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About reimaginingthefuture

Husband, Dad, Son, Brother, Friend, Doctor, Dreamer, Singer, Writer, Believer, Activator, Communicator, Woo, Achiever, 7, ENFP,

The Complex Commodification of Healthcare

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Not the most eye catching title, but bear with!

I’ve been thinking quite a bit about what on earth has happened and is happening to healthcare, particularly in the UK, but globally, also. My musings are being particularly influenced at the moment by the writings of William T Cavanaugh, Georgio Agamben and Michael Foucault. More from WTC and GA another time (when thinking more about healthcare and the nation state)….

Foucault, speaks of biopower, i.e. the commodification of life itself, so that even what would have been considered within the private sphere of our lives, is now the fodder of the economic machine. Truthfully, healthcare has become utterly commodified and in such a complex way that we find ourselves entangled in a sick web and it takes some major diagnostic work to make sense of what is happening.

Firstly, the system of healthcare has become commodified and is itself driven by economic greed. I have yet to find any clinician who thinks that the top down reorganisation of the NHS in the UK at the hands of Andrew Lansley, (but started by the government of Thatcher and most certainly compounded by Tony Blair’s team) has been in any way a good thing. It has cost literally billions of pounds, and has led to and will lead to more private companies, limited by shares, owning and running the health care services. This is driven by the EU-US trade agreement and is based on an utterly flawed philosophy that competition will improve patient care. Except, it won’t. The problem is that share holders don’t give a toss about the needs of the chronically sick or the marginalised poor. Rather they want to protect and guarantee their ‘income’. So health care will worsen. The WHO recently stated that the NHS is the best health system in the world and yet our government has thought it best to dismantle it! The claim is that the system is costing too much money! The thing is that the NHS is and has been ‘in profit’ for a long time. It isn’t run badly. All the cuts that are being made (which the Tories won the last election by promising they wouldn’t make) are in part due to the fact that many corporations are paying such little tax, and also because we have such an utterly corrupt banking system. The reason that successive governments have not stood up to the banking sector or these corporate giants (and are now cutting public services instead of challenging them) is because they are not really the government! The banks and the corporations are (well they are not either, but they act as though they are)! That is why the healthcare system itself is becoming more commodified! At a corporate level it is simply fodder.

Secondly the patients have become commodities. Do not be deceived. We have a healthcare system based on a Pasteurian philosophy of healthcare. Kill the disease. You are a commodity. Your children are a commodity to the advertising companies, cheap supermarket trash and fast food chains, which are driving up childhood obesity and diabetes, whilst we take exercise out of schools. You are a commodity to the pharmaceutical industry and when you reach 40, if you’re not there already, you will be offered a free NHS health check, which will tell you that your BP, Blood Sugar and Cholesterol are too high, so you will shortly be needing some medication to control it all. But here’s the thing…..it’s mainly too little, too late. What happens in our early life far more affects our health in older age. We need to be majorly cheerleading the promotion of healthy living to our kids, especially our young women, as the health of your mum whilst she is pregnant has a huge impact on your future health, far more so than drugs you take after your mid-life crisis. You are also commodified by the breakdown of the welfare system. We don’t have time or money, apparently, for you to be off sick. We need you back in work to get the economy going. You will notice that most therapies are being extremely cut back – we don’t have time for you to get really healed, we just want you functional……

Thirdly, there is the commodification of the health-workers. Burn out, low morale, tired and flagging. The pressures are mounting and we are not taking care of our staff, and the sad truth is, it will get worse and not better. One reason is that we are becoming increasingly self-centred and demanding as people, due to a multiplied sovereignty in our history, which leaves us feeling like we have the right to behave like mini-emperors. Another is a kind of learnt helplessness due to the breakdown of community. A third is the anxiety driven nonsense we find daily in our media, a kind of chicken-licken hysteria about every mild ailment. And fourthly, there has been little foresight or planning to think about where on earth our workforce is going to come from if we don’t train them. We have a 50% trainee doctor shortage in the Emergency Departments. We will shortly have a national shortage of over 30000 GPs (and yet the government is promising 7 days a week cover, 8-8, just incase you want to discuss your piles on a sunday afternoon), but little thought is given to exactly where we will magic the workers up from. And if we take them from the EU? What then of healthcare in those countries? Ah yes…..multiplied sovereignty, we don’t really care. That’s why we continue to complain bitterly about the health services in this country, and yet we have the same population as South Africa, and ten times as many doctors. How do like them apples? Try being grateful!

Complicated, huh?

So we and our health are commodified. So what? How does knowing do anything except add to our already felt sense of powerlessness?

Well, we have some choices and some options.

We can choose to subvert the system wherever possible.

We can create some exciting alternatives.

We can protest.

We can radically love Andrew Lansley

We can vote out this government at the next election, though we must press for a new way of doing government, and allow our selves to completely reimagine how we do life.

We could have a revolution.

We can treat patients as sacred beings and refuse to treat them as commodities.

We can treat workers as gifts and not use them or abuse them.

We can be thankful that we have the best health system in the world and change our attitude somewhat.

At What Cost?

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I was handed a book this week entitled: “People over Capital” (the co-operative alternative to capitalism) and I’m looking forward to reading it on my way to Toronto later next week. The back cover starts with these words: “Economic turmoil, rampant inequality, austerity politics, climate chaos. Capitalism is clearly failing and ordinary people are being forced to pay the price. Faced with such deep-rooted problems there is real hunger for alternative ways of organising our economic systems.”  Increasingly I am becoming aware of the effect of what Foucault calls “biopower” or the commodification of life itself.

The film UK Gold has highlighted with insightful and expository brilliance the true relationship between the UK ‘democratic’ government and the corporate giants. If we’re not careful, we turn a blind to the cost of the cuts and the immense toll that the squeeze is really having on the little people. Whilst literally billions of pounds are being siphoned off into tax havens to bolster the super rich, we are making unbelievable cuts to our public services and welfare systems. The heartbreaking truth is that we are paying for this, not only financially, but people are being eaten up like bread, fodder for the economic machine that is destroying the very life we are made for. I know of two people in the last few days who sadly took their own lives under extreme pressures being placed on them as they tired to serve the public good – one a police officer, the other a social worker…….

I have blogged about ‘revolution’ and the need for something utterly and life-givingly different to what we have now, but I maintain that even in the face of the pain and sorrow, stress and strain that many find themselves in, the answer has never been and will never be violence. There is another way, and it is the way of love. We must love those who perpetrate these crimes against humanity. Our only hope is to forgive the wrong we are suffering and so find a better future for us all. How do we ‘turn the other cheek’ when we feel smacked in the face by an uncaring system that would squeeze the very life out of us for the sake of keeping the economy going? How do we give of ourselves lovingly in the face of such opposition and uncaring greed? How do we dance to a different rhythm than the dominant marching beat that sets it’s metronome to the whims of ‘market forces’?

Now is the time for creative experiments, like those of William Penn, before his sons sold out to greed and dominating hierarchy. These are days to love our enemies until there is nothing left for them except to love us back, as Martin Luther King demonstrated. We are in a moment of extraordinary potential. We must not rush, but take our time to let new hope, vision and pragmatic ways of reorganising ourselves to germinate within us. Kenarchy is about emptying out power, laying our lives down in love for one another, prioritising the dispossessed and radically renegotiating our relationship with money (sacred economics). We can remain as we are but the stark ongoing cost will be destruction, demoralisation and death. Or we can put on love, forgive the past, learn from it and embrace the future. It will cost us everything, but our hope is one of life.

Revolution and Spiritual Transformation

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Yesterday we were at the house of some of our best friends and I picked up their copy of the New Statesman. Given my last blog, you would think I had already seen it!  So I was excited to read from a selection of contributors what “revolution” means to them. Noam Chomsky starts by quoting Rosa Luxemburg’s ‘eloquent critique’ of Leninist doctrine: “a true social revolution requires a spiritual transformation of the masses degraded by centuries of bourgeois class rule”. Oliver Stone and Peter Kuznick give a powerful rebuttal of those like Stalin and Mao who stole the concept of revolution in the pursuit of power and control. They are equally scathing of trivialising the very idea of revolution in the west by a pathetic misapplication of the word to things which matter very little. But they show that these things have not discredited the true idea of revolution, just as 2000 years of Crusades, child abuse, warfare and oppression perpetrated in the name of Christianity have not discredited the social revolution of Jesus Christ.

To my mind there has never been and will never be a more revolutionary person than Jesus. And if it is true that revolution requires a spiritual transformation of the masses, in my view, it is to him that we should look. Jesus had no qualms about deliberately setting a political course which utterly undermined the bourgeois class of his day. When he declared himself to be the son of God, he was directly challenging and undermining both the religious and political authorities. He came to declare that God can not be put away in a temple or related to by only a few special people, but is here to be known by everyone, whoever they are and wherever they live. He came to demonstrate that God has nothing to do with empire in any of its forms and is in fact the antithesis of it. He came to reveal the priorities of God lie not with the rich and powerful, but with the poor, the broken, the marginalised, the sick, the refugees and asylum seekers, the oppressed – in particular women and children and those in prison. His life was one of extreme love and his leadership was that of servanthood, quite different to the image of God many of us conjure up in our minds when we think of the divine….

His death was not caused by an angry God needing retribution for all the ways we have offended him. His death was the result of a life laid down, loving other people, which so challenged the status quo that they wanted rid of him. And in the moment of his death, instead of calling for retribution on his oppressors, he makes a public demonstration of how appalling human behaviour and the powers can be at times, calling us instead to the way of forgiveness. In his death we find the forgiveness for all our fallen humanity, all that seeks to control, abuse, and destroy ourselves, our communities and the earth we live in. But in his resurrection, we find hope that love is in fact stronger than death. So, when we set our lives in the way of this revolution of overcoming love, even if we lose our lives in the process, they are not lost. The ‘ruling powers’ have already been defeated by this way and one day all things will be made right, every tear will be wiped away and there will be no more war. And the fruit of our toil, no matter in what arena of life we work will be seen in those days. Jesus never came to found a religion. Nor did he come to make himself emperor. Slowly, after centuries of believing some contrary things about him, we are coming full circle to understand just how utterly radical he is.

His invitation is still there for us to stop living for ourselves, change the way we think and to follow him.  To make his priorities our priorities and in so doing to transform the world we live in. And better still, he doesn’t leave us alone, but has given us the same spirit that is within him, to be in us, so we can also recover what it means to be fully and truly human. We can be healers, reconcilers, forgivers, servants and revolutionaries just like him. As I have followed Jesus, I have found my life has been utterly transformed and I am finding the grace and power to live in this radical way. By no means am I perfect and by no means have I made it, but in him I find the hope for transformation. You can believe whatever you want to and go wherever you want to go, but if we want to see a real revolution that changes the world for good and forever, I commend Jesus as a really good place to start.