Modest Expectations – Union

One can hardly believe that in a country with so many challenges there is so much concern over some footballer who made a list of people he wished to be assigned to Hell.

Echoing what I wrote in an earlier blog, Peter Singer, the bioethicist, is reported as having written:

“Folau is a born-again Christian, and his post was an expression of his religious beliefs. To prevent misunderstanding, I should say that I do not share those beliefs. As an unrepentant atheist, I am among those for whom, Folau believes, hell awaits. But that does not trouble me, because there is, in my view, no god, no afterlife, and no hell. Nor do I differentiate, ethically, between homosexual and heterosexual relationships.”

Singer picks up the “hell awaits”. It is not as though Folau is advocating violence or even earthly sanctions. Nevertheless, the sheer arrogance of such a list should not have goaded the Rugby Union establishment into a response, which in turn has started a chain reaction. It has enabled the fundamentalist Christian groups to start braying about religious freedom, using Folau as a martyr strung up on a goal post.

In the course of this saga the community is being suckered into a situation where a silly statement is now being adopted by those who want to use the cloak of the Christian Church to run extreme agendas; where dominance of women is one of, if not the main objective.

Symptomatic is the resurfacing of the anti-abortion crew, who have never gone away – the matter has become a surrogate for maintaining the subservient role of women. Christian churches out of the mainstream are very good at keeping women as handmaidens, where the violence is not necessarily physical. And it is not limited to Christianity.

I have a visceral dislike for abortion, but it is not my business – not my choice. It should be a woman’s choice.

There was one occasion when I was faced with a friend who wanted an abortion, and the potential father had disappeared. It was at a time before the Menhennitt ruling changed the secrecy and enabled abortions to occur openly, and the words “criminal abortions” rendered obsolete. (In Victoria, a landmark Supreme Court ruling in 1969 (‘Menhennitt ruling’) established that an abortion will be lawful if the accused held an honest belief on reasonable grounds that the abortion was both ‘necessary’ and ‘proportionate’.)

The whole episode made me so disgusted that we, in an ostensibly Christian society, were allowing women to be exposed to emotional and – on those occasions when the “backyard” procedure went wrong – physical trauma on women. Here a degrading scene was being played out, because men – predominantly men, and celibate men at that – thought it sinful.

Fortunately, my friend survived the ordeal. She recounted what had happened, I was appalled but we never talked about it again.

That is the worry if this whole Folau imbroglio, with the forthcoming legal action, is allowed to energise this group of anti-abortionist misogynists over what is, in the end, a belief lodged somewhere inside Folau’s head that should have nothing to do with anything but his contract with RU.

Nearly 20 years ago, Susan Ryan, the former senator, reminded us it had not been that long ago that the House of Representatives’ vote against abortion – four years after the Menhennitt ruling – was 98 to 23.

“The debate was conducted in an all male chamber, the women were outside rallying, organising, shouting through loud hailers, preparing for disappointment. I decided that next time we should be in there making the laws.”

It is not often that I agree with Susan Ryan, but I do on this matter – wholeheartedly. The whole of the Coalition voted against the decriminalisation of abortion although one young Liberal party member who stood up with a flourish as though he was going to break ranks and cross the floor to vote for decriminalisation, looked around and seeing he would be on his own, sat down.

As for Folau, it may have been easier to tell him to get lost. Of course he would not have, but I do hope that when some other sportsman near the end of his career and with enough notoriety to be noticed, says something as stupid as Folau has, that the situation is better handled, including not to renew the contract at some astronomical figure.

For instance, select him in an Australian team and he can then work out who is the adversary, given that he likes to compile lists.

Somewhat more important than Israel Folau

Opera is watched by an estimated a total audience of 300,000. It is a form of artistic licence that belongs to a different age. In that age women were treated dreadfully, composers had various forms of pathology. Who knows how many operas were written under the creative phase of syphilis so rife then. But now, to try and change the opera so as to satisfy a fad is as crass as the efforts of the Bowdler family in the 19th century to change Shakespeare to remove the “dirty bits”.

It is ironic that a report in the SMH of the opera “deisembowdlerising” itself, is perched alongside a report about the number of hate and violent items appearing on Twitter, Facebook/Instagram and YouTube. Here those indulging in such unspeakable behaviour are totalled in the millions.

So while token behaviour to cauterise opera plots may make those involved feel appropriately righteous, the problem is not solved by tokenism towards women’s rights.

However there is, as reported, a public health emergency in the way social media has become diseased.

Humans coming in contact with one another harbour the means of infecting one another with both the good and the bad. Globalisation is the jazzy word that we have for the removal of barriers to the spread of a vector, be it conventional trade, disease or whatever.

As the globalisation of Christianity occurred so did the spread of European disease against which the Pacific islanders and Australian aboriginals among others had no defence.

Similarly the globalisation of those who went to the New World of the Americas took a cornucopia of transmissible diseases as the contribution of Europe in this “free trade of infection”. In return Columbus is reputed to have brought back larges doses of syphilis. So it was a form of bilateral trade.

In those days when there was no idea what caused disease: perhaps the miasma, which was great for the perfume trade; or some dark unknown medium, which provided the excuse to torch women – and the ersatz cure – the miracle sustained by intercession via prayer or veneration of some osseous part of a saint.

Perhaps it is encryption that is the best analogy, especially as the means it has to deceive is akin to microbial mutation.

However, it is always the word “plague” which focuses the mind. And while we do not have the spectre of bodies loaded on carts being wheeled to mass graves, the world is entering into a time of cyberdisease, and “cyberplague” is convenient shorthand, although it has been used in generic terms before.

We now know the bacteria Yersinia pestis causes plague. Fleas and lice carry the bacteria. They can also lodge directly on humans if sanitation is bad – otherwise rats, dogs and cats inter alia are convenient intermediate hosts.

These abbreviated instructions from the Centers for Disease Control (CDC) in Atlanta on how to prevent plague provide clues:

* Reduce rodent numbers. Make your home and outbuildings rodent-proof.

* Wear gloves if you are handling or skinning potentially infected animals to prevent contact between your skin and the plague bacteria.

* Use repellent if you think you could be exposed to fleas or lice.

* Keep fleas off your pets by applying flea control products. Do not allow dogs or cats that roam free in endemic areas to sleep on your bed.

So it should not be too difficult to assign the appropriate language to deal with Cyberplague. One thing is for sure: it is the role of Government to supervise. The private sector does not do this well.

This darkening cloud over social media is the scourge. It is a public health emergency. And Donald Trump seems able to call a National Emergency, at a drop of a red cap… if he understands.

Where did all the Money Go?

I received an email this week from John Kitzhaber, once the Governor of Oregon and the man who received international attention when he devised the Oregon Health Plan. In part he wrote:

The cost of health care in this country is utterly out of control.  Mind-boggling. Approaching $3.8 trillion a year. This amount of money has attracted a whole host of private equity funds (that are) simply milking the system to feed shareholder profits. We had big national for-profit insurance companies that are likewise using public funds to increase shareholder value instead of reinvesting in the community.

John Kitzhaber – painting by Henk Pander

That problem is now also occurring here. When the Medibank model was established here in Australia, the expectation was that the patient would receive a medical benefit when they consulted a medical practitioner to assisting in paying for that medical service.

Doctors were considered to be in solo or group practice, and in fact when the first benefits were struck for procedural items, it was assumed that the benefit reflected what the government was prepared to pay to the patient for the perceived skill of the doctor.

Therefore when the array of medical benefits was struck for a surgical procedure, it was assumed the patient benefit recognised the skill of the doctor. The cost of the attendant scrub nurses, the surgical materials, the operating theatre were all absorbed into hospital costs, covered either by the public or private hospitals. In other words, the Medibank the scheme was constructed on a guild model – a hangover from the time when doctors sent accounts in guineas to patients who could afford to pay.

However, the medical professional entrepreneurs recognised that with the advance in technology, particularly in pathology but followed by diagnostic imaging with the arrival of the CT scans, there was a “pot of gold” awaiting. Radiotherapy and general practice have followed, and now other specialties such as cardiology are the target.

Technology improvements emphasised two of the problems with an open-ended floor price scheme as Medibank and subsequently Medicare demonstrated. The first one was the entrepreneurial manipulation of throughput against capacity for a particular procedure. This was lucrative when the Medicare benefit was set at a low throughput and not scrupulously adjusted over time as throughput increased with technological improvements. The second was the tiresome ‘pass-the-parcel’ game between the state and federal governments, otherwise known as ‘cost-shifting’. Private sector entrepreneurs have been able to utilise this for their financial gain but state governments have equally become adept at the cost shift and at the same time burying the real costs of health care.

As can be seen, health financing was drifting away from the original intention of enabling the patient to get a fair and reasonable subsidy for their medical care

The problem with the business model, which may have been devised first by economic rationally doctors in the Edelstein mould, is that it has been transformed into a business model not unlike the one described by Kitzhaber.

Here the doctors may be listed as the providers but in reality it is a company which employs them in some form which is harvesting the profits and shovelling Medicare money who knows where into tax havens around the world. Medicare money has acted as seeding finance for the eventual acquisition of overseas health companies.

It is difficult to watch the Federal government being so compliant. The problem is compounded by these companies giving a fraction of their Medicare-seeded profits to political parties for them to enable to run election campaigns saying they are looking after “all Australians” and thus these private firms to have a firm foothold into the political process.

The central governmental agencies know this but at present their political masters are impervious to this flow of taxpayer’s money off shore – after all we have a taxpayer Medicare levy so some firm profiting from such taxpayer funding can buy a health service in the USA or a pathology company in Germany – in effect using Australian taxpayers’ money to fund their business and not only that, but funding where there is a guaranteed floor price for each of services. So risk is negligible once the investment model is settled.

Kitzhaber’s comments are more than timely.

And for us in Australia, it gives us gives another meaning among others for a sonic boom.

Mouse Whisper

Heard between Nobby and Cambooya driving through that magnificent black soil country of the Darling Downs.

“Mate, the soil is so good out here you can plant nails and they come up crowbars.”

Yes, appropriately it is Steele Rudd country out here. But as my young mouse cousin asked “Who is Steele Rudd?”

 

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