“I’m passionate about free enterprise …..”“I believe in gving people the freedom to make their own decisions…”“centralised government is ‘broken’ so we’re devolving more powers to the localities…..”
And in the news two days ago:
In an unprecedented intervention, the medics – who represent all 21 medical royal colleges in the UK – said too many patients were being forced to endure tests and treatments which could do more harm than good.
They said the payments system in the NHS, which means hospitals are paid according to the number of procedures they perform, and GP pay linked to diagnosis and treatment, could act against patients’ interests.
The senior doctors said it was time to “wind back the harms of too much medicine” and replace a culture of “more is better” with balanced decision making.
If you look at these two sets of quotes together you are looking at two opposing and mutually different social pressures on healthcare. Its not immediately obvious though.
What a waste of time – the Medical Colleges call for less unnecessary healthcare whilst standing by and watching the dismantling of the NHS, the relinquishing of state responsibility for health security, and the unrestrained exponential marketisation if healthcare.
The recent Tory victory in the UK elections and the ongoing privatisation of the NHS in which the state has relinquished responsibility for the NHS relinquishes hope for future health and social security for all.
This should make us wonder whether the social drivers of healthcare are changing. Foucault claimed health surveillance arose out of a mixture of State nationalism, to ensure survival of the labor force to create profit for the employers, concern for racial purity, security against the dirty and immoral pollutants etc, as an exercise in governmental biopolitics of population security through an entrepreneurship of the self.
But the State is being rolled back, the TTIP Transatlantic Trade and Investment Partnership provides the global market with all the power.
In the meanwhile there is still a rhetoric of austerity still fuels a governmentality of biopolitics that seeks to exclude the immoral pollutants by vilifying the immigrant with HIV (Farage and UKIP), the parent of the unvaccinated child (Abbot, Australia) and the obese addict (Duncan-Smith UK Tory). These austerity induced discourses that rhetorically protect the ‘hard working nativist tax payer’ whilst setting working classes agaInst the unemployed and diverts attention away from tackling inequalities and the evident continuing ability of the rich to make surplus profits. There is a market induced fetish for healthcare as a marketized commodity.
Under free enterprise the NHS will wither, the numbers uninsured will increase, healthcare will become a marker of individual wealth and individualised supremacy and superiority. This is being accompanied by a changing subjectivity of lost souls with a modern day existential angst concretised by a fetish for a life that must be made to live by the individual in a frenzy of repetitive feeding orgies of self consumption through more and more medical investigations aided and abetted by the insecure medical expert desperately legitimising his status as expert whilst, just as existentially angst ridden as the patients, scrabbles around for his decision analyses and theories of probabilistic reasoning whilst ordering more and more tests. The experts call for less demand for unnecessary healthcare whilst watching the Government dismantle the one collective protective force against the market. Fiddling whilst watching Rome burn. In the market the medical experts role is to provide the weakened cannon fodder for the market of ‘more tests’ by probing and prodding with the stilettos of the matador torturing the bull, the prepared patient/test-consumer.
The wealthy health-insured, will seek more and more second opinions, more molecular genetic fingerprinting, more expensive marque there will be more and more marqueés of ‘material success’, amputations and disfigurement, and continuing unhappiness. Oh Joy!