Sunday, 24 June 2007

Doctors Again

by Charles Pooter

I know I've already mentioned Doctors recently, so I just want to say in advance that I haven't got a particular bee in my bonnet about them (well any more than I have about anyone else). One of the contributors to this blog is training to be a physician and he seems a thoroughly decent chap.

OK, now that's out of the way, on with the ranting. Dr Rant has criticised The Devil for his take-down of The British Medical Association who, as usual, are trying to get the Government to further restrict our liberty.

I left the following comment on both blogs:

“It is a bad enough that the quacks managed to get their little guild recognised by the state, thereby artificially restricting the supply of medical care (causing untold pain and misery) and artificially increasing the size of their pay packets. But to have these pompous bone technicians lecture us about how we may or may not ‘go to hell in our own way’ is intolerable.


  1. End the last major closed shop in Britain (besides the legal racket) by abolishing the GMC and repealing all legislation regulating medicine.
  2. Split up the NHS and hand it over to local private mutual friendly societies with membership and voting rights to all citizens in that area.
  3. End all state funding of healthcare and medical training.
When the medical closed shop is ended, leading to a blossoming in the supply and diversity of medical care available; when quacks are effectively scrutinised and their services purchased at consortium prices by large friendly societies; and when doctors have to pay for their own training our of their own pockets—then they will be too busy competing with each other for work, like the rest of us have to, to have time to lecture us on how we live our lives.”
You can see the fallout from that comment here.


Edwin Hesselthwite said...

Ok, I'll admit it, I am completely split on this one:

On the one hand, I fully agree with The Devil that Public Health is an issue that gets right under my skin, and it is notable that Dr Rant mentions The Broadstreet Pump in his post...

To my mind Public Health splits into 2 distinct groups, firstly there is the Methodist/Quakerish view of public health which involves "enabling" people to perfect their lives by adding disincentives to what you dont want them to do. On the other hand their is the Socialist view of Public Health which involves such measures as fluoridation of water, vaccination campaigns and measures such as the broadstreet pump rules. These involve spending money and effort to resolve obvious deficiencies.

I see these as two distinct and seperate sides to public health, and think the doctors (as a sponge off the taxpayer) should get their noses out of our liberties... But since New Labour is something of a Scots/Catholic creature they are likely to stick with the former.

On the other hand, your increasingly deranged anarcho-socialist interventions in blog arguments are becoming baffling. I cannot imagine how you could possibly go about instituting the reforms you envision without a statist hardman, and suspect you are arguing this position purely from a Randian "intellectual highground".

This requires a complete reform of the current system from the bottom up, with the time to develop a new free-market under idealised government-intervention free conditions. Basically you want the world to stop for twenty years, the NHS to get abolished, and a new system allowed to develop in total isolation following your broad principles.

This is, as you know, an impossibility... So when you argue this position your aim is pretty much just to take the intellectual highground and throw rocks at pragmatists of all colours. So I will tag you as what you are - a left-wing Randroid.

Charles Pooter said...

Rather unfriendly Edwin. I don't see what any of my points have to do with the deranged Ayn Rand.
So this blog should just be a pragmatist talking shop? I think the Labour and Conservative parties already exist as forums for that. I am happy to argue about gradualist reforms, but sometimes it gets a bit boring limiting oneself to discussing how many angels can dance on the head of Gordon Brown. Principles matter and ideas matter.

Edwin Hesselthwite said...

Ok, but here's my main beef with this anarcho-socialist position.. You attack the medical closed shop - fair enough, you attack government intervention in health care - also fair enough...

However, what could you possibly do to resolve this? I mean, in order to do what you want you need to tear down the NHS, and you need to tear down medicine. We all know the solution wouldn't emerge immediately, but in order to institute the order you are aiming for, we need a period of complete global isolation (we cant let external factors influence this new anarchised market in medicine) while the new system is established... This is a utopian position...

To jump into the midst of a pragmatic argument and throw in a utopian position as "the solution" is just to throw intellectual rocks at your opponents, comfortable in the certainty that you can neither lose the argument or ever have to act on your ideals. It was unfair to mention She but that was a technique she was extremely fond of using.

Charles Pooter said...

I wouldn't use the word "socialist" to describe my position on anything. To suggest so is frankly bizarre. And my arguments are practical as well as principled. I don't want to "tear down the NHS", I want to put its capital into the hands of mutual societies comprised of the consumers of the services (or possibly, a mix of the consumers and the producers). Why would we need global isolation? I don't mind ouside enterprises moving into the market. Any system which requires trade isolationism is doomed to failure.

And, yes, I'm quite happy to "throw rocks". When a group rises to such an elevated posiiton in society tht they feel they have the right to pronounce on what should and should not be legal it is worth reminding them why they occupy that position in the first place.

Pritchard Buckminster said...

I have to confess to confusion on this one - it is an argument that Edwin and I have had on many occasions. I started in the 'examples of how the NHS has fucked up' camp. Quickly moved to the 'tear it down and rebuid completely' camp and am now dwelling somewhat tentatively in the 'increase the alternatives but maintain the core operation' camp. The problem I have with the free market version is that it does assume a basic level of intelligence on the behalf of the consumer. Would you allow faith healers to advertise? What about holistics or crystal healers? See, people are pretty dumb. If you leave them to their own devices would they choose the best treatment for themselves or the one with the best PR? Or the one their parents use? I believe you would simply end up with another, massive, regualtory body over the whole sorry mess, desperately trying to control it and failing dismally. And please don't tell me that market forces would mean that the best service would come out on top. The closest analogy I can think of is financial products. If you know anything about personal finance you know that any product advertised on TV is not the best product of that type as they wouldn't have to advertise it if it were. And yet every year billions is spent on glossy advertising essentially to fool people (without technically lying). Imagine that in a free market medical environment. Chaos!

Charles Pooter said...

At the risk of reapeating myself (I seem to be doing that a lot in this debate), I think that, in a free market, heathcare would be an ideal sector for mutual societies to act as consortium purchasers for their members. These mutual societies would also have the time, power and money to act as regulators and quality controllers, in a way that individuals do not.

This is not to say that people wouldn't also be free to go the crystal purveyors and snake-oil salesmen, but then they can now. Ultimately you can't protect people from themselves, but what I'm sure is possible is giving people the choice to pool their resources to get decent healthcare at a reasonable cost to themselves and their fellows.

Pritchard Buckminster said...

Would the mutuals regulate themselves or each other? I'm disagreeing with Edwin here and suggesting that your model is workable....probably. But factors like that are key to determining the validity of the position. Pie in the sky is fun but remember, we will ALL be guests of the NHS at some (or many) point(s) and I for one would quite like not to die by a mistake.

Its interesting that the two strands of this argument seem to have rejoned in your last comment as you say you can't protect people from themselves which of course is where the it all started with the indigination at the government's interference. Would co-ops / mutuals truly work in a free market or would one aggresively sieze the advantage for it's members? If so you're back to Goverment regulation again....

Ted Hoffman said...

"Would you allow faith healers to advertise?"

For the record; on my reading of the following link, faith healers can advertise now, so long as they don't claim it works. Nothing a good ad man couldn't get around.

Rob Fisher said...

Pritchard Buckminster wrote:

"The problem I have with the free market version is that it does assume a basic level of intelligence on the behalf of the consumer."

It looks like you can't even regulate against stupidity, as the NHS Directory of Alternative Medecine and a post by Scott Burgess show.

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