We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.
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Austin Bay at Instapundit:
Li’s anti-government behavior was using a private internet chat group to tell a handful of doctors and medical students that he was seeing signs of a viral epidemic.
Rather than listening to the message and taking immediate action, the government of China instead spent crucial days suppressing that message and punishing the messenger. Dr Li Wenliang and seven other doctors were arrested for spreading rumours, rumours which turned out to be accurate observations. Li has since died of the very disease that he noticed starting to spread.
China: Don’t just get mad, get even.
John Harris is one of the Guardian‘s best journalists. He is a left winger who wanted to remain in the EU, but the series of video reports by him and John Domokos called “Anywhere but Westminster” showed their determination to literally and figuratively move outside their comfort zone on the issue of Brexit.
Now he has turned his attention to a new subject: health apps and Big Data in the age of the Internet of Things.
Will having longer, healthier lives be worth losing the most basic kinds of privacy?
The deal has yet to be approved by the relevant regulators, but Google has got most of the way to buying Fitbit – the maker of wearable devices that track people’s sleep, heart rates, activity levels and more. And all for a trifling $2.1bn (£1.6bn).The upshot is yet another step forward in Google’s quest to break into big tech’s next frontier: healthcare.
Last month, in a Financial Times feature about all this, came a remarkable quote from a partner at Health Advances, a Massachusetts-based tech consulting company. Wearables, he reckoned, would be only one small part of the ensuing story: just as important were – and no guffawing at the back, please – “bedside devices, under-mattress sensors, [and] sensors integrated into toilet seats”. Such inventions, it was explained, can “get even closer to you than your smartphone, and detect conditions such as depression or heart-rate variability”.
Most people here will probably think that the article and even more so the comments give too much weight to the creepiness of private corporations monitoring your every breath and too little to the creepiness of the NHS doing it. But even the biggest fans of capitalism can feel unease at anyone having this level of knowledge of the most intimate aspects of our lives. (Time was it was only little green men from flying saucers who had such a probing interest.) Nowadays both the private and the public sectors are amassing data, and whichever of them gets a comprehensive health surveillance system working first will promptly sell it to the other.
Then again, before you declare that you will never allow the Internet of Things anywhere near your body, read this comment from “ID20857”:
A few months ago my Mum had a stroke. She is now paralysed down half of her body and confined to a wheelchair. I’m sure if she had the option of an early warning which could have prevented her stroke she wouldn’t give a f**k about her privacy.
The BBC reports,
Calls for ‘virginity repair’ surgery to be banned
Campaigners are urging the government to outlaw “virginity repair” surgery.
Many Muslim women risk being outcast, or in extreme cases killed, if their spouses or families discover they have had sex before marriage.
And some are opting for a medical procedure in which doctors restore a layer of membrane at the entrance to the vagina.
But there are concerns a ban would increase the dangers to Muslim women by driving the procedure underground.
Guidelines from the General Medical Council (GMC) state a patient’s consent to undergo a procedure should come into question if it is suspected of being “given under pressure or duress exerted by another person”.
Those GMC guidelines are correct. Forcing a woman to have her hymen repaired is a serious crime, as is threatening her with violence because she had sex outside marriage to get it broken in the first place. That violent threats so often go unpunished is a national scandal.
But the fact remains that most women who go to have their hymens repaired want it done. In less drastic cases they want the procedure for such reasons as to get and keep a husband, to avoid letting their parents know that they no longer adhere to traditional Muslim mores, or to avoid a breach with their husband’s family. You may say that it is a bad thing that such crushing social pressure for a bride to be a virgin remains prevalent in some communities in the UK. But the principle that an adult human being owns their own body does not cease to apply because he or she gives in to social pressure. Plenty of women get boob jobs and bum lifts because of social pressure, too. Are these bad decisions? Possibly. Cosmetic surgery has risks. But good or bad, the decision is theirs to make.
In more drastic cases women want their hymens repaired because it is the only way to protect themselves from the twisted “honour” of their fathers and husbands. Of course no woman should have to resort to such desperate measures in order to be safe from murder. But what sort of idiocy is it to see a person taking extreme measures to protect themselves from murder and then to think the course of action that best serves justice is to prosecute the victim – or the surgeon who is helping her keep safe?
The usual sort, unfortunately.
Wearing face masks in public is presently illegal in Hong Kong and compulsory in Wuhan
– Michael Jennings
There is a fascinating article in today’s Observer, “Out of the lab and into your frying pan: the advance of cultured meat”.
(The best comment is from “Tintenfische”: “You call that cultured meat? Pah, not even close. Last week my steak took me to the ballet and a symposium on the evolution of beat poetry as seen through the eye of the beat.”)
The author of the article, Zoë Corbyn – I’ve always liked the name Zoë – describes the background:
To a certain extent, the science of culturing meat is relatively well understood. The process begins when a cell is taken from an animal and grown up in a lab to permanently establish a culture (called a cell line). The cells can come from a range of sources: biopsies of living animals, pieces of fresh meat, cell banks and even the roots of feathers, which JUST has been experimenting with. Cell lines can either be based on primary cells – for example muscle or fat cells – or on stem cells. Stem cells have the advantage that with different nutrients, or genetic modifications, they are able to mature into any cell type. There is also no limit to how long stem-cell lines can live, so it is possible to use them indefinitely to produce a product. Once a good cell line – for example, one that grows fast and is tasty – has been selected, a sample is introduced into a bioreactor, a vat of culture medium where the cells proliferate exponentially and can be harvested. The resulting meat cell mush can be formed into a plethora of unstructured items, from patties to sausages – with or without other ingredients added for texture. Conventional meat has a variety of cell types from which it derives its flavour, including both muscle and fat, and the companies are trying to broadly replicate that.
Not everybody is happy that this hoary science fiction trope seems to be on the point of commercial viability. Apparently an advertisement in the Brussels metro…
…contrasts a barn of cows surrounded by greenery to a “meat lab” surrounded by transmission towers. It is the work of the European Livestock Voice campaign – set up last year by a number of European farming industry groups to stress the potential social impacts of upending the meat industry.
Cannon to right of them, Cannon to left of them. The would-be purveyors of a guilt-free equivalent of meat to vegetarians are also opposed from the other side:
The website Clean Meat Hoax was launched last year by an informal group of 16 animal rights scholars and activists. It rails against cultured meat on the grounds that it still suggests that meat is desirable, and that animals are a resource people can draw on. It contrasts with the more pragmatic position other animal rights groups such as People for the Ethical Treatment of Animals (Peta) have taken in favour of the technology on the grounds that animals’ lives will be saved. “What is incredible to me is how uncritically this technology is being celebrated and I don’t think that’s an accident – we don’t want to consider the possibility that we can stop eating animals,” says site founder John Sanbonmatsu, a philosopher at Worcester Polytechnic Institute in Massachusetts.
“Less pragmatic than PETA”: not a concept one meets often. I think the Clean Meat Hoax people have something in common with the opponents of vaping. What really distresses them is that after all their years of exhortations to make the smokers or meat eaters repent, the jammy bastards might be enabled to cease doing the bad thing just like that, with no redeeming pain.
“I implore people to stop using private healthcare: it’s killing the NHS”, writes Jessica Arnold, who is described as “associate director of primary care for NHS Bromley clinical commissioning group”.
…this is one of the most insidious and immediate ways privatisation is affecting our universal healthcare system – by poaching staff from their NHS jobs. Private hospitals, private diagnostic testing services, private general practices and other privately run services are creating a vicious cycle of detriment. It is a major contributor to the some 100,000 vacancies currently in the NHS today.
“Poaching” is a strange metaphor to use, given that the “birds” in this case are not being kidnapped by the private sector but leaving the National Health Service to work elsewhere of their own free will. Perhaps Ms Arnold is referring to the eventual destiny of the birds under a gamekeeper’s care that do not get poached.
I am surprised that this story from Pakistan – perhaps this is real ‘lawfare’? –
Three die as marauding Pakistan lawyers rampage through cardiac hospital
has not gained more attention, there is a paywall but there is other coverage. The gist of it is that after a dispute at a cardiac unit over priority for treatment, and insults being traded between physicians and lawyers, a riot of lawyers ensued that the Pakistani police could only contain with military assistance, and there are unconfirmed reports of patients dying after either being attacked by lawyers or deserted by medical staff.
Breitbart has the story too, with a death toll of around 12.
A mob of two hundred lawyers attacked the Punjab Institute of Cardiology (PIC) in Lahore, Pakistan, on Wednesday, causing at least 12 deaths, several of them critical care patients whose treatments were interrupted by the riot.
The swarm of lawyers was armed with firebombs and a number of handguns. Police cars were set ablaze during their confrontation with riot police, while the hospital suffered damage to windows, doors, and delicate equipment inside.
The genesis of the dispute is reported as being:
The bizarre rampage was touched off by a scuffle on Tuesday that sounds like a comedy skit gone horribly wrong: a lawyer demanded priority treatment at the hospital, the doctors said no, and the lawyer marched off to the local police station to demand they arrest the recalcitrant doctors on terrorism charges.
When the police said no, the infuriated lawyer returned to the hospital with some of his colleagues for a confrontation with the doctors, who filmed the ensuing confrontation and posted the video online with commentary mocking the lawyers. The following day, a mob of two hundred enraged lawyers descended upon the hospital and began trashing everything from parked cars to medical equipment.
So the good news is that Pakistan’s police have a firmer grasp of the concept of the rule of law than this gang of lawyers.
The hospital itself is the Punjab Institute of Cardiology, which provides free health care to almost 500,000 patients a year. Presumably it is State-funded, but there may be some religious charitable giving. It does accept donations for patient welfare, and provides private treatment in the evenings.
So why couldn’t the uppity lawyer who started this have waited till the evening and paid for some private care?
There may be more to this than meets the eye, the article alludes to long-running tensions between lawyers and doctors in Lahore (but no reason for them). A local lawyers’ rep. doesn’t seem to be particularly conciliatory:
The vice chair of the Pakistan Bar Council, Syed Amjad Shah, condemned the violence but described it as “the individual act of a few lawyers” while blaming the doctors for starting the fight by “misbehaving.”
Presumably the ‘lawyer’ pictured pointing a pistol in this local piece fully complies with the rules of professional conduct? In the USA, he might be simply vigorously demonstrating the Second Amendment.
What is the answer to this sort of behaviour, apart from rigorous law enforcement? It is, I suppose, a backhanded compliment to Pakistan’s hospitals that people will kill if denied priority treatment. Why doesn’t the NHS provoke such passions?
Long ago, Milton Friedman suggested the US might be better off without the Food and Drug Administration. People wrote to him saying the FDA should not be abolished but reformed so it would act differently. Friedman replied by writing a column he titled ‘Barking cats’:
What would you think of someone who said, “I would like to have a cat provided that it barked?” … The way the FDA now behaves, and the adverse consequences, are not an accident … but a consequence of its constitution.”
Today I chanced to hear a couple of medical professionals discuss the Tesla they have just arranged to buy, bemoaning its cost but rejoicing there would be “no more gas-guzzling trips”. Later they spoke of government policy on parking at NHS hospitals. Labour brought in the policy – which Cameron and May kept on, of course – to help save the environment by making parking at hospitals difficult (its proposers used different words) to encourage use of public transport. I learnt this policy much annoys shift-working NHS staff, who must sometimes travel in and out at hours when there is little or no public transport (or in areas that are not too salubrious). I already knew from my own friends and family that it much annoys elderly relatives visiting hospital patients – friends of mine have had to give up and go home again because an old man was not up to walking the distance from the nearest viable parking to visit an old woman, and might have had to be signed into the hospital himself if he’d tried. These Tesla-buying NHS professionals conceded that the numerous (by government policy) almost-always-empty electric-car-only spaces that adorn the limited hospital parking provided were also annoying. The man remarked that a hospital he’d recently served at really wanted to convert an available site nearby into a car park – “but knew they’d never get permission.” The woman said that if the government wanted NHS staff and patients to use public transport, they should try and ensure large hospitals were well-served by buses, but her experience was the reverse – “They need some joined-up thinking!”.
The thought flitted across my brain that greenie civil servants were not alone in needing to join up their thinking. And then I thought of Friedman, long ago, recalling his “Barking Cats” column of yet longer ago:
The error of supposing the behaviour of social organisms can be shaped at will is widespread. It is the fundamental error of most so-called reformers. … It explains why their reforms, when ostensibly achieved, so often go astray. (‘Free to Choose’)
Of course, I believe that the western world’s social organism could be shaped to respect science more and virtue-signalling AGW non-science less. So maybe I shouldn’t be too critical. Still, the BBC reported today that SUVs are outselling electric cars 37:1, “making a mockery of UK policy” so there is hope – of a kind.
UK Prime Minister and Conservative Party leader Boris Johnson has made much of how he would shower “our wonderful National Health Service” with money (from we lucky taxpayers and future generations, no doubt) in this election campaign. Cynics will say that he probably does not mean it all that much but such statements are the price one must pay for persuading wavering Labour voters into switching from the Red to the Blue team, etc.
But I wonder. There does seem to be a deeply rooted attachment to the NHS that goes beyond all logic and reason. A service created in the late 1940s, run as a monopoly (private healthcare in the UK is relatively small versus the NHS), paid for out of tax and delivered free at the point of use. Result: its services must be rationed. Some of its actions are pretty good, some far less so. I got treated for water on the knee last year and was dealt with reasonably well, although the diagnoses given were so wide and contradictory that in the end I learned more by surfing the internet and talking to some medically savvy friends. Many people’s experiences with NHS treatment vary from excellent to terrible. It does certain things very well, but in my view is poor at area such as tracking patients after their initial encounters to make sure they are keeping on a regime, etc. I think that the UK could and should move towards private healthcare provision for the bulk of the population, via a mix of healthcare accounts that one builds up over time (people will tend to draw from these funds more as they enter middle age), insurance (for large, catastrophic spending) and some public provision for those in serious poverty. The Soviet model that we operate under seems not just anachronistic, but dangerously resistant to innovation and change. (James Bartholomew had good thoughts on the NHS in this article.)
And yet the NHS is, as former UK finance minister Nigel Lawson once said, rather like a state religion, such as the Church of England. Criticise it at one’s peril. The other day on Facebook an acquaintance of mine, a senior nurse on a good salary, bleated about the hours she has to work. I pointed out that as a small business owner I have put in 60-plus hours a week, but accepted that as part of my choice to work in this way. The meltdown, and the sarcasm, that I received from this person’s friends was something to behold.
The NHS is, like the BBC, one of those institutions that seems to defy all logic, no matter what it does and how ropey its output is.
So it wasn’t George Bernard Shaw after all.
It wasn’t him in the funny story about the dinner party, I mean, the one where a man teasingly asks the woman seated next to him, “Would you sleep with me for a million pounds?” Laughing, she answers, “You bet!” “All right,” he says, “How about for five pounds?” Now she is outraged and says sharply, “What do you take me for?” He replies, “We have already established that. All we are doing now is haggling over the price.”
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“Bristol Southmead Hospital: Racist patients could have treatment withdrawn”, reports the BBC.
North Bristol Trust (NBT) launched its Red Card to Racism campaign after staff reported an increase of abuse from patients and visitors at the city’s Southmead Hospital.
The abusive behaviour covers racist or sexist language, gestures or behaviour.
Trust chief executive Andrea Young said they wanted staff to “challenge and report it”.
Under the scheme, any patient abusing staff would be challenged and warned, leading to a “sports-style disciplinary yellow card” followed by a final red card in which treatment would be “withdrawn as soon as is safe”.
and
Ms Young said: “We’re sending a strong signal that any racism or discrimination is completely unacceptable – we want staff to challenge and report it and we want everyone to know that it will have consequences.”
Although I am not an adherent of the worship of the National Health Service that has replaced Anglicanism as the British English state religion, I can understand what people like about the NHS. Its founding principles were that its services should be comprehensive, universal and free at the point of delivery. I think the experience of other countries shows that there are many other healthcare systems that would work better overall, but it is a genuine advantage to the UK system that when a British person falls ill they do not have to even think about where and how they will get treatment, or how they will pay for it. It’s universal.
Or it used to be. Bristol Southmead Hospital has changed all that.
I could go on about how easily this policy by North Bristol NHS Trust could be abused, could lead to tragedy. A story by Jack Montgomery at Breitbart UK did just that. But in a sense all that is just haggling over details: once it is established that the NHS is no longer universal, what is the point of it?
The National Health Service was meant to be like the justice system: no one can ever lose the protection of the laws, not proven criminals, not actual racists, and certainly not some shabby old man who has been waiting in Casualty for five hours and can’t stop himself blurting out some non-PC word because he is in pain.
On the other hand, in other contexts I have argued that state systems should drop their obsession with universality. When I was a teacher I saw how one feral child in a class in a state school could ruin the education of thirty other children. For a mess of perverse reasons the policy of putting them in “sin bins” was never applied wholeheartedly, and there are some children so monstrous that even the other denizens of the reformatory should be spared their company. Not to mention the teachers, many of whom quit the profession rather than having to face one more day trying to control these thugs. Whenever it was suggested that the state should simply cease the attempt to educate such children someone would wail, “We can’t just abandon them”. “We can and we should,” I would say. “If they make themselves so unpleasant that no one wants to teach them, no one should have to.”
So don’t those arguments also apply to NHS staff members and patients who find themselves cheek by jowl with some aggressive bigot spewing out obscenities? In this case I am not talking about people who are unjustly deemed to be racists or sexists (real though I think the threat of this happening is), I am talking about truly nasty people. I said one of the best aspects of state healthcare was that it is available to all. But my own words regarding state education, also meant to be available to all, come back to haunt me: if some people make themselves so unpleasant that no one wants to cure them, surely no one should have to.
What do you think?
“Prohibition showed bans can be good for us”, writes David Aaronovitch in the Times. Unironically. He means it. He thinks Prohibition was good and wants it back. I suppose it was ever thus; it is like the way that when the people who remember the last banking crash die the banks start crazy lending again.
Mr Aaronovitch writes,
Your mental charge sheet against prohibition may well include the accusation that it didn’t get rid of drinking but sent it underground; that the resulting appetite for “bootlegged” liquor led to the rise of organised criminal syndicates, Al Capone, the mob and the St Valentine’s Day massacre; that it helped to make corrupt hypocrites out of public servants; that the rich were able to indulge while the poor were criminalised.
Why yes, it does.
And after just a few years the Americans saw what a disaster it was and repealed it. It may not improve your view of it to know that the Ku Klux Klan were very much in favour of prohibition.
That does not surprise me.
Strangely though, the one question that almost no one seems to ask of this epic public health measure is whether or not it actually improved public health. Yet it doesn’t take much digging into the available statistics to discover that it did — quite a lot, in fact.
Excessive alcohol consumption is linked to all kinds of adverse health conditions. The most obvious is alcoholic cirrhosis (or scarring) of the liver. In 1911 the death rate for cirrhosis among American men was nearly 30 per 100,000. By 1929 that had been reduced by more than 30 per cent. Registered admissions to mental hospitals for psychosis linked to alcohol more than halved. Even by 1933, when Volstead was revoked, alcohol consumption had gone down by a third since pre-prohibition. Whatever Mark Twain may have written, prohibition saved many, many lives.
The commenters made several good points to contradict that assertion. Some pointed out that in the same period alcohol consumption also went down other countries, including the UK, where alcohol continued to be legal. Bryan Dale said, “If prohibition reduced alcohol consumption by a third that can hardly be called a success. It was supposed to eliminate it entirely after all. With 2/3 as much alcohol being illegally consumed as had been done legally before prohibition, the impact on respect for the law must have been dreadful.” Others described well-stocked drinks cabinets in modern Saudi Arabia, or the way that the type of alcohol consumed shifts from beer to spirits when it must be sold and transported illegally.
I expect readers of this site can supply many other historical and factual arguments. All I will say is that there is a void at the heart of the passage I quoted above. Mr Aaronovitch never even questions the assumption that it is for him and people like him to decide what other human beings may or may not put in their own bodies.
These people who live a vigorous life to 70, 80, 90 years of age—when I look at what those people “do,” almost all of it is what I classify as play. It’s not meaningful work. They’re riding motorcycles; they’re hiking. Which can all have value—don’t get me wrong. But if it’s the main thing in your life? Ummm, that’s not probably a meaningful life.
— Ezekiel Emanuel, chair of the University of Pennsylvania’s department of medical ethics and health policy and “a chief architect of Obamacare”.
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Who Are We? The Samizdata people are a bunch of sinister and heavily armed globalist illuminati who seek to infect the entire world with the values of personal liberty and several property. Amongst our many crimes is a sense of humour and the intermittent use of British spelling.
We are also a varied group made up of social individualists, classical liberals, whigs, libertarians, extropians, futurists, ‘Porcupines’, Karl Popper fetishists, recovering neo-conservatives, crazed Ayn Rand worshipers, over-caffeinated Virginia Postrel devotees, witty Frédéric Bastiat wannabes, cypherpunks, minarchists, kritarchists and wild-eyed anarcho-capitalists from Britain, North America, Australia and Europe.
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