Health and recovery

An extract from Chapter 6 of the book Transcending Politics:

6. Health and recovery

On the face of things, the field of healthcare poses a stern challenge to the technoprogressive vision that I am championing. In countries all around the world, costs of healthcare are rocketing. Chronic diseases such as diabetes, heart disease, and dementia are consuming huge resources. National budgets are facing crises under the resulting strains and stresses.

To give one example, Simon Stevens, the CEO of Britain’s NHS (National Health Service), has spoken out on several occasions about the growing financial burden of chronic diseases. Here are his comments in an NHS England news article entitled “Get serious about obesity or bankrupt the NHS”:

Obesity is the new smoking, and it represents a slow-motion car crash in terms of avoidable illness and rising health care costs. If as a nation we keep piling on the pounds around the waistline, we’ll be piling on the pounds in terms of future taxes needed just to keep the NHS afloat.

Speakers in support of a campaign by the British Pharmacological Society emphasised the risks of runaway expenditure on medicinal drugs:

The NHS drugs bill is spiralling out of control and will bankrupt the service unless urgent action is taken, experts say. It jumped more than £1 billion between 2014/15 and 2015/16, to nearly £17 billion. This means the cost of providing medicines is the second biggest NHS expenditure after staff salaries…

The problem is partly due to an aging population, which has more health problems and a wider range of medication to treat them. However, drug wastage is also to blame. Up to 40% of patients prescribed drugs long term do not take them, wasting the equivalent of £350 million a year…

Sir Munir Pirmohamed, the society vice president, said: “We cannot carry on like this. We urgently need to reduce drug wastage and optimise the drugs patients are on to ensure they get the right drugs, and the correct number of drugs, so that they are not being over-medicated.”

Simon Maxwell, chairman and professor of clinical pharmacology at Edinburgh University, added: “This will bankrupt the NHS and is not sustainable.”

In January 2018, stirred to action by a series of fraught experiences in their hospitals over the ongoing winter period, a group of highly experienced healthcare professionals wrote a public letter to Theresa May, the British Prime Minister:

We are writing to you as Consultants in Emergency Medicine, Fellows of the Royal College of Emergency Medicine and as Clinical Leads (Consultants in charge) of our Emergency Departments, representing 68 Acute Hospitals across England and Wales…

We feel compelled to speak out in support of our hardworking and dedicated nursing, medical and allied health professional colleagues and for the very serious concerns we have for the safety of our patients.

This current level of safety compromise is at times intolerable, despite the best efforts of staff…

Meanwhile, in the United States, debt arising from medical fees is the number one cause for people to become bankrupt.

Technology is not enough

In principle, technology ought to be reversing these expenditure trends. Innovative technology has the potential to automate aspects of medical treatment, to provide timely early warnings of ill health, and to deliver targeted new therapies that are more effective than previous treatments. However, rather than being a part of the solution, it seems, worryingly, that technology is part of the growing healthcare budget problem:

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Tools for better politics?

Which solutions most deserve mention, in a list of “tools for better politics”?

Tools for better politics

As I’m reflecting on comments from reviewers of the draft chapters of the forthcoming book Transcending Politics, I’ve reached the view that I should add a new section, towards the end of the book, entitled “Tools well worth watching”.

This will fit well into Chapter 14, “Afterword”, which already contains a similarly-themed section “Communities well worth joining”.

If you have any suggestions or comments, either leave them in the Google Doc for Chapter 14, or as replies to this blogpost.

Ideally the list will include tools applicable to one or more of the systems described below (this is an extract from Chapter 1).

  • Transparency systems, so that the activity of public organisations and decisions are visible, and can be judged more easily and accurately
  • Fact-checking systems to determine more quickly and clearly, via an online lookup, if some information is misleading, deceptive, biased, or in any other way suspect or substandard
  • Thinking training systems to help everyone understand and routinely practice the skills of critical thinking, hypothesis formulation and testing, and independent evaluation of sources
  • Accountability systems to hold people and organisations to account whenever they pass on damaging misinformation – similar to how codes of conduct already operate in the fields of advertising and investment communications
  • Bridging systems to encourage people with strong disagreements to nevertheless explore and appreciate each other’s points of view, so that shared values can be identified and a constructive dialog established
  • Educational systems to keep politicians of all sorts informed, succinctly yet reliably, in timely fashion, about the trends that could require changes in regulations
  • Simulation systems to help politicians of all sorts creatively explore possible new policy frameworks – and to gain a better idea in advance of likely positive and negative consequence of these new ideas
  • Monitoring systems to report objectively on whether regulatory policies are having their desired effect
  • Concentration systems to boost the ability of individual politicians to concentrate on key decisions, and to reach decisions free from adverse tiredness, distraction, bias, or prejudice
  • Encouragement systems to encourage greater positive participation in the political and regulatory processes by people who have a lot to contribute, but who are currently feeling pressure to participate instead in different fields of activity.

One source of ideas, by the way, is the H+Pedia article on “Politics 2.0”.

 

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