From the Annals of Rampant Stupidity

The latest bright idea is that apparently granny would like to scrabble in the dirt for a few potatoes the day after her hip replacement:

Even if hospital patients have always hated their food, whether it’s microwaved meals, over salted vegetables, or fresh fruit, there are still things we can learn from the past. One obvious change in food provision is the loss of the hospital garden. Until the nineteenth century many hospitals had outdoor space, part of the therapy for recuperating patients, a place for Apothecaries to grow healing herbs, and a site for kitchen gardens to feed the staff and patients. Outdoor space was lost in the nineteenth century as giant hospitals were built in crowded urban areas, and as convalescent and elderly patients were moved to homes and hospices elsewhere. There’s quite a trend for ‘urban farming’ in the twenty first century – perhaps that could extend to give hospitals back their gardens too?

The idea of a little herb garden where patients can convalesce in the sun amid the mint, rosemary and the butterflies they attract is obviously wonderful. The idea that anyone should be trying to grow bulk foods in an urban environment is simply ludicrous.

For we’ve invented this thing called “transport” as well as “economy of scale”.

Hospitals are, as they note, in urban settings. Because that’s where all the people are and it’s sensible to treat people near where they live, near where their families live so they can visit them. Excellent: but that means that land is expensive where hospitals are because that’s where all the people are. A few acres of urban land can be worth millions upon millions of pounds: using that to grow £50′s worth of vegetables is simply not sensible. What is sensible to to use that agricultural land 50 miles away, worth perhaps £5,000 an acre, to grow the same vegetables and then splash a fiver or so per tonne of food on the petrol to transport them. We thus use fewer resources to get to the same goal, feeding the sick, and this is a process that makes us richer as a whole.

It’s also true that agriculture is subject to the most enormous economies of scale. We can tell this: food grown in those 50 acre monocrops is markedly cheaper than food used to be when we all had our little 15 acres of the country to cultivate. This is true even if we don’t include the labour we used to perform “for free”. The urban poor would spend 80% of their income on food and rent in centuries gone by. Today the average is 10-15% on food.

The idea of feeding the sick from hospital gardens is simply bonkers: guess that’s why it’s being suggested in The Guardian.

The reason we’re all such fat lardbuckets

A number of reasons are put forward as to why the nation has, in its entirety, become a population of fat lardbuckets. Big Food pushes ever more unhealthy comestibles upon us, advertising to children is for some reasons still allowed, there’s no tax on sugar, or fat, we’ve even got those who insist that inequality causes obesity.

Of course, all these reasons come with their own solutions: we should ban advertising to children, or of “unhealthy” food, or reduce inequality or something. As Chris Snowden shows in his latest little report (The Fat Lie)all of those reasoned proffered are simply wrong:

If we look at the average body mass of English adults since 1993,
we see a steady increase from 72.4 kg to 77.4 kg (Figure 7). This
seven per cent increase contrasts sharply with the data from DEFRA
which shows a decline in domestic calorie consumption of nine per
cent in the same period (Figure 8). If we confine ourselves to the
period 2002-12, for which we have solid data for food consumed
inside and outside the home, we see the same ‘paradox’: an increase
in average body weight of two kilograms coinciding with a decline
in calorie consumption of 4.1 per cent and a decline in sugar
consumption of 7.4 per cent.

Britons are eating fewer calories than we all used to. What is causing the increase in weight is that we’re all also doing less physical labour than we used to. The imbalance between calories consumption and expenditure is growing but not the total amount of calorie consumption. We’ve thus got under-expenditure of calories, not over-consumption of them.

Note that if we are all consuming fewer calories this does then mean that if Big Food has been trying to get us to eat more they’ve failed and failed dismally.

It’s also worth noting one more thing, that inequality argument. This should really be turned on its head: it is greater equality that is to blame here. There’s always been a certain calorie richness, calorie density, to the British working class diet as compared to its middle class (or even upper) equivalent. This made perfect sense back in the days of heavy manual labour. We now have much greater equality in the workplace, there’s very few of us making a living from the exercise of our muscles rather than what’s between our ears. And that greater equality has had a larger effect on those still eating that culturally calorie dense diet than it has on those whose diet adapted to less physical labour earlier.

It is still possible to point out that it’s the poorer among us who are the lardbuckets. But this isn’t the result of ineq1uality at all, it’s the result of greater equality in the workplace, in all of us now expending fewer calories in pursuit of our daily bread.

Actually, people aren’t willing to pay more tax for the NHS

There’s a report out announcing that loads of people would be entirely happy to pay more tax if that extra cash was allocated to the NHS. Two important things #to say about this. The first being that it’s untrue and the second being that if it is then that’s just great:

Almost half of voters say they would be happy to pay more income tax as long as the money went directly to the NHS, which is facing a £30bn gap in its finances by 2020.

Polling firm ComRes found that 49% of people would be prepared to pay more tax to help fund the health service, one in three (33%) people said they would not be ready to do so, and 18% did not know either way.

However, if only the views of those who expressed an opinion are considered, as many as 60% of people are willing to pay more tax to help the NHS providing its wide range of services; 40% are not.

The reason it’s not true is our old friend revealed preferences. We should never try to divine what people really want from what they say: we should instead look at what they do. And we do have a method of being able to pay extra tax: simply send the cheque to “The Accountant, 2 Horse Guards Road, London SW1″ and they’re absolutely delighted to apply it to whatever area of public spending you wish to inform them you favour. Admittedly it’s a few years since I looked into this but in that year an entire 5 people had actually done so and four of them were dead, leaving bequests.

So revealed preferences tells us that exactly one live person was actually willing to pay higher taxes for any reason at all, not just for the NHS.

But let’s assume for a moment that this is in fact true. That the reason, perhaps, that more people don’t pay is because they don’t know where Mr. Accountant resides? All we have to do is tell everyone where he does and that’s the problem solved, isn’t it? A few people to open the flood of envelopes that will no doubt overwhelm the office and we’re done. Everyone who wants to pay more tax for the NHS may do so and no one who does not needs to.

If only all public policy questions were as simple to solve as this one.

The remarkable logic of the minimum booze price people

This is an interesting example of the logic of the anti-booze prodnoses. They tell us that a minimum price for alcohol will affect really heavy drinkers almost exclusively because really heavy drinkers drink cheap alcohol:

A new study of liver patients shows that a Minimum Unit Price policy for alcohol is exquisitely targeted towards the heaviest drinkers with cirrhosis. Researchers studied the amount and type of alcohol drunk by 404 liver patients, and also asked patients how much they paid for alcohol. They found that patients with alcohol related cirrhosis were drinking on average the equivalent of four bottles of vodka each week, and were buying the cheapest booze they could find.

No, really, that’s it, that’s their argument.

Published today in Clinical Medicine, the peer review journal for the Royal College of Physicians, the researchers studied the amount and type of alcohol drunk by 404 liver patients, and also asked patients how much they paid for alcohol. They found that patients with alcohol related cirrhosis were drinking on average the equivalent of four bottles of vodka each week, and were buying the cheapest booze they could find, paying around 33p per unit, irrespective of their income. In contrast, low risk moderate drinkers were paying on average £1.10 per unit.

If the government set a MUP at 50p, it wouldn’t affect pubs or bars and would have no impact on moderate drinkers; the average cost would be £4 per year and 90 per cent would not be affected at all, the research shows. The impact on heavy drinking liver patients would be at least 200 times higher.

They’ve not even attempted to work out what the actual effect of an MUP would be. No discussion at all of whether people would in fact drink less. Or even whether people are in fact budget constrained and if they are whether it would be other things (oooh, I dunno, food maybe?) that would get dropped from their budget in the face of such price increases. They’ve just said that alcoholics drink cheap booze so we’re right!

And they’re still not attempting to answer the point we’ve been making here for so long. Which is that an MUP is still a ludicrous way of dealing with this. Even if it’s true that higher booze prices would reduce the amount alcoholics glug, even if they’re correct on that point, it’s still a ludicrous solution. If you want more expensive booze then raise the alcohol tax: at least that way there’ll be a bit of revenue and we can cut other taxes to boot. Why on earth you would try to raise prices and then insist that the extra margin stays with the manufacturer or retailer is very hard to fathom.

The problem with price fixing NHS drugs

Markets have a funny way of getting around behind the rational planner and biting him in the buttocks. And so it is with price controls on NHS drugs. Sure, it sounds great that we use the power and majesty of the law to keep taxpayers’ money out of the hands of those rapacious Big Pharma companies. But the problem is that this is leading to there being no drugs for people to take:

Patients are being harmed and put at risk because of national shortages of some prescription drugs, doctors have warned.

Medicines currently subject to shortages include Tamoxifen for breast cancer, Naproxen for arthritis and Amiloride, used to treat heart failure and high blood pressure.

A poll of GPs has revealed that more than nine in 10 family doctors have been forced to write prescriptions for “second choice” medicines because the drug they wished to provide was out of stock.

In recent years, scores of medicines, including those for breast cancer, arthritis and schizophrenia have run low because drugs intended for British use are being diverted abroad for profit, while others have been subject to production problems.

The survey of more than 600 family doctors by GP magazine found that one in three said their patients had suffered harm as a result, or faced a longer recovery.

The background to this is that there is an absolute freedom of trade across the EU. This is what the Single Market means. And we also have the NHS insisting that it will only pay certain prices for certain drugs. Fine, volume discounts aren’t a problem and, if we’re to be honest about it, nor is the use of countervailing economic power as a near monopsonist argues with the monopolies that pharma companies have over their still in patent drugs. But we do get to the standard problem with price fixing. Set the price too low and you’ll get a shortage of whatever it is you’ve set the price of. Too high and you get a glut, fix prices at what the market price would be anyway and what’s the point?

Here what’s happening is that the freedom of trade is bringing that iron law of one price into play. Different EU countries fix (or don’t even try to fix) drug prices at different levels. So there are arbitrage opportunities to buy pharmaceuticals in one country, at that country’s controlled price, and move them to another EU country where the price is higher. It is this that is causing the shortages here in the UK.

Of course, people are trying to deal with this:

Because of the shortages, the Department of Health has introduced a system of rationing, which is supposed to mean the right number of drugs are held in stock. However, the system often means particular parts of the country run low on stocks, because they are not allowed to have more than their quota of medicines.

Facepalm. If the problem is initially caused by having fixed prices too low then the solution is to raise prices, isn’t it? Remove the arbitrage opportunity and there won’t be any arbitrage.