Labour Parties

Mark Jones markjones011 at tiscali.co.uk
Wed Sep 25 08:32:48 MDT 2002


At 25/09/2002 14:43, Michael wrote:


>Maybe one way of looking at this process is to go back to the policies of
>Harold Wilson's 1960s governments,

This is all wonderful stuff and we are in your doubt for the insights. I
only have to qualifying comments on your analysis of NHS possible
privatisation and this is about what is meant by 'minimum standards of
care' as in 'the World Bank  "state as guarantor" model'. The implication
seems to be that there is a difference between minimum standards and the
best possible clinical standards of care and treatment. Is this so? There
are 2 political constraints on any advanced capitalist state's desire to
economise on health care. First there are international comparison of
mortality and morbidity rates, life expectancies, survival rates for cancer
and heart disease etc. These drive competition between different national
health services and create political support for more spending; no western
(OECD) govt which wants to be re-elected can permit significant lags to
emerge between its own infant mortality rates etc and those of rival peers.
The British public perception that the Germans and French for eg were
living longer was a major propaganda opportunity for Labour's attacks on
the poor Tory record with the NHS. So minimum standards are driven by
competitive comparisons. Equally, if the minimum is seen as less good than
the best available treatment in particular clinical modalities, there is
always popular resistance: thus for eg when the postcode issue arose in
Britain because some regional health authorities would not provide
expensive procedures for eg breast cancer treatments, and others would, the
inequity resulting from having an address in the 'wrong' postcode created
great pressure for raising and equalising standards generally. I don't see
how any govt could re-elected on a platform of giving inferior treatment to
poor sectors of the population, even tho this, we know, does happen in
practice, and is evidenced by higher mortality and morbidity rates among
inner city populations and low-paid sectors.

Only general social collapse as in the USSR can make it possible to destroy
health and welfare services with minimum popular resistance from a cowed
population. If, per contra, your argument is that the US will enforce or
impose its own health care models on other advanced capitalist states, I
would argue that this is politically impossible. The abysmal US record of
health care, evidenced by mortality and morbidity rates which are poorer
than most other advanced states and worse than Cuba's on some indicators,
is the result of having no real public provision, no real safety nets, and
a privatised health service so that what you get is a vast surplus of
hospital beds, great big new medical facilities, state of the art
technologies, coinciding with absolute insecurity, poor health care and
even absent care, for many millions of ordinary Americans. The colossal
scale of human suffering which the US health care system inflicts on the US
population is a subject all by itself. That it works at all is only due to
the relative degree of private affluence, the high levels of consumption,
which are bought at the price of incredible, planet-wrecking profligacy,
such that the average American used twice as much energy and raw materials
as the average German, Italian or Briton. The colossal degree of waste and
human suffering created by the US 'health' service is just one more
indicator of the colossal wastefulness, predatoriness and greed of the
unsustainable US economy.

Mark


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