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All your genitalia are belong to us – Part 2.

One of the very first things I wrote on this blog* was on the thorny topic of abortion, its then illegality in this state, and the proposal in front of the Victorian Parliament at the time to legalise it. In particular I thought it odd that a state sufficiently liberal to no longer object to women using their vaginas to make money still wanted to exercise ownership of their uteruses.

Abortion is a crime in the State of Victoria. So what, you may say. There are plenty of other places in the world where it’s illegal, and whatever your views on the issue (and for the record mine are that it’s distasteful but as I’m lacking a uterus I’m not going to tell women what to do with theirs) it’s not an unusual situation. I think the same applies in the Republic of Ireland, and no doubt girls who inadvertently get themselves up the duff nip over to the UK for a quickie termination. Australia’s physical isolation makes that a bit tricky but a quick bit of googling shows that the law is a little less strict in New South Wales and, since 2002, abortion on demand has been legal in the Australian Capital Territory (Canberra and surrounding areas for those unfamiliar with Australian administrative divisions – think Washington DC with even weirder animals).

But here’s the strange thing – Victoria is one of several States to have very liberal prostitution laws. Brothels and escort agencies have been legitimate businesses here since 1994 (though street prostitution is still illegal) and no-one gets a record for using or working in one, the girls get regular medicals and blood tests and so on. So… how come a woman has less freedom when it comes to her uterus than she has in respect to the rest of her reproductive system?

Shortly after I wrote that the Victorian Parliament voted to change the law despite predictable opposition and the state joined the ACT by legalising abortion pretty much on demand (on demand up to 24 weeks, potentially later with the agreement of two doctors). This is the only state (the ACT being a territory) to have gone this far. The rest vary, but the Sunshine State of Queensland in particular is stuck in another age.

In Cairns, a young couple await a magistrate’s decision on whether they will stand trial for allegedly procuring an abortion using drugs imported from overseas. Section 225 of Queensland’s Criminal Code, its wording unchanged from 1861 English law, states that “any woman, whether she is or is not with child, who administers to herself any `noxious thing’ is guilty of a crime and is liable to imprisonment for seven years”.

Wait, what? 1861? Eighteen fucking hundred and fucking sixty-one? That’s nearly a century and a half ago. Can that be right? Well, this is coming from a lady by the name of Caroline de Costa, and while she isn’t a lawyer she is a professor of obstetrics and gynaecology at James Cook University school of medicine in Cairns. I think it’s not unreasonable to assume that she’d have a fair grasp of the law on abortion in her state.

In 2009, a 19-year-old woman faces this charge, her partner accused of assisting her. The law, written four years before Joseph Lister discovered the benefits of doctors washing their hands before operating, was intended to protect 19th-century women from unsafe abortion. It failed to do so then and is completely inappropriate for 21st-century abortion practice. Section 225 has been used once in Queensland in the past 110 years and the woman then involved was acquitted. However, it seems likely the present case will proceed.

Well, it has gone ahead and made news ten thousand miles away.

The case has caused controversy in Queensland, and polarised the debate on abortion in Australia, under whose Victorian-era laws it remains a crime in most states including Queensland.

So heated has the debate become that Ms Leach and her boyfriend have been forced into hiding after their home was fire-bombed and Mr Brennan’s car was attacked.

Oh, how fucking lovely. Funny how violent pro-life people can be, isn’t it?

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists is pushing for state governments to take abortion out of the criminal codes so that doctors can work under clear rules, but pro-life groups have seized on the Leach case to push their own agenda with some describing the suggestion that abortion should be decriminalised as it is in the UK as “depraved”.

As depraved as the state having de facto ownership of a woman’s reproductive organs? As depraved as a bunch of people who think their religious beliefs give them the right to commit violence against property and people? Look, I don’t like abortion. As I said back in August 08 I find it distasteful and I think there are better options for birth control, but not having a uterus myself I’m not about to tell people who do have them what to do with them. And as a practical matter, as the professor points out, archaic and authoritarian laws just create abortion tourism.

One result has been the transfer of Queensland women urgently needing abortions interstate or to India and New Zealand. Some of these women have had diagnoses of serious foetal abnormality, some have serious conditions themselves, and some — such as a 13-year-old transferred from a country town — have social reasons for abortion.

As I write, the number of women transferred is estimated to exceed 30, all paid for by Queensland Health. Undoubtedly a larger number of women have gone interstate for abortions. Such abortion tourism is the result when women are denied access to the procedure at home. Until the situation is resolved and doctors feel safe in their practice, abortion tourism from Queensland will continue.

That’s just the ones being paid for by the state. And if anyone thinks that won’t increase they’re dreaming. It’s not nice but the reality is that some women will want to terminate a pregnancy. All that’s being achieved in Queensland law is discrimination against those who can’t afford to travel to do it, which is presumably why Queensland Health is tapping the taxpayer for the money.

Meanwhile, doctors are muzzled. Queensland Health has forbidden any contact between its doctors and the media. It also refuses to speak on their behalf, although the Royal Australian and New Zealand College of Obstetricians and Gynaecologists has valiantly supported Queensland Health obstetricians concerned about the law.

Fucking hell, that really helps, doesn’t it? What if they speak out anyway? Will they be transported to Austral… oh.

RANZCOG specialist obstetricians head all the maternity units providing care to Queensland women in pregnancy and during birth. They are doctors who have spent at least 15 years acquiring the skills and experience to do so. Those RBWH doctors who practice in maternal foetal medicine spend further years to gain that expertise. Yet these highly qualified and compassionate doctors are unable to be heard publicly in an important debate about women’s health. The only possible solution to this impasse is reform of the law so that abortion is no longer a crime in Queensland for doctors and for women. The sooner the better.

Meanwhile women will still be jumping on planes to escape Victorian attitudes, and the irony is that some will no doubt be coming to Victoria.

* In actual fact it was the second ever, and so probably no fucker ever looked at it except me, Mrs Exile, and perhaps the insane cat who likes to watch computer monitors in case the screensaver is worth playing with.

Hospital food bingo.

Fucking gold.

>No easy way out.

>It’s not often I disagree with the Ambush Predator, and not because of the teeth and claws but because I usually find myself nodding at what she has to say. But while I was picking though the bones outside her cave I found something that she’s left some meat on.

“Life clocks are a lie! Carousel is a lie! There is no renewal!”

Much kudos for the Logan’s Run reference there, O feasome toothed one. This is going to be about the state offing old people then, yes?

Er… actually, no. Not really.

Mixed feelings about this move:

The Royal College of Nursing is to meet Scottish MP Margo MacDonald to discuss proposals on legalising assisted suicide after the organisation dropped its five-year opposition to the policy.

I might be taking this a little too literally, but that sounds like nothing more than a professional body representing nurses no longer supporting the state preventing people who want to end their lives from doing so with expert assistance.

It seems there’s a movement afoot to ‘normalise’ this, supported by polls:

The move comes as a poll found that 74% of people want doctors to be allowed to help terminally ill people end their lives.

The survey in today’s Times found that six out of 10 people said they wanted friends and relatives to be able to help their dying loved ones to take their own lives, without fear of prosecution.

When the alternative for most is likely to be a drawn out and miserable, and possibly painful, ending on the NHS is it surprising? I suspect the fear of being dead is now smaller than the fear of the process of dying, but also that people are starting to want the ultimate – in more ways than one – control of their lives.

However, while I can’t say that I think those who take their relatives abroad to Dignitas should be prosecuted (far from it)…

Excuse the interruption because that point is not black and white. As I mentioned in a comment at Julia’s, we would currently expect an investigation if there was good reason to believe that someone jumped off a bridge at the urging of grasping relatives who wanted Gran’s money early or freedom from the hassle of looking after her or whatever, and if there was evidence we’d expect a prosecution as well. There is no reason this should not be applied to someone who was coerced into getting on the plane and going to Dignitas, and in that respect the law shouldn’t change. But it certainly should stop routinely going after the grieving relatives of someone who has chosen to end their life of their own free will and has asked for help in doing so. The law simply should not have anything to do with that decision unless there is reasonable suspicion of coercion.

I doubt Julia and I actually disagree here and imagine that she’d still want someone prosecuted for buying the Olds a one way ticket to Switzerland and dragging them out of a bridge game and onto the plane against their will. I’m more clarifying where I stand on this point than having a pop at Julia.

… I’m wary of this becoming the norm. And I’m not alone.

The Christian Nurses and Midwives organisation said today it regretted the RCN’s policy shift. Secretary Steve Fouch said it sent out the wrong signals “at a time when there is growing anxiety about how we will care for the elderly and severely disabled in the future”.

Their statement will be pooh-poohed as ‘religious scaremongering’.

Not necessarily religious scaremongering, but certainly religiously influenced thinking. Couple of points here. First, without wanting to go on about invisible sky fairies or sound like Richard Dawkins when a group of people believe something is Holy Writ you simply cannot have a rational debate with them about it. This is a deal breaker for most Christians, something that they’d see as quite un-Christian to support. Fair enough. I don’t think they should support homosexuality either when their Holy Book tells them not to, but nor should they get in the way of those who are gay or those who want an assisted walk towards the light. Second point is that I think the Christian Nurses mob are attacking a straw man by talking about growing anxiety over aged and disabled care in the future. There is indeed anxiety about it in the UK because it’s largely state provided and the fund, if you choose to dignify it by calling it such, is well and truly fucked. But the fear that legal assisted suicide will be offered as an alternative to increasing poverty and misery and despair is illogical when suicide is always going to be an option anyway for the majority who are physically able to take it. Naturally they’d be forced to use methods that tend to be crude and messy rather than being offered something that will send them to sleep and prevent them from waking up again, but the point is that when Britain can’t afford to care for pensioners and the disabled in a humane way because of the Ponzi scheme that NI has always been some will choose suicide over slowly starving and freezing to death anyway. All that would be changed by allowing assisted suicide is that those who want out but are unable to take their own lives because of disability or because they left it until they were too frail have the same choice as those who are more physically able. In some respects it’s like putting in a wheelchair ramp to the shops so everyone can go, except of course that those who do won’t be coming back.

…a glance across the Channel to the continent will show this has already been experienced in the Netherlands:

Euthanasia critics have talked about the “slippery slope” as a possibility; in the Netherlands, it is a fact.

Many old people now fear Dutch hospitals. More than 10% of senior citizens who responded to a recent survey, which did not mention euthanasia, volunteered that they feared being killed by their doctors without their consent. One senior-citizen group printed up wallet cards that tell doctors that the cardholder opposes euthanasia.

Is this just panic and scaremongering?

Well, I wouldn’t call it an entirely rational fear, though not entirely irrational either given what this guy did. But since the survey specifically didn’t mention euthanasia the 10% who fear their doctor killing them may not be afraid they’ll be euthanized so much as murdered for more prosaic reasons. There is also the point that elderly people suffering from dementia can be a bit paranoid sometimes (I have personal experience of this though fortunately we see far more good days than bad ones). Needless to say dementia patients who are too far gone to be able to make a rational decision shouldn’t even be in consideration for assisted suicide. Also euthanasia will probably remain illegal since it doesn’t necessarily imply consent of the one being euthanized, whereas assisted suicide does. I feel the distinction is quite an important one and not just semantics. The whole issue after all is about individual choice.

Can it be dismissed as ‘something that can’t happen here’?

Well, we are on the right road to it:

What makes the Dutch comfortable with euthanasia? One factor is that their doctors became comfortable with it. “The Dutch have got so far so fast because right from the beginning, they have had the medical profession on their side,” Derek Humphrey, founder of the Hemlock Society, told the Toronto Globe and Mail last September. “Until we get a significant part of the medical profession on our side, we won’t get very far.”

Have the Dutch got so far particularly fast? I think that’s a matter of opinion. We could just as easily say that the Dutch have simply been less slow than everybody else. In any case it seems inapplicable to the UK where, according to those surveys, the majority of British people are way ahead of the doctors in becoming comfortable with it. To repeat what I said at the beginning, all that is happening is that one, aha, body in the medical profession no longer supports the state actively obstructing assisted suicide. That’s it, and I’d hardly say it qualifies as having the medicos on side.

So, how has this gained such a grip on the doctors?

Glad you asked:

How did Dutch doctors change their thinking so dramatically in the space of one lifetime?

The path to the death culture began when doctors learned to think like accountants. As the cost of socialized medicine in the Netherlands grew, doctors were lectured about the importance of keeping expenses down.

In many hospitals, signs were posted indicating how much old-age treatments cost taxpayers. The result was a growing “social pressure” from doctors and others, says Arno Heltzel, a spokesman for the Catholic Union of the Elderly, the largest Dutch senior-citizen group, which favors voluntary euthanasia. “Old people have to excuse themselves for living. When they say that all of their friends are dead, people say, ‘Maybe it is time for you to go too,’ rather than, ‘You need to find new friends.’ “

I bet NICE has some of those posters ready to go to the printers already…

I’m no fan of the grossly inappropriately named NICE* and wouldn’t put much past them. But given that this comes from a spokesman for a Catholic organisation I have to wonder if there’s a little bias in there. In fact the emotionally charged phrase “path to death culture” makes me wonder about bias in the whole article.

However, I do concede that British doctors are forced to think like accountants, or more probably are actually controlled by accountants. And obviously from a cost point of view there’s a lot to be said for encouraging the old and sick and disabled to save a few bob for the increasingly cash strapped state, stuck with the consequences of its own NI Ponzi scheme, by holding their breath for the next 20 billion years. But as I said above, suicide is an option right now so the state can already drive people towards it to save money. It could be argued that it in fact it’s already done so in the past and continues to this day, though more through ineptness and stupidity rather than as a deliberate aim. Still, the point is that I don’t think the availability of a comfortable assisted suicide is going to change much when the pensions cesspool hits the fan because in the absence of a Dignitas style option I expect orderly queues to form at bridges and cliff tops instead.
All the same I don’t trust the government as far as I could throw it and have used pretty much this same lack of trust and thin end of the wedge argument against letting the state bring back capital punishment (or retain it where it already exists), and I argued it with the Ambush Predator herself when we discussed it here and here. It’s ironic that Julia is now making a similar argument to me opposing assisted suicide. We’re both using the same argument to oppose deliberate action to cause death, and on both occasions we’re taking opposing sides of the argument. But as I said in the comments to Julia’s “Carousel” post, if you trust the government not to abuse the power to execute criminals why not also trust them on assisted suicide? Equally I could be asked why I distrust the government on execution but support assisted suicide, and the answer is because I don’t think it’s the same thing anyway. Again, I want to make assisted suicide distinct from euthanasia – one implies choice and the other does not**. Aside from the fact that the British government lacks the balls to kill murderers and rapists and therefore seems unlikely to have an appetite for wasting grannies, we’re not actually talking about giving the state more power anyway. Quite the reverse, we’re talking about taking away the power to obstruct that it already has. Fundamentally I believe that people own their bodies and when they don’t want to use them anymore they should be able to seek expert help. I’m not saying the state should provide the service. In fact for the reasons Julia mentions, and for the reasons I oppose the state having the power of execution, I’d say it certainly should not provide the service. It shouldn’t even ensure that anyone does. It should simply keep out of the way of rational adults who wish to end their lives without resorting to the crude options that are mostly all that’s available to them now. In other words, if I should actively choose to die at some point in the future, rather than sticking the end of my Beretta in my mouth and trying to reach the trigger or traumatizing a train driver by jumping in front of his office I ought to be free to look for someone with the medical know how to send me into the forever in a state of supreme fluffiness***. And providing there is no suggestion that I was coerced this should be absolutely no concern of the government. It should be a decision made by one individual and a service provided by one or more others, a transaction for a song sheet and seat in the Choir Eternal. It should be much the same as buying a car or a computer except that presumably you won’t come back to life three months out of warranty or have to pay extra for the essential update to Decomposition 2.0.
In short, and as usual, what I want is more freedom. Our bodies and lives are our own, and whether we choose to end them ourselves or to seek assistance should be no business of the state unless there is a good reason for thinking it might not have been entirely voluntary. That aside the state should fuck off and leave us all alone.

* I’ve long suspected NICE is also an example of coming up with the acronym first and then finding a vaguely relevant name that fits the acronym. Given the often not nice nature of NICE we might as well change it to the Clinicians’ Unit for Nationwide Treatment, and yes I did come up with the name the same way.

** Doesn’t necessarily imply coercion either. I’m just saying that someone can choose to be euthanized OR someone can be euthanized regardless of choice, as opposed to an assisted suicide which by definition strongly suggests a decision to end one’s own life. Suicide that comes as a result of coercion would be suicide in name only and in practice more like euthanasia, or possibly even murder.
*** I might not be able to find anyone, but that’s not a concern of the government either.

>Oink oink.

>Run for your lives. Get as much food and guns as you can and get the fuck out of the cities. The swine ‘flu apocalypse is nearly upon us, and it could be worse than a terrorist attack according to health experts… er… according to doctors… ahm… according to a police officer..

A police officer. Riiiiiggght.

So if in the increasingly unlikely event I go back to that North Atlantic island asylum anytime soon and am unfortunate enough to be robbed should I go report it at the fucking Accident & Emergency department of the nearest hospital? Or what?

Superintendent Steve Anderson from West Midlands Police said officers could be forced to stop non-emergency work in a worse case scenario.

Oh really? No shit! I can see why they made you a fucking Superintendent. Someone promote Steve Anderson to ACPO’s Department of the Blindingly Fucking Obvious, quick. Nothing gets past him. Do you know what, Steve? I’m prepared to bet that with the exception of the sort of retarded twunts who dial 999 because they’ve lost a biro most people would guess that non-emergency police work stops when something like that happens. When the July 7th bombs went off I reckon the overwhelming majority in London, and probably in Britain generally, would expect the police would be a bit on the busy side. Apart from the biro fuckwits of course.

Oh never mind, carry on Doctor Plod, do (my bold)

“We have this thing called a community risk register, which is in effect a who’s who list of scary things that could happen in the community,” He told Channel 4 News.
“And we’ve assessed each of those based on actually how likely it is to happen, and the impact on communities – and even as bad as terrorism, as bad as heatwave, as bad as flooding can get, a worse case scenario is that pandemic flu would be worse than any of those.”

Fucking hell, the whole place has gone mad, though I’ll have to give bonus panic points to Supt Anderson for working in the terrorism Horseman as well as what might be an oblique reference to global warming. I can’t imagine how he could have worked paedos and organized crime, but I think he missed a golden opportunity to mention that swine ‘flu could kill more people than drugs*.

Back in your box Steve. Go arrest someone while we listen to a medico instead.

On Thursday Prof Sir Liam Donaldson, the Chief Medical Officer, told the NHS to plan for the possibility of up to 65,000 deaths from the disease this winter…

Oh for fuck’s sake. Face, allow me to introduce palm. Palm, this is face.

Prof. Donaldson, as pointed out here, is the twat who came up with the concept of passive drinking and wants to ban smoking outdoors – well, even more of the outdoors considering it’s already banned on outdoor railway platforms** and bus shelters. I have a vague feeling he may have mentioned tertiary smoking as well, though it could be another health nazi, and I have little doubt that passive obesity has only made it to the back burner because of the bloody pig ‘flu. Or perhaps because Prof. Donaldson is a bit of a fat knacker himself. He might be better off working on passive wanking making other people go blind, because the sight of him knocking one out would probably make me rip out my own eyes and jump up and down on them.

But in fairness to Prof. Donaldson there’s a bit of media “if it bleeds, it leads” scare story paper selling going on. The quote above reads in full (my bold):

On Thursday Prof Sir Liam Donaldson, the Chief Medical Officer, told the NHS to plan for the possibility of up to 65,000 deaths from the disease this winter – although he said as few as 19,000 could occur.

But of course the headlines in The Telegraph and other papers are tending to stress on the 65,000 number. And it gets worse, because further reading suggests that Donaldson has pulled these numbers out of his arse.

Sir Liam insisted that the figures for the number of deaths were not “predictions” but worst case scenarios that the health service should plan to deal with.
He said: “We haven’t had enough cases to even give ballpark figures of estimates.”

Credit where it’s due, he doesn’t really know and he’s being honest and professional enough to say so. So it would be honest and professional of the media to stress this point – that it’s all fucking guesswork and estimates – rather than talking about tens of thousands dead and vastly more sick. It’s usually in the articles somewhere but Jesus you have to go digging through to find it. On the strength of what he’s actually said even the “as few as 19,000” figure could be out by a factor of ten in either direction.

They. Don’t. Fucking. Know. Yet. Got that?

Come back to me when the streets of London are empty and it looks like a scene from 28 Days Later. Until then I’m not going to worry.

UPDATE: Swine Flu Catches Cherie Blair.

Professor Henry Brubaker, of the Institute for Studies, said: “The Cherie virus will attach itself to the swine flu and suck at it like a big, patronising leech that thinks it’s better than you.

“Viewed through a microscope the early form of the the mutant CherSwine virus looks like a spiky ball of pus with the mouth of Ronald McDonald.

“And after just ten minutes on the Petri dish it leapt into my wallet and started pocketing all the fivers.”


* Funnily enough I was only making a remark about the Horsemen of the Infocalypse riding in on sick pigs over at Sue’s, who deserves a big tip of the bush hat for her post on Donaldson and the whole 65,000 figure.
** That’s reminded me of one of the best examples of British idiocy I’ve ever seen. Years ago, before the smoking ban obviously, you used to be able to smoke at Wimbledon station on platforms 5 and up but not on platforms 1 to 4, even though 1-4 were just as outdoors as all the rest. In fact platform 5 was (presumably still is) only the width of a couple of trains away from platform 4. The reason for this? Because platforms 1-4 ran London Underground District Line services and smoking had been banned on the whole Tube network in response to the 1987 King’s Cross fire. The reason was to avoid the risk of another disastrous underground fire, but Wimbledon Tube station, like about two thirds of the London “Underground” is on the surface, and it’s hard to see what good it achieved when people at Wimbledon could puff away within twenty feet.

>Worst or best in Europe.

>This boils my piss, this fucking sense of entitlement people have now and how they just fucking expect everything they want in life to be handed to them, generally by the state. And the state itself is to blame for attempting to fund anything and everything it thinks its citizens want out of life, thereby encouraging this sense of entitlement in the first place. This includes fertility treatment on the NHfuckingS, which is what is boiling my piss right now.

Poor NHS funding of IVF means that infertile British couples are among the least likely in Europe to receive the treatment they need to start a family, new official figures have shown.

The latest European league table of access to fertility treatment has placed Britain 11th of 13 countries providing data for 2006, with only Germany and Montenegro providing fewer cycles of IVF in proportion to their population.

Well? Fucking good I say. The only thing that’s wrong with that is the UK isn’t 13th out of 13, or better yet, dropped out of consideration altogether by not fucking funding fertility treatment at all. Children are not an entitlement. I have almost endles sympathy for couples unable to have a child of their own without medical intervention but, and I can’t stress this enough, life is like that sometimes and you just have to play the hand you’re dealt. There’s no God given right to have children – how can there be even if there is a God to give it? Some people can’t have kids naturally, and some of them won’t be able to avoid private IVF treatment. Sad, but why should everyone else be forced to pay? Look at it this way, some people will be born so ugly or with such deeply unattractive personalities that nobody will want to procreate with them unless money is involved. Does the NHS pay for the cosmetic surgery and/or therapy to improve their chances of a long term shag and maybe a sprog or two? Of course it fucking doesn’t, so why the fucking fuck does it pay for IVF?

Stop it, and stop it right now. Children are a not a right or an entitlement to be gifted by the state’s health provider. Children are a privilege to be treasured. That means that those who can’t have kids need to deal with it, just as previous generations had to. It’s harsh, but as I believe I’ve already mentioned life can be like that.

>Also on health…

>… but back in the usual hemisphere that I get upset about, I read this By Minette Marrin:

A tax on junk food will help offset those looming NHS cuts.

Give me fucking strength…

Debt means cuts. There is no way around this obvious fact of life. If you have run up serious debt on jam yesterday, there will be no jam today nor any jam tomorrow, for many tomorrows to come. You will have to spend more of your income on debt and less (if any at all) on jam. Vast public debt such as ours means huge public-services cuts.

Okay, sounds reasonable, go on.

Yet most politicians seem either unwilling or unable to talk about it like responsible adults.

Yeah, also true. And?

There will, for instance, have to be cuts in the National Health Service, no matter what they pretend. Last week the NHS Confederation predicted an enormous shortfall in NHS funding starting in 2011 – the equivalent of a cut of £8-£10 billion. The government is trying to get out of admitting this, but failing. The Tories have admitted something of the sort but are backtracking. All that’s clear is that the golden years of NHS spending are over.

No shit, Sherlock. There’s some more stuff about how NHS spending under Labour is up but productivity is down, but let’s just cut to the chase, shall we?

I think what’s needed now is a quick fix or two – something simple and fast-working, something even a health secretary with attention deficit disorder can understand.

The most obvious, I realise, has to do with preventing chronic illness in the first place. Until last week I had always thought this fell into the category of bossy government intrusion – wasting squillions on telling people how many potatoes to eat and on useless quangos. To me the phrase “public health” had come to mean “public nuisance”.

You’re not the only one, but “until last week” you thought it was bossy government intrusion and a nuisance? Hmmm, not looking good for individual freedom.

However, my mind was changed… the main burden upon the NHS comes from chronic diseases – cardiovascular disease, lung disease, diabetes and cancers – which, apart from causing drawn-out suffering and death, are hugely expensive to treat. All these conditions are often caused or made worse by smoking, inactivity and a bad diet.

Oh fuck. I knew it. Another fucking dose of fucking health nazism. Strength Through Joy.

I am sick of people talking about health education and “lifestyle choices”. What’s clearly needed, contrary to everything I’ve always thought, is a little compulsion. Our NHS and our economy cannot take the consequences of poor lifestyle cho

Well I’m sick and fucking tired of revolting authoritarian cunts telling me how to live my fucking life and how to treat my fucking body, and I despair whenever I hear that someone who has recognized this nannying for what it it is in the past has gone over to the enemy. As for the NHS being unable to afford these lifestyle choices, Minette, has it not occurred to you that the fact that so many people expect the NHS to sort out their bad decisions might perhaps be the fault of the NHS itself? Mr Fatfuck of 20 Rothman’s Terrace expects the NHS to sort out his smoker’s cough and dodgy ticker for free because that’s the whole point of the NHS, and because politicians of both sides keep wittering on about the NHS being free at the point of need. Mr Fatfuck therefore has absolutely zero incentive to change his lifestyle, and Minette Marrin and others with similar opinions must be vaguely aware of that or they wouldn’t be advocating “a little compulsion”. But if Mr Fatfuck had to pay his medical costs himself, or more realistically via insurance premiums weighted according to the risks the insurer assigns to his lifestyle, he might well choose a healthy lifestyle voluntarily. Of course, Mr Fatfuck in turn is aware that he’s already paid for any NHS treatment he needs through his taxes, though of course he’s really overpaid or underpaid since the chances of any individual’s NI contributions covering exactly the amount of medical care they need are pretty remote. That’s by the by, the point is that there is no incentive for Mr Fatfuck to get health insurance, which in turn means the incentive of market driven risk related costs persuading Mr Fatfuck to change is lost.

Second, the polluter must pay, as the Greens always say. The polluters who manufacture junk food of all kinds should be forced to label it, like cigarette packets, with simple information about calories. And the food itself, the pollutant, should be made extremely expensive, by high taxes, so that those who are polluting their own bodies would have a powerful incentive to stop.

Unnecessary, complicated and intrusive for both companies and individuals. An equally powerful incentive could be achieved if, as I said above, the Mr Fatfucks of the world chose private health insurance. The only obstacle is that there is currently a disincentive for them to bother – the “freebie” NHS. Now if Mr Fatfuck paid less tax in return for having private health insurance he’d have a powerful incentive to stop whatever unhealthy habits he had – every pound he can reduce his premium by is a pound he has to spend on something else. So, pulling a few numbers out of the air, say his tax bill goes down by fifty quid a week but as a fat smoker who thinks exercise involves green faced children with rotating heads his health insurance is about £40. So he’s tempted to do it because it save him a tenner a week, but it is only a tenner. However, already he’s not the NHS’s problem anymore, on top of which he might start asking about how he can reduce his premium and save money. Perhaps he’ll be told that it’s a fiver less for losing weight, another ten if he gives up smoking and five more for taking up jogging – half his costs, which were already 20% lower than being a fat bugger waiting around for the NHS to fix anything that goes wrong as a result of his unhealthy lifestyle, and that’s before any savings from the change of lifestyle itself. Now obviously those numbers might not be that realistic but a free and competitive health insurance market should keep premiums down anyway, so the tax reduction need only be enough to tempt even unhealthy people off the state and into the insurance market to begin with. Large enough to feel noticeable after likely insurance costs basically. After that the incentives of the market take over by rewarding healthier lifestyles with lower premiums.

Your suggestion, Minette, unpleasant and authoritarian as it is, does have the financial incentive of not spending money on overtaxed unhealthy living. But that’s the only incentive it offers, and we know from the numbers of smokers still around or the level of alcohol abuse – both heavily taxed – how effective that’s likely to be. You want to reduce the drain on the NHS to cope with the inevitable cuts that in the near future some politician, spineless though they might ordinarily be, will be forced by circumstance to bring in, and you want to use people’s wallets to do it. Fine, but surely you’ll achieve more by getting people to want to opt out of the NHS altogether. Give them a reason to take responsibility not only for their health but their healthcare, and not only can you expect healthier people but the cuts you foresee will come about as a natural result of the NHS doing less. In fact it might not do all that much less since a lot of treatment funded by health insurance will probably happen in NHS hospitals anyway, just with an insurer picking up the bill.

Not everyone will want to do this of course. Some might be ideologically wedded to the idea of the “free at the point of need”* NHS and others might simply fear the market and the possibility of variable costs (though I don’t know how that can be a greater fear than the variable amount forcefully taken from them by the government, or indeed the variable quantity and quality of NHS health provision – the “postcode lottery” – as things are now). And of course others will simply be unable to afford to opt out of the NHS because they’re already on the breadline as it is and pay such a small amount of tax any reduction wouldn’t cover premiums.** For them the NHS and how they pay for it can remain pretty much as is, but if I was one of them looking at friends or family enjoying their extra disposable income from the savings on their healthcare costs, which incidentally can only benefit the economy as a whole and as such will provide a little extra VAT etc to the Treasury, I’d be very tempted to follow suit.

* Translation – paid for on an ongoing basis regardless of any need.
** No idea how many this would be but there’d certainly be some, though given that the British poor are overtaxed anyway it might not be as many as we’d first think. Just say you raised the tax threshold a bit anyway to slacken the jaws of the poverty trap, because it’s too damn low by far at the moment, but raised it a lot for those who bought private health insurance. What effect might that have?

>Health, wealth and unhappiness.

>From Thoughts on Freedom, the blog of the Australian Libertarian Society, comes depressing news of proposals to make health provision in Australia a fairer and more equal system. Apologies for quoting en bloc but it’s not long.

“As citizens we should all use the same health care system. Poor and rich should have access to the same health care services from teh same providers … the well-off and the poor should not have separate providers … All should share the one, high quality system.”

This is a very scary mentality. The authors of the above (McAuley and Menadue, quoted by Buckmaster (PDF – Angry Exile)) want to enforce total equality when it comes to health services. Note that their prioerity is not to improve health, but simply to make sure that it is always equal.

Enforced equality is so important to them, they repeat it four times in the same paragraph.

The above position is not simply an argument for government intervention in the health industry. And it is not an argument for improving the health care for poor people. Both of these are common and reasonable suggestions.

It goes far beyond that, and calls for the government to actually ban the purchase of extra health cover. The authoritarian policy suggestion of McAuley and Menadue would limit the amount of health cover that a person could buy to the government-approved level, with obvious negative consequences to health outcomes.

This policy cannot be defended on the basis of concern for poor people. The only defence for this policy is that the proponents simply want to hurt richer people and prevent them from buying extra health services. And the likely long run consequence would be worse health care for everybody.

Mostly when I disagree with people on the left I can sympathise with their goal, but disagree about their approach. In this instance though I think the thought process is offensive and dangerous.

Quite. I don’t often comment on ToF posts but on this occasion I had something to say. Again, I’ll repeat it in full here (with very minor editing).

Having moved here from Britain this sounds like someone intends to copy the UK’s National Health Service, and having been on the receiving end of what the NHS laughingly described as treatment I’d like to say a few words to the people of my adopted country:

Don’t. Fucking. Do. It.

Seriously, and with apologies for the f-bomb, just don’t. Health provision here may not be perfect, but where is? This is certainly not going to help and if you ask me is likely to prove a massive step backwards. Sorry for the length of this comment but let me describe my NHS experience to give you an idea of what an “it’s there for everyone, free at the point of delivery, one size fits no-one” system of socialized medicine is like.

I needed a minor op to drain an abscess, and since it was getting infected I was admitted in the afternoon as an acute case. The op was done that evening and I was told I’d be in for a few days. So far, so good. They took their time wheeling me back to the ward because my blod pressure was a bit low and they wanted to get some extra fluid dripped into me before then. Fair enough, though they said I’d be peeing for Britain all night long. Early the next day someone came to change the bedding and put the sheets on my feet. I was still half off my face from a combination of poor sleep and morphine and accidentally kicked it onto the floor. The staff member picked it up and put it on one side. I stumbled off to the lavvy, which had someone’s blood on the seat, to deal with the last of the previous night’s extra fluid and wake myself up with some water on the face, and when I got back apologized for making them go and get another set of bedding because of my clumsiness. Yeah, you guessed it, they didn’t bother and just used the bedding the stoned patient had kicked on to the floor. A floor, incidentally, on which I’d left a blood stained piece of dressing on my trip to or from the bog. And there it stayed for the next hour and a half before I called a nurse and asked if it might be an idea if someone got rid of it. Nobody cleaned the area of floor where it had been because the cleaners had already been around, so it wasn’t to be done again till the next day. I had regular BP checks by some patronizing woman who kept saying that it was fine even though the damn machine was next to me and I could see that the reading was still on the low side (I’d had a medical a few months earlier for work and remembered what normal was supposed to be), though being treated like I was either 15 years younger, 50 years older or simply retarded may have just been an unorthodox treatment to get my blood pressure back up again. I had a very boring afternoon because I hadn’t been able to shell out the cost (hugely overpriced having been, like the car parks, subbed out to a private contractor) of the card for my bedside phone and internet via the TV due to my quick admission the previous day, and couldn’t have used the internet anyway as the TV was bust. Nor did I feel like going to the hospital bookshop and since they had a huge theft problem I’d given my wallet and mobile phone to my wife on the advice of the doctor who’d admitted me the previous day. It was a very hungry afternoon as well because the incompetent clowns forgot to feed me, and I assumed they were just being cautious because I’d been under general anaesthetic for the op. No, it was just the good old British cock up at work, so I got an apology and a plate of stone cold beef and potatoes in what might have been congealed gravy. Given what else it might have been in a hospital and how tasteless and rubbery it was anyway I decided being hungry was actually the better option. The good news was that my blood pressure must have been fine now, though in hindsight I think they probably overdid it. So did the guy in the next bed who kindly lent me his phone card so I could call my wife. I told her what had been going on and to please come and get me the hell out of there, at the point of a twelve bore if necessary, before I either cracked or croaked. The suggestion that I was going to leave didn’t go down well with the BP monitor woman, who said it was supposed to be a 2.5-3 day stay so I shouldn’t go until sometime the next day, and that in any case I wouldn’t be allowed home – yes, that was the phrase used – allowed home until I’d moved my bowels. Not wishing to argue post operative care I checked the toilet again, only to find there was even more blood on the seat than earlier. I went back and told her that if she thought I was going to drop my arse in a khazi that was slick with someone else’s blood while I still had an open wound from my operation then she was a mad as a box of frogs and should get herself to the pharmacy PDQ for some lithium or something. Shortly afterwards my wife turned up with a banana she’d managed to get by shouting at someone. I wasn’t sure whether to eat it or use it to poke the BP monitor woman in the eye with, but since she’d wandered away I settled for eating it, getting dressed and doing a runner hobbler, telling only the main reception that I’d left the ward and was going home to crap in a clean bathroom.

Bad luck, you might think. Maybe, but maybe good luck. My dad got food poisoning in hospital (soooo glad I left that dodgy looking gravy) and thousands, perhaps as many as ten thousand, die in British hospitals every year from secondary infections they pick up while they’re there. Compared to going down with C. Difficile or MRSA (as happened to a client’s son who’d gone into the same hospital for the same op) being treated like a moron and not being fed wasn’t so bad. We must also remember that among other things Britain’s NHS – the envy of the world according to politicians, especially Labour politicians – has long waits for many treatments, regularly rations treatment according to where patients live and has one of the poorest cancer survival rates in Europe. And that’s despite employing over 1.3 million people – approaching the population of South Australia, though famously the NHS employs more admin and clerical staff than it has beds for patients – and enjoying the lion’s share of Britain’s enormous (something like 45% of GDP) public sector spending. Think Britain’s nuclear deterrent sounds expensive? Or the fleet of nuclear powered submarines, both missile launchers and hunters, that goes with it? Nope, it’s cheap by comparison with the NHS. The replacement for the Trident nuclear weapon system was provisionally estimated at £20 billion, and even allowing for a cost blow out of 25% that’s still less than the increase – the increase – in annual NHS spending proposed a year ago by the opposition Conservatives after they got suckered into a spending competition with Labour. Compared to that lot a fleet of nuclear submarines looks like a bargain, on top of which it kills far fewer people. So in Britain most people who can afford it prefer to go private, and many will go so far as to get on a plane and have elective surgery done abroad. An elderly relative tells me that India is a popular destination for Britons wanting their cataracts fixed, and she was seriously thinking about it herself until an appointment to see an eye specialist in the UK came up. I don’t want you to think that has racist undertones because it’s nothing to do with colour or India being usually considered a developing nation. It’s simply an observation that more than a few British people prefer nine hours on a plane, quite possibly with Slumdog Millionaire as the in flight movie, to get their eyes operated on in an Indian hospital to having it done on the health service for which they’ve already paid for through their taxes and which, they’re constantly told by their government, is supposedly the envy of the world. With what I experienced I’d agree with them 100%. You might be wondering why they don’t simply pay the difference between the cost of treatments to the NHS and at a private hospital and have them done privately? Or even to pay up front and get reimbursed later similar to the way I now pay $50 to see my doctor and then get about $33 back from Medicare? Well, it’s because that’s not allowed in Britain. It’s not equal you see. Can’t have “two tier” health provision, say the politicians, though if wealthier Britons with health insurance or simply leaving the country and paying for treatment abroad doesn’t qualify as “two tier” I don’t know what does. But for those who can’t afford that, and whose local NHS trust can’t or won’t give them the best treatment, the pig headed, bloody minded, stubborn refusal to allow patients to buy “top up” treatment can be as good as a death sentence.

So don’t do it, Australia. Please, just don’t.

Incidentally, that op I mentioned? The one that was supposed to be a three day stay before I was able to get my wife along and discharged myself? A mate here in Melbourne has been in for the same thing, and what a difference. He was in first thing in the morning and out again early in the afternoon, and while he’d have been happy to wait and have it done on Medicare it was a busy year for him for various reasons, and being able to pay to have it done right away made life much easier. And some fuckwit wants to end this and bring in people dying prematurely because they can’t afford extra treatment from private sources. Worse still, they want to ban people buying private health insurance, thereby almost doing away with private medicine altogether. Aside from the obvious implications for health provision I hate, I mean really hate, the sort of cunt who thinks they have some God given right to say what other people can spend their money on. How dare they? How fucking dare they? Would they ban certain brands of car in the name of equality? No BMWs, Jags or Mercs? Hey, fuck it, we’re going for full fairness and equality, right? So why not ban everything that isn’t a Holden Barina? Well, because aside from making us look like banckwards and protectionist it’d be fucking ridiculous to restrict people’s choice as to what make, model and type of car to spend their money on. And hen parties will look pretty stupid in a stretched Barina instead of something like a giant pink Hummer, though I’ll concede that the Barina might be more tasteful.

So in short, it’s a terrible idea. It’ll certainly restrict individual freedom, and it sure as hell won’t achieve equality because even with banning health insurance the wealthiest will still be able to buy private healthcare either here or abroad. And worst of all I believe it’ll almost certainly sacrifice real lives on the altar of socialist beliefs. In fact it’ll be a lot like the NHS really, but actually much much worse. Well done McAuley and Menadue, well done indeed. Why don’t you just give Martin Bryant a gun and let the fucker out?