Posts Tagged ‘Elderly’

Code Pink Urges US Institutions to Boycott Arms Industry

October 25, 2017

This is another important piece by RT America on attempts by American peace activists to stop the war machine that is currently killing and making homeless millions of innocents in the Middle East, as well as the courageous American and allied squaddies sent to fight in it, and which has also resulted in massive cuts to public programmes in order to fund it.

The left-wing peace group, Code Pink, has launched a conference to encourage universities and financial institutions to boycott and divest from the arms industry. The group’s leader, Medea Benjamin, states that the reason these wars have dragged on so long is because they are incredibly profitable to the arms manufacturers. Every time Trump goes to Saudi Arabia, for example, to announce a multi-million dollar sale of armaments, the share price of companies like Lockheed Martin goes up. So, she says, they are simply following the money and trying to get institutions to stop funding and supporting these ‘merchants of misery’.

Vijay Prashad, the director of International Studies at Trinity College, states that even though millions are being killed in these wars, there is no accountability, no outrage, no pity for the victims and no sense that anybody should be dragged before an international tribunal. Instead, the victims of these wars themselves are blamed, as is happening now in Syria, while the reality is that these wars are destroying country after country.

The Black American activist, Ajamu Baraka, who was the Green Party’s presidential nominee, also makes the point that in order to fund this war machine, the American state is cutting vital welfare services and programmes. These include those for the homeless, support for education, such aid for the poor to go to college, environmental protection policies will be cut, energy assistance for the poor and elderly will also be cut, all in order to find the money to provide the £696 billion granted to the US military. It’s money that has been supplied at the expense of poor people’s basic needs.

The clip ends with Medea Benjamin stating that the conference is designed to get people together to say ‘enough is enough’ and that institutions no longer want to make profits from the military and their wars.

All of this is correct. People in America, as well as those over here, are seeing welfare budgets slashed partly to provide funding for the continued wars in the Middle East and elsewhere. These are not being fought for democracy, or the defence of the West and its allies against evil dictators. They are being fought to provide profits for American arms contractors, who provide millions of dollars in funding for American politicos. Iraq wasn’t invaded because it had weapons of mass destruction. That was a lie. It was invaded because the Saudi-US oil industry wanted the Iraqi oil reserves and its industry. American multinationals also coveted Iraqi state enterprises, and Israel hated the aid Saddam Hussein was giving to the Palestinians.

And the same is true of Syria. The neocons want to destroy it, because its an ally of Iran and Russia and a potential threat to Israel. They and a group of Arab states, including Qatar and Jordan, also want to oust Assad because he’s blocking the construction of a massive gas pipeline, which will stretch from Qatar to Turkey. In fact, these nations even told the Americans they’d pay for the war if America attacked Syria.

And the neocons have already destroyed Libya, they’d like to destroy Somalia, Sudan and Iran. Hence Trump’s step in decertifying the Iranian nuclear deal with Obama.

General Smedley Butler described all this back in the 1930s in his book, War Is A Racket, detailing the way American big business had profited from the First World War. As for the poor suffering because of the need to cut services to fund the military, I think it was president Truman, who described it has taking food from the mouths of the poor, and denying the construction of schools and hospitals.

I’ve already said in my last article about the revelation that the CIA was staging fake academic conferences as part of its campaign against the Iranian nuclear programme, that Lobster had published an article expressing similar concerns about the way some of Britain’s universities were also supporting the British war machine. Millions are being plunged into poverty and death, including American and British squaddies, all for the profits of the merchants of death and big business like Haliburton. It’s time for this obscenity to end, and universities and investment houses to pull out of supporting the war machine.

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Guy Standing’s Arguments against Workfare: Part 1

August 8, 2016

Workfare is one of the most exploitative aspects of the contemporary assault on the welfare state and the unemployed. It was advocated in the 1980s by the Republicans under Ronald Reagan in America, and in Britain by Thatcher’s Conservatives. At its heart is the attitude that the unemployed should be forced to work for their benefits, as otherwise they are getting ‘something for nothing’. Very many bloggers and activists for the poor and unemployed, including Mike over at Vox Political, Johnny Void, the Angry Yorkshireman, and myself have denounced it as another form of slavery. It’s used to provide state-subsidised, cheap labour for big business and charities, including influential Tory donors like Sainsbury’s. And at times it crosses the line into true slavery. Under the sanctions system, an unemployed person is still required to perform workfare, even if the jobcentre has sanctioned them, so that they are not receiving benefits. Workfare recipients – or victims – have no control over where they are allocated or what jobs they do. The government was challenged in the courts by a geology graduate, who was forced to work in Poundland. The young woman stated that she did not object to performing unpaid work. She, however, had wanted to work in a museum, and if memory serves me correctly, had indeed got a place at one. She was, however, unable to take up her unpaid position there because of the Jobcentre’s insistence she labour for Poundland instead. A young man also sued the government, after he was sanctioned for his refusal to do 30 hours a week unpaid labour for six months for the Community Action Programme. The High and Appeal Courts ruled in the young people’s favour. They judged that the government had indeed acted illegally, as the law did not contain any stipulations for when and how such work was to be performed.

Iain Duncan Smith, the notorious head of the Department of Work and Pensions, was outraged. He called the decision ‘rubbish’ and said, ‘There are a group of people out there who think they are too good for this kind of stuff .. People who think it is their right take benefit and do nothing for it – those days are over.’ This is rich coming from IDS, who was taking over a million pounds in farm subsidies from the EU. Eventually, Smith got sick of the criticism he was taking for the government’s welfare policies, and flounced off early in 2016 moaning about how unfair it all was that he should get the blame, when the notorious Work Capability Tests inflicted on the elderly and disabled were introduced by New labour.

They are in no sense free workers, and it similarly makes a nonsense of the pretense that this somehow constitutes ‘voluntary work’, as this has been presented by the government and some of the participating charities.

The political scientist Guy Standing is also extremely critical of workfare in his book, A Precariat Charter, demanding its abolition and making a series of solid arguments against it. He states that it was first introduced in America by the Republicans in Wisconsin, and then expanded nationally to the rest of the US by Bill Clinton in his Personal Responsibility and Work Opportunity Reconciliation Act. It was part of his campaign to ‘end welfare as we know it’. Single parents receiving social assistance were required to take low-paying jobs after two years. Legislation was also passed barring people from receiving welfare payments for more than five years in their entire lives.

David Cameron, unsurprisingly, was also a fan of the Wisconsin system, and wanted to introduce it over here. In 2007 he made a speech to the Tory faithful at the party conference, proclaiming ‘We will say to people that if you are offered a job and it’s a fair job and one that you can do and you refuse it, you shouldn’t get any welfare.’ This became part of Coalition policy towards the unemployed when they took power after the 2010 elections. Two years later, in 2012, Boris Johnson, speaking as mayor of London, declared that he was going to use EU money from the Social Fund to force young adults between 18 and 24 to perform 13 weeks of labour without pay if they were unemployed.

Ed Miliband’s Labour party also joined in. Liam Byrne, the Shadow Secretary for Work and Pensions, declared that

Labour would ensure that no adult will be able to live on the dole for over two years and no young person for over a year. They will be offered a real job with real training, real prospects and real responsibility … People would have to take this responsibility or lose benefits.

This was echoed by Ed Balls, who said

A One Nation approach to welfare reform means government has a responsibility to help people into work and support for those who cannot. But those who can work must be required to take up jobs or lose benefits as such – no ifs or buts.

Standing traces the antecedents of workfare back to the English poor law of 1536 and the French Ordonnance de Moulins of twenty years later, which obliged unemployed vagabonds to accept any job that was offered them. He states that the direct ancestor is the 1834 Poor Law Amendment Act, the infamous legislation that, under the notion of ‘less eligibility’, stipulated that those receiving support were to be incarcerated in the workhouse, where conditions were deliberately made much harsher in order to deter people from seeking state support, rather than paid work. This attitude is also reflected in contemporary attitudes that, in order to ‘make work pay’, have demanded that welfare support should be much less than that received for paid work. This has meant that welfare payments have become progressively less as the various measure to make the labour market more flexible – like zero hours contracts – drove down wages. The workhouse system was supplemented in 1905 by the Unemployed Workmen Act, supported, amongst others, by Winston Churchill. This directed unemployed young men into labour, so that they should not be ‘idle’ and be ‘under control’. Nor were leading members of the early Labour party averse to the use of force. Sidney and Beatrice Webb, two of the founders of the Fabian Society, were also in favour of sending the unemployed to ‘labour colonies’, chillingly close to the forced labour camps which became such as feature of the Nazi and Communist regimes. Liam Byrne also harked back to the Webbs to support his argument for workfare as Labour party policy. He stated

If you go back to the Webb report, they were proposing detention colonies for people refusing to take work … All the way through our history there has been an insistence on the responsibility to work if you can. Labour shouldn’t be any different now. We have always been the party of the responsibility to work as well.

The result of this is that many unemployed people have been placed on the Mandatory Work Activity – MWA – scheme, which requires them to perform four weeks of unpaid work for a particular company, organisation or charity. The scheme also includes the disabled. Those now judged capable of performing some work are placed in the Work-Related Activity group, and required perform some unpaid labour in order to gain ‘experience’. If they do not do so, they may lose up to 70 per cent of their benefits.

This has created immense fear among the unemployed and disabled. Standing quotes one man with cerebral palsy, who was so afraid of being sanctioned for not performing the mandatory work, that he felt physically sick.

The system also affects those in low-paid part-time jobs or on zero hours contracts. These must prove that they are looking for more working hours or a better paid job. If they do not do so, they may lose benefits or tax credits. In 2013 the Tory-Lib Dem government made it even harder for people to claim tax credits by raising the number of working hours a week, for which tax credits could not be claimed, from 16 to 24.

Private Eye on Andrea Leadsom and the Hedge Funds Backing Brexit

June 9, 2016

This fortnight’s Private Eye also has an interesting piece on Andrea Leadsom, one of the leading Tory Brexit supporters. Leadsom has been complaining that several of the organisations warning of the dire consequences Brexit will have on the British economy are funded by the dreaded EU. The Eye points out that Leadsom herself is also funded by her brother-in-law, a hedge fund manager based in the Channel Islands, and that the hedge funds generally support Brexit in the expectation that it will help them avoid paying tax. The Eye writes

Hedging Her Bets

“I put it down to a big institutional ganging up on the poor British voter,” complained Andrea Leadsom, the leading “outer” who is said to be having a good war, referring to the way the Institute for Fiscal Studies and others point out the likely costs of leaving the EU. “What do they have in common, these organisations?” Number one – lots of EU funding.”

The energy and former Treasury minister perhaps knows more than she has previously let on about the power of financial backing to influence views and policy. Leadsom herself ahs had plenty of financial backing from the offshore hedge und run by her brother-in-law Peter de Putron, as has the EU-sceptic Open Europe thinktank, she has championed (Eyes passim ad nauseam).

What result the Guernsey-based donor hopes for is not known. But plenty of other hedgies want out so they can escape EU regulation of their funds (inexplicably confident that a British Tory government would be kinder to them). Others are just pleased it’s all getting nice and tight so they can take positions on sterling and cash in on the early exit poll information they are paying for outside the polling booths. (p. 7).

Her connection to hedge funds and their managers should be one good reason alone why no-one should take Andrea Leadsom remotely seriously. Many of the private care home chains that collapsed a few years ago were run by hedge funds, as is a private hospital in Bath. These organisations see health and social care as a lucrative investment, and their financial arrangements are so organised in order to make it appear that the firms are operating close to their margins so they can benefit from tax breaks. As a result, the care homes and hospitals they manage are often underfunded and genuinely in a precarious financial situation. Hence the appalling failures of several care homes to provide acceptable standards of care to their elderly or handicapped inmates, and their spectacular collapse.

And unfortunately, at the moment the hedge funds and the parasites in charge of them are all too right in their expectations that a British Tory government won’t tax them. The Tories have shown absolutely no interest in doing so up to now. In fact, quite the opposite. They are trying to do their best to protect London and the rest of the country as a low tax haven for dodgy businessmen and financial speculators right across the world. It’s why one international politician declared Britain to be one of the most corrupt countries in Europe, because of the safety it provides to gangster right across the continent and the globe to launder their ill-gotten gains. The Tories are quite comfortable with this vile situation, and will do everything they can to protect it as far as possible, up to and including Brexit.

Private Eye from 2009 on Corporate Lobbying at the Tory Party Conference

March 8, 2016

Private Eye printed this piece about the corporate sponsorship of the Tory conference that year in their issue for the 4th – 17th September 2009.

Conference Countdown

David Cameron has warned lobbyists to keep their distance at the Conservatives’ forthcoming party conference in Manchester. With the keys to No. 10 within his grasp, the last thing Dave needs is another cash-for-access scandal. But corporations that want to get close to the PM-in-waiting can always go the think-tank route.

Policy Exchange is the most Cameroonian of these bodies, and its preliminary conference timetable shows how easy it is for business interests to pay for face time with shadow ministers.

Shadow energy minister Charles Hendry will be speaking about “energy security and decarbonisation” courtesy of Oil & Gas UK, the trade body for the North Sea oil firms, alongside the group’s chief executive. As the meeting is being paid for by the oil lobby, energy security will most likely trump global warming, and wind and wave power, like energy saving, will not get much of a look-in.

Shadow health minister Stephen O’Brien will be discussing whether funding for long-term care should be by “individual, state or partnership”. The answer may well be by “partnership” because the meeting is being paid for by Partnership Assurance which specialises in funding elderly care through equity release and insurance schemes and so has a direct interest in less government funding for elderly care.

Fellow shadow health minister Mark Simmonds meanwhile will discuss whether “We need more public health initiatives for the worried well?” The obvious answer would be ‘No we don’t”, but as the meeting is sponsored by Alliance Boots, which would love to be involved in government health initiatives to drum up more business, the answer may well be in the affirmative.

Shadow business minister Mark Prisk is addressing a meeting called “Britain won’t be great if we don’t make anything anymore”, paid for by the arms firm BAE Systems. He will speak alongside BAE’s spin doctor, Bob Keen. BAE’s contribution to Britain’s greatness includes taking huge amounts of the defence budget for military kit marred by cost overruns and late delivery – overpriced and late schemes like the Astute Class Submarine (£1bn over cost, four years late) about which the Tories have been making a fuss.

The British Airports Authority, so close to the current government, is taking no chances with a new administration and so is sponsoring a meeting on “infrastructure” with George Freeman, Cameron’s “A List” candidate for the safe Tory Mid Norfolk seat. BAA’s spin doctor, former spokesman for Tony Blair Tom Kelly, will also address Tory delegates at the meeting.

Shadow culture minister Ed Vaizey meanwhile will be talking about “the future of television ” on a platform funded by BT Vision, alongside the TV-on-the-internet firm’s chief executive. BT Vision of course currently lobbying the government to merge with Channel 4. So no hidden agenda there.

This shows how duplicitous Cameron has always been in trying to deny the corporatist agenda behind the Tory party. He wanted to hide the influence of the lobbyists at this party conference, just as his lobbying bill is supposed to make government more transparent by limiting them at Westminster. In fact, it’s aimed at charity and other political pressure groups and denying them access, and leave the corporate big boys untouched.

And it also shows the very deep connections between his Tories and the corporations seeking to profit from privatisation and government outsourcing.

Republicans Attacked Unions as Terrorist Supporters after 9/11

February 21, 2016

This afternoon I put up a piece showing the continuity between Trump’s plans to exclude Muslims from the US and compel the registration of those already in the country with the round up of Arabs and other Middle Easterners as ‘suspicious persons’ under George Dubya after 9/11.

I’ve also been alarmed that Conservatives on both sides of the Atlantic will move from interning Muslims and persecuting other minorities, such as Mexicans and Blacks in America, to incarcerating left wing and labour activists. In the 1970s at the head of the paranoia about Harold Wilson MI5 and MI6, along with elements in the Tory party, were planning a coup. They investigated the possibility of setting up an internment camp for 40 MPs, ‘not all Labour’, and a total of 5,000 others, including journalists, youth, minority and senior citizens’ activists, as well as trade unionist, and members of the Socialist Workers and Communist parties.

It seems that after 9/11, certain sections of the Republican party also wanted to do the same. John Kampfner in his book Freedom for Sale: How We Made Money and Lost Our Liberty describes how in 2003 the office of the House majority leader, Tom DeLeay, sent out a letter appealing for donations to supporters of the National Right to Work Foundation. This is an anti-union pressure group. The letter stated that organised labour ‘presents a clear-and-present danger to the security of the United States at home and the safety of our Armed Forces overseas’. It attacked ‘big labour bosses’ who were ‘willing to harm freedom-loving workers, the war effort, and the economy to acquire more power.’ (p. 244.)

Kampfner traced the DeLay’s office’s assault on the unions to the Red Squads that were set up by the police forces in major cities like New York, Chicago and Los Angeles in the 1920s to combat ‘subversives’. These included Communists, Anarchists, civil rights activists, feminist activists, trade unionists and just about anybody else they thought was a threat to good, Right-wing patriotic American values. (p. 243).

I blogged the other day about the Tories’ plans to build a special prison for radical Islamists following Mike’s article on this. Mike considered this approaching the Nazi concentration camps. I concur. It looks very much like the first steps towards creating internment camps. And it won’t just be Muslims that will eventually be interned. There are enough people on the British Right, who share the Republicans’ attitudes that trade unionists and organised Labour are a subversive threat.

Much has been written recently about the various employers’ groups, who compile black lists of trade unionists and other ‘disruptive’ workers and pass them on to firms so that those same workers don’t get jobs. There have been a number of excellent documentaries on them since the 1980s. One of them was Hakluyt, but there are others. Hakluyt was the successor of a much older organisation dating from the 1920s, the Economic League against Industry Subversion.

And several of the national papers have also demanded that striking workers should be jailed. I can remember reading a piece in the 1980s in the Sunday Express, which recommended that laws should be passed preventing workers in essential industries from going on strike. Those who did, like air traffic control personnel in America, should then be arrested and jailed.

Cameron has already passed a series of legislation designed to emasculate the trade unions. In the latest of these, he allowed employers to hire scab labour from agencies, though reducing the right to strike to being merely symbolic. This has been criticised by the International Labour Organisation in the UN. It also follows a long line of anti-union legislation passed by the Tories, and similar actions intended to break up strikes by the Italian Fascists and Nazis in Germany. And members of his own party attacked part of his anti-union legislation. This was the clause demanding that trade unionists on pickets should give their names to the police. Even David Davies, the right-winger’s right-wing, found that a step too far and called it ‘Francoist’.

Given the authoritarianism and intolerance of Cameron and his aristo cronies and the way they and their Lib Dem enablers pushed through the establishment of secret courts to try accused terrorists, I think it is all too possible that after the Republicans in America and Tories over here have finished rounding up the Muslims, they’ll start on trade unionists and organised labour. All while loudly claiming that they stand for freedom, transparency and democracy, of course.

Robin Cook’s Attack on Private Health Insurance for the NHS

March 15, 2015

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I’ve blogged several times about the threat to the NHS from the Tories and the Lib Dems. There are 92 Conservative and Lib Dem ministers, who advocate the privatisation of the Health Service, and who stand personally to gain from it. They include Iain Duncan Smith, the current minister for culling the poor, the sick and the old. Andrew Lansley, the current health minister, has openly stated he is in favour of privatising it. So has Nigel Farage, and the Unterkippergruppenfuhrer, Paul Nuttall.

I blogged earlier today about the Fuhrage’s forked tongue about the NHS, and how he follows the Tory policy going all the way back to Thatcher of promising to defend it while secretly plotting how to sell it off. In the 1980s, Thatcher set up a review into the NHS and its funding. This so alarmed Labour’s Robin Cook, that he wrote a Fabian pamphlet, Life Begins at 40: In Defence of the NHS, attacking possible proposals to privatise the Health Service.

Previous reviews had given the NHS a clean bill of health. The extremely high quality of the NHS and its doctors was recognised by the heads of American healthcare firms: Dr Marvin Goldberg, chief executive of the AMI health group, told a parliamentary select committee that the Health Service provides ‘outstanding health care and British NHS hospitals are at least as good as those in America while British doctors are better.’

The then Conservative MP for Newbury, Michael McNair-Wilson, also testified to the effectiveness of the NHS. He had suffered kidney failure. He had private health insurance, but it did not cover operations such as the one he needed because of the expense. He said ‘I have cost the NHS tens of thousands of pounds – much more than I could have afforded privately … Had my treatment depended on my ability to pay, I would not be alive today.’

Pre-NHS Britain: Some Areas Completely Without Hospitals

Cook’s pamphlet also graphically described the patchwork state of healthcare in Britain before the NHS. In London, where there were plenty of paying customers, there could be hospitals in neighbouring streets. Out in the poorer British provinces, there were hardly any, and many operations were carried out not by surgeons but by GPs. He cites Julian Tudor Hart’s book, A New Kind of Doctor, to show how bad this could be. Hart described how he joined one of those practices in Kettering. One patient was left under anaesthetic as the London specialist operating on him was called away to continue a stomach operation on a London patient, which the operating GP had been unable to complete.

Cook was deeply concerned that the Tories’ review would not be at all interested in improving quality, only in opening up the NHS to the market and privatisation.

Cook on Private Health Insurance

One of the issues he tackled in the pamphlet was the possibility of the introduction of private health insurance. This covers two pages and a column and a bit in the original pamphlet. This is what he wrote, though emphases and paragraph titles are mine.

The mechanism proposed to square the incompatibility of health care with the market is insurance. All market approaches to the NHS submitted to the Review stress the case for much wider private insurance and almost as frequently propose subsidies to boost it.

Insurance-Based Systems Encourage Expensive Treatment

The first thing to be said is that private insurance does not offer to health care the alleged benefits of the discipline of the market place. At the point when the individual requires treatment he or she has already paid the premiums and has no incentive not to consume as expensive a treatment as can be reconciled with the policy. The position of the doctor is even more prejudiced in that he or she has every incentive to obtain as much as possible from the insurance company by recommending the most expensive treatment. Both patient and the doctor are in a conspiracy to make the consultation as costly as possible, which is a perverse outcome for a proposal frequently floated by those who claim to be concerned about cost control.

Insurance-Based Systems Encourage Unnecessary Surgery

The compulsion in an insurance-based system to maximise the rate of return is the simple explanation why intervention surgery is so much more often recommended in the United States. For example, the incidence of hysterectomy there is four times the British rate. This is unlikely to reflect higher morbidity rates but much more likely to reflect the greater willingness of doctors on a piece-work basis to recommend it, despite the operative risks and in the case of this particular operation the documented psychological trauma. I can guarantee that an expansion of private insurance will certainly meet the objective on increasing expenditure on health care, but it is not equally clear that the money will be spent effectively.

Insurance-Based Systems Require Expensive bureaucracy to Check Costs

One direct diversion of resources imposed by any insurance-based scheme is the necessity for accountants and clerks and lawyers to assess costs and process claims. The NHS is routinely accused of excessive bureaucracy, frequently I regret to say by the very people who work within it and are in a position to know it is not true. Expenditure in the NHS is lower as a proportion of budget than the health system of any other nation, lower as a proportion of turnover than the private health sector within Britain, and come to that, lower than the management costs of just about nay other major enterprise inside or outside the public sector. I am not myself sure that this is a feature of which we should be proud. ON the contrary it is evidence of a persistent undermanaging of the NHS, which is largely responsible for its failure to exploit new developments in communication, cost control and personnel relations. Nevertheless, there is no more pointless expansion of administrative costs than the dead-weight of those required to police and process and insurance-based system. These costs would be considerable.

Forty per cent of personal bankruptcies in the US are attributable to debts for medical care

Part of this additional cost burden is incurred in the task of hunting down bad debts, which does not contribute in any way to the provision of health care. Forty per cent of personal bankruptcies in the US are attributable to debts for medical care, a salutary reminder of the limitations set to insurance cover. These limitations have three dimensions.

Insurance Cover Excludes Chronic and Long-Term Sick, and the Elderly

First, insurance cover generally excludes those conditions which are chronic and therefore expensive or complicated and therefore expensive. Standard exclusions in British insurance policies are arthritis, renal dialysis, multiple sclerosis or muscular dystrophy. Most people do not require substantial medical care until after retirement. Most insurance cover excludes the very conditions for which they are then most likely to require treatment. Short of retirement, the most expensive health care required by the majority of the population is maternity care, which is also excluded by the majority of insurance policies.

Private Healthcare Limits Amount of Care due to Cost, not Need

Secondly, insurance cover is generally restricted by upper limits which are arbitrary in every sense other than financial. I recently met a psychiatric consultant to a private clinic, who was prepared to discuss candidly the ethical dilemmas of treating patients whose financial cover is fixed at five weeks of residential care, but whose response to treatment may indicate that a longer period of hospitalisation is desirable.

Private Health Care Geared to Selling to Healthy not Sick

Thirdly, insurance cover is further limited by exclusion of those most likely to claim on it. I am often struck at the sheer healthiness of the patients who illustrate the promotional literature of BUPA and PPP who appear in such pink of good cheer and fitness that it is difficult to figure out why they are in a hospital bed. These models are though in a sense most suitable for the purpose as the objective of insurance companies is to attract the healthy. They therefore claim the right to screen for the unhealthy and reject them from cover. This discriminatory approach was defended earlier this month by the managing director of WPA, Britain’s third biggest health insurer, on the principled grounds that it meant ‘essentially healthy people are not penalised by unhealthy people.’ This statement has the advantage of originality in that it perceives healthy people as the vulnerable group and proposes a market remedy that protects them from the inconvenient costs of the unhealthy.

Given this limited character of health insurance in Britain, the private sector is patently not in a position to substitute for the NHS and to be fair most directors of BUPA or PPP would be horrified at the notion of accepting the comprehensive, open-ended liabilities of the NHS. It is therefore perplexing that so much effort in and around the Review appears to be addressed to the issue of how the private sector may be expanded rather than how the public sector may be improved. Two major devices are being canvassed to boost private cover-tax relief on private cover or opt-out from public cover, or for all I know both of them together. Both would be a major mistake.

Tax Relief on Private Healthcare

Tax relief is open to the obvious objection that it targets help most on those who need it least – the healthy who are most likely to be accepted for private cover and the wealthy whose higher tax rates make relief most vulnerable. These are curious priorities for additional health expenditure.

Tax Relief Does Not Create Higher Spending on Health Care

Moreover, even in its own terms of stimulating higher spending on health, tax relief is likely to prove an ineffective mechanism. If for example the average premium is £200 pa the cost of tax relief for 6 million insured persons will be £300 million. The numbers under insurance need to increase by a third before the increased spending on premiums matches the cost of the subsidy and provides any net increase in health spending. Up to that point it will always produce a larger rise in health spending to increase the budget of the NHS by a sum equivalent to the cost of tax relief.

It is apparently being mooted that these objections could be circumvented by limiting the tax relief to the elderly. At this point the proposal moves from the perverse to the eccentric. This restriction targets help for private insurance on the very group for whom private cover is most inappropriate as their most likely health needs are the ones most likely to be excluded from cover. Only a moment’s reflection is required on the multiple ways in which we need to expand our health provision for the elderly to expose the hopeless irrelevance of tax relief as the solution for them.

Opt-Out Penalises those who Remain in the System

Opt-out is even more objectionable. The basic problem with opt-out is that it requires the payment towards the NHS of every individual to be expressed in a manner that gives him or her something to opt-out from. The principal attraction to Leon Brittan of his proposal for an NHS insurance contribution appeared to be precisely that it paved the way for opting out ( A New Deal for Health Care, Conservative Political Centre,, 1988). Nor is this inconvenience confined to the need for a whole new element in the tax system. If one in ten of the population chose to opt out, it would be remaining nine out of ten who would have to prove they were not opted-out when they went along to seek treatment. With the new contributions comes a requirement to maintain a record of payment of them, and presumably a mechanism for credits to those not in work but who do not wish to be counted has having opted out of the NHS.

Private Healthcare Undermine NHS as Universal System

The more fundamental objection both these proposals is they explicitly threaten the NHS as universal health service catering for everyone. Moreover, they threaten its universality in the worst possible way, by encouraging those with higher incomes and lower health needs to get out, leaving behind the less affluent and the less fit. In this respect such an approach to the NHS would be a piece with the Government’s strategy of erosion towards the rest of the social services-housing, pensions, and now education, where the Government has encouraged those who could afford it to opt-out of public provision, leaving behind the poor who could be expected to put6 up with a poor service.

This is the reality of the private healthcare system which Cameron, Clegg, Farage and the rest of the Right wish to introduce. It is expensive, bureaucratic, does not stimulating further spending, and excludes those with the most acute and expensive medical need, especially the elderly.

And the Tories and their counterparts in UKIP and the Lib Dems know it. Why else would the Tories spend their time trying to deny what they’re doing? Why does Farage appear to be advocating retaining the NHS, while arguing for an insurance based system, like America? It’s because they know that private medicine does not provide the solutions they claim. It is only source of further enrichment to them and their corporate donors.

And since Cook wrote that pamphlet, more than 20 per cent of all Americans can no longer afford their healthcare. It’s why the firms are trying to get their feet under the table over here.

Don’t let them. Miliband has promised to reverse the privatisation of the NHS. Support him in the coming election.