Without the state

How Ya Gonna Pay?

For those who argue that the NHS isn't working, read this.

[Via Ronni Bennett]

Election - health issues

There doesn't seem much to choose from between the parties on health issues. The Tories blame Blair because Mrs Bloggs in Northampton (or wherever) catches an MRSA infection and promise to give matrons the power to close wards. The fact that the power to close wards already exists seems to have escaped them but they succumb to the big government trap of thinking that doing anything centrally is better than letting people get on with their jobs. Meanwhile Labour announces health initiative No 4129 offering detailed guidance on handwashing from the Minister of Health.

Both major parties appear to think that MRSA is about cleanliness, even though 30% of the population carry it on their skin. MRSA is a bacterium which is resistant to most antibiotics. It gained that resistance because we have for the past 50 years used antibiotics for everything from colds and flu (viral infections on which antibiotics have no impact) to fattening cattle. And now we are surprised that resistant strains have emerged? Feh!

Surprisingly one move by Labour may in the end offer a way forward. The creation of Foundation hospitals is the first sign of a possible return to local management and control. Of course in their usual inimitable style they have managed to hugely over complicate the process but even so local control of hospitals - and much else - is no bad thing.

In American Health Care, Drug Shortages Are Chronic

This article from the N Y Times seems to confirm the general impression on this side of the Atlantic - that US citizens pay huge amounts for generally poor standards of care that fails to meet the needs of a large proportion of its citizens.

ANGRY about not getting a flu shot? Imagine being unable to find supplies of a medicine that limits damage from a spinal cord injury, a medicine that improves the health of a premature baby, or a medicine that fights systemic bacterial infectious.

Each of these drugs, and dozens of others, are in shortage in the United States right now. On any given day, 50 to 80 drugs, many of them life-saving, may be difficult or impossible to find. Some patients die waiting for them, or because a frustrated doctor substituted another drug without having adequate training.

The larger story behind the flu vaccine shortage is that drug supply disruptions in the United States have become routine.

[via Time Goes By]

The Face of addiction

Some shocking pictures on the BBC site show the dreadful physical decline of an addict under the influence of crack cocaine over a nine year period.

This one's for Norm - you all take care now!

Ig Nobel Award 2004 The Effect of Country Music on Suicide

Country music is hypothesized to nurture a suicidal mood through its concerns with problems common in the suicidal population, such as marital discord, alcohol abuse, and alienation from work. The results of a multiple regression analysis of 49 metropolitan areas show that the greater the airtime devoted to country music, the greater the white suicide rate. The effect is independent of divorce, southernness, poverty, and gun availability. The existence of a country music subculture is thought to reinforce the link between country music and suicide. Our model explains 51% of the variance in urban white suicide rates.

See here for an explanation of my concern.

ASI on drink driving

Britain has fairly few road accident deaths by international standards, but some are caused by drunk drivers. There is a campaign to lower the legal blood alcohol limit for drivers from 80 milligrams per 100 millitres of blood to 50 milligrams. A large proportion of the deaths is caused by repeat offenders who are several times over the legal limit. There is no evidence that any deaths are caused by drivers with between 50 and 80 milligrams of alcohol in their blood.

This quote from the Adam Smith Institute Blog is another example I think of their desparate urge to be seen as radical, regardless of how nonsensical the position they take up.

There is of course ample evidence that even low levels of blood alcohol affect your judgement. This is from the Scottish Road Safety Campaign

At blood alcohol level 20-50mg/100ml

Inability to see or locate moving lights correctly. Problems in judging distances. Tendency to take risks.

At blood alcohol level 50-80mg/100ml

Impaired judgement of distances. Impaired adaptability of eyes to changing light conditions. Impaired sensitivity to red lights. Severe impairment of ability to react and of concentration.

At blood alcohol level 80-120mg/100ml

Euphoria setting in - overestimation of one's own abilities. Impairment of peripheral vision. Increased impairment of eyes' reaction to light and dark. Impaired perception of obstacles and deterioration of ability to assess dimensions.

At blood alcohol level 120-140mg/100ml

Beginning of complete unfitness to drive. Serious impairment of concentration and vision. Very delayed and impaired reactions. Major orientation problems.

I don't know about you, but I think the ability to see or locate moving lights correctly, judge distances or avoid risks - all impaired at 20-50mg/100ml of blood - are pretty significant aspects of safe driving.

If you don't want to believe that source how about this from Rutgers University in New York

For most people, driving ability becomes impaired at about .05% B.A.C. (Blood Alcohol Concentration). Although the legal definition of intoxication in New Jersey is .10% B.A.C., the chances of being in an accident, of being stopped and arrested for impaired driving increase substantially after the person's B.A.C. reaches .05%. If the person drinks no more than one drink per hour, his/her B.A.C. should remain at a relatively low, safe level.

(A BAC of .05 is the equivalent of 50mg of alcohol/100ml of blood.)

We aren't just talking about the effect on the driver here.

In 2002, 22% of the 2,197 traffic fatalities [in the US] among children ages 0 to 14 years involved alcohol

This time the position taken up by the ASI isn't just stupid, it is dangerous and against all the evidence.

(And - sigh - YES I have commented and NO it wasn't accepted and YES I'm going to try a trackback with this post but NO I don't think it will be allowed through)

As for Adriana who seemed to think that my disagreeing with the ASI automatically means they are doing something right - what's your view this time?

The reality of life - and death

In her blog about aging, Ronni Bennet has been posting a series about her mother’s death. Some of this I have seen on her Fotolog, but much was new. These posts are deeply personal but still have something to say for all of us.

Our society somehow manages to both ignore (or at least suppress) death while at the same time obsessively generating images of it on Film and TV and in the written media. Every action film, every crime thriller is filled with it, stylishly rendered into balletic action or gruesomely depicted with dismembered body parts and cartoon blood filling the screen. Look for example at the success of violent movies from the Wild Bunch onwards, or at the CSI franchise now all over TV screens. Generally such stylised deaths are anonymous – the victims’ only purpose is to die – crushed beneath the juggernaut of the storyline. We even use them as vehicles for humour.

For most of us though, when we meet with death it isn’t happening to some anonymous, faceless character or to some cartoon villain. It is happening to our friends, our children, our parents. It is immediate, painful, harrowing and often messy. When we use humour it is not to raise a laugh but as a defence against the truth. Sometimes it is the only way to tell the truth. This is in his way I think Pratchett’s message to us – death (sorry DEATH) is normal, death is banal. Philadelphia and La Traviata tackle death in different ways, facing it head-on

Sadly, such emotional honesty is too often missing from the depictions that fill our screens daily. We do not face death honestly by carving up bodies on screen. We face it by recognising the reality – as Ronni does.

MRSA in the NHS

According to the Adam Smith Institute MRSA is a public sector disease. They argue this, citing an article in the Sunday Telegraph as their source.

Unfortunately for the ASI, the article they cite makes no such claim. What the article really says is that while the NHS has a particular problem, hospitals in other countries - like such hotbeds of private medicine as Sweden, Finland, Denmark and the Netherlands - have all been highly successful in preventing the infection reaching the bloodstreams of their patients. This information is confirmed here.

On the other hand this article from the US PubMed shows that the incidence of MRSA in the USA is sgnificantly higher than in Germany.

It is clear that there is a real problem with the NHS and MRSA. It may be down to the micro-managment style which this government is so fond of adopting, but the alleged evidence offered by the ASI in support of that is not only lacking but says something different to that which they claim for it. Moreover, even if the article had said as they claim, recycling someone else's assertions is at best evidence of nothing but sloppy thinking.

[for obvious reasons I haven't attempted to either comment or trackback]

Comparative health care costs

More on health - did you know that the country with the highest health costs per capita in the developed world is the USA and that one of the lowest is the UK?

[mainly via Crooked Timber]

NHS hospitals are filthy, says Express says ASI

The ASI headline says Adam Smith Institute Blog - NHS hospitals are filthy, says Express but the reality is that the report comes from a part of the government bureaucracy called the National Audit Office - inconvenient for them I know but true. They give a link to the NAO but not to the report, which you can find here (scroll down to the National Health Service section).