a sausage.

Two decades in which to manage a complete polar reversal in doomsday-scenario is pretty good going but it pales into 'also-ran' status by an eerily similar polar switch in the rather more mundane field of eating disorders.

This is from the BBC website in July 1998:

Doctors have hit out at the media and advertisers for encouraging anorexia by portraying skinny supermodels as the beauty ideal instead of 'more buxom wenches'.

The British Medical Association's annual conference in Cardiff voted overwhelmingly for a motion condemning the media obsession with ultra thin supermodels.

Dr Muriel Broome, a former director of public health, said "the constant image of very thin models" encouraged girls to develop eating disorders. "We urge the media to be more responsible and show more buxom wenches," she said.

I know not whether Dr Broome's advice was acted upon, but I am now informed that we have, indeed, taken on the mantle of buxomness with some considerable gusto. From the BBC website today:

Improving children's eating habits is the key to tackling an obesity "timebomb", MPs have warned.

The Commons Health Select Committee attacks the government, food industry and advertisers for failing to act to stop rising levels of obesity.

From 'ultra-thin models' to 'obesity timebombs' in the space of slightly over half-a-decade. Now I am no statistician but I think even I am qualified to regard that as a quite remarkable national metamorphosis.

Nor are these select MPs (who clearly have nothing better to do) speaking out in some frolic of their own. The media that only five years ago was, apparently, inciting and encouraging starvation and skeletal thinness is now tripping over itself in scolding us for being too fat!

From today's Telegraph:

The food industry should be given three years to end the "cynical" promotion of high-fat, high-sugar food aimed at children, MPs say today.

In a scathing report they criticise high-profile advertising campaigns that use sports stars and celebrities to sell chocolate and crisps and call for a voluntary ban on television food advertisements aimed at children. If the industry fails to act the Government should step in, they say.

And from today's Independent:

Britain's "devastating" epidemic of obesity could threaten the very existence of the NHS, a report warns today.

So it's not all bad news then. And (as if they were going to miss out on all the fun) from today's Guardian:

It should not be a surprise that we have become gripped by an obesity crisis. After all, the warning signs have been there for some time. Lifestyles have become more sedentary. We have become more attached to our cars. Life is also faster; there is less time to prepare food and eat. More parents are working and have less time to cook for, and with, their children. Meanwhile, the food industry has become hyper-competitive and, in the battle for market share, children have become fair game.

This last article is the most significant because it is not from any of the Guardian's usual columnists (although it is written in the same hectoring politburo party line style) but from a certain John Krebs who, we are informed, is:

...chairman of the Food Standards Agency.

So clearly his opinions are above and beyond the febrile scribblings of the average hack. This article is an ex cathedra statement of intent.

Those companies that fail to respond with healthier products will, like the dinosaurs, be doomed to extinction.

For once, a reliable prediction. Reliable because it is self-fulfilling. What he means is that suppliers who do not toe the Food Kommisars line on acceptable products will be actively driven into extinction by the said Food Kommisar and his obedient minions.

I must say that I am rather glad that Mr Krebs has come out and laid it on the line because otherwise there are some unwordly people who might be fooled into believing that this tsunami of propoganda in the press is merely a coincidence or, worse, a reflection of concern about a genuine problem. It is further proof of the axiom that one must never underestimate or dismiss the power of vested interest.

The Food Standards Agency was set up at the tail end of the 1990's as a response to the BSE crisis. Such was the trauma of the 'mad cow disease' outbreak that all food suddenly became suspect and 'da gubbament' had to do something. The something they did was the same thing they always do: they set up another government agency to 'restore public confidence in the food we eat'.

When I first heard of the FSA, I predicted (yes, we can all play that game) that this would spell trouble. And this is why it pays to be cynic because I was right. The BSE crisis has long-since slipped into history and there are no mad cows roaming the quiet countryside anymore (or, at least, the fear of them has been played out). So do we still need a lavishly-funded, well-staffed FSA? Of course we do because food is dangerous once again.

Take careful note because if this is not a text-book case of bureaucratic empire-building, well then, I don't know what is. And if those press articles have not been drafted (or, at the very least approved) by apparatchicks in the FSA then I will eat my hat (fried in butter!).

There is no 'obesity timebomb' in this country or any other country and the only thing that needs to be put on a strict diet is our bloated, grasping, greedy, flatulent public sector. Starve them down to the bone, I say. Make them anorexic. Then we can all get on with enjoying our lives and the fruits of our labours without being nagged into an early grave.

It is official: food is the new enemy of the international left.

While the crashers were doing their stuff on the neatly-manicured lawns of Geneva, dark plots were being hatched inside the gleaming towers:

All 192 countries in the World Health Organisation have tentatively agreed to an unprecedented policy on diet and health to tackle global obesity.

Did that include the Ethiopeans?

The voluntary plan was hammered out at talks in Geneva in the face of stiff opposition from lobbies such as the sugar-producing nations.

We are privileged indeed to witness the birth of a brand, new imaginary straw-man. Ladies and gentlemen, making its debut on the world stage, but soon to making regular appearances in the columns of every angry, left-wing polemicist in every media venue on earth, please give a warm welcome to..... "the Sugar Lobby" (boo, hiss). Stand right here in the spotlight, Sugar Lobby, and take your place among right-wingers, big tobacco, industrialists, zionists, gun manufacturers, motorists and George Bush.

Nearly one in six people worldwide is now considered overweight.

Amazing is it not? Seems like only five minutes ago that the battlecry of the social-working class was "feed the starving". Now, in the blink of an eye, they have changed it to "starve the fed". Astonishing stuff!

The BBC's Imogen Foulkes in Geneva says this is the first ever attempt to regulate the world's eating habits.

And we all know that it will not be the last.

Dr Kaare Norum, a Norwegian obesity expert who advised the WHO on the development of the plan, said the agreement was a victory for public health.

DR. NORUM: "I have been studying obese people for many, many years and the incontrovertible data I have collected as a result leads me to conclude that these people are very fat".

WHO: "You are obviously an expert. Come join our committee".

Honestly, the whole article sounds as if it has been lifted from an old issue of Pravda. Mind you, it comes courtesy of the Beeb.

So be warned you choca-holics and doughnut-dunkers: your stodgy, sticky delights are on the hit list. Lock them away in secret bunkers while you still can.

The May 1 issue of New Scientist contains an item 'Why our fears about fat are misplaced' written by Paul Campos, a Professor of Law from the University of Colorado. We have often stated our belief fat is the new job frontier for government bureaucracy and Professor Campos seems to agree with us. He states unequivocally that no research directly links fat to shorter lifespans. Sedentery lifestyles and other factors, yes. Fat alone? No. In his own words:

Ultimately the current panic over increasing body mass has little to do with science, and everything to do with cultural and political factors that distort scientific enquiry. Among those factors are greed (consensus panels put together by organizations such as WHO that have declared obesity a major health crisis are often made up entirely of doctors who run diet clinics), and cultural anxieties about social overconsumption in general.

He notes that in one recent study:

It added up to just one extra death per 10,000 "overweight" women per year. The authors still treated the findings as strong evidence of a causal relationship between weight and cancer

Professor Campos also has a book on the subject, The Obesity Myth.

Like a lot of folk who spend much of their time working in an office in Central London, I try to grab what exercise I can by going to a gym. I have been visiting one of these places in London for about eight years, and, gratifyingly, my once pencil-thin physique has acquired a bit more muscle. (I have a long way to go, mind, not that I remotely want to look like the Governor of California). I have also acquired other benefits, such as being able to sleep much better, better chance of avoiding injuries in everyday life, and a better pallor... The benefits have not gone unremarked by my girlfriend, either.

Gymnasiums are now a major business. Their success in the West speaks of an ever-expanding desire on our part to live the healthy life and do something direct about it. I find it amusing that at a time when we are constantly told by our masters that we need new laws, taxes and the like to avoid obesity and other problems, that more folk than ever before are getting off their backsides and working out. Screw the nanny state, put on some gym shoes! It is a rather encouraging sign that the spirit of self-help, at least when it comes to developing a flat stomach or a nice torso, is well alive.

The gym culture also I think shows just how secular British society has become. If you lack faith in an afterlife, and want to squeeze the most out of life on this Earth, then get fit! Also, if you do not believe that pride is a sin, as I do not, then there is nothing wrong in doing one's best to look good and feel physically on top of the world, and enjoy that fact.

Dave Barry links to this:

Phil Henry said he went to Helen Ellis Hospital in Tarpon Springs and was admitted for abdominal pain. A few days into his stay, his I-V malfunctioned causing his right arm to swell.

"On Tuesday night my right arm started hurting. I rung for a nurse. I didn't get anyone and my arm got swollen up about the size of two golf balls and started bleeding," Henry said.

After ringing for a nurse several times, he decided to take matters into his own hands.

"I took my urinal can and threw it out in the hallway, still got nobody. I hollered two or three times. Nobody came so I picked up the telephone and dialed 911."

He said he told the dispatcher his name, where he was and described the problem with the I-V.

He then asked the dispatcher to call the hospital.

"Then I got a nurse. After that they took good care of me."

Warning to British people: Do not try this with the NHS.

Tony Blair's 10 Downing Street web site is claiming that some spurious target or other, for the National Health Service to recruit an extra 2,000 General Practitioners, has almost been reached. That is, according to some figures produced, and I use the word advisedly, by the UK government's Department of Health.

However, I have just watched a hilarious piece on Channel4's News programme where the Royal College of General Practitioners challenged how these good news figures had actually been arrived at? I felt like phoning the programme up and telling its producer about a civil service game called Hard Target, which involves a pack of marked cards, a set of rusty darts, and a small bag of pistachio nuts. But I relented and listened on.

With an increasing number of GP surgeries refusing new patients and an increasing shortage of GPs around the country, for instance in Barnsley, as mentioned by Channel4 tonight, and even in relatively well-funded towns in Scotland, the Royal College puts the alleged increase in GPs at something more like 200, rather than 2,000, and if you take into account the increasing number of GP retirements and the increase in part-time GP working, the full-time figure actually shrinks, in real world terms, to something more like 26.

So, well worth increasing the spend on the NHS then, to nearly one hundred billion pounds, from about sixty billion. I know that's almost £1.54 billion pounds per extra GP, but hey, is it really possible for us heartless libertarians to put a monetary price on the sanctity of human life and its guardians in the general practitioner service? Shame on us.

Which leaves me in a dilemma? Do I believe the UK government figures or do I believe the ones from the Royal College of General Practitioners set at about 1% of the government's own claims? It is a toughie, I will admit, but you know me. I always believe everything the government says on principle. For where would civilisation be if we ever lost trust in the government?

I am an Aardvark.

As someone often accused of never having one word for a subject, where three hundred and fifty seven will do, I am afraid the following act of collectivized lunacy has simply left me stumped. Gazumped. And just plain flummoxed.

A National Health Service surgeon, from the Queen's Medical Centre in Nottingham, has been suspended on full pay, for a week now, in a row over whether he took too many croutons to go with his lunchtime soup.

No, I am really not making this up.

I particularly like the comment from some idiot going under the name of Lord Warner:

I am reliably informed that there will be no detriment to patients, because the work that that doctor was due to perform will be covered by his colleagues

Tell you what, to save NHS costs let's sack every surgeon in the entire country except one, who can cover all the rest. There will be no detriment to patients, obviously. We just better make sure we have a fleet of helicopters ready to whizz him about the country and a good supply of amphetamine pills to keep him awake.

Like I said, words fail me. Just pick your own croutons from the following word soup and gently flavour with Basil:

Parasites. Fools. Cretins. Croutons. Bananas. Idiots. The sooner the NHS is privatized the better. Monkey nuts. Lickspittles. Guardian-reading Enemy Class. Arse. Feck. And of course. Drink. Lots and Lots of Drink.

I particularly like Monkey nuts.

That's it, I've had enough. I just could not believe my ears, last night, listening to some po-voiced BBC reporter agreeing with some equally pompous do-gooding UK doctor that British people simply cannot be trusted to look after their own health. They also agreed that Wanless Chinder's HM Treasury proposal, to introduce yet more tax-funded social engineering into British health care, was a desperately needed breath of fresh air.

Jesus H. Christ. Just when will you people get it? When will you get it into your thick skulls that it is your damned social engineering policies, over the last sixty years, which have created all of your alleged problems in the first place? When you take away people's responsibilities for their own health care, by providing them with an MRSA-infested paid-for-by-everybody-else National Health Service, the obvious response is for many of them to start abusing their own bodies, or at the very least to start taking less care of themselves. Why? Because someone else will be forced to pick up the pieces afterwards, that's why. So what the hell, let's eat another cream cake, let's drink another bottle of whisky. Because the NHS will pay for any liposuction I may need, afterwards, and the NHS will always supply me with a new liver, should I need one. And if they refuse to, then I'll sue them for a loss of human dignity.

Take, for instance, asthma patients who smoke. I came across many of these, as a medical student, when I worked in the Northern General Hospital, in Sheffield. So why do they smoke when this lands them in an oxygen tent manned by a medical student making a mess of their right-arm, in his pitiful attempts to take blood samples from them every morning? Because the NHS supplies all of the Ventolin Inhalers they may need, supplies all of the incompetent medical students they may need, and supplies all of the sick notes and hospital beds they may need, to help their damaged lungs recover from their stupid and continuing nicotinic self-abuse. Some of them were even happy to be there, to spend a few weeks away from home, relaxing, getting paid on the medical sick note, watching television all day, and chatting to nurses and medical students. Oh yes, and when well enough, slipping outside for a quick smoke.

Would they abuse their bodies as much, smoking with asthma, if they had to supply their own wages insurance, had to pay the full cost for their own Ventolin supplies, and had to pay for their own hospital treatment insurance, to pick up the pieces, at a special ten times rate for asthmatics testing nicotine-positive on their blood samples? Of course they wouldn't. And will more social engineering and more extravagant government targets make them quit smoking? Are you kidding me? They're in hospital, facing death through smoking, right in the face. And a subsidy on Kumquats funded by a tax on chocolate Kit-Kats is going to make them give up? Beam me up, Nanny. Even an outright ban on smoking would only stop them for a few weeks, until the rapidly expanding tobacco and chocolate black markets got them hooked back in again.

When nanny supplies a comfortable cot and a bottle of warm milk, baby is just going to lie there lapping it up, even if it begins a process of artery clogging. And by the way, just what divine right is it you possess anyway to stick your noses into their lives, even if they did choose to be so stupid? I suppose, you might say, because Joe Taxpayer is forced to fund the NHS, so Joe Taxpayer, in the form of your good selves, has the right to make people obey health diktats. I have a better solution. Let's get rid of the filthy disgusting chippy-staffed NHS, instead, problem solved. And let's not forget the sheer hypocrisy of your leading priests, as they genuflect at the font of the God of Society.

You've got lardy High Priest Gordon Brown, whose fat jowls are now dropping well below his tailored shirt collars, and the even fatter and the even lardier Head Whipping Boy John Prescott, whose broad face is the very road map which highlights the dangers of personal over consumption.

And then, of course, there's Social Engineer-in-Chief and Lord High Defender of the Faith, Anthony Charles Lynton Blair, a coffee-abusing man who can only carry out his job because there's a team of heart specialists waiting 24 hours a day at the Nomenklatura Hospital, in Chelsea, waiting for him to collapse again through overwork, so they can re-start his heart. I assisted in such procedures, in the Rotherham General hospital. But despite what Blair's aides have reported, even when such heart restart procedures are scheduled, they are never routine. Stopping and re-starting someone's heart, to get it into the correct sinus rhythm, is not something you do either lightly or while scoffing a Kit-Kat. It is always dangerous and it is sometimes lethal. Everyone around the table, especially the man with the shock paddles, gets a big hit of adrenaline when the capacitors charge up. Many people die in hospitals. But it's not every day you get to personally perform the action which kills them, especially when it is the bare chest of a British Prime Minister in front of you, all smothered in conductive K-Y Jelly.

But yet we all have to take lessons on health from this workaholic man, who is driving himself into an early grave through endless political briefs and night-time flights, because he is Social Engineering Superman. Despite heart restarts, which are nature's way of telling you to stop politicking and to start gardening, he still knows better than the rest of us as to how we should look after our own health. He even has the right, apparently, to force us how to look after our own health, through taxation and social engineering, because assorted health fascist Guardianistas, who make their obscene gravy-train living from the health-and-welfare monster that is the British state, say that he has this right, as they float around in a comfortable tax-funded sea of their own, smoking cannabis, drinking Chardonnay, and engaging in dubious STD-inducing night-time practices of sexual self discovery.

Well, good luck to you in your private lives. But if you do it, why can't anyone else? Your stupid social engineering, your filthy hospitals, and your unbelievable waste in the NHS, make me, and everyone else, sick. We will all be a damn sight better off, if we simply got rid of all you social engineers, and all of your terrible self-defeating Nanny State works, which make everything worse rather than better. Do you never learn anything? Sixty years of continuing NHS failure and your benighted solution is yet more of the same. It is simply unbelievable. It is time this ratchet was broken.

It seems Gordon Brown's favourite useful idiot, Derek Wanless, has been at it again. The much-criticised former banker, who disastrously turned the giant NatWest bank into a tiddler taken over by the Royal Bank of Scotland, has taken a second lump of taxpayer cash from HM Treasury, to produce a second report telling them, once again, what they wanted to hear in the first place.

This follows his previous report, also commissioned by HM Treasury, which told them National Insurance payroll taxes should be raised to increase government spending on the NHS. Which duly happened, straight after the last General Election.

Dilbert Derek's latest report tells us essentially that the government should do more to look after the health of its citizens. In much the same way, of course, that pig farmers should look after the health of their pigs. Welcome to the farm, citizens.

What this will undoubtedly turn into is a righteous claim, as predicted by our very own Mr David Carr, that HM Treasury should, unwillingly, and after due consideration, raise our taxes again. For our own good. Bless them.

Who cares what the actual tax will be? A fat tax, a hat tax, a stick it up your jumper tax, don't worry, they'll think of something. So my hot gambling tip of the day, if you've got any money left after this year's January self-assessment tax deadline, is to put your loot down on 'More Taxes Soon', in the five o'clock at HM Treasury. This may be your last chance to ever have any spare money, so enjoy it while it lasts. Get a McDonalds with your winnings. Don't worry. They won't mind. They just want your money.

Back in November 2003, I predicted that the end result of the anti-junk-food campaign would be 'sin taxes':

Then on to Step 5: the levying of 'sin taxes' on hamburgers to 'encourage a change of behaviour'. The money raised then pays for a lot more Food Standards Agents.

I hope I will be forgiven for this brief episode of smugness because, not only has my prediction come to pass, but it has come to pass rather more rapidly than even I had anticipated:

A Downing Street-based policy unit has proposed a plan to place a "fat tax" on junk food in an attempt to tackle the rising incidence of heart disease.

According to The Times, the Prime Minister's Strategy Unit raised the prospect of extra duty or VAT being imposed on some of the nation's favourite foods after heart disease overtook cancer as Britain's biggest killer, and more young people started developing diabetes.

That is what it was really all about. All the media-hype, all the hand-wringing, all the brow-furrowing and all the phoney 'caring'. It was all an elaborate ploy by the public sector classes to get their hands on more of your hard-earned. It really is all about revenue.

I heartily recommend pessimism. It enables you to amaze your friends with your powers of prediction and bask in the satisfaction of being borne out by events.

There are two reasons why I could not possibly let this one pass by without comment.

First, while the free market argument against anti-smoking laws (such matters should be decided by means of individual choice and the exercise of property rights) are both meritorious and rational, nowhere near enough attention is actually paid to questioning the decades-long propoganda war against tobacco. Far too many people have now accepted as fact that inhaling tobacco smoke is a uniquely dangerous activity.

However, it is my view that, while smoking tobacco is not entirely risk-free, the dangers of doing so have been grossly exaggerated.

It has taken some time (these things usually do) but now some people are prepared to start challenging this taboo:

As for smoking bans in "public places", there are three reasons why they're unjustified. First, pubs and clubs are actually private property. Second, bars don't have to be smoky any more, with the air-cleaning technology available. But most importantly: no danger from "second-hand smoke" has ever been proven. Unlike most journalists, politicians and, regrettably, doctors, I've gone through all of the more than 40 studies. Only a few show any risk, and it's statistically insignificant. There are higher risks from drinking milk, using mouthwash and keeping pet birds. I swear I'm not making this up! People who use this sort of "junk science" to stigmatise smokers and to nag and bully us out of our pleasures should be bloody well ashamed of themselves.

So they should. Regrettably, they appear to be all too bloody well pleased with themselves.

Secondly, the above broadside was angrily discharged by Joe Jackson, the Grammy Award-winning British singer and recording artist and that makes it doubly significant. Like everybody else I have grown weary of members of the entertainment industry seeking more attention than they could ever possibly deserve with some conformist, fashionable claptrap about 'saving the planet' or similar bunkum. So it is encouraging to note that not everyone in that industry has lost the capacity for critical thought.

My warmest congratulations to Joe Jackson. Twice!

[My thanks to Kevin McFarlane who posted this link to the Libertarian Alliance Forum.]

Now see here all you bloody smoking bastards. They have just about had enough of you and your pathetic, juvenile, surly insolence. Why can't you seem to get it through your amazingly thick skulls that this sort of thing just is not on?

They have tried to be reasonable. They have tried to be understanding. But, oh no, that wasn't good enough for you, was it? Well, here's a news flash for you, chummy: the party is over. Their patience is at an end. The 'good cop' routine has not worked, so its time to send in the 'bad cops'. Yes, that's right. The gloves are finally coming off:

Pictures of diseased organs and rotting teeth could feature on cigarette packets under new government plans.

Similar pictures appear in Canada, Thailand, Brazil and Singapore - now a public consultation will be held on whether to introduce them in the UK.

"We need to continue with fresh, hard-hitting ideas, providing more information that will help smokers quit," Health Secretary John Reid said.

And if that does not force you to quit, well, then they are just going to have to break out the Celine Dion records and play them on a loop until you damn well come to your senses.

Don't make them do it!

I believe I detect some tantalising signs that the Many-Headed Hydra of the British State is, at last, beginning to eat itself:

Institutional racism is a "blot upon the good name of the NHS", a report on the death of a black patient has said.

An inquiry said the failure to give ethnic minority people proper mental health care was a "festering abscess".

It follows the death of schizophrenic patient David Bennett in 1998, after he was restrained at a clinic in Norwich.

Retired High Court judge Sir John Blofeld, who lead the inquiry team, said the death of Mr Bennett - known to friends as Rocky - was "tragic and totally unnecessary".

His team said it believed institutional racism was present throughout NHS mental health services.

This 'institutional racism' thingy has turned out to be a very useful multi-purpose weapon. Perhaps they should drop one into Iraq to help quell the insurgents.

In any event, considering the disproportionately high number of people from ethnic minority backgrounds who work in the NHS, I find this accusation very hard to believe. In fact, I will go as far as saying that it is bunkum. Bunkum on stilts. Bunkum with knobs on. About as plausible as an EU anti-corruption drive.

It made more than 20 recommendations including the demand that NHS staff working with the mentally ill are trained in "cultural awareness and sensitivity".

We have to respect the fact that some people choose to be stark, raving bonkers and that that choice is just as valid as people who happen to be in full control of their mental faculties. All states of mind are the same and doing things like eating spiders and lurking around public parks flashing the old one-eyed trouser snake at little old ladies are merely alternative lifestyle choices that we should celebrate. In fact, these people are not barmy at all, they are just....differently conscious.

But, truly, this is a puzzlement. The NHS is the 'Jewel in the Crown' of the public sector and the only thing still holding that wheezing, cankered Leviathan together is the commitment and morale of the staff working within. What better way to dissolve all that goodwill than by subjecting them to the kind of Inquisitional ordeal that 'cultural awareness training' entails?

Do these accusers not appreciate or realise that the possible consequences of their campaign might be to cattle-prod this most sacred of sacred cows straight into the merciless metal teeth of the abbatoir? Or perhaps they do realise but they simply do not care? Perhaps the years of unimpaired success have so sharpened the appetites of these professional race warriors that they have become like ravenous wolves, turning on their class confreres and ripping out great gobs of flesh in a feeding frenzy?

Well, either way, I say it is best to let nature take its course.

Medical researchers have condemned the new Human Tissues Bill as an impediment to teaching and research.

But scientists say the changes go too far and will make teaching and medical research extremely difficult.

There is no discrimination between whole organs and a collection of a few cells on a microscope slide, they say.

Cancer charities and the Wellcome Trust are calling on ministers to make changes to the Bill.

Doctors have to obtain written consent if they wish to use any form of human tissue removed from a person living or dead, even if they are checking for the prevalence of a virus in the general population. One can think of the consequences if tests could not have been carried out for AIDS, given the level of stigmatisation that accompanied the virus. There is a quandary since informed consent is surely necessary before the tissues of any individual are extracted, preserved and used for any purpose, even if it is for public health.

However, it is estimated that 3,000,000 samples and 100,000,000 blood samples will require written consent, proving another bureaucratic excess for the NHS. Public health is often used as an argument to override the concerns or refusal of an individual to provide any form of sample. No doubt there is an argument that rational individuals will understand the necessity of acting in concert when faced with an unknown disease or epidemic. However, this is often not the case.

Grappling with the issue of public health and a libertarian society, certain questions have presented themselves: Do individuals who refuse to cooperate with ventures sourced in civil society to track and curb the spread of any disease in a minarchy open themselves to claims of compensation since their actions could be viewed as endangering others? At such times, is the action of 'opting out' of a collective venture to track and curb an epidemic by any individual sufficient to trigger claims against that individual on the grounds that their actions placed others in danger?

Perry de Havilland has limited the notion of public health to "communicable diseases", but even here, it is unclear if such matters require a coercive authority mandated to use the measures necessary to curb any disease. As it stands, the new Human Tissues Law will require written consent before any part of your body is taken and used for another purpose, even if it is in your own interest. Surely an advance on the contemporary thefts by state institutions in the name of 'research'.

I got a Valentine's Card once. I cannot remember the exact year but I think it might have been around 1937.

Since then my doormat has been graced with a small mountain of bills, a cascade of unwanted mail-order catalogues and the occasional muddy footprint. But I harbour no grudges and, as the day of luuuurrve and romance fast approaches, let me take this brief opportunity to extend my warmest wishes to all those gaily courting couples of the world. May the aim of cupid's arrow be straight and true and may it pierce the fluttering heart of paramours everywhere. For what is life but to love, as some philosopher once said. Or should have said.

Forgive the mawkishness but I have been driven to such sentimentalities as a reaction to the rather less enchanting message that is being broadcast from people who, purportedly, are rather more caring than I am:

A hard-hitting advertising campaign to warn young people about the dangers of unsafe sex has been unveiled by the Government.

The campaign, launched in the run-up to Valentine's Day, features cartoon images of realistic looking Valentine's cards, with powerful messages about the risks of sexually transmitted infections (STIs).

One features a sunset scene of a couple on the beach with the poem: "Oh Valentine, since you came to me you're always in my thoughts. I'll never forget the night we met and you gave me genital warts."

Another shows a pink teddy bear in obvious pain, with the message: "I love you so much it hurts... when I pee."

Such a bunch of twinkle-eyed, slushy romantics, are they not?

Health Minister Melanie Johnson said it was "vital" to tackle this boom in sexually transmitted diseases and improve sexual health.

"This campaign is aimed at targeting those most at risk by using thought-provoking imagery and direct language.

"The Sex Lottery campaign is targeted specifically at sexually active 18 to 30-year-olds, and has already achieved significant behaviour change.'

At Christmas it's the dangers of overeating, overdrinking and faulty electrical goods. In the summer it's skin cancer, sunstroke and cornea-damage. Now, the season of romance invokes finger-wagging and tut-tutting about STD's. I think what the Department of Dour Presbyterian School Ma'ams is trying to tell us is that life is a bitch, no good will come of it, pleasure is sin and we will all be jolly well sorry we ever started.

While the theological analogy is tempting, it is probably too deep. The real problem lies in there being far too many many state bureaucrats with far too much time on their hands and way too much of our money burning a hole in their pockets. But I do wonder if these people actually mean what they say? I mean, is all this sanctimonious hectoring just a way of bailing out the huge waves of cash that HM Treasury has flooded them with in recent years? Or do people like Melanie Johnson really see the world only in terms of the demons waiting to pounce with malice aforethought on the unsuspecting life-reveller? Are these apparent neuroses just convenient rubrics or is this, in fact, the true face of our political classes that we are seeing, genital-warts and all?

I would like to think that it is the former but, increasingly, I suspect the latter. I really do think that our entire ruling class is deep in the grip of some paralysing psychosis that has turned them into medieval peasants, muttering incantations and kissing toads to protect themselves from the Dark Faeries That Dwell In The Woods.

Generally speaking, the world is a dangerous and worrisome place for defeated and exhausted people.

So George 'Hitler' Bush and his shadowy cabal of extreme right-wing neo-conservative warmongers are, once again, showing their contempt for the peace-loving, democratic will of the international community:

The United States is challenging a strategy by the World Health Organization (WHO) to tackle obesity.

Some scientists accuse President Bush's administration of planning to water down proposed junk food regulations, in order to protect big business.

No mention of who these 'scientists' are, mind. Perhaps they are Indyscientists.

Anyway, I support the WHO. I think it is only reasonable and fair that I should be told what I can and cannot eat by a panel of experts from Libya, Chad, Cuba and North Korea. It's for my own good!

I learned long ago not to hang my rhetorical hat on anything as unreliable and insubstantial as a scientific report, especially when they are described as 'surveys'. It always conjures up visions of earnest researchers scurrying about with clipboards asking random people multiple-choice questions about household detergents.

However, that said, it would not surprise me in the least to discover that this does, in fact, have some substance to it:

Millions of Africans believed to have HIV/Aids are free of the disease, according to research published yesterday.

The survey will dismay those who claim the West is ignoring a pandemic so acute it could wipe out the populations of entire African states.

I know exactly who those 'dismayed' people are. They are the lobbyists, charity scammers, tranzi office-holders, preachy celebrities and other assorted NGO-fodder who have turned AIDS into an international fund-raising and foreign junkett circus. Joining them will be a host of African kleptocrats who know only too well that 'AIDS' is the magic word with which to open the purse-strings of Western treasuries.

Africa still has that 'dark continent' quality about it that makes it impenetrably mysterious to gringos in the West. So when we are told by talking heads with august-sounding titles that squinty million zillion trillion people are dying of AIDS in Africa every four minutes, very few of us (if any) have sufficient knowledge of the situation on the ground to raise so much as a batsqueak of doubt. By the same token, it would all look the same if the figure-compilers lumped in deaths from all manner of other maladies and diseases in order to inflate the victim-toll.

I remember so clearly when AIDS became a big public health issue in Britain in the mid-80's. From out of nowhere came legions of 'experts' to assure us that it really was the new 'Black Death' and it was poised to wipe out the civilised world. Resistance was futile. Most of us would be dead before breakfast.

It never happened in the West and maybe it is never going to happen in Africa either.

With a rapidity which defies belief, Mr Bezos, of Amazon.com, has delivered to my grasping hand Professor Hans-Hermann Hoppe's The Myth of National Defense, and a copy of Ludwig von Mises' Bureaucracy, direct from Amazon's Seattle headquarters, via standard shipping, in less than a week. Remarkable.

I thought I'd warm myself up for the big one, from Herr Hoppe, with the 1944 classic from Herr Von Mises. And what a true classic it is. I'm only on page 19, of its one hundred and thirty four pages, but already it has staggered me with its guillotine-sharp language, its brutal power, and its Germanic eloquence. Magnificent.

We simply are unworthy of this greatest of the twentieth century's bearers of the flame of liberty.

One quote has already caught my eye, after a recent David Carr article:

It [modern socialism] is totalitarian in the strict sense of the term. It holds the individual in tight rein from the womb to the tomb. At every instant of his life the 'comrade' is bound to obey implicitly the orders issued by the supreme authority. The State is both his guardian and his employer. The State determines his work, his diet, and his pleasures. The State tells him what to think and what to believe in.

Now I could mention how clever it was, in 1944, for Von Mises to spot the increasing role, in the 21st century, for our illiberal friends at a certain UK newspaper, but let's take a closer look at the subject of diet, something Professor Mises told us in 1944 the totalitarians would feel bound to try to control us with, for whatever miserable reasons they dream up.

I must also thank Uncle Stephen Pollard for his excellent Times-published article about the Atkins diet. I relapsed from Atkins, somewhat, over November and December. But Uncle Stephen has slapped me round the jowls and got me back on track. When I was that healthy vision of virility, which I keep in my mind, and a blindside rugby flanker, less than 10 years ago, my fighting weight was 14 stone. This crept up to an outlandish 17 stone 10 pounds, over the next few years, following retirement from the scrum, meaning I was 52 pounds overweight. Crikey.

A simple use of Atkins, over a few months, got this down to 15 stone 8 pounds, i.e., I lost 30 pounds, and only had 22 to go. But you get smug on Atkins when none of your clothes fit any more, because you've lost so much weight. So I relaxed the regime and drifted slowly back up to 16 stone 4 pounds. This means I now have 32 pounds to lose, instead of 22. But now I'm back on the program, much to the consternation of UK taxpayer-funded nutritionists, dieticians, and other Von Mises predicted health fascists, everywhere. One was on the UK Today program this morning, virtually accusing the Atkins diet of being worse than that most evil of consumptive habits, smoking, shrilly accusing Boots the Chemist of virtual genocide for daring to stock Atkins-brand chocolate bars. How dare they! Don�t they know who rules this country?

So in my bid to repay Ludwig von Mises, Stephen Pollard, and the late great Dr Atkins himself, and to induce apoplexy into socialist health control fetishists, wherever the sad useless fools may be, I thought I'd pass on a recommendation as to my favourite greasy spoon restaurant, in the whole wide world.

This is, of course, the spectacular Gorge Cafe on the south side of the Caversham Bridge, in Reading. Popular with Reading Festival attendees, motorbikers, and other discerning denizens of monster grills, you just cannot beat the Gorge. Good prices, quick service, top quality sausages, excellent tea, fried eggs always done just the way you like them, and all cooked and served by people who really look like they're enjoying themselves, especially the girls in those modern jeans which only start going down halfway round the bum. Most excellent.

The parking's a bit tough, with only a few spaces outside for Gorge customers, in the BP garage forecourt next door. But as you'll be arriving on your Harley Davidson anyway, don't worry about it (or you can park by the Caversham rowing club, down behind the Holiday Inn hotel opposite, if you get a bit stuck, or in the Rivermeade leisure centre car park, just up the road).

With two split levels in the Gorge, non-smokers like me, who are waiting for the UK government to ban the filthy weed so they can start up again, are well served by the lower non-smoking level, and top quality smokers can relax in the upper level, imbibing their nicotine amongst friends (though good air-conditioning quickly cleans the air). I often dine up there, just to get the fumes. Ah, memories.

What else can I say about the Gorge? They have an excellent Atkins-style breakfast, which is basically their monster grill without the beans or toast, and there's usually plenty of seating room inside, despite the unusual pink ceiling cave decoration which makes you feel like Fred Flintstone would be happy in there.

As greasy spoons go, the Gorge is also a true classic, like Bureaucracy, as any of its regulars will testify. Despite searching, I've yet to find a greasy spoon restaurant as good, or as memorable. Its ceiling, particularly, truly is world class.

After your splendid Atkins-style Gorge breakfast, take a walk down by the Thames, to see the swans, or do this beforehand to build up your appetite. Either way, if you're in Reading, in the Caversham area, and you want to stick two fingers up to the diet and health control freaks you're forced to pay for through your taxes, always make sure you pay a culinary visit to the Gorge. If you can do this on your 1000 cc Ducati Monster, this gets bonus extra points. And remember, extra points means extra rashers of bacon.

It is now 2004 and may I take this opportunity of wishing all Samizdata readers a happy, healthy and prosperous New Year.

As for me, I have resolved that I will be in the same bad mood this year that I was in last year. It makes perfect sense. My enemies don't change their ways, so why should I change mine?

It is time to stand up for the "nanny state" - for Jowell and Hodge and, in other areas, Patricia Hewitt and Harriet Harman. And also, in general, for the state's right and duty to involve itself in questions of diet, health, family budgets and good parenting.

So it turns out that all the leftie carping about 'big food' in 2003 wasn't a joke after all. They really mean it. I predict, before the end of 2004, a 'burger tax'.

The crucial point which critics of the nanny state fail to mention is that individuals and families don't stand alone. None of us lives in a neutral social space, unharassed, and free to make wise long-term choices. Whatever the philosophical ideal, in the real world we are bombarded by corporate messages cajoling us and our children to consume and borrow. We are inhabitants of the more, now, spend-it, eat-it society, which - let us not forget - boosts the profits of the multinationals.

We are also inhabitants of ban it, tax it, regulate it society which - let us not forget - boosts the profits of the political classes.

Health-hectoring is now being added to enviromentalism and 'anti-racism' as a legitimating ideology of the ruling class. Another self-sustaining justification for their power, wealth and status. Nothing new about that of course, only now they are prepared to put the whole process on public display before nailing it into place.

Alright, I wrote that quotation myself. But anyway, this is what I hate about the Guardian: it's so damned gloomy (what I hate about the Telegraph of course, is the stair-lift adverts). Can anyone tell me exactly how the Guardian manages to publish this...

Newly revised predictions from the Government's Actuary Department (GAD) reveal that the life expectancy for men who will be born in 2031 has risen to 81 years, compared with 75.9 years for those born in 2002. For women the figure jumps to 84.9 years, compared with 80.5 years for those born last year.

And now the bad news. The figures are around one and a half years higher than the GAD had assumed as recently as its last report in 2001, and will fuel further fears about the ability of future governments to cope with the profound problems associated with an ageing population.

...on the same day as this...

The full scale of the health timebomb caused by Britain's descent into lazy lifestyles is to be exposed in a landmark report by the Government's Chief Medical Officer.

Sir Liam Donaldson will spell out for the first time how two-thirds of Britons are now so inactive - with most people, particularly women, failing to do even the minimum recommended amount of 'moderate' exercise - that they are at risk of getting cancer, diabetes and heart disease.

I don't know which is more shocking and dreadful, the fact that Brits are living longer or the fact that they take no notice of government fitness targets! Did you all get your fitness targets in the post? No? That's strange, neither did I.

Professor Ken Fox, a social psychologist at Bristol University and an expert on how to increase activity levels, said: 'To make a real impact we have to redefine what activity means. You don't have to be sporty to be active. You could use your legs and do a bit more walking, which would really help you.

So, exactly how do they know we're not walking much, or already "incorporating bursts of activity into daily life", eh? Did they see how many times I run up and down stairs every day? No, they did not. They're just being anti-evolutionary for the sake of it:

'We have been conditioned, since Victorian times, to find easier and easier ways of living. We want lots of dishwashers and lots of cars.'

Right. We're living longer because we don't have to slave as scullery-maids or walk ten miles to labour at the cotton-mill each morning.

Readers of Samizdata will of course find the government's attempts at nannying both predictable and irritating. I think what matters more than any "slippery slope" argument, however, is simply that we understand what the anti-capitalist worldview consists of, and work out how to persuade the left that they are wrong. The idea that the progress of human civilisation somehow corrupts and destroys us is as fundamental to anti-capitalism as the idea that a growing population means a growing fiscal burden, as opposed to a growing economy and knowledge-base.

What we need to share in 2004 is our knowledge of how capitalism works, and why it is good. The fixed-wealth theory must be replaced by a common-sense appreciation of economic and evolutionary dynamics. It's not a glamorous job, and it's not a matter of heroically rescuing the UK from certain Khmer Rouge tyranny. It's just about spreading sensible ideas and helping things gradually improve. But few things are more important than that.

It annoys the hell out of me when I hear the chattering classes in Britain describe this country's decrepit socialist National Health System as 'the envy of the world'� and it astounds me when idiots in the USA think it should be emulated over there.

As someone who has all too much first hand contact with the NHS, as well as having been at the tender mercy of other nation�s healthcare systems when I have broken bones, crashed cars, got shot, fallen through a weak floor, head-butted a flying bottle, been bitten by snakes/dogs/rats/, skied into trees, caught exotic unpronounceable tropical diseases and all the other things that happen to folks such as myself who travel to far off places and foolishly venture out of the hotel� and I can assure you that the NHS is at its best nothing special compared to much of the rest of the world and at its worst, it absolutely sucks. I certainly never saw a dirty ward in a hospital in Croatia or Ghana or the USA like those I have seen in Britain's state run hospitals.

In reality, not only does the NHS provide indifferent care (an appointment I needed once took 11 months to arrange), it does so at vast cost and in reality a large chunk of the burden of healthcare is done privately. In fact, the NHS could not survive without a large healthcare private sector, the size of which Eamonn Butler points out over on the Adam Smith Institute's own blog.

When my grandfather was gravely injured a few years ago, the treatment he received from the NHS was adequate - but after it became apparent that he was not able to look after himself any more due to brain damage, my family ended up shelling out well over £40,000 ($70,000) per year to keep him in a private nursing home which did not smell of piss. I am not complaining, after all what the hell is money for if not for something like that? However the role played by the non-state sector is a largely unsung one and I wish more people in Britain realised that the fact the state does not provide a healthcare service does not mean one will not be provided. If the state did not take such a whack of tax money to fund the monstrosity that is the NHS, far more people would have healthcare insurance.

Of course that might not end up costing much less than the existing system but the evidence outside Britain suggests it would certainly produce a higher quality system than the one of de facto healthcare rationing in use in the UK now.

The British Medical Association cuts to the chase. No shilly-shallying about. None of these namby-pamby half-measures or pathetic, milquetoast compromises, no, they have decided to go for the kill and demand another full-blown drug war:

Smoking should be completely banned in the UK, according to a top medical journal.

The Lancet said tens of thousands of lives would be saved by making tobacco an illegal substance and possession of cigarettes a crime.

Might as well really. The political climate is right, the enforcement apparatus is all in place and resistance will not be futile because it will be non-existant. In fact, they are probably kicking themselves for not coming out with this sooner.

Dr James said the government had already shown it was willing to pass similar legislation, such as banning the use of hand held mobile phones while driving.

Once again we see that appeasement does not work. Give the bullies an inch and next they want a mile. These people cannot be placated.

Forest director Simon Clark said the Lancet was "the true voice of the rabid anti-smoking zealot".

He said smokers should not be treated as criminals, adding: "The health fascists are on the march.

Oh no, Simon, they have been on the march for decades. Now they have taken the citadel.

"What next? Will they urge the government to ban fatty foods and dairy products?"

Yes. There is no reason for them not to.

Empathy is the thing in schools history these days. You get the kids to think their way in to what it was really, truly like to be a fourteenth century Bohemian swineherd and feel their pain. Empathising with groups neglected and derided by the "Kings 'N' Battles" school of history is particularly favoured.

As part of my personal commitment to this school of thought, I'd like to bring up for public view the sufferings of a marginalised and stigmatised group. Slaveowners. Ever thought about their problems, huh? You probably think a person who can legally demand the unlimited services of another human has everything he wants. But you'd be wrong.

The ancient and modern chroniclers agree. Slaves were frequently lazy, dishonest and obstructive. Lacking initiative and zeal. Endlessly prone to saying, "yes massa, coming massa," and yet still somehow unwilling to put their hearts, souls and scrubbing arms into bringing out that deep-clean sparkle when scrubbing out the vomitorium.

Here is Seneca, writing in the Rome of the first century AD: "A household of slaves requires dressing and feeding; a crowd of ravenous creatures have to have their bellies filled, clothing has to be bought, thieving hands have to be watched, and the service we get is rendered with resentment and curses." (From On Tranquillity.)

Seneca knew no other system than slavery. In contrast English observers of the US writing after 1833 could observe the system from outside. I found several quotations in the Penguin Portable Victorian Reader illustrating how shoddy slave-work was. A passionate enemy of slavery, Charles Dickens, wrote "Richmond is a prettily situated town; but like other towns in slave districts (as the planters themselves admit) has an aspect of decay and gloom which to an unaccustomed eye is most distressing.�

Even an opponent of slavery as lukewarm as William Makepeace Thackeray had to admit, writing to a friend in England: "Every person I have talked to here about it deplores it and owns that it is the most costly domestic machinery ever devised. In a house where four servants would do with us �. there must be a dozen blacks here, and the work is not well done."

Barbara Leigh Smith Bodichon, describing her experiences in Savannah for The English Woman's Journal, also notes a certain lack of devotion to duty: "The [slave] boy was sent to bring a cart and horse to his master directly, but he very cooly put him off, in a way that would have lost a boy his place in England."

It must all have been very frustrating to the owners. They had important things to do, and here were the lazy good-for-nothing slaves delaying and dallying and just not putting their heart and soul into it.

Now, just possibly you the reader aren't very sympathetic. Just possibly you opine that the slaveowners had only themselves to blame - �Well, of course,� you are saying, �it's no surprise that if people are forced to work for nothing then they don't bust a gut.�

So why do so many people expect these familiar laws of human behaviour to suddenly change when the time is now and the work to be done is AIDS research?

In this link Stephen Pollard quotes Roger Bate, writing in the Wall Street Journal, as saying that AIDS drug development is trending downwards.

Why the decline?

Because the drugs companies no longer believe that they are going to get rich out of AIDS research. In fact they begin to doubt they will get any compensation at all. They read the newspapers, they study the speeches of politicians, and they sense that the popular wind is blowing against them. They think, probably rightly, that governments will either force them to sell at a loss drugs that were developed at huge expense or will bypass them and the law entirely by buying generic copies of patent drugs. Governments, after all, are the ones who can change the law when it is inconvenient. One minute the authorities will come down like a ton of bricks on pirate music or pirate videos. The next minute they will say that it is 'unacceptable greed' for companies to actually want to profit from patents on medical discoveries. I accept that there are subtleties and genuine conflicts of principle in the field of intellectual property � but the bottom line is that if pharma companies get nothing but abuse for the work they put in they bloody well won�t put in much more of it. Just as for the slaves, it�s no surprise that if people are forced to work for nothing then they don�t bust a gut.

The Concerned Classes have gradually become aware that AIDS research is slowing down. After a period of astonishment that the drugs companies might actually decline to work for nowt they have gone into a huddle and have come up with their usual strategy: force. Dammit, we�ll make them find a cure! Or perhaps we can be more subtle. We'll get the work out of them by veiled threats of legal action and harassment, and by egging on our toadies in the press to yet more slander.

In other words, the master sees the work ill-done and gets out his whip. He need not use it - most of the time. It is enough to finger it in a meaningful manner. This strategy appears to succeed at first. Oh, the hurry and scurry among the slaves! There is great show of work being done. Yes massa, coming massa! But somehow - still - things are still shoddy, unimaginative. Creativity cannot be got by means of a whip.

The slave has his own strategies. Fine says the company. Our research budget will be as big as ever. (Many companies find it useful to have a drainage swamp. Here's where they'll pile the "miscellaneous" funds; they can always contrive to get them back later if need be.) Redundancy looks bad and costs money, so we'll send Arthur to AIDS research. You don't know Arthur? Nice chap, you'll like him. Not top notch, perhaps, but no one actually thinks he's a deadbeat. Still, if things were different he would be let go in hard times - but now they have a much cosier solution. They'll promote him, even. Put his picture in the company magazine and, better yet, the press release. The syrupy article on the fine, public-spirited work Arthur and his team are doing for the suffering people of Africa almost writes itself. The company publicity officer will certainly have a busy morning sending this press release to ministers and journalists and AIDS lobby groups. (Yes massa, coming massa!) Arthur himself is vaguely aware that he has been sidelined, but he doesn't mind. The pressure is off. He is doing Important Work. The status of virtue replaces the status of success. It can be comfortable being a slave.

This is, naturally, a statistical tendency rather than a universal law. Individual researchers of great creativity and diligence will stay in the field of AIDS research for the love of it and humanity � but the pool of talent will be reduced by all those not so altruistic. It�s happening now, and it�s not just the researchers themselves that are affected. Everyone seems to hate medical managers but they are in fact necessary. A talented go-getting manager who wants get promotion, dosh, and glory by saving his company�s ass as expressed in the balance sheet - he'll hot-foot it to some other department than AIDS Research.

That's bad enough. But the real harm is only just beginning. A young medical researcher is wondering which line of study to pursue for his doctorate. New headache pills maybe... the next Ibuprofen? Or AIDS research? But somehow AIDS research just doesn't seem to be where all the hot-shots go any more. Without the glamour of serious profit it is no longer, to use a painfully apt metaphor, sexy. Our researcher is scarcely conscious that his decision has any component of self interest at all, as most of us prefer not to dwell on such things. Somehow the science of headache pills glows a little brighter in his imagination and that of retro-virals looks a little more dowdy.

Some readers may find my comparison of AIDS researchers to slaves rather melodramatic. I admit the charge, in so far as it extends to workers. Individual AIDS researchers are free men and women. The sort of compulsion we are seeing in the field of AIDS research is an infinitely lesser evil for the companies and their workers than the outrage of slavery... a lesser evil for them, but it may kill as many black men and women as slavery ever did.

Slavery is: work for nothing. Slaves are: lazy, obstructive, lacking in zeal. "The work is not well done." Yes, life must have been tough for the owners of lazy slaves. And it always will be. Important work is done by free men.

Melanie Phillips links to and comments extensively on this article about NHS nursing by Harriet Sergeant from last Saturday's Telegraph, which flags up a publication also by Sergeant from the Centre for Policy Studies, entitled Managing Not To Manage (.pdf only). That's about the management of the entire NHS, and not just the nurses, but the bit of the Telegraph article that particularly caught my attention concerns the way that the education of nurses is now heading:

The training of nurses has promoted them further and further away from the interests of their patients. In the late 1980s, nursing turned itself into an academic profession. Nurses desiring increased status and greater parity with doctors sought to transform their training into a graduate profession. The result is "a frigging mess", according to a member of the King's Fund, a charitable foundation concerned with health.

One senior staff nurse at a hospital in the West Country, who teaches at the local university, pointed out - logically enough - that the academic status of the qualification means "there has to be a lot of theory". But there is too much theory, too much emphasis on social policy and communication skills - and not enough practical work.

At a London A&E department, a staff nurse who had recently qualified complained to me that her training had not prepared her at all. In 18 months of study, she had spent only one and a half hours learning how to take blood pressure and a patient's temperature. On the other hand, a whole afternoon had been devoted to poverty in Russia. �

The usual assumption is that if there is a problem, it will take money to put it right, but that enough money will do it. But training nurses who knew how to nurse didn't take any more money than teaching them about poverty in Russia costs now, surely. The problem will be forcing through the decision to teach nurses well instead of badly. My answer would be to phase out the NHS � gradually, no rush, say over a period of, I don't know, three months � and thus allow a world to re-emerge in which good nurses get paid far more money than bad ones.

Melanie Phillips blames feminism. But why does feminism only seem to do damage to public sector institutions?

First, they came for the tobacco.

With the 'junk food' demonisation campaign in full swing, now is the time for our heroic public officials to do their stuff:

All foods - including fast food and snacks - should carry clear warnings about their calorie content, MPs suggested on Thursday.

Top executives from McDonalds, Cadbury Schweppes, PepsiCo UK and Kelloggs faced questions from the House of Commons Health Select Committee.

Obesity levels are soaring in the UK, but the firms said they did not believe that this was their fault.

The Food Standards Agency has described the problem as a "ticking timebomb".

Well, they would, wouldn't they. If food were not a problem then we would not need a 'Food Standards Agency' and then we would all be on our way to hell in a handcart (and we all need a handcart because we will simply be too obese to walk there).

This Court of Inquisition is merely Step 2. Step 3 is a choice of either legislative force or 'voluntary code of conduct'. Step 4 is another public campaign (disseminated by a reliably compliant media) because Step 3 'is not working'.

Then on to Step 5: the levying of 'sin taxes' on hamburgers to 'encourage a change of behaviour'. The money raised then pays for a lot more Food Standards Agents.

There it is. Step-by-step. Simple when you know how.

We are all in the wrong business.

Thomas Sowell has an excellent column today laying out in lucid terms the economic ignorance behind current proposals to reform health care in the US.

An OECD study shows that the percentage of patients waiting more than 4 months for elective surgery in English-speaking countries is in single digits only in the United States, where we "lack" the "benefits" of a government-run medical system. In Canada 27 percent of patients wait more than 4 months and in Britain 38 percent. Elective surgery includes some heart surgery.

Shortages where the government sets prices have been common in countries around the world, for centuries on end, whether these shortages have taken the form of waiting lists, black markets, or other ways of coping with the fact that what people demand at an artificially low price exceeds what other people will supply at such prices.

. . . .

Americans, who produce a wholly disproportionate share of the world's new life-saving drugs, are being asked to imitate price control policies in countries where such policies have dried up the costly research behind such discoveries.

. . . .

Politicians who claim to be able to "bring down the cost of health care" are talking about bringing down the prices charged. But prices are not costs. Prices are what pay for costs.

No matter how much lower the government sets the prices paid to doctors, hospitals, or pharmaceutical drug manufacturers, none of this reduces the costs in the slightest.

Evidently, most of our policymakers and "thought leaders" are so gobsmackingly stupid that they cannot retain elementary economics and history in their pointy heads, and by all accounts honestly believe such gibberish as "price controls lower costs."

No matter how many times socialistic policies crash and burn, no matter how many times market-based systems beat the pants off of top-down autocratically controlled systems, the "liberal" elites in government, academia, and the media in the US return time and time again to shopworn socialist prescriptions.

Like a dog to its vomit.

I was lying on a piece of blue tissue roll in one of Tony Blair's world-class Accident and Emergency hospital departments, a few weeks ago, at around 3am on a Sunday morning. As you do, in such a situation, I was thinking about death, and Simon & Garfunkel albums. But being one who recently qualified as an NLP practitioner, under the tutelage of Californian shaman Richard Bandler, I thought to myself how can I turn this around into a positive experience? How can I come out the other side of this seemingly grim situation mentally refreshed rather than mentally battered? So I made a deal with myself. If I make it out the other side of this alive, I stipulated, I'll turn the entire experience into a piece for Samizdata. You see, some of us mad-eyed libertarians really do care.

So I was going to bend your ears with a Theodore Dalrymple-style diatribe on the drunken street scum of Berkshire, around me, demanding to be allowed to smoke, and arguing with stoic nurses while dripping with blood from self-induced beer-night injuries. I was also going to mention, in passing, the unpleasant tone of the queue managers, the uncomfortable beds, and the reasons why I was waiting to be seen, after a MASH-style nurse triage, rather than why there wasn't already a swarm of surgeons all over me instantly administering reassurance, sympathy, and curative scalpel blades. But then I thought, come on Andrew, stop being such a Victor Meldrew prima donna. You're still breathing, you sad git.

You've got a problem, of that there was no doubt, but at least the nurse had seen me, and had determined that a glorious English sunrise would see my smiling face for at least one more happy time before Death sent Mort along to claim his latest victim. The scum of Berkshire may have been regretting picking fights with broken bottles, and the bed may have been uncomfortable, but the surgeon would be along in a minute, right after seeing that screaming baby that had just come in after me. Maybe I wasn't in the best hospital in the world, and maybe the NHS is crawling with MRSA, and maybe I had been made to shout my medical predicament to the receptionist, behind her plexi-glass shield, so that the fifty other people waiting could hear every detail, but at least I was in the best hospital in the nearest 100 miles, and I would have refused to swap my current position, lying on this blue paper roll, with anything other than instantaneous transportation to Dr McCoy's sick bay on the starship, Enterprise.

Thankfully my condition that night didn't prove immediately fatal, as may be obvious. Three years at the Royal Hallamshire Medical School, in Sheffield, has made me into a dreadful hypochondriac, where I know enough to be dangerous, but not enough to be useful. It turned out that what I thought was a potential surgical emergency was something treatable by Nurofen. What a big girl's blouse, you might be thinking, and you might be right. But what happened next, or rather, what didn't happen next, is the real root of the problem within the NHS.

For my rather painful condition, which I later learned happens to 20% of the people in Britain at some point in their lives, usually caused by some form of trauma, might have been a cancer, an aggressive one, and that this nasty potential cause had to be excluded before any further treatment could be considered. So I thanked my nice South African doctor, which New Labour had successfully removed from the world's poorest continent to fill the gaps caused by early-retiring UK doctors sick of endless target-driven paperwork, and asked him how long it would take to organise a proper scan. A day, I asked, maybe by Wednesday?

And then I found out why the NHS has succeeded in delivering Britain the worst cancer death rates in the entire western world. "Oh," he said, with obvious admiration for the way the NHS may manage to treat cancers better than somewhere like, say, Namibia, though even this may be debatable. "Go and see your GP tomorrow. They should be able to sort you out within a couple of weeks."

Within a couple of weeks! You've got to be kidding me? I had something inside me which could have been metastasising right now across my entire body, into my brain, into my lungs, and into my kidneys, and the NHS was going to wait a couple of weeks before taking the issue any further, before even examining me properly? "Don't worry," he said, almost gleeful that he could get me out of his Accident and Emergency department without any further need to treat me; this must have been given him the right to tick some box on a piece of paper, I thought. "It's only a small chance it's cancerous. You're the wrong age group." And with that, he was off, stethoscope around his neck, the way all we poncey medical students used to wear them when desperately trying to impress nurses. Only a small chance of cancer then, not a big one. That was good, nothing really to worry about. I didn't have the heart to tell him that I too had studied those same normal distribution charts he was thinking of, and that I already knew I was in the wrong age group, at least for the bulk of cases. But that these curves had very long tails on both ends, when I last saw them, and I was well within one these tails. But I didn't want to upset the nice doctor. He was a busy man doing his best, I knew the structure of the NHS wasn't his fault, and I was preventing him from carrying out his duty to get that four-hour waiting time target down. Sorry doc. Next time I'll sit outside in a tent, like they have at some NHS hospitals, as the four-hour waiting time target only applies as soon as you cross the department threshold. So if you're held in a tent outside, you can be out there all night but the hospital will still reach its four-hour waiting time goals, as you aren't brought in until it's only three hours and fifty-nine minutes to go before you're seen. Why are bureaucratic targets always just so fine and dandy? And don't laugh America. When the Democrats get in again, and they get Medicare past you, it's your turn next.

Fortunately, before these denizens of the state turfed me off their premises, a nice young lady doctor gave me some impressive looking painkillers, the kind they give to elephants before they shoot them, and sent me into the night, another grateful, though worried, supplicant of the producer-led NHS. Trying to take my mind off things, this led me to think of another major problem the NHS has created, one caused by a subtle jobs protection scheme long hidden under the guise of political correctness. For the government needs doctors, to meet all of its stupid target promises, so it has ramped up the numbers of medical school places. Each medical student takes at least five years to train, soaking up, along the way, hundreds of hours of consultant time, and costing hundreds of thousands of pounds per doctor, to the poor sodding taxpayer.

And shortly after many of them qualify, they give up medicine, or go part-time, to concentrate on looking after their families, often started with another doctor who continues to work in this well-protected and generously salaried, and particularly well-pensioned, state-controlled profession. This is good for the BMA, and the medical establishment, who control the student entry numbers into the medical schools and NHS career grades, as it ensures there are a limited number of doctors who can therefore demand and receive excellent salaries and pensions, as they all move in a cohort up towards lucrative consultant or GP status. Or, as one nice professor said to me back at medical school, "Just keep passing your exams, Andrew, and you've got a well-paid job for life. We've designed it to work out that way. That's why junior doctors will always be under pressure. Because we need to avoid a career pyramid, as each junior doctor must be guaranteed a senior post when they're older, and we can't do that, as a profession, if we expand the numbers of junior doctors." Oh, the highways and byways of jobs-for-the-boys protectionism. And so well camouflaged. Don't you think?

But getting back on-topic, this constant haemorrhaging of newly-qualified doctors is terrible for NHS patients, as there is a constant shortage of doctors. However, it would seem many people go to medical school, not to be doctors, but to meet doctors who they can marry and have children with, with a comfortable middle-class salary to support them all thrown in for fun. Wouldn't a dating agency be cheaper? Well, not to the student, who is still highly subsidised.

Although even Tony Blair's fatuous Junta may make medical students pay a few of the hundreds of thousands of pounds it costs to fund their training, over five years, this will still be a fraction of what it costs the rest of us in tax. So the end result is that the NHS are now throwing billions of pounds at the training of doctors, while knowing it will lose many of them before they become productive, because they were only in it to acquire the right "status" in the first place, or to impress their parents, or just to get a "nice" degree, without ever expecting to work full-time. So what am I suggesting? Slavery? Should we force all newly-qualified doctors to work 60 hours a week, for 20 years, after they qualify? Even better, do we need to round up all those ungrateful drop-outs who did three years, and force them back into the profession to work under the same Gulag conditions, possibly as porters if they won't do their exams?

Well this might be a socialist solution, I suppose, but not what I had in mind. No, what we need to do is make prospective medical students pay the full cost of their medical training, to ensure they're properly motivated to actually practice medicine later, when they qualify, so taxpayers aren't forced to carry the financial burden of impressing Johnny and Jane's parents. The market will remunerate them accordingly, later, via medical charges. We also need to open up the medical schools to however many people want to train in them, so that the dreaded market will work out how many doctors we need, rather than the BMA or the UK government, in their collective wisdom, for their own convenience.

The market will also cut the cost of training as much of what an NHS doctor does in five years is complete rubbish. Yes it's nice that every British doctor knows about virtually every area in the entire medical world, in quite some detail, but is it essential that they do so? Does a psychiatrist really have to pass surgical exams? Does someone who has only ever wanted to be a surgeon really have to study community medicine? You might think so, but it seems clear to me that these long degrees covering every possible topic are mainly about jobs protection and profession entry limitation. The market will be the best place to decide the issue. And for the market to work effectively, to maintain an evolving balanced structure, we need to privatise the NHS in its entirety, so that good hospitals, with good professionals, will prosper and spread best practice, and the bad ones will go bust with inadequate staff everywhere being forced out into professions they're better suited to.

But, I thought, wandering through Reading in the dark, at 4am, nobody is allowed to say anything regarding the numbers of early-profession leavers, in medicine, as it's obvious I'm talking about mostly, though not entirely, female doctors, and that this topic is a sacred cow, with often over 50% of a typical medical school's intake being women, even though the largely male consultants give them less attention than male students, with the system knowing that many of them will fail to make it much further than medical registration and occasional part-time work at their local GP practice. And this is despite medicine being one of the most over-subscribed University courses in the country, where I'm sure many who could do it, and who would stick to it given a chance, are excluded because of the first-year pressure on places. But gotta keep those junior doctor numbers down, remember, to keep a consultant post open to every man, so the admissions tutors and the BMA never complain too much. Full course payment by each student will solve this early-leaver problem immediately, of course, as only the truly dedicated will ever apply. I know I'd certainly have been a little less cavalier in chucking myself into it if I'd known I'd be handed the bill. But what are the chances of this happening to such a profession, one burrowed so deeply and comfortably within the Leviathan? Well, they're odds-on, if I ever become life-president of the United Kingdom with my political motto, "Government is useless, I will hand you back everything". But unlikely otherwise.

BTW, my last political act will be to sack myself to remove the last parasite.

So where was I? Oh yes, wandering off into the night wondering, rather melodramatically it must be added, with the 20-20 benefit of hindsight, if I was about to die. Now, the sensible thing would've been to phone BUPA up the next day and get seen immediately by a consultant, but your useless idiot here panicked. The one last real link I have to my socialist roots is my emotive belief in the NHS, a Soviet-style monopoly to which I devoted three years of my life. So I tried in vain to sleep, something I've had a lot of trouble with over the last few weeks, and retreated into grateful guinea pig mode. "They must know best," I tried to fool myself. "I'm in the wrong age group."

Fool. Next time I'll know what to do, but please forgive my stupidity and halfwit behaviour. It's easy to be rational, when you have a clear mind, but difficult when you're not getting much sleep.

So, the next day at 8:30am sharp, I booked an appointment at my GP's surgery, and I was there by 10am being prodded and poked once again; the most private part of the NHS, the GP system, is one of its few saving graces. "Oh, we should be able to get you into the hospital within two weeks. It seems unlikely it's cancer."

"Yes," I replied. "I'm in the wrong age group." Jesus, did we all read the same textbook? What a bunch of automatons they turned us all into.

And so began the wait. Little sleep. And the wait. The postal workers strike didn't help. "Where is my appointment slip?" I used to wonder, every morning, with increasing fury. Then after the promised two weeks had been and gone, my resolve to trust the NHS finally broke. "Right, that's it. I'll doorstop the bastards if I have to and they'll have to get the police in there to get me out. I'll make sure I take two tape-recorders and a digital camera. Outpatients Department here I come." And then, just before I was about to drive down and physically attack the Byzantine Empire that is the NHS appointments system, a letter popped through the letterbox. The appointment letter had arrived, and more importantly the NHS appointment number within it, a veritable sliver of gold.

"Great," I thought. "It'll be tomorrow morning, and I'll found out one way or the other." And then ripping the sucker open, like a Willy Wonka chocolate bar with a magic ticket, I found out what Dr John Reid, the New Labour Secretary of State for Health, had decided on my behalf. In his magnificence, via one of his numerous flunkeys, he'd decided I needed another ten days on the shelf. Yes, that potentially aggressive cancerous condition was scheduled to be seen 24 days after I had first presented it, in its glory, to the sanctimonious monster that is the NHS. I bet Tony Blair doesn't wait 24 days to be seen in the Chelsea and Westminster, if his toenails need clipping. I bet Tony Blair doesn't wait 24 minutes, but then, of course, the state does need him a lot more than it needs me. All I do, along with all the other miserable suckers, is pay for the damn thing.

And so there I was, finally, this morning, Nurofenned up to the gills, nervous, and perspiring, a grateful supplicant thankful to the monster that was deigning to let me enter its glorious marbled halls. Fortunately, I had the luck to meet one of the nicest and best doctors I have ever met, a total star who would make a fortune in my free health system of the future, who gave me the good (or the bad) news, that you poor unfortunate people haven't heard the last from me yet. Ha ha! I live again, to be accused of insanity by various Guardian readers, Europhiles, other libertarians, and men in white suits.

But Jesus H. Christ. What a terrible four weeks. I suppose if you look at it from a macro point of view, it was a sensible use of resources. It probably wasn't cancer, and consultant surgeons are a precious resource, so from the government's economic point of view they weren't risking losing too much tax income, by sweating me for 24 days while I put my life on hold. And even if I'd died that would've been one less state pension to pay, and my family were probably protected by insurance, so the welfare costs would've been minimal. So let's make him wait. We'll get to him in our own good time. And what's he complaining about anyway? He's alright. Isn't he! And Andrew, baby, it wasn't personal.

Which is of course the point. Only a free system can deliver health care where the person matters, not the system.

And so, I can only say to Mr Blair, in the best J.R.Ewing fashion: "Tony, you can stick the NHS where the sun doesn't shine." From my point of view that was perhaps the worst four weeks of my life, where I was unable to work, unable to sleep, and unable to communicate properly with anyone around me, which made my family's life a total misery coping with this morbid Klutz. What a banana. And they call this a 'service'?

In the sense, of course, that the bull services the cow.

My experience, and the similar experience I'm sure of millions every year in the United Kingdom, in a nutshell, is that this is the battle we have to win, the direct fight between the individual and the state. Here I am, a piddling UK taxpayer, being forced to hand over at least £8,000 pounds a year to a compulsory NHS health insurance policy, for my family, whether I want to or not, and all I get back is something I wouldn't pay £800 pounds a year for, in which I may be lucky or unlucky depending on which specialists I'm designated to see, which is dependent on where I live in the country, and on which particular waiting list target the government, in its vast munificence, is concentrating on, at that particular moment in time. Yet that massive wedge of coerced tax, extracted ultimately at gunpoint from my wallet, prevents me from being able to afford proper health care, for me and my family's benefit, which on a free unprotected market would be better and cheaper, anyway. Well sod that. From now on it's BUPA all the way, either through insurance or direct payment, with as much private health care as I can afford to provide to my family. Professor Hoppe wants me to try to withdraw from the state, to bring about its decline, and I shall do my best to meet his stipulation.

And pity the poor sods who do find, after such waits, that they do have cancer. I shudder to think how long they're currently waiting for the actual treatment. And here's where another old phrase comes back to haunt me from days in Sheffield. I can't remember who said this, perhaps some sarcastic oncologist or other, on a bad day in Sheffield's Western Park hospital, but the refrain was like this. "The patients have to wait so long for radiotherapy, these days, most of them are dead before they get here." Good for clearing waiting lists, I suppose. And for keeping down the payout figures on government pensions. Toot for the NHS? I should coco.

That this monolith, the NHS, has survived so long, is a testament to the virility of the free market which sustains it via taxation, with inflation-busting increases in spending every year for decades failing to realise much in the way of improvement. Someone else may have the exact figures, but a 20% increase in spending on the NHS recently got us something like a 1% improvement in productivity. Let's just thank God that more of the British economy isn't run on these Soviet lines, these days, as it used to be in the 1970s, or we'd all be down the tubes. Maintaining hospitals in this hideously inefficient manner surely cannot continue for much longer. I jest of course. I'm sure it will continue indefinitely until the British people wake up.

However, spitting in the wind as I may be, as an ungrateful taxpayer, who has only had to take this merest brush from the NHS's callous disregard for human life, I demand that this system be changed, and that the people who work within it, and the patients who are forced to use it, are all freed. Immediately. Give me back my money. I am not an NHS number. I am a free man.

The sooner the NHS is privatised the better. It cannot come soon enough.

That, and I'm going to claim maximum marks for managing to sneak the word ' haemorrhaging' into the piece above. And tonight I'm going to drink a very large bottle of champagne. Cheers!

The Guardianistas are worried. Very worried.

In a fit of anxiety I can only describe as an accute attack of 'foodophobia', they publish two articles on the same day, one of them claiming that young people are too fat:

The child obesity epidemic caused by poor nutrition and lack of exercise is creating a looming health crisis, with average life expectancy expected to drop for the first time in more than a century.

And the other one claiming they are too thin:

Anorexia nervosa has the highest mortality rate of any psychiatric condition - the Eating Disorders Association estimates that 18 per cent of sufferers will not survive. They are usually highly intelligent, gifted young females aged between 15 and 25, but with a perfectionist disposition that drives them to starve themselves.

Honesty, of course, but if we promote the notion that 'thinliness is not just next to godliness, it rates way, way above it' and run pictures of stick-thin models, we are doing just what the experts warn us against: we are influencing vulnerable young minds.

Good grief, what is wrong with all these youngsters? Either they are human blimps or they are walking skeletons. Why can't they just get it right?

What is a caring, concerned person to do??!! The government must get them to eat less....no, wait!...the government must get them to eat more!...oh, it's a nightmare, I tell you, a nightmare.

What on earth is the use of having friends in high places if they can't do you the odd favour now and then?

The wife of Lee Kuan Yew, Singapore's founding father, was pushed ahead in the queue for emergency treatment at an NHS hospital after Government officials intervened on her behalf, it was claimed yesterday.

Mr Lee said that his wife, Kwa Geok Choo, 82, who had suffered a stroke, was given a brain scan four and a half hours earlier than planned at the Royal London Hospital after medical staff were contacted by Downing Street.

Using political leverage to get better treatment is just so much more ethical than paying for it.

This is excellent news. More and faster, please.

Bernie Greene wonders just how scientific is the science behind the smoking debate?

Epidemiology began with a fellow called John Snow investigating to find the cause of a cholera epidemic in London in the 19th Century. He had the idea that it might be coming from contamination in a well. So he took a map showing the locations of wells and plotted the incidence of the disease on the map. Sure enough they were mostly in close proximity to one particular well. He had the well put out of service and there were no more new cases of cholera. That is a simple story of logic and surveying intelligently applied to test a theory.

It is very unfortunate that it was so simple to solve. He might then have left a better example for his followers.

What if he had found that the 166 ¹ total cholera cases were scattered all over the map pretty evenly but that they all had pink carnations on their coats? One hundred thousand people wore pink carnations and 99,874 did not get cholera.

What does he do now? Well if he were a tobacco investigator he would petition the government to do something about pink carnations. But let's say he is a brighter boy.

He decides to go and interview the cholera cases in more depth.

He asks them all kinds of questions about themselves and about pink carnations - how many years have they been wearing them? How old were they when they started? etc. etc. He gathers all the data and looks for similarities. He gets a few things and tabulates them. He then interviews other people who don't have cholera but who do have pink carnations. He asks all the same questions again and tries to find something about pink carnations that is consistent among those who don't have cholera and is absent from those who do, or vice versa.

He finds one item in common. The cholera sufferers all work in the City though they live all over London. There are lots of carnation wearers in the other group who also work in the City and don't have cholera. So he knows that working in the City isn't the cause either so he correctly calls it another correlation just like pink carnations. But he now has two correlating pieces of data and a line of enquiry worth following.

He now goes back to the cholera group and asks a single new question. "What can you tell me about working in the City and wearing pink carnations?" They tell him it is the thing to do. They tell him all the ladies like it. They tell him their bosses like it. They tell him they buy them from a vendor right next to St Paul's Cathedral. etc. He notes their responses and tabulates them again. He asks the same thing of the non cholera group that also works in the City. They give him lots of very similar answers but on where they buy them from the answers vary and none of them are anywhere near St Paul's Cathedral. So he now has a third correlation and this one is far more promising as it is entirely absent from the non cholera group. He knows it isn't the cause itself because lots of people who go to St Pauls don't also get cholera but in combination with pink carnations he knows it is a significant correlation.

He gets the vendor to close down for a few weeks to see if it makes a difference to the number of new cholera cases. There are no new cases after 10 weeks where formally there had been several new cases each week. This is progress he thinks. He could stop right here, have the vendor permanently closed down and that might be enough to prevent further cases. But as he still doesn't understand how pink carnations and a vendor near St Pauls can be the cause of a cholera epidemic he continues to investigate.

He sets up a watching station opposite the vendor and sits there for many hours watching him ply his trade. He notices one thing that seems to offer a really plausible cause covering all the factors he has so far noted. A woman empties a huge chamber pot into a hole immediately behind the boxes of pink carnations. The scientist walks over and sees that some of the former contents of the woman's chamber pot have spilt into the boxes holding the carnations. He finds they contain the feces of several cholera victims the woman tends to.

It wasn't as easy a case to crack but it does illustrate what a scientist dedicated to truth and who won't compromise with logic would do.

In the case of smoking research I would say that back when the Hill/Doll study of 1956 was done an honest and worthwhile conclusion would have been:

We now know that most cases of lung cancer occur in smokers of a certain amount of tobacco after a long period of time in a very small number of cases relative to the number of smokers who smoke that amount for that long. Tobacco smoking isn't the cause of lung cancers but it is connected in some way that we don't yet understand. We can predict that many more smokers will get lung cancer than will non smokers. Something like 24 times as many. But we must also say again that there are far more smokers than there will ever be cases of lung cancer. This in itself makes it obvious that something else is involved.

Further because we can predict that a very small fraction of all smokers will account for the majority of lung cancer victims, and that because we don't know why this is so, we must responsibly inform smokers of this increase in risk. We must also inform smokers that the risk, whilst small compared to all smokers, is of a grave disease that is likely to be very painful and also fatal. Obviously smokers themselves have to decide if they want to cut down or quit smoking altogether because, as a scientist, our job is to research and discover threats to life but that it is the individual's responsibility to act on that information as he
sees fit.

We now have something new to discover. Most cases of lung cancer occur in a small number of smokers, but if smoking were the cause of those cases then what is preventing it in so many more cases? If smoking is not the cause of lung cancer then what factor is present in those smokers who do get it but which is not present in those who don't?

That to me would have been a logical, decent and honest approach. It may not have been so easy to understand as "Smoking causes lung cancer" but it would have been a whole lot more honest and the consequences of that could have changed subsequent history in many dramatic ways, and might have led some curious researchers into the field who would have known that there were still very significant questions to get answered, and they may have been capable of getting those answers by now.

Instead they told the government that tobacco was causing lung cancer and demanded that something be done about tobacco! Wrong target and thoroughly irresponsible as scientists in my opinion. That was a defining moment in the history of tobacco and it has been in decline ever since. Unfortunately so has epidemiology.

¹ Don't know what the actual number was. This was to make it closer to what Hill/Doll found with regard to lung cancer and smokers. 166 out of 100,000 after decades of 25 grams per day.

Competing interests: I once worked for a tobacconist shop. I am also a
pipe smoker. I'm not a scientist and I could be wrong. I would
appreciate being shown where with logical rather than ad hominem
argument.

Bernie Greene © 2003 . All Rights Reserved

This posting now is rather non-topical, in that the clutch of words it refers back to was emitted three weeks ago in a news story about how our Prime Minister is going to stop us all getting so fat. I paid attention to this anti-fat initiative because I was interviewed on the radio about it, and one particular little phrase associated with this story has since stuck in my mind. I still have some print-outs of the relevant media coverage. Here's how the Observer reported it:

In a letter to Culture Secretary Tessa Jowell, a copy of which has been leaked to The Observer, Blair spells out what he sees as the Government's failure to promote exercise: 'Government policy has not delivered the outcomes we want in this area,' he writes. 'We have started to make progress on the school sport agenda, but also need to more effectively tackle activity levels in the adult population.'

Referring to the Government's long-term target of getting 70 per cent of people physically active by 2020, the letter, written in July, states: 'We need an ambitious delivery strategy, using the Olympic bid as a catalyst, to develop more innovative and interventionist policies across the public, private and voluntary sectors in both health and sport if that target is to be achieved.'

Setting aside the nightmare vision of the Olympic Games being held in Britain and coinciding with a government propaganda barrage tell us all to do physical jerks, the phrase that interested me here was Tony Blair's reference to the government not having "delivered the outcomes" that he wanted.

This phrase � "delivering outcomes" � sums up everything I don't like and don't admire about this government, and it says, in two words, why, despite all the inevitable drawbacks and disappointments it would bring with it, I would prefer a Conservative government instead.

Everyone who writes for this blog and the majority of those who read it wants "limited government", and the way to have limited government is for it to be confined to a core curriculum of rule enforcement � like: don't murder, don't attack people, don't rob, don't riot, don't swindle people � but otherwise, as Americans would say, to butt out. Provided we do not sink below a few extremely low standards of behaviour, what else we do with our lives is � or should be � of no concern to the government. Government is not there to promote all the virtues. It is not there even to restrain or punish all vices. It is there to restrain and punish a very restricted set of vices, of the kind that cause direct and unjustified hurt to others, of the sort which if unpunished and unrestrained would mean people regularly coming to blows with each other. As individuals, government ministers may regret the fact that so many of us fail to display as much in the way of virtue as they might individually like, but so long as we do not do too much, too obviously, of the vice variety, they will not, in their official capacity, bother us.

If symphony orchestras play vilely out of tune, if football supporters shout vulgar and yobbish things at their team's opponents, if architecture is ugly, if the Internet is disgusting, if young people these days are appalling, if people generally are too snobbish, ill-mannered, ungenerous, ugly, graceless, self-centred, nasty � well, that's all very regrettable. But these are not, or should not be, governmental matters, provided none of this results in actual murders, assaults and pillages and fights.

In particular, if the outcome of what shape we all turn out to be is that we turn out in many, many individual cases to be what our doctors regard as obese � again, this should not be government business. This should be for obese people to worry about, when people tease them, or refuse to marry them, or decline to pick them for sports teams, or to give them starring roles in movies.

But in Tony Blair's mind it would seem that obesity is a government issue. Not only does he, as an individual, think that many of us are too fat. He wants the government to make us thinner. He thinks that making us thinner is part of his job. He thinks that thinness is an "outcome" which it is his duty to "deliver".

On its own, such a belief, unrestrained by any other beliefs, would make Tony Blair into a straightforwardly evil tyrant. But to give him credit, he believes in other things also. In particular, he believes that there has to be some freedom, at least in the economic sphere, or there'd be no national wealth to tax, and he believes in himself and his government continuing to win elections. He can't do that if he simply orders us all to do exercises every day. If people start being seriously bullied in a way that they are able to trace directly to Mr Blair this won't turn them from fat Labour voters into thin Labour voters; rather will it turn them from fat Labour voters into fat Conservative voters. Blair won't push it that hard.

So the "outcome", to use Blair's word, of this anti-fatness campaign isn't going to be any less in the way of mass fatness. The only people who will be got at all seriously will be the particular professionals, such as teachers and doctors, who find themselves instructed to make people thinner, by doing � well by doing all the things that such people do anyway, like urging heart problem sufferers to cut down on fatty foods and take some exercise, and by organising games for children to play in. The main difference will be that they will now have to fill in lots of forms about it all, and send them off to London. All of which will cost money and interrupt all their other duties, so the "outcome" will be an increase in public spending and a decline in the efficiency of public services, in the form of a diminished willingness to do the job of supplying such services, to no good effect.

But Mr Blair's belief, and similar beliefs on the part of thousands of other people who are now powerful (in the sense that their mistakes cost the taxpayer money and are seriously annoying to people), that it is Mr Blair's duty to shape not just rules but outcomes has a profound effect on the texture of British public life, and of the kind of "outcomes" we actually end up being surrounded by. If fatness is the government's business, and good manners among young people (that's been a government concern for some time), and educatedness (which famously has been an obsession from day one of this government's existence) � if goodness of all kinds, rather than badness only of very extreme and particular kinds is a constant government concern � then the result is not government that is lean and efficient and authoritative, but government that combines expense, intrusiveness and ineffectualness.

People aren't going to get any less obese and useless as a result of Mr Blair's latest thoughts on obesity. The government is going to get more obese and more useless.

Interesting story out of Oregon on their state health insurance scheme. Much to the relief of Oregon taxpayers, no doubt, some 40,000 people have dropped out of the Oregon Health Plan program, which provides state-subsidized health insurance.

The reason they dropped out? I don't know, really, but it is interesting that the newspaper casts the story entirely in terms of the poor folk being dropped from the program. I say the participants dropped out because they apparently chose not to pay the premiums, which are as low as $6.00 per month. The response of "advocates" for the poor is just priceless.

Advocates for the poor say the premiums are too expensive for some people and the government may have overestimated the ability of people to mail a check.

"It's an enormous barrier," said Ellen Pinney, director of the Oregon Health Action Committee. "Let alone the $6, there is the whole issue of writing a check or getting a money order, putting it in an envelope with a stamp and putting it in the mail to this place in Portland that must receive it by the due date."

$6.00 a month too expensive? Give me a break. This sounds to me like a classic example of "I can't afford it" as code for "I have other things I would rather spend the money on." If you forego a single trip per month to McDonald's, you will save enough to pay a $6.00 monthly premium.

Really, though, the notion that poor people are incapable of mailing a check has got to be the last word in condescension and infantilization. Believe me, anyone who can fill out the paperwork to qualify for Medicaid or other state-paid health insurance (or find someone to do it for them) is capable of writing a check or getting a money order and putting it in the mail.

I'm not sure what larger point this story illustrates, to tell you the truth. Perhaps the corrosive effect of the welfare state on its recipients. Perhaps that, if you support the welfare state, sooner or later you will start to sound like a total ninny.

Thanks to OpinionJournal for the link.

Another day, another public enemy.

The campaign to add so-called 'junk food' to the tobacco-alcohol 'axis of evil' has been fulminating for quite a while. There is nothing on the Statute books yet but I think we all know that it is only a matter of time.

In the not-too-distant future, the Samizdata will be reporting the police raids on clandestine onion-ring factories and publishing underground recipes for 'academic and research purposes only'. By that time, I sincerely hope that there will be a wider understading of the social-working class mentality that has led to that woeful state of affairs. Nothing could illustrate that mentality more starkly than this article from the UK Times:

People are incapable of saying no to junk food and other health risks, and it is the duty of the State to influence them, according to a senior public health official.

In defence of the "nanny state", Professor Dr John Ashton, regional director of public health in the North West, said yesterday that government intervention was needed to protect those incapable of protecting themselves. "Individuals cannot protect themselves from bioterrorism, epidemics of Sars, the concerted efforts of the junk food industry, drug dealers and promoters of tobacco and alcohol," he said.

Thus lumping together consumer choice, forces of nature and murderous aggression into one misleading and grossly stupid soundbite.

He said that it was the job of the State, not of the individual alone, to resist health problems brought about by drink, food or drugs. The State had a duty to protect and influence young people, many of whom were building up problems by adopting sedentary lifestyles and eating junk food.

"It is in no one's interest to have an obese generation, riddled with diabetes and degenerative heart disease and a burden on the taxpayer," he said. "The Government has a duty to take action about it.

It is in no-one's interest to have a power-obsessed generation, riddled with this kind of contemptuous paternalism.

The State is the guardian of the weak and underprivileged. It should intervene to encourage people to eat healthily and take exercise.

"Furthermore, it has a duty to ensure that those less well-off in society have safe, warm, low-cost housing, convenient transport links to shops and amenities, and the protection of police on the streets. The State is our protector and we must defend its right to fulfil that function."

There are no citizens, only 'clients'.

He has three grown-up sons, but recently became a father again with his partner Maggi Morris, 47, a director of public health in Preston. Their baby has been named Fabian Che Jed, after the Fabian Society, Che Guevara and the Old Testament prophet Jedediah.

And doesn't that say it all.

There are lots of dark forces at play here but the oft-overlooked one is the element of kulturkampf. What these people mean by 'junk food' is hamburgers, hot-dogs and milk-shakes. For people like Dr.Ashton the hamburger has become a symbol of what they consider to be American cultural imperialism and that is the real basis of their animus.

Quite aside from the fact that the fashionable demonisation of 'fatty food' is ill-founded (which it is), an Indian or Chinese meal contains more fat and calories than McDonalds could ever dish up. As does the homegrown popular delicacy of 'Fish and Chips' (all deep fried). Nonetheless when these people speak it is 'burgers' that they invariably identify as the alleged enemies of public health.

The 'War against Junk Food' has been carefully crafted to fulfil both the practical and ideological needs of the social-working class. Not only will its successful prosecution provide them with more wealth and status but it also opens another front in the cultural and political war against America.

[My thanks to Nigel Meek who posted this article to the Libertarian Alliance Forum]

Some people are just so selfish. Rather than queue patiently for their state ration of bread and cabbage, they'll conjour up all sorts of ruses to get an unfair advantage: [from the UK Times]

A GRANDMOTHER at the end of her tether after waiting seven months for an operation mixed cranberry juice with crumbled biscuits to simulate her own blood and dialled 999 for an ambulance.

After claiming to have been vomiting blood, Trizka Litton, 62, was taken to Walsgrave Hospital in Coventry. The mother of three got rid of her fake blood, which she was carrying in a plastic container, before it could be tested and underwent surgery to remedy a serious hiatus hernia.

Obviously an extreme right-winger and an enemy of the people.

�I carried a heavy burden of guilt and shame at being forced to cheat and lie,� Mrs Litton said, �but that vanished when doctors told me just how near death I had been.�

Well, in the circumstances I suppose this indiscretion can be overlooked. But anymore tricks like that and it's re-education for her.

British smokers are refusing to lie down and die of nagging. The European Union directive requiring that cigarette packets be used as a means of harassing smokers with loud offensive messages like SMOKING KILLS!, YOU WILL DIE! NOW! and the more succinct and efficient FUCK OFF!!! Is soon to be superseded with graphic pictures of diseased organs which will by law have to cover at least 150% of the surface area of the packaging.

Yet good old British creative thinking is successfully combating this ludicrous and patronising nonsense. People have noticed that cigarettes can actually be removed from their packaging and placed in other receptacles, perfectly legally- and that it is still within the law to cover one�s cigarette box with a piece of brightly-coloured fabric! And a whole new market in old-fashioned silver cigarette boxes, and new-style box-covers, has opened up and is blossoming in the UK. What a good idea, and recyclable hence money-saving too, so surely an improvement even on those clever ironic stickers for covering up the offensive messages which were featured in a blog here some time ago. Go capitalism!

It almost makes me want to take up smoking again, just for the pretty cases. If only the things didn�t give one cancer.

(Cue Samizdata blog predicting inevitable future EU plans forcing smokers to hold unmodified and unadorned officially-approved packets up for inspection by the police on demand�)

I honestly think I have grossly underestimated the entrepreunerial skills of the social-working class. It must take a certain talent to keep inventing new make-work schemes and then successfully sell them to the government.

I cannot imagine how I would begin to pitch this one:

The Government is losing its war against flab after spending £9.6 billion on projects to tackle obesity across all departments.

I just love the idea of porcine civil servants being sent to huff and puff their way around an army assault course but I rather think they are not the intended target of this new 'war'.

Anyway, it seems the government is losing the war. They cannot make fat people slim again by bureaucratic means. I am shocked, SHOCKED I tell you.

The fat epidemic shows no sign of abating.

'Epidemic'! Now there's a panic-inducing trigger-word if ever there was one. I bet that was the deal-closer. 'Minister, unless you write out a blank cheque there's going to be an epidemic!'.

Obesity is serious.

At £9.6 billion, yeah I would say that's bloody serious.

It kills 34,000 people a year in Britain...

And HMG is going to keep spending money until the target of Zero deaths from all causes is reached.

...and costs the economy in England �2.6 billion a year, estimated to rise to �3.6 billion by 2010.

How can they possibly know that?

It cannot, however, be tackled by the Department of Health alone.

Well, it might be helped by fat people going on a diet but we wouldn't want them taking the law into their own hands, would we.

Strategies to deal with obesity in children and adults now involve four Government departments with support at Cabinet level.

The Department of Health and the Health Development Agency, the Department for Education and Skills, the Department of Environment Food and Rural Affairs, the Department of Culture, Media and Sport are all players in the anti-fat campaign.

Defeating the Third Reich didn't require this many people.

And, therein lies the rub because even this public admission of failure will do nothing to stop the flab-fighting government juggernaut now that it has been sent rumbling forth onto the highway of national life. The conspicuous failure of fat children to shrink to normal size will merely prompt demands for 'more resources' to fight yet another phoney war. Problems are not meant to be solved because careers aren't built that way. Problems are to be fabricated and then carefully nurtured and maintained until...well, ever.

The £9.6 billion wasted thus far was merely the appetiser. Small change. Petty cash. Mere peanuts already swallowed up with a forest's worth of reports, initiatives, projections, surveys, committee minutes and action plans. This is Britain where the new national ethos is to throw good money after bad into the bottomless sinkhole of guilt and paranoia.

If any reader is tempted to laugh out loud at the Swiftian absurdity of it all then I can hardly blame them. But really it isn't funny, it's pathetic and it is only a matter of time before it moves beyond the sad to the downright nasty:

One is the Food and Health Action Plan which aims to promote healthy eating in all age groups.

An aspect of this is the schools fruit programme, now being implemented, which aims to give all primary school children in their first three years, a portion of fruit a day.

The second is the Game Plan, a strategy for promoting physical activity with the somewhat vague target of ensuring that 70 per cent of the population is "reasonably active" by 2020.

This is what they call a 'consciousness raising exercise', a customary pre-cursor to new expansions of state power. 'The voluntary approach hasn't worked', they will cry. 'What we need is tough legislation'. And they will most likely get it too and disapproved products will start to be pulled from supermarket shelves and nobody will be allowed to open a bank account until they can produce a 'Physical Fitness Certificate'. This may sound alarmist but the one thing I have never underestimated is the vanity and ambition of our political classes.

Britain isn't obese, it's anaemic. It's life-blood is being drained from it by an army of worthless, self-propogating parasites.

Colour me cynical (it suits me to a tee) but my opinion of the capabilities and ethics of the British public sector has sunk so low, that I am now inclined to regard their frequent pronouncements as a sort of inverse benchmark.

So when the Food Standards Agency issues an official warning about the allged perils of the Atkins Diet, my instincts tell me to draw the very opposite conclusion:

The first official warning about the dangers of the Atkins diet has been issued by the Government amid concern about the rising number of people opting for the high-fat, high-protein regime.

The Food Standards Agency, which is responsible for all the Government's nutritional guidance, has published a statement alerting the public to the health risks of low-carbohydrate diets, including Atkins, claiming that they are linked to heart disease, cancer and even obesity

Surely 'obesity' is the one thing that devotees of the late Dr.Atkins claim to have conquered? And that word 'linked' again. It is fast developing a reputation as quite the most manipulative term in the English language. By employing the word 'linked' in any sort of press release one can convey a sense of ominous threat without the bothersome necessity of explaining precise details or producing so much as one iota of empirical evidence.

I am not sufficiently familiar with these people to question their motives but their methods alone are sufficient to leave me with the firm impression that the Atkins diet is not only healthy but also very effective. Get guzzling that protein.

Every time there is even a semi-serious debate in this country about the provision of health care and reform of the NHS, the reactionaries cry 'Do we want to be like America?'. It is the British equivalent of 'Do you want Farmer Jones back?'.

Well, do want to be like America?

Patients who have major operations on the National Health Service are four times more likely to die than Americans undergoing such surgery, according to a new study.

The difference in mortality rates was blamed on long NHS waiting lists, a shortage of specialists and competition for intensive care beds.

One of these fine days, that plaintive, theatrical and bogus rhetorical bleat is going to result in a resounding 'yes'.

I first came across this story in the dead tree Times, and although the virtual Times probably has it too, we have a policy here at Samizdata about linking to that which is that we don't.

So here is the same story from canada.com:

Researchers have discovered a genetic glitch that makes some smokers up to 10 times more likely to develop lung cancer than others, a finding that may explain why only 10 per cent of heavy smokers develop the deadly disease.

A simple blood test that will be able to detect which smokers are at an especially high risk of developing lung cancer could be on the market within three years, researchers told the Times of London.

Ah look, they got it from the Times too.

In other words, it will separate ordinary, high-risk smokers from extra high-risk smokers.

It will be interesting to see what the anti-smoking lobby makes of this. They ought to rejoice. But I think they will be angry.

Their starting axiom is that cigarettes are evil. If this discovery makes it that cigarettes actually do less harm than hitherto, that will be bad. They will react like hellfire preachers who have been informed that hell, for many sinners (now identifiable in advance), is not as hot as they had previously supposed, and that sin is accordingly less frightening for these particular sinners to indulge in.

Overall, smokers with low levels of the DNA-repairing enzyme were 120 times more likely to get lung cancer than non-smokers with normal OGG levels. Smokers with the genetic risk factor were also five to 10 times more likely to develop the disease than smokers with normal DNA repair activity.

So smokers with normal levels of DNA-repairing enzyme will now be sinning like there's no tomorrow. Bad. Very bad.

It'll be fun to watch.

Well, at least the language is sort of getting there:

John Reid, the health secretary, has embarked on the biggest ever programme of ministerial visits to NHS hospitals to persuade staff to accept fundamental changes in working practices to improve the service to patients.

He has told colleagues that the public will not accept there has been genuine improvement in the NHS until patients are treated with the same promptness and respect that they get as consumers of other goods and services.

As 'consumers of other goods and services' they are the paying the piper and therefore calling the tune. Contrast the NHS where the paying customer is the government and the patients are units of production.

Health ministers think their biggest political challenge is to engineer this change in the working culture of NHS organisations. They want them to tailor services to suit the preferences of the individual instead of expecting patients to adjust to the convenience of the professionals.

Fat chance! Public services are not run for the benefit of the public they are run for the benefit of the public sector. If you want 'services to suit the preferences of the individual' you need a free market in healthcare.

So another doomed 'initiative' will shortly bite the dust but not before, I hope, Mr.Reid and his advisers reach the logical conclusions of their own ideas.

Oh no, the elephants are at the watering hole again.

The government's National Institute of Clinical Excellence (NICE) says that In-Vitro Fertilisation (IVF) treatment should be free, whatever the heck 'free' means, which I suppose in this case means I have to pay for it whether I want to or not.

Here's one of those hot medical areas which it is easy to avoid discussing. But being one who is constantly trying to seek the best position on any particular 'moral' or 'ethical' position, I was wondering if anyone out there is willing to offer me further guidance? My current views on 'free' IVF treatment are as follows.

Infertility is God's way of letting you know you have several lifestyle alternative choices on offer:

• You could shrug your shoulders, accept God's wisdom, declare your unconditional love for your partner, and then spend the money saved on lavish consumer products, holidays, and financial support for Samizdata's bandwidth costs, rather than nappies, five-bedroomed houses, people carriers, and all the other paraphernalia of decades of expensive child care.
• You could split from your current partner, and you could both try to have a baby with someone else.
• You could adopt one of the many unwanted babies born in the UK, and God bless you if you do.
• If you exist above a bare level of poverty, and dependent on how far above this line you are, you could sell the BMW for a second hand scooter, you could sell the house in the south-east and move to Carlisle, you could cut the foreign holidays and spend your time on camping holidays in Wales, cut the manicures, cut the business coaching sessions, or cut the golf club fees. You could then invest any savings made in private IVF treatments.
• If you exist on a bare level of poverty, and you really don't mind bringing children into the world to share this level of poverty with you, which is a whole thread in itself, you could seek out private charities to help you with the cost of IVF.

Now call me an Old Scrooge McDuck, but what I don't think you have is the right to tap me on the shoulder, relieve me of my wallet, and force me to pay for IVF, or a boob job, or a penis extension, or a tattoo removal, or any other such 'lifestyle' enhancement (for want of a better term), just because it would upset you not to have the treatment.

If we lived in a better world, we in the UK would all have private health insurance, and I would be in the plan which most suited my needs, and I would certainly take the Leviathan Insurance discount for not having IVF cover in event of my present or future infertility, as I'd be quite happy to live with the infertility options presented above, if such a terrible affliction struck me. I would also be quite happy to see you take out the full Leviathan Insurance cover, which did include such protection, if you weren't happy with the above options.

So I suppose this comes down, again, to whether you believe in socialised medicine, and if you do, whether it should provide everything or whether it should provide a certain minimum set of obligations. Although I would much prefer the NHS to be abolished, as soon as is practicable, I can just about stomach being forced to shell out for it, via my taxes, for the ramshackle minimal health services cover it currently provides me and everyone else with. This is because although I object in principle to being forced to contribute to it, under a fully privatised system I would certainly choose to contribute to private health charities to help provide this minimal system. But what I think is an outrage is being forced to pay for the never-ending flow of new and modern treatments which come on-stream as technology advances, while watching the basic system of straightforward illness treatment and emergency cover crumble.

Before even considering IVF, and imagining I was still a socialist, what I would personally like to have 'free' are services such as accessible dentistry, chiropodists, opticians, chiropractors, and other such grey-area 'luxuries'. But of course I can't get them on the NHS, not round my way, because although in cloud-cuckoo moron land everything is 'free' on the NHS, here on planet Earth the laws of economics dictate that scarce resources must be rationed, either via price mechanisms on the free market, or via straightforward socialist queuing and queue-jumping, a system which is especially good for those with friends on the inside, or access to the splendiferous Chelsea and Westminster hospital. So to decide who are the 'deserving', with the NHS, we also have to add on top yet another layer of expensive bureaucrats, with the laughable New Labour acronym of NICE, who ponder like angels in heaven on who deserves what, and for how long, and the periods in which they are eligible. What it must be to be one of these angels ministering out politically correct medical treatments to healthy young couples while old age pensioners with diabetes lose their feet because they can't afford chiropodists.

The sooner the NHS is abolished the better.

There can be few afflictions more tragic and debilitating than blindness.

So I sincerely hope that this qualifies as some sort of breakthrough:

A blind man can see again after being given a stem cell transplant.

Mike May, of California, had been blind for 40 years since an accident at the age of three where he lost one eye and was blinded in the other.

The operation transplanted corneal and limbal stem cells into his right eye.

My very best wishes to Mr.May and to medical team who restored his sight. The possibility that this technique can be used to help blind people everywhere is something that is worth hoping and praying for.

The UK state has long been scared of the effects of cannabis, especially its anti-state effect on people who want the freedom to eat, and smoke, and drink, whatever the hell they like.

But soon, specially selected National Health Service patients are to be given cannabis as part of a government-funded trial, costing half a million pounds, to see if it can work as an effective pain relief drug.

Of course, all of the sufferers from long-term pain who regularly use cannabis right now, illegally, to get themselves through the long days and nights of multiple sclerosis, and other painful complaints, could have told them this years ago. And have done so, many times. But not to worry. Spending half a million of other people's money costs the government absolutely nothing, after all, so where's the worry?

It should be interesting however, if Her Majesty's Government do legitimise 'medical cannabis'. Expect to see queues out the door of most General Practitioners' surgeries filled with 'migraine' sufferers, for whom Nurofen doesn't quite cut the mustard anymore.

Actually, I can feel this throbbing pain in my left temple, right this second, probably from all this cheese I'm eating on the Atkins diet. Maybe I should chuck the diet in, and get back to carbohydrates? Anybody got any 'interesting' chocolate cake mixture recipes?

Here's one trend that's going the opposite from the US that's actually good news for the Brits. A new private Accident & Emergency unit is to be opened this October in Brentford, West London. To non-British readers, that's a private Emergency Room.

This has been widely reported as the first attempt to set up ER in the UK wrongly as it turns out. I contacted the BBC and the wording has changed to it claims to be the first. Obviously emergency healthcare in Britain existed before the state nationalized hospitals in 1948.

This report from 1998 shows that at least one serious attempt has been made to charge people for access to emergency healthcare in Britain. It failed for two reasons: the location was not ideal. The middle of Hampstead Heath is not the most obvious demand area for ER services and the Manor House Hospital (owned by a trade union) was sold to property developers.

The other interesting point in the BBC report is the view of the British Medical Association, the monopolistic body that represents the producer interests of doctors in the UK.

A Department of Health survey published in July found 6% of hospital patients waited at least 12 hours in A&E on a trolley or a chair. The government wants 90% of A&E patients to be assessed, treated, discharged or admitted within four hours. But doctors attending the British Medical Association's annual conference in June denounced the target and said it would damage patient care.

So let me see if I have this straight - doctors believe that reducing the amount of time patients lie on trolleys or blood-splattered chairs in the waiting-room (I've sat on some of them), from 12 hours to four hours, being denied treatment, will damage patient care.

Dr Shipman I presume?

It must have been about a decade ago that I first became aware of the alleged dangers of exposure to the sun and the 'link' between over-exposure to ultra-violet radiation and skin cancer*. Looking back, it was a 'consciousness raising exercise' that mushroomed from 'never heard of it' to widespread health-panic with remarkable speed.

Assisted, perhaps, by the miserabalisit anti-hedonism of the Nineties and the suspiciously convenient dovetailing with the doleful predictions about 'global warming', we should have been more sceptical. But medical opinion was converted and few people have the confidence to fly in the face of such an august edifice. The new orthodoxy was nailed down with copious amounts of 'official' advice to stay in, wrap up, cover up and, if you are foolhardy enough to venture out in the sun, only do so after smothering yourself with gallons of sunblock.

But that was then, and this is now:

A scientist is claiming too much sunscreen can lead to vitamin deficiency.

Professor Michael Holick of Boston University is advising people to spend up to 10 minutes a day in the sun unprotected to guard against a lack of vitamin D.

He said: "In our efforts to protect people from the sun we've thrown the baby out with the bathwater."

So Professor Holick just a publicity-seeking iconoclast or is this the heretical opening shot of a debunking campaign?

Perhaps the only danger we really need to worry about are the risks arising from an over-exposure to 'experts'.

[Note to professional scare-mongers: 'cancer' is the panic word of our age. Linking lifestyle choices to heart disease or kidney failure just doesn't cut the mustard.]

...the state does, in the person of Mr. Justice Sumner, that is who owns your body.

Over himself, over his own body and mind, the individual is sovereign
- J.S. Mill, On Liberty, 1859

Given that so many in the 'free world' are subject to compulsory educational conscription, how many people are in fact 'sovereign' over their own minds? And in an era in which the state can force you to put certain chemicals in your body regardless of your wishes, are you sovereign over your own body? If you are a child, clearly not... and even if you are an adult, clearly not.

The mothers, the sole carers of their daughters, argued that immunisation should be voluntary and it was not right to impose it against the wishes of a caring parent and it would cause them great distress.

The elder girl had asked not to be given the MMR jab but had asked for meningitis protection. Some parents fear the MMR vaccine could be linked to autism, even though doctors and most experts say there is no evidence of a link.

Mr Justice Sumner decided both children should receive the jab because the benefits outweighed the risks.

But her views obviously count for nothing. If you do not truly own the insides of your body, then what are you? "The elder girl had asked not to be given the MMR jab". Is she a slave? A serf? A chattel? I have fulminated before on that particular issue when confronted with people arguing for mandated mass medication... the issue is not one of health but rather 'who owns your body'. What the judges and doctors who would use the violence of state to force other people to change the chemistry of their own bodies show us is not that they care, but rather their totalitarian mindset.

Can it really surprise us that the state does not respect individual property rights or the right of self-defense if it does not even respect the right of individuals to judge what chemicals should or should not be put in your own body? This is not a minor issue because it goes to the very heart of whether your perception of freedom is an illusion or not.

I think it safe to say that all those people in the British political and media classes who want this country to be 'more European' have good cause to feel quietly satisfied today because parts of Britain are, indeed, starting to resemble East Germany:

The image of hundreds of people queuing to register with an NHS dentist provided a stark reminder of the problems people encounter in finding an NHS dentist, experts say.

They need 'experts' to tell them this?

The queue was prompted by the announcement that a practice in Carmarthen, Wales, could take on 300 more patients - but many more were hoping to register.

The TV news has now picked up on this story and are reporting that over 600 people turned up in the hope of getting state dental treatment. They lined up along the street and had to be issued with lottery tickets in order to prevent disputes breaking out. Over half of them were turned away.

Dr John Renshaw of the British Dental Association told BBC News Online: "That picture evoked a Third World country, where you have to queue to access what ought to be part of NHS care."

No, that picture evoked life behind the Iron Curtain where people queued up all day to get a meal. And for the same reasons!

A debate is currently raging in libertarian as well as in less refined political circles about whether the USA should allow 'reimportation' of prescription drugs. Basically, the problem is that patented drugs in the US are sold at prices much higher than they are available overseas. Patented drugs are the newer drugs for which no generic equivalents are available, giving the patent-holder a monopoly on that drug while the patent endures.

The drugs are available more cheaply in other countries for a variety of reasons, but in large part because the governments of those other countries have intervened in the drug markets to set prices. Canada, in particular, has 'negotiated' some sweet deals for high-demand drugs, and Americans have flocked across the border to get some of that cheap drug action. With prescription drug prices soaring in the USA, legislation has surfaced to allow drugs to be 'reimported' from these socialist havens at the prices that prevail.

On the one side, many libertarians see lifting the ban on reimporting as a simple case of freeing up the market to let it do its magic. Probably the best case that I have seen for this side of the ledger is Conservative Drug Split at National Review Online.

However, it seems to me that this approach overlooks some pretty major issues. Leaving aside the safety issue, which my clients in the drug industry assure me is no straw argument, I do not believe that the cause of free markets is well-served by allowing reimportation.

To cut a long and sordid story short, prices are so cheap in other countries because the governments of those countries demand that the drugs be sold at slightly above their production cost. They can do this because (a) in many countries the government is a monopsonist via the national health system and/or (b) the government simply threatens to break the patent and start manufacturing the drug itself (or allowing someone else to manufacture the drug).

To claim that the sale or reimportation of drugs that are priced under this system has anything to do with the free market strikes me as delusional. First, of course, the prices now obtaining in these markets are not market prices, but are monopsonist prices extracted by threatening to break the patent. Keeping these drugs out of the relatively free US market is no more of a barrier to free trade than keeping the local fence from selling stolen TVs out of the back of a truck.

Proponents of reimportation seem to assume that, when reimportation is allowed, the drug companies will go to these nations and threaten to either cut them off or raise their prices, and the governments will meekly go along. This in turn assumes that these governments will not simply break the patents, as they have repeatedly threatened to do and in fact have occasionally done in the past. Nor am I convinced that breaking the patents will result in any real consequences for the nations that do so. The only hammer over these nations would be the WTO or other treaties, and I do not believe that the government of the US would go to the mattresses to protect Big Pharma's patents. It never has in the past, and there is no reason to believe that it would in the future. With reimportation allowed, in fact, the US government would have to be crazy to do so, as protecting the patents overseas would dry up sources of cheap drugs that reimportation allows back into the US.

Sadly, the lure of cheap drugs is too much for your average politico to resist, so I think we can look forward to the corruption of the US drug market by overseas socialism.

It is a central plank of federast propoganda that the European Union is the only way to stop conflagrations like WWI and WWII from happening again. I have always regarded such pronouncements as specious self-delusion. Indeed, certain features of life in wartime Europe are beginning to re-appear, such as austerity, rationing and empty shelves:

Gardeners were banned from buying dozens of pesticides from yesterday under new European rules. The 80 gardening products, mostly lawn treatments, have been withdrawn from the shelves. They can be used until the end of December.

They include many sold by major retailers including B&Q, Asda and Do It All, and are being banned alongside 135 agricultural products.

Thus we are saved from the cataclysmic horror of law treatments. Household cleaning products are probably next.

Nor is this the end but merely the beginning for what we are seeing is the EU's 'precautionary principle' in action. As a result, thousands of chemicals used everyday, domestically and commercially, now have to be subjected to an exhaustive and expensive testing procedure to ensure that they post not the even the merest smidgeon of a hint of a suggestion of a risk to health. This is despite that face that, in most cases, these chemical products have been used for years, even decades, without anyone growing three heads as a consequence.

For many, particularly smaller scale, producers the cost of compliance means bankruptcy so they simply withdraw the products from sale. Result: a gradual emptying of shelves.

And who, exactly, is behind it? As if we couldn't guess:

Friends of the Earth welcomed the move but raised doubts as to whether the outlawed pesticides would be disposed of properly. The environmental pressure group also claimed some products were not covered by the ban despite being proven to damage human health.

Yes, the enviro-mentalists. Europe's 'jihadis'; they may be self-righteous creeps with faces one can never can tired of punching but they have managed to secure themselves a svengali-like grip on the minds of Europe's Cardinals.

By this time next year, Samizata articles will be written on papyrus scrolls and distributed to our readers by mule-train.

Never mind the 'luck of the Irish', what about the luck of the lawyers? I ask you, has there ever been a group of people so consistently blessed by the fickle finger of fate? Somebody 'up there' must like them, that's for sure.

'Not so', I hear you cry? Well, how's this for proof? No sooner has the legal profession turned its formidable guns on the fast-food industry than, flash-bang-whallop-wham-as if by magic, some learned scientists turn up with a whole bunker full of ammunition:

Women with a high-fat diet may increase their risk of developing breast cancer later in life, say researchers.

A study of more than 13,000 women from Norfolk found that women who ate the most saturated fats - such as those found in chocolate snacks and fast food -were almost twice as likely to develop cancer, compared with those who ate the least.

I am sure it is nothing more than coincidental. Honestly. Really. But, you must surely concede, the timing could not be better.

And is that lucky or what?

It is a little known fact but Britain is a world-leader in the manufacture and distribution of paranoia. We even export it.

For most of the time our public officials are hard at work busily churning out the stuff for both the domestic and foreign markets. But, what happens when one health-panic runs headlong into another? Well, the whole machine just grinds to an embarrassing halt:

A council has forbidden pupils to apply sunscreen in school - in case other children suffer an allergic reaction.

Cancer Research UK, which launched the Sun Smart campaign to warn of the dangers of the sun, said it was "amazed" by the policy.

Manchester City Council says it is following health and safety guidelines.

Pity the poor child, stuck out on a limb, while two different nannies squawk at them with two entirely conflicting demands. Maybe the nannies could solve the problem (and do everyone a real favour) by just dropping dead from worry.

Deepest thanks to David Farrer for linking to this fascinating article by Dr Raj Persaud in the Scotsman.

Could your political beliefs determine how long you live? New research from sociologist Dr William Cockerham and colleagues from the University of Alabama in the United States has found that differences in attitudes to looking after your body and your health are predicted by your political allegiances.

It seems those who believe the state should take responsibility for most aspects of life also tend to eschew personal responsibility for taking care of themselves. As a result, they are more likely to engage in lifestyles hazardous to their health, including drinking to excess and not exercising.

The just-published research was conducted among Russians, comparing those who longed for a to return to the old-style Soviet system with those who preferred the free-market approach to the economy.

Personal interviews with almost 9,000 Russians found significant differences in how much they looked after their own health depending on where they placed themselves on the political spectrum.

David says that this reminds him of Glasgow, another great bastion of socialist intellectual self-abuse, and bodily self-abuse by other more enjoyable but equally destructive means. But Dr Raj Persaud doesn't seem to have heard about Glasgow.

The old divisions between socialists and capitalists may have largely disappeared in modern Britain but elsewhere in Europe, particularly in the old eastern bloc countries, the political conflict between socialists and capitalists remains. These countries have experienced unprecedented upheaval since the collapse of the old Soviet systems and it is still not clear to large sections of the electorate that abandoning the old centrally-planned economies has brought any real benefits yet.

But the Russian plunge in life expectancy began several decades ago, so the capitalism they've been having over there lately can hardly be blamed.

Russian male life expectancy stood at 64 years in 1965, but steadily decreased to around 62 years by 1980. Male longevity improved during Gorbachev�s brief (1984-87) anti-alcohol campaign, reaching almost 65 years in 1987, and then entered a period of accelerated decline - centred around the fall of the communist regime - in which life expectancy fell to a modern low of roughly 58 years in 1994. The most recent figures for 2000 show Russian males living 59 years, on average some five years less than in 1965.

Things have improved a tiny bit, in other words, but not nearly enough to take Russians back to the good old days before the system so many of them yearn for began its final collapse.

Persaud ends his article with what can only be called a philosophical attack on the whole idea of collectivised medicine.

The dilemma in politics is that some kind of safety net for those unable to look after themselves seems desirable, yet if the net becomes too extensive it may act as a disincentive for fostering individual personal responsibility for looking after one�s own health.

Solving this dilemma is an urgent requirement of modern politics because it could even determine how long we live.

"Solving this dilemma" sounds an awful lot like "squaring this circle" to me. This is our old friend moral hazard, a sadly familiar concept to all too many providers of care or help. You help someone who's down, to get him back on his feet, and he uses your help to make staying down more comfortable, and when you finally give up with helping him, he's lost the trick of walking. The Welfare State sets up a trampoline, and it turns into a swamp.

There is a fine article in The Times today (link requires registration and may not work outside UK) by Mick Hume, bemoaning the decline of belief in individual responsibility and the growing use of the word "addiction" to describe almost every form of repetitive behaviour.

As the article can only be read through registration (grrr), here's the opening gaff:

"We are becoming a nation of addiction addicts. Our society has become hooked on the habit of blaming human behaviour on some form of addiction. Apparently normal people - doctors, scientists, politicians (normal? ed), even journalists (ditto? ed) - seem incapable of resisting the urge to inject "addict" or "dependency" into any discussion of social problems."

Exactly. The use of the word addict is used by policymakers to assault the idea of Man as a being with free will. We are all essentially passive victims. By doing so, it opens the floodgates to authortarian control of our lives. Look at the massive lawsuits against tobacco firms. Now I hold no brief for such firms, but the idea that people become so "addicted" to X or Y that they are unable to resist is surely contradicted by evidence all around us of people quitting such repetitive habits. Millions of people have in recent decades quit smoking, for example, like the good David Carr of this parish. Many have taken the painful step of quitting hard drugs or quitting alcohol. Of course change can be acutely difficult, which is why we praise folk who take the step of leading a healthier life.

Addiction is a word in danger of being rendered useless by applying it to just about every form of behaviour which is either frowned upon or a repeat form of activity.

Come to that, I suppose I must be "addicted" to blogging. Help me nurse, I am using Movable Type again!

Every so often (and it doesn't happen often enough for my liking) the British public remind us of the yawning gap between received wisdom and wisdom.

Ever since the 1940's it has been a core article of faith among the left (and more than a few Conservatives I might add) that services like healthcare and education can only be provided for the masses by central government and funded by general taxation. They even have the gall to denounce alternative models as 'unworkable'.

Well, if the results of this survey are anything to go by, that canard may be reaching the end of its shelf-life:

Voters are prepared to pay for health insurance if it guarantees them better and faster care, according to a ground-breaking new poll that suggests the public is far more open to radical ideas than politicians realise.

The survey finds strong support among taxpayers for a range of controversial policy alternatives, including giving parents the right to choose private schools for their children and American-style "zero tolerance" policing.

I wonder if there is still 'strong support' for British-style "zero tolerance" for self-defence?

The poll appears to contradict the Prime Minister's claim that voters are opposed to health and education solutions that allow individuals to decide where their money is spent.

And it would also appear to contradict my long-held belief that the British public would never relinquish their single-minded devotion to the National Health Service. The day when consumer expectation finally outstrips the ability of the state to keep up with it may be closer than I had imagined.

The American food giant, Kraft, is taking a number of steps to ward off the threat it may be sued by obese folk claiming its foodstuffs made them so big. This comes in the wake of threats by an American man to sue various fast-food chains for making him so big.

Kraft, of course, is fully entitled as a private company to adjust its products as it wishes. It is probably a wise move. In the U.S., and sadly, increasingly also here in the UK, the idea that the consumer should adopt the posture of caveat emptor (let the buyer beware) is on the decline. We are increasingly told that we are all victims, passive suffers of the blandishments of big, evil, and mostly multinational corporations.

The idea of taking responsibility for your actions is dying out. We are on the way to all being treated like naughty little moppets in a creche.

And of course if we do still sneak into a fast-food joint for a big burger, there's a chance our state nannies will want the evidence recorded on CCTV.

Are you gainfully employed? If so, does your wicked employer make all manner of unreasonable demands upon you, such as actually turning up for work or doing the job you're being paid to do?

Up until now, there was no means of redress for such manifest injustice and rank exploitation. But, lo, the dark ages are at an end. Thanks to the Health & Safety Executive, all employers must now comply with a 'Stress Code':

Employers will have to protect their staff from stress - or risk legal action, a watchdog has warned.

The Health and Safety Executive has launched a six-point code which firms must abide by.

They must support their employees and ensure they do not feel overly pressured in their roles.

Now I don't profess to any expert medical knowledge or even any medical knowledge at all but even I know that a broken foot is a broken foot and pretty easy to detect. But how on earth is something as subjective as 'stress' going to be either properly identified or measured?

Well, the bright sparks at the H&S have come up with a forumla:

Companies will be assessed to see if they have reduced stress to manageable levels.

If fewer than 65 to 85% of all staff feel each standard has been met, the company will fail its assessment.

If that isn't a charter for malingerers, clock-watchers, perennial malcontents and compensation-sniffers then I don't know what is. And, short of being paid to go the park every day and feed the ducks, what job doesn't involve some level of stress at some point or other?

Up to 13.4m days a year are lost due to stress at work.

And I wonder how many of those are actually 'I've-got-tickets-to-the-football-match' kind of 'stress'?

It would be tempting to suggest that there is some insidious political agenda behind this but I honestly don't believe that much thought has gone into it. More likely it is another classic case of bureaucratic empire-building which, as in this case, is usually done on the back of quackery, junk science and manipulated statistics.

The result is the same regardless. British entrepreneurs, already snowed under with laws, regulations, diktats and directives, have yet another welfarist function to fulfil and, I daresay, yet another sheaf of related forms that they will be required to waste their time completing.

I have a dream about just how much more prosperous and innovative our society could be if its wealth-creators were not required to spend so much of their productive time jumping through government hoops and avoiding state-created bear-traps that have no right to exist. It is rather similar to the dream that, one day, somebody in the parasitical public sector will realise that there is only so much blood they can draw out of the private sector before the latter simply rolls over and dies. I am not at all confident that either dream will be realised any time soon.

Switch on the TV, open a magazine, buy a newspaper or surf the net and it won't be any time at all until you come across an advertisement for some diet-related product. Be it an exercise-contraption, a formula drink or a low-calorie food range, the market cup runneth over with weapons we can use to fight the Global War on Flab.

As a veteran footsoldier in this campaign (my abdomen is more 'lunch-pack' than 'six-pack') I bear many scars of battle. But I long ago realised that I can never really win this war. Though I have succeeded, with grim determination and effort, to cast off the oppressive tyranny of blobdom, my liberation has only ever been temporary. Somehow, by various means, the forces of fattiness manage to regroup and come roaring back to overwhelm me again and take me prisoner.

Still, surrender is not an option and I am always on the lookout for new ideas that may, I pray, grant me permanent victory and eternal snake-hips. Somebody recently suggested that getting one of those Jane Fonda videos might help and, prickly with expectation, I went out and bought one. Another let-down, I'm afraid. I spent the whole of last weekend watching 'On Golden Pond' and I didn't shed an ounce.

Now, fortunately, I have private health insurance which means that my midriff mission-creep has few practical consequences apart from a vampiresque aversion to full-length mirrors and the occasional 'magic flying shirt-button'. The same cannot be said for many of my fellow citizens who find themselves at the less-than-tender mercy of the state healthcare system:

Patients could have to sign up to healthier lifestyles under new plans being considered by the Labour Party.

Written contracts would ensure a certain standard of treatment in return for people following doctors' advice and attending appointments.

Or, 'Ve haf vays of making you slim'. Okay, in some ways I am quite pleased that this is now out in the open because it has actually been bubbling away just below the radar for a good few years now, mostly as ominous mutterings from NHS doctors that they might refuse to treat patients who smoke (despite the fact that taxes paid by smokers prop up the NHS).

Yes, carry on I say. How about a 'no dangerous sports' contract? A 'stress-free career' contract? A 'no casual sex' contract? A 'no riding motorbikes' contract? Why not? Since the NHS is clearly destined to become a lifestyle-policemen they may as well go the whole hog. And I sincerely hope they do because then our dirty, little secret will be secret no longer. The dirty, little secret (that no-one ever mentions in polite company here) is that nationalised healthcare is not free healthcare, it is rationed healthcare and this is just the latest rationing scheme.

The unpalatable truth is that this is a cost-cutting measure. Not so much doctor's advice but bureaucratic diktat. Despite the extra squintillions of pounds that have been poured into it by the current government, the NHS still cannot meet the market demand for healthcare and so increasingly ruthless ways to cut the waiting lists are having to be formulated.

I have no doubt whatsoever that proposers of the scheme will argue they are only finding ways to improve people's health and forcing them to lose weight and give up smoking is therefore a truly kind act of a caring government. But that is not why they're doing this. And, while no reasonable person would argue that losing weight and quitting the weed can by anything but beneficial to health, a threat to withdraw healthcare for those who fail is nothing but a squalid act of bullying.

But, this is time for satisfaction not outrage. The great fabian promise of free healthcare for all regardless of who they are or how much they earn is finally showing up for the lie it always was. Let it grow and deepen. Perhaps, when some poor sod has been turned away from a hospital because of his 'irresponsible' roller-skating hobby, the British public will finally realise what Ayn Rand realised a long time ago: that the difference between a welfare state and a totalitarian state is merely a matter of time.

Health fascism? Islamofascism? Same thing?

[My thanks to Marc Brands for posting this to the Libertarian Alliance Forum]

Next time you run into a bunch of eco-loonies howling from the rooftops about the number of innocent Iraqi children killed by Anglo-American sanctions or the number of Africans whose lives are blighted by the alleged predations of globalisation, you might want to take some comfort from the realisation that what is really going on here is a massive exercise in guilt-displacement.

Green campaigns, you see, are not just a laughable manifestation of Western illiberal neurosis. They actually kill real people in the real world. There is no better illustration of this than their the long-standing (and shameful) war against DDT, an extremely useful chemical spray that has a proven track record in stopping the spread of malaria but which the greenies regard as a 'toxin' that must be eradicated in order to 'improve' the environment.

Using their customary formula of junk-science, scare-mongering, moral blackmail and religious fervour, the enviro-mentalists have managed to persuade Western governments to lean on the governments of developing countries to prohibit the use of this life-saving bit of technology.

This is neo-imperialism of the worst kind. Western greenies seem to regard the Third World as a sort of benevolent plantation where they can administer their muddle-headed, quasi-mystical, do-goodery to the poor, benighted fuzzy-wuzzys.

The results have been disastrous but the good news is that the 'noble savages' have had just about enough of this crap:

Kenya's leading research center has come out in favor of using DDT to stem the toll of malaria in the country, reigniting a bitter debate between those who want to protect the environment and those who favor saving African children.

With the announcement, Kenya is poised to join a handful of other African countries, which are disregarding donor-nation admonitions that the chemical is an environmental disaster.

Proof (as if any more were actually needed) that one can afford to play along with these self-indulgent parlour games and humour the participants until such times as actual lives are on the line as a result. The Kenyans have rudely (and justly) reminded the world that they are critically vulnerable to the consequences of fashionable clap-trap in a way that over-stuffed and ridiculously coddled Western metropolitan elites are not.

"DDT is not the only weapon against malaria, but given its success in other parts of Africa, it would be of great benefit for malaria control in Kenya," Richard Tren, director of Africa Fighting Malaria, in Johannesburg said yesterday. "Not using DDT, in effect, condemns Africans to die."

Dr. Davy Koech, director of KMRI, said DDT is one of the most effective pesticides against the anopheles mosquito, which transmits malaria. He said malaria in Kenya has reached epidemic proportions.

Every person engaged in this campaign of prohibition should hang their heads in shame and ignominy.

Cheap and effective, DDT was once considered a modern miracle for dealing with malaria and insect pests in agriculture. It was used during World War II, when entire cities were sprayed to control lice and typhus. DDT was used to eradicate malaria in the United States, but it was also used by the ton for agriculture, where it killed birds. DDT was named the culprit and vilified by Rachel Carson in her 1962 book "Silent Spring," leading to its ban in the United States in 1972.

I wonder if that book has even been objectively scrutinised?

Zambia recently decided to reintroduce the chemical for malaria control, and Uganda announced that it would begin using DDT again.

"In Europe, they used DDT to kill anopheles mosquitos that cause malaria," Ugandan Health Minister Jim Muhewezi told the Monitor newspaper in Kampala. "Why can't we use DDT to kill the enemy in our own camp?"

Because, Mr.Muhewezei, some Westerners regard ideology as being more important than life itself.

I sincerely hope that this outbreak of common sense continues to spread. I also hope that this episode goes some way to persuade sensible people in the Third World that their lives will not improve until they dismiss the idiotic ravings of Western socialist cranks and start to embrace the enlightenment of technology, capitalism, progress and property rights.

And, if there is any justice in this world, Western enviro-mentalists will all be rounded up and prosecuted for crimes against humanity.

[My thanks to Chris Cooper for flagging up this issue on the Libertarian Alliance Forum]

Because I grew up in the 1970's I still associate Trade Unions with the rank-and-file of the British urban proletariat; the lantern-jawed, barrel-chested, horney-handed, hobnail-booted sons of industrial toil. These were the rough, tough, no-nonsense men who hewed the coal, forged the steel and rivetted iron plates down in the boiler-room of the British economy.

In those days 'male grooming' meant a smell of honest sweat and a smear of brickdust and anyone who was stupid enough to go into a working class pub and prissily complain about the smokey atmosphere was more likely than not to experience 'Death by Shipbuilder'.

Alright, I know that's a cartoon but at least it was corroborated to a small degree in real world of shop floors, lathes and jackhammers. But the coal fields are silent now, the shipyards have all gone and the smokestack industries are billowing clouds of vapour over Taiwan not Teesside and so the Trades Union Congress (TUC) needs new rubrics to campaign on. Out has gone the fiery old rhetoric of revolution, strikes and class war and in has come the priggish, condescending ideology of health fascism:

Pubs, clubs and restaurants could increase their takings by banning smoking, says the TUC.

The TUC is pushing for the ban, because it believes passive smoking presents a health risk to waiters, waitresses and bar staff.

Very useful this 'passive smoking' hoax. What would organisations like the TUC do without it?

Rory O'Neill, editor of the TUC-backed Hazards magazine which published Saturday's report, said: "Big Tobacco (the lobby) has spent big money to prevent UK workplaces going smoke-free.

Ah yes, the hobgoblin of 'Big Tobacco', yet another shadowy capitalist conspiracy determined to preserve our right to choose. They're a 'lobby', don't you know. All 'lobbies' are malevolent and driven by greed, as opposed to organisations like the TUC which is motivated solely by altruism and love for their fellow humans.

Let us hear the voice of the 'lobby':

But Simon Clark, director of smokers' rights group Forest, said: "Neither the consumer nor the hospitality industry wants a complete ban on smoking and there is absolutely no need for it.

"If the overwhelming majority of people wanted smoke-free pubs and restaurants it would happen, believe me, because people vote with their feet.

Is this Apostate of Hell trying to tell us that if that people wanted a smoke-free environment then any entrepreneur who opened a non-smoking restaurant would clean up? Just further proof that the concept of a free market is a standing affront to people with agendas to advance and empires to build.

My, how the TUC has apparently changed its tune. In the good old days they denounced 'profits' and told the workers that they had nothing to lose except their chains. Now they seem to want to enourage profits while telling the workers to lift that barge, tote that bail, have a little smoke and land in jail.

If the Devil makes work for idle hands it is surely because he has no need to find any for busy bodies. They are far too engaged on Satanic projects of their own.

These infernal Children of Eternal Night are, it appears, girding their loins and grinding their battleaxes for another Unholy War, this time against....Vitamins!!

In accordance with sacred Samizdata liturgy there is no link to this UK Times article but here are some of the best bits:

The Food Standards Agency says that many vitamin supplements do more harm than good, and urges people to cut down on vitamin C, calcium and iron. It has for the first time set safe daily limits for various supplements, issues strong warnings on six and even demands the ban of one product � chromium picolinate, which athletes and slimmers use to help them to stay lean or lose weight.

Just a warning, of course. Mere sensible advice. A directive. Guidance. Official common sense. Satanic intentions are usually dressed up in the terminology of caring and sharing in order to mask the faint whiff of sulphur. We all know the Path to Hell has been pre-scripted though. This is where it starts and it is only a matter of time and bureaucratic stealth until the vitamin products they have targetted become restricted by law and then made available by prescription only (which must be accompanied by payment of the state fee, of course).

But this is not the first time ominous noises have been made:

Workers at a Sussex vitamins firm could lose their jobs if a European directive on food supplements becomes law.

Owners of G&G Food in East Grinstead have called on Euro MPs to block the European Directive on Food Supplement which they fear would take vitamins, minerals and herbal remedies off the shelves.

So is this an empire-building initiative from the British Food Standards Agency or are they merely minions taking their order from the Pit of Hades? It matters not, I suppose, because battle is enjoined and the signs are that it is going to be long and bloody:

Ralph Pike, of the National Association of Health Stores, which represents 12,500 health shops, was incensed by the "meddling", and demanded: "Where are the dead bodies? There has not been one death anywhere in the world from people taking a legitimate vitamin supplement. This is disgraceful, and all it will do will scare people from taking safe and legitimate products for no good reasons. The authorities just don�t like people taking control of their own health and they want everyone to abrogate responsibility for their lives to the nanny state."

Praise be to Mr.Pike for he has surely Seen The Light and is ready to step up to the ranks of the Holy Warriors.

The European Central Bank has said that joining the Euro would mean the end of the free NHS, reports The Times (we do not link to the Times). Apparently the April edition monthly report of the ECB said that:

Governments should distinguish between "essential, privately non-insurable and non-affordable services", such as emergency treatment, and those where "private financing might be more efficient".

In truth, the actual ECB report [pdf file] does not say anything quite so bluntly. The actual report is full of careful conditionals and non-assertions: "governments may have to rise contribution rates", such co-payments could increase efficiency", "pre-financing [of geriatric care] has been proposed" and "It has been argued that setting of budget caps...can improve overall performance". (page 45)

Nonetheless, this report should be taken very seriously. It is the formal monthly report; not a mere research paper or discussion document, but the official view with the imprimatur of the body charged with running the Euro. Given the sanctity of free NHS provision in mainstream British politics, to have its underlying rationale brought into question by a multilateral institution of such power and influence is a political bombshell. We are not talking 'Private Finance Initiative' here; the ECB is suggesting that for most operations patients should arrange their own insurance voluntarily, pay up when they need it, or go without. In suggesting patient co-payments for operations, rather than mere privatisation of provision with continuing government funding, the report goes far further than anything suggested by the Conservatives.

Chancellor of the Exchequer Gordon Brown is due to report to Parliament on the 'Five Tests' for Euro membership shortly. Before then there will be a major Labour rebellion on Foundation Hospitals; giving hospitals slightly greater control of their own funds and services is already too radical for many MPs (including, with little concealment, Gordon Brown). This report is therefore also be an amazingly timed intrusion into that debate.

One can imagine the glee with which Iain Duncan-Smith will seize upon this report: he will be able to simultaineously portray the Foundation Hospitals policy as unduly timid, with the full weight of the ECB as 'independent experts', while also saying that the NHS is only 'safe in Tory hands' because of the government's committment in principle to joining the Euro. After all the kerfuffle on IDS' leadership in recent days, I shall be reserving my judgement on his capabilities to see whether he makes real capital out of this absolute gift from Europe.

Last night I watched a Channel 4 TV documentary about SARS.

Meanwhile, according to the Radio Times, over on Channel 5 they were showing the movie Outbreak, starring Dustin Hoffman and Rene Russo. Sometimes Britain's broadcasters cancel things at the last minute if they feel that the bounds of bad taste are being crossed, so I made a point of checking if Outbreak was actually being shown. It was.

The way that SARS is, we were told, being contained, is that the various people who took the lead in spreading it are being restrospectively tracked in minute and individual detail, so that all their contacts can in turn be tracked down and placed in quarantine. The movements of the "super-spreader" Professor Lee, who took the contagion from South China to Hong Kong, were recounted as if doing the research for the disaster movie script that all this will surely yield in due course. The scene where the already coughing Professor shares a lift with a young businessman called something like Johnny Chang will undoubtedly be in this movie, with very scary music.

Cut to Toronto, whence one lady had travelled from (I think they said) Hong Kong. With luck, the deaths outside of China will be in the hundreds rather than the thousands, and the contagion will be contained.

In China it is already clear that they won't be nearly so lucky, and the blogosphere has for several days been making much of the threat that the rapid spread of SARS in China poses to the Chinese economy, and by extension to the very survival of the present political system in China. Briefly, during the crucial early days and weeks of the disease, they covered it up rather than faced the problem. They opted for denial rather than facing up to the disaster and trying to contain it. The phrase "mandate of heaven" (loss of) is now doing the rounds. Those tyrannies which are so tyrannical that their basic method for dealing with problems is to beat the private parts off anyone who dares to publicise problems will not do so well out of SARS. The case for adding the tyrannical intrusions of a competitive media industry to the old fashioned tyranny of governments like the present government of China, so that, in among all the hoo-hah about the ex-private lives of Soap stars, things like SARS can be flagged up a month sooner than the government would like, will be hard to argue against.

But meanwhile, throughout the West, you can bet that the SARS story will be used as an excuse for all manner of tabs being kept on the honest citizenry. From the government's point of view, the beauty of contagious disease is that, unlike crime, the law-abiding majority spreads it, not just criminals (although criminals too of course), and so stopping contagious disease is a matter of keeping tabs on the herd of honest citizenry. Ergo, compulsory "smart" ID cards for everyone. Ergo laws that say you can't take so much as a piss in a public toilet without getting a personalised receipt and leaving a personalised electronic record. We are only hours away from the Euro-speeches and Euro-pronouncements that say all this, and for all I know they have already begun. (See this interesting although off-message comment number one here, about and linking to this. And mark, to answer your question, thanks for the article, which I hadn't seen, but the story has been tracked by such groups as Privacy International and the Libertarian Alliance for years now, not that it will make much difference in the end.)

Contagious diseases are the perfect excuse for the state to tyrannise over the individual. After all, if someone is carrying pestilence towards the healthy majority, the healthy majority really is entitled to stop such a person, by force if necessary.

Also, contagious diseases are emergencies, and governments do love emergencies. It makes them feel important. During contagions, they are important.

What SARS is achieving is our old friend "convergence". The super-tyrannies will be embarrassed into being somewhat less tyrannical, at any rate in their media-suppressing aspects, but the milder tyranny of the democracies will get less mild. Maybe Francis Fukuyama should have stuck with the "end of history" for a bit longer.

Also, when that SARS movie hits the cinemas, something tells me that the World Health Organisation is going to come out of all this very well. Here's what Channel 4 says about them:

If it weren't for the coordinating activities of WHO, it's quite likely that we in the UK still wouldn't know about SARS. Certainly, the viral agent wouldn't have been identified and characterised so quickly and infection controls would not have been put in place so rapidly around the world. If and when SARS is contained all credit should be given to WHO and their collaborating teams of scientists. It is thanks to WHO that we can breath a little more easily in the face of other more serious, more infectious agents that are bound to crop up in the future.

Big Brother is watching over us.

UPDATE: I should have included this link.

Just who do these arrogant Canadians think they are?

Canadian Prime Minister Jean Chretien has thrown his weight behind efforts to get a World Health Organization travel warning withdrawn.

Mr Chretien told journalists the WHO had come to the "wrong conclusion" when it advised travellers to avoid Toronto, Canada's largest city.

We must condemn this aggressive, unilateralist, neo-conservative challenge to the authority of the World Health Organisation.

There are altogether far too many people in the world with far too much time on their hands and not nearly enough genuine trauma in their lives to occupy them. That, in a nutshell, is what lies at the root of so many of our problems.

First it was narcotics, then guns, then tobacco, then fast-food and now it looks like we are witnessing the opening salvoes of the War on Sugar:

The World Health Organization has accused big business interests in the United States of trying to influence a new report on the dangers of consuming too much sugar.

Fresh guidelines to be published by the organisation on Wednesday will stress that sugar should form no more than 10% of a person's diet.

What a perfect set up! The 'honest', 'caring', 'selfless' professionals of the WHO pitted against the obesity-spreading, profit-obsessed vested interests of the corporate suger industry. I can just see the latest anti-globo protest banner now: 'SUGAR IS WORSE THAN RICIN'.

Well, let me nail my colours to the mast right here and now and say that I stand shoulder-to-shoulder with the corporate neo-sugar mongers on this one. Since I am usually to be found agitating vigourously on behalf of the productive profit-seekers of this world, I am hardly in any mood to abandon them now, especially when they're genuinely fighting a good fight and probably telling the truth.

And let no-one be fooled by the use of the innocuous word 'guidelines'. As if these things are merely helpful suggestions. We all should know by now that these directives are only 'advisory' until such time as they are successfully enacted into state law. The anti-tobacco injunctions used to be just 'guidelines' as well.

"I don't think this is a very wise strategy by the industry, because the evidence is so strong and the great public believes this message," said Dr Puska.

Methinks Dr.Puska protests too loudly. Does he really expect us to believe that he gets millions of plaintiff letters from people all over the world saying, "Please rescue us from the capricious tyrrany of sugar, Dr.Puska"?

I don't buy any of it any more than I bought into the 'global warming' hoax which, incidentally, appears to have set the methodological template for all future junk science scares. Nor am I the slightest bit interested in entering any debate as to the merits (or otherwise) of consuming sugar because I simply don't give a damn. I speak as somebody who has a fair shot at getting a job as Danny De Vito's body-double but I'll be damned to the deepest pit of perdition if I am going to sit back and allow some otherwise-unemployable tranzi penpusher tell me what I can or can't sprinkle on my breakfast cereal.

Never mind Saddam, or Al-Qaeda or gangs of shadowy, homicidal Islamofascists, when are we going to start a War on Busybodies?

Determined to prove that there is a bureaucratic solution to every problem, the European Commission has announced plans to set up a European Centre for disease control:

The European Commission is set, by the end of May, to propose that a European centre for disease prevention and control be set up.

The news comes as several parts of the world succumb to new cases of SARS (severe acute respiratory syndrome) the flu-like virus which attacks the young, old, healthy and unhealthy alike - and has caused several deaths.

Cunning and astute as ever, the Commissioners already have a plan to prevent the spread of SARS in Europe. According to Dutch Health Commissioner Willy Van Der Pimp:

"No further cases of SARS will be allowed into the European Union as this disease does not conform to European safety standards".

However French Commissioner Bertrand Maginot was even more forthcoming:

"We must abandon the idea that disease can be beaten by medical science. This is simplistic and dangerous and will only be the cause of more disease. Epidemics can only be prevented by negotiating with the various diseases as part of the political process."

The Commissioners are in the process of forming a sub-committee to look into the 'root causes' of disease.

Britain's Channel 4, whilst known to have more than its fair share of nit-wit journalists, does nonetheless turn out some splendid documentary programmes. The best of the current crop being a series called 'Secrets of the Dead' which attempts to explore the science behind great disasters of the past.

This past week (and I cannot help wondering if the scheduling was more than coincidental) they devoted themselves to the great Spanish Flu outbreak of 1918/19 that swept right around the globe and claimed some 20 millions lives. Or at least, that is the death toll that I believed was generally accepted but, according to this documentary, the real toll was between 50 million and 100 million! If that is so then surely it must rate as the single most lethal pandemic in history? Not to mention that fact that, coming hot on the heels of World War I, it has to be the biggest ever kick in the head.

But here is the rub, because according to the senior virologist advising the documentary makers, there is some convincing evidence that the troop concentrations of World War I is what led to the outbreak:

John Oxford and his team found pathology reports from an army camp in Etaples, northern France, that have given him vital clues about the origin of the 1918 pandemic. Etaples was a huge army camp, almost the size of a city. 100,000 soldiers, well and wounded, moved through the camp daily. To supply food to this number, the army installed piggeries at the camp. There is evidence that soldiers bought live geese, chickens and ducks from the local French markets. Crucially, there were lots of opportunities for a flu virus to move from bird to pig, to soldier. Indeed, in the winter of 1916/1917, Etaples pathologists describe a disease-like flu that ended in heliotrope cyanosis and death. John Oxford believes the weight of evidence points toward Etaples as the viral mixing bowl that produced the 1918 strain of flu.

Mr. Oxford also adds,

'If we had another influenza pandemic, and we will have another influenza pandemic, I think it will make the HIV outbreak almost look like a picnic.'

Blimey! The only thing missing from that is the spooky background music. Still, TV producers do like to spice up their dry-as-dust science programmes with a bit of melodrama and, let's face it, general doom-mongering has probably overtaken fly-fishing as a favourite recreational activity. But I would more prepared to let this slide into great public melee of cried havoc were it not for the persistant, and increasingly troubling reports, of SARS:

Dr Carlo Urbani, a 46-year-old Italian and an expert on communicable diseases, had identified Severe Acute Respiratory Syndrome (SARS) in an American businessman admitted to hospital in Vietnam in February.

Hong Kong, Taiwan and Singapore are all confining people to their homes if they have been exposed to the disease.

Isolated cases have been identified in Europe and North America.

Of course, SARS (the technical name for which is 'shitscarey-itis') appears to be a virulent form of influenza or pneumonia and we've got very large troop concentrations indeed in Iraq and the surrounding vicinity. Who was it that said that history doesn't repeat itself but it does rhyme?

Now I am not about to get all wild-eyed and apocalyptic on you. In fact, as soon as I have finished posting this I am going to go to bed and sleep like a baby. Also, and let me be quite emphatic about this for the benefit of the 'quagmire' lovers out there, there is no comparison whatsoever between the current hostilities in Iraq and World War I and I do believe that SARS has, in fact, been knocking around South-East Asia for quite a few months but we've only recently got to hear about it.

But, crystal-clear distinctions aside, nobody is going to tell me that there isn't just a hint of eerie resonance here.

So, just three things here so far today, one very short and two rather serious. So here are a couple of curiosities.

First, there is this map, which was originally claimed to have been taken posthumously by Columbia before it burned and crashed. You want this to be true, don't you? As did Michael Jennings. But as I commented at Michael's, those killjoys at snopes.com have now killed this particular joy. But it is still a thing of beauty, and certainly has my little country looking its best. Snopes says it is "false", but their map is even bigger than the one Michael put up, so they liked it even as they trashed it.

And the other is a beating heart, courtesy of b3ta.com. Who are those guys?

When you consider all the metaphorical baggage that has been loaded onto the human heart over the centuries, it turns out to be very small and yucky, and you can swap yours for another with "you" carrying on pretty much as usual. It's just a pump.

And a picture is just a picture.

An article in yesterday's Daily Telegraph Sports section speculates as to why the bid for the Olympic Games in London for 2012 might fail. Apparently the expected losses for hosting the games will be a massive £2,600 millions.

However, as no one has actually published what the toal budget would be, I can only assume that normal public sector project costs will apply: i.e. the original sum multiplied by ten. It is easy to see why the government is apparently unconvinced by the urgency of commiting to such a scheme.

My critics may argue that this sum of money spent on promoting the Olympic Games will do a lot less harm than if allocated to almost any other public programme. This is true. One shudders at the thought of what dregs passing themselves off as doctors would be employed in state hospitals if this sort of money got awarded the National Health Service.

Oh dear, I just realised, the NHS has been given that extra sum over the next two years. Perhaps we should have persuaded the government to spend vast amounts of money on hopeless attempts to bring the football World Cup to Staines, or the Winter Olympics to Blackpool, or even finance half a dozen Americas Cup challenges.

I missed this story last week, and so, I'm guessing, did most of you.

A bricklayer plagued by migraines has turned his torment into a brainwave.

Hywel Edwards, 28, from Merthyr Tydfil in the south Wales Valleys, has invented a cap which allows a migraine sufferer to block out the light as well as surround their head with a cold press.

And the idea - thought up after two days' agony when tablets and lying in a darkened room was not working - is set be a business winner.

The interesting thing about this invention is that Mr Edwards didn't need any specialised scientific knowledge to think of it, and make it work. He just needed to know what already worked for him, but in a much less user friendly form. He knew that he needed cold applied to his head, and that he wanted the light to his eyes blocked out. It wasn't rocket science. He just made it work.

Good for him. I hope Mr Edwards gets rich, and gives lots of others the idea that they too could strike it rich, simply by applying common sense and by applying, well, application.

The Centre for Policy Studies published a report warning that the National Health Service is "on the brink of implosion" as government plans for a record 40 billion pound cash injection risk being squandered on bureaucracy. The author of the report, Dr Maurice Slevin, is a cancer specialist at a top London teaching hospital:

"I have seen at first hand the steady decay of a great public institution ... The NHS is on the brink of implosion."

Slevin, who came to England from South Africa and now works at Barts and the London NHS Trust, said he was full of enthusiasm when he started working for the NHS 24 years ago. But today it was clear that the quality of care delivered in Britain was far below that of other western countries. He warned that without major reforms, the 40 billion pound promised for the NHS over the next five years would "simply disappear into deeper and deeper layers of bureaucracy, with more and more monitoring of more and more targets."

"Waste is endemic. The Department of Health itself admits that up to a fifth of the NHS budget is lost through waste, fraud and inefficiency."

So it's not more money that needs to be thrown at the public services as some community minded people would have us believe. The NHS is a strange institution, rooted in the meta-context of the collective effort the British nation experienced during the WWII and resisting any rational discourse by both the politicians and the public. Horror stories of patients suffering at the hands of NHS are part of regular reporting routine and yet, it still seems to be a political suicide to talk about real modernisation and de-nationalisation of the health care system.

Public services, being the most direct way for politicians of bribing the public into voting for them, have always been the most sensitive political issue. I have this horrible vision of the entire GDP disappearing into the NHS blackhole before the British public acknowledges the failure of the NHS as a system of health care provision and confronts the gruesome reality of public services.

It seems the shakedown artists (sorry, legal campaigners) trying to sue fast food colossus McDonalds are not giving up their fight easily, even though a judge recently threw out a case from a man claiming he had been been turned into a lardbutt.

At first, it is tempting to file stories like this under this blog's 'humour' category, and of course in the past stories about overweight folks suing fast-food joints would have been the sort of thing to have been written up in the The Onion or Private Eye. But no longer. It seems one feature of decades of Big Government has been the steady infantilisation of large chunks of the populace to the point where the concept of taking responsibility for one's own actions no longer applies.

Perhaps folk who sue fast food retailers should instead sue the State education system for making them so dumb in the first place.

Bill, an arts student, has never donated blood to the NHS. It is not for lack of opportunity. Quite regularly, the Town Hall is opened for donations amid a fanfare of publicity. Other students say, "You simply must go and donate blood." Must he?

The reason why the NHS has such a shortage in blood is because the government is not prepared to pay for it. Medical schools teach that buying and selling blood is unethical. Blood, because it is necessary to human existence, shouldn't be left to the marketplace. Instead people should give it for free. So goes the argument. The problem is that it applies equally well to food. Thank God there isn't a ban on buying and selling food, or there would be famine.

Despite the shortage being government-caused, shouldn't he give blood anyway? The logical consequence of him not giving blood may be that someone will die. He doesn't like that prospect. But it reflects his choice � and the choice of most other people � not to spend all of his time sacrificing himself for others.

He doesn't like the idea of giving blood. There's a cost involved and it is mainly emotional (to do with fear of needles etc.). On the other hand, he supports several charities. They are ones that he considers important. (Egoists would argue that his is in fact not acting altruistically by giving helping these charities, because it is pursuing his aim that these charities should get more cash.)

But despite supporting charities, he chooses not to give all of his money to charity. Like 99% of the population, he spends most of it on himself. If it is immoral for Bill not to give blood, is it not equally immoral for him not to give �10 a month to Christian Aid? He could do without the blood, and he could still exist without the money. What's the difference? The logic of those who say it is immoral not to give blood is simple. Any resource that you have that is not required for survival should be given away.

Perhaps a more reasonable conclusion would be that it may be virtuous to give blood, but that there is not a moral obligation. Neverthless, greater reserves of blood is good for society. Those keen to increase blood reserves would be wise to advocate markets. Markets are much better at benefitting society than calls for altruism. In countries where the government leaves food production up to markets, the poor get to eat. In countries where markets are blocked by government, they starve. Blood is too important to be kept out of the marketplace.

I have now been a non-smoker for seven days. A week. Nearly a fiftieth of a year! It is my sad duty to report that I don't feel any better for having quit. In fact, I feel worse.

The cravings, though fewer and less severe, still lap tauntingly at my nervous system. It's like having an itch between the shoulder blades. My temper is, shall we say, far from even. I no longer have anything resembling a sleep pattern. Oh I do sleep. At least, I think I sleep. I find myself standing in the bathroom, scratching my arse, yawning and wondering what happened to the last seven hours. That's sleep, isn't it? I hope so.

I no longer eat, I graze. Strange hungers afflict me at unorthodox hours. Oh Lord, why don't cheeseburgers come in packs of twenty? I am accumulating fat like a bear preparing to hibernate.

The mood swings are the worst. Last night the BBC Weather reported roads blocked by snow in the West Midlands. I was on the verge of tears. Euphoria to desolation in the space of half-an-hour is about the norm.

People say stupid things when you're trying to quit smoking. 'Hey, David, it's all in your mind'. 'No kidding??!! And there was me thinking it was all in my foot. Of course, it's all in my f*cking mind, you stupid c*nt. If it was all in my computer's hard-drive I could just delete it and have done with.'

Testy. Did I mention that I was a little testy? Well, I'm a little testy.