NHS Hagiographers Continue To Use Commonwealth Fund Survey As A Shield Of Bias Confirmation

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Britain’s NHS idolaters cling to the Commonwealth Fund’s rosy but skewed assessment of the National Health Service like shipwreck survivors cling to floating wreckage

Brexit is not the only issue which reveals the intellectual limitations and paucity of vision of our politicians. Simply whisper the letters “NHS” and the vast majority of parliamentarians instantly turn into zombies, mindlessly repeating the same worn-out old paeans of praise to centralised government healthcare as though they were under the control of a hypnotist.

There are few better demonstrations of this pathology than yesterday’s segment on BBC This Week, in which Andrew Neil questioned uncritical acceptance of the Commonwealth Fund study (the only survey which routinely rates the NHS favourably) and Kate Andrews of the IEA gamely tried to advance the heretical notion that Britain might do well to learn from other advanced countries when it comes to organising healthcare delivery.

This went down like a lead balloon with bipartisan couch-warmers Anna Soubry and Alan Johnson, whose minds are both welded shut against any information that might suggest that the NHS is not, in fact, the “envy of the world”. Neither host Andrew Neil nor Kate Andrews are able to break through this veil of self-imposed ignorance:

From the segment:

Andrew Neil: Let’s just take the Commonwealth Fund now, because you politicians on both sides, you’re always using it —

Alan Johnson: Well, it’s the only one —

Andrew Neil: No, it’s not. It’s the only one in which the NHS does well, and actually in the Commonwealth Fund it measures inputs, not outputs, not patient care. Indeed, on the patient care – on actual health outcomes – even in the Commonwealth Fund the NHS comes tenth out of eleventh. The Guardian remarked on the Commonwealth Fund: “the only serious black mark against the NHS in Commonwealth Fund research was its poor record of keeping people alive”.

Alan Johnson: Yeah, America came eleventh, by the way, but…

Kate Andrews: Why America? Why not Germany or Belgium or Switzerland or France?

Alan Johnson: Because you came on here and said Trump has a point, are we supposed to talk about Sweden when you said Trump has a point?

Kate Andrews: You’re right, I did say Trump had a point, this whole point is that the NHS is failing, that doesn’t make America any better. Look, I’m from America, I’m not coming over here saying look, adopt the American system”, as I said in the video I wish both countries would look at Switzerland. But let’s stop painting this black and white decision because it’s not about USA versus NHS.

Alan Johnson: The Commonwealth Fund is the only one who measures things like health inequalities and fairness and how it affects the poorest —

Kate Andrews: What is fair about thousands more people in European countries surviving? What is fair about that? What is fair about the fact that 13,000 more people in Germany every year will survive the five most common types of cancer? What is fair about that?

Alan Johnson: [Becoming more incoherent and hysterical with every passing moment] You quote that without saying — as if the NHS was very keen for people to die of cancer —

Kate Andrews: No, of course they’re not, but we can do something about this —

Alan Johnson: One of the biggest problems is early reporting, is people going to their GP, particularly men —

Anna Soubry: Absolutely, it’s the biggest factor.

Kate Andrews: Great. Well, you need access to the GP, don’t you? You need shorter waiting times.

Anna Soubry: We have – please, please, don’t tell me that you don’t have – depends on where you live —

Kate Andrews: The waiting times for this country are appalling compared to their European counterparts.

Anna Soubry: [Disingenuously talking about same-day emergency appointments rather than scheduled GP appointments] Excuse me. Your GP, it depends exactly where you live, because certain GP surgeries like mine, I can see my GP if I want to on the morning that I have – I can ring up and can get in straight away. It depends where you live —

Kate Andrews: That doesn’t sound like a very fair system. It doesn’t sound like a postcode lottery is a very fair system.

Anna Soubry: No, it’s not a postcode lottery.

Kate Andrew: Well he [Alan Johnson] is talking about fairness, and that’s what the NHS is good at, but you were talking about a postcode lottery system. There’s nothing fair about that system, and there’s not a lot that’s very good about it either.

So the NHS is perfect, equality of dismal outcome is preferable to aspiring toward excellence, and if you are one of those people whose deaths would have been prevented by another, superior healthcare system it’s your own stupid fault for not seeing your GP (the unnecessary gatekeeper to practically all NHS care) on time. So say Tory wets and Labour centrists alike.

This is mental subservience to the Cult of the NHS, pure and simple. Every day, the high priests of the NHS surpass themselves in new feats of bias confirmation. One might think that the NHS coming second from last in the rather key metric of keeping people alive might give pause for introspection, but throw up any fact or scenario which suggests that the NHS is inferior and immediately two things happen.

Firstly, up goes the wall of ignorance and denial. Why are you fussing about health outcomes anyway, they splutter. Don’t you know that fairness, ease of access and cost-effectiveness are the only metrics worth considering? And if that doesn’t work, then out comes the good old US/UK false dichotomy, where NHS defenders pretend, quite slanderously really, that anybody who questions the NHS model or expresses an interest in learning from other countries secretly wants to emulate the US system.

Kristian Niemietz has also been fighting this lonely fight against uncritical acceptance of the Commonwealth Fund survey for a long time:

The Commonwealth Fund study is the outlier among health system rankings, because it pays little attention to outcomes – it is mainly based on survey responses and general system characteristics. But it has one category which does relate to outcomes, and in that category, the UK comes out 10th out of 11 countries. So even the preferred study of NHS cheerleaders confirms that in terms of outcomes, the NHS is one of the worst systems in the developed world.

Niemietz concludes:

The jingoism of Little Englanders is sometimes unedifying, but it is not nearly as cringeworthy as the NHS patriotism of the left. The NHS is the country’s most overrated institution. It is the Carling of healthcare systems. It achieves nothing that dozens of other healthcare systems do not also achieve, and usually better – and it’s time we admitted that to ourselves.

I made the same point in a television interview several years ago, pointing out that if you want to make a staunchly internationalist, post-patriotic left-winger sound like the stereotypical swivel-eyed Ukipper all one has to do is whisper the letters “NHS”, at which point they will immediately start ranting about British superiority and exceptionalism, waxing lyrical about how we alone have unlocked the secret of compassionate, universal healthcare delivery, while the other, benighted nations of the world look on at us in envy.

If the NHS is ever to be meaningfully reformed, if healthcare outcomes are ever to improve in Britain relative to the countries which are overtaking us, this wall of ignorance and denial must be torn down. But just from the facial expressions and physical demeanour of Anna Soubry and Alan Johnson in this BBC This Week segment, you can see that they will not be reasoned with. And if politicians who style themselves as pragmatic centrists cannot take the emotion out of an argument and drop the NHS hagiography for an honest discussion of healthcare reform, what chance is there?

This is a cult, plain and simple. When people cannot look dispassionately at a government service but instead debase themselves by sanctifying it (as though universal healthcare were in any way unique to Britain), observing its holy days, quoting its founders and worshipping its historical figures, what you have is a cult.

 

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Brexit, Public Protest And The Judiciary

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No, criticising legal rulings is not fascism

Right now the internet is bubbling with a lot of nonsense about the role of the British judiciary as relates to Brexit, and though I have my head full of US election news ahead of tomorrow night’s Semi-Partisan live blog, there are a couple of pieces of egregious stupidity which need slapping down.

Today, of course, Nigel Farage made headlines by announcing his intention to lead a march of 100,000 people on the Supreme Court in an effort to demonstrate the public’s supposed strength of feeling about ramming Brexit through without any Parliamentary scrutiny.

From the Telegraph:

Nigel Farage is planning to lead a 100,000-strong march to the Supreme Court to coincide with the start of the Government’s attempt to stop peers and MPs delaying Brexit.

The march, organised by the anti-European Union campaign Leave.EU, will end with a rally in Parliament Square within sight of the court building where judges will be hearing the appeal.

The campaign group is planning to “crowd fund” £100,000 from its supporters to pay for barristers to represent Leave supporters in the court action.

This will mean that the anti-EU supporters will have their own barristers in the legal action, who can challenge claims made by Remain supporters and even the Government.

[..] A spokesman for the organisers said that Mr Farage and Leave.EU millionaire backers Arron Banks and Richard Tice had “secured support from thousands of Leave voters” for the march and legal action.

The march will most likely take place on December 5, which is expected to be the first day of the hearing. The Supreme Court has cleared four days for the hearing which will be streamed live on the internet.

As this blog recently laid out, I am fairly relaxed about the High Court case and the coming appeal to the Supreme Court. If David Cameron’s utterly useless government had a) planned the referendum properly, and b) considered the possibility of Leave winning then all of this might have been spelled out clearly at the time of the referendum, as it should have been.

That being said, MPs are aware of the hellfire which would rightly rain down on them if they seriously attempted to subvert the referendum result; if they now want to give their cosmetic blessing to a high-level instruction to the government to invoke Article 50 then they are welcome to go ahead.

Of course, some people inevitably then take it too far. UKIP leadership candidate Suzanne Evans quickly took to the airwaves making incoherent comments about the need to exercise “democratic controls” (whatever that means) over the judiciary.

From the BBC:

Ms Evans told BBC Radio 4’s Today programme there were likely to be “protests and demonstrations”, but added that these would be peaceful.

She added: “I have a concern that Article 50 is not intended to facilitate nation states leaving the European Union. I think it’s there to frustrate them.”

Ms Evans said she thought the legal process could “water down Brexit”.

She added: “I think it’s amusing that the very same people who say it’s all about parliamentary sovereignty have, for the last 48 years, been trying to undermine parliamentary sovereignty”.

Ms Evans said: “I think there’s a debate to be had about whether or not judges are subject to some kind of democratic control.”

She did not want to undermine “their judicial independence”, but added: “I suppose that in this case, we have had a situation where we have judges committed to stay in the European Union…

“I’m questioning the legitimacy of this particular case. We know that the legal profession threw a collective hissy fit when we voted to leave.”

This is just incoherent garbage. “Democratic controls” could mean anything from moving towards a system where many judges are elected (as in many American states) toward some kind of constitutional fix to prevent judges from ruling to delay or impede the government from carrying out the instructions from this or any future referenda.

At no point does Suzanne Evans articulate what kind of controls she has in mind, which naturally plays into the hands of tremulous Remainers who are lightning-quick to portray any intemperate or ill-considered language from Brexiteers as a sign of the oncoming fascist apocalypse wrought by Brexit.

From the Huffington Post:

Her comments were branded “irresponsible”. by Labour’s shadow Brexit secretary Keir Starmer. “Some of us have worked in countries where judges do as governments tell them and we know that is highly corrosive of the rule of law and democracy,” he told Today.

Starmer said the High Court had simply “upheld the rule of law” by deciding the prime minister did not have the power to trigger Article 50 without a parliamentary vote. “It’s a slippery slope,” he said of Evans’ comments. “Principle is really important here. The rule of law really matters. It underpins this country.”

However Evans said she had not been talking about judges being subject to elections, but instead “pre-appointment and confirmation hearings” and “scrutiny by select committees”.

Typically, hysterical and bitter Remoaners like Coke Zero Conservative Anna Soubry led the way with her cries of “fascism!”:

However, many pro-EU commentators, in their sudden high-minded support for the independence of the judiciary, seem to be suggesting that any form of protest directed at judges or the courts is absolutely unacceptable and fascistic, whatever the reason.

LBC’s notoriously and stridently europhile presenter James O’Brien ripped into the protest, essentially declaring that it is wrong to protest legal decisions and rulings:

Today James gave his reaction to the march and it’s safe to say he wasn’t impressed: “We’re post-truth now…what’s Mr Farage doing? Having a little march to the Supreme Court to complain about British judges enacting British laws in British courts.

“Truly we are down the rabbit hole!”

James continued: “He says to remind people what they voted for. I appreciate your core support is a little bit flaky pal, but I don’t think anyone’s forgotten what they voted for.

“It’s quite incredible. Yet we’re all still standing alongside, going: ‘Oh, I wonder why this is happening.’

“I’m not wondering why this is happening. I know why this is happening. Same reason it’s happened throughout history. You take angry people who feel like they’re not getting a fair deal, give them a false target for their fury and just sit back and watch the whole place burn down.”

Presumably O’Brien feels similarly sickened when crowds of people assemble in front of the United States Supreme Court to protest in favour of socially progressive outcomes, like striking down the Defence of Marriage Act (DOMA). Except we all know that O’Brien would have no problem with such protests. Demonstrating about legal cases is abhorrent and intimidating when Nasty Brexiteers do it, with their thuggish and populist ways, but absolutely fine when the people march under a rainbow flag or advocate for a progressive cause.

But some of the most thin-skinned people of all are those within the legal profession, who apparently feel under assault by Brexiteers and parts of the media in the wake of the High Court decision.

From the Guardian:

The justice secretary, Liz Truss, is embroiled in an extraordinary row with the country’s barristers, after she was accused by the Bar Council of not fulfilling her role as “the conscience of the government”.

Truss has failed to condemn vitriolic attacks on the three judges who last week ruled that parliament must be given a vote before Britain triggers article 50, launching the Brexit process.

Chantal-Aimée Doerries QC, the chairman of the Bar, the representative body for barristers in England and Wales, told the Observer that the cabinet minister had a duty to uphold the rule of law. “[Her job] is sometimes called the conscience of the government and one would expect her to speak out on something like this,” she said.

The high court ruling on Thursday, which the government has said it will appeal, unleashed a torrent of personal abuse directed at the judiciary, with one prominent cabinet member claiming the judges’ decision was “unacceptable”.

Under huge pressure to defend the independence of Britain’s judges, Truss – who is also lord chancellor – issued a terse statement on Saturday, observing: “The independence of the judiciary is the foundation upon which our rule of law is built and our judiciary is rightly respected the world over for its independence and impartiality.”

What more do these wobbly-lipped victims want? The High Court made a decision, and various citizens together with certain press outlets exercised their free speech rights to criticise that decision in loud and forceful terms. Did anybody attempt to physically or mentally coerce the judges who made the ruling? No. Has anybody hatched a plan to neuter the judiciary’s ability to rule in future such cases? No. So what, exactly, does the Bar Council want? Apparently they want to be exempt from criticism. And to elevate the judiciary into such an exalted position would be truly frightening and totalitarian.

If the Bar Council, assorted other members of the judiciary and a coterie of Remainers expect Liz Truss to stop the Big Bad Scary Media from uttering opinions about the validity of legal decisions or the motivations of the people who make them then they really have taken leave of their senses, as well as any conception of the role of a free press in a democracy.

All in all, many Remainers seem to be taking leave of their senses. Those people who never gave the judiciary a second thought but who are now lionising it simply because they delivered a verdict which seems to frustrate some Brexiteers need to realise that the judiciary is not always high-minded and impartial.

The BBC reports that Lord Judge, the former Lord Chief Justice, opined that the Supreme Court should not overturn the High Court’s ruling because to do so might be *perceived* as a victory for the demonstrators:

The justice system could be undermined if a ruling that only Parliament can trigger Brexit is overturned, a former lord chief justice has said.

Lord Judge said it would be seen as a victory for pro-Brexit demonstrators should the Supreme Court reverse last week’s controversial High Court ruling.

[..] Lord Judge, who was the most senior judge in England and Wales between 2008 and 2013 and who is now a crossbench peer, told BBC Newsnight that people were entitled to protest but he was concerned about the impact the case might have on the legal system.

“People can march as much as they like,” he said.

“I don’t think it makes any difference to the judicial decision but it does make a difference to public order.

“Let’s say for the sake of argument the Supreme Court decides the High Court was wrong, it will undoubtedly be conveyed as a victory for the demonstrators.

“It won’t be but that’s what will be conveyed. And if that is conveyed, you’ve undermined the administration of justice.”

In other words, the head of the judiciary from 2008 to 2013 thinks that the Supreme Court should make a decision not based on the law, but rather on a desire to signal to unruly Brexiteers that judges cannot be pushed around. Even if there are found to be legal grounds for overturning the lower court’s decision, Lord Judge believes that the Supreme Court should allow error to go uncorrected in order to put the people in their proper place.

And yet criticising these people or displaying the slightest scepticism about their motivations and objectivity is apparently tantamount to fascism.

Give me a break.

 

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Should Eurosceptics Just “Get A Life” And Learn To Love The EU?

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Conservative cabinet members are now openly insulting eurosceptics, as the Tory rift widens

Who cares about the European Union? What’s all the fuss about? Eurosceptics should stop making fools of themselves, get with the times, and stop embarrassing themselves by articulating their pesky concerns about democracy and national sovereignty.

Or at least so says the Conservative Minister for Small Business, Anna Soubry. While speaking at a Conservative Party Conference fringe event organised by European Movement, Soubry had some choice words for seemingly anyone who does not faithfully adhere to the “in at all costs” mindset.

The Telegraph reports:

Speaking at a conference event hosted by European Movement and other pro-EU bodies, Ms Soubry told campaigners they must not “underestimate” the emotion of “those who want us to leave”.

“That is a very difficult thing to begin to debate with, to engage with, and it’s difficult often to beat because they do have this passion that is an obsession. They live it, eat it, drink it, sleep it,” she said.

“I don’t just mean a few people in our own party but obviously all those other people who’s name we’re not going to mention”.

Ms Soubry went on: “It means that they have this obsession that they will do almost everything and anything, they will devote all their time in a way that really is not healthy for them in this run-up to the referendum.”

“Because as I say, they live it, they eat it, they drink it. You want to say to them: For God’s sake, get a life. But they’ve gone beyond that. That makes it very difficult for us.”

Yes, that’s us: swivel-eyed, obsessive cranks who are unreasonably fixated on a single issue to the exclusion of supposedly more important matters. Ideologically blinkered and impervious to facts, that’s us, unlike the enlightened pro-Europeans who are so famously open to dissenting ideas.

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