Friday, June 06, 2003

A newspaper editor who really should resign

American webloggers are celebrating the end of Howell Raines at the New York Times. The ever-reliable Andrew Sullivan says:"It means that the errors and biases of the new NYT could be exposed not just once but dozens and dozens of times. It means that huge and powerful institutions such as the New York Times cannot get away with anything any more....(Sullivan's campaign against the New York Times) was about stopping a hugely important media institution from becoming completely captive to the elite left and a mercurial, power-crazy Southern liberal "

Personally, I have more problems with an editor who authorises a payment of £10,000 to a convicted criminal for a front page story about a crime, a payment that causes the subsequent trial to collapse and suggestions to be made that the whole thing was a set up.

But, in this brave new world where the powerful will be punished, that editor has left her newspaper... to be promoted to be editor of the Sun.

How do the News International papers report the case? "News of the World defends Story". God, I'd hate to see a hugely important media institution becoming completely captive to it's owners self interest and a power crazy Aussie conservative. Fox News ain't seen nothing yet.

News International. Home of probity in Journalism since last Wednesday.

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Thursday, June 05, 2003

Tory Health care - a tax break for the rich, a slow death for the NHS

Well, who’d have thought it, the day after Stephen Pollard and I have a big row about healthcare, the Tories announce their alternative to the state-funded NHS system so loathed by Mr Pollard, Mr Murray, Mr Cuthbertson and many others with whom I have the pleasure of corresponding and debating from time to time.

So what does the policy say?

Basically it is a voucher system. Every operation and procedure will have an NHS tariff. (For example, a Knee replacement might be £9,000). If your doctor agrees you need that operation, you effectively get a voucher to take to an NHS hospital- or, if you want, to your local private hospital. Of course, your local private hospital will charge you £15,000 for the same operation, so you’ll need to find the extra £6,000 from somewhere, almost certainly an insurance scheme.

Now, the Tories are a little bit coy about this. In the summary of their healthcare proposals they say that the value of the patients passport “voucher” outside the NHS might not be the full £9,000. You might need to find an extra £8,000 or £10,000 to go private.

On top of this, the plan is to give Private Insurance Tax relief.

So what’s the problem with this?

I shall let a Doctor spell out the first difficulty.

"To be frank with you, if you are going to introduce tax incentives in the way that has been suggested, there is very much a dead weight to be borne there. In other words you'd actually be paying a lot of people who already have private health cover to keep the same cover going."
Liam Fox, BBC On The Record, 25 June 2000

Basically, If you currently have private insurance, The Tory policy is to write you a big cheque. You’re currently paying for the whole cost of your operation. Suddenly you won’t have to, the Government will pay (around) half of it and in addition, you get Tax relief on the insurance you’re already taking out take out to cover the additional cost of Private Medicine. Go on, guess the demographic profile of those people who will benefit from this huge tax cut. You're way ahead of me.

So how does this save the government money? Well the Tories hope to take more people out of large parts of the NHS altogether. Hence the NHS won’t have to treat as many people and the costs go down.

This only works if people stop using the NHS and start spending their hard earned money on hospital care, rather than on holidays and new sofa's.

Why would they do that? After all, the vast majority of people aren’t leaving the NHS now, even though Private Medicine is perfectly allowable, Insurance is widely available and if you believe the tabloids, the NHS is a lumbering cockroach infested nest of bureaucrats.

They're not leaving because, even if the marginal cost of Private insurance is driven down by these methods, there is a limited market for paying for similar standards of care to that provided free.

Only if the NHS is seen to be a clearly second class service, with a standard of care that most people would rather not endure will this scheme ever work.

Take Private education as a good example of this- Expansion only really occurs when people think State schools are failing badly. Dentistry is perhaps an even better example- only when the NHS dentistry system was starved of funds did we see a major change to Private treatment and insurance- and even there you actually had to pay to get most NHS treatment anyway. (I shall leave alone the catastrophic impact of this policy onthe state of poor people's teeth, but draw your own conclusions)

So the tactic the Tories use is to drive down the cost of private health care- First off, by granting Tax relief to Private medicine and secondly by giving private healthcare a massive government subsidy will only prove effective if it also coincides with a slow strangulation of the NHS, after all, if the NHs works as well , even as it does now, people will stick with the NHS. How do I know?

In 1990 the Tories introduced tax relief on Private Insurance for the over 60s. Despite public spending of over £1 billion on this initiative the numbers of over 60’s on Private Medical insurance rose by only about 50,000 in seven years. The vast majority of the cost was taken up by people who would have taken out Private insurance even without the Tax relief. (there are caveats of course- Over 60's are unlikely ot get great private insurance rates- but you know, there's a hint there)

I can’t imagine that the Tories would want to advertise this, so they won’t pledge to cut NHS spending, but it can ONLY work if they hold NHS service levels down, limit the operations available on the NHS, and generally make the idea of going to an NHS hospital as unattractive as possible. Only then will Middle class families be open to the idea of paying more for private healthcare.

Still don't believe me? Alright. Let's look at the Tory vision of the NHS under this new system. If as Liam Fox claims, this system produces an NHS services which has small wait times, high quality care and all possible services, why would anyone currently in the NHS spend any extra money on private insurance?

The cost of doing this is not only to limit the services available to the poor, but to provide a massive Tax break to the better off, a tax break worth billions of pounds.

And to think the blogosphere is outraged by the NHS telling fat, sick people they need to go on a diet.

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Wednesday, June 04, 2003

The Perils of Policy.

Poor policymakers. You wirite great big policy documents, filled with worthy and dull ideas. Then the media jumps on one of them, distorts it, lies about it and dominates the media coverage with the distortion before you get to clarify. It’s enough to make you lose faith in the whole thing. This article take Stephen Pollard's latest piece as evidence of the idiocy of this journalism.

Let us examine Labour’s Health document, Improving Health and Social Care.which has been the focus of Media attention for some days for it's plans to "deny care to Porkers". What does it say?

"(a Patient agreement) would involve people in their own care, asking them to share the responsibility for their own health care and well being. Agreements could be drawn up to help people to cut down or quit smoking, to lose weight, to take more exercise or to eat a more nutritious diet. The agreement could provide a formal channel of redress should the level of service fall below an acceptable standard – doctors have responsibilities to their patients too, in keeping to appointments and in keeping delays to a minimum. But it could also bind the patient into honouring their duty to the health service, putting the relationship onto a statutory footing.

Of course asking people to sign up to a novel type of agreement in this way may present a challenge, especially if we ask patients to actively participate in the relationship. To win support for this we need to be clear about what it is that we are trying to do – we must emphasise that in return for free, convenient, high quality care the patient is being asked to use this resource responsibly.

This type of agreement would not be legally binding. It could take the form of a joint statement of ‘mutual good intent’. The idea being not to exclude patients from care but to remind them of the need to use the health service – a free yet finite service – responsibly."

Now what does this mean, stripped of the Policy wonk jargon?

You weigh 25 stone and suffer from high blood pressure, related health problems and find it difficult to walk. You go to the doctor for help. The Doctor says. Well, I can recommend you for a Stomach Stapling operation, but it’ll do no good if you keep eating the way you do now. So before operating, I want to see you lose two stone, to show that the operation will be worthwhile. Here’s how you do it, and I’ll get you a meeting with a nutritionist to help you improve you diet. Come back in three months two stone lighter and we’ll operate. If you don’t there’s not really much point in having the operation.

Now in response to this idea, Stephen Pollard, a writer I usually admire, writes in the Times.

“You have to hand it to the masterminds who came up with this one. The NHS can’t cope with the demands made on it so (it’s a masterstroke, it really is) let’s tell the very people who cost the most — people who don’t have perfect lifestyles, perfect diets, and perfect bodies — that they can go jump in a lake. You don’t feel well? Tough. You should have eaten some cabbage instead of that egg and chip butty.”

Umm no, Stephen, it blatantly isn’t saying that.

It’s saying that if you're fat, find it difficult to breathe and have heart problems and want to get better, the best thing you can do is stop eating the Chip butties and smoking fags. If you can find a Doctor to tell you that Ill patient should carry on with unhealthy lifestyles during treatment for Obesity and Cigarette related conditions, I’d be very interested.

“As the document puts it: “The concept of reminding patients about the limits of the NHS and about their responsibility in using its resources sensibly is one we want to take forward.” Indeed. We wouldn’t want anyone who isn’t healthy getting involved with the NHS, would we? What a waste of precious resources that would be. “

No again, The relevant point is that if you use the NHS, there’s little point in treating someone whose actions outside of the Doctor’s surgery directly contradict the efforts of the doctor. Healthcare doesn’t happen only in the hospital.

“So if you’re overweight, don’t even think about bothering the doctor. He’s got far more important things to do than waste time on porkers. There are decent people out there who deserve to be treated: people who know how to look after themselves properly; who were brought up in good middle-class families and spend their money on organic salads. Not those wretched poor people who eat their horrid burgers and clog up doctors’ surgeries with tiresome heart problems and diabetes, and who wouldn’t know a papaya if it popped out of the back end of their flabby, heavy, colonically unirrigated bodies.”

Another distortion, combined with a ludicrous line about the middle class. If you’re overweight, go and see the Doctor. She’ll help you lose weight, but she can’t do it for you. If you want to lose weight and get healthy the NHS will help. But if you keep eating too much, don’t expect the NHS to come up with a magic bullet to stop making you fat.

“Has there ever been a more grotesque example of the blinding stupidity of juice-bar lefties, who begin their day with a shot of carrot and wheatgrass and think everyone else lives next door to a health-food shop?”

Ahh.. our old friend the ad hominem attack. I’m not sure what relevance it has to the policy.

“There is a direct link between obesity and poverty. Charging those who break their “contract” means, quite specifically, charging the poor — the very people who most need access to their GP because of the effect of their diet. “

Ah, here we are. Commentary at it’s finest, combining one true fact, a distortion of what the policy says, the assumption that “the poor” are incapable of changing behaviour, and the unsupported and unevidenced introduction of a policy not mentioned in the document (charging).

And then the finest piece of work of all.

“But the brains of Britain behind Labour’s new “ugh, poor people, how perfectly horrible” NHS plan have done us all a favour. They have shown the inevitable path down which a state-funded, state- delivered healthcare monopoly ends up travelling, with a rationale at once totally logical and totally surreal. If demand for a service is too high, bar access to those who use that service most. Even if they use it most because they need it most. It’s genius. It really is.“

The unmentioned alternative to this State monopoly? Either a Social Insurance system- Still compulsory, but poor people get worse care than rich- which would really help the poor fatties Stephen is so concerned for, or a non-mandatory health system, as In the US, where some 50 million people are uninsured at any one time, so they really get to use the service well, don’t they? (and their obesity rates really are something to shoot for, so that system works well..)

Distorted facts, crocodile tears, and a solution that would make the people worse off. Bravura journalism, Stephen.

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Tuesday, June 03, 2003

Understatement of the week

"It is disheartening that the military was unable to secure Saddam’s large nuclear-material storage site at Al Tuwaitha before the looters got there. Materials for a “dirty bomb” could have found their way by now into the hands of terrorists." Newsweek, June 9th


Disheartening eh? Well, at least they got to the Oil Ministry in time..

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Blame Bush.

The only reason Tony Blair is facing a crisis is a US Administration that is in danger of destroying every American ally it touches.

Last year, Josh Marshall wrote an article which questioned the competence of the US administration.

A lot of us went ‘huh?’ at that. I mean, The Bushies seemed to be ruthless, aggressive, gung-ho and downright unpleasant, but incompetent? Well, it doesn’t look like it.

But, the only viable challenge to Tony Blair’s authority will come if it is found that there were no weapons of mass destruction in Iraq, or such a small wquantity as to be laughable.

In a sense, this shouldn’t matter. As I’ve argued before, if Saddam used to have WMD, acted like he still had WMD, and refused to co-operate with inspectors then whether they actually had them or not is irrelevant to whether it was reasonable to assume they were.

Tony Blair is being punished right now, not because there are no WMD to be found, but because some Journalists, politicians and editors felt that not enough time was given to inspections. They believe that this process was rushed- that there was no attempt to wait and see.

Why was it impossible for the UN to wait a little longer on its investigations of WMD?

Because the US insisted. There was no evidence that Iraq was going to co-operate, but the Americans were so eager not to appear restrained by soft multi-laterals that they wanted action immediately and would brook no opposition.

Another few weeks and Iraq still wouldn’t have co-operated, the International community would have been more settled. Not unanimous maybe, but clear that Iraq was not co-operating.

So right now, Tony Blair is paying the price for American impatience.

I happen to think for all sorts of reasons that Tony Blair did exactly the right thing. It was reasonable to assume that Iraq had WMD, The danger of a unilateral US was too awful to contemplate, Saddam Hussein was a brutal dictator, The cross-pollination of WMD and terror was a real threat.

The question the world should be asking, and would be asking, were it not for Bush administration incompetence, is “why did Iraq act like it had WMD if it didn’t, even when it was clear that to do so meant invasion?”. Instead, and solely because of George Bush refusal to compromise, the world is asking “why did the US and the UK lie about WMD?”. They didn’t, but the perception of governments desperate to hurry a confrontation is hard to shake. Especially when US hawks were crowing about just that.

By next year it is now possible that Germany and Spain will have seen Pro-US parties lose elections because of their support for the US. France and Russia will see their strategic position strengthened as declared oppositionists to US policies across a range of proposals, that Pro-US governments in the UK and Italy will be significantly weakened and facing far stronger internal opposition.
In exchange for this, George Bush will have a recalcitrant, possibly still violent Iraq.

And all because George Bush would not wait a few weeks.

If that’s not terrible diplomacy, I don’t know what is.

Blame Bush for this mess.

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Monday, June 02, 2003

Tax Freedom Day- a modest proposal

The Tories are to propose that “Tax Freedom Day” should be made a national holiday, according to this report in the Sun.

Well, no-one ever lost any votes by proposing a holiday and it gives a nice plug for the Tories and the tax cutters in the Sun.

But surely we should extend the principle. Surely everybody’s holiday should fall on a different day? Everyone could make it clear from their tax returns how much tax they pay as a proportion of their income, and take their holiday on that day.

This would have one huge advantage as wealthy tax avoiders (and residents of Belize) would be taking holiday sometime in February, and all us PAYE mugs might just start to wonder why we let them get away with it.

It should appeal to low wage employers too, as if you didn’t earn enough to pay taxes, you wouldn’t get a day off at all!

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The endless march to the left of the Trade Union moverment.. or so they say..

Despite the spin surrounding the election of Tony Woodley as the new General Secretary of the T&G, I'm becoming increasingly sceptical of the "march to the left" meme regarding the election of the "new generation" of "awkward" trade Union leaders. A fine example is the Independent interview with Mr Woodley today. The basic line taken follows the well worn path of new generation of militancy, awkward squad, crisis for Labour, funding, disaffiliation, call for more radical policies to please union members.

Seems like a nice self contained theme, no? Every election of a "left-winger" fits nicely into it and provides lots of nice copy, as we've seen with the successive elections of Derek Simpson (Amicus- AEEU), Dave Prentis (Unison), Kevin Curran (GMB) and now Tony Woodley (T&G).

But is this really a march to the hard left and the unionism of the 1970's? I doubt it.

First of all, does anyone actually remember Rodney Bickerstaffe and John Edmonds? I don't recall them rolling over to have their tummies tickled by Labour's leadership. Ken Jackson (AEEU) was a leadership loyalist, it's true, but his defeat was much more linked to internal AEEU politics than a straight left-right split. Indeed my sources tell me that had virtually any other right of centre candidate stood against Simpson, they would have won. (Though perhaps Tom Watson, as a former AEEU politcal officer, can enlighten us on this). So any argument that these new leaders are too the left, has to accept that well, almost all union leaders are to the left of Tony Blair and always have been.

Second, There seems to be a failure on the part of journalists to distinguish between really radical union leaders- those openly aligned with either the Socialist Campaign Group or parties all point left- and those who are what would be regarded as "soft left" and those who are running to the left out of fear or opportunism.

In the first camp, the real left, we should place Bob Crowe of the RMT, Mark Serwotka of the PCS, and Mick Rix of ASLEF. Even Billy Hayes of the CWU, widely seen as a radical, is more of an old style Labour left-winger, as this Socialist Worker article, which drips with factional contempt, makes clear.

But these are all small unions. The big unions have elected people with what might be called a twin track approach. They're more than willing to criticise the government, and make more strident demands of it than their predeccessors, but they're prepared to work with ministers too, and they're not going to start a wave of industrial action.

Why am I so confident of this? Because of their respective records before they began running for their top jobs.

Kevin Curran was best known in the North-East for his moderate, hand in glove approach to the shipbuilding industry. Indeed, it was sometimes hard to go a week without seeing him in the papers with the Chief Executive of Swan Hunter.

Dave Prentis was the "moderate" candidate in the Unison internal elections, as this article in the Weekly Worker makes clear.

Tony Woodley spent quite a lot of time talking about Traditional values in a modern setting, (sounds familiar) when the was working to save Rover cars by attracting venture capitalists to buy the business.

Even Derek Simpson, the most wild of these big 4 new leaders, was run as the left candidate against Ken Jackson precisely because is image was that of a decent guy who wanted to stick up for members, not a left wing ideologue. In any cas,e he doesn't have anything close to a majority on he AEEU executive, and the MSF group will also act as a handbrake.

So, if most of these men are more soft centre than flying picket, why are they turning up the volume?

First, there's their internal pressure. each of them is worried about being charged with being in the pocket of the government by the left.

Second, it's negotiating strategy. If you shout about your red-line areas, you can negotiate on the vital issues for you with a freer hand. There are some key areas the unions want to push the government on- Recruitment, minimum wages, rights at work. Talking tough across the piece is a good strategy to get these things done with a minimum of fuss.

Third, opportunism. If the way to win the Presidency as a Democrat is to run to the left in the primaries and to the right in the General election, the way to win a Union election is to run to the left and then run to the left some more.

Finally, It gives them an easy way of "standing up for members" without having to get involved in industrial action. If you're following a vbasically moderate recruitment and strike balloting policy, it's very convieniant to bash the government over the head every now and then as a way of proving you've not given into the capitalists. While the RMT and ASLEF are launching strike actions, the big four aren't.

So there you are. Hard left Union militancy? Don't believe all the hype..

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