… like hostage victims love their hostage takers. The world’s most disheartening hash tag on Twitter today: #WeLoveTheNHS, throwing up lots of rather highly strung debates.
Why disheartening? As with most things in the political realm, one emotion dominates: Fear. Fear trumps everything else. Most of the hostile comments I get on this blog come from people absolutely terrified of something or other. For many unscrupulous politicians, fear is the simple and easy way to bypass people’s reason and make them believe… well, whatever you want them to believe, really.
In the UK it’s fear of losing free at the point of use health care that makes people go quite mad at any suggestion of tampering with it. In America they’re afraid that by adopting a universal health care model, especially a ‘single payer’ model where there’s only one source of health insurance they’ll end up with rationed health care ‘as bad as the UK’s’.
What both countries suffer from is a generally poor standard of health care – for different reasons, but enough for there to be some political will for change.
America’s health care is the most expensive, per head, in the world. As a side note: contrary to popular opinion, Health Insurance in the US is highly regulated with significant restrictions on what Health Insurance are allowed to exclude from their coverage. There’s also help for the poorest and pensioners – it is not a lassez faire free market system. There’s room for improvement, things that could be done better, actions that could be taken to start bringing down the cost of health care but, for all its faults there’s people really really scared of losing it.
There’s plenty of reasons to complain about the NHS, too – rationing, waiting lists, MSRA, half a million bureaucrats and poor cancer survival rates compared with the rest of Europe are obvious issues – saying ‘you love the NHS’ uncritically helps absolutely no-one… but things aren’t quite as bad as the Republicans would have you believe: Palin’s pressed the thermonuclear panic button by referring to ‘Death Panels’ which… which strongly suggests the GOP aren’t changing ‘any time soon’.
This sort of rhetoric is utterly toxic, but it’ll influence those who won’t be bothered finding out for themselves what the truth about the NHS really is. And, worst of all, it’s not even a real argument. It’s just fear-mongering and low politicking of the worst kind.
But I note with some irony it is the US system that is always used by NHS advocates in the UK as a terrifying example of the horrors that await a.. gulp.. privatised… gulp… National Health Service.
When Republicans use the UK as an example of a horror story, we call them propagandists and liars and cheats. But when we use America as an example of a horror story where people will be left dying in the streets? Well that’s WELL TRUE and so it’s perfectly fine.
Sheesh. I bang both your heads together.
Of course I’m left disheartened, wondering if it’s ever possible, anywhere in the world, to have a rational debate about health care.
Sara Scarlett said...
12 Aug 09 at 9:49 pm
Preach on, Sister Charlotte!! Let them see the light!!
Roger Thornhill said...
12 Aug 09 at 10:13 pm
I am sure you and I, Charlotte, could have a rational debate about healthcare.
What most people don’t realise is how many private companies operate de facto monopolies within the NHS behemoth and that the rest is a State run monopoly.
Free at the point of use? Well, car insurance, AA roadside recovery, warranties of any kind, they all provide “free at the point of use”. Insurance, you see.
Those that love the NHS should be free to do so, but on condition the rest can opt out. Oh no! Collectivism is all about shared suffering.
Pete said...
12 Aug 09 at 10:31 pm
I’ve lived in both places, and in truth have received better care in the US than in the UK, but statistically I’m irrelevant. If you’re relatively young and healthy, who cares? In the US you’ll probably not take health insurance unless it’s a work benefit, in the UK you’ll probably not see a GP from one year to the next. In volume terms it’s all about pregnancy, kids and old people. For these people, the level of care you receive almost certainly comes down to how professional and caring your local GP or medical centre is and I fear that UK GPs often give a lacklustre service. Whether this is because the NHS is underfunded, inefficient, beset by political manouvering or just badly managed or a combination of all 4 is moot.
Tom James said...
12 Aug 09 at 10:47 pm
I want to have a rational debate about healthcare. One based on empirical evidence, not ignorant propaganda.
What alternatives to the current NHS system would you suggest Charlotte?
Are you in favour of fewer managers, partial or whole privatisation, greater competition between the private and public sector?
Jock said...
12 Aug 09 at 11:17 pm
By the way, there is a figure on a post at Counting Cats today that asserts that there are around 9 million people in the US who don’t have any kind of cover because they can’t afford it and are too “well off” to qualify for the existing low income social programs. Which would suggest that only around 5% of the adult population have no cover at all. An article I saw last week suggested it was around 19%, but that may include those who are eligible for the existing socialized programs.
There is still huge amounts of rent seeking in the US system, which of course is only possible if there is a state to grant the various actors privileged positions.
Ian B said...
12 Aug 09 at 11:35 pm
Not taking sides as such (I’m not one of those who, were I magically to become PM, would immediately abolish the NHS, for practical reasons) one of the primary problems with the US system is the provision of healthcare by employers. It obviously makes no sense. It’s equivalent to having one’s food provided by employer insurance- your employer does a deal with Tesco or Sainsburys, and then you get all your food from them and can’t go somewhere else if they’re not what you want. It’s an obvious disaster for market forces.
There’s an interesting little free market lesson in that actually. Employer provided healthcare in the USA took off during the war years. Employers were trying to attract more staff and thus wanted to raise wages, but Roosevelt had wage price fixing in operation, so they couldn’t. As a consequence they started offering other benefits, particularly health insurance, to get around the price fixing regulations. Once started, the system became ingrained and the idea of part of one’s wages being paid as health insurance became normalised.
The problem there is that then people stop thinking of the health insurance as just part of their wages being spent on their behalf, and see it instead as an entitlement distinct from the wage; just as, if it had become normal for employers to buy employees’ food for them, they’d be upset at some rightwingextremist suggesting that people should buy their own, out of their wages.
Jock said...
13 Aug 09 at 12:03 am
just as, if it had become normal for employers to buy employees’ food for them, they’d be upset at some rightwingextremist suggesting that people should buy their own, out of their wages.
Well, with Hillarious’s search for a meaning for DEFRA resulting in wanting to impose state planning on food supplies, I suspect it won’t be too long before people are convinced too that tha’s a great idea too!
Student speed dating said...
13 Aug 09 at 7:25 am
Thanks for good information on NHS. As per the newspaper 20% of American become bankrupt because of their health care expenses.
Tristan said...
13 Aug 09 at 8:06 am
Mark (and many of your commenters) obviously did not read this post before commenting.
#welovethenhs seems to be more about nationalism than anything else – just shows the vulgar left is just as nationalistic as the right. Its just as ugly as well.
Its starting to descend into racism too.
Roger Thornhill said...
13 Aug 09 at 8:37 am
I’ve lived in Singapore and had a Medisave/Medicare account. It was a sensible mechanism and very fair – it made people think about abuse or use of healthcare resources as their own use is made plain to them.
I mean, people in Wales on benefits go to the GP to get a prescription for Calpol. Why? Because it is “free” – to them, anyhow.
The biggest problem with the NHS is most people who say they like it are utterly ignorant of the NHS, let alone systems elsewhere.
A blend of German, Swiss and Singapore systems is what I would like to see.
Scott said...
13 Aug 09 at 8:42 am
I’m sure we can have a good debate in New Zealand, afterall, thats supposed to be a rather good system isn’t it??
Jack Hughes said...
13 Aug 09 at 8:51 am
Here in NZ I can see the doctor I want – when I want. Often the same day I call.
I pay about $50 (20 GBP) for this. Children and pregnant women are free.
The doctors surgery is clean and modern – and spacious. The doctor comes out to meet and greet each patient when the appointment starts.
I had a minor eye op a few years ago and it cost some $200.
People who ‘love’ the NHS have never seen anything else.
Stu said...
13 Aug 09 at 9:34 am
I agree, the NZ system seemed to work really well when I was there with a newly pregnant girlfriend. Not being citizens, we weren’t entitled to free healthcare on account of the pregnancy, but we went to see an excellent GP in a walk-in clinic, and paid some $40NZ to be given excellent advice and treatment without any problems. And we weren’t putting any burden on the NZ taxpayer.
I may be romanticising through lack of experience, but both of us were left with the distinct impression that the system worked pretty darn well – and wondering why we didn’t do something like that here.
Then again, somehow New Zealand manages to make the public transport system run on time, too. And be inexpensive. And it’s an absolutely gorgeous country.
In fact, WTF am I still doing living in Britain? :-/
Letters From A Tory said...
13 Aug 09 at 9:42 am
“What both countries suffer from is a generally poor standard of health care”
I strongly disagree, Charlotte. 50 million Americans might not have health insurance but those who do have adequate cover get superb and often genuinely world class treatment. Yes it can be expensive but you get what you pay for in the US, but the same cannot be said for the NHS that provides substandard care at an extortionate cost.
Joe Otten said...
13 Aug 09 at 11:53 am
LFAT, that 50 million – or however many it is – are left out is what makes the US standard a poor one. Here, once you get to the top of the queue and are actually treated, the standard is again usually very high.
But I disagree that Americans are getting what they pay for. They have very high costs for various reasons including restrictions on the numbers going into medicine, inflating salaries. And non-recognition of foreign qualifications for the same reason.
Scott said...
13 Aug 09 at 12:27 pm
@LFAT – that is the main problem with the US healthcare! While I don’t like the NHS, I completely agree with the principle that we should all have free healthcare (paid by taxes). The NHS just needs a major reform and a re-look at what we should offer on it! Also, foreign nationals should be charged if they use it (which they might do already (I don’t know)).
ANON said...
13 Aug 09 at 1:02 pm
What is MSRA?
Surely you mean MRSA
And it much more common now in the USA than prviously thought.
“The Centre For Disease Control (CDC) estimate that there are about 90000 deaths per annum related to Hospital Acquired Infections (HAI’s)in the USA”
Jock said...
13 Aug 09 at 1:46 pm
Okay Scot, but what do you think should be free? Should it be, as the Tories were claiming last week equal and free access to IVF treatment?
Why on earth ought I who has to accept I’m unlikely to have kids have to contribute towards someone else refusing to accept that and demaning everyone else pays for them to add to this overpopulated world?
Similarly with clear lifestyle choices – my tobacco “tax” ought to go towards additional private insurance, paid for perhaps by the tobacco companies as part of their settlement of all the claims against them, but I should not expect you or anyone else to be coerced into paying for my dangerous habit’s consequences.
I think the bare minimum should be for those conditions that you cannot help and immediate relief of pain and prevention of death. Not simply “inconvient” bits of you that don’t work properly but do not threaten your life.
I don’t see why someone whose personal or religious ethics tells them that abortion is murder should be forced as part of their healthcare contributions to pay for children to be murdered, as they see it.
Laurence Boyce said...
13 Aug 09 at 3:42 pm
I wish I had a pound for every time I heard somebody say that the NHS must be wonderful because it fixed my dad’s heart, and mended my mum’s back, and so on, as if all those things were done cost free out of the goodness of their hearts. I don’t think I love the NHS one little bit.
mel said...
13 Aug 09 at 4:42 pm
Well i love the nhs flaws and all. Wouldn’t be here today if it wasn’t for it.
Martin said...
13 Aug 09 at 6:17 pm
Does that mean it’s impossible to improve? I mean, look at the comment directly above your own.
Tim Almond said...
13 Aug 09 at 6:18 pm
One of the problems with the NHS is that people don’t connect payment with service. It’s why so many people who get treated in hospitals view them as “angels” rather than “people doing their job” and why so often patients get treated as though they are having a favour done for them.
The first thing is to get competition. I want to be able, as a patient, to fire a hospital and take my business elsewhere. Then bad hospital managers get replaced by good ones.
We already have a model for this: supermarkets. Competing suppliers with an insurance system to prevent poor people starving, and it works. OK, so poor people don’t get M&S or Waitrose organic hand stuffed olives, but they do get enough food. And the result of this system is that the price of food has steadily decreased in real terms.
Getting rid of the NHS in its current centralised, monopolised form is an uphill struggle. It’s so vital to Labour’s heritage, so fawned over by the BBC that exposing its faults and demonstrating better systems is tough. It’s going to probably require the privatisation of the BBC first.
Andy said...
13 Aug 09 at 7:38 pm
The reason for a clear, simple ‘I love the NHS’ message is that we’re dealing with morons incapable of understanding nuanced arguments.
I, personally, quite like the NHS because it’s ahead on points for me at the moment in the ‘family members who are alive or died with dignity vs botched operations’ scorecard.
But that option doesn’t exist in this debate at the moment. The discussion going on in the comments here is a different debate, involving different people (most of whom have brains), in a different country. The only available options in the debate that the #welovethenhs hashtag is designed to be a part of are ‘the NHS will kill your grandmother’ and ‘the NHS is fantabulous’.
Saying ‘we love the NHS’ critically won’t help fix the problems in the NHS, but it does have some validity as a blunt instrument with which to hammer brain-dead lunatics on the idiot side of a binary argument.
Atlas said...
13 Aug 09 at 7:57 pm
Of course the NHS can be improved upon, but this blog seems to be entirely missing the context in which this NHS love-in is taking place. That context is its usage as a weapon for corporate America to terrify citizens there in to continuing with their absurd system.
Of course for Americans that can afford it the treatment is world class, but they spend twice the GDP on healthcare that we do, and yet only give the bare minimum treatment to tens of millions of people.
For those of us that consider ‘community’ to be more than simply a potential profit source, the NHS is – for all its faults – also a wonderful symbol of social values. I’ve seen the poor in America treated in what looks like field hospitals set up in a disaster zone, so when that same system attacks the NHS, yes, I’m quite happy to say that I love it.
Tim – your comparison with supermarkets simply doesn’t work, not least because there is a rather considerable difference between picking up the weekly shop, and undergoing months or years of cancer therapy. Just as there is a difference between ‘getting enough food’ and ‘getting enough drugs to cure you’ – one gives you less taste, the other kills you. Also, supermarkets have reduced the cost of food by squeezing the smaller fish that supply them – the same principle doesn’t work when talking about Big Pharma.
Tim Almond said...
13 Aug 09 at 8:45 pm
“Tim – your comparison with supermarkets simply doesn’t work, not least because there is a rather considerable difference between picking up the weekly shop, and undergoing months or years of cancer therapy.”
There certainly is a difference. But my point was more abstract about models of public provision. We don’t have centralised, monopolised supermarkets to ensure that poor people get food, but we think we need to for health.
“Also, supermarkets have reduced the cost of food by squeezing the smaller fish that supply them – the same principle doesn’t work when talking about Big Pharma.”
I presume by “Big Pharma” you are referring to patented drugs which are subject to monopoly supply for a limited period. There’s not much you can do to bring those prices down (and I’ve yet to see a better way to get new drugs).
But that’s a fraction of the NHS budget. In 2005, £8bn was spent on brand name drugs out of a total of £77bn. This sum also includes where the NHS buys a non-patented drug from it’s orginal manufacturer.
So something like 90% of the costs of the NHS can be subjected to market regulation.
For the sake of transparency, I did once do some work for a clinical research organisation
Tim Almond said...
13 Aug 09 at 8:45 pm
oops. replace “market regulation” with “market forces”…
Ian B said...
13 Aug 09 at 9:01 pm
Also, supermarkets have reduced the cost of food by squeezing the smaller fish that supply them
…because their customers “squeeze” them for lower prices. Just like employees squeeze their employers for higher wages, householders squeeze tradesmen for cheaper plumbing works, and so on and so on. That is why the market gets steadily more efficient. Because we all “squeeze” each other. And that is why socialist government is such a terrible burden on us, because unlike the ever-squeezing marketplace, it glories in pushing costs up! We are spending more! Vote for us!
Atlas said...
13 Aug 09 at 9:46 pm
Tim – “I presume by “Big Pharma” you are referring to patented drugs which are subject to monopoly supply for a limited period. There’s not much you can do to bring those prices down”
On the contrary, you can leverage the purchasing muscle of the NHS to secure significant reductions on the price of drugs. A benefit lost with competition.
But that’s a fraction of the NHS budget. In 2005, £8bn was spent on brand name drugs out of a total of £77bn…So something like 90% of the costs of the NHS can be subjected to market forces.
Reminds me of another point: the lack of market forces means no advertising budgets, no profit margins or shareholders, no insurance paperwork. The ‘inefficient’ NHS has a fraction of the administrative costs that that US model has.
Ian B – That is why the market gets steadily more efficient. Because we all “squeeze” each other. And that is why socialist government is such a terrible burden on us, because unlike the ever-squeezing marketplace, it glories in pushing costs up!
Lovely neoliberal rhetoric. Shame the masters of the universe have been found out. Of course there are benefits in market competition, there are also many costs, both environmental and social. The supermarkets gave us cheap food, they also gave us huge numbers of farmers having to leave the industry, produce with carbon footprints the size of Kenya, industrial farming and BSE, and played their part in the obesity crisis. Market forces must be balanced with the specific circumstances of the market in question, not slapped on regardless of context. Christ, just look at the joke that is the rail network. And the US – competitive – healthcare system that this dicussion started with, which “glories in pushing costs up!”
Atlas said...
13 Aug 09 at 9:48 pm
Damn, if you’re going to enable XHTML tags, you should really have an ‘edit post’ button, for idiots that forget to close them.
Charlotte Gore said...
13 Aug 09 at 10:06 pm
I just fix them. XHTML tags are for hardcore leet hax0rz only
Ian B said...
13 Aug 09 at 10:24 pm
Lovely neoliberal rhetoric.
No, it’s a description of how markets actually work. You see, despite what you may choose to believe, there are actually things which are true and things which are not true. Believe what you wish, but the truth, as they say, is out there.
Shame the masters of the universe have been found out.
Hmm?
Of course there are benefits in market competition, there are also many costs, both environmental and social.
You can explore them through economics too. The trick is to actually apply reason, rather than wishful thinking.
The supermarkets gave us cheap food, they also gave us huge numbers of farmers having to leave the industry,
Yes, inefficient businesses leave the market, the efficient ones remain, efficiency goes up, and everybody wins. The less efficient farmers redeploy in the market place where their talents can find a merket. That’s how you get growth.
produce with carbon footprints the size of Kenya,
I hate to break this to you, but all living matter is primarily carbon.
industrial farming
Yes, efficient farming that gives us cheap food, allowing billions to live without the starvation of inefficient farming systems.
and BSE
Progress involves risk. You get an unexpected problem, you investigate and fix it. If you wish to avoid all the risks of progress, you will have no progress. Go back to the Dark Ages, do not pass GO, do not collect £200. The question is whether avoiding the small number of deaths from NVCJD would be preferable to millions starving in the regular famines of subsistence agriculture that plagued Europe prior to intensive farming.
and played their part in the obesity crisis.
A crisis which is entirely invented by the miserable, mad, neo-puritan progressive movement, btw.
Market forces must be balanced with the specific circumstances of the market in question,
By whom? Wise philosopher kings? They haven’t done very well so far have they?
not slapped on regardless of context.
Market forces aren’t “slapped on”. They are what happen when you leave people alone; the default state is that everyone prefers a good deal to a bad one. You are offered two identical apples- apple A costs twice apple B. Which you gonna choose? Apple A. That’s all it is, natural behaviour, not an evil scheme invented by sinister capitalists.
Christ, just look at the joke that is the rail network.
Yes, it’s state managed. You don’t think it’s a free market, do you?
And the US – competitive – healthcare system that this dicussion started with, which “glories in pushing costs up!”
Which is also state managed. It hasn’t been a free market for a very long time.
State managed industry is called corporatism. The fact that the industries may be nominally in private hands does not make it a free market. It is a form of state control in which the state gets plausible deniability- by regulating and managing the “private” industries then blaming them when it all goes wrong, which it always will.
Just as an example of the subtle dead hand of government, here’s an anecdote. A friend of mine is an electrical engineer and railway nerd who participates in a preserved railway society. Out of interest he dismantled and compared two emergency light fittings from the same manufacturer- one standard one and one “railway certificated” one. They were identical to the component level. The certificated one cost ten times the price of the standard one.
Apply that understanding to all things in massively regulated sectors like railways or healthcare, and you start to see where the immense financial costs come from. Rather than this endless debate about how to pay the exhorbitant costs of these sectors, we need to start looking at why the costs are so high in the first place. The government plays an enormous part in that.
Tim Almond said...
13 Aug 09 at 10:25 pm
Atlas,
“On the contrary, you can leverage the purchasing muscle of the NHS to secure significant reductions on the price of drugs. A benefit lost with competition.”
I suggest you read the OFT report into the Pharmaceutical price regulation scheme from 2005 (http://www.oft.gov.uk/shared_oft/reports/comp_policy/oft885.pdf). Specifically page 50. It shows a table of comparable drug prices of the UK and Europe. UK prices are higher on average than most of those compared.
Austria and Belgium have cheaper drug prices on average. Which suggests that in this instance, size isn’t important.
Ian B said...
13 Aug 09 at 10:31 pm
Erratum-
That’s Apple B you’d choose of course, not Apple A.
Ian Eiloart said...
14 Aug 09 at 10:50 am
@ Jack Hughes:
My experience with general practice in the UK is exactly as you’ve described NZ. I can choose which doctor I want to see. I can get a same day appointment. I can do both if my doctor happens to be working that day.
The clinic is clean and bright, and the doctor comes out to welcome me at the start of the appointment.
The only difference here is that it doesn’t cost me $50 a pop. Which is a good thing, especially considering that many lives are lost through putting off visits to the doctor with apparently minor symptoms.
I know of cases where women deemed too old for NHS fertility treatment have paid thousands of pounds for treatment at fertility clinics – only to be told later that the clinic had never successfully treated a woman in that age group. The thing is that clinicians should not be permitted to profit from providing useless treatments. That’s very hard to arrange with private medicine, even when insurance schemes are in place.
Atlas said...
14 Aug 09 at 11:37 am
Tim – I believe the NHS’ policy of obtaining bulk discounts has only been pursued seriously in the last two or three years, so I wouldn’t expect 2005 figures to reflect the practice.
Ian – you want to talk about truth, and yet all you have is blinkered neoliberal ideology. An ideology that, in the current economic climate, looks no more like a panacea for our problems than communism looked in 1991.
You can explore [social and economic costs] through economics too. The trick is to actually apply reason, rather than wishful thinking.
Sure, if putting a price tag on it makes you feel like you’ve considered it rationally, then feel free. Don’t mistake one for the other however. Regardless, it doesn’t change the argument. I actually mis-spoke (as they say in Washington) in my previous post – supermarkets haven’t given us cheap food, they have given us the illusion of cheap food, by deferring the cost to elsewhere in the system. Whether it’s farmers; livestock; high streets; the taxpayer or the environment, some one is still carrying the can.
Yes, inefficient businesses leave the market, the efficient ones remain, efficiency goes up, and everybody wins. The less efficient farmers redeploy in the market place where their talents can find a merket. That’s how you get growth.
That blinkered ideology again. Clearly, everybody doesn’t win (see the list of costs above). Another idea that you’ll no doubt find shocking is that growth doesn’t have to trump all other considerations. In fact, if you take environmental and social degredation seriously at all you might well ask whether further growth in the West is even desirable.
I hate to break this to you, but all living matter is primarily carbon.
You don’t appear to be a simpleton, so I assume the message you are conveying here with this elusion is that you are a climate change denier. Truth sure can be pesky, can’t it? How do you keep growing in a finite world?
Yes, efficient farming that gives us cheap food, allowing billions to live without the starvation of inefficient farming systems.
Since you raise the point, and we’re all for truth, I suggest you research the impact that attempts to impose Western industrial farming has had on both on African crop yields over the last 3 or 4 decades, and on malnutrition caused by the replacing of food crops with produce for Western markets. We should not forget either all those kicked off their ancestral land to make way for GlobalFarm Inc.
[the obesity] crisis which is entirely invented by the miserable, mad, neo-puritan progressive movement, btw.
If you’re going to make silly statements like this, surely its inadvisable to start your post with a rallying call for truth? Rising obesity is an empirical fact, as is it’s adverse effect on health.
By whom? Wise philosopher kings? They haven’t done very well so far have they?
You’re right, they haven’t done well. However, I think you’ll find that these decisions have, certainly since the 1980s, been made not by philsopher kings, but by neoliberal economists.
Market forces aren’t “slapped on”. They are what happen when you leave people alone.
Oh come on! This markets-are-the-natural-state discourse is so tired now! All human transactions, throughout history, have taken place in some form of regulated environment that favours some and not others. Modern ‘free-market’ capitalism is no different. If you want proof of that, then take a look at where billions of pounds of taxpayer’s money has gone in the last year: propping up the teetering City, aka the citadel of free market capitalism. Had it been ‘left alone’, the system would be nothing more than dust right now.
Ian B said...
14 Aug 09 at 12:03 pm
You know Atlas, you could have put “discourse” nearer the top of your comment to save me the hassle of reading all the way through it to confirm I’m dealing with a committed marxist. I’m sorry, but until you can face the world as it is rather than as you desire it to be, you will never understand it, and as such it is effectively pointless trying to explain it to you.
Just look at it this way; in your last paragraph you quite clearly stated that the free market does not and has never existed, and then blamed the free market for the economic collapse. Can you see the contradiction in that?
Ian B said...
14 Aug 09 at 12:22 pm
Atlas-
It’s also interesting to note how your enthusiastic if poor quality fisking suddenly ran out of steam just at the point where I’d described how our system is not free market, but corporatist. Did your keyboard suddenly break down? I wouldn’t like to think you’d avoided that bit because you couldn’t think of an answer.
Matthew Huntbach said...
14 Aug 09 at 1:00 pm
I think you have this completely wrong, Charlotte.
What is actually prompting people to respond in this way is outrage about what seem to be lies told by opponents of health care reform in the US.
The basis of the problem seems to be a belief that a guaranteed level of state care means the abolition of any private insurance top-up, which we know is wrong in the UK, and I’m assuming it’s not what is being proposed in the US. But the opponents have added to this basic wrongness hugely exaggerated claims about the limits of care in the UK state system.
Someone who has a concern for truth and for good political debate will hate the idea of lies, and will want to jump in when they know from their own knowledge that lies are being told – ir if not lies, distortions being spread by people who don’t have the knowledge to know they are distortions. Sometimes this does end up with a person concerned for truth defending an institution or situation they recognise is not perfect. The next stage in this sort of discussion is for the person who jumped in to counter the lies or distortions to be accused of being a full and uncritical supporter of the institution.
I recall something similar in discussion with Americans on Northern Ireland. Americans who had discovered their Irish ancestry were often led to believe that the situation in Northern Ireland involved hugely more discrimination against Catholics than actually existed. They tended to think the situation there was a majority population yearning to be united with the rest of Ireland and just a small garrison population of British occupiers standing against that, with the support of a British government doing this because it had a mad imperialist wish never to give away any territory.
There were a small number of people deliberately spreading propaganda to create this impression, and a larger number of people who believed it because they wanted to believe it and it fitted in with their stereotypical views and myths and legends they had picked up. However, if one attempted to correct it, the usual assumption was that one was oneself a “British imperialist” who was 100% on the side of the “occupiers”. In such discussion I found the Ameericans tended to believe I was some sort of extreme Ulster Unionist, or the stereotypical “up the Empire” British military type from the time when Britain still had an Empire. The fact that I am a Catholic who if living in Northern Ireland would probably vote SDLP and would certainly support Irish unity in any referendum just didn’t get through, because they had such a black and white view of politics – you were eitehr a 100% IRA supporter, or an evil British imperialist, there was nothing else anyone could be.
I hope this is a sufficiently neutral issue to make my point here. As I have said elsewhere, this sort of “black and white” view seems to bedevil discussions between self-styled “libertarians” and everyone else.
Atlas said...
14 Aug 09 at 2:54 pm
in your last paragraph you quite clearly stated that the free market does not and has never existed, and then blamed the free market for the economic collapse. Can you see the contradiction in that?
Nope, I clearly state that the free market does not and has never existed, and as an example reference recent events, which have seen hordes of your anti-regulation, dog-eat-dog, survival of the fittest breathen all of a sudden come cap in hand to the evil state to bail them out for their greed. Tell me, what price calculation do you put gross hypocrisy?
It’s also interesting to note how your enthusiastic if poor quality fisking suddenly ran out of steam just at the point where I’d described how our system is not free market, but corporatist. Did your keyboard suddenly break down?
So you can duck all my arguments, because I used the word ‘discourse’ and hence can be pigeon holed and dismissed as a Marxist crank (incidentally are you getting confused with ‘dialectic’, because I don’t recognise your connection?), but I must address all of yours? I guess its fitting that neoliberal would load the dice in a debate.
The reason I didn’t bother with your last comment was because its a tiresome trick I’ve seen too many times before from your ilk: the faults of any system can be blamed on the fact that they are not ‘free market’ enough. Of course, you love regulation that favours you – preferential trade tariffs; developing markets forced open by the World Bank for Western companies to exploit at the expense of the locals; trillion dollar bailouts when your greed gets the better of you – but you just keep banging that free market drum.
We do agree on one thing though – this discussion is pointless. Its also only loosely on topic, so I bid you adieu.
Jock said...
14 Aug 09 at 3:28 pm
Ian Eiloart @ 10:50 am
Actually fertility treatment is one of my betes noir. I would not offer it at all on the NHS personally. Lots of us can’t or won’t have kids however much we may want to. It’s not an illness but some kind of bodily malfunction that, by and large at least, does not threaten your life or health. Sometimes we must accept that we are not born the same.
Also, I was going to blog about this myself so won’t go into too much detail here but as to insurance, IVF is simply not an insurable risk and I doubt in a properly free market system with no state coercion on what they must offer any insurance company would cover it. It is the job of savings or credit/payment plans to deal with this sort of thing and frankly if you are intending to bring a little one into this overpopulated world, which is likely to cost somewhere in the order of £140,000 and £180,000 (strangely by the same research only days apart!) while they are more or less dependents, I don’t see why you shouldn’t too either save up or pay credit terms to have it in the first place if you cannot conceive naturally. If you know you are infertile (and your insurance probably would at least cover the diagnosis) early enough you could be saving in some kind of endowment plan for example.
Finally, at the moment we think of private insurance as something roughly like what happens in America. In a genuinely free market it would be very different even from that, because the American system is very much not free market, there are huge restrictions, barriers to entry and so on. I’d suggest that what you are likely to find in a properly free market is actual experts in a particular speciality running such savings and insurance schemes and having a huge economic incentive to ensure that they only referred people to practitioners they were able to verify and trust in their speciality.
Equally, at the moment, if I were to go for a heart operation on the NHS, whilst in theory I have a choice, in fact the only viable hospital for me would be the JR in Oxford which has an awful death rate for heart patients and everyone knows it. I’d have a quarter the chance of dying if I were able to get to Papwortt, say. The NHS then actually contrives to increase my statistical risk of being killed by their doctors for want of competition. In a private system I would hope to be able to get Magdi Yacoob to come to me in Oxford, say.
Matthew Huntbach said...
14 Aug 09 at 11:27 pm
Equally, at the moment, if I were to go for a heart operation on the NHS, whilst in theory I have a choice, in fact the only viable hospital for me would be the JR in Oxford which has an awful death rate for heart patients and everyone knows it
Is that because they deal with particularly difficult cases? I’m not saying it is, just it could be. So, in a market-oriented system if you had a serious heart cindition and a high chance the operation you needed would fail, you might find your favoured hospital saying “No thanks, we can’t operate on you, you’re a liability, you’re likely to drag us down the death rate league tables”.
In a private system I would hope to be able to get Magdi Yacoob to come to me in Oxford, say.
So would everyone else. He’d be a VERY busy man, wouldn’t he? Or just put his prices up so no-one but the very rich could afford him?
In any case, plenty of our top medics will see you privately, there’s only a few who insist they’ll only work for the NHS. So the existence of the NHS doesn’t mean you are denied that choice, though lack of money means you might be.
Jock said...
15 Aug 09 at 12:38 am
No the JR does not deal with particularly difficult cases. Papworth does. I am quite sure that if I were to pay the earth Magdi Yacoob would visit Oxford for a day, however that is not what one would want. In a real free market he would likely be leading a firm of peripatetic specialist heart surgeons, all of whom he’d probably have given his imprimatur to or risk his own reputation, and available for booking to any hospital in the land within a day or so.
The current system means that he is tied to Papworth for most of his time and I’m stuck with the butchers of Barton.
I’m not the one voting for people to die on the NHS.
Ian B said...
15 Aug 09 at 1:49 am
The reason I didn’t bother with your last comment was because its a tiresome trick I’ve seen too many times before from your ilk: the faults of any system can be blamed on the fact that they are not ‘free market’ enough. Of course, you love regulation that favours you – preferential trade tariffs; developing markets forced open by the World Bank for Western companies to exploit at the expense of the locals; trillion dollar bailouts when your greed gets the better of you – but you just keep banging that free market drum.
Nope. This is the point you see, libertarians don’t agree with any of that stuff. Firstly we believe in Free Trade, not tarriffs. We are bitterly opposed to protectionism such as “preferential trade tarriffs”. We do desire everyone to have open markets, because that allows everyone to trade. But for instance, we would want the EU to drop tarriffs that harm the Poor World’s ability to sell to Europe.
And libertarians argued fiercely against the bailouts. The banks and businesses should have been allowed to fail. This is a central part of libertarianism, and to claim otherwise is the direct opposite of what we argued for all the way through this mess, and in general.
You simply don’t know what you’re talking about.
Caron said...
15 Aug 09 at 11:17 am
If the US system does provide protection for most of its people, then why is it deemed necessary to bring in what seems to me quite basic comsumer protections – for example, stopping your insurance company from refusing you cover if you’ve been sick, or discriminating on the basis of gender, or charging ridiculous amounts for expenses. To me this http://www.whitehouse.gov/health-insurance-consumer-protections/?e=11&ref=hicp seems quite mild.
We have polarised round the NHS at the moment, to defend it from the misrepresentations not just from Daniel Hannan but the powerful and rich American right and its health related commercial interests. Remember that a lot of the inaccurate information about the NHS comes from organisations with direct fiinancial interest in maintaining the status quo.
For me, the provision of health care that is free at the point of use is not something that I ever want to see interfered with, and I will protest against anything that seeks to take that away. I don’t trust models that give private industry too much control over the provision of healthcare because I don’t believe that they will fulfil their obligations to the most vulnerable.
I don’t think the NHS is perfect by any stretch of the imagination, nor do I think the public’s expectations of what it should provide are always realistic. It can and should definitely become less bureaucratic and more people centred. I really don’t think there is any significant belief, though, that we should depart from its founding principles of it being free at the point of need.
Ian B said...
15 Aug 09 at 11:38 am
Caron, it is a state run bureaucracy. It is inherently bureaucratic. It is not “people centred” because the people it is serving are not its customers; the state and various special interest groups are its customers. There is no way to change that because it is inherent to nationalisation. If food were provided “free at the point of use” by the state, the same would apply. The “people” would not get what we want.
It would be expensive (to the taxpayer), lacking in diversity, and lacking in quality. We would all moan about how the National Food Service ought to do better, but that would never translate into real improvement.
And then there would be complaints about big eaters getting more than light eaters, and beer wouldn’t be available becuase nobody needs beer, and so on. And nobody would be allowed to criticise the “angels” who provide our food, they would say, “the NFS feeds sixty million people, that’s amazing, people shouldn’t moan about it if their apples are a bit maggoty. They’re free aren’t they?”.
The American system has profound problems, largely because of regulation by the state (and very high costs due to the fear of litigation by the same “progressives” who complain that the costs are so high), but nationalisation is not the answer that will help them. Hannan said that creating an NHS will be a disaster for Americans, because it will be. He also correctly pointed out that, as with Britain, if they let this disaster happen they’ll never be rid of it.
The NHS is crap. Let’s stop lying to ourselves. It’s a load of bollocks, isn’t it?
Caron said...
15 Aug 09 at 11:48 am
Ian, it’s not crap. It’s not perfect, but it’s not crap. And I don’t for a minute think that private companies will make it people centred – unless you are looking at people centred being the customer focused/customer service con that most of us face on a daily basis.
I cannot dismiss a system that kept my very poor grandparents alive for long enough for me to get to know them, which safely delivered my daughter and my nieces and nephews, that has saved my husband and members of my family as well as friends from life threatening conditions, which has immunised my daughter free of charge from all sorts of illnesses and which has provided me and many other people with free contraception.
I’ve certainly got niggles with the NHS, but it’s been there for me and mine when we’ve needed it. I’d hate to think I could be in the US and find that the day after I lose my job, my 10 year old doesn’t have any sort of health cover.
Ian B said...
15 Aug 09 at 12:10 pm
Caron, you’re making the error that because the NHS did those things, only the NHS could have done those things, which is the same as I illustrated with the “National Food Service” example.
“How can I criticise the NFS, when it has fed me and my family for our entire lives?”
But the debate in that case would be liberals saying, “If we did not have the NFS, you’d have a bigger choice of better food”. People used to the NFS would deny that, they’d say “in other countries people have to BUY food in the supermarket! How unfair!” So it’s down to whether you want better food, or free crap food.
Besides which it isn’t free of course. We’re all paying through the nose for it via taxes. If I take £10 off you, then later give you £5 worth of service for it, that’s not actually “free”, you know.
And buy your own goddamned contraception. Or do you expect the taxpayer to keep you in lingerie and lube, also? I mean, once you start with this “free at the point of use” thing, why stop?
Joe Otten said...
16 Aug 09 at 1:11 am
Compared to US health costs, they are taking £10 off us and giving us £20 worth of service. So in that sense it is half free.
And they don’t even have universal coverage.
I’d be quite happy to switch to one of the continental models if it provided better value for money – which I daresay many of them do – but universality is essential, and that is what is fundamentally wrong with the American system.
Matthew Huntbach said...
16 Aug 09 at 9:54 pm
I am quite sure that if I were to pay the earth Magdi Yacoob would visit Oxford for a day, however that is not what one would want. In a real free market he would likely be leading a firm of peripatetic specialist heart surgeons, all of whom he’d probably have given his imprimatur to or risk his own reputation, and available for booking to any hospital in the land within a day or so.
But why would he want to do that? Maybe the guy loves doing surgery. So why would he want to give that up and instead be a manager of surgeons? Why would he want to risk his own reputation by taking up a different calling giving out his imprimatur in this way? Why do you libertarians always suppose absolutely everyone wants to become businessmen or loves to pore through manuals and charts and league tables to choose between products, or be pestered by advertisers each putting the case of rival products?
Why can’t you accept that sometimes certainty rather than risk is what people want? Certainty in many cases gives me more freedom – if there are some aspects of my life I know are certain, I can take more risks and make more choices in others. If I am always having to watch my back because people like you want to make everything a risk, I end up leading a scared and restricted life because I feel I can’t afford to take some risks for fear of others.
This may be why so many people like the NHS and are jumping to its support. It takes away one big risk in life. If I don’t have to worry about being bankrupted due to some health issue popping up, I am more free to take risks in other areas of my life. I am much more free to take risks in setting up my own business, for example, if I know certain basic things like health care and housing will always be provided at a minimum acceptable level for me.
Matthew Huntbach said...
16 Aug 09 at 9:59 pm
But the debate in that case would be liberals saying, “If we did not have the NFS, you’d have a bigger choice of better food”. People used to the NFS would deny that, they’d say “in other countries people have to BUY food in the supermarket! How unfair!” So it’s down to whether you want better food, or free crap food.
If there were people starving to death because no companies thought they could make a profit selling them food, perhaps a NFS to keep them alive might be needed. If food were something where people’s needs sometimes unexpectedly boomed to levels beyond what they could afford, perhaps a NFS would be needed. If food were not an enjoyable thing and what people wanted from it was just a uniform level to keep them alive, perhaps a NFS would be preferable.
Matthew Huntbach said...
16 Aug 09 at 10:07 pm
Besides which it isn’t free of course. We’re all paying through the nose for it via taxes. If I take £10 off you, then later give you £5 worth of service for it, that’s not actually “free”, you know.
And if I had to pay for it through an insurance premium, would I get £5 worth of service for £5 payment? Would all those clerks working the insurance system do their job for free?
The POINT about it being free is that it FREES me from the worry that if suddenly I become very ill, or lose my job and can’t afford the premiums, I know don’t have to worry I’ll be told “Sorry, if you can’t pay, we won’t give you health care”.
These right-winger opponents of state health care in the US talk about “death panels”, so is there no equivalent in the US system? Is there no-one who ever says “Sorry, we can’t care for you” for whatever reason such as no payment? Is there no-one who has the job of saying “this level of health care is beyond what you’re insured for”?
Jock said...
17 Aug 09 at 12:03 am
You are making some pretty broad, and to me unsubstantiable, assumptions based on an incomplete reading of many of our positions, Matthew, that life in a stateless society would be like “Tesco without the state” and things would just bumble along as they are but with no central direction.
Do you not think that Mr Yacoob does not already run a firm of surgeons, or that people try to get prized training places in his hospitals so that they can also trade on his name. Absent the NHS and the protectionist regulations that keep training places down, and doctors in a level of supply that ensures they have an economic rent (also prevalent in the US system, if not more so), such as he, if they wanted to have the sort of well paid careers they have enjoyed under the NHS would almost certainly have to be a bit more entrepreneurial. Of course, it’s not for everyone, but I suspect, as happens today with surgical firms, most would be unlikely to want to work alone.
As to your certainty and risk, I have a personal, and immediate example of how that is just wrong. My best friend was at an orthodontist on Thursday. He noticed a discolouration on his palate, called his oral cancer expert doctor contact, who opened up his surgery on Thursday night when he was supposed to be out at dinner to remove a patch for biopsy. He took it personally to the lab at the JR and then spent most of Friday chasing it before flying out on holiday on Saturday (they failed to return results on Friday despite all the chasing).
He said that if you go on the NHS, they have this two week wait maximum for a cancer suspect – before even getting the biopsy let alone a prognosis and starting treatment. He says that if it is a malignant tumour he will want to operate within the next seventy-two hours – that two weeks is easily enough to bring the prognonsis down from a ninety percent survival rate to fifty-fifty at best. Since he is on holiday in Switzerland he has arranged for a surgeon there to see my friend if the results return positive tomorrow and is trying to arrange for one in Oxford if he can get hold of him so he doesn’t have to make the journey.
This will of course cost him money (but, for example, no more than insuring a modest car would cover), but the cost of waiting for the NHS might well be a dramatically increasad probability of death. Is that teh sort of “certainty not risk” you really want – because some bureaucrat has decided that people can wait two weeks for a cancer test?
Now, in a stateless society, more people are going to have more money and more financial freedom – the most wealthy will see their wealth accumulate much more slowly – as it is usually generated at least in part by protectionist privilege that only a state can grant and enforce, prvilege that increases the returns to capital at the expense of returns to labour.
Proper competition will drive down the costs of such health care (and most other costs of living), absent the politically motivated clinical meddling and all the rent seeking involved in both the state system like the NHS and the state protected but privately run system such as in the US. Insurance unencumbered by the tight regulation in the US system will be cheaper for most people, who after all tend to go through most of their lives without a great call on medical services and won’t be being forced to pay for others’ lifestyle treatments or uninsurable risks.
For the few others, who are unable even to work for any of their lives, and who have no personal connections who care about them enough to help, well even for them, private charity will be much more available in a world where people are not being forced on pain of imprisonment for not paying for things they may not agree with. Quality of life for many less well off and elderly people with chronic conditions in Japan is markedly better through the Hureai Kippu system – a collection of complementary currencies that reward people who carry out personal care for friends, family and people in their communities with credits that can be used themselves for a range of wellness facilities like gyms and so on.
If you continue to think that what we are talking about is some Thatcher-like project you are the one exhibiting the wavey hands syndrome not prepared to listen and just knee jerking your prejudices. It could not be further from that if it tried.
You might like to have a read, if you can be bothered, of this essay which won last year’s Libertarian Alliance essay prize on the theme of “Can a libertarian state be said to be Tesco minus the state” and the one I linked to from the Centre for a stateless society on an anarchist approach to healthcare reform. Then you might want to come back and apologise profusely for suggesting that we’re all some kind of crypto-Thatcherites, for you’ll find nothing that would tickle her in either of those I suspect.
Jock said...
17 Aug 09 at 12:21 am
Oh, and why do you think an individual is going to have to pore through league tables and so on to determine where they should go for treatment? I suspect they might for insurance, but what do we have experts for? Why would you not believe your general practitioner’s advice about where to go and when?
You wouldn’t expect everyone to be expert enough to manage their own investment portfolio would you, or their household repairs, or car servicing? Why would you expect it with healthcare? Another of those very common objections that really do not stand up to the most mediocre imagination.
Matthew Huntbach said...
17 Aug 09 at 12:21 pm
Jock, you appear unable to get my point, which is not that I disagree with every point from the “libertarian” side or think it not a useful contribution to the debate, but that I am finding the “We’re 100% right and the rest of you are just evil socialists” line your lot tend to use along with very simplistic arguments and inability to accept and question the dogma, to be just so tiresome and juvenile. Trying to debate these things with your lot seems to be just such a waste of time, as I keep saying it’s like when I used to argue with the Trot.
Jock, if it helps, you’re the one I find at least mildly more interesting and thoughtful and with some answers to my concerns than the rest.
So if you want to sell your ideas to me, you and your lot are going to have to find a better way to do it. You’re coming across as sloppy, pumping out in a more extreme form the fashionable ideology of the day, so thinking yourselves rebels but actually the ultimate conformists. Just like the Trots of old when Socialism was the fashion of the day.
I really think I must stop here as I’ve wasted far too much time on you and your lot. You have managed mostly in that time to put me off and turn my personal politics away from your ideals rather than towards it by your manner. Any more reading of you and your like, any more of your posing arrogance, and I fear I might be converted to full-blooded socialism.
Ian B said...
17 Aug 09 at 12:50 pm
Considering that libertarianism is not represented by any political party or power/pressure group of our times, it would be hard to describe it as “the fashionable ideology of the day”.
Progressivist socialism is the fashionable ideology of the day. Have you really not noticed?
Matthew Huntbach said...
17 Aug 09 at 4:10 pm
Ian B makes my point so very well, doesn’t he? Just like the old Trot for whom all politics but his own is just “capitalism”, and the answer to any problems of anything which resembles his politics is “oh, that wasn’t really socialism, it was just state capitalism”. True socialism was always just round the corner, and whichever corner the socialists led us to there we were still in state capitalism with another corner to turn.
OK, so here we go
Progressivist socialism = state capitalism = real life
I welcome Ian giving me a translation into libertarianese of the term.
Ian B said...
17 Aug 09 at 4:34 pm
Matthew, I merely addressed your contention that libertarianism is “the fashionable ideology of the day”. You have two choices here; either you contend that libertarianism is the mainstream, in which case you can’t claim that libertarianism is a crazyu extreme which libertarians must defend, or else libertarianism is not the mainstream, in which case you can’t claim it is “real life”. You can’t hve it both ways, which you appear to be trying to do.
I think most people would agree that we do not live in a libertarian society. Are you claiming that we do? I would like to see Mr Brown, Mr Cameron or Mr Clegg comment on the assertion that they are libertarians. I don’t think they would agree. Do you?
Ian B said...
17 Aug 09 at 4:35 pm
Neither do I know what term you want me to translate into “libertarianese”. Could you specify, please?
Jock said...
17 Aug 09 at 4:50 pm
Then there is the elephant in the room as regards the state though Joe. In doing what it does, even if we are persuaded to like some of what it does, how much more damage does it do in other areas or even in the same areas.
We contend that welfare entrenches poverty. We may feel nice about having a system that saves people from the worst vagaries of life but even when Lloyd-George wanted to implement health and unemployment insurance only 10% of the population were not covered by private means. Between unemployment and incapacity benefit we have that much idle today.
How much does its regulations keep employers from hiring people who may then learn things and progress to better jobs? How much do its regulations entrench privilege that simply would not be possible without a state to enforce artificial rights. Even if not, people are more inclined towardss voluntarily helping those who are at least trying to help themselves, and when they do not feel that they are already paying through an enforced charity via the state – when the parish was responsible for pensions, those who were judged to have tried and failed to provide for themselves rather than those who had not bothered trying, often got up to 75% of the local aveerage working wage.
And then in other areas – it is states, not individuals, that wage war – war and associated atrocities are estimated to have cost more than 200 million lives over the last century.
And you know, one of the problems when a state does something wrong is that you are far less likely to get adequate restitution than you would if a private enterprise was did the same thing. Since we are all supposed to love the state we often get palmed off with an apology – after all, suing the state is taking more money of your next door neighbour for something someone else did. Look at the compensation for long term imprisonment after a miscarriage of justice for example.
Anarchism is multi-dimensional – we look at both what the state does ostensibly for good and claim it’s not quite as good as you make out, and we look at what the state does taht causes much of the distress that it then needs to alleviate with coercive redistribution or draconian laws.
Matthew Huntbach said...
18 Aug 09 at 9:53 am
Ian B, your comment is like saying that just because extremist Trotskyists dismissed every form of socialism that existed in practice as “state capitalism”, there was in the 1960 and 1970s no fashion for socialism, and discussion and assumptions at the time was dominated by libertarian assumptions. I myself dismissed socialism in he 1970s for much the same reason I dismiss you – too much sloppy thinking, too many people adopting it because it was the smart fashion and it could make you look clever by spouting dogma, and the worst being the extremists whose only answer to “but when something like that was tried, …” was “oh, that wasn’t real socialism”.
Anyhow, I can see it is pointless arguing with you and your type. You live in your own closed smug little world. That is why you cannot understand my point. Since it appears you lack the sense of gradation which enables you to distinguish between anyone who isn’t 100% in agreement with you, it is pointless trying to argue with you and establish a common ground and bring up cases where I think you are ignoring some concerns. Like Evangelical Christians or Islamists or Trotskyists, your position is that either you are saved by 100% accepting the message, or you are numbered amongst the damned and there’s no point in quibbling about details.
That is how you, and most other people I have argued with in this blog and others are coming across. Perhaps this way of thinking and acting does win converts, well yes that’s why the Evangelicals and the like are doing so well. But it doesn’t impress me.
So number me amongst your damned if you like, I can’t be bothered wasting any more time on you and your type.
Ian B said...
18 Aug 09 at 10:22 am
Matthew, I reiterate- my only claim was that libertarianism is not “fashionable”. If one describes something as fashionable, it inherently implies something widespread and normative. Mini-skirts in the 60s were fashionable, meaning that women in general wore them. If only a few people had worn them, they would not have been appropriately described as “fashionable”. The term also tends to imply that whatever is fashionable is normative among society’s dominant classes- again, as with mini-skirts. All the “top people” are wearing them. But again, that just isn’t true of libertarianism. It’s very hard to find any public figure declaring themselves interested in libertarianism. It just isn’t fashionable. Your accusation that it is fashionable is simply false. To say socialism was fashionable in the 60s or 70s is valid because millions of people, including many notable figures, believed in it.
Currently progressivism is fashionable. It is the dominant ideology. We are arguing for something different. I accept that you disagree with what we are arguing for, but that doesn’t make our arguments “fashionable”.
Your argument that I, or other libertarians, are purists, may or may not be true. There is a wide degree of difference between libertarians- we are like herding cats really. But the general idea is for change in a different direction. Progressivists seek greater government control and centralisation, and an imposed ideology. We are trying to argue for deregulation, decentralisation and ideological diversity. The libertarian view is that each person may believe what they like, and are only restrained in not being allowed to impose that view on anybody else. Think what you like, say what you like, worship what you like and so on.
So there isn’t a purist end-state we seek, other than an absence of one, in a sense. It’s arguing for the null position. I know some libertarians are ultra-tradiutionalist capitalists, whereas others seek the liberty to live in mutualist co-operatives. Liberty would just be a state in which either may live as they wish, subject to not imposing on their fellows.
So your argument that we are like Trots declaring that communism is never real communism doesn’t quite work. For instance, our country is pretty much religiously libertarian at the moment- you may worship how and what you wish, so long as that does not impose on others. We simply wish to broaden that principle into other areas, while observing that under progressivism that diversity is being reduced. That may be too purist to you, but I think it’s a reasonable enough intention.
It is probable that any real world system for the foreseeable future will be, as you say, some kind of “mixed”. So for libertarians it is simply a desire to change the mix towards greater individual freedom. Troskyites have a pure “system” in mind, which must be imposed, so indeed any real world structure is never pure enough for them. But libertarians are arguing for, as much as possible, an absence of such imposed systems. As such, you are like somebody in an intense theocracy arguing with a person who desires freedom of worship, by saying, “there is always a state church, you extremists will never be satisfied”. We know that religious tolerance and diversity can be attained, because it has been done in many real world countries. Libertarians are simply arguing for such diversity to be extended in other areas.
I appreciate that in your mind that makes us all extremist purists. But extremism is largely defined simply by distance from where we currently are. Much of the behaviour of our state today would have seemed like the most outrageous extremism a century ago. If my desire for each of us to live our lives as freely as practicably possible is extremist ideology then, heck, I stand guilty as charged.
Charlotte Gore said...
18 Aug 09 at 10:25 am
Your ridiculous trot analogy which you continue to depend on as your killer argument us nothing of the sort. Whether or not the trots were delusional is completely irrelevant.
Furthermore the analogy doesn’t even hold. Socialism has been tried and proven to fail. Liberalism, on the other hand, is proven to generate wealth, prosperity, improve technolgy and the quality of our lives.
In other words, you’re talking out of your arse. Again. Like when you said libertarianism was state approved paedophilia. I do wonder why anyone bothers debating with you.
Jock said...
18 Aug 09 at 11:03 am
Matthew, there is one point on which we are fundamentally opposed to each other and it seems difficult to imagine what middle ground could exist. You may want to “agree to disagree” on certain things, but we cannot agree to disagree when your system demands that we obey with the will of some “majority” (which is of course nothing of the sort anyway) or be faced with punishment.
We do not wish that on you – you can engage in as many collectivist schemes as you like; indeed I personally happen to imagine that in a stateless society there will be rather a lot of collectivist (ie mutual) schemes will swing into action to replace some of the things the state currently tries to do for us, but they will be voluntary membership arrangements of people with similar aims in a particular issue.
At the moment, you want us punished for not agreeing with your preferred way of doing things, and that is a big gulf. And it makes us very different to your ranting trots of course, who themselves wanted to punish everyone else for not doing it their way.
Matthew Huntbach said...
18 Aug 09 at 12:17 pm
In other words, you’re talking out of your arse. Again. Like when you said libertarianism was state approved paedophilia. I do wonder why anyone bothers debating with you.
Again, my point is proved very well by the fact that you clearly did not understand nor wish to engage with the concern I was raising here, so pretended it was something else completely.
Matthew Huntbach said...
18 Aug 09 at 12:24 pm
If my desire for each of us to live our lives as freely as practicably possible is extremist ideology then, heck, I stand guilty as charged.
You may desire it, it’s the claim that the politics you endorse leads to it that I contest.
Charlotte Gore said...
18 Aug 09 at 12:25 pm
There’s nothing to argue with. You’re using rhetoric, appeals to emotion, irrelevant information, non-applicable metaphors and analogies and lots of other fallacies to make your case. When you do attempt to appeal to facts, you usually prove to be misinformed at best, completely wrong at worst.
What’s to argue with?
Matthew Huntbach said...
18 Aug 09 at 12:28 pm
You may want to “agree to disagree” on certain things, but we cannot agree to disagree when your system demands that we obey with the will of some “majority” (which is of course nothing of the sort anyway) or be faced with punishment.
And your system says that when some person says “I own this” and therefore denies me the freedom to use whatever this is, I have to agree to it.
Matthew Huntbach said...
18 Aug 09 at 12:34 pm
There’s nothing to argue with. You’re using rhetoric, appeals to emotion, irrelevant information, non-applicable metaphors and analogies and lots of other fallacies to make your case. When you do attempt to appeal to facts, you usually prove to be misinformed at best, completely wrong at worst.
Well, Charlotte, this thread starts with you wondering whether “it’s ever possible, anywhere in the world, to have a rational debate about health care” and ends showing that what that means, according to you, is people saying “Yes Charlotte and fellow Libertarians, you are 100% right and I bow down to your superior knowledge and insight into the world, any thoughts and concerns I have are as nothing compared to that”.
Charlotte Gore said...
18 Aug 09 at 12:41 pm
Yeah, that sort of thing. You show us how you think and feel about what we’re saying, which is useful – but not really worth arguing with you about.
Jock said...
18 Aug 09 at 12:58 pm
And your system says that when some person says “I own this” and therefore denies me the freedom to use whatever this is, I have to agree to it.
So what is yur solution to the problem of scarce goods and conflict? In fact “our” system is not so simple really as you make out there. What it does is establish a set of norms for making a claim defensible in an arbitrated hearing.
The norm of allowing the first person who takes something to which nobody else has previously laid claim out of its natural, unowned state and made some profitable use of it to claim right of first ownership is one that does go a long way back in liberal thought too – it is not peculiarly libertarian.
Any other system, that does not at least offer a set of those basic norms against which an adjudication may be made (and it should be added that such a claim is not as straightforward as it seems – if someone has taken somethging out of nature, claimed it for itself, and then abandoned it through lack of use, it is distinctly possible that someone else could lay claim to it and win), and which, as implied by your message, says that it is okay for someone else to take and use anything regardless of who may claim ownership of it, is at the very least condoning outright theft, and at worst, communism.
Despite whatever you may think others on here were calling you, I had never thought of you as either a kleptocrat or a communist. But if you do not have such norms then it seems you might well be.
Like I say – you are very welcome, in a libertarian world, to join and seek to invite others to join some communist kleptocracy voluntarily if you like, in which no firm ideas of private property prevent anyone taking and using anything else, but don’t please foist it on us.
Matthew Huntbach said...
18 Aug 09 at 4:43 pm
… and which, as implied by your message, says that it is okay for someone else to take and use anything regardless of who may claim ownership of it, is at the very least condoning outright theft, and at worst, communism.
If you had any sort of liberal sense and concept of logical argument, you might have been able to see that I raised this as a debating point rather than as a position I hold to absolutely.
Quite obviously this is really a reductio ad absurdum, posing one very extreme and limited definition of freedom, the “property is theft” one, which lay at the basis of the most extreme and simplistic forms of socialism, to pose against your equally extreme and limited definition of freedom.
You complain in absolutist terms at one acceptance of norms for the problem of scarce goods and resources, that involving the existence of the state, but you have no problems with the other, that involving acceptance of past property deals even though this may be greatly restricting on real freedom for those who have nothing. You seem unwilling to reach a balance, arguing that anyone who isn’t 100% with your definition of freedom is 100% against it.
Charlotte calls this position “liberalism” though it is not the position of the Liberal Democrats, nor was it ever the position of the Liberal Party. I might have been more willing to move to a position closer to yours if I had some sense that you had answers to the fears I have raised, but I have no such sense. Your inability even to understand the points I am making shows that.
Alex said...
20 Aug 09 at 10:58 am
“Then again, somehow New Zealand manages to make the public transport system run on time, too. And be inexpensive. And it’s an absolutely gorgeous country”
since when has there been a re-nationalisation of public transport? if you are complaining about trains or buses running on time then you have to complain to the private companies who own them. if you forgot they were all privatised many many years ago. But maybe you are right for showing us that when the private sector get hold of something then the first thing that happens is the price goes up and the service goes down. And whilst you are waiting for your late train or bus you might want to consider how much money in bonus’ are being to paid to the top end of these companies who are making you wait in the cold. was the system better nationalised? No. But it was cheaper.
Victoria said...
26 Aug 09 at 12:11 pm
Why is an emotional response to someone belittling something which a lot of people hold close to their heart, healthcare provided to them no matter their circumstances, disheartening? You seen to forget that in every political battle there is some kind of heart behind it, people would not do or fight for things if they did not believe in them.
I am not in fear of losing the NHS although I do think it would be a really stupid thing to do to get rid of it. We’ve always known it’s had its faults and it will never be perfect, what thing is? Even Aneurin Bevan, its founder knew that. He said “We shall never have all we need. Expectations will always exceed capacity. The service must always be changing, growing and improving – it must always be inadequate.” (Toynbee, P. 2008) #WeLoveTheNHS wasn’t created so people could declare their undying love for the system. I am almost sure that most people who support the campaign could find more than one thing to complain about it. It was, as Graham Linehan its creator said, made “simply to counteract lies from Fox news and the like.” (Linehan, G 2009). What makes me mad is that people across from the pond are suggesting that our healthcare system is somehow floored for trying to afford everyone the same level and rights to health care as the person they’re sat next to in the waiting room. I personally think our system does more for human rights than theirs. At least our waiting lists and lack of service is due to weight of traffic through the doors, assessment based on need, and lack of funding and not simply because our paycheque can’t afford it.
In the U.S. if your company pays your insurance then if you get sick and can’t work then, no work means no insurance so you are essentially screwed because you have no way to pay the medical bills. That would never happen in the U.K. It would be interesting to check the figures to see how many people immigrate to the U.K. for healthcare. The U.S. should take note that yes we have the NHS but if people aren’t happy they can always get their own private healthcare as well. Which is fine for them and I am sure that if I was faced with the waiting list for treatment I may well stump up the cash to go private but for the whole thing to be private I think is inherently wrong. Look at all the other services we privatized and how they’re doing. Let’s just hope you don’t have to catch a private train to the private hospital otherwise you might find the waiting list to get on one of them is longer than the procedure you are going in for!
I agree that our healthcare could be better but if it is compared to say a country such as the Dominican Republic then it is doing spectacularly well. I once heard whilst on holiday out there that if you didn’t have private healthcare (which almost all the population did not) then all you could afford and the hospital would give you was aspirin. That is disgraceful.
Those who say they love the NHS are not uncritical. If you think of the NHS as a sibling, spouse or offspring then those who are supporting the ‘we love the NHS’ campaign are merely doing what any family member would do. Even though you find that sibling, spouse, offspring annoying at times, they have odd habits like trimming their toenails in bed, picking their nose or do things which annoy you like answering back and saying out past curfew, you still love them because when you don’t have to worry if they’ll be there to support you. They’re there unconditionally. The NHS is like that. It has its faults but if you get hit by a car tomorrow you know that you won’t have to check your pockets for change to pay the ambulance man to save your life.
Linehan, G. (2009) Granham Linehan’s Twitter Page. [Online] Available from: http://twitter.com/Glinner [Accessed on: 25th August 2005]
Tonybee, P. (2008) F or all the hyperbole, Bevan would have approved of this. The Guardian. Tuesday 1 July. [Online] Available from: http://www.guardian.co.uk/commentisfree/2008/jul/01/health.nhs [Accessed on: 26th July 2009]
Helen said...
17 Dec 09 at 9:11 pm
Jock – complaining about women receiving fertility or pregnancy related treatment – they aren’t complaining about vasectomys and prostate care.
I don’t drink, smoke or do drugs so don’t cost the nhs in that way ( nor do I complain that some people do ) -when I need support for pregnancy it should be there – even if the all knowing Jock wouldn’t need it.
The NHS needs to be protected – the problems do need to be sorted out – it is a big job but not impossible. Fear should not drive us in to the arms of private companies there to simply take our cash.
Jock said...
17 Dec 09 at 11:21 pm
The last is an illness. The second last is a lifestyle choice and no, I would not want my money to pay for that either. There is a simple way for a man to avoid causing a pregnancy and I don’t have to pay for him not to have sex. Complications of pregnancy, like illnesses like prostrate problems or breast cancer, are completely unlike fertility treatment. Complications of pregnancy et al are insurable risks, infertility is not. Nobody has a right or a necessity to have a child. And certainly not at someone else’s expense. As to whether any of these have any relationship to issues of self abuse, like smoking, drinking or drug taking, that comparison is utterly unfathomable.
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