Tuesday, 12 January 2021

"We don't have a public health crisis, we have a public healthcare crisis..."

Said Sobers in the comments here:

... The current alleged 'second wave' is nothing of the sort, its just the NHS being incapable to coping with winter demand as is ever the case. Deaths are the only true statistic we can rely on in these reality bending days - even the NHS and PHE etc can't fudge how many dead people there are. And the number of funerals tells us we are currently experiencing an entirely within normal parameters winter. The 'second wave' is a figment of the failings of the PCR test, in fact its exacerbating the problem by causing thousands of NHS staff to be 'off sick' when there's nothing wrong with them.

Well, yes and no.

The NHS always 'struggles' in winter. Presumably it has enough capacity for most months of the year, but not quite enough for winter.

Excess deaths are not particularly high (so far, touch wood) during the 'second wave' (which clearly exists, it's not just miscounting). But that is not the metric. If Covid-19 were completely incurable and people just dropped dead within a couple of hours, this would not place any particular strain on the NHS. That would be a health crisis, but not a healthcare crisis.

The issue is that Covid-19 is very curable in most cases, but treating it is very labour intensive. There are currently 32,000 people in hospital being treated for Covid-19, which is about one-fifth of the total number of beds in the NHS. Which is either 'not much' or 'a heck of a lot' depending on your point of view.

What interests me, as an economist and armchair general (most of whose Covid-19 related predictions have been wrong or unproven so far, lolz), is the cost-benefit analysis.

The lockdown appears to have lopped £500 billion off GDP this year. Marginal tax rates in the UK are about 50%, so the government UK has racked up an extra £250 billion of debt. These numbers are subject to large margin of error, but it's clearly huge amounts. That's money we'll never get back.

If we'd had a milder, saner and tolerable level of lockdown (applied consistently from the start, not with this constant chopping and changing and different rules for different areas - people can get used to anything except constant change), there would have been more infections, patients and deaths of course. The vulnerable and elderly can do the sensible thing and self-isolate; that doesn't mean that kids shouldn't go to school either - the kids will all catch it but nearly all those cases are asymptomatic or mild, and after that they have immunity (we believe).

How much extra money would the NHS have needed to be able to ramp up capacity to be able to treat the extra patients? You can't train up doctors and nurses overnight - but you can pay them more generous overtime; poach some from abroad; delegate more nursing task to less qualified people and medical students; take people off unnecessary tasks like smoking patrols or 'diversity and inclusion enablers' and put them on cleaning duty etc.

The normal NHS budget is £140 billion a year, we could have given them a temporary 50% increase, and it would still only have cost a fraction of the economic cost of the lockdown. We could have doubled it and still better than broken even.

42 comments:

L fairfax said...

The NHS is the envy of the world. The NHS struggles in winter.
If both these statements are true - the rest of the world must be in a mess.

Staffordshire man said...

It's fine to do a cost benefit analysis but remember that the ones getting the benefit and the ones paying the cost are not always the same people.

Mark Wadsworth said...

LF, both of those statements are exaggerations/propaganda, put out for different reasons. A lot of countries do better than we do; but most countries do worse. And the NHS does 'struggle' a bit in winter (to what extent it is their own fault for poor planning, I couldn't possibly comment).

SM, if it had been or were possible to ramp up NHS capacity in this way, then everybody benefits. I'd rather have £70 billion extra public debt than £250 billion extra. People would rather not lose their jobs or see their business fail. Kids are better off in school. And nurses get a (temporary) pay rise. What's not to like?

L fairfax said...

@Mark Wadsworth
With the exception of Americans obviously. I have never met any foreigner in the UK who thinks our system is significantly better than theirs.
Of course this is anecdote not data.
I am not surprised that any system struggles at high demand to be fair. A lot of systems have problems like this.

Staffordshire man said...

Everybody who survives benefits. You said yourself that there would more deaths.

Man Beach said...

£140 billion? With a UK population of just under 70 million, that's about £2000 a year for everyone in the country (including children).
According to Moneysavingexpert, £2000 is pretty much the annual BUPA insurance cost for the average healthy 70 year old man - and 3 times the cost of annual health insurance for the average healthy 35 year old.
Why doesn't the Government just provide everyone with free health insurance? It'd be cheaper!

Mark Wadsworth said...

LF, yes, most European systems are probably slightly better than the NHS. You get what you pay for. And everybody is used to their own country's system and assumes that is the right way to do it (I am no exception).

SM, you can ascribe a monetary value to years of life lost, and governments do. Then knock off the old age pensions we're no longer paying etc. Then chuck the net amount into the cost-benefit analysis.

MB, private health insurance would end up way more expensive. They have loads of exclusions, stuff they won't cover, won't insure against pre-existing conditions. NHS care is mainly on older people, tens of thousands a year in some cases. Most 35 year olds never get sick, so cost the NHS nothing. It averages out to £2,000, which is fine by me. In Germany I would be paying twice as much for a better service, also fine by me.

Sobers said...

"most European systems are probably slightly better than the NHS. You get what you pay for."

Its not the lack of money in this country, its the NHS system. Free at the point of delivery and State provision of services is a recipe for mouldy buildings, sullen staff and indifferent to the patient's needs. We could pour twice as much money into the NHS and it would still provide a sh*t service because there's no incentive for it to provide a good one. Patients are a cost to the NHS, we need a system where patients are source of income and profit. Then we'd get good service instead of being treated like something they stepped in.

Sobers said...

I would also argue that the UK's underperformance in the covid crisis is down to the UK public being in very poor shape, due the lack of incentive for the public to look after their own health, because the 'free' healthcare will always pick up the pieces. If being type 2 diabetic cost you money in extra insurance fees or extra charges to see doctors etc then people might actually look after themselves better. As it is they have zero incentive to make the hard choices about diet, exercise etc. And as a result the UK population is in far worse overall health condition than other European nations.

Bayard said...

Sobers, whilst that argument is superficially attractive, you only have to look at the US, the nation with the most unhealthy population and the most expensive healthcare to see that there is something seriously wrong with it.

Bayard said...

"Free at the point of delivery and State provision of services is a recipe for mouldy buildings, sullen staff and indifferent to the patient's needs."

Unfortunately, free at the point of delivery and private provision of services is a recipe for price-gouging on a massive scale, so that's not the answer, either. We could try having an insurance scheme run by the state to prevent the sort of profiteering seen in the US, with everyone contributing a fixed amount of their income and use that to pay for healthcare. We could call it National Insurance, oh, wait, we've been there already and it morphed into just another tax on labour. The problem is that you either have a system free of interference from the state which is liable to profiteering or a system controlled by the state which is subject to the whims of politicians, who, 99% of the times have other interests than the public one closest to their hearts.

Sobers said...

"The problem is that you either have a system free of interference from the state which is liable to profiteering or a system controlled by the state which is subject to the whims of politicians, who, 99% of the times have other interests than the public one closest to their hearts."

You are never going to have a healthcare system that is free from interference from the State, but it is perfectly possible to run a mixture of the two, as is the case on the Continent. It seems to me that the State is best utilised in the money gathering element but the private sector is best utilised in the provision of services. Thus (IMO) the best sort of socialised healthcare system would comprise the State as the basic single insurer, using the tax system to raise the funds, as you say via dedicated healthcare taxes, but to hand the running of the services to the others, the private sector, charities and mutual organisations. Thus creating the situation where the patient is the client of the service provider, and the State's only involvement with the patient/doctor relationship is to pay the bill. That appears to be the system in Germany and to a large extent in France too, and their healthcare systems work far better than the NHS ever does.

We accept this principle in other areas of welfare - we do not run a National Food Service to provide everyone with food, we give the poor money raised via the tax system and let them spend it as they see fit, and everyone else can augment the State welfare payments with money they earn themselves. The same can apply to healthcare IMO, its not that different a scenario. Yes there might have to be some small sections of the NHS kept in State ownership and control, A&E would probably benefit from such in order to maintain the universal coverage. But the vast majority of NHS functions would be better transferred to the private sector, and the State to butt out of its management entirely. This would not preclude hospitals being run by charities, or mutual bodies, indeed that would be encouraged. But crucially all these organisations would get their funds as a result of work done for patients, not as a block grant direct from the State. The needs of the patient should drive the management of the system, and the money should follow the patient as well. The NHS is a monopoly, and just because its a State owned monopoly does not make it any more immune to the anti-consumer attitudes that monopolies create.

Mark Wadsworth said...

S, you seem to despise the NHS for not being good enough, and similarly to despise your fellow citizens for deliberately becoming ill because they enjoy using the NHS so much.

But your summary of the German system is correct, and it does work well (or did when I lived there), hardly surprising as they also spend about 50% more than we do.

B, there is little price gouging in Germany because there are set rates for how much a doctor or hospital is paid for a certain treatment. The 'health insurers' pretend to be independent, but in practice they are government controlled and not-for-profit.
-------------------------
When you need treatment, you ask around and find out which doctor or hospital has a good reputation for treating that particular thing and you go there. If and when hospitals get a bad reputation, people stop going, income dries up, whoever was running it gets booted out, and some other organisation takes over the running of that hospital.

The good and quick service means that Germans go to the doctors for every little thing instead of just putting up with it, like we do. So it's a moving target and impossible problem. Supply creates its own demand.

Unknown said...

https://www.google.com/amp/s/www.bbc.co.uk/news/amp/uk-politics-55607160

Mark Wadsworth said...

U, sad but true.

mombers said...

@U
Per household VAT bill from 2018 is £5083 per year. As a stealth tax, has been going up an alarming rate from £3231 in 2010, a raise of 57% at the same as council tax 'freeze'. For VAT to go up by £90 a year it needs rise by just 1.8%. Which is the bigger bogeyman here? Council tax is regressive for sure but not as much as VAT. You don't pay more council tax if you have children to raise, but your VAT bill goes up dramatically.

mombers said...

A big problem with insurance based healthcare is marginal tax rates go through the roof for the low to middle paid. Can't afford a $10k premium on a low to middle income? We'll give your insurer a subsidy then. Oh you got a raise? Let's have some of that back! Obamacare has introduce a new 70% marginal tax rate in the US, dragging more people in every year.
Many problems with every way to solve the healthcare puzzle but a free at the point of use enhances private property rights in my view.

Mark Wadsworth said...

M, re VAT, agreed. Ultimate stealth tax.

M, re social security taxes, that is a big weakness in the German tax system. Compulsory health + unemployment + pension insurance is about 40% of wages up to EUR 50,000, above that wages are exempt. So it is hugely regressive. Even ignoring German VAT (main rate 19%, temporarily reduced to 16%), the marginal tax rate on people earning less than EUR 50,000 is about 60%. Chuck in VAT and it's more like 70%.

Sobers said...

"S, you seem to despise the NHS for not being good enough, and similarly to despise your fellow citizens for deliberately becoming ill because they enjoy using the NHS so much."

I do despise the NHS because I have seen far too many family members, friends and acquaintances treated like sh*t by the NHS, to the extent some of them died and others are left with debilitating conditions. Combinations of poor diagnoses, poor care and hospital acquired infections. The NHS treats patients like a problem to be made to go away, and if people are not suitably pushy , clever enough to know how to play the system or well connected they fall between the cracks. Any private sector organisation that was as riddled with borderline criminal behaviour as the NHS is (for example how many people died at the start of the covid crisis because some NHS staff decided blanket DNRs should be applied to all elderly patients, regardless of their wishes or medical need? No-one will ever have been so much as admonished for that, let alone prosecuted for illegal behaviour) would have been closed down decades ago as a criminal racket. Yet the NHS sails on untouched and unabashed, leaving a trail of corpses in its wake.

And I don't blame people for not looking after their health and causing extra medical problems for the healthcare system to sort out, why should they when healthcare is 'free'? Its a perfectly rational attitude to take. I'm just suggesting that creating the conditions so such attitudes can arise is manifestly foolish for the nation as a whole. People value what they pay for, and the link between healthcare and how people pay for it is so theoretical that its no surprising most people consider it 'free' and limitless and behave accordingly.

Bayard said...

"B, there is little price gouging in Germany because there are set rates for how much a doctor or hospital is paid for a certain treatment. The 'health insurers' pretend to be independent, but in practice they are government controlled and not-for-profit."

So it's not really private provision of healthcare, is it?

"Yet the NHS sails on untouched and unabashed, leaving a trail of corpses in its wake."

I think you'll find that's how the health system operated before nationalisation, too. It's more a function of the "we know it all and you know nothing" attitude of the medical profession than anything to do with the NHS being stae run.

Mark Wadsworth said...

S, like most people, I find the NHS receptionists to be utter shits. But the NHS nurses and doctors are fine, once you get through to them. And who's to say that your friends and relatives would have been able to afford truly private healthcare, like in the USA?

B, "So it's not really private provision of healthcare, is it?"

It is very much is 'private' provision from the view of the patient! It's funded out of taxes (as regressive as they are) and competing organisations do the providing (for fixed prices) with an interest in making income exceed cost. The patient chooses which doctor or hospital to visit.

Those competing organisations might be private individuals or partnerships; trade unions; insurance companies; university departments; the local council; whatever. Most of them are not 'private' in the neo-liberal sense. But they are 'competing' and that is what drives better services.

It's like people spending their welfare money in the supermarket. Public funding and private providers. Best of both worlds.

Blissex2 said...

«If we'd had a milder, saner and tolerable level of lockdown (applied consistently from the start [...] How much extra money would the NHS have needed to be able to ramp up capacity to be able to treat the extra patients? [...] The normal NHS budget is £140 billion a year, we could have given them a temporary 50% increase, and it would still only have cost a fraction of the economic cost of the lockdown.»

That is a completely incorrect framing of the issue, perhaps out of amazing innocence, or perhaps out of instinctive or deliberate thatcherism because...

It has been well known for thousands of years, and recently amply demonstrated by events in more civilized yet comparable countries like south Korea or China-Taiwan that there are only two effective ways to contain an epidemic:

* Pervasive testing, tracing and isolation of just the infectious.
* If pervasive testing or tracing cannot be done, everybody has to self-isolate (hard lock-down).

Note: "testing, tracing and isolation" must be preceded by a short period of hard lock-down while the "testing, tracing and isolation" is being ramped up.
There is no case for "a milder [...] lockdown".

The problem with "testing, tracing and isolation" is that it is politically incompatible with thatcherite countries because:

* It requires raising taxes for the state to fund ahead of need a significant amount of spare stocks, training and capacity the healthcare system.
* Since it would be successful it would show that public issues can be solved well with public solutions, rather than individual solutions.

As the experience of other countries shows, "testing, tracing and isolation" is cheap, requires no long term national or regional lock-down, and is very effective at preventing illness and death. But none of that is more important than upholding thatcherism.

Blissex2 said...

«The NHS is the envy of the world. The NHS struggles in winter.
If both these statements are true
»

Both statements are indeed true: the NHS delivers pretty good outcomes for quite cheap, and in addition is it squeezed for "maximum efficiency", that can only be achieved by having 100% utilization at all times. That 100% utilization at all times can only be achieved by having queues at all times, the difference between summer and winter is that in summer they are fairly short, and in winter fairly long.

That this is by design is easier to understand the concept of "plan" (bronze, silver, gold0, because it is key to understanding the approach of many businesses to customers, and that of tory (Conservative, New Labour, LibDem0 governments to public services:

* The NHS offers "bronze" plans for lower class users: minimum cost thanks to overloading capacity, and relying on the goodwill of staff to often pay personally, with overwork, for the overloading of the system. In this not different from the "crapification" strategy of Virgin Mobile etc.
* BUPA etc. offer an upgrade from the "bronze" plan to a "silver" plan for people with middle class jobs: its contracts specify that customers must use the NHS for high cost items, but it then offers quicker, better customer service for most lower cost items, thanks to less heavilz overloaded private capacity.
* Many companies offer "gold" plans to directors and top executives: essentially unlimited health credit cards where the executive or director can go to any top, not overloaded, healthcare providers and get it paid fully by their business.

Sobers said...

" It's more a function of the "we know it all and you know nothing" attitude of the medical profession than anything to do with the NHS being state run."

Well yes doctoring certainly does seem to attract the authoritarians in society, or maybe the medical educational system inculcates that into its students, I couldn't say which. Certainly all the doctors I've had to deal with come across as arrogant d*cks. Not much of a human touch for sure. Which is all the more reason not to give them monopoly power over people's lives............if a doctor's livelihood depended on repeat custom they might just provide a better standard of customer service. Medicine is after all a service industry..........not that you'd ever think it was by the way doctors and nurses behave towards patients.

George Carty said...

Blissex2,

South Korea was able to use test/trace/isolate to keep Covid under control for a long time, because they set up a near-Orwellian surveillance state of the kind that westerners likely wouldn't tolerate. And even they lost control last December, likely because their surveillance was business-oriented (it was based on QR code check-ins on the doors of business premises, along with credit card surveillance) and thus was foiled by pre-Christmas gatherings in private homes.

The other successful countries – including Taiwan, Vietnam, Australia and New Zealand – sought not just to suppress the virus but to eradicate it outright. The most important part of such policy is that early on they ensured that every person entering the country was quarantined.

If you can't do that (which I suspect no country in Europe or the Americas could for reasons of essential international trade) then no amount of lockdown will be able to get you to a position where (barring vaccination) normal life can resume.

Sobers said...

"If you can't do that (which I suspect no country in Europe or the Americas could for reasons of essential international trade) then no amount of lockdown will be able to get you to a position where (barring vaccination) normal life can resume."

If you tried it in the UK/US the usual suspects would scream 'Racism!' because it was disproportionately affecting ethnic minorities, who obviously have
more connections abroad and this are more likely to be leaving and entering the country. We saw what happened when it was suggested that flights from China be stopped back in March 2020, that too was racist apparently.......

George Carty said...

Sobers: "If you tried it in the UK/US the usual suspects would scream 'Racism!' because it was disproportionately affecting ethnic minorities, who obviously have
more connections abroad and this are more likely to be leaving and entering the country."

Yes there's that too – I've had at least two people block me on Twitter as "anti-immigrant" for pointing out the level of border control that a zero-Covid policy requires, even though the problem is clearly tourists and business travellers far more than actual immigrants.

I also often think that New Zealand paradoxically benefited from having a very woke PM: if only Nixon could get away with going to China, perhaps only Jacinda Ardern could get away with sealing the borders?

Lola said...

What people seem to forget is that we, the UK, has always had a national (as opposed to nationalised) health service. Pre 1947 the UK had a relatively excellent market system of varying types of organisation providing health care. There were also excellent teaching hospitals and the like. Friendly societies provided excellent benefits for all sorts and grades of workers. GP's were plentiful and mostly moaned about their low pay. There were local authority hospitals. If you wanted to you could buy well priced catastrophe insurance to deal with things like cancer. If you had a chronic condition like asthma (which I had / have) there were charity hospitals who could treat you without large costs. The mix of provisions and services made the health care system very robust. Even under the NHS in the early years charity still played a part. I know this as I benefited form it by being sent to Switzerland for my asthma to a sanatorium run by the Red Cross.

I entirely dispute that under such a system insurers will profiteer and that there will be no 'price gouging' (a phrase I consider stupid - deliberately emotive).

And a factoid for you. The first genuine NHS hospital was not built until 1963. What the NHS used was all the existing infrastructure. The NHS Act also destroyed a lot of the charitable or mutual insurance providers (like friendly societies).

Mark Wadsworth said...

We appear to be drifting further off the actual topic, which is it might have been better to have a milder lockdown and give the NHS more money.

B2, you clearly haven't even understood the point of the post, which has nothing to do with "Thatcherism" (which was not a coherent system or philosophy anyway, it was just being nasty for the sake of appearing tough and electable).

George Carty said...

MW,

Milder lockdowns may be better for people's mental health, but (given that they'd have to go on for longer) I can't see how they'd be any better for the economy.

Lola said...

MW. Good point. My answer. Probably not. 'Giving the NHS more money' just ends up in 'rents' to bureaucrats. That's the lesson of history. Blair Brown doubled the NHS budget for zero increase in productivity. The NHS as a structure is fatally flawed.

Mark Wadsworth said...

GC, L, those are all things to throw into the cost-benefit analysis.

Lockdowns - whether mild or harsh - will end when the elderly and vulnerable have all been vaccinated, which at current UK vaccination rates will take about ten months. If they get up to 2 million per week, then we're done by the middle of this year.

Bayard said...

"B, "So it's not really private provision of healthcare, is it?"

It is very much is 'private' provision from the view of the patient!"

Well yes, but you can't logically say that there would be no profiteering with private provision of healthcare and then go on to cite an example of private provision that is so heavily controlled to avoid that very profiteering that it is, to all intents and purposes, indistinguishable from state provided healthcare. It's like people who are "contractors" to the NHS. Technically, they are self-employed, but, given the amount of control that the NHS has over their working day and their pay, they are in reality indistinguishable from employees.

GC, S, I very much doubt that our borders were kept open for "reasons of international trade" or not wanting to seem to being nasty to ethnic minorities. After all, strict quarantine could have operated without there being an interruption in the trade in goods, andin these days of the internet, how much physical travel is actually necessary in the trade in services? No, I suspect the airports were kept open so as not to inconvenience the rich and influential members of the jet set.

"I entirely dispute that under such a system insurers will profiteer and that there will be no 'price gouging' (a phrase I consider stupid - deliberately emotive)."

We are not the same society that we were before 1947; our attitudes have changed, and not for the better. The idea of "public service" has largely disappeared and the question people ask themselves is much more often "what can I get away with?" than "what ought I to do?". The US is a good example of these attitudes applied to healthcare and their whole healthcare system is a massive example of profiteering. Nor is it any good saying that that sort of thing doesn't happen in France of Germany, because we are not French or Germans.

"'Giving the NHS more money' just ends up in 'rents' to bureaucrats. That's the lesson of history."

Which is why I always say that the Tories (in which I include Blair and Brown) have never funded the NHS properly, rather than saying that the NHS has been underfunded.

M, speeding up the vaccination rate is one area where more money definitely would help. After all, how long does it take to train someone to give a vaccination?

Mark Wadsworth said...

B: "it is, to all intents and purposes, indistinguishable from state provided healthcare"

I lived there, and it is very much distinguishable! This is not a hypothetical debate! Sobers is right on this one.

It is a best of both worlds type system (like in many other European countries). Paid for out of taxes (albeit regressive ones); free or cheap at point of use; competing providers to keep service standards high; price regulation to prevent gouging.

Sobers said...

" I very much doubt that our borders were kept open for "reasons of international trade" or not wanting to seem to being nasty to ethnic minorities"

Here's a typical article from CNN from late Jan 2020 basically calling everyone who wanted to keep people from travelling to their country (not only Western ones but other Asian countries too) from China racists.

https://edition.cnn.com/2020/01/31/asia/wuhan-coronavirus-racism-fear-intl-hnk/index.html

Thats the sort of attitude one has to deal with in the West. Yet Jacinda Arden closes her entire country down like a prison ship, and she's lauded to the skies.

Bayard said...

Mark, I'm not saying it doesn't exist, nor that it doesn't work, just that the heavily regulated private provision of healthcare that they have in Germany wasn't what I was referring to when I said the would be profiteering, I was referring to the virtually unregulated version of private healthcare they have in the US and that is far more likely to be what we would get here, because we are not Germans and we aspire to everything American.

Bayard said...

S, the fact that what passes for the Left in the US was calling people racist for trying to keep out plague-bearing travellers from China a year ago does not prove that a) the British government give a stuff about what the likes of CNN think or b)that even if they did, it had any bearing on their decision to keep the borders open, nor have you given any evidence that the same people who were calling Jacinta Ardern a racist were the same ones lauding her later. You can't please all of the people any of the time.

George Carty said...

Lola @ 11:50 I entirely dispute that under such a system insurers will profiteer and that there will be no 'price gouging' (a phrase I consider stupid - deliberately emotive).

Perhaps here we should all be using only the good Georgist term "rent seeking"?

MW @ 16:42 Lockdowns - whether mild or harsh - will end when the elderly and vulnerable have all been vaccinated, which at current UK vaccination rates will take about ten months. If they get up to 2 million per week, then we're done by the middle of this year.

There's bad news and good news on the vaccination front. The bad news is that "the elderly and vulnerable" will probably need to include everyone over 50, because while the average age of a Covid death is over 80, the average age of a Covid ICU patient is only 62.

The good news is that the rate of vaccination may be increased to half a million a day by next week, allowing all over-50s to be vaccinated by the end of March.

Bayard @ 17:58 I very much doubt that our borders were kept open for "reasons of international trade" or not wanting to seem to being nasty to ethnic minorities. After all, strict quarantine could have operated without there being an interruption in the trade in goods, andin these days of the internet, how much physical travel is actually necessary in the trade in services? No, I suspect the airports were kept open so as not to inconvenience the rich and influential members of the jet set.

Wouldn't surprise me, given that the Brexit Tory Right (at least stereotypically) do see the UK's main economic role to be that of a tax haven where wealthy foreigners come to stash their money.

I think you downplay the issue of international trade: while China and Vietnam have been able to trade across their common border in a Covid-secure way, the fact that both those countries are communist dictatorships committed to eradicating Covid must surely help there? Plus their border crossing has a throughput of 150 trucks/day: isn't the typical number of trucks crossing the Channel more like 10,000/day?

Just look at the chaos that renewed post-Brexit customs checks (which must surely last hours at most) have caused in Kent! Surely it would be far worse if no-one was allowed to enter or leave Britain without spending 14 days in quarantine?

(Another reason why I'm bemused by Remainers who became zero-Covid zealots...)

Sobers @ 19:03 That's the sort of attitude one has to deal with in the West. Yet Jacinda Ardern closes her entire country down like a prison ship, and she's lauded to the skies.

The CNN article you posted was from January, while Jacinda didn't totally shut down travel to NZ until mid-March. Perhaps the real issue wasn't Jacinda's wokeness so much as how radically the Overton window shifted throughout the Western world, in response to the harrowing scenes in the hospitals of northern Italy?

Australia and New Zealand were advantaged during January/February 2020 because their isolated geographic location meant they were importing fewer cases, while being in the southern hemisphere (where it was then summer) meant that community transmission was slower (because all coronaviruses spread more slowly in summer than in winter). This meant that they were politically able to lock down at a point when actual case numbers were still low (which meant complete eradication was a realistic possibility for them: being able to promise "freedom thru zero Covid" works wonders when it comes to lockdown compliance).

Mark Wadsworth said...

GC, ta for research.

Lola said...

B

"'Giving the NHS more money' just ends up in 'rents' to bureaucrats. That's the lesson of history."

Which is why I always say that the Tories (in which I include Blair and Brown) have never funded the NHS properly, rather than saying that the NHS has been underfunded.


eh?

Bayard said...

"Plus their border crossing has a throughput of 150 trucks/day: isn't the typical number of trucks crossing the Channel more like 10,000/day?"

At the port near me, many of the goods being loaded onto the ferries are in cabless trailers, meaning that the drivers don't have to leave the UK.

L, what is it you don't understand?

Blissex2 said...

«B2, you clearly haven't even understood the point of the post, which has nothing to do with "Thatcherism"»

The point of the post seemed to me, whether it was intentional or spontaneous, to ignore the cheaper, more effective choice of a state-funded and organized test-trace-isolate system, and present as the only possible choices harder vs. milder lock-down, where "milder" means in practice "optional for many people".

In effect the advocacy of milder lockdowns (as opposed not just to harder lockdowns or test-trace-isolate) is based on the notion that it is up to individuals to take personal responsibility for not getting infected by someone else, by isolating themselves if they wish (and can afford to), and not isolating themselves that much if they wish to avoid risks (or cannot afford to avoid them), pretty much a "market based" approach.

Methodological individualism and distrust of public solutions to public problems is a big component of thatcherism, even if other aspects may be debatable.