Posts Tagged ‘Roy Porter’

Roy Porter on Rising Cost of American Medicine

March 19, 2015

Blood and Guts Cover

The historian of medicine, Roy Porter, devotes a couple of pages to the development of medicine in America in his book Blood and Guts: A Short History of medicine. He notes that the development of private medical insurance and the fees-for-service system in America caused medicine to become a highly developed and lucrative industry. Competition was at the heart of this system, with doctors and hospitals competing to offer better medical service, such as better tests, a fuller range of elective surgery, more check-ups and so on. However, the costs of these procedures became correspondingly expensive, so that President Truman in 1948 mooted a national health service for America. This came to nothing, however, as the American Medical Association campaigned against it.

Part of the American system of private health care are the HMOs, the Health Maintenance Organisations, which began with the Kaiser Foundation Health Plan in California. These arose as a cheaper alternative to ordinary medical insurance like Blue Cross. Porter states that health costs have continued to rise, not just in terms of medical personnel and equipment itself, but also in the growth of hospital bureaucracy, administrative and marketing teams – including corporate finance, lawyers, medical insurers, public relations firms and accountants. He states ‘Expenditure has continued to rise, quite disproportionately to measurable improvements in health.’ (p. 167). The result is that by 2000 40 million Americans had no medical insurance. That’s almost one in six people under the age of 65.

This is the system that Cameron, Clegg and Farage wish to import over here. Meanwhile in America, Conservatives are attacking the soaring costs of medicare and Medicaid, introduced by Lyndon B. Johnson to allow the state to pay for the medical care of the poor and elderly, who couldn’t afford it.

There are 92 Tories and Lib Dems, who have links and positions on the private health companies waiting to profit from the Tories’ privatisation of the NHS. Andrew Lansley, the current health minister, is a supporter of the privatisation of the health service.

If they win, and get another term, we will not see the NHS survive. The poor will be deprived medicine, but the Tory, Lib Dems and Kippers will profit immensely.

We mustn’t let them.

Labour NHS Privatisation UKIP

NHS-privatisation

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Working Class Experience and the Tories’ Hatred of International Human Rights Legislation

May 19, 2014

Democrat Dissection pic

William(?) Dent, ‘A Right Honble Democrat Dissected’, 1793. In Roy Porter, Bodies Politic: Death, Disease and Doctors in Britain, 1650-1900 (Ithaca: Cornell University Press 2001) 243. The caption for this reads: The various portions of his anatomy display every form of hypocrisy and immorality, personal and political.

The Tories Attack on Human Rights Legislation

Last week I reblogged Mike’s piece, ‘The Tory Euro Threat Exposed’, which demolished some of the claims the Tories were making about the EU, including their promise to hold a referendum on Europe. One of the criticisms Mike made was against the Tories’ plans to withdraw Britain from the European Court of Human Rights. Mike pointed out that the Court is actually nothing to do with the EU, and if Britain withdrew, it would mean the Tories could pass highly illiberal legislation ignoring and undermining the human rights of British citizens. He specifically mentioned workfare, the right to a fair trial and the current laws protecting the disabled as areas that would be under threat. It is not just European human rights legislation and international justice that the Tories are opposed to. They also plan to repeal Labour’s human rights legislation at home.

The Memoir of Robert Blincoe and 19th Century Working Class Political Oppression

Jess, one of the commenters on mine and Mike’s blog, suggested that the part of the problem was that most people now don’t recall a time when there was no absolutely no respect for human rights in Britain, and people were genuinely oppressed and jailed for their political beliefs. As a corrective, she posted a link to The Memoir of Robert Blincoe, a 19th century working-class activist, who was jailed for setting up a trade union. She wrote

Part of the ‘problem’ convincing people of the validity of human rights legislation is they have no concept, or memory, of what things were like before such things began to be regulated. Or the fight it took to force such legislation through Parliament.

This small book, ‘Memoir of Robert Blincoe’, now online, courtesy of Malcolm Powell’s Northern Grove Publishing Project
http://www.malcsbooks.com/resources/A%20MEMOIR%20OF%20ROBERT%20BLINCOE.pdf

“The Memoir….” was first published by Richard Carlile in his journal ‘The Lion’ in 1828. It was republished as a pamphlet the same year, and then re-serialised in ‘The Poor Man’s Advocate’ later the same year.

The pioneer Trades Unionist, John Doherty republished it in 1832, with the co-operation of Blincoe and additional text. Caliban reprinted Doherty’s text in 1977. For some reason it was not mentioned in Burnett, Mayall and Vincent (Eds) Bibliograpy (of) The Autobiography of The Working Class.

19th Century Oppression, thatcher’s Assault on the Unions, British Forced Labour Camps and the New Surveillance State

She has a point. For most people, this was so long ago that it’s no longer relevant – just another fact of history, along with the Tolpuddle Martyrs, the Great Reform Act and the Workhouse. It’s an example how things were grim back in the 19th century, but it doesn’t really have any direct significance today. In fact, it’s extremely relevant as the Tories are doing their best to strangle the Trade Unions with legislation following their decimation with the Miners’ Strike under Thatcher. The Coalition has also passed legislation providing for the establishment of secret courts, and Britain is being transformed into a surveillance society through the massive tapping of phones and other electronic communication by GCHQ. And I reblogged a piece from one of the other bloggers – I think it was Unemployed in Tyne and Weare – about the existence of forced labour camps for the unemployed here in Britain during the recession of the 1920s. I doubt anyone outside a few small circles of labour historians have heard of that, particularly as the authorities destroyed much of the documentation. Nevertheless, it’s a sobering reminder that Britain is not unique, and that the methods associated with Nazism and Stalinism certainly existed over here.

Britain as Uniquely Democratic, Above Foreign Interference

Another part of the problem lies in British exceptionalism. There is the view that somehow Britain is uniquely democratic, with a mission to spread freedom and democracy throughout the world. This conception of one’s country and its history is strongest in America, and forms a very powerful element of the ideology of the Republican party and the Neo-Cons. America has repeatedly refused to allow international courts jurisdiction in America and condemned criticism of American society and institutions by the UN, on the grounds that these organisations and the countries they represent are much less democratic than the US. To allow them jurisdiction in America, or over Americans, is seen as an attack on the fundamental institutions of American freedom. Thus, while America has demanded that foreign heads of states responsible for atrocities, such as the Serbian president Slobodan Milosevic, should be tried at the International War Crimes Tribunal in the Hague, it has strenuously resisted calls for the prosecution of American commanders accused of similar crimes.

Britain Not Democratic for Most of its History

This sense of a unique, democratic destiny and a moral superiority to other nations also permeates the British Right. Daniel Hannan, the Conservative MEP for Dorset, who wishes to privatise the NHS, has written a book, on how the English-speaking peoples invented democracy. It’s a highly debatable view. Most historians, I suspect, take the view instead that it was the Americans and French, rather than exclusively the English-speaking peoples, who invented democracy. Britain invented representative, elected government, but until quite late in the 19th century the franchise was restricted to a narrow class of propertied men. Women in Britain finally got the right to vote in 1918, but didn’t actually get to vote until 1928. Part of the Fascist revolt in Britain in the 1930s was by Right-wing, die-hard Tories alarmed at all of the proles finally getting the vote, and the growing power of Socialism and the trade unions. Technically, Britain is still not a democracy. The architects of the British constitution in the 17th and 18th centuries viewed it as mixed constitution, containing monarchy, aristocracy and democracy, with each component and social class acting as a check on the others. The House of Commons was the democratic element. And the 17th and 18th century views of its democratic nature often seem at odds with the modern idea that everyone should have the inalienable right to vote. It seems to me that these centuries’ very restricted view of democracy ultimately derived from Aristotle. In his Politics, Aristotle considers a number of constitutions and forms of government and state, including democracy. His idea of democracy, however, is very definitely not ours. He considers it to be a state governed by leisured, landed gentlemen, who are supposed to remain aloof and separate from the lower orders – the artisans, labourers, tradesmen and merchants, who actually run the economy. In his ideal democracy, there were to be two different fora – one for the gentlemen of the political class, the other for the rude mechanicals and tradesmen of the hoi polloi.

How seriously the British ruling class took democracy and constitutional freedom can be seen in the very rapid way they removed and abolished most of it to stop the proles rising up during the French Revolutionary and Napoleonic Wars. Burke is hailed as the founder of modern Conservatism for his Reflections on the Revolution in France, in which he argued for cautious, gradual change firmly grounded and respecting national tradition, as opposed to the violence and bloodshed which occurred over the other side of the Channel, when the French tried rebuilding their nation from scratch. At the time, however, Burke was seen as half-mad and extremely eccentric for his views.

Imperial Government and Lack of Democracy in Colonies

The lack of democracy became acute in the case of the countries the British conquered as they established the British Empire. The peoples of Africa, the Middle East and Asia were largely governed indirectly through their indigenous authorities. However, ultimate authority lay with the British governors and the colonial administration. It was not until the 1920s, for example, that an indigenous chief was given a place on the colonial council in the Gold Coast, now Ghana. Some governors did actively try to involve the peoples, over whom they ruled, in the business of government, like Hennessy in Hong Kong. For the vast majority of colonial peoples, however, the reality was the absence of self-government and democracy.

British Imperial Aggression and Oppression of Subject Peoples

And for many of the peoples of the British Empire, imperial rule meant a long history of horrific oppression. The sugar plantations of the West Indies have been described as ‘concentration camps for Blacks’, which have left a continuing legacy of bitterness and resentment amongst some West Indians. The sense of moral outrage, as well as the horrific nature of imperial rule for Black West Indians and the indigenous Arawak and Carib peoples in books on West Indian history written by West Indians can come as a real shock to Brits, who have grown up with the Whig interpretation of history. Other chapters in British imperial history also come across as actually quite sordid, like the annexation of the Transvaal, despite the fact that the Afrikaaner voortrekkers who colonised it did so to get away from British rule. The Opium War is another notorious example, the colonisation of Australia was accompanied by the truly horrific genocide of the Aboriginal peoples, and the late 19th century ‘Scramble for Africa’, which saw much of the continent conquered by the French and British, was largely motivated by the desire to grab Africa and its resources before the Germans did.

Whig Interpretation of History: Britain Advancing Freedom against Foreign Tyranny

All this gives the lie to the Whig interpretation of history. This was the name the historian Butterfield gave to the reassuring, patriotic view of British history being one natural progression upwards to democracy and the Empire. There’s still an element of it around today. The view of the Empire as promoted by patriotic text books like Our Empire Story, was of Britain establishing freedom and justice against foreign tyrants and despots, civilising the backward nations of Africa and Asia. Similar views can be found in Niall Ferguson, who in his books states that Europe and America managed to overtake other global cultures because of their innately democratic character and respect for property. Ferguson presented this idea in a television series, which was critiqued by Private Eye’s ‘Square Eyes’.

Another, very strong element in this patriotic view of British history is the struggle Between Britain and foreign tyrants, starting with the French in the Hundred Years War, through the Spanish Armada, and then the Napoleonic War and Hitler, and finally as part of the Western free world standing against Communism. In fact, many of the regimes supported by Britain and the Americans weren’t very free at all. Salvador Allende of Chile, although a Marxist, was democratically elected. He was over thrown in the coup that elevated General Pinochet to power, sponsored by the CIA. Similar coups were launched against the democratic, non-Marxist Socialist regime of Benz in Guatemala. And it hasn’t stopped with the election of Barak Obama. Seumas Milne in one of his pieces for the Guardian, collected in The Revenge of History, reports a Right-wing coup against the democratically elected government in Honduras, again sponsored by America. at the same time Britain and America supported various Middle Eastern despots and tyrants, including the theocratic, absolute monarchies of the Gulf States, against Communism. If you are a member of these nations, in South and Central America and the Middle East, you could be forgiven for believing that the last thing the West stands for is democracy, or that it’s a hypocritical pose. Democracy and freedom is all right for Britain, America and their allies, but definitely not something to be given to the rest of the world. And certainly not if they don’t vote the way we want them.

Origin of Link between Britain and Democracy in Churchill’s Propaganda against Axis

In fact, it’s only been since the Second World War that the English-speaking world has attempted to make itself synonymous with ‘democracy’. While Britain previously considered itself to be a pillar of freedom, this was certainly not synonymous, and in some cases directly opposed to democracy. Some 18th and 19th century cartoons on the radical ferment about the time of the French Revolution and its supporters in Britain are explicitly anti-democratic. Martini Pugh in his book on British Fascism between the Wars notes that large sections of the colonial bureaucracy, including the India Office, were firmly against the introduction of democracy in England. According to an article on the origins of the English-Speaking Union in the Financial Times I read years ago, this situation only changed with the Second World War, when Churchill was faced with the problem of winning the propaganda battle against Nazi Germany. So he attempted win allies, and hearts and minds, by explicitly linking British culture to the idea of democracy. This may not have been a hugely radical step, as Hitler already equated Britain with democracy. Nevertheless, it completed the process by which the country’s view of its constitution, from being narrowly oligarchical, was transformed into a democracy, though one which retained the monarchy and the House of Lords.

House of Lords as Seat of British Prime Ministers, Not Commons

And it wasn’t that long ago that effective power lay with the upper house, rather than the Commons. During the 19th and early 20th centuries a succession of prime ministers were drawn from the House of Lords. It was only after Lloyd George’s constitutional reforms that the head of government came from the Lower House, rather than the chamber of the aristocracy.

Most of this is either unknown, or is just accepted by most people in Britain today. The British’ idea of themselves as uniquely democratic is largely accepted unquestioningly, to the point where just raising the issue of how recent and artificial it is, especially with regard to Britain’s colonies and the Empire’s subaltern peoples, is still extremely radical. And the Conservatives and their fellows on the Right, like UKIP, play on this assumption of democratic superiority. Europe, or anywhere else in the world, for that matter, isn’t as democratic us, and has absolutely no right telling us what to do.

Need to Challenge Image of Britain as Uniquely Democratic, to Stop Tories Undermining It

And so the British image of themselves as innately, quintessentially democratic and freedom-loving, is turned around by the Right to attack foreign human rights legislation, courts and institutions, that help to protect British freedoms at home. This needs to be tackled, and the anti-democratic nature of much of British history and political culture needs to be raised and properly appreciated in order to stop further erosion of our human rights as British citizens, by a thoroughly reactionary Conservative administration determined to throw us back to the aristocratic rule of the 19th century, when democracy was itself was highly suspect and even subversive because of its origins in the French Revolution.

Radical Balladry: The Poor Man Pays for All

May 13, 2014

I found this piece in Roy Palmer’s A Ballad History of England 1588 to the Present Day (Batsford: 1979). The book is exactly what it’s title says it is: a collection of ballads dating from the late 16th to the late 20th century, describing contemporary life and events. Many of these are explicitly political, especially those dealing with the reform and working class protest movements for democracy and better conditions from the 18th and 19th centuries. Some of them are quite long – the Poor Man Pays for All is 11 verses in length. For all its origins in the 17th century, it’s still very relevant today when the government is cutting taxes for the rich and throwing the tax burden onto the poor, who are also expected to pay their way despite the government’s austerity programme of wage freezes and cuts.

The Poor Man Pays for All

As I lay musing all alone
Upon my resting bed,
Full many a cogitation
Did come into my head:
And, waking from my sleep, I
my dream to mind did call:
Me thought I saw before my eyes
How poor men payes for all.

Me thought I saw how wealthy men
Did grind the poor men’s faces,
And greedily did prey on them,
Not pitying their cases:
They make them toil and labour sore
For wages too-too small;
The rich men in the taverns roar,
But poor men pay for all.

Me thought I saw an usurer old
Walk in his fox-fur’d gown,
Whose wealth and eminence controlled
The most men in the town;
His wealth he by extortion got,
And rose by others fall;
He had what his hands earned not,
But poor men pay for all.

Me thought I saw a courtier proud
Go swaggering along,
That unto any scarce allowed
The office of his tongue.
Me thought, were’t not for bribery,
His peacock’s plumes would fall,
He ruffles out in bravery,
But poor men pay for all.

Me thought I was i’th’ country,
Where poor men take great pains,
And labour hard continually,
Only for rich men’s gains:
Like th’ Israelites in Egypt,
The poor are kept in thrall;
The taskmasters are playing kept,
But poor men pay for all.

Me thought I saw poor tradesmen,
I’ th’ city and elsewhere,
Whom rich men keep as beads-men,
In bondage, care and fear.
They’ll have them work for what they list –
Thus weakest go to the wall.
The rich men eat and drink the best,
But poor men pay for all.

Me thought I saw two lawyers base
One to another say,
“We have had in hand this poor man’s case
A twelve month and a day:
And yet We’ll not be contented be
To let the matter fall;
Bear thou with me, & I’ll bear with thee,
While poor men pay for all”.

Me thought I saw a red nose host,
As fat as he could swallow,
Whose carcase, if it should be roast,
Would drop seven stone of tallow.
He grows rich out of measure
With filling measure small,
he lives in mirth and pleasure,
But poor men pay for all.

And so likewise the brewer stout,
The chandler and the baker,
The malt-man also, without doubt,
And the tobacco-taker.
Though they be proud and stately grown,
And bear themselves so tall,
yet to the world it is well known,
That poor men pay for all.

Even as the mighty fishes still
Do feed upon the less,
So rich men, might they have their will,
Would on the poor men cease.
It is a proverb old and tr4ue –
The Weakest go to the wall;
Rich men can drink till th’ sky look blue,

But now, as I before did say,
this is but a dream indeed,
Though all dreams prove not true, some may
Hap right as I do read.
And if that any care to passé,
I doubt this my dream shall,
For still ’tis found too true a case-
That poor men pay for all.

Other ballads in the collection include ‘A Political Christmas Carol’, ‘The New Poor Law and the Farmer’s Glory’, The Agitator, and the ‘Man that Waters the Workers’ Beer’. The last song, by Paddy Ryan, is about a man, yes a very fat man, who waters the workers beer, adding meths, strychnine and other ‘orrible stuff in order to prevent there being a strong working class that could challenge the employers.

And needless to say, I can’t see some of this stuff being particularly welcome to Tories or the new parties of the Right.