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How to Solve the Obesity Crisis!

By Sara Scarlett
January 9th, 2014 at 4:55 pm | No Comments | Posted in drugs, health, Nannying, UK Politics

Replace sugar with cocaine.

There.

My work here is done…

Seriously, though – the Government has been giving huge amounts of free money to the Sugar Industry and the Corn Industry, which produces High Fructose Corn syrup, for decades. Before any taxes are imposed on people who enjoy their sugar responsibly, perhaps it would be wise to cease subsidising these industries instead.

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The Anti-science of the Left & Right

By Sara Scarlett
August 25th, 2013 at 6:14 pm | 3 Comments | Posted in freedom, health

This is a very sad story. This part especially hit home:

Not owned by any company, Golden Rice is being developed by a nonprofit group called the International Rice Research Institute with the aim of providing a new source of vitamin A to people both in the Philippines, where most households get most of their calories from rice, and eventually in many other places in a world where rice is eaten every day by half the population. Lack of the vital nutrient causes blindness in a quarter-million to a half-million children each year. It affects millions of people in Asia and Africa and so weakens the immune system that some two million die each year of diseases they would otherwise survive.

Most GMOs have hitherto been developed for the benefit of farmers e.g. creating plants that are resistant to disease and that give higher yields. This particular GMO has been developed solely for the benefit of the consumer. It is quite clear that both the Left and the Right have dedicated anti-science viewpoints. The Left’s hatred of GMOs is as indefensible as the Right’s creationism, and possibly worse due to its horrendous effects on the poorest people in the world. Technology used in the private sector has rarely been used for evil on the scale that technology used by governments has been evil. Golden rice won’t even be the only choice of consumers – they could still buy the other rice if they wanted to. It is both anti-science and anti-humanist to prevent the use of a technology that can minimize human suffering.

What free-at-the-point-of-use Health Care looks like in a Free-Market

By Sara Scarlett
June 23rd, 2013 at 11:48 am | No Comments | Posted in health, UK Politics

My fear of hospitals has been exacerbated lately with the latest stories of cover-ups and bribes. This behaviour may be shocking but it is typical of all socialist industries. The problems facing the NHS are the problems that always occur in industries structured this way so throwing money at the problems of the NHS is won’t help. No amount of money can cure problems of structure.

When talking about different health care systems everyone always says to me ‘Oh, but the American system is so much worse…’ (as if the NHS and the American system are the only two health care systems on Earth…) The answer to this is obviously – yes! The American health care system should be used in the ‘what not to do’ section of every public policy handbook. It is a 50% government funded mess of regulation, red tape and bizarre diktats left over from WWII meaning health care is tied to employment and other such nonsense. That said, individuals who have health care in America generally have better health care than individuals in the UK. A large amount of Americans do not have health insurance, however, and the difference between not having health insurance and having the NHS is a lot bigger than that between having the NHS and having American health insurance.

People seem to think that since the American system is capitalist it is free-market. This is obviously false. People also seems to think that the NHS is the only version of free-at-the-point-of-use health care. Tellingly, when the Soviet Union fell, none of the former Soviet states, or anyone else is Europe for that matter, chose to structure their health care like the NHS.

So, in light of all this, it was put to me that a lot of people struggle with visualising what health care in a free-market would look like. I’ve written this piece so that some of those who do not get how free-market health care would work can visualise the system.

USING FISCAL TOOLS CORRECTLY

First of all split health insurance and health coverage. These are two different sets of fiscal tools. Insurance is a fiscal tool used to pay for things that happen infrequently and, if you’re lucky, not at all. I think health insurance should be mandatory but every adult picks which private provider they insure with, just like car insurance (it doesn’t have to be mandatory but I think this would more pragmatic – depends if you want to go full voluntaryist or not). Ambulance and A&E services would be paid for with these funds.

Health coverage is the fiscal tool you use for paying for health care costs you know you are going to need at some point in the future e.g. general GP visits, minor operations. In a free-market you could rely on the following means to fund your coverage; individually, with a health coverage company, with a Health Savings Account (HSAs), by joining a friendly society, by private charity and I wouldn’t be opposed to government vouchers in certain circumstances but they probably wouldn’t be necessary.

All health care providers would be privately owned and compete with each other in terms of quality, price and the nature of their care. They could be non-profits or for profits; share-held, cooperatively held or run by charities.

WHY IS THIS BETTER THAN SINGLE PAYER?

Right now, our ‘Lords and Masters’ manage funds allocated for health care and if we don’t like how they are managed we can vote some of them out at the next election (or try to) apart from the Civil Servants that we cannot. In a free-market, were a greater number of us to join friendly societies, we would have direct democratic control over who manages our collective funds and the option to leave if we felt they were being mismanaged.​ A greater plurality of ways to fund health care means all of those ways get better and you would spend a lot less on health insurance and coverage than you currently do on taxes to pay for your health care.

Friendly societies self-police. Why? Because you have a closer relationship with the individuals who are responsible for your health care and who’s health care, in turn, you are responsible for. You would have a greater incentive not to waste those resources since you are more connected to your money and who spends it. You would have multilateral relationships with other human beings and not a unilateral relationship with the state.

Drugs will become higher quality and less expensive. Monopsolies are a bad idea if you want cheaper drugs. In order to drive down their own costs health care providers would now have an incentive to bargain and negotiate for cheaper drugs. Pharmaceutical companies would have more of an incentive to create better, cheaper drugs. With a monopsoly, there’s nothing stopping drug companies cooperating with each other to charge higher prices.

Health care will go up in quality and down in price. There is only one sector of the health care market that operates closest to a freer-market and that is the plastic surgery sector. Quality in the plastic surgery sector has gone up consistently and prices have gone down consistently in the last thirty years.

Health tourism, as a problem, would disappear altogether. Non-UK citizens would be billed just like everyone else.

SO HOW DOES THIS FIT TOGETHER?

You get sick. You go to a private GP/hospital. They send your bill to you, your private coverage provider, your HSA manager, your friendly society or a charity after.​

You get in a car crash. The ambulance you’ve already paid for through your catastrophic health insurance takes you to A&E. They stabilise you. You are transferred to a hospital. The hospital sends your bill to you, your private coverage provider, your HSA manager, your friendly society or a charity after.

I wouldn’t rule out the use of government health vouchers for people who genuinely lose the health lottery, like kids who get cancer, for example. They distort the market less than other forms of government funding.

So there you have it! Health care in a free-market system. This is unfortunately one of those posts where I simply don’t have the time or energy to have the comments turned on because of the crazy it attracts. So much crazy… This post is essentially thought crime… but f*ck it, that’s my specialty.

Public health ideologues don’t come cheap

By Guest
May 14th, 2013 at 10:00 am | No Comments | Posted in health

Back in 2009, Dick Puddlecote highlighted a particularly odious piece of behaviour from a member of the “caring” profession who had long before decided that he could make a greater contribution to our collective wellbeing and his bank balance by practicing politics rather than medicine. Chris Spencer-Jones attempt to close the legally exempt smoking room in a hospice on ideological grounds were of course ignored by the mainstream media presumably because it views people who hold medical degrees as saints who can never be shown to do anything other than good works for the rest of humanity.  Fortunately the Birmingham Mail is rather less squeamish when it comes to exposing unpleasant ideologues and reported the Public Health Director’s inhumane efforts.

Obviously, Spencer–Jones was not fired or even reprimanded for what he did as common decency is not considered all that desirable in the modern public health bureaucrat.  He soldiered manfully on, talking utter twaddle, attending meetings, preparing PowerPoint presentations and performing all the other duties of a public health official until 2012. The Birmingham Mail also soldiered on, exposing the fact that Birmingham had not one but at one stage five Directors of Public Health and that they cost £600,000 per annum between them.  Two of them were paid more than the Prime Minister. Spencer–Jones was on over £145,000.

Spencer-Jones and his colleagues do appear to have been paid rather extravagantly for doing very little but they were by no means the highest paid public health bureaucrats in the land.  Thanks to the Guardian’s report on civil service pay back in 2010 we can see that the highest paid Director of Public Health at that time was ardent socialist, champion of the NHS, opponent of big business and “plain” packs supporter Gabriel Scally.

oakley blog salaries
I do not normally comment on the salaries of others but I am happy to make an exception in the case of public health because for many years it has been a gravy train for the not especially talented and those with political axes to grind. In recent decades it has cost many millions and delivered very little except for a more divided and unhappy society in which an increasingly judgemental approach is encouraged towards behaviours deemed unacceptable by a well-heeled elite. Huge sums have been spent on lifestyle propaganda whilst the people who work in “real” public health laboratories have had their budgets squeezed.

Gabriel Scally very publicly resigned in 2012 ostensibly because he doesn’t like the current government and what he thinks that it is doing to the NHS. He also doesn’t care much for responsibility deals and is upset by the very thought of elected governments treating legitimate companies that he doesn’t like as anything other than enemies of the state. Prior to resigning he apparently saw his staff shrink from 50 to 9, which although unfortunate for his staff, who I hope found something more worthwhile to do, has to be a very good thing overall. Similar good things seem to have been happening in Birmingham where at around the same time Spencer-Jones and his colleagues were reduced from four to one.

Before we get too excited about the NHS reforms actually doing some good, we should pause and consider the fact that the government is not promising a reduction in spending on the public health industry but is simply shifting responsibility for public health to local authorities and a new QUANGO that may be no less profligate than those that preceded it. A number of local authorities appear to be acquiring Public Health Directors and the going rate seems to be £75-£100,000 which is consistent with what the local authority contingent of the Birmingham four /five were being paid. Chris Snowdon has pointed out that the transfer of budget to local authorities from PCTs has done nothing to curb spending on health lobbyists in the North East where £2.8 Million is already earmarked to pay spin doctors to lobby government and tell people how to behave. Apparently the “The unanimous view of the new directors of public health, together with the Health and Well-being Committees, was that funding … should continue.” Health and Well-being Committees sound rather ominous so I am not hopeful that we are going to see much change. One would hope that local authorities would at least be more accountable than the NHS but does anyone know who the new people responsible for bankrolling the lobbyists are?

By Chris Oakley. Chris’ previous posts on Liberal Vision include: Minimum pricing – policy based evidenceAlcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth Lies, damn lies, statistics &… , The Department of Health is Watching You! , New bounty on smokers helps GPs balance their books, Smoking ban health miracles

 

 

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Smoking ban health miracles

By Guest
April 15th, 2013 at 10:00 am | 7 Comments | Posted in health, pseudo science

Earlier this year a paper was published in a peer reviewed journal that was so contrived and so flawed that I had hoped it would convince any doubters that the evidence for miraculous immediate health effects from smoking bans is entirely the figment of activist’s febrile imaginations. Sadly, it appears that I was wrong and that true believers including David Cameron still cling to the notion that smoking bans “have had a pretty dramatic health effect”.  This delusion is shared by Anna Soubry who unforgivably and untruthfully claimed reductions in heart attacks and childhood asthma admissions as a result of the English smoking ban in evidence that she gave to the House of Lords (page 11).  The fact that she was standing next to the less than impartial Andrew Black at the time is no excuse as only someone without interest in truth or reality would take anything Black says at face value.

The “growing body of peer reviewed evidence” used to justify these counter-intuitive claims is an indictment of public health industry ethics and medical journal standards. This recent contribution claiming a 12% reduction is asthma admissions as a result of the smoking ban originates from Imperial College London which is cause for further concern because Imperial is a top UK research establishment and as such charges young people a small fortune to be educated by what one would hope are top academics.

The culprits behind this affront to science are Stanton Glantz and Christopher Millett. In case anyone is labouring under the illusion that these two are objective scientists, Glantz is a well-known anti-tobacco activist who together with Millett holds extreme views on smoking in movies. Glantz was recently mentioned in the US congress in relation to a $680,000 grant that he used to make the bizarre claim that the Tea Party was created 25 years ago by big tobacco. It is extraordinary that we ban tobacco company funded research on the basis of scientific objectivity but, by a widely accepted double standard, treat the output of blatantly biased activist obsessives as “scientific evidence” fit for Prime Ministers.

This paper is yet another example of torturing numbers to fit a theory. The authors produce a lot of complex statistical waffle to obscure the deception but their essentially simplistic claim can be illustrated using annual data for childhood asthma admissions from the same NHS source they use. In the figure below the blue bars are years pre-ban and the orange ones the year of the ban and one year later. The solid red line is a simple linear fit to the pre-ban data.

asthma 2002 2009

The claim that the ban reduced asthma admissions depends on showing that admissions rates were increasing pre-ban and that after the ban admissions were lower than predicted had that trend continued along the path illustrated by the dashed red line.  Millett uses the period 2002-2007 to model the “rising trend” in admissions but the NHS data goes back further and if we use all the available data the “trend” changes somewhat.

asthma 1998 2009

Cherry picking time periods is a common deception practiced by the public health industry together with taking advantage of coincidental variations in data series that happen to fit a theory or policy.

Those desperate to believe might argue that I am being too simplistic in that the “experts” took a more sophisticated approach and used monthly data. A 12% fall in admissions should not need sophisticated techniques to be apparent but it is true that 2007-08, the year of the ban, saw a big fall in admissions compared to the previous year. However, a look at NHS data for monthly admissions covering three years around the ban serves only to illustrate how the second element of the trick works.  asthma 2005 2008

If I asked a group of seven year olds which of the lines on the chart above was the odd one out, I would expect the majority to say the orange one. The orange line represents monthly admissions for the year before the ban. We can align the data on the month of July which was when the ban came in but it makes little difference. Admissions were low in the year the ban came into force but not unusually so. Both the alleged upward trend before the ban and the apparent fall in the year it was enacted work for the activists only because peak season admissions were unusually high in the year before the ban. That stroke of fortune combined with the cherry picked time frame form the basis of the deception.

This peer reviewed paper appears to be nothing more than a cheap trick, an abuse of academic freedom for political purposes. The authors admit to some of its flaws but this did not prevent them from issuing a carefully worded press release that inevitably led to a misleading claim being widely broadcast by a gullible and uncritical media. It even made BBC TV news! This is not an isolated incident. It forms part of a body of highly publicised but fundamentally flawed “research” that has led some politicians and at least one national leader to erroneously believe in unlikely health miracles associated with interventions such as smoking bans. This might well influence opinions when reviewing existing or considering additional interventions, which one can argue is the main purpose behind such publications and their attendant publicity.

Of course, those politicians obsessed with public health are never slow to accept even the most unconvincing “evidence” if it suits their prejudices. Despite widespread incredulity over the facile “evidence” underpinning the implausible notion that smoking bans produce big falls in heart attacks, Sarah Wollaston of minimum alcohol pricing fame has claimed that the UK smoking ban:

“…was a very good example of evidence-based policy. If you look at what has happened in terms of deaths of cardiac disease, it has been staggering. There’s been a huge drop … It surprised even the health experts.”

Wollaston exhibits blind faith in “evidence” that is of no better standard than the article reviewed here. Her need to believe does not make it true, or a good basis for policy.

I have contacted Pediatrics and asked how something so obviously contrived as the Millett paper could survive peer review. I was informed that it was reviewed by people who are “experts in their field”.  I wasn’t told what field, but expertise in either mathematics or ethics was apparently not considered necessary in this case. There are reasons why political stunts like this usually appear in medical journals rather than elsewhere in the literature and it is remarkable just how low some set the peer review bar. Peer review is supposed to be a minimum requirement able to identify fundamental methodological errors or false claims. Every time an article such as this is published in a “peer reviewed” journal, respect for this gold standard and science in general declines a little bit further. The collective damage is becoming significant and the implications extend way beyond smoking.

I have also contacted Imperial College press office but they have declined to comment on why they inflicted this press release on the general public. From direct experience I know that Imperial College employs many excellent lecturers and research scientists but based on this output I think that we should question what exactly young people are being taught for £9,000 a year and who is doing the teaching. Honesty, integrity and academic excellence are qualities that I would expect to see in those who benefit from the fees young people are now being asked to pay. I appear to be in a minority.

By Chris Oakley. Chris’ previous posts on Liberal Vision include: Minimum pricing – policy based evidenceAlcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth Lies, damn lies, statistics &… , The Department of Health is Watching You! , New bounty on smokers helps GPs balance their books.

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