Re: So are Labour on their way out?
Posted: Sat 04 Jul, 2009 08.55
Gavin - I don't accept that the level of offense is comparable at all. I criticised a policy. You attacked me personally. If you can't recognise a material distinction between those two things, then I'm not prepared to enter into a debate with you again. This will be my last post on the matter.Gavin Scott wrote:Well I'm sorry if that comment offended you Mr Q, but I was similarly offended to hear you dismiss the NHS as a "joke". If it seems that way to you then either you're hearing a very slanted view in the cross-world media, or you are basically saying that healthcare should only be there if you have the means to pay for it.Mr Q wrote:You know what Gavin - it's fine if you want to snap at me rather than engage in a discussion of the issues. But to liken my point of view to advocating Nazi-style eugenics is deeply offensive. If that's the sort of attitude you want to take, I'm not really sure I care to be a member of this site.Gavin Scott wrote:I really, really don't want to live in your "ideal" capitalist society Mr Q, because it sounds to me like you're a very small step from sterilising the poor and euthanising the disabled.
From that I drew a line further which may have misrepresented your view, so I withdraw it.
What I don't understand in your view is where you think a society comes in to play. Is it every man for himself as far as you're concerned?
Was it wrong of me to call the NHS a 'joke'? Indeed it was. It was an unfair and glib response - healthcare is not a laughing matter. I'm sure the NHS can deliver a high quality service - Britain has the resources to fund decent equipment for hospitals, and to train and employ well qualified doctors and nursing staff. But at the same time, there are some failures present in the system. James H has given one such example from his own personal experience. These are systemic issues, not isolated incidents - they speak to the way the system is designed to ration access to services. Rationing of course isn't a bad thing - it's essential in fact. But I find it disappointing that people would be forced to wait months - even in excess of a year - for medical treatment that they need. I happen to think society deserves better than that. That's why I criticised the NHS (after, I might remind you, you specifically asked for my view on it) - not because I think it is completely broken (because it isn't), but because there should be a way to make it work better. Of course Gavin, if you happen to the think the NHS is perfect as it is today, you're more than welcome to that opinion. (I'm not in the business of personally attacking people for the views they hold.)
I will readily acknowledge that I do not know what the best approach is to healthcare. It is one of the most challenging areas of public policy. The fact that every country in the world seems to take a different approach - with each presenting their own problems - I think highlights the complexity of the issue. As I indicated in an earlier remark, I don't think the US system - largely regarded as a 'user pays' approach - is particularly desirable. While there are characteristics I admire (for instance, the level of innovation within the US health system and the diversity of players involved), I also know that costs are ridiculously high. On that score at least, competition doesn't appear to be working as one would ordinarily expect. I don't know whether that's because healthcare can't function effectively without strong government intervention, or whether current government interventions on the margin are making things worse (one area of concern: there are taxbreaks for company healthcare plans, but not for coverage taken out by individuals). I suspect in all honesty it is probably a mix of both those things. Yes, there may well be a legitimate role for government. Shock, horror.
Despite your assertions to the contrary, my primary interest in policy is to improve society's wellbeing - to make people better off. I do not take comfort from seeing people suffering. I simply question the degree to which government 'assistance' proves to be beneficial. Policy interventions cause distortions (and indeed, that is presumably the reason for intervening - to change an outcome). But policies can have unintended consequences - with efforts to help today being overshadowed by the cost it imposes tomorrow. To me, a classic example of this is foreign aid. There is mass starvation throughout parts of Africa, and a traditional approach to addressing this is for foreign governments to supply affected regions with free food aid. This can indeed save lives today. But it also devastates local farmers in Africa who no longer have a market they can sell their food to - they can't possibly compete with free food being dumped from abroad. So those farmers have no incentive to grow more food than is enough to feed themselves - they are pushed into subsistence farming, leaving entirely unfulfilled the potential for a vibrant agricultural industry which creates jobs and spreads prosperity in the region. Compounding this is that the lack of economic opportunity is also a prime catalyst for conflict, which can lead to many more lives being lost through war.
Let me make this point as clear as I can - because obviously I need to - I am not attacking the motives of those who advocate or implement foreign aid, for they are genuinely trying to help. But I feel compelled to point out that, despite their best intentions, they are probably making things worse. (You would not be surprised to learn that I think the greatest single contribution the developed world could make to improve conditions in the developing world is to tear down agricultural trade barriers - specifically, to end the mass subsidisation of farming in Europe and the US.)
I do not shy away from the fact that I assess things in terms of costs and benefits. When I hear people say things like "Not everything should be measured with a cost/benefit analysis", what that in fact suggests is that we should adopt ill-informed policies because they feel like the right thing to do. Obviously I disagree. But this view is quite common, and I think it stems from perhaps the greatest misperception of economics - that costs and benefits are solely pecuniary in nature. They are not. A sound economic framework takes full account of social (and, for that matter, environmental) factors. These things are clearly hard to measure - but that most certainly does not mean that they are ignored. Were this not the case, economics would be an entirely worthless profession, because the policy conclusions would routinely leave society worse off.
I have taken the last day or two to reflect on the recent comments in this thread. I did not want to respond in such a way that I might later regret my words. But I am just as angered and upset today as I was when I read Gavin's post on Thursday. I have never claimed to know all the answers. I simply express my views where I think they can add value to an interesting debate. I don't appreciate being attacked for doing so. I don't believe I deserve that kind of treatment.
This may well be my last post on Metropol. It will almost certainly be my last for a little while. I feel it would be appropriate for me to take a break. Although we have frequently disagreed on a range of issues, Gavin is someone that I had always maintained the greatest respect for. I can no longer say that is the case. As a staunch libertarian (perhaps too staunch), being likened to a Nazi - someone who would strip people of their freedom and their dignity - is rather galling. It will take some time yet for that particular wound to heal.