Aug 072009

Not too many weeks ago, I ran across a blog, the name of which I cannot now remember, in which the author posted a hypothetical government ban on books – not because of their literary content, but because as old books decay, they could release fibres and other toxins which might be inhaled by the reader, thus damaging the reader’s health. He was using it to illustrate, if I remember correctly, the way the government wishes to restrict or ban anything which gives us pleasure and justifies doing so on rather spurious ‘health’ grounds.

If anybody knows the blogger I mean, do let me know, because I’d like to give him a head’s-up:

Congress to ban sale of children’s books printed before 1985

Why? Because they are hazardous to the health.

UPDATE: Yes, it was Frank Davis.

Aug 032009

1. Everything in America is huge.

2. Including the creepy-crawlies.

3. American healthcare costs what it does because of (a) widespread, mild hypochondria and (b) creepy-crawly-borne diseases.

4. American food is now too rich for my palette.

5. Big weddings are more trouble than they’re worth.

6. A supportive family can turn a hell into, if not exactly a paradise, at least a reasonably tolerable purgatory.

7. Virgin Atlantic is my new favourite airline, and I won’t hear a word spoken against Sir Richard ever again.

8. It’s good to be back home in the UK, for another 28 days anyway.

Jun 092009

A commenter at the Devil’s Kitchen, who obviously couldn’t be bothered follow the link over here to leave his correction, says:

I appreciate your position, but Bella’s interpretation of Protocol 1 Article 2 of the ECHR (which she calls a ‘charter’) (and thus the Human Rights Act) is incorrect- and I wouldn’t want you to be misinformed by it (and I’m not suggesting that it is).

It is actually a reinforcement of a negative right, rather than a positive – ensuring that citizens have a right not to be denied an education. It certainly doesn’t compel subscribing states to provide an education.

The protocol doesn’t provide for “the right to an education”, nor does the Human Rights Act itself.

On the issue of healthcare , the convention doesn’t even mention the subject, so that straw man is knocked down. Only health is mentioned in the context of public authorities not interfering with the rights set out by the convention except for where the protection of health requires it.

He is right; I was thinking of, not the European Convention on Human Rights, but the UN’s Universal Declaration of Human Rights, which says amongst other things (emphasis mine):

Article 22
Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality.

Article 25
(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Article 26
(1) Everyone has the right to education. Education shall be free, at least in the elementary and fundamental stages Elementary education shall be compulsory Technical and professional education shall be made generally available and higher education shall be equally accessible to all on the basis of merit.

And so I stand corrected.

Feb 032009

Mr Smug Git at work left a note on my desk this morning containing the following information:

(2002) US health expenditure: $5267 per capita, 14.6% GNP
(2005) UK health expenditure: $2598 per capita, 8.2% GNP

(2006) US life expectancy: 75.4 (male), 80.7 (female)
(2005) UK life expectancy: 77 (male), 81 (female)

It would seem that Americans spend more on healthcare for less result than the UK, thus making the UK system ‘more efficient.’

I’m going to assume these figures are genuine, although I don’t know where they come from and I haven’t the time at the moment to verify them; but I’m puzzled. Does the US per capita figure include spending on health insurance? And if so, how much of that actually gets spent on healthcare provision?

Points to ponder…

UPDATE: A bit of interwebs-wandering has led me to a 1999 study published in the New England Journal of Medicine. Amongst other things, the study itemises administrative healthcare spending. About insurance overhead, it has this to say:

In 1999 U.S. private insurers retained $46.9 billion of the $401.2 billion they collected in premiums. Their average overhead (11.7 percent) exceeded that of Medicare (3.6 percent) and Medicaid (6.8 percent). Overall, public and private insurance overhead totaled $72.0 billion — 5.9 percent of the total health care expenditures in the United States, or $259 per capita (Table 1).

Presumably the $46.9 billion the private insurers ‘retained’ in 1999 represents (a) the cost of operating the company and (b) profit. I see no problem with this; insurance companies are meant to generate a profit. If they didn’t, they wouldn’t exist.

There is also this 2008 paper from the US Congressional Budget Office, which analyses the relationship between new technology and healthcare expenditure. It defines new technology as:

changes in clinical practice that enhance the ability of providers to diagnose, treat, or prevent health problems. Technological advances take many forms. Examples include new drugs, devices, or services, as well as new clinical applications of existing technologies (providing a particular service to a broader set of patients, for example). Other technological changes are newly developed techniques or additions to knowledge.

The paper goes on to examine a handful of new treatments: revascularization for coronary artery disease, renal replacement therapy for kidney failure, bone marrow transplantation, joint replacement, diagnostic imaging, and neonatal intensive care.

But here is the key paragraph:

Advances in medical science during the past several decades have greatly increased the set of available medical services, allowing practitioners to treat patients in ways that were not previously possible. Most health policy analysts agree that the long-term increase in health care spending is principally the result of the health care system’s incorporation of these new services into clinical practice.

So, part of that massive difference between US and UK health expenditure is, first, the involvement of profit-making insurance companies in the US, and second, the development of and increased access to new treatment technologies in the US. Do those things count as ‘inefficiency’?

And as for the delightful NHS – if it is so efficient, why does this piece exist? And this?