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]
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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.
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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.
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.
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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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