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Tuesday 11 December 2012

Poverty & Wealth – Sickness & Health



I am returning tonight (as a dog to his vomit) to what I increasingly believe is a fundamental divide between politico-economic schools.

Those on the “left” want to deal with poverty – reduce it, eliminate it, “make it history”. This is a moral standpoint and, at least superficially, understandable and perhaps laudable.

Those on the “right” observe that the western world has seen a historically unprecedented increase in wealth over the past two centuries; they want more and more people to share in it. This is a moral standpoint.

So, you have these two groups of moralists, opposed to each other over every conceivable policy. Good people, indubitably, on both sides.

Suppose we turn our attention from economic well-being to physical well-being. The analogy is not perfect; analogies never are.

But, just suppose, the Emperor has two advisors: Dr Sickness and Dr Health, both decent and compassionate men.

“Your Majesty,” says Dr S, “we see that a large number of your subjects suffer from a painful, life-threatening disease. I and my team have developed a variety of drugs and procedures which can, to some extent, alleviate the ghastly symptoms. Some of our patients have recovered completely. May it please your Majesty to grant us increased resources to combat this scourge? Your subjects will surely be pleased to be taxed to this end.”

The Emperor smiles benignly. His benignity is what the people love him for.

“Thank you, Dr S, pray be seated. Dr H, do you oppose the measures proposed by your learned friend?”

“Your Majesty,” replies the second sage, “my colleague has, indeed, apparently cured some patients, although some sufferers have relapsed or even (apparently) died of the cures. We thoroughly endorse what we have taken to calling ‘evidence-based medicine’. It is no part of my proposal to entirely eliminate the treatment of this or any disease, at least insofar as every pill, every operation can be shown to have a positive result. Your Majesty understands well the costs associated with Dr S’s proposal. My proposal is more modest. My team has shown, I believe convincingly, that the sufferers fall into a definable cohort, all of whom share certain behaviour patterns. If your Majesty pleases, a campaign for encouraging different behaviour patterns would require far less in the way of resources than my friend is requesting and would reduce this horrible scourge.”

Concentrating on Health and Wealth does not mean neglecting Sickness and Poverty. But, what makes people wealthier reduces poverty – just as making people healthier reduces sickness.

What the “left” proposes is intervention (drugs and procedures, ie entitlements). What free-marketeers propose is the liberty to “get on with your own life, in the light of what experience teaches, regardless of what the authorities mandate (Faith, Family, Work and deferment of gratification.”)

Don’t treat sick people; don’t help poor people. THAT IS NOT WHAT I AM SAYING.

A huge (and increasing) amount of “medical” thinking relates to “healthy eating” – The “Healthy Eaters” don’t all agree with each other.

The Emperor wears yellow. His throne faces South. He smiles.

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