Tim Worstall says that Hayek’s much-derided argument that government health care would make us serfs of the state is supported by an astonishing piece by Nick Cohen which appears to argue that so it would, and so it must. Part of me hopes that Cohen, who has often been one of the more principled voices on the British Left, is writing tongue in cheek or trying to provoke a reaction. But the commenters nearly all seem to take it quite seriously and only berate him for not going far enough.
Here’s the piece from Cohen: “Saving the NHS means forcing us to change the way we lead our lives”.
If you imagine a healthy future for Britain, or any other country that has put the hunger of millennia behind it, you see a kind of dictatorship. Not a tyranny, but a society that ruthlessly restricts free choice. It is a future that views the mass of people as base creatures jerked around by desires they cannot control. Expert authority must engineer their lives from above for their own good and the common good.
Speaking as a base creature myself, I do not believe it would be a healthy future at all to be ruled by people with such contempt for me.
Here’s my partial sketch of how Britain would have to change to limit the costs to the NHS that stunted lives and avoidable pain will bring. Pedestrians and cyclists would have priority on the roads. If the roads are too narrow to take cars, cycle lanes and a pavement wide enough to allow pedestrians to walk or run in comfort, then cars will have to go. School runs will become history as heads refuse to admit any able-bodied child who arrives at school in a car.
It will not necessarily be illegal to drive in towns and cities, just pointless. Motorists would inch along because cycle and bus lanes would take up road space and pelican crossings would be reset so pedestrians never had to wait more than a minute to cross a road. Even when they reached their destinations, drivers would search forever for a space because car parks would have been demolished and replaced with public parks.
No fast-food outlet would be allowed within a one-mile radius of a school. Agricultural subsidies for fat and sugar would be abolished. Rapeseed oil and sugar beet cultivation would stop as new subsidies for public transport began. Meanwhile, the manufacturers of processed food high in sugar, salt and fat would face advertising bans and punitive taxes. (If food manufacturers want to dump prematurely sick patients on the NHS, we will say, they can damn well pay for the privilege.)
A commenter called “erikus” put their finger on what all this was reminding me of:
Stardate 21327.5. Captain Picard & the crew of the Enterprise arrive at a world where the local inhabitants are suffering the apocalyptic consequences that fell upon them after they tried to re-engineer themselves in order to meet the expectations they believe are placed upon them by the institutions that were created by their ancestors and which they’ve come to regard as sacred & inviolate.
Picard’s final speech: ‘They killed themselves for this. They died because they believed that they had to sacrifice themselves in order to preserve in perfect form the institutions left to them by their ancestors: Institutions that were themselves originally created with one simple purpose: To preserve their lives:
We must remember that the institutions that we create exist for our well-being & that once we begin to worship them & think their well-being transcends that of our own, they lose their reason for existence.’
This appeared just after my item about the NHS. Please stop reading my mind without telling me! This would make a good (as in horrific) book or movie about an NHS Britain. At least a healthy Britain could then out-perform Europe! And you might win Olympic medals.
This is happening in Minneapolis, except for the part about making it easier for pedestrians to cross the road. The city just reworked a street that runs near my house. Used to be two lanes in each direction. Now it’s one. But there’s more street parking, and nobody can drive in the parking lane because the curbs come out to prevent that at every intersection.
Really causes trouble when snowplows make the road narrower.
Poe’s law is kicking in here … I can’t decide if the article is meant as a satire or what he actually wants to see implemented.
Hmmmmm!
He’s being very blunt and unusually honest, but he’s 100% correct in how he sees any future that embraces a socialistic, equal-outcome entitlement society. Anything that you enjoy that isn’t very cheap, very plentiful, and equally enjoyed by everyone will be labeled an “addiction” and banned. We will all learn to love the nourishing and economical Soylent Green.
Because of some of the things that I do, I am very aware of the concept of factory farms, and the evils it supposedly entails. Wouldn’t it be ironic if the same impulses that banish the factory farm for animals imposes it instead on humans? That’s what he describes, with a yearning that strikes me as diseased.
More and more, I’m accepting that it will have to be a battle to the death with these people. Otherwise, it will simply be a surrender unto death under them.
Those who have declared themselves to be our intellectual and moral betters have neither difficulty nor restraint in dictating the lives of their inferiors. They call us deplorables and bitter clingers to dehumanize us, the better to excuse what they intend to do when they have sufficient power. The Jews of Germany in the 1930’s could not believe that the Nazis actually meant what they said. It was all just inflammatory rhetoric. We all know what followed. It will happen again if allowed.
The title of Nick Cohen’s article is:
How about we just don’t save the NHS.
Instead we replace it with a health system adapted to us, its customers!
Best regards
Has anyone heard the latest ‘Change for Life’ radio ad? Basically a diatribe about how sugary drinks and snacks are making your children fat and rotting their teeth, followed by an infuriating jingle:
“Look for one hundred calorie snacks, two a day max – look for one hundred calorie snacks two a day max.”
I think it provides a very informative window into the minds of the new puritans.
Self driving autos will move this along quite nicely. I envision that the baby boomers will be the first ones to have their driving priveleges canceled, once self driving cars become a reality. “They do not need them, because self-driving cars provide them with the transport that they need.” Bob Lutz, the former president of GM, agrees with this predicition.
All transport will be run by a few companies that work for the govt to provide transportation services to the masses. You will have an app to summon a vehicle, which will provide you with the transport you need, as approved by the govt after it considers you request.
They will likely stop issuing driving licenses to youths at the same time the boomers lose their priveleges, for the same reasons. Everyone else will gradually lose the privelege as well.
Nick Cohen is not being serious with this article, that much is obvious. I think it id intended to be a mirror, and it works quite well this way in the guardian.
One of the problems with being fat in the UK is that gluttony is the sin you wear on the outside. You’re a “social problem” that needs fixed. Never mind that the people pointing the finger at you often have hearts as black as night, none of that matters because they’re not fat and you are.
On the radio the other day they had someone calling for a ban on discounts and multibuy deals on “unhealthy” (they don’t say how they’ll define this) foods. They want to “help” me by forcing me to pay more for food. While I don’t doubt that there is a price they could drive food up to which would make me less Alfred Hitchcock shaped and more Warsaw ghetto inhabitant, I thought they were rather missing the point.
Speaking for myself, I don’t overeat because food is especially cheap. Indeed food prices have gone up considerably over inflation in the UK over the last 20 years or so. I overeat because I enjoy it. It makes me feel good, probably because I come from a lower class family that expressed love with food. And I need to feel good sometimes because much of what I do in my day to day life makes me deeply unhappy.
And you know what’s right at the top of the list of things that make me unhappy, and by extension go to town on the chocolate biscuits? That’s right, authoritarian busybodies taking away my agency “for my own good”. Unless they raise food prices to starvation levels, I don’t think this sort of interventionism will combat obesity. Quite the opposite.
I would ask the broader question: what is it about life in Britain that makes people feel like they need to self medicate with whatever just to get through the day? Because I think the UK regulatory class would find rather than fat people and discount Tunnock’s Tea Cakes being the problem, it’s them that’s the issue.
But that’s just the opinion of a “social problem” so take it for what it’s worth.
PS – Obesity is a disease of plenty. It’s a good problem to have. For most of human history the idea that people en masse would have problems because they have too much food was unthinkable.
James Mates writes yesterday for ITV News on Why aren’t European hospitals facing a ‘winter flu crisis’ like the NHS?. He includes these interesting snippets:
I summarise (proportionate to population, GDP and money): 3.12 times as many hospital beds and 1.46 times as many doctors for 1.12 times as much of GDP (1.29 times as much money at GDP(PPP)).
Best regards
From my quotes page:
KIP’s LAW: Every advocate of central planning always—always—envisions himself as the central planner.
http://kipesquire.powerblogs.com/posts/1195619277.shtml
– And everyone else as shmucks, it might be added.
Amit Varma: http ://indiauncut.com/iublog/
KIP’s LAW: Every advocate of central planning always—always—envisions himself as the central planner.
(kipesquire – powerblogs)
– And everyone else as shmucks, it might be added.
Amit Varma (india uncut)
That’s my take too. While speaking well of Brendan O’Neill, recently, I gave a tip of the hat to another former Marxist whose name I didn’t recall. It was, of course, Cohen.
Except that’s not what happens, at least as far as top shelf items are concerned. Experience has shown us that Islay Malts will still be produced, but their sale will be restricted to members of the Politburo and the Nomenklatura.
Stonyground, Teenage campaigner challenges 100-calorie snack advert
Completely ignoring how it was government ‘wisdom’ and interference that lead to all of this in the first place (as has been discussed here in the past, e.g. https://www.samizdata.net/2016/04/war-on-sugar/#comment-704766, plus others in the thread).
Interestingly, there is a growing movement that links the rise of govt controlled central banking to the decline of nutritious food – fiat money begets fiat food. Meet the Bitcoin Carnivores: https://lfb.org/gold-meat-rise-bitcoin-carnivores/
I heard about it on a great podcast episode with Saifedean Ammous about his upcoming book “The Bitcoin Standard” – https://noded.org/podcast/noded-030-with-saifedean-ammous/
“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”
– C S Lewis
@Nigel Sedgwick…
That spending on healthcare in Germany and other Continental Countries is not Government spending alone, but includes a large slice from private insurance and non-reimbursed costs out of the pockets of patients.
In Germany and other Continental Countries over 50% of provision is private, competitive and for-profit so it is exposed to the rigours of the free market with the efficiency that brings which is why those healthcare systems provide much more with only marginally more spending.
And yet these Countries still manage to ensure equal healthcare of ‘the poor’.
The problem with the population of the UK, is there is nobody alive who has ever experienced anything other than the NHS and so can make no comparison, but everyone has been brainwashed into believing they should not have to pay for their own health and everyone will die with a different system not wholly funded and provided ‘free’ by the State.
I am yet to hear of any Remoaners urging us to adopt a more ‘European’ health care system.
Thank you Duncan S for the link. I noticed that being a BBC report there was no questioning of the received wisdom that we have a childhood obesity problem. 34% of 10 and 11 year olds are allegedly overweight. In fact they are only shown to be overweight due to misapplication of the BMI which, among its many faults, is not suitable for application to children. I noticed that the girl who made the film had no problem with the existence of the interfering busybodies of PHE, only that she thought that they had got the message slightly wrong.
As an aside, I am very fit despite being a type 2 diabetic. Recently I have had a problem with feeling faint while exercising and, after an anomaly showed up on an ECG scan, I have been referred to a cardiologist. He said that the problem is probably being caused by a virus, that there is no treatment for that, and that I will most likely just have to give it time to clear up on its own. He has put me down for some further tests to ensure that it isn’t anything more serious. So far I have few complaints about the service that I have been getting from the NHS up to now.
I am 59 and my high level of fitness is down to training for and doing triathlons of various distances from sprints all the way up to the full 140.6 ones. I got the impression from the cardiologist that he was not too keen on guys who are pushing sixty doing extreme levels of exercise. I don’t smoke, I drink a little but only when I’m not in training for an event. My thought was that you can’t win then can you? If I was smokey drinky sedentary and fat he would have been on my case about that. Diabetes symptoms are massively reduced by exercise, my diabetic nurse is very encouraging but my cardiologist apparently is not.
“Saving the NHS means forcing us to change the way we lead our lives”.
That’s good news. Because then we can refuse to change, and get rid of the NHS at the same time.
As one who is completely ignorant of Nick Cohen (except the name itself) and every word of his “body of work,” the quote in the posting struck me as neither satire nor the urging of an agenda, but rather as a simple warning. “Be careful what you wish for: you might get it.”
UPDATE: Well, on re-reading the opening sentences, perhaps my impression is all wet.
The fact of the probable itinerary on this journey, however, is correct.
John B writes in reply to me:
Is he stating that the UK figures given in the ITV News article are not also total figures? Therefore very poor reporting of cost/performance statistics? That was not my reading; I suspect that James Mates and ITV deserve at least a link to support any criticism of their claimed facts.
On John B’s middling points, he emphasises points made by me in: my earlier linked comment.
On John B’s last comment:
That is an interesting and useful point, though exaggerated somewhat. Given its founding in 1948, one probably only needs to be around 70 now (aged 10 then) to remember before that. Also, on that point, I recollect that the Russians threw off the older 1917-founded political/governmental system when one would have had to be 85 in 1992 to remember (as a 10-year old) its predecessor. The USSR and Russian communism still went.
The wiser sort of people, though they doubtless value very highly their own personal experiences, do actually look around too. And with low-cost foreign travel, TV/radio and the Internet: the opportunities are better than ever for them to do that.
Best regards
I spy an error in my arithmetic. One would have to be 80 now to be 10 in 1948.
Sorry
Which is why it is very important that the Authorities retain the ability to prevent dissemination of false stories purporting to show that in some places there are (or, at least, have been) more successful, or desirable, or morally acceptable ways of dealing with the system of health care.
I am 80 and can remember the UK before the NHS. We did not pick our way through streets filled with the terminally ill poor dying in shop doorways. The hospitals made provision for those who could not pay. Perhaps the so-called “amenity wards” were less attractive than the paid-for ones but they existed. I doubt if the treatment was any worse. The hospitals themselves had, in many cases, hundreds of years of charitable gifts and endowments for the very purpose of treating the poor. Better-off individuals insured themselves, either through their employers’ schemes or directly through insurance companies or friendly societies or trades unions. We ourselves paid the equivalent of, I think, about £5 in present money to visit the GP but there were Local Authority run clinics and other free services. Obviously medicine was less advanced but it was certainly available to all. The vision of the Government was, I suspect, that no-one should have to rely on something that looked or felt like charity. It was seen as demeaning and divisive and must be replaced by a service that gave every citizen a right to free care on an equal basis.
I think it likely that actually the real problem for the poor was not the cost of treatment but the loss of income that serious illness would bring – and that was something that needed dealing with.
But these are just my childhood recollections. It would be interesting to have a reference to a proper study of the circumstance of the immediate post war medical and employment protection services. I may be quite wrong.
@Robert
Thank you for both your personal recollections and your interpretation. Both are much appreciated.
Best regards
Some 20 – 15 years ago, Labour managed to reduce the number of beds available to the NHS, and to make the reduction difficult to reverse (some detail in the second paragraph of point (1) in Natalie’s old post here). They did this while simultaneously greatly increasing spending on the NHS.
This post put me in mind of my last comment on another post on this site.
The “liberals” are resolving the contradiction between their economic collectivism (for example the NHS – which was modelled on the Soviet Union health service ACCEPT that the NHS is not a monopoly, private healthcare was NOT made formally illegal in Britain) and their support for civil liberties – but in a horrible way.
Instead of rejecting their economic and social collectivism – the “liberals” are rejecting civil liberties, hence such things as smoking bans, and demands that no “fast food” be sold within a mile of a school (soon it will be that no one should be allowed to sell “fast food” at all).
The late J.S. Mill argued (or rather stated) that there was a fundamental difference between restrictions on business (sellers) and restrictions on ordinary people (buyers) – “old fashioned” Whigs rejected the idea of a distinction, and we are being proved correct. There is no fundamental difference between economic liberty and civil liberties – essentially they are the same thing.
As for the nature-of-man…..
The view of Thomas Hobbes, David Hume, Jeremy Bentham (and so on – including J.S Mill??????) is that Free Will (moral agency) does not really exist – that people can not do other than we do (we can not freely choose to change our conduct) and that reason “is, and ought to be, the slave of the passions” (David Hume – deliberately turning traditional moral philosophy, and its conception of what a human is, on its head, utterly negating it – what J.S. Mill called the “light of Hume” is really the darkness of Hume).
With this view of humans as brute beasts, or flesh robots (rather than human BEINGS) any degree of statism may be justified – “for our own good”. The state “must” intervene – or humans will eat fatty foods and so on (we can not stop ourselves).
The scenario reminds me of the BBC series for children, ‘Bootleg’, that ran about fifteen years ago, envisioning a health-obsessed future society that had outlawed chocolate, to the dismay of kids everywhere. It opened with scenes of armed thugs arriving in armoured vehicles at supermarkets to confiscate the newly-illegal contraband substance.
Yes, I did say ‘BBC’ – I would be surprised if a similar theme would make it past the Thought Police now, as it might pollute impressionable young minds with the idea that arbitrary, censorious, ‘for-your-own-good’ authority is something to be resisted rather than celebrated and grovelled before.
It’s on YouTube: https://youtu.be/u8xXtB9Ltqg?t=227
@Stonyground,
I am 59 and my high level of fitness is down to training for and doing triathlons of various distances from sprints all the way up to the full 140.6 ones. I got the impression from the cardiologist that he was not too keen on guys who are pushing sixty doing extreme levels of exercise.
Your cardiologist probably isn’t keen because there’s some evidence to suggest you get more calcification in your coronary arteries from “extreme” levels of exercise. There’s a happy medium between too little exercise and too much.
The most recent post at The last Ditch covers this topic with equal concern and erudition:
http://www.thelastditch.org/2018/01/an-unexpected-encounter-with-a-monster.html