Christopher, Martin and Mark,
Thanks in part to some research by Robin Hamilton as we discussed the health
care topic you've raised, I've found a useful article by Princeton economist
Uwe Reinhardt [NYT 1 March 2009, from Economix 21 November 2008], entitled,
"Why Does US Health Care Cost So Much? (Part II: Indefensible
Administrative Costs)". His "Part I" helpfully lays out the context for
this article:
http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/
Best,
Judy
2009/3/1 Christopher Walker <[log in to unmask]>
> The UK government has stared into the bottoms of successive US presidents
> for close on 11 years now as though in search of the sun. That's been one
> of
> its many flaws. If Mrs Thatcher was 'neo-liberalism in one country' (in
> Susan Watkins' phrase) New Labour is its globalised extension. That's been
> another. What Martin rightly calls 'a new kind of fascism' is a third.
>
> At least Mrs Thatcher managed to make eye contact with President Reagan.
>
> <snip>
> The same kind of forces that have undermined health provision in
> the USA have seen to it that the NHS, conceived as a socialist innovation
> during WW2, is being hollowed out, whatever the surface rhetoric of the
> "managerial" Nu-Labour party. [Martin]
> <snip>
>
> It's actually worse than that. *Connecting for Health* is a quango which
> oversees and publicises the new ICT arrangements within the NHS, in which
> the 'internal market' continues to be key. Who runs it? Well there's a
> medic
> who knows about livers, but also a non medical IT 'consultant', an IT bloke
> who defines what he did in an earlier life as 'Government IT Profession:
> National Competency Lead for Delivery Management', plus another IT
> professional, this time a career civil servant. And so on. So who actually
> 'implements' all this clever ICT stuff? That comes about through tiered
> outsourcing, as far as I can tell. Lots of precarity. Lots of skimming of
> profits. Lots of transatlantic accents. And no one 'owns' any problems, to
> use that idiot phrase.
>
> So what about the system that has caused such chaos here in
> London? Ah yes. That's a Cerner system straight out of US health provision.
> It's been puffed as the beginning of a marvellously joined up NHS. My
> understanding is that at its core it's actually a suite of programs to
> account for transfer pricing.
>
> <snip>
> Which isn't to deny that the UK needs to invest more in
> education and medicine and less in prisons. [Mark]
> <snip>
>
> The problem isn't money. It's that New Labour has been sedulous in
> undermining the ethic of public service, or what was left of it. (See
> above.) NHS funding has roughly doubled under New Labour. However, much of
> it has been pissed away on bankrolling private contractors and their
> subcontractors and their subcontractors' mates and on producing dodgy
> statistics, which has developed into an industry (part of manufacturing
> consent). Conversely, the penal system is also close to collapse. In
> London,
> for example, the probation service is virtually non existent, bailed out
> (as
> it were) by yet more subcontracting. I haven't checked but I'm not even
> sure
> whether spending on prisons did increase by all that much until the sheer
> pressure of rising prison numbers (up by more than 50% by 2007, I believe)
> finally rendered the issue more or less unavoidable.
>
> What changed was the will to lock people up and otherwise hound them and
> interfere with them and menace them, which hugely increased under New
> Labour. The failed 90 days' detention proposal, for example, was a retread
> of Section 17 of South Africa's General Law Amendment Act of 1963,
> passed under Hendrik Verwoerd. The conceptual change, even with the
> current,
> more modest arrangements, is breathtaking.
>
> CW
> _______________________________________________
>
> We're not paying for your crisis!
> (Italian Student Slogan)
>
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