medicine

Trotsky on the Failure of Capitalism

I found this quote from Trotsky on how capitalism has now outlived its usefulness as a beneficial economic system in Isaac Deutscher and George Novack, The Age of Permanent Revolution: A Trotsky Anthology (New York: Dell 1964):

Capitalism has outlived itself as a world system. It has ceased to fulfill its essential function, the raising of the level of human power and human wealth. Humanity cannot remain stagnant at the level which it has reached. Only a powerful increase in productive force and a sound, planned, that is, socialist organisation of production and distribution can assure humanity – all humanity – of a decent standard of life and at the same time give it the precious feeling of freedom with respect to its own economy. (p. 363).

I’m not a fan of Trotsky. Despite the protestations to the contrary from the movement he founded, I think he was during his time as one of the leaders of the Russian Revolution and civil war ruthless and authoritarian. The Soviet Union under his leadership may not have been as massively murderous as Stalin’s regime, but it seems to me that it would still have been responsible for mass deaths and imprisonment on a huge scale.

He was also very wrong in his expectation of the collapse of capitalism and the outbreak of revolution in the Developed World. As an orthodox Marxist, he wanted to export the Communist revolution to the rest of Europe, and believed that it would be in the most developed countries of the capitalist West, England, France, and Germany, that revolution would also break out. He also confidently expected throughout his career the imminent collapse of capitalism. This didn’t happen, partly because of the reforms and welfare states established by reformist socialist parties like Labour in Britain and the SPD in Germany, which improved workers’ lives and opportunities, which thus allowed them to stimulate the capitalist economy as consumers and gave them a stake in preserving the system.

It also seems to me that capitalism is still actively creating wealth – the rich are still becoming massively richer – and it is benefiting those countries in the Developing World, which have adopted it, like China and the east Asian ‘tiger’ economies like South Korea.

But in the west neoliberalism, unregulated capitalism, certainly has failed. It hasn’t brought public services, like electricity, railways, and water supply the investment they need, and has been repeatedly shown to be far more inefficient in the provision of healthcare. And it is pushing more and more people into grinding poverty, so denying them the ability to play a role as active citizens about to make wide choices about the jobs they can take, what leisure activities they can choose, and the goods they can buy. At the moment the Tories are able to hide its colossal failure by hiding the mounting evidence and having their hacks in the press pump out favourable propaganda. But if the situation carries on as it is, sooner or later the mass poverty they’ve created will not be so easily hidden or blithely explained away or blamed on others – immigrants, the poor themselves, or the EU. You don’t have to be a Trotskyite to believe the following:

Unfettered capitalism is destroying Britain – get rid of it, and the Tories.

Yasmin Alibhai-Brown on the Economic, Academic and Social Costs of Brexit

Published by Anonymous (not verified) on Thu, 16/01/2020 - 9:17pm in

Yasmin Alibhai-Brown issued another stinging attack on Brexit in the I yesterday. She sharply criticised the Brexiteers triumphalism, that made them demand the mass celebration of Britain’s departure from the EU with a ‘festival of Brexit’, churches ringing their bells up and down the country, street parties and ‘a big, fat, jingoistic party in Parliament Square on January 31st’. She compared the proposed celebrations with the forced, state-mandated festivities of North Korea, and quoted the Roman satirist Juvenal on how the rich distracted the plebs with bread and circuses while taking away their liberties. She also bitterly complained about the way Remainers were now seen as somehow treacherous for their rejection of this wave of jingoism despite the closeness of the vote in the referendum. But she also made very good points about the immense cost Brexit had already inflicted on our economy, education, and society. She wrote

According to a detailed report by ratings agency S&P, Brexit has already cost the economy £66bn. It calculates that the amount is more than we paid into the European Union for 47 years. The economy is stagnant. The Union  of the four nations may not hold. Migrants and black, Asian and minority ethnic Britons are experiencing more hostility. Complaints are met with increased hostility or disbelief. Universities are panicking about the potential loss of EU grants and the Erasmus+ scheme – a travel bursary for young people which enriched their lives.

Musicians and artists are losing essential EU connections. Care homes cannot get workers because EU citizens are leaving. Too many feel unwelcome or are discouraged by new, costly and unfair immigration rules. NHS workers from elsewhere are becoming disillusioned.

She then describes how an Asian friend, Priti, told her about the increasing racism she was experiencing.

My friend Priti, a nurse who came over from India five years ago, says: “This is not the country I came into. Not the place my parents loved when they studied here. It has become so impolite. Even when I am changing a bandage or putting drops in their eyes, some patients shout at me to go bac. My colleagues are great but I am going – I have a job in Dubai. They need us but don’t behave well.”

We need these foreign nurses and doctors, who do an excellent job caring for our sick. It’s disgusting that they should be treated with such contempt and abuse.

Brexit is wrecking our economy, placing the Union under potentially devastating stress, and impoverishing our education system, our arts and culture, and denying needed expertise and labour to the NHS. But somehow we are meant to celebrate all this as a victory for Britain.

Alibhai-Brown herself says that Remainers should follow Will Hutton’s advice, and light candles on 31st January before going back to Brexit. She says that we must, for the sake of the younger generation and the future of this once-formidable nation.

I don’t think we can reasonable go on opposing Brexit forever without isolating ourselves politically. But I think we should be trying to get the best possible deal with the EU and trying to forge lasting, beneficial links with it.

While pointing out that so far, it is a massive, astronomically expensive failure.

Austerity and Prison Violence

Published by Anonymous (not verified) on Wed, 15/01/2020 - 11:37pm in

A week or so ago Mike put up a piece reporting and commenting on the death of a disabled man in prison. From what I remember, like many such instances the man’s own special needs had been ignored and he was actually in prison for a minor offence. At least, one that should not merit his murder. Mike connected this to the Tories’ ongoing campaign of mass murder against the disabled.

In fact, violence, including self-harm, has risen massive in British jails since the Tories launched their wretched austerity. Joe Sim has authored an entire chapter on it in Vickie Cooper’s and David Whyte’s The Violence of Austerity. Sim has his own particular view of the crisis. He considers that prison violence hasn’t itself been created by austerity. It’s always been there, and is part of society’s brutal maltreatment of the poor and marginalised. But it has been massively intensified by the Tories’ cuts.

The stats are horrifying. Between 2011 and 2016, sexual assaults almost doubled. In 2014-15 there were over 400 serious incidents requiring the intervention of the specialist National Tactical Response Group, In 2015 an average of 160 fires were started each month. Self-harm rose by 40 per cent in two years, so that in 2015, 32,313 incidents were recorded.

321 died in the year to June 2016, an increase of 30 per cent on the previous year. 105 of these were self-inflicted, a rise of 28 per cent. Deaths by natural causes rose by 26 per cent to 186. Between January 2010 and December 2016, 1637 prisoners died, 542 of which were self-inflicted.

In 2015-15 there were nearly 5000 assaults and acts of violence against the different groups of people working in prisons. These included 423 on prison officers below the rank of principal officer, 828 on nursing auxiliaries and assistants, 640 on nurses, 535 on care workers, and 423 on welfare and housing associate professionals.

Sim states that to many commentators, including the media, Prison Officers’ Association and mainstream politicians, the cause of this increased violence are the cuts to the prison budget. These amounted to £900 million between 2011 and 2015, or 24 per cent of its overall budget. The Prison Reform Trust said that it was

[n]o mystery that violence, self-harm and suicide rise when you overcrowd prisons, reduce staff by almost one third, cut time out of cell and purposeful activity. The backdrop is a more punitive climate, increased injustice and uncertainty which have sucked hope out of the system for prisoners and staff.

I’m not disputing that very many of those incarcerated are guilty of the most heinous offences, and fully deserve their incarceration and punishment. But it is very clear that austerity has resulted in a massive deterioration in conditions which fueling violence in prisons against staff and prisoners. There’s obviously a long and complicated debate about the purposes of prison – to punish, reform, or even both – but it is clear that neither staff nor prisoners deserve the maltreatment and violence the cuts have generated.

This isn’t reformative. It isn’t proper punishment. It is carnage.

But the Tories just love killing and death when it’s directed against the poor and powerless.

‘I’ Article About Research into Artificial Wombs and their Morality

This is another science story from yesterday’s I for 7th January 2020. It’s about current research into developing artificial wombs. At the moment, these would be for very premature babies, but they could in theory go much further, which raises some serious ethical issues.

The article by Alla Katsnelson, ‘Baby in a bag: could humans be grown in an artificial womb?’ runs

Critically preterm babies face an uncertain future. Although a foetus is considered viable at 24 weeks of gestation, only about 60 per cent of babies born so young will survive, and many will experience life-long complications.

For those born a couple of weeks earlier, the statistics are even more dire: just 10 per cent of babies born at 22 weeks are likely to survive.

building a so-called artificial womb could potentially save these babies. In October, researchers from Eindhoven University of Technology in the Netherlands announced that they had received a grant for E2.9m (£2.5m) to develop a prototype of such a device. But the project isn’t the only artificial womb on the horizon. In 2017, researchers in Philadelphia transferred foetal lambs, aged between 105 and 115 days of gestation (equivalent to about 28 to 30 weeks human gestation), into a so-called biobag filled with artificial amniotic fluid. After several weeks in the bag, the lambs developed normally. And in March 2019, an Australian and Japanese research team kept younger lambs, about 95 days’ gestational age, alive in a different system.

Dr Matthew Kemp, who led the latter work, admits that researchers don’t fully understand foetal growth in the womb, which makes replicating it a challenge. The Dutch group noted plans to roll out a clinic-ready prototype in five years, but Dr Kemp says it will probably take much longer. And because the technology is so costly, it’s unlikely to be widely available any time soon.

So far, what researchers call artificial wombs are essentially souped-up incubators. They provide a fluid-filled space in which a foetus can receive nutrients and oxygen through a ‘placenta’. From there to full-on ectogenesis – incubating foetuses outside a human for the full duration of a pregnancy – is an enormous leap.

But many bioethicists note that technology moves quickly, and proactively thinking through the possibilities is important.

In this more futuristic vision, artificial wombs can do a lot for society, says Dr Elizabeth Yuko, a bioethicist at Fordham University in New York. It could allow people who can’t carry a pregnancy for whatever reason – illness, infertility, age, or gender – to do so. It might also shift some of the childbearing responsibilities carried by women. But it also raises concerns. For example, ex-utero gestation would probably turn reproductive rights on their head, says Elizabeth Chloe Romanis, a lawyer and bioethicist at the University of Manchester. If a foetus can gestate outside a woman’s body, the choice fo whether or not to have the baby might be deemed out of her hands.

Another issue is that our legal rights are predicated on having been born alive. “I don’t think that a gestating subject in an artificial womb necessarily meets that requirement,” says Romanis. “That raises some questions about human entities ex-utero that have never existed before.

There have been newspaper articles about the development of artificial wombs since the 1980s, at least. The Absurder published one c. 1985, and I think the Independent also published one in the 1990s. And the whole area of artificial reproduction has been a live issue since the first ‘test tube’ baby created through in vitro fertilisation in the 1970s. But it also raises the spectacle of the kind of dystopian society Aldous Huxley portrayed in Brave New World, where humans are bred in hatcheries, engineered and conditioned for their future role in society. The Auronar, the telepathic race to which Cally, one of the heroes of the Beeb’s SF series, Blake’s 7, also reproduced through artificial gestation.And one of the predictions in Brian Stableford’s and David Langford’s future history, The Third Millennium, is that during this millennium this will be the preferred method of human reproduction, at least in some extraterrestrial colonies. And over a decade Radio 4 broadcast a series in which various intellectuals created fictional museums. One was ‘the museum of the biological body’, set in a post-human future in which people were neuter cyborgs born from hatcheries. This is obviously very far off, and I doubt anywhere near the majority of humans would ever want to reject gender and sexuality completely, whatever certain sections of the trans community might believe.

As with cloning and Dolly the Sheep, it raises very profound and disturbing questions about humanity’s future and how far technology should expand into the area of reproduction.

Privatisations Not Nearly as Popular as Maggie and the Tories Claim

Published by Anonymous (not verified) on Sat, 04/01/2020 - 2:27am in

I found this extremely interesting snippet in Oliver Huitson’s chapter on the way the media, including the Beeb, promoted the Tory privatisation of the NHS in Jacky Davis and Raymond Tallis’ NHS – SOS. Huitson states that despite the massive media bias and their highly distorted reporting, there was a sizable chunk of the British public that fully understood the issues involved and did not like it one little bit. He goes on to write that trust in politicians is at an all time low – 19 per cent of people trust them, just two per cent above journos at 17 per cent (p. 171). And then there’s this passage in which he explains that privatisation wasn’t as nearly as popular as Thatcher and her poodle press claimed:

It should also be remembered that the public have now had thirty years’ experience of the privatisation of state assets and services, as well as the rhetoric that accompanies such moves, and they are increasingly cynical about the purported aims and efficacy of such ‘reforms’. Margaret Thatcher spent millions of pounds marketing her privatisations to the public, yet polling revealed that support for this policy never rose above 50 per cent. In the wake of the Iraq War, the expenses revelations, the financial crash and the phone-hacking scandal, public trust in the political class as a whole, including in the national media, is extremely low. (p. 172).

For the past forty years we’ve had it rammed down our throats that privatisation was not only necessary, it was massively popular. Everyone was right behind Maggie and Major on the issue, and if you weren’t, you were an evil Commie. But like neoliberalism and austerity generally, it’s a massive lie.

No wonder the Tory media are now screaming that Labour lost because Corbyn was ‘too far’ left, and only a return to Blairism will make the party popular.

Systems of Forced Labour: Workfare and the Nazi Concentration Camps

Published by Anonymous (not verified) on Tue, 31/12/2019 - 10:42pm in

I had yet another book catalogue come through the post the other day, this time from PostScript. One of the books listed is a historical study of the informers, who snitched on Jews in Nazi Germany, Who Betrayed the Jews? The Realities of Nazi Persecution in the Holocaust, by Agnes Grunwald-Spier (Amberley 2017). The catalogue’s description of this book runs

In The Other Schindlers Agnes Grunwald-Spier wrote of the many unsung individuals who helped the Jews during the Nazi persecution; in this study she uncovers the individuals and groups who betrayed them. Quoting extensively from survivors’ accounts, and in sometimes shocking detail, she examines betrayals made for ideology or greed, but also the ‘commercial betrayals’ by the railway companies, who transported Jews and the industries that used forced labour, and the betrayals made in fear and desperation.

The SS in particular exploited skilled Jewish labour for commercial profit. They used Jewish artisans and craftsmen to manufacture a range of goods available for purchase, even bringing out a catalogue of such items. At the same time, during Stalin’s purges Soviet industries also encouraged the arrest of workers and technicians for their use, even sending the KGB lists of the type of workers they needed.

I’ve blogged before about the similarity between these systems of totalitarian slave labour and the Tories’ workfare, in which the long term unemployed are forced to do voluntary work in order to prepare them for getting a real job. This actually doesn’t work, and it’s been found that you’re actually more likely to get a job through your own efforts than from workfare. And it has been used to prevent skilled individuals doing the voluntary work they want, as a geography graduate found. She had arranged to work in a museum, but the workfare providers decided she had to stack shelves in a supermarket. So she took them to court, and won.

Others haven’t been so lucky. The Violence of Austerity by Vickie Cooper and David Whyte contains a chapter, ‘The Violence of Workfare’, by Jon Burnett and David Whyte, which describes how exploitative workfare is, using figures and testimony supplied by Boycott Workfare. Benefit claimants were frequently humiliated, forced to work in unsafe conditions with inadequate equipment to safeguard their health. Many were forced to do work that was medically unsuitable for them. One worker said

[I[ [w} to work as a volunteer. Made to feel like a slave. Unsafe working conditions i.e. H and S [health and safety] and Fire regulations breached. Told to leave because I complained and took pictures of the unsafe conditions. (p. 63).

Another said

I can’t stand or walk for more than 10 minutes and have severe stomach illness that means when I eat I’m in agony half an hour until 4 hrs after. They may as well have sent me a death sentence. (p. 64).

One man provided a particularly full description of his experience.

They made me work without safety boots for the first week and without a protective jacket. All day was hard labour 9 -5 pm. ~All day I either had to move wood or clean their place. Or they would send me with other people to places to clean houses and back gardens which they would get money for. They claim to be a community place but didn’t see them help anyone. I told them of my back pain and they just ignored it; they didn’t care. Also another business these people had was to charge local people money to pick up their rubbish and then sell it at their place. We were the ones who had to go to pick up the rubbish and there were many hazards. The truck we went on had not seat belts – just disgusting practice. (Same page).

Now let’s not exaggerate. There are obviously profound differences between the Nazi and Stalinist systems of forced labour and workfare. No-one in this country is forcing the unemployed into camps and gas chambers. But workfare nevertheless is part of a system of austerity that has killed over 130,000 people, despite the Tories’ denials.

It is exploitative, doesn’t work, but it supplies cheap labour to their corporate donors and allows them to claim falsely that their doing something about unemployment.

All the while humiliating the unemployed and the sick, and further endangering their health and wellbeing.

Which is how the Tories want it.

Tories Going Ahead with NHS Privatisation

Published by Anonymous (not verified) on Tue, 31/12/2019 - 10:07pm in

Here’s another broken promise from Bozo the Clown Prime Minister – but it’s one everyone on the left knew very well was going to happen. Johnson’s going full ahead with the Tory privatisation of the NHS, despite Tory claims that we still have a publicly-owned healthcare system that’s supposed to provide care free at the point of use.

Mike reported a few days ago that Johnson’s government has drawn up a new framework for the NHS, the NHS Shared Business Services in which hospital trusts will buy services from a list of private companies. The services put out for tender include cardiology, gynaecology, paediatrics and oncology. That means it also covers children’s medicine and cancer care. The report Mike cites, at MirrorOnline, says it could mean services worth £117 million being contracted out over four years.

As Mike points out, we don’t have a system of universal healthcare anymore, as the private firms that supply the NHS with some services don’t cover the whole country. He also states clearly that it isn’t free at the point of use, as Tory policy is intended to make patients, who aren’t able to get proper NHS funded care are supposed to go private. Meanwhile, other NHS services are being starved of cash for the government to fund the private healthcare companies they’ve allowed into the NHS.

See:  https://voxpoliticalonline.com/2019/12/29/when-is-a-public-health-service-not-a-public-health-service-when-its-run-by-tories/

The Tory claim that this is private expertise making the NHS more efficient is a lie. Private healthcare is actually less efficient. It does not adequately cover – if at all – the poor and those with long-term health problems. Private hospitals are typically smaller than NHS hospitals. They’re also far more bureaucratic. About 10 per cent of private healthcare costs are management, though this can rise to 40 per cent. In America, something like 20 per cent of the American public can no longer afford their private health insurance. 40,000 people die every year because they can’t afford medical care. In Virginia, people actually sleep out in their cars for the weekend when the dentists offer their services free.

This is what will come to Britain if the Tories and Johnson have their way and run down the NHS completely. They do want it to become a second class service for the poor, who cannot afford private medicine. Or else introduce the American system, where everyone is supposed to go private, but there is medicare and medicaid to provide some limited care for the poor and elderly. Or else people can seek treatment at the local hospital’s Emergency Room.

Don’t believe the Tories’ lies – they are privatising the NHS purely for corporate profit. And Britain’s people will suffer.

Outrage as Iain Duncan Smith Given Knighthood

This is a really sick joke, and shows the absolute contempt the Tories have for the poor, the unemployed and the disabled. Iain Duncan Smith, the architect of the Tories welfare reforms, has been given a knighthood in the New Year’s honours. Smith is the pompous nonentity who was briefly the leader of the Tory party at the beginning of this century before David Cameron took over. It was a period of failure, in which the party utterly failed to challenge Blair’s Labour Party. He was, however, a close ally of his successor, and has also served Boris. He tried to stand up for Johnson when our farcical Prime Minister was denied the lectern in Luxembourg, claiming that the Luxembourgers should be grateful to us because we’d liberated them during the War. But we hadn’t. The Americans had. And under Tweezer he’d also peddled the line that there would be no legal divergence between Northern Ireland and the rest of the UK.

But what Smith is most notorious for is mass murder. As head of the Department of Work and Pensions, he was responsible for the welfare reforms, including the Work Capability Assessments and the system of benefit sanctions, that have seen hundreds of thousands denied the welfare payments they need and deserve. He is also responsible for Universal Credit and Personal Independence Payments. UC is supposed to combine all the welfare payment into a single system. It has proven catastrophically flawed, with people waiting weeks or months for their payments, which have been significantly lower than the previous system. Mike in his article about it quotes statistics that some of those on UC are £1,000 a year worse off. But this jumped-up, odious little man boasted that Universal Credit would be as significant in lifting people out of poverty as the ending of slavery in the British Empire in 1837.

The result of IDS’ reforms is that at least 130,000 people have died. The true figures may well be higher, as the DWP has been extremely reluctant to release the true figures, as Mike and other disability campaigners have found. His attempts to get the Department to release them under the Freedom of Information Act were refused, then stonewalled. Finally Smith’s Department released some figures, but interpreted his requested so that they weren’t quite the figures Mike had requested.

As well as the financial hardship there is the feelings of despair and humiliation that his reforms have also inflicted on the poor. Doctors and mental health professionals have reported a rise in depression and suicide. The Tories, naturally, have repeatedly denied that their policies have any connection to people taking their own lives, even when the person left a note explicitly stating that this was why they were.

Some sense of the despair IDS’ wretched reforms has produced in young people is given by the quotes from them in Emma Bond and Simon Hallworth’s chapter, ‘The Degradation and Humiliation of Young People’ in Vickie Cooper’s and David Whyte’s The Violence of Austerity. ‘Julie’ said

The way that it feels walking into the JobCentre is that you are there to do what you are told to do and that’s it and then you leave. They are not there to actually help you it is just like, you have to do this and if you don’t do this or you won’t get no money. (p. 79).

And ‘Bridget’ described how she felt so low at one point she contemplated suicide.

I am ashamed to admit it but I did feel suicidal at one point. I felt so down after I was made redundant that I felt that there was no point. I had worked really hard at school and I got good grades but for what? I was happy when I got my job, it wasn’t that well paid but it had prospects and a career path – or so the recruitment agency told me – I had my flat and that and I thought I was OK. But when it [the redundancy] happened I felt like I had been hit by a brick wall. I got really down especially when I went to the JobCentre and they would not help me. I felt so depressed. I could not afford my rent. I lost my flat and the few things I had saved up for. I did not know where to turn. I took drugs for the first time in my life – I felt so wretched. I wanted to die. I was too ashamed to tell my parents that I had lost my job. (p. 80).

But IDS, as Zelo Street reminds us, is the man who laughed at a woman talking about her poverty in parliament. He’s also blubbed on television, describing how he met a young woman, who didn’t believe she’d ever have a job. ‘She could have been my daughter!’ he wailed. But this is just crocodile tears. He, like the rest of the Tory party, have no love whatsoever for their victims as the guffaws with Dodgy Dave Cameron in Parliament showed.

Mike in his piece about the wretched man’s ennoblement has put up a large number of Tweets by ordinary people expressing their outrage. One woman, Samanthab, states how rotten the honours system is when it rewards not just IDS, but other creeps and lowlifes, like the sex abusers Jimmy Savile, Stuart Hall and Rolf Harris.

The outrage is so great that one NHS psychiatrist, Dr Mona Kamal Ahmad, has launched an online petition at Change.Org calling for the scumbag’s knighthood to be withdrawn. She describes him as responsible for some of the cruellest welfare reforms this country has ever seen and notes that Britain is the first country the United Nations has investigated for human rights abuses against the disabled. She states clearly that the suffering and impoverishment in Britain today is a direct result of Smith’s welfare reforms.

30,000 people, including myself, have already signed it. If you want to too, go to Mike’s article at: https://voxpoliticalonline.com/2019/12/28/will-you-sign-nhs-doctors-petition-to-stop-iain-duncan-smith-receiving-knighthood/ and follow the links.

See also: https://voxpoliticalonline.com/2019/12/27/chorus-of-derision-greets-announcement-that-iain-duncan-smith-is-to-be-knighted/

https://zelo-street.blogspot.com/2019/12/arise-sir-duncan-cough.html

Private Medicine and the Demand for the Privatisation of State Medical Care

Published by Anonymous (not verified) on Tue, 17/12/2019 - 11:02pm in

The book Health Reform: Public Success – Private Failure also makes it clear where the demands for NHS and the privatisation of other systems of state healthcare come from: the private medical sector, including the insurance industry. The book states

Arguments for private markets in health care are not only persistent, and resistant to both analysis and evidence, but they also come forward from the same groups of people. Again over the decades, and across countries, one finds the same arguments for private organization and funding coming from spokesmen for private practitioners’ associations – physicians, dentists, pharmacists – as well as from private insurance companies and drug manufacturers. In addition they tend to come, as noted above, from representatives of ‘business’ and, more recently, from ‘ideological entrepreneurs’ that support themselves and their organisations by championing the interests of the wealthy, cheerleading for the private marketplace. Indeed, they are simply taking advantage of the general ideological climate, currently more favourable to re-open old issues. (p. 28).

‘Ideological entrepreneurs’ seems to be another term for right-wing thinktanks and astroturf pressure groups.

The book states that in contrast with hospital workers, who want to see cheap or free medical treatment provided to the poorest, the private sector is interested in maximising its income.

Hospital workers, whose patients/clients tend to be very ill and/or have very limited resources – the unhealthy and unwealthy – are generally very supportive of public payment systems. Their opportunities in a private marketplace would be quite limited. But they do not support hospital ‘downsizing’ or containment more generally; the ideal policy would be more money from public sources, to hire more highly trained and better paid staff….

The loud voices for privatisation, by contrast, come from those who believe that they could do better, in the form of increased sales of or higher prices for their products and services, in a more entrepreneurial environment. It is not clear how many, if any, of these would support a truly private system, with no direct or indirect contribution of public funds. The economic mayhem among providers would be truly awesome. Instead what seems to be contemplated is a continuation of public support on a large scale, but without limits on private fee setting or delivery, or private insurance – rather like the United States, in fact, before more widespread ‘managed care’. 

This sounds very much like the thinking behind the privatisation of NHS services – private healthcare providers supported by the state – and Trump’s intention to open up the NHS to American private healthcare firms and remove the NHS’ price fixing mechanism keeping drug prices as low as possible.

NHS privatisation is all about private profit, not public care or the provision of health services at minimal cost. Don’t fall for the rhetoric of the Tories or Blairites in Labour. Get rid of it, and them.

Private Clinics Are Not Better Than Those Run by the State

Published by Anonymous (not verified) on Tue, 17/12/2019 - 10:22pm in

Here’s another vital little snippet on the failure of private healthcare to give adequate provision to society generally from the book Health Reform: Public Success – Private Failure, by Daniel Drache and Terry Sullivan, eds. This discusses the Canadian experiment in expanding healthcare provision by including private clinics. It states

Advocates for private clinics argue that they enhance access and supplement an over-strained public system. The evidence for such claims is mixed to dubious; they tend to reduce to ‘more is always better’. If government cannot or will not pay for more, then private individuals must. Our concern here, however, is to emphasize that whatever the effects of ‘more’ on the health of Canadians, all the privatization initiatives and supporting arguments involve a transfer of income, through higher prices as well as higher volumes of care, from payers to providers. But even if there were no restrictions on extra billing or private facilities, there are likely to be limits on ‘what the market will bear’ in private charges, particularly in the presence of a free public system. Denigrating or inhibiting access to that system can assist in recruiting private patients, but could also trigger a political backlash if people begin to see ‘their system’ as being sabotaged. (p. 38).

Blair wanted to expand the NHS through the construction of health centres or polyclinics, which would be privately run. And the Tories are running down the NHS in order to privatise services at one level and encourage more people to go private at another. Hence Boris Johnson’s 2002 speech lamenting that 200,000 people had given up their private health insurance because Gordon Brown had ended tax exemption for it, in which he angrily denounced the ‘monolithic’ NHS and called for its abolition.

But the next sentence in that paragraph states very clearly that for private clinics to function properly, it has to be accompanied by private health insurance.

For really significant increases in total system costs and incomes, it is probably necessary to introduce private health insurance…. out of pocket charges provide something for private insurers to cover, and that coverage permits increase in the level of such charges. Private medicine and private insurance are symbiotic. (My emphasis).

Don’t be misled by the Tories or Blairites. The inclusion of the private sector in NHS provision will lead to its total privatisation and an insurance-based system like the US.

Don’t allow it.

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