The new technologies must pay for the old:
Or, you know, people could read the online sources available?
The new technologies must pay for the old:
Or, you know, people could read the online sources available?
In my book, “How to Win Every Argument”, I document many types of logical fallacy. One of these is the Zero Sum Game, in which resources are believed to be limited where they are not. In popular parlance some call this the “pizza pie” fallacy, stating that if a group were to receive a bigger slice, others must receive smaller ones. This only applies to cases involving a fixed size.
Many falsely suppose that at both national and international levels, if poorer people are to receive more, it must come from richer people. This has never been true. Poorer people become richer when wealth is created, not when it is redistributed. I cannot think of a single undeveloped country that has ever become rich on money transferred from richer ones; they have done it by trade and exchange, by selling goods.
One of the great tragedies of the NHS is that it has unnecessarily turned health into a Zero Sum Game. Because it has a limited budget, money spent on one treatment means that it cannot be spent on others. It therefore has to make life and death decisions based on what those running it perceive to be its priorities.
The money spent on intensive care for a severely premature baby cannot also be spent on giving several elderly people the hip operations they have been waiting for. The money spent on an exotic new drug that might give a cancer sufferer a few more months of life cannot also be used to provide kidney transplants to those who need them to survive.
The NHS as presently constituted must decide how its fixed budget is to be allocated between competing claims for treatment. This is why there will always be a demand from different parts of it for more funds for their specialist area, and why the BBC will always be able to highlight “underfunded” areas to expose as a “scandal.”
There are several solutions to this problem, including that of turning the NHS into an insurance-based system in which people know what their level of cover is, and what treatments it will buy. The alternative is to continue with a system in which demand is infinite but funds are limited, and to have its rulers make decisions about people’s lives that gods might make, but humans should not.
Here is a wondrous example of how ridiculous the conversation about housing and affordability is:
Almost one in 10 new homes created in the last two years were converted from offices without having to go through the planning system, according to research by the Local Government Association (LGA).
This loophole of permitted development rights (PDR), which is legal, means that these new homes do not come with responsibilities to pay for affordable housing or invest in infrastructure such as roads, schools and health services.
The LGA, which represents councils across England and Wales, calculated that as a result it has led to the potential loss of 7,644 affordable homes over the last two years.
Housing completions are, roughly enough, 200,000 a year at present. So, we've gained 40,000 houses by the conversion process. As compared to not gained 8,000 from the tax upon new housing (that's what this affordable housing requirement is, a tax upon new housing). Now, neoliberals that we are, we think that's a net gain of 32,000 units. But then what do we know?
We would also insist that every single new housing completion makes all housing just that fraction more affordable. This supply and demand stuff really does work.
So, the only way we can explain this is that it's a bureaucracy complaining that they didn't get the money to spend or manage, rather than it being any concern about the amount of housing available or its price.
We'd also take one more little point from this. If being free of the affordable housing tax leads to more housing units then why don't we just abolish the affordable housing tax and have lots more housing units? After all, we do know that if you tax something you get less of it......
Last week, Trump allegedly questioned why US should accept more immigrants from Haiti, El Salvador and other ‘shithole countries’ in Africa, which honestly is a reasonable question. In all fairness, these countries are in one way or another not that desirable to live in. This, however, doesn’t mean the US or any other country shouldn’t accept immigrants coming from these countries just because they drew the shortest straw in the lottery of life. Most people in a similar position would try to amend their situation - and should be able to, especially considering the fact that half of the people in Haiti and El Salvador would, if possible, migrate to a different country and nearly 40 % of Africa.
These people suffer under corrupt governments who are suppressing growth and entrepreneurship - migration barriers cement these injustices into place and rob the people from the developing world of the opportunity for a better life. We should instead help them out of their dreadful situation and give them a chance to engage in free and voluntary trade in order for them to create better lives for themselves.
One of the things underlining this point is the wage difference. Because of the stifling governments and economies in the developing world, immigrants might see a twofold, a threefold or even as much as a thirtyfold rise in their wages, which emphasises the border discrimination going on and the huge missed potential. Some might object to this on the basis that, if we expand labour mobility from developing countries, there would be huge costs. But according to this paper, we could effectively substitute foreign aid programs with an increase in immigration and gain from it.
When the UK voted to leave the European Union, one of the reasons often stated was that the UK is able to create free trade agreements with other countries independently from the EU. But what featured more prominently in the Leave campaign was a focus on the return of control over immigration and, quite frankly, restrict it. Richard B. Freeman manages to sum it up in his paper:
The policy debate over globalization in the past decade has largely bypassed the international mobility of labor. Restrict trade and cries of protectionism resound. Suggest linking labor standards to trade and it’s protectionism in disguise. Limit capital flows and the International Monetary Fund is on your back. But restrict people flows? That’s just an accepted exercise of national sovereignty! During the last few decades, when most countries reduced barriers to trade of goods and services and liberalized financial capital markets, most also sought to limit immigration
For decades, economies around the world has become increasingly integrated and have accordingly liberalised trade. Yet one aspect of globalisation that hasn't received as much positive press as trade is immigration. The thing is, though, that maybe we should see free trade and migration as two sides of the same coin.
If we really want to prosper, free trade shouldn’t be the one and only priority. In fact, we could double the world GDP with less restrictive barriers on immigration policies contrary to the amount to be gained from the elimination of trade and capital barriers, which only constitutes a few percent of world GDP.
In addition, immigration might even foster trade between countries. In a study of the effect immigrants have on bilateral trade, the evidence shows that a 10% increase in immigration leads to a 1.5% increase in trade. What's true for immigration is also true for emigration. This is mainly due to immigrants lowering the transition cost through their knowledge about their home country which in the end has a positive effect on both export and imports. By contrast, immigrants preferences are only expected to boost imports through demand of goods from their home country.
So to answer Trump’s question: The immigrants from these countries are simply trying to do what those immigrants coming to America more than a century ago tried to as well. The fact that they are willing to chase that dream just goes to show that they are made of exactly the same stuff that the rest of America is built of. This is why the US should allow more immigrants from the so-called ‘shithole countries’. Instead of setting up new barriers for people trying to chase the American Dream, we should tear already existing ones down - life for everyone alike should be better with loads of opportunities to reach that goal. That is what the American Dream is about - opportunities, not barriers.
To finish off this piece, here’s a quote from a Republican hero, Ronald Reagan:
Many people are welcome in our house, but not the bigots.
We thought this was an interesting comment on a proposed bill:
This coming Friday, 19 January, a bill is to be debated in parliament that could hugely improve the lives of many people in England.
The Homes (Fitness for Human Habitation) Bill would give private and social tenants the ability to take landlords to court if their home is unsafe. Over a millionhomes are thought to pose a serious threat to the health or safety of the people living there. This classification, also known as a “category 1 hazard”, covers 795,000 private tenancies – one in six of the privately rented homes in the country.
Ooooh, private landlords! How terrible they are. Why not use the righteous anger of the people against them?
But then we get:
Although there are fewer of them, social tenants with an unsafe home currently have even less recourse, particularly where the landlord and the council are one and the same, as became tragically apparent following the Grenfell Tower fire last June.
So, we've those dastards in the private sector, facing competition plus independent (of them at least) enforcement of standards. We've then got the governmental (and quasi-such) sector with a monopoly supplier, no independent enforcement and thus consumers have even fewer rights and methods of gaining them.
Thus we must change the law.
OK, the basic idea seems fair enough to us. Yes, that governmental supply should indeed be subject to the same consumer protections as the market sector. In fact, shouldn't this be true of the entire economy?
Lord Saatchi and Dominic Nutt last week published a remit for a Royal Commission on the NHS. The NHS staggers from crisis to crisis. The demand for a non-political party strategic review, first proposed by Norman Lamb, then shadow Health Minister for the LibDems, is growing. About 100 MPs agree. We supported the idea some months back. The government does not (yet) agree.
The Saatchi paper was cited by Dr Andrew Murrison who also pushed for a Royal Commission in a PMQ on 10th January. The Prime Minister briefly dismissed the proposal with disdain: any problems the NHS may have need immediate attention, rather than awaiting a Royal Commission. The party line is that everything is fine because the Department of Health now has a Plan. The PM’s response is flawed: a strategic review would not inhibit any improvements that can now be made.
The only previous NHS Royal Commission was set up by Harold Wilson in 1975. Little has changed. Waiting times at A&E were one concern, excessive bureaucracy and layers of management were two others. Some of the reports’ conclusions are familiar: “The development of nursing homes could make a major contribution to the care of the elderly.” (22.32) Mental health needs to “be integrated fully into a unified psychiatric service, and to receive a proper share of capital monies.” (22.34) “22.35 Finally, we concluded that communications between the hospital and the community services were not all that they should be, and that the arrangements for community workers to work in hospitals, and hospital workers in the community needed to be improved. Strong links were particularly important in the rehabilitation services.” Many of the 58 recommendations, such as compulsory seat belts, were successfully implemented but many others still, 39 years on, need to be.
That report focused on effectiveness, i.e. NHS value for money, but even so, it took four years to produce. In contrast, the Saatchi remit covers almost everything conceivable: “The aim should be to produce a fully costed blueprint that delivers the best possible outcomes over the coming decades at the lowest cost.” Actually: “a series of options for implementing its central ideas, each of them fully costed”. Identifying and measuring “the best possible outcomes” would be ambitious, never mind quantifying all the alternative cost implications. Health inequalities between different parts of the country and of society would be corrected along the way. “The Royal Commission would also be tasked with investigating a range of other issues, including the gap in health outcomes between rich and poor, and between Britain and other countries; the ageing population; the pace and cost of medical innovation; the need to integrate social and long-term care with health care; the case for and against greater private sector involvement in the delivery of health care; the tensions between privacy and better use of health data; and potential additional sources of revenue for the NHS to complement general taxation.” And “Mental health provision must also be considered, including as a chronic, public health issue which causes, and can be caused by, poverty.”
This brief, to cure the NHS, adult social care, mental problems and poverty, would, if it were feasible at all, require many more years than the four of the 1979 report. Can the NHS afford to wait that long?
Norman Lamb’s proposal that a non-political party “convention” be tasked to report back within a year is realistic and practical. Like the 1979 report, it should focus on value for money, i.e. minimising waste, and leave the issue of the quantum, i.e. the total amount of the departmental budget, the nation can afford to the Chancellor. This would make the convention far more acceptable to a government tired of being lectured about increasing NHS spending.
There is plenty to go for. The 2016/7 Department of Health accounts (p.119) shows that, of the total Department of Health £139bn. expenditure, £106.9bn. (77%) went to NHS England, £2bn of which was passed on to Local Authorities for social care (unblocking beds). The vast majority of adult social care is funded by the Department for Communities and Local Government (as it was until January 2018). Only about £100bn. (72%) reached the front line, i.e. treating medical and dentistry patients, medicines and devices. 5% of the departmental total (£7.2bn) went on quangos – some necessary, some not.
Comprehensive as the Saatchi remit is, a few areas seem to be been overlooked such as:
Restraining demand through co-payments, as already apply to dentistry and prescriptions, and redrawing the boundary of what the NHS should provide.
How to push treatment back from higher cost (acute hospitals) to lower cost provision (towards cottage hospitals or home).
The impact on management hierarchies of closer integration of the (vertical) NHS and (local/lateral) adult social services. The latter is less top heavy and may be the better model. For example, the widely discredited CCGs could be eliminated at a saving of £1bn. p.a. of managerial costs.
We are short of GPs, geriatricians and nurses essentially because people don’t want those careers. Paying them more would help up to a point but the problem has more to do with job satisfaction. Less bureaucracy, interference, record keeping and more trust would help.
A Royal Commission is attractive but, sadly, not feasible. The Saatchi remit would take too long, cost too much and arrive on the desk of a new government which is unlikely to share the perspective of the current team. We need decisions before the next election. On the other hand, the Lamb proposal of a non-political party, year-long convention is something the government should rush to accept. If it does not, the House of Commons Health Committee should commission it as it is perfectly entitled to do.
Public Health England is the body that recently proposed that we should limit
ourselves to 1,800 calories per day, versus the government’s previously
recommended 2,000 calories for women and 2,500 for men. It is “demanding” a
calorie-cap on supermarket ready meals that would limit breakfasts to 400
calories and lunches and dinners to 600 calories each.
The government’s Chief Medical Officer published revised alcohol guidelines in
2016, taking the recommended limit down to 14 units per week for both men
and women. The previous recommendation had been a maximum of 21 units
per week for women, and 28 for men. The new limit, 14 units, is about 6 pints a week, or 6 medium glasses of wine—not even one per day.
The sugary drinks tax coming in this year will be applied to drinks containing
more than 5g of sugar per 100ml. That’s because sugar is the new public
enemy. Before that it was saturated fats we were told to avoid, in the belief they
led to heart disease. Now it is thought that carbohydrates are the enemy. At one
stage we were told to limit our eggs to only two a week to avoid building up
cholesterol. That was before we discovered that we don’t absorb the cholesterol
One could be forgiven for taking all of this contradictory and changing advice
with a pinch of salt, but we are told to avoid salt in order to combat high blood
The question arises as to whether government should be doing this, and
whether the advice is helpful. One of the principal effects might be to make
people feel bad about themselves, inducing feelings of guilt and lowered self-
esteem if they eat and drink what they fancy. Guilt and low self-esteem raise
stress levels, and it is quite possible that increased stress levels contribute
themselves to health problems.
It is not really government’s job to make people feel miserable, and it is
certainly no business of theirs to legislate what people may or may not eat. The
fact that the recommended limits are so low is justified by officials on the
grounds that people will always exceed recommendations, so ultra-low ones will
make them exceed to tolerable rather than intolerable levels. The problem with
this approach is that the ultra-low targets simply discredit the whole process of
recommendation. If people think they are absurd, they will simply ignore them,
even though guilt and lowered self-esteem might follow on from ignoring them.
There is a very good case for proposing that government should stop doing this
altogether. There is plenty of good medical advice that people can read in the
press, and most people are aware of the ancient dictum, “Nothing to excess.”
Most of us, I suspect, would like to indulge ourselves occasionally without
having official bullies making us feel bad about doing so.
It’s become almost cliché to complain that Facebook, Amazon and Google have become unassailable monopolies. Critics, from the left and right, argue that big data and network effects combine to create massive barriers to entry.
The idea behind network effects is straightforward. Facebook isn’t very useful to me if none of my friends are on it. Google’s ability to put the right adverts in front of your eyeballs depends on their ability to analyse large pools of data. The more data-points they get, the better they can target consumers. Intuitively, it implies that there are massive first-mover advantages in the platform economy and that once a firm gains critical mass then insurgent startups don’t have a chance. Calls for trustbusting, and even public utility regulation inevitably follow.
The problem is, as an excellent article in this month’s edition of Regulation points out, that the evidence doesn’t fit the theory. Authors Evans and Schmalensee bash the armchair theorists who presume that whenever there are network effects then insurmountable monopolies inevitably follow.
One key mistake is to ignore that network effects can work in reverse too. Take instant messaging services. They’re only useful if your friends use them too. If there is anywhere where network effects should be able to create insurmountable monopolies then it is instant messaging. But, we’ve seen AOL Instant Messenger and MSN Messenger lose their market-share to WhatsApp, Snapchat and Slack.
The same is true of social media. The Guardian may now publish op-eds arguing that “We need to nationalise Google, Facebook and Amazon”, but just a decade ago they were asking “Will MySpace ever lose its monopoly?”
Why are the doomsayers wrong? Evans and Schmalensee explain:
“The flaw in that reasoning is that people can use multiple online communications platforms, what economists call ‘multihoming.’ A few people in a social network try a new platform. If enough do so and like it, then eventually all network members could use it and even drop their initial platform.”
Examples of ‘winner take all’ markets are often the result of economists and journalists misidentifying what the market is. Google may be the dominant search engine, but in the highly profitable product search market it has stiff competition from Amazon.
It’s become trendy to say ‘data is the new oil’ but slogans shouldn’t be a substitute for evidence. It is often asserted that ‘big data is bad for competition’, yet the last twenty years have seen incumbents with reams of data being displaced by nimble better services. Evans and Schmalensee give half-a-dozen examples:
“AOL, Friendster, MySpace, Orkut, Yahoo, and many other attention platforms had data on their many users. So did Blackberry and Microsoft in mobile. As did numerous search engines, including AltaVista, Infoseek, and Lycos. Microsoft did in browsers. Yet in these and other categories, data didn’t give the incumbents the power to prevent competition. Nor is there any evidence that their data increased the network effects for these firms in any way that gave them a substantial advantage over challengers.”
This isn’t to say it is impossible for Google, Amazon and Facebook to abuse their market position, but just as competition theorists rejected simplistic ‘big is bad’ assumptions in the 80s, it’s time for critics of so-called ‘tech titans’ to move beyond ‘big data is bad’.
There's a certain paradox in complaining about what you insist no one will want:
Supermarket giant Lidl has faced a backlash for selling pre-peeled "naked" onions in plastic packaging.
There is no point in complaining about, nor campaigning against, what you insist no one will or could want. For, in a market economy, if no one wants it then it will quickly enough disappear for lack of demand.
It is only if you think that people will buy it but that they shouldn't that there is a case for banning or saying that people shouldn't.
As with, say, a new supermarket. If everyone does indeed want to shop in the High Street then the existence of the new and larger store will make no difference. It is only if you think they won't shop at and therefore maintain the High Street that you have a case for protesting.
That case only being that people will do as they wish and you wish they wouldn't.
Peeled onions? If no one wants them then they won't be sold beyond a most limited trial. If people do then why shouldn't they have them?
Sequels of Hollywood movies are often more expensive and worse than the original, and it’s the same in politics. With the news that the House of Lords has decided to push the government to open a second press inquiry, that doesn’t seem likely to change.
It is, however, good news that the new culture secretary has come out fighting against the move by the House of Lords a week ago, with Matt Hancock saying:
"The House of Lords have just voted to restrict press freedoms. This vote will undermine high quality journalism, fail to resolve challenges the media face and is a hammer blow to local press. We support a free press and will seek to overturn these amendments in the Commons."
We are rightly keen to chastise and lampoon the enemies of a free press away from home (whether its mocking Trump’s attacks of #FakeNews and his calls to open up the libel laws, Chinese censorship or Turkey’s Erdogan shutting down private papers and TV channels). But the threat that comes from the House of Lords should be just as worrying.
The original Leveson cost the public £5.4m and cost the industry £43.7million. It was widely regarded as being broad in scope and unearthed wrongdoing that led to the arrest of 10 journalists. It led to sea-changes in operations at paper media organisations and was widely regarded as comprehensive (and in many ways counterproductive). Another inquiry was said to be designed to be focussed on relations between the press and the police but this was an area that the original inquiry already focussed on – something that Dr Marianne Colbran has argued led to a breakdown in relations between the two institutions.
Calls for evidence from across media would cost further millions of hours and thousands of hours spent. With the scope a second Leveson trailed as being any editorial coverage of any matter past, present or future, the inquiry would be open to abuse with complaints intended to deter and disrupt investigations.
The newspaper industry has changed its practices and its outlook. But it isn’t playing on a level playing field. The rules that govern online players, including the likes of facebook and twitter, as well as the myriad blogs and apps, do not apply uniformly. One of the recommendations, being pursued by Liberal Democrat and Labour Lords, was that press would have to bear the legal costs of both sides during investigations into their practices (by bringing into force Section 40 of the Crime and Courts Act 2013) following the Press Recognition Panel's decision to grant Impress the recognition of the Royal Charter. After local and national media highlighted the cost implications of the new regulations, the then Culture Secretary Karen Bradley backed away. She was right to do so, it could have meant investigations grinding to a halt under pernicious acts of those anxious to avoid scrutiny. The Conservatives were right to subsequently to recognise the too high a cost of a second inquiry when they stood on a manifesto of dropping it and the Section 40 provision at the election earlier this year.
British people get a great deal from a free and open press. No-one is safe just because of their status or position. Whether it's the Profumo affair, the Sunday Times investigation into Fifa's world cup allocations systems, the Telegraph's MPs expenses, or the Winterbourne care home abuse, our press keeps us all in the loop and everyone accountable. The Lords should back away from another damaging inquiry. Our press must remain free to publish without fear nor favour.