I hate to say it, you're living in dreamland. Just because your particular use of OOH GP services from SERCO has been fine doesn't mean that SERCO are doing a good job in general. Case in point, they are not. Anecdotal does not override the dataset that is coming out of Monitor, the various CCGs and parliament. It goes beyond SERCO as well - take a look at Circle, Southern Cross and Virgin. Arguably Circle are doing the best, but that's coming at the expense of their bottom line. Deciding who gets what treatment, and who provides it, are intricately linked. Cost drives these decisions (established as a QALY, Quality of Life, metric) as to what treatments are available, with CCGs (commissioning groups) then establishing what they can afford in their region. Their costs are then dictated by the contracts they sign, be that with an NHS provider or a private provider. In the ideal world this should mean that we get the services needed at the cheapest, but effective, rate possible. Experience and time is rapidly showing this is utterly false - using SERCO as our example, they deliver a service that is substandard and not cheap either. Further, private companies only bother to tender for the contracts where they think they can turn a profit. The CCG can jump up and down until it is blue in the fact that they want competition, but if it isn't profitable nothing is going to appear - which means they end up being government funded.
Well the way I see it is that you don't want to buy in "healthcare" but "treatment. The NHS clooses whether it wants to give someone an operation and then looks to see who can do it. That's not an insurance model where you pay a provider to provide medical coverage for a bunch of people, but simply about the provision od specific services. Just because the system has been royally fugged up and the management are clueless doesn't mean it couldn't be done better in the future.
I'm only saying that getting in private provider to provide specific services can work. I'm not sure about providing coverage in some muddled way. But take medical imaging wouldn't a contractor have an incentive to provide a service at the weekend wehre we often don't at the momnet. Or blood testing where some (not all hospitals) seem not to care whether they bother to send the blood for the right tests or try and clear the queue of patients - (personal experience).
Same difference. The problem is, as Cei suggests, whether anyone wants to operate on this patient. That operation may not be profitable business; patient may be obese, have health complications or be high-risk in some other way, requiring lots of additional special care, so no company comes forward to tender for it. They won't touch it. Where does the NHS now send the patient? To the NHS service. That would have been fine when it covered everything, and was able to offset the loss of an unprofitable treatment against the profit of a profitable one. But the profitable treatments have all been poached by private companies. Now what? Whether an NHS service can run efficiently, and whether staff can be made to care, is not an issue you are going to solve by market forces. They are not a magical answer to everything. It's a management problem, not an economical one.
Sorry to go back a few pages here but I have just started reading this again. 1. The government has nothing, the army has the guns, hence military coups. 2. Civil disobedience does not mean violence, it means the disregard for accepted and established social norms of behaviour dictated by adherence to a 'social contact'. Civil disobedience can be in the form of protests, not voting etc Civil disobiediance was grown up enough for Gandi, Nelson Mandela, Desmond Tutu, the bringing down of the Berlin wall, The Boston Tea party, The Arab Spring, Thích Quảng Đức (the burning monk), the man in Tiananaman Square - shall I go on? Unfortuantely, humans are predictable and easily influenced animals whose behaviour is easily controlled, so asking for humans to evolve a new mindset is a fantastical idea. Even when shown to be wrong humans don't change their mind, in fact they tend to double down ( I will try and find the study which was recently done).
You mean those mostly messy conflicts in countries struggling with dictatorship and oppression? I don't think we quite need to resort to the same solution yet (and I would not quite include the Boston Tea party in the list). But I see your point --it's just civil disobedience is a poor name for it. We're not naughty kids. Basically it is about a rewriting of the social contract.
An analogy for private health. There was a cinema where I used to live that charged £3 for a film. it was an OK cinema, but not the same standard as the VUE that moved in. The VUE did £1 film nights 3 times a week, it could afford to take the hit. Less than a year later the other cinema closed. The very next week the £1 nights stopped and ticket prices rose to between £12 and £23. The point is, when there is competition the big boys play nice, they have to. When that competition goes under then its only about profit. Your surgery too expensive, sad day for you. The NHS has so many private fish that have already taken a bite out of the profitable parts that it is creeking already. Privitisation has never brought better results for large public institutions, Royal Mail, BT, National Rail, American schools and colleges ete, etc. All carved up and the non profit making parts dumped on the tax payer and demonised in the media. Just a quick scan of private eye will open your eyes to how deep it all goes.
Do you expect those with power to relinquish it peacefully and easily? I would say that the UK and especially the US are more a dictatorship than a democracy, the same families and related groups in power generation after generation, as Norm Chomsky called it, manufactured consent. The body is the same, you just get to choose which fist you are punched with. Look at one of the most popular US issues, removing private money from politics. Congress won't even look at a Bill related to it even though over 98% of Americans believe it corrupts the system.
You found that what you really wanted was power and there were much politer ways of getting it. And then you realized that power was a bauble. Any thug had power. The true prize was control... When heavy weights were balanced on the scales, the trick was to know where to place your thumb. And all control started with the self. --Terry Pratchett, The Fifth Elephant All control starts with the self. That means not voting for governments in the expectation that they will solve your problems for you. Don't expect them to curb immigration because you can't be asked to present a better employment prospect than some dude with foreign qualifications who barely speaks English. Don't expect the NHS to fix your ailments when you smoke too much, drink too much and are overweight. Don't expect schools to teach your kids if you make no effort to raise them yourself. Don't expect to eat well, affordably, if you don't learn how to cook. Think about what you want a government for. Then visit your local MP and drive home the message. Don't expect them to do things for you, but with you. Get involved and build the community you want; don't expect that ticking a box every four years will make people do it for you. If governments have power, it's because they filled the power vacuum that the population left for them to fill.
No. Just because you don't get your own way doesn't mean it isn't democratic. Look at the UK prim ministers over the last few decades. The backgrounds of Thatcher, Major, Blair, Brown and Cameron are very different and for that matter their politics. In the US sure you can point out the Bush family and talk about Hillary perhaps getting the job 16 years after Bill, but are you really suggesting that Obama is a continuation of GW Bush? Or that Romney and Obama was all the same thing? Sure there has perhaps been a post-war consensus in western countries where no that mattered was advocating fascistic or communist dictatorship, but I'm pretty much okay with that. I can't really get much past Churchill on this:
What you are describing is the same as a scientific study found out. Too Important for Clever Titles -- Scientific Study Says We Are an Oligarchy (Update) http://www.dailykos.com/story/2014/04/14/1292085/-DINO-New-Scientific-Study-Says-Yes-But-It-s-Not-What-You-Think FYI this study was from 1981-2002 the conclusion even then is that America had become an oligarchy.
All of those whom you have mentioned have been and are corporate capitalists, slightly different retoric but similar policies pushing everything right. Politics really changed direction after about 1972. There is no left option available and if you really think that everyone has an equal opportunity to be elected into power then you are living in a fantasy world or you don't really understand how the system has been built to maintain itself. I'm not asking to get 'my' way but to have a real democracy. A democracy doesn't start and end with voting once every 4-5 years for one of a number of established powers. Unfortuantely most people think that democracy is just that. Who said we were only looking at presidents? The real problem in the US however is corporate personhood and money in politics. Also look at the policies, not the mouth piece when deciding if things are the same or different. I mean Obamacare was originally a republican policy and Obama hardly tried to push the public option did he, he never fights for the supposed left. His policies have on the whole been right of Bush. This isn't a choice of extremes you know.
You sound like you're coming from the far left or anarchist position. You just have to face up to the fact that no matter how strong your feelings are the vast majority of the population just didn't agree, still don't agree and that's what they haven't voted for hard left parties over many years. Sure you can claim that the press are controlled by big companies and so on, but ulltimately you are then saying that the polulation are too stupid to see your truth. I'm aftraidf I don't buy that. There sure as hell seems to be plently of differing political views in this country and the USA and they seem to elect politicians who certainly don't seem to all agree with each other. Various flavours of scocialism have been tried and ultimately they fail when the run out of other people's money, while the hard left just announces that it wasn't "True Socilaism" and we need to look to the next place (a think Venezuela is still in vogue a bit, but it sure as hell doesn't look like my idea on an earthly paradise).
What hard left parties? Name one that has been given any political space, invited to debates and given serious unbiased TV coverage. The problem is that the political spectrum has been continually moving to the right since the early seventies, that now a centrist position is considered left and as such a left position is considered far left. You have now twice alluded to me 'not getting my way' on something. What are you alluding to? The only thing I can see is that I said that 98% of the US population wanted to remove money from politics, in fact, when polled it was the top issue, over things like terrorism and the economy. I wouldn't call that 'my' want. Or we could use the gun background check issue in the US, over 80% of people agreed with background checks, did it pass? No, the NRA, who represent gun manufacturers now, not owners, kicked off and nothing passed. Moneyed interests usually prevail. If you want we can talk about how the media helps this, but that might be another topic. Or how about not defunding entitlements. Remember these are entitlement, not benefits. We paid into these on the promise of getting something back another issue that government goes against the popular consensus, always saying that there is no money but then cutting tax rate for the top 10%. Or lets look at Brazil. People want health care and education above everything. We are continually told there is no money. World cup and Olympics come and oh look at that, $32 billion so far. And who get the vast amount of the money generated by these events, FIFA and the IOC. These events never positively effect the local economies of the areas in which they are held. I am not saying that the public is to stupid at all, naive maybe, or uninformed yes, but stupid, no. In fact when polled, the public more often than not choose the leftist option but there is no representation of this in the current political landscape. The current choices pay lip service to different ideas but all policies go towards those with the financial clout to manipulate people and the system, just look at the Koch brothers financing state leaders, congressmen and presidential candidates. 95% of the time the candidate with the most money wins, who can give the most money? Large corporations. do you think they give it out of the kindness of their hearts? You have also made the mistake many make. When I say I hate the conservatives, everyone crys 'well labour are no better'. I did not voice support for that option , you assumed that. The same here. I voice my hate of crony, corporate capitalism and you cry that socialism is no better, as if they are the only 2 choices and that by deriding one, I am advocating the other. This is just intellectually dishonest. You are continually bouncing between extremes like the only options are black and white. Grey exists, in many shades. IMO for somethings a more socialist view is better, health for example, for others a more conservative view is better i.e. manufacturing. Also if you do understand conservatism then you will understand that what the Tories are and the republicans is not conservative. Or do you just wave your teams flag without caring or looking into what they are actually doing?
Actually I will disagree with you on this precise point, people ARE stupid. Very. All the information is out there, and you don't have to dig that much, just go on wikipedia for starters. People just vote for whoever their tabloid tells them to, in the US, they vote for whoever party ran the most ads. This is where democracy breaks and becomes a charade. The Americans manage even to vote for policies that harm them, something that never ceases to stagger me. When you say more people than not chose the leftist option, actually, most people just chose the "populist" option, whatever that is. We are seeing that the far right is slowly replacing the traditional left in terms of populism. I call "populist" whatever solution is the simplest that caters to short-term, narrow, concerns of the targeted population. It's a bit like giving candies to a kid instead of dinner just to keep them happy. A typical populist example would be trade barriers. They are shown to be detrimental to economies over and over (won't go in detail as to not bore anyone, but can expand separately if you want), however, when given the choice people support them. My ideal democracy would be one where only educated and intelligent people get to vote. You pass an exam showing a basic understanding on how parliament, house of lords... and the rest of the legislative system work, and you get your voting licence. Perhaps even some basic economics. I find it crazy that Joe public, that can't even distinguish between the EU commission and the EU council, gets a vote on an EU referendum (in or out). WTF?
Not quite true, people choose the left option when it is presented neutrally, but yes you are correct when you describe the herd mentality, but we often call what is on TV news the popular opinion. Have you seen TV news ratings recently however, especially when divided into age demographics. People aren't stupid for the most part, do you have time to read everything and research it in depth? They do, however, form an opinion by reading a few column inches in their preferred bias of newspaper and then just repeat what they read with now real thought or understanding of an issue. As I said before human nature is easily predicted and controlled.
An interesting survey in the US asked the general public: - How do you think wealth is distributed across society? - How do you think it should be distributed? Generally, all people felt that it was very unevenly distributed, and that it was unfair, and should be more evenly distributed. The reality is that it is even more unevenly distibuted than people think. But the really interesting thing was: both Republicans and Democrats said exactly the same thing. They had exactly the same ideas about how wealth was distributed, that this was wrong, and how it should be distributed more evenly. Turns out that when it comes to the fundamentals, all people, regardless of political persuation, think pretty much the same.
I can attest that out in the USA the general population know absolutely nothing about politics, nor do they care to know. From what I saw with my ex's family they just voted for the guy they liked the look of. Hence, Reagan, Clinton etc. I feel that Obama was only bought in as a novelty tbh. Just the fact they could say that they had a black president. But yeah, I've seen videos on the net of hordes of people all protesting with signs to vote in the Republicans, even though the Republicans were going to screw that type of person (Alabama IIRC).
I favour Chris Rock's theory: George Bush has ****ed up so bad, he made it hard for a white man to run for president!
