Wednesday 11 December 2013

Alice Thomson: fool or knave?

A columnist called Alice Thomson has written another badly researched, hastily written and logically inconsistent plea for the state to tax and ban us into government-approved lifestyles in The Times (see also Sarah Vine).

Taxes will rise if we reject the nanny state

After ludicorusly misrepresenting the current government are a bunch of laissez-faire libertarians, she makes the case for public health authoritarianism.

The problem is that nudging often doesn’t work. More than 90 per cent of the population is aware of the five-a-day fruit and vegetables advice but fewer than 20 per cent follow it. Most of the great advances in health, such as the Clean Air Act, have worked because we have been given almighty shoves in the right direction.

Sorry, are you saying that people should be forced to eat five a day? Are you aware that the five-a-day advice is based on no scientific evidence whatsoever? Do you even care? I doubt it.

Nearly 50 years after the drink-driving limits were introduced, 69 per cent of motorists refuse to have a drink before getting behind the wheel. Yet 280 people still die every year in drink-drive-related accidents. Safety campaigners are desperate for an even lower drink drive limit.

That tells you a lot about campaigners who think that the world can be made perfect through legislation. The reason people still die in drink-driving accidents (the majority of whom are the drivers incidentally, by the way) is because people don't obey the existing law, not because people have half a pint of lager and then crash.

The Department of Health wants to be able to keep imposing tougher measures. Preventable illnesses such as obesity now present the fastest growing challenge to the NHS. Internal research suggests that poor diet, lack of physical activity and drinking too much are already crippling the health service.

What internal research is this? Is it so secret that you can't provide a reference? Last time I checked, the highest estimate of the cost of obesity to the NHS was £5 billion, which is less than 5 per cent of the NHS budget. This figure doesn't include any savings the state makes from premature mortality. Other research has found that the lifetime healthcare costs of the obese are lower than those of people of normal weight and concluded that: "Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures."

As for alcohol, the £607 million that was recently said to be the cost of alcohol-related admissions to  NHS hospitals is about £11,393,000 million less than the tax we pay on our drinks. So you can park that argument straight away.

Public Health England was set up to co-ordinate a more vigorous approach to helping people to live healthier, longer lives. It has four options: eliminate choice, shove, nudge or do nothing. While Tory strategists would prefer to do nothing, experts in the Department of Health point out that the first two options are already working. The Stoptober campaign to encourage people to give up smoking had 1.2 million website hits with 61 per cent reported quitting. More than 3.5 million have now watched the graphic anti-smoking tumour advert on YouTube.

This paragraph doesn't make any sense. Aside from the fact that website hits are not a measure of health, a voluntary campaign to stop smoking neither eliminates choice nor requires shoving. Nor does showing anti-smoking advertisements.

The Dementia G8 summit this week has shown that we need the same hard-hitting approach to exercise and diet. We spend £17 billion a year on seven million people who have dementia and there is still no sign of any cure. But if we exercised more, ate a healthier diet and drank less we could reduce the likelihood of developing dementia by up to 60 per cent.

Compelling evidence for that claim has not yet appeared. Exercising more, eating a healthier diet and drinking less is the medical establishment's 21st century equivalent of a course of leeches—recommended in any circumstances where the cause, and cure, of the disease is unknown. And readers of The Wages of Sin Taxes won't be surprised to hear that the £17 billion figure she quotes is not what "we spend" on dementia, but comes from a study that includes things like lost productivity and informal care as costs. Only 8 per cent of that £17 billion refers to NHS costs.

The same tactics would help with the obesity crisis.

That is rather more plausible.

When I read about the five-year-old child in Wales who was taken into care because she was over ten stone I assumed she must be an anomaly, but a third of pupils are deemed to be seriously overweight.

That's like saying "I thought 9/11 was an anomaly but there are millions of violent acts carried out every day." A five year old weighing ten stone is an amomaly. It is three times the average weight for a child of that age. The third of pupils that Thomson claims are "severely overweight" is a corruption of a statistic showing that 28% of Welsh schoolchildren are overweight or obese (closer to a quarter than a third). It is questionable whether the crude and arbitrary Body Mass Index measure is appropriate for growing children, but the 28 per cent of children in this survey are not severely overweight—that is an invention of the author. Hardly any of them are in the same league as this ten stone girl because she is an anomaly, hence she became a news story.

Since 1996 the number of people with diabetes has increased from 1.4 million to 2.9 million, largely linked to weight increase. The most obvious solution is to tax sugary drinks and fund more physical education, for children and adults.

That's the obvious solution, is it? Then perhaps you can provide some scientific evidence showing that sugary drink taxes have reduced obesity rates, let alone diabetes rates, anywhere in the world? I won't hold my breath because there isn't any. A solution, by definition, has to solve the problem. Sugary drinks taxes will just make sugary drinks more expensive.

Taking these preventive measures is going to be the only cost-effective way of controlling the NHS budget given the ageing population.

If the ageing population is going to increase NHS costs—and it will—how the hell will making people live longer be a cost-effective way of reducing those costs? It won't. There are a number of moral arguments nanny statists can make to justify state-enforced longevity, but reducing NHS costs is not one of them.

The cost of legislating for plain cigarette packaging or minimum alcohol pricing damages Treasury revenues — as well as the profits of drink and tobacco firms — but won’t cost much up front. 

On what planet does making products more expensive not lead to higher costs? The cost of minimum pricing is estimated to be £2 billion. The cost of a sugary drinks tax is estimated to be £1 billion. These are real costs that real people will have to pay. They far exceed the most optimistic predictions about what savings could be made in terms of healthcare. They are, by any standard, a highly inefficient way of tackling the issue and they will make people poorer. Anyone who cries crocodile tears over the hypothetical costs of obesity or drinking to the NHS while calling for the public to cough up billions of pounds in extra tax is a fool or a knave.


Leg-iron said...

The health industry is now only concerned with keeping us all alive as long as possible until it's time for them to kill us off as no longer economically viable.

Doctors no longer see patients as individuals but as 'units' that must be moulded into the British Standard Human. Any deviation from the manual must be corrected.

We are all 'human resources' now. Nothing more.

As for me, I definitley get my five-a-day. Chocolate is a vegetable, chips are vegetables, whisky is made from cereal grain and wine and cider are fruits.

Cereal for breakfast anyone?

Junican said...

" a fool or a knave."