The 46 million myth

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As my colleagues Steve Bettison and Tom Papworth have pointed out in previous blogs, the frequently quoted figure of 46 million uninsured Americans is something of a myth. To restate some salient facts:

  • 9.7 million of these uninsured are not US citizens.
  • 14 million of them are eligible for the government programmes Medicaid or SCHIP, but not registered. If they ever presented at an 'emergency room' they would be signed up.
  • 17.6 million of those without insurance earn more than $50,000 per year. 10 million of them earn more than $75,000. That means that around 38 percent of the uninsured probably make enough to afford health insurance, but for some reason choose not to buy it.
  • 18.3 million of the uninsured are under 34. Many of those may simply think, mistakenly or otherwise, that they do not need health insurance.

It is also worth pointed out once again that the 46 million figure does not mean that 46 million people are permanently without insurance. Indeed, it is estimated that 10-20 million are only temporarily without coverage. In many instances, that could be because the US tax system creates huge distortions in favour of employment-based health insurance – something which causes problems when people switch jobs.

Clearly, some people will fall into more than one of the categories I've outlined, so you can't you can't just subtract all of those numbers from 46 million to give you a fair figure. However, most people seem to think that 10 million or thereabouts would be an accurate reflection of reality. Back in 2003, a Blue Cross survey found the 8.2 million Americans were actually without health coverage in the long run because they are too poor to afford private insurance but earn too much to get government assistance.

Quite plainly, that is still a problem, but it is not a problem that suggests huge government intervention is needed (which is probably why President Obama prefers the 46 million figure). Interestingly, research from the University of Minnesota has suggested that if the US government simply permitted its citizens to purchase health insurance across state lines, 12 million more people would be able to afford insurance.

Fabricated evidence

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Tory MP Damien Green has claimed a ‘small but significant victory for freedom’ as he has successfully campaigned to have his DNA records deleted from the national Police database. Damien Green is correct, this is a ‘small’ victory, but it’s hardly significant – the deletion of one DNA record, for entirely political reasons, is nowhere near far enough.

The Home Office seem very proud of their national DNA database, which isn’t surprising considering they have spent £300million (the equivalent of 10,000 police salaries) of our money developing it. This is probably why senior policemen have been told to continue logging the DNA of innocent people, despite a Human Rights ruling from the European Court. Their website boasts that our database is the largest in the world, holding the records of 5.2% of the population – Maybe this is a reflection of our governments inability to prevent crime, rather than their data collecting prowess.

The most fundamental problem with the DNA database as it stands is that there are around 850,000 records which should be deleted. These belong to people who were never convicted or tried and should therefore be considered innocent. It seems wholly against freedom and liberty for somebody’s DNA to be held on a database, accessible to many public servants just because a policeman considered them the ‘type of person’ that might one day commit a crime.

Not only is this expansion of this database an unnatural infliction upon our freedom, it is also an increasing security risk. This government’s track record of ensuring the security of individuals personal data is pathetic at best. Recent evidence suggests that DNA within blood and saliva can now be fabricated and cloned. This scientific advancement could eventually destroy the utility and reliability of DNA evidence in criminal investigations. Although this could prove to be a step backwards for policing, at least it may signal the end of the dreaded DNA database.

Taking aim

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Just over a week ago a man appeared outside a town hall meeting in New Hampshire carrying a sign that read, "It is time to water the tree of liberty". Nothing sinister in that. What was apparently sinister was the fact that he had a loaded firearm in a leg holster. This has sent certain sections of the media into howling, screaming fits of rage. As can be witnessed here when Chris Matthews interviewed Wiliam Kostric the man who was carrying the sign and the firearm. The discussion surrounding this issue was ramped up further when others openly carried arms at a speech by President Obama to veterans.

This debate has exposed how parts of the media view the issue of state's rights and gun laws. Their shrill intonations also expose how they suffer from quick knee jerk reactions and completely misunderstand the issue of gun laws that vary from state to state. They have a conception of an America that is primarily a federal jurisdiction and their own beliefs should be channelled via the President to ensure that the Second Amendment is abolished.

It seems that while the President, state enforcement agencies and those carrying the guns are level headed, the media are running around and wildly screaming. The media is a devilish mistress and one that is continually becoming a hindrance to liberty rather than a promoter of it. It is no longer acting as a brake against government wrongdoing. In America it consistently chooses to ignore the Constitution and suggest a tyrannical course of action. Is it any wonder that they are going out of business and being overtaken by internet based news websites/blogs? They have disconnected from their customers to follow their own politicised agenda, a self-inflicted suicide.

Private vs. public healthcare

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People in the operating room pay attention to a rich patient's wishes because they know a rich person can make their lives miserable. He can complain to the hospital president, or call the mayor. But the side effect is that their high quality care becomes habitual, and all patients receive it. When a poor person complains in most environments, no one listens. But in health care, through a common private insurance system, poor people go to the same hospitals and doctors as rich people and thus enjoy the benefit of rich people's power.

The public option severs this link. Dissatisfied with government-run health care, the rich will exit the system. The poor and middle-class will be left to flounder alone inside the public system. Government-run health care will become like the public schools.

 Ronald Dworkin, 'An Anesthesiologist's Take on Health-Care Reform', WSJ

Alcohol, localism and the post-bureaucratic age

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Cameron is planning once more to get tough on cheap booze. The Conservative’s have yet to give any clear policies on this matter, but a minimum price for alcohol might well be on the agenda.

Drinking alcohol and getting drunk are of course not problems in and of themselves. However, the antisocial side of its effects are best dealt with through the devolution of political powers to local levels. Sadly localism comes with its own problems, but short of the privatization of all land and the natural creation of contract-based communities, at present there might be no politically realistic alternative. With more representation and varying policies at the local level, people will have a greater say over where and how they live. Alcohol can flow to where it is most readily appreciated. This transfer of power should be done contemporaneously with an end to the national taxation of alcohol and a hefty reduction in centrally dictated regulations.

As for the more serious cases of alcoholism, once again the centralised state and politics does not have the answers. Regulations and prohibitions will not solve the underlying causes of people’s decent into alcoholism. Salvation ultimately comes from the strength of the individual and the support of institutions predating the modern state: family, friends and charity. And despite the Ian Duncan Smith’s constant calls through CSJ for the state to support these institutions, much better would be to leave them alone to flourish as they did prior to the massive extension of the state.

A minimum price for alcohol is hardly in the spirit of the post-bureaucratic age Cameron is so keen to promote. And this is ultimately the problem with this vision; he has has not signed up to the reduction of the central state that is essential if localism is to be anything more than another control upon our lives. A skeleton central government as the defender of our freedoms and local governments as the many and varied expressions of the will of the community could and should be the practical reality of Cameron’s post-bureaucratic age.

This would be no small revolution, and a serious blow to collectivism. Of course there are solid arguments that this does not go far enough, but in reality, it would be more than we can currently expect.

A healthy debate

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Second only to zombies, the topic du jour it seems is lambasting the NHS. A new study brings some suitably shocking statistics for those who’ve already sorted their contingency plan for an invasion of the undead and aren’t overly concerned with Kerry Katona’s mental health. Apparently not only do NHS workers take more sick days than the average public sector worker and smoke just as much, but more than a quarter have absences due to ‘stress, depression and anxiety’.

Yes, the figures aren’t promising and are worth some consideration, but in reality they’re far from shocking, and most are in fact related to the job. Work in a hospital? Congratulations, your chances of getting an infection have significantly increased. While the Telegraph says picking up infections from patients wouldn’t explain all the absences, the runny noses and common colds the rest of us can work through will worsen the condition of the already sick. Far better to take a sickie and not risk it.

Saying the smoking figures should be lower because those working in hospitals have seen the effects first hand is failing to acknowledge that we all know someone who’s had cancer, we’ve all seen the effects and it hasn’t stopped one in five of us. Why should they be any different?

And the high stress and anxiety levels also come with the job. Every sympathy with that bad day in the office, but you don’t have people putting their life in your hands, you’re not handing out life-changing diagnoses, and you’re not dealing with people who are upset through sickness and bereavement – all valid reasons for a calming cigarette.

In the end, perhaps not so shocking. If these statistics extracted those in front line services from bureaucrats there might be a story. As it is, it is another missed opportunity to tackle the many necessary debates that need to be had on the future of healthcare in this country.

Rose Friedman - defender of liberty

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Yesterday Rose Friedman passed away peacefully at her home in California. The wife of Milton Friedman, she co-authored many publications with him, most notably Free To Choose in 1980 which was followed by a successful TV Series on PBS. She and her husband were champions of free market economics and liberty, highlighting how intrusive government held back progress and hampered human development. Advocates of choice they supported voucher schemes in education establishing The Friedman Foundation for Educational Choice in 1996 to further promote this idea. She will be as sorely missed as her husband of 68 years is.

You can read the NY Times Obituary here. And the Friedman Foundation's announcement here.

Soft' A-Levels

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The Conservatives’ new exam shake-up plans are all very well and good for gaining support from a public where the general consensus is that exams just aren’t the same as they were in the good old days (and who mostly haven’t sat an exam in over a decade and never will again) but in practice will only cause more problems. Schools pushing pupils into ‘soft’ A-Levels to inflate their league table position will push pupils towards whatever raises their scores, be it maths or media studies. Worse, the plans may pressure pupils into taking ‘hard’ subjects simply because they believe it’s what’s expected of them, rather than because they enjoy them. Ironically this will see further grade inflation with weaker students taking up these subjects, pushing those stronger candidates who would have taken the subject regardless further into the top grades.

Besides, while PPE at Oxford may suit Mr. Cameron, he fails to realise that not everyone is suited to, nor wants, the kind of classical education he got. The world works because people, rather than being united by desires of further education and a multi-million pound job, are good at and want different things. I note that none of the top unis are offering me a degree in plumbing (nor do I want one). Need I worry? No: my plumber, Tom, who did not go to Oxbridge or study quantum mechanics, but who is a proud possessor of several vocational qualifications (a big Conservative no-no), knows pipes like the back of his hand. Yes, we need trained scientists and doctors, but we also need people in those ‘less academic’ trades. Besides, we’ve got enough unemployed graduates as it is.

One last word on the ‘hard’/’soft’ debate: does academically undemanding translate as easy? Cameron seems to think so – so, if the results of the next general election swing in their favour, I would like to make them getting the legislation through conditional on one thing: that every single Conservative party member get an A in A-Level Dance. And then post the results on YouTube.