STRAWS IN THE WIND: by Max TeichmannNews Weekly
Your good health / Costly hospitals / Voter discontent in Germany and Switzerland
, October 23, 2004
Your good health
We all remember Ivan Illich and his work on deschooling education: where the students taught the teachers and called the shots as to what they learned, or whether they learned at all, like fickle voters in a directionless democracy. Where there weren't to be any "elite" schools, "elite" universities or "elite" knowledge; where there would be no inspection, no external assessment, no accountability. And where everyone passed.
We are now engulfed with the consequences of all that, and its effects, which are running right through society; viz the family, the economy, marriage and the uncontrolled consumerism which, for more and more people, is the meaning of life.
As a sign, on a passing tram, promoting a shop selling women's gear put it: "I shop, therefore I am".
Insulting in a way, but true. The desiccation of culture and of bona fide nurturing and education produces, almost of necessity, a gullible, impressionable mass. The lonely, hungry crowd. But they shop ... therefore they are.
But very little is said nowadays, except by Peter Singer, about Illich's views on medicine and doctoring, and the rich getting the pick of the life chances.
First, said Illich, the rich West had good and improving health services, whereas the Third World, where most people lived, had bad or worse. Their quality of life is poor, life expectancy is far less, their disease morbidity often tragically higher.
But, within the rich West, the affluent classes possessed advantages over their fellow citizens, which were, in a way, as substantial as rich countries had over poor ones. So, the goals of medicine must be redirected to provide good health and equality for all, wrote Illich.
He provided no costing, so far as I can remember, so we couldn't assess the feasibility of this radical scenario. It was a familiar, even over-familiar, thesis repeated in many other parts of social life. In those areas, where the "same for all" and in equal quality and quantity was tried out, the results have usually been disappointing or disastrous. But health?
Illich thought enormous wealth was being devoted to the prolongation of life, the amelioration of the effects of ageing, and the saving of babies severely damaged in some way, who would otherwise die as a matter of course; and this wealth and niche spending went side-by-side with the most primitive services for most people in the world.Costly hospitals
His remedy? Put the great and costly hospitals and avant-garde research empires into mothballs, and create a new profession of barefoot doctors who would cure diseases that the West had even forgotten about.
I won't go on - but two processes of levelling down and raising up should occur between societies and within societies.
Now that argument hasn't gone away. We're still having it. And the exponential growth of medical research to cure or mitigate often statistically minor diseases arising in the West, as we live longer, is clear.
But so are visibly declining health facilities and standards in our own
societies. Long waiting-lists; pushing patients out of hospital as soon as possible; and, difficult to evaluate but almost certainly, an increasing rate of new infection contracted while in hospital; medical misadventures; and an ever-shortening time doctors are spending with patients - all symptoms of medicine having lost the plot.
All this co-existing with world-standard research, enormously expensive medical machinery and the rise-and-rise of the drug industries.
Governments are spending more-and-more to stay in the same place - in fact, appear to be losing the fight.Redistribution
As to Illich's dreams for the Third World (as we used to call it), the attempted redistribution of the social product of the rich states to the poor has proved a chimera.
The poor countries will just have to raise drastically their disposable income to service their peoples, as part of a great leap forward in their social products.
That in turn will lead to a massive rise in pollution, and in demand for non-renewable resources. (What price oil? And water?)
And the world's population is set to rise another couple of billion before leveling off at eight billion - but only, some pundits say, if societies get rich enough to want to trade material goods and enjoyments for children.
Illich didn't go into these matters much, as I remember.
But he would be grimly amused at the latest developments in global medicine and niche research.
Hospitals are appearing in cities like Bangkok, where the best medical treatment in the world is on offer - but costing a thousand dollars a day or more just to stay there. Staffed by the best doctors and nurses - many Western, mostly Western-trained - they are catering for the super-rich, which include new Asian and Middle Eastern moneyed classes.
Now that organ transplants and stem-cell research are taking giant steps, so is the demand for organs, and stem-cell implants. Where and from whom the organs are coming, I leave to your imagination. But not, I fancy, from the rich. Mammon has eaten Hippocrates.
Meantime, people lie on hospital trolleys for 18 hours in Melbourne and other big cities. Is no one in charge? Don't we really need an entirely different approach to health, medical ethics and social life?Voter discontent in Germany and Switzerland
Some German regional elections, and a remarkable referendum result in Switzerland, have passed most of our media by, determined as they are by a gestalt of juvenile obsessions or by fashions.
In the East German states of Brandenburg and Saxony, the main parties - Schröder's Social Democrats (SPD) and the Christian Democrats (CDU) - have suffered severe losses at the hands of the Far Left and the Far Right.
If Schröder's party in particular continues to lose relevance for more-and-more East Germans, one wonders in what type of condition they will be, at the general election two years hence.
The SPD is now polling only 26 per cent in Germany overall; and the halt in the rise of the CDU - it is now 43 per cent plus its ally, the Free Democrats (FDP), at seven per cent - is only coming from leakage to the New Right groupings.
These have come out of the wilderness, with one party in Saxony - the National Democratic Party - not only gaining nine per cent from nothing, but now holding 12 seats, one fewer than the Social Democrats.
The reformed Communists - the Party of Democratic Socialism - finished second in both state polls.
The only way the two main parties will hang on to power in the short run is to form a grand coalition to exclude the others.
This tactic works when general conditions improve; but if they don't, then both parties are tarred with the same brush, as they were in the late 1920s and early '30s. Then the two extreme parties - Left and Right - seemed the only hopeful vehicles of change.
One Deutsche Welle
commentator pointed out that, in the past, German right-wing parties did well when the economy went bad, but declined rapidly when good times returned.
When this occurred, these extreme parties started to fight among themselves and quickly disintegrated. And, he added gratuitously, things are starting to improve in Germany.
It was not merely gratuitous but false. West Germany is stalled and East Germany getting worse by the day. The only sector holding up Germany is that of exports, but outsourcing or just moving lock, stock and barrel to Eastern Europe or Asia is the greatest game in town.
The Americans, who have extensive holdings in Germany, are leading the charge. They have motives other than purely economic ones.
To return to East Germany, which has been soaking up 100 billion Deutschmarks every year since reunification, to no avail ... it's interesting to speculate whether if, instead of opening East Germany to the full blast of competition from West Germany and the EU, privatising public property and closing down the uneconomic parts thereof, Berlin and the German capitalists had installed a quasi-command economy and carried the weaker economic units while modernising and recapitalising them, East Germany wouldn't be a far more prosperous place today with far less unemployment and far fewer social problems.
But the bigotry of economic rationalism and its level playing-fields - plus the taboos on any alternatives from bureaucrats in Brussels, based on the same economic bigotries - blocked any humane options.
So East Germany became a second Mezzogiorno. There, northern capital and commerce, instead of lifting southern Italy, devoured and ruined its existing industries.
The same has occurred in Germany. But this is only one reason for Germany descending from European powerhouse to one of its poorest performing members.
You must also thank the well-heeled infantile Communism which has swept the middle classes, plus a large, immoveable and sclerotic trade union movement.Worse off
At any rate, 24 per cent of West Germans think themselves worse off since the fall of the Wall and 20 per cent would like it rebuilt.
In Switzerland, parliament - overriding the objections of the largest party, the Swiss People's Party (SVP), an anti-immigration conservative group - passed laws to give citizenship, in stages, to all foreigners, mainly guest workers or their descendants. These foreigners, et al, number 25 per cent of the population.
A referendum was demanded - as it can be in Switzerland concerning any law.
The opposition was led by the SVP, and the anti-citizenship case triumphed by a large margin.
Citizenship is not going to be given out or watered down. It is for the Swiss alone. Switzerland is going to be a much harder nut to crack by "world opinion" (i.e. the rich) than was Haider's little Austria.
Interesting - for similar sentiments are flourishing just under the surface in Germany and other places.