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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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.
- 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.
- ‘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.
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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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