Fifth Decade

Not often I comment on celebrities - in fact, this is the first time. But julia Roberts just happens to be one of my favourite actresses, intelligent, beautiful, and a great artist.

So, I was a little disappointed to see her on the TV at some event in today’s news with a very much thinner than normal face - just like she’d had cosmetic surgery. Too much cosmetic surgery. The Michael Jackson sort of too much cosmetic surgery. She just looked so thin. Much of her beauty had gone as her sunken cheeks stared out of the TV.

I blame a society in which image is considered paramount, but in which thinness is considered the main component of beauty. Well, by the image makers in Hollywood, anyway. I’m not convinced that they have realised that normal people don’t think quite the same anymore, after all, people are getting much bigger in Western societies and stick insects look spiky and unfriendly when compared to a woman with her natural curves and musculature fully intact.

Thing is, these actresses and other women who put themselves under the knife seem to be chasing a female view of beauty - to be thin because they think men want them to look thinner. But most heterosexual men do not. Sure, men aren’t after obesity, but the cosmetic surgery industry is just ruining too many faces of once beautiful actresses and entertainers.

Maybe the higher numbers of homosexual men in the fashion, glamour and entertainment industries skew the look of the average woman in such roles because they sub-consciously try to turn the women into boys and therefore select-out “normal” looking women?

Most men like curves, they like the natural swelling of a female stomach - they don’t want a woman with a six-pack. Men like a woman with a friendly and supportive looking face, one that offers softness that to them represents gentleness, not sharpness or thinness which represent meanness. I won’t even mention curves in other places.

Please women of the world, leave the cosmetic surgeons to people who really need them, like burns victims. And if a man tells you to go under the knife, ask if he is gay, or just married. Chances are, he won’t have your real interests at heart.

I was just reading an interesting story in MacFormat magazine about the NHS. They’ve spent a load of dosh (they can’t do anything without spending a load of dosh, apparently) on bringing themselves into the online age with a couple of applications - Choose and Book, and the even more expensive Electronic Patient Record system.

Anyway, they’ve spent £5,600,000,000 to be exact. That’s £5.6 billion. Plus £64.5 million on top. Like a kind of tip…

The story unfolds on Page 8 of the April issue of the mag “Safari users failed by NHS” and describes how NHS online schemes are unavailable to thousands of Mac users because the NHS systems only support Microsoft Internet Explorer and Firefox browsers.

Health Minister Ben Bradshaw was queried in the House of Commons by the Conservative’s Stephen O’Brien about the £64.5 million Choose and Book appointments system and replied in a written answer using what can only be called Microsoft-speak:

Because of the number of browser versions available to internet users, priority has been given to certification of the application against the most popular browsers in the first instance.

Well, that is strange. I thought there was such a thing as Internet Standards? You know, rules like we have for driving - drive on the left, steering wheel on the right, accelerator on the right, clutch on the left and brake in the middle. Standards that when used mean that any manufacturer can build a car that works on the road, and that any driver can use without having to learn a new system.

On the internet there is a set standard, even a set of standards, and the best websites use what is known as “Standards compliant coding” which basically means they only have to design and code for one International Standard. It is then up to the browser writers to comply with those agreed standards. This saves a lot of money for developers.

I mean, why develop for many different systems when you could develop for just one global standard?

Ah, but that doesn’t help Microsoft sell their software does it, because when there are standards that anyone can use, there is no way to lock them in to having to buy Microsoft. Microsoft have a long history of sabotaging international standards, as we have just seen with the ISO voting process for Microsoft’s OOXML file format when there was already a perfectly adequate ISO standard with far wider acceptance in the Open Document Format (ODF).

That’s exactly what they have done with the internet. In order to force users to buy their Operating Systems they incorporated features into their browser that were sufficiently different to the agreed standards to make life difficult for those with different browsers. In fact, in many ways Internet Explorer does not read standards compliant websites awfully well at all - it’s a flawed browser on many levels, not least of which being security, something of a concern where our health records are concerned.

It’s the waste that gets me though. How on earth could the government spend £5.6 billion on any computer system at all? And then not have it fully working? That’s a lot of tax money. It’s a lot of free prescriptions. It’s a lot of patient beds, a lot of life-saving equipment. Oh, I forgot, it’s also a lot of profit for Microsoft and its supporters.

Well, at least we know what the NHS considers most important then.

A little while ago I wrote my piece on the dietary regime I’ve been following to combat Diabetes. I was diagnosed with the condition on 15th April 2007 and spent a week in hospital. Since then I’ve been trying to live as healthily as possible, and it’s had a marked effect on my life. For the better. My goal was to combat the disease through a combination of healthy eating and exercise. I wanted to lose 10Kg of weight each year for three years.

Well, the changes to my lifestyle and my attitude are really paying off big time. In seven weeks I’ve lost 8Kg - that’s about 18 lbs, or 1 stone 4 lbs in old money. Without feeling hungry. And while enjoying my food even more than before. Different food, sure, but it certainly isn’t boring. Maybe one meal a week is forgettable, but that’s just down to bad planning, or experimenting to find a new dish.

The weighing scales I bought that can calculate the proportion of body fat, water and muscle also show big improvements in the kind of weight I carry. Fat down from 35% to under 30%, with muscle mass up from 34% to 37%. When I lose my next Kilo I will officially no longer be considered obese! Man, that feels good.

Before my change to a healthy lifestyle I had got to the stage where just getting up off the floor from playing with my one year old was a struggle that needed all four limbs to lift me up - tragic I know, but so many people have similar problems. Now, I almost float up stairs, and relish the next staircase to walk up. Getting up off the floor is easy again - no hands needed! Because I’m not on a fad diet I’m not just losing weight, I’m also getting stronger. My neck is thinner and more muscley, my paunchy stomach is much, much smaller, and my muscles glow even when I’m sitting still, so I am burning more sugar just because there are more of them.

I’m also doing well on the medication front. Within a very short period of time after leaving the hospital I managed to give up insulin, although I am still taking Metformin to help my body deal with the sugars better. Just last week I gave up the blood pressure drugs that had been necessary when my blood pressure was 140 over 90. Now it is pretty stable around 105 over 70 - without any medication at all to reduce it.

My seven day average blood sugar level is 5.7 mmol/L which compares nicely with a non-diabetic value of 3.9 to 5.5 mmol/L. I’ll stay on the Metformin a bit longer though, it seems to be helping, and I have to lose quite a bit more weight yet. But I’ll get there.

Of course, I’m lucky with the weather at the moment. Spring and summer are here, with mostly dry, sunny days in which it is really easy to cycle or walk just that little bit further. But winter lies ahead and I have to prepare for it. I need an exercise machine.

I looked in a couple of gyms at the equipment they have, and compared it with the normal consumer stuff you see in sports shops. Mostly the consumer stuff is a pale comparison of the serious equipment a gym can provide. But I haven’t signed up for a gym yet. Most gym memberships fail after two months. In fact, for some people just signing the application form gives them more of a workout than they ever get in the gym itself.

I asked around at a couple of manufacturers at the prices of new kit - too much for me - but they sometimes get in reconditioned stuff after gyms have had the kit for three years on a contract before they renew with brand new equipment. I found I could save 75% off the cost of new gym level equipment, fully refurbished and with all the latest software just by waiting a little. Delivery should be just around the time the weather changes and outdoor exercise becomes less easy, and I’ll be paying about the same as I would for a top level consumer item that would actually give me less back.

I’m going to get a bike, rather than a rowing machine or treadmill for no other reason than that of space saving. For exercising the rest of me I’ll continue doing those circuit training exercises I learned all those years ago when as an athlete I tagged onto the weekly rugby training sessions, together with some isometrics.

Isometrics are easy to do, build muscle mass quickly, and take very little time. They also have the benefit of being possible anywhere. The basic principle is that you push against an immovable object so that your muscles try and try to move it, but instead just stimulate their own growth.

One example of an isometric exercise is to stand in a doorway, place the palm of each hand on either side of the wall so that if the wall were not there your hands would meet palm to palm with elbows bent so you push them together, trying to squash the wall. Another good one is to stand with bent legs for as long as you can manage, rest for a minute or so, and then repeat two more times. It’s amazingly effective.

Just don’t do isometrics without something to get your cardio-vascular system going as well though - that means one of cycling/swimming/walking/jogging so that your heart rate reaches a level sufficient to burn off fats, about 120-130 for me from what I can gather (see previous post about this).

Equipment that has helped me
I get paid nothing for saying this, and have no connection with any of the companies concerned other than my positive experience as a customer.

• Kitchen Scales: Tefal Copper 5 digital scales - very small, fit anywhere
• Bathroom scales: Soehnle Body Balance Rio (measures weight, fat, water, muscle masses)
• Pedometer: Silver Apple iPod Nano with Nike+ (calculates calories burned)
• Cyclometer: Marks and Spencer (calculates calories and fat burned)
• Glucometer: AccuChek Aviva (for measuring blood sugar)
• Blood Pressure meter: Omron R6 Wrist Blood Pressure monitor (simple, light, quick way to get a reading of blood pressure one handed)

I’ll write some more another time and let you know how my regime goes. I’m quite enjoying life at the moment though, and I am so pleased something like Diabetes came along and shocked me out of my apathy. I’m enjoying life a whole lot better now, and feel a lot more positive about myself too.

As the song goes “Always look on, the bright, si-de of life! Da-dum, da-dum die dum die dum…“

I said in this post that I would give you more details about my successful diet, so here we are.
(I’m not a nutritionist, but I did study physiology as part of my University degree, spent time as an athlete, and have had some chats with nutritionists recently).

No diet is going to work effectively without exercise. It’s very important to always remember this, as it is the key to good weight loss. I’ll tell you why. Continue reading ‘A Healthy Diet that works for Diabetes (and others)’

I haven’t posted for a while as the hospital room I was in had no internet access. I’d like to say I got plenty of rest as a result, but in hospital? With the comings and goings of staff and other patients, nurses and Doctors poking and prodding you - and the condition you brought with you to contend with as well - rest is not at the top of the list of things a hospital provides. So why stay there?

I’d had a fairly average Sunday visiting my sister-in-law’s for a meal. Now, I like my food. There aren’t many things I won’t eat - although lemon curd and lemon meringue I can live without - so as the years passed I gradually put on more and more weight. At my sister-in-law’s I ate my normal two portions (it was a salad this time, so not very fattening) but afterwards I had a hyperglycaemic attack which led me to hospital. Here they noticed I had high blood sugar of 32 mmol/L which is about five times higher than normal.

Diagnosis: Type 2 diabetes.

That’s the one where you inherit the likelihood of developing diabetes provided you also stuff yourself silly and gain weight. Once my Body Mass Index (BMI) passed 30 I was classed as obese. Like many people, I ate and ate but did no exercise. I sat in front of the TV or computer and avoided exercise like the plague, despite once having been an avid athlete.

As my fat cells increased in number, they began to interfere more and more with my normal sugar metabolism. It’s a fascinating story of physiology, but I’ll spare you the gory details. Suffice it to say the body loses the ability to get the energy the sugar carries in the blood into the cells that need it. The blood runs thicker, blood vessels can become blocked, and because less sugar gets into each cell the brain sends messages asking for more and more food. It’s a vicious circle, and can lead to lethargy, tiredness, and other nasties. Amputation for instance. Blindness. Death. It’s serious business.

Surprisingly, sugar is actually a poison: go on, think about it, when did the sugar in your house ever go mouldy? That’s why jam uses sugar to preserve fruit and why low sugar jams go mouldy quicker than full sugar jams.

Type 2 Diabetes isn’t all black though, it can be treated quite easily in many cases using a combination of diet and exercise. It sometimes vanishes completely, although the damage it does generally cannot be repaired.

And that’s where having diabetes can actually improve your life! It’s forced me to change my lifestyle - for the better. I am back to a regular programme of exercise after 25 years without, and I eat so healthily now it’s unreal. I feel I have been given my life back - and I feel a lot younger as a result. My healthy diet (I’ll say more about that in another post when I get around to it) has also resulted in my skin becoming softer, less dry, younger looking. Instead of the 8 Kg weight gain the Doctors expected, I’ve actually lost a bit.

While the drug therapy can substitute for diet and exercise, exercising really does affect your blood sugar in a positive way: your muscles suck sugar out of your blood as fuel, and this allows your natural insulin to get to work again.

I can’t emphasise enough how important diet and exercise are, so I’ll leave a description of them until another post. What is important though, is that having Diabetes is not the end of the world, you can even get a lot of positives from it. I have!

You may remember a few years ago that Apple was in such dire straights it had to run to Microsoft for some money or go bankrupt. Of course, Microsoft asked for some shares in exchange, and promptly became a 25% shareholder in Apple Computer. I haven’t checked whether they still are, but have been told this relationship ended years ago. But I still wonder…

Microsoft’s launch of Vista has been a big disappointment by all accounts - even Windows fanboys don’t like it. There have been reports of Microsoft haemorrhaging money, with the megalith’s cash reserves halving recently. Vista is causing huge problems for Microsoft, whose penchant for long legal wrangles is so strong they really need a huge inflow of money every month in order to fund just that.

But Microsoft’s problems have been seen as a B I G opportunity by Apple supporters. They want Leopard (the new version of Apple’s Operating System) to be launched at the moment of maximum weakness for Microsoft, thereby killing off their old adversary. Now that’s a bit optimistic.

However, with the announcement on the Apple Hot News website today of Leopard’s delay to October:

“We now plan to show our developers a near final version of Leopard at the (June WWDC) conference, give them a beta copy to take home so they can do their final testing, and ship Leopard in October.”

any talk of a favour being returned by Apple to Microsoft cannot be ignored. Which is both a bad and good thing. Bad, because it lets Windows off the hook. Good, because Apple can now release programs, applications and other stuff (such as a decent spreadsheet in iWork) to compete with MS without breaking a gentleman’s agreement, spoken or implied, not to directly compete with Microsoft - if you don’t believe me, look for an area in which Apple directly and aggressively competes with Microsoft: they don’t.

Apple’s TV ads always point to PCs being for work, and Macs for the home; their software is always for niche groups such as graphic artists and sound engineers, not mainstream businesses involving finance and accounting, databases, visual charting tools for organisations, or other everyday uses.

This stance is aided and abetted by MS whose current Office app excludes the popular Access database and the oft maligned but school recommended MS Publisher, while the new version of Office will exclude Visual Basic for Applications entirely, so the software will be even less useful for businesses looking for cross platform solutions. OK, Real Basic could step in here, but you get the picture?

Contrary to some expectations, I’m not completely against Microsoft. I believe there is a place for them in the computing world. I just don’t believe their dominance of any market they act in is good for that market, or ultimately, for the rest of us.

But how is the delay of Leopard going to affect Apple? Apart from giving the some-would-say “dying” Microsoft another lease of life, moving the launch of Apple’s major Vista competitor until after Vista’s first service pack can be launched will also severely impact sales.

Why? Many people - such as myself - were in the market for some new Macs, the ordering of which they were holding back until the new OS was launched. I was going to order four new Mac minis and four copies of the newly expected iWork ‘07 for the office. On top of that I wanted to buy a new iMac 24″ plus a copy of Final Cut Studio, a family pack of iLife 07 and a family pack of iWork for home. Now I, like many others, am just going to have to wait. That will hit Apple revenues quite hard because the revenue won’t be coming in, but the goods will be being sold.

On top of that, with reports saying “New Mac Pro hobbled by memory, Tiger?”it seems a lot more is riding on this Leopard than was first thought.

Leopard was supposed to be a significant upgrade (we are already up to v 10.4.9 for the Mac OS so we shouldn’t really have any more incrementals). It was supposed to be capable of allowing a user to easily install Windows XP or Vista onto an Apple Mac computer, but Microsoft have changed the licencing requirements on Vista and announced that they will be removing Windows XP Pro OEM edition from the beginning of 2008, leaving Apple with just two months to get the “Switch to Mac” juggernaut moving and attempt to bring the Mac platform into dominance (OK, eat a little more into the Windows monopoly). It ain’t gonna happen.

So, it looks to me like when the seminal moment arrived, rather than stepping up to the plate and hitting a Home Run (I know what one of these is now, thanks to my fantastic Nintendo Wii) Apple wobbled, and instead of hitting Microsoft for six, they decided to play with a little hand toy of their own, the totally untested, untried marketing newbie of the iPhone rather than their solid and known product range. Apple had the choice of getting either the iPhone or Leopard ready for release in June, they chose the untried high risk option.

Maybe Apple as personified by Steve Jobs doesn’t want to be popular in the larger marketplace? If that is the case, Steve Jobs is heading for another fall at the hands of the professional shareholders, just as he did once before. Allowing Microsoft to lick it’s wounds and come back again, stronger and even more dangerous.

Nice move, Steve. That itty bitty toy the iPhone needs to be a pretty good distraction to make up for the other losses…

How can I say this gently… people of my age aren’t supposed to be “Gamers”.

Closest we’re supposed to get is to like playing solitaire at work. Actually, maybe I’ll come back to this blog later - after I’ve had a quick blast on Freecell… No, just joking! I’ve come to the conclusion that Solitaire doesn’t cut the mustard anymore. Why not? I’ve just bought a Wii.

What an amazing thing this is. Since I bought it a couple of days ago at a price far below the prices of the other gaming machines out there (the Sony Playstation 3 and the XBox 360) it’s been played on - most enthusiastically I add - by both my 40+ year old female partner and my two teenage daughters who are usually glued to their Sims game on their Mac. I’ve actually got stiff muscles. From playing on a computer! I’m impressed.

It is said that the graphics on the other two gaming machines is far better than on the Nintendo Wii, but because the Wii’s games are so involving I really don’t notice the lack of detail on the screen. Having to swing a golf club or Tennis racquet and actually connect in the same way as the real equipment does in real life makes for more realism than any semi-perfect virtual image of reality can ever provide.

The trap Sony and Microsoft fell into was believing their virtual reality world was ever going to be a replacement for reality. They became so arrogant about this premise that they just didn’t see the Wii coming. And now Nintendo is outselling both Microsoft and Sony combined in the States…

I can’t believe I ever bought a gaming machine. But then it is a little more than that. Exercise machine, intellectual challenge, social centre when a group of friends get together and play, and a few other things that other gaming machines do too which I have yet to look into. What do we think overall?

Wii Like It!

The only rich country that treats its children worse than the USA is Britain, according to a recent Unicef report [1.5Mb pdf]. OECD and WHO studies contributed to the results which show the direction to go in is clearly the European one as the Netherlands came first, and Denmark and other Scandinavian countries were in the Top 5. A summary can be found on the BBC’s Newsnight webpages.

I’ve had a read through the report, and while there are clearly areas which may have been misinterpreted, there seems no doubt that in broad terms the report’s findings should be listened to. It is clear the Anglo-American model of life is not as helpful to our children, and ultimately to our adult societies, as we would like to think.

OK, we score higher for affluence, but is money happiness? Or are there other factors that affect wellbeing? What areas did the study cover? I’d like to comment on a few striking points.

Continue reading ‘Britain and America worst environments for children of any of the Top 20 rich countries’

Most obvious of course is that it still exists almost 200 years after it was introduced to fund the Napoleonic Wars - which we won ages ago anyway.

One big problem with Income Tax is that it is normally collected by people who live a long way away from where we do. What’s worse is that they have totally different ideas of how they should spend our money.

So - make it local!

How would this work? Well, at the moment Income Tax is collected centrally, and Council Tax is collected locally. Problem is, the Council Tax is topped up with money that comes from rebates from the centrally collected Income Taxes.

Inefficient? Of course it is. Why not just let each local community collect the taxes they need to pay for the services they provide by collecting the income tax themselves?

So, every County/Unitary authority would set it’s own income tax rates payable by all residents of their area. At election times the politicians would be judged on how well they managed our money, and whether the services they provided were too expensive, or not. If the population believed what they got for the money they were charged the politicians would be reelected, if not, they wouldn’t.

If you thought you lived somewhere that charged too high a rate of income tax, you could move to somewhere cheaper. Of course, house prices would also be affected, as who would want to live in a particularly highly taxed area?

Local taxes would be spent on everything except for National Security and International Affairs. Oh, and maybe on National infrastructure like motorways, railways and airports.

But local spending would go on local roads, education, local health services (which would not get any money from large and inefficient centralised centres in London); police and emergency services would be managed from the localities as they are now, but without the need to go to London with a begging bowl for top up funds; it would be much easier to raise funds for local issues that were unique to your areas.

If you live outside of London, how do you know how much of your tax bill goes to subsidising things such as the Covent Garden Opera House for the benefit of people who live hundreds of miles away? Maybe your own local theatres and arts providers could do with the money instead?

If you live in London, are you happy for your tax money to be spent on large regional aid projects “oop North” in places you wouldn’t even want to drive through in an APC?

If you live in an unemployment black spot, wouldn’t you like your local authority to be able to charge lower taxes to encourage companies that brought employment to the area?

Would you be more interested in local politics if it affected your income tax bill?

If schools in your area are failing, wouldn’t you like to be able to increase their budgets and provide an education system more tailored to local needs - eg increase the amount of computing and/or maths and/or commerce and/or vocational skills - and wouldn’t you like to be able to increase the budgets to the schools in your area without needing to have to beg? Imagine, each pupil with their own school provided laptop…

If the health service in your area didn’t have enough scanners, you could allocate funds to make sure they were provided. You wouldn’t have to close hospitals or their wards if you didn’t want to.

Your MP (who you probably never hear of right now, except at election time) would become less important than your local councillor who you would see a lot more of as he wouldn’t be so close to Covent Garden any more.

So, you may ask, how is this all financed? First of all, there’d be the same amount of money coming in in total as there is today; it just wouldn’t have to go via London. Cutting out the trip to London and back would eliminate one layer of cost from the equation, and London costs - as we all know - are higher than anywhere else in the country, so the savings would be big.

Let’s face it, the rest of the country currently pays for the London weighting on civil service salaries; move these jobs to local councils and you’d have cheaper administration costs immediately.

Democracy would also be improved because the control of money would no longer be in the hands of people who had very little connection with your area, but in the hands of people who lived, worked, and travelled in the area every day.

People would have a sense of ownership.

There are working examples of this kind of set up - in Switzerland. It works very well, it keeps taxes low, services high, and competition between areas maintainis high levels of employment too. In fact it works so well the EU is actually complaining about the Swiss tax system, saying it is “unfair”! Just because the French and Germans are too monolithic and in need of restructuring to efficiently manage their own economies.

If you dislike the EU because it is too big, too bureaucratic, then why is the UK system that is centralised on London any different?

Local spending should be controlled by locals. It’s your money, so why give it away to strangers?

Charles Clarke, MP, former UK Home Secretary, made a speech at the London School of Economics (LSE) today (Thursday, 8th Feb) in which he queried the way the UK’s National Health Service (NHS) works. That’s very brave for a politician; it’s the sort of thing they usually lose their jobs over, but he’s already lost his, so he’s got nothing to worry about.

Remember, he was the guy who lost his job the week before his successor gave a press interview and famously said this department “is not fit for purpose!” Some epitaph for a man who was hardly in the job for long enough to make any kind of difference. But old Clarkey (who for some reason reminds me very much of Noddy, can’t think why) did tend to keep things to himself. Except those foreign prisoners, immigrants, and parolees who had a habit of disappearing when he was in charge.

[Less to do with him, the Home Office really had and has big problems with record keeping. Nothing to do with the big NHS National IT Project the UK government wasted many billions on in the Health service, or the similar amount wasted on the National Insurance computer system that actually lost one and a half years worth of records (no wonder they reduced the number of qualifying years down to 30 to get a pension - they had to! All those lost records...). The Home Office really is a leviathan whose time is come.]

Anyway, since he was sacked because of the bad press over the mismanagement in the giant department that is responsible for internal affairs such as the Police, Immigration, the Justice system and so on, he’s kept a low profile. Bit difficult for a man like that, I know. Reminds me of a boy at school, very similar physique from the ears to the Mr Wobbly-Man waist to the great height. Fatty we used to call him, but boys can be awfully cruel without really meaning to be. I think most kids really liked him, and after all, we all had pretty strange nicknames back then. Since the teachers all called us by our surnames, a nickname was far more personal, and like the given names of Native American braves, we suffered our badges proudly.

But I digress. Sometimes I’m good at that.

Old Clarkey said some interesting things though. For once, we heard a politician call a spade a spade, although he did backtrack quite a bit on Newsnight on BBC afterwards, apparently. I saw the BBC interview but not the LSE speech.

Most interesting thing he said though was along the lines of “Why don’t we charge for certain health services at the point of delivery and have insurance pay the bill?” Now I know a few smartarses are going to say, all indignant-like, “But we do pay for Insurance - National Insurance!”

Well, that’s a joke.

No, I mean it. National Insurance doesn’t collect enough money to keep a family of sparrows fed through a warm winter. And think of all the work it has to do, all those eventualities it has to pay out on: Invalidity Benefit, Unemployment Benefit, Basic Old Age Pension, Health Care, Maternity Benefit, all the normal trappings of the welfare state.

Clarkey’s right of course, dead right. As better and better treatments become available, their price escalates more and more, and that means fewer people can take advantage of them, the pot of money being fairly finite. What Clarkey’s saying, is let’s collect some money for it elsewhere. The man’s a genius. Well, relatively so, in his chosen field.

The problem is the tabloid press will probably lambast him for daring to interfere with one of those Sacred Cow subjects. Well, they might have gotten the sub-continent right, but chose the wrong animal. It should be looked at as a giant White Elephant, not a Sacred Cow at all.

Now, don’t get all indignant on me. Why can’t we look at how Health Care is delivered in the UK? Why should how we pay for it be set in stone?

Clarkey was suggesting car insurance should pay for personal injuries such as whiplash injuries. and that other minor procedures should have similar payment schemes, even making people who arrange Doctor’s appointments but don’t turn up pay for the time wasted. Some of that seems fair enough at first glance, doesn’t it?

OK, the missed appointments thing I’m not sure about as half the problem seems to lie with most Doctors surgeries seemingly not really wanting to see any patients at all, making you wait so long for one you’ve either recovered or died by the date of the appointment and so of course you don’t need one. But I believe he’s missing the big picture.

Most politicians are so used to the NHS as it is that they can’t think of any other way. When they do find and talk about one, they are knocked back by a rabid tabloid press who all follow each other pretty much, like a pack of slavering dogs. (Good word, slavering - hope I spelled it right. I checked using an online dictionary, and it was one of those American ones, not British English which I have yet to find one for - drop me a comment with a link if you know of one ).

Let’s get serious for a minute. How about instead of privatising the Health Service, they privatise National Insurance? First you’d have to split it up into it’s different components. So, you’d have one deduction for Invalidity Benefit, a seperate one for Unemployment Benefit, a different one for the Basic Old Age Pension, one for Health Care, one for Maternity Benefit and so on - men could choose whether to pay into this last one or not, but if they didn’t pay they wouldn’t be eligible for any paternity benefits when they had kids, just to be fair.

To be honest, I don’t think this would be a bad thing to do even if National Insurance stayed in public hands. They keep on saying we need more transparency in our investments, mortgages and insurances, so why not in National Insurance? Transparency in Government always keeps them on their toes.

From a political point of view, I rather think it would be quite useful to break the payments down to show the rest of us just how little we actually pay for each service. They do it in other countries, and payslips with three or four more deductions are still easier to understand than a Rail worker’s payslip back in the UK. There, successive wage claims and management counter claims have produced a situation in which a workers full, final salary pension can be as much as, oh, 25% of his take home pay! But that’s another story, all about Union negotiators who didn’t understand maths, or who did but were cynical enough to think their members didn’t so they could get away with whatever they wanted…

But imagine it. You pay into a compulsory, privatised insurance system. Logically, a good way to split the pie up would be into three sectors - insured benefits (unemployment, invalidity, maternity etc), healthcare benefits, and retirement benefits. You’d have lots of providers all competing with each other, thus giving efficiency.

But let’s keep our focus on Healthcare. It would have to be different to how it works right now in the UK and in the US, or else it couldn’t really work as a privatised system that catered for all which would have to be the goal. Well, only if you wanted folk to vote for it, that is.

How about some safeguards? OK, it starts out being compulsory as it is now. To be fair, the insurance companies would have to be forced by law to accept everybody into the scheme, no matter how ill or what their medical history was. But let’s be fair to the insurance industry too, or we won’t get any providers to play ball! OK, how about a carrot and a stick?

The carrot would be: health insurance companies could offer high value-added extra services for more expensive, higher add-on fees for higher profit margin services such as having a single room in hospital, being able to choose your consultant independently, alternative healthcare services such as acupuncture, laser treatment for cataracts, or any of a raft of special extras not normally associated with healthcare, but which some people might actually want to pay for. How about breakfast served at 10am for instance, after a gentle wake-up call at 9.30am? It’d reduce your stress, relax you and probably help you get better, or at least suffer less on the way.

The stick would be, if they want the high end opportunity, they have to serve their time providing cover for all at a more basic level, which could of course be quite a high standard set by the government or an independent authority. “Two tier NHS!” I hear you screaming deafeningly in my ear. Well, what is it now? There’s teaching hospitals on one level, Harley Street on another level, the BUPA and private hospital level, and then there’s the GP surgeries and small cottage hospital setups. There already is private care and non-private care in the UK. The basic cover would be compulsory to join and pay for, and be compulsory to be accepted into.

If you’re setting up such a fantastic system there are bound to be people abusing it, aren’t there? So, how about free health care for hospital visits, but for trips and treatments at to your GP you pay a modest 10% of the cost. Just so you can see what’s going on. People on low incomes could have these contributions paid for from a social welfare fund set up by the state, or through a levy on health insurance premiums.

If you privatise the funding system, it doesn’t really matter if the health workers work for a single employer (the State) or many different ones in competition to attract patients by offering better or more convenient services locally. What happens is that things improve, the government are no longer responsible for managing the health system, just for over-seeing it at arm’s length.

Clarkey was right: it’s about time the system was changed.

What I’m describing is a system that already exists, is well funded, with practically no waiting lists (no more time delay than getting an appointment with your financial advisor perhaps). The highest quality equipment, treatments, and drugs are used and given to all - even those on the basic insurance level.

No, it’s not the US system where it is usually the employer that pays, which makes employees beholden to their bosses and companies uncompetitive compared to their rivals; it isn’t even the French or German systems where inefficient setups are sucking in state money, just like the NHS does - only more so, so that the system at least gives good healthcare benefits.

I’m talking about the system that works in Europe’s richest country, when measured by head of population - Switzerland. This little country isn’t in the EU, so is more often than not forgotten by journalists comparing how Britain does with it’s European rivals/partners (delete according to your political stance) yet it has a number of secrets that should really be studied more closely by other nations for no other reason than they are cost efficient and they work. Switzerland doesn’t have a budget deficit, doesn’t have a trade deficit, has low taxes, plus low inflation and low unemployment according to the Economist’s Pocket World in Figures, one of my favourite little books. What’s so surprising is that nobody has thought to copy the Swiss yet!

So, paying at the point of delivery should be encouraged, and Charles Clarke was right when he said the insurance companies should pay. The hospitals should send their invoices to the insurance companies!

You just have to look between the lines to see that what this means ultimately, is that the State should not collect your money, guard and spend it unwisely, and then give you back a bit for your healthcare, but should allow you to choose who you trust to provide the funds for your healthcare, who you can see will manage the funds well before payment is due and who will encourage fast treatment since everyone knows this costs less money in the long run.

One day maybe we’ll even discuss privatising hospitals and so on, but that’s a hot potato I’ll leave for another day. It’s the National Insurance system that needs the real reform. What do you think?