wondering if we can’t afford the #nhs is obscene

Wondering if we can’t afford the NHS is obscene.

Any country which wonders whether it can afford or not a free at-point-of-use health service is obscene.

You could just as easily ask: “Mightn’t it be righter to let our subjects and citizens die in their front rooms and on the streets?”

You know how this goes, after all.  The trickle-down effect and its grand virtues.  (They say, I don’t know if it’s true, that it all started out as a music-hall joke …)  (It’s no longer funny, by the way – nor satire.)

Let it work its way through, they argue, and whilst some of the perishable and finite goods which are human beings may die in the process, the vast majority will eventually benefit from the crumbs which fall from the world’s high tables.

That’s the theory.

Neoliberalism

To be honest, it’s just a theory.  In fact, as far as theories go, it was never quite a theory either.  A stratagem perhaps: a way of imposing irrational, illogical and unkind rule over and against the interests of the vast majority I mention.

Any society, whatever its political mix, which argues that a person who’s ill – in the very moment they are ill – needs to submit to reams of paperwork, insurance decisions coldly taken one way or another, fears of probable personal bankruptcy somewhere down the line and a host of other matters quite subsidiary to the infirmity in question … well, any society like that has quite forgotten the meaning of human solidarity.

What it is to be human; what it is to be a social being.

I don’t mean social as in the monetising networks we attach ourselves to via devices complex and simple.

I mean social as in love; as in physical and mental touch; as in altruistic kindness.

The society we now witness, however, is different to the latter social I describe: it is obscene, self-serving and self-justifying to the max.

And whilst we continue to stand idly by, in a way, sadly, I’m afraid, we ourselves shall also mirror those obscenities.

fisking rodney on a saturday evening in june

The title’s a bit Hemingway-like I think.  Kinda reminds one of Cuba, marlins and the best bits of literary summers, recounted by the giants of the novel.

Anyhow.  Rodney’s very kindly put virtual pen to paper and argued why Labour doesn’t deserve to be in power from 2015 onwards.  This is in response – most recently – to some tweets, but also as a result of a to-and-fro relationship between us of an intellectual nature in relation to the subject of party politics and where it’s brought us.

Mainly to a standstill, I think – or, at least, that is probably how most of us currently see it.  Me too, a while ago, before I stopped blogging at 21st Century Fix (a place I’ve recently returned to, by the way – just in case you want to take another peek …).  In the thought time that not blogging very much has allowed me, however, I’ve been able to rethink some of the disgust political practice has caused in me, and it’s led me to reassert some older beliefs.

Let’s start off with the bits of Rodney’s piece I’d like to fisk.  This, for example:

Whilst it is true that the present government has been unable to achieve all it wanted to achieve – indeed all it said it would achieve – I do not agree that they have done all that badly. […]

This I would agree with, thought not as he might think: this government’s main priority was to remove all vestiges of successful English socialism from the face of the United Kingdom.  By hollowing out, selling off and/or dismantling the NHS and Legal Aid services, they’ve made a highly successful bid to destroy clear evidence that the English were quite capable of making pragmatic socialism work.  In their own terms, then, they’ve not just not done all that badly: they’ve actually done overwhelmingly well (especially with their lapdogs, the BBC, manifestly in tow).

Rodney continues his paragraph in the following way:

[…] A profound truth (assuming I am right) is that governments are really not all that powerful. Whether we like it or many large global corporations can do more things that effect the everyday life of each and all of us than can the government. […]

This, I’m afraid, is disingenuous in the extreme: whilst in a sense it’s true that large global corporations can do more things than governments, the reality is actually that what they do, they are able to do precisely because they do it through governments.  Via lobbying activities of all kinds, expensive and permanently focussed in-house legal teams, agenda-setting think-tanks, direct sponsorship of political parties and representatives and a whole host of other means – both nudging and blatant, both covert and overt – global corporations do so well at affecting our lives precisely because they use government so effectively as an extension of what they judge are their interests.  Now if only we could do the same, then governments really would be powerful bodies.  As it is, they are stuffed with business agendas of all kinds to the extent that they simply replicate the interests of those whose interests sadly no longer coincide with so many of ours.  To be honest, part of the gameplan is surely that: to convince us that governments as we have them must inevitably be unrepresentative of our interests.

And so we continue, from within, to undermine the very idea of representative democracy and its possible rehabilitation.

Rodney’s next paragraph touches on the market.  Here he suggests (the bold is mine):

Probably the most significant increase in the cost of living for many people has been the increase in the cost of power. This was way outside the control of the government as it was caused by one such global event. Mr Milliband has realised that this is having a serious impact on many people and so would like to regulate energy prices. That would, in my view, be a disaster (every time any government of any colour tries to control market forces they face innumerable unintended consequences which usually hit the very people they are trying to help).

Again, this is disingenuous.  Governments control market forces very cleverly: when they want, are encouraged to or have an incentive such as the retaining of their political power.  Through all kinds of legislation and international trade treaties, which even as I write are being drafted behind what those responsible would prefer to remain very closed doors, and at the beck and call of those who know how to get governments to represent their interests (Rodney’s already-mentioned global corporations), the real free market and all its ideals have been transmogrified into the corporate capitalism we have now: yes, it may deliver big products and services but it certainly doesn’t allow for the mystical free market to be unleashed for the good of all us citizens.  In truth, it’s easy to control market forces.  It only gets difficult when it involves controlling the actions of the big for the benefit of the small.  Mainly because the big then use a rising gradient of diplomacy, coercion and – ultimately – blackmail to get governments to do what they want.

Always in the name, you’ll notice, of the free market too.

Rodney now moves on to wealth creation and the need to reward those who supposedly create such wealth:

[…] If the UK is a difficult place in which to create wealth, those who have it in them to do just that will find somewhere else in which to do it.

It follows that to encourage the creation of wealth we need to reduce the regulations on the wealth creators and create a tax system which is as benign to business as possible. Everything that the present Labour leadership says demonstrates that they just do not understand how business works.

And again, here I would charge Rodney with being utterly disingenuous.  Labour, or at least that bit which exactly Ed Miliband occupies, understands very well how bad business (abusive energy cartels; feral media empires; murky payday-loan offshoots of a banking sector, stopping at nothing to pursue its deregulating instincts) operates in our latterday society.  And if we want real wealth creators to flock to Britain – or even, God forbid, to arise from within – we need a different kind of business culture where ideas, innovation, their professional implementation and behaviours which choose probity over the instinct to fraud replace the rentier capitalism that Rodney seems to approve of.

We move on, then, to conflating being ultra-rich with being a wealth creator:

[…] What right have they to have these wonderful lifestyles when millions are far worse off?

There are two answers to that question.

The first is that generally speaking they have earned it. The days of vast inherited wealth are over – we are talking about are people like David and Victoria Beckham, Richard Branson and, of course, those who by some means (not all admirable) have become ultra-rich.

This is absolutely unreasonable: being one doesn’t mean you are the other.  Just because you have access to large amounts of money doesn’t make you a wealth creator.  There are plenty of ways of letting money sit burning holes for the benefit of mainly a privileged minority, without one wishing (or caring) (or knowing how) to make it work hard.  (The examples Rodney gives are a mixed bag I shan’t take issue with, but I can think of a bunch of millionaire Cabinet ministers who right now are doing very little to create anything at all except fear in the most defenceless our society can contemplate.)  (Millionaire ministers who have inherited their wealth, by the way …)

Conversely, just because you want – and are able – to be a wealth creator doesn’t mean you need to be ultra-rich.  I really fail to understand (have done so for decades now) why our society believes that to make a rich person work harder, they need to be allowed to become personally far richer – even as, in order to face down their working days and participate constructively in democracy, their workforces need to fear the knock of the bailiffs at the front door and the doctor’s inevitable diagnosis of costly infirmity.

It’s a highly focussed, highly partial, fear we using to line our societies with; a fear we believe we need in order to keep the poor under control; in order to prevent the poor from becoming wealth creators themselves – as if they weren’t wealth creators already!  After all, who makes the widgets the sales of which add to the cash piles that pump up the shares of Rodney’s blessed global corporations?  And in a continuous improvement and “lean” business environment, who – if not the humblest worker – is responsible for each and every addition to company efficiency, ingenuity and craft?  So don’t tell me the workers don’t create wealth.  In modern company structures, they’re the very first to do so.  Every day of the damn working week that they fear the energy tariffs, the hospital bills, the food shop, the mortgage payments – and the terrifying final entrance of those bailiffs.

*

Rodney concludes thus:

Really, I suppose that what I am saying is that party politics as we have then are no longer fit for purpose.

And yes, even just a few months ago I would’ve agreed.  But now I see no alternative.  His Coalition government, a government which “hasn’t done so badly”, has tied up in knots huge swathes of extra-parliamentary activity in the periods before general elections, so that an organisation which isn’t inscribed by political parties will be very very difficult to make work.  His Coalition government, and its broadcasting arm the BBC, a corporation we have no choice but to fund on pain of criminal prosecution (tell me, if you can, where in the world government propaganda is paid for by the voters it’s designed to confuse), has smothered mainstream news of the sell-off of the NHS; of the suffering disabled people have undergone due to a series of deliberately targeted measures; and of the impact the unnecessary dismantling of Legal Aid will have on us all.  And in truth, his Coalition government, an agreement between two leaders who have carried their spineless rank and file before them, who under the guise of serious global dislocation have carried out a neoliberal agenda like none we have ever seen before in the UK, is what really isn’t fit for purpose here.

They want us to believe the system is beyond recovery.  I want you to understand it’s the people we need to change.

And for this reason, and only this, I believe in the round that towards today’s Labour Party many such good people are gravitating; imperfectly it is true, but with a desire to make this system, any system, whatever we’ve got, whatever we have to operate with, whatever is still left to us, work to better the lot of us all.

Before, dearest Rodney, it’s too late.

so this is why hospitals must be made easier to close – payg healthcare

Nuffield was once a wonderful source of inspiration for me.  I studied, if I remember rightly, its Physics syllabus of practical and experimental learning.  Today, however, this admiration for everything it stood for has collapsed in a heap of conceptual ashes.  I’m talking about this healthcare flyer which came through my letterbox.

Nuffield health flyer

The headline reads as follows:

Get affordable pay-as-you-go healthcare when you need it.

It then goes on to say:

Healthcare that lets you get on with your life

You don’t need healthcare insurance to get all the advantages of private healthcare.  With pay-as-you-go healthcare from Nuffield Health Chester Hospital, you can get the treatment you need when you need it.

The affordable alternative

Pay-as-you-go makes private healthcare far more accessible.  A simple, one-off payment covers everything, with no hidden extras.  You may also be eligible for interest-free credit, so you can spread the cost without paying more.

Yippee!  Interest-free credit!

No wonder Jeremy Hunt wants to acquire the power to easily close down local hospitals.  With the likes of Nuffield Health Chester Hospital and their PAYG plans around, who in their right minds would voluntarily move from a competent free-at-point-of-use system to a PAYG equivalent – however private?  Unless, of course, your local hospital simply disappeared …

More from Nuffield on PAYG hospital treatments (plus prices, of course, via a drop-down menu) can currently be found here.  As one example of this PAYG wonder, cataract surgery at the Chester location costs as follows:

Patient Pathway Initial Consultation Pre-assessment Main Treatment Post-Discharge Care Total Cost:
£2440
Hospital Fees No charge Included Included Included
Consultant Fees £150 Included Included Included
Guide Price Guaranteed Price
Cost £150 £2290

The disclaimer does run as follows, mind:

The price displayed for your initial consultation is a guideline only as Consultant fees vary according to their own individual fee schedules. The price displayed above however for pre-assessment, main treatment and post-discharge care is guaranteed and inclusive of all costs.

So anyhow, what do you think about the prospect?  This world where ideological government can close your nearest NHS hospital at the drop of a surgeon’s mask, obliging you to fork out two and a half thousand quid or face encroaching loss of sight …

I mean, is this really what the British public actually thought they were letting themselves in for when they allowed the Coalition to come to power?  PAYG healthcare?

Oh, and as a final by-the-by, this flyer was delivered to an area of staunch social housing.  Just imagine what you’ll be getting in the leafier parts of Chester: contract varicose veins, anyone?