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.

Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

What is so special about health that it cannot be done by capitalism?

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.

Puffs of smoke

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?

The boys who cried flu

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.

“We have to wait for the fire brigade because of health and safety”

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.”

Samizdata quote of the day

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)

Another argument for crushing the National Health Service

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.

What a great Olympic swimmer should say

This is wonderful, funny and true.

Via Radley Balko.

Paying homage to Bacchus

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.

“Choose freedom?” That would be nice.

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: → Continue reading: “Choose freedom?” That would be nice.

Nano-medicine

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!

Images of the brain like you have never seen them before

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

An infestation

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?