Speaker by Various Artists

19

Land of the brave little kids

by Rob Salmond

My former colleague Sarah Austen-Smith recently posted some observations from her experience of America. I had an experience last weekend that caused me to think about the same NZ vs US comparison from another perspective: health care.

Of course, a lot has been written about this before. Their system is more than twice as expensive, their system is very bureaucratic, our system delivers better population-level results, and so on.

Our system generally comes out looking pretty good. But those broad comparisons don’t tell the full story.

First, there are things the US health system does better than ours. If you’re really sick, with a rare disorder, you want to be living in the US, not New Zealand. I saw this sharp end of the American medical system first-hand caring for my late daughter Sophie, and it is very impressive.

The US has many of the best specialist doctors and largest, most successful specialised hospital units in the world. The reasons are fairly simple: salaries and scale.

As a general tendency, the larger and more specialised your unit, the better your chances, because the doctors are more likely to have seen lots of cases like yours before. Practice makes perfect and all that.

That’s why those New Zealanders advocating for a South Island Starship hospital are so mistaken. Having two high-complexity children’s hospitals rather than one dilutes our expertise, meaning if your kid gets a rare disease, the doctors you see are less likely to have seen it before. They get less practice, which means the treatment is less perfect.

Yes, South Islanders will travel less time to see their sick kid in the hospital. But it’s more likely their kid will die, too.

I’ve often wondered why New Zealand’s system of escalation for really complex illness goes usually to Australian hospitals first, then to British ones. US hospitals are closer than British ones, and are often better, too, due to scale. Why not send the really complex kids to Australia first, then to the US?

So the US system is better at some big, complex things. How about small things?

This weekend my little Miss 2 presented with an angry rash. Our home medical centre was closed, so I packed Miss 2, Miss 4, and myself off to Wellington urgent care.

I’ve been to urgent care in the US, so I thought I knew what was coming. I packed my computer, DVDs, books, colouring pencils, toys, and food. I expected a four-hour adventure.

I’d made my first visit to American urgent care after picking up a hot charcoal briquette like a drunk dunce. I sat with a burning hand in the waiting room at UCLA. Several people came past with GSW. They got priority. Fair enough. Four hours later I went home, unseen.

I went a few times with Sophie, starting when she was 16 days old. She’d got out of hospital the day before, and promptly developed symptoms the specialists had told us to look out for. She was immune compromised, but it took an hour in the waiting area before we got a room, then four more hours before an overworked junior doctor sent us home, looking out for more of these same symptoms.

Other trips with Sophie got a bit better in terms of treatment – as parental Bolshie-levels rose towards 11 – but no better in terms of efficiency.

On all these occasions, there were complex insurance forms to fill out, and co-pays to pay or co-pays to argue about for months and then not pay.

Last weekend’s Wellington urgent care adventure wasn’t like that. At all. From leaving my house to getting home again was 57 minutes. I filled in one name/address-type form on arrival, then Miss 2 was seen by the nurse within 10 minutes of arriving, then 10 minutes later we saw the doctor. The doctor prescribed some antibiotics straight away, which I got filled in 5 minutes in the pharmacy next door.

No money changed hands.

And, even though some New Zealanders do pay to see the GP, we don’t pay as much as the “free” GP visits included with American health insurance plans, because the plan itself is massively expensive (average cost well over $1,000 a month for a family), and economists generally agree this is mainly money that would have otherwise gone into salary, especially for modest-wage workers.

I think our health system is better than the US’ for most people, but not for all people. But that’s no reason to ignore all lessons from the US, nor a reason to avoid all parts of the US system. Some of our sickest Kiwis need US-level care, and we’ve got the means to give it to them.

25

Protesting private prisons

by John Palethorpe

On May 2nd the Minister of Corrections, Sam Lotu-Iiga was interviewed on TV3’s The Nation about the opening of the new Wiri prison in South Auckland and its management by Serco.

A few weeks later the UN reported on concerns about the high level of inmate on inmate violence at Mt Eden corrections facility, as well as highlighting the over-representation of Maori within NZ’s prisons.

These percolated, and I wrote a post illustrating just some of the many failings outsourcing to Serco has produced. But last week I realised that maybe writing about it, or tweeting in an increasingly frantic style was not enough. Having attended many protests and demonstrations, I suddenly found myself organising one. The Facebook page for it can be found here.

The protest is, obviously, in response to the shocking details of the mismanagement of Mt Eden, revealed through leaked footage of violent incidents and accounts. There have been further allegations, both from families of injured or deceased inmates and in Parliament from MPs.

This evidence indicates both a troubling culture of violence within the facility and either wilful negligence or deliberate concealment of the facts by Serco. That this information has only come to light through leaks is in line with similar revelations of equally catastrophic mismanagement in other Serco run services in the UK and Australia. And while we’re beginning to talk about Serco, it’s definitely time for some action.

While the Corrections Chief Executive, Ray Smith, has invoked a ‘Step In’ clause to take control of the management of the prison, this further highlights the failures of privatisation. It is public servants who are being transferred from their own place of work in order to solve the problems that Serco have created, only for Serco to retain both the contracts for Mt Eden and the recently opened Wiri facility in South Auckland.

How the disruption of New Zealand’s publicly run prisons and the necessity of an investigation into brutal violence is a ‘cost saving’ is beyond explanation. For example, only 10% of Serco’s fee is performance-related and penalties for failing to effectively manage the prison cannot exceed 10% quarterly or annually. So, for their $30,000,000 a year, are New Zealanders getting the effective service they deserve?

The past week has seen the Minister of Corrections, Peseta Sam Lotu-Iiga, first deny a problem, then admit there might be a problem, then say there is a problem but it’s definitely not his fault and finally the Prime Minister trying to blame Labour for their role in revealing information about Serco’s failings.

The problem for the Government is that if they admit that Serco has failed in New Zealand, like they have in the UK and Australia, it raises serious questions about their competency in managing Wiri as well as excluding them from the mooted outsourcing of mental health and social care services. The issues here should obviously focus upon the appalling conditions within Mt Eden, but also raise serious questions about the alleged benefits of privatising essential public services.

In organising this action I seek to highlight the fallacy of attempting to run an essential, if relatively invisible, public service for profit. The role of corrections is to ensure that those in their care are denied their freedom, not their human rights. It is also to create an environment in which inmates are able to develop the skills and mentality to make a positive contribution to society upon their release.

The privatisation debate is framed by its advocates as the only option, with the cry of “We can’t just do nothing” in response to problems within state run public services. This creates the illusion that privatisation is progressive.

But it’s not progressive to make services more unaccountable and less effective. It’s also not progressive to pay your taxes, expect decent public services but instead fund the profit margin of a British company like Serco. The argument for quality public services where every dollar goes into effective service provision should not be seen as either regressive or radical. It’s just a reasonable expectation.

However, these are my views and mine alone. Others have been fighting for recognition of the problems of public and private prisons for far longer than I have, and it is not right for me to speak for them.

Those attending on Saturday will include family members of those within New Zealand’s prisons, established prison reform and prison abolition campaigners, MPs, activists and many others whose affiliation is simply to ensure that New Zealanders get an effective and humane prison service. There will be many views about the role and existence of prison present, all seeking to have their voices heard but all united in their belief that Serco and its like has no place in profiting from New Zealand’s prisons.

I have spent the last few days talking to different parties across the political spectrum and getting in touch with various interested groups to invite them along. This demonstration comes under no single political banner, because the issue of effective humane prisons as a public service is one which cannot and should not be claimed by one single political party. Public attention is focused both on Serco and the issues of privatisation, which need a serious and open debate. Now is the time to act.

See you Saturday.

Postscript

I would also like to thank everyone who has given me advice, constructive criticism and support so far. I’ve never organised anything like this before, and the warmth and empathy which has been expressed from so many different people and groups is humbling. And again, see you Saturday.

78

Too much to swallow on the TPP

by Rob Salmond

As Public Address readers will have seen, Labour has announced it will not support New Zealand joining the Trans-Pacific Partnership Agreement unless it meets five conditions:

  1. Protecting Pharmac
  2. No corporate litigation against NZ law changes
  3. NZ still allowed to restrict land sales to foreigners
  4. Te Tiriti upheld
  5. Meaningful gains for NZ farmers

David Farrar broadly agrees with these conditions, and even wants to add another:

  1. No changes to New Zealand IP laws that would hurt our internet experience.

Here’s my personal take on this: There is no way the TPPA will meet those five or six conditions. No way. That means Labour will be opposing, not supporting, the agreement that makes its way finally out of the smoke-filled room. And I think that is a good thing. Here’s why.

First, New Zealand has no credible bargaining chips on free trade. When we ask another country to make a concession, and they ask “or you’ll do what?,” we have no answer. That’s because New Zealand unilaterally dismantled most of its tariffs and other trade barriers in the 1990s, without asking for anything in return. Who was the author of such a self-defeating, masochistic exercise? Why, none other than MFAT’s trade negotiations surpemo of the time, one Tim Groser.

Now, thanks to Groser and friends, we show up at these negotiations with a long list of things we need, and nothing to trade for them. It’s like showing up naked to a strip poker game, or going to the store with a shopping list but no money. I’ve written academically about this error before.

That means when New Zealand turns up at the TPP and demands the agreement include this thing but exclude this other thing, the rest of the room has no incentive to pay attention. Countries, like people, respond to incentives. No incentive; no response.

Second, the agreement Labour and David Farrar is seeking, with…

  • no extra rights for Big Pharma or other firms harmed by our social legislation;
  • no extra rights for Americans with spare cash to invest globally;
  • no extra rights for American copyright holders;
  • but still with gains for our dairy farmers in the US, harming US farmers;

…is not the slightest bit palatable to the US Senate. If the agreement meets Labour’s bottom lines, it fails the Senate’s. It’s that simple.

Yes, it is possible there will be a TPPA agreement that the Senate can ratify, and that several other countries can ratify, too. But that agreement will not do what Labour needs, meaning Labour will inevitably end up opposing this deal.

I’m ultimately pleased about that, despite being an advocate, in general, of freer trade. That’s because this deal is not ultimately about creating freer trade; it is ultimately about restricting trade. Here’s Paul Krugman on this aspect of the TPPA:

In any case, the Pacific trade deal isn’t really about trade. Some already low tariffs would come down, but the main thrust of the proposed deal involves strengthening intellectual property rights — things like drug patents and movie copyrights — and changing the way companies and countries settle disputes. And it’s by no means clear that either of those changes is good for America.

On intellectual property: patents and copyrights are how we reward innovation. But do we need to increase those rewards at consumers’ expense? Big Pharma and Hollywood think so, but you can also see why, for example, Doctors Without Borders is worried that the deal would make medicines unaffordable in developing countries. That’s a serious concern, and it’s one that the pact’s supporters haven’t addressed in any satisfying way.

On dispute settlement: a leaked draft chapter shows that the deal would create a system under which multinational corporations could sue governments over alleged violations of the agreement, and have the cases judged by partially privatized tribunals. Critics like Senator Elizabeth Warren warn that this could compromise the independence of U.S. domestic policy — that these tribunals could, for example, be used to attack and undermine financial reform.

So I’m pretty clear that, given its current position, Labour will oppose the eventual TPPA text. The bigger question is: what will Labour do in government if it passes? Unraveling an agreement like this is massively harder than opposing it in the first place. Sadly, my own guess is that, if National saddles us with an agreement that does undermine our social legislation or our rights to regulate who owns our country, then Labour will be pretty much stuck with it.

Note: While Labour is a client of mine, I have played no part in formulating its position on the TPPA. This post represents my views alone.

30

The CERA transition that no one wants to talk about

by James Dann

At the end of last month, the government released the draft transition recovery plan, the most important document for the governance of the rebuild since 2011. While CERA was widely expected to wrap up when its powers expire in 2016, this document proposes a new entity, which will take on a number of the roles CERA had, as well as some of the special powers CERA had, until as far out as 2020.

Despite the significance of these proposals - it will require new legislation to go through parliament, something that hasn't happened since the previous bill in 2011 - the public has just 30 days to comment on it. And while they have an extensive communications department - now employing more than 7% of their total staff - CERA is not hosting a single meeting about the proposals. Not. One. Single. Meeting.

Reading the document, there are plenty of admissions that CERA's time is up:

International research shows that, for recovery to be sustainable in the long term, it needs to be ‘owned’ and led by local communities and institutions. Central government leadership and coordination of the recovery, through CERA, was needed in the immediate aftermath of the earthquakes, but the time has come for central government’s role in the recovery of greater Christchurch to evolve.

Yet the suggested new entity is almost a complete rejection of this. There is no ownership from local communities and institutions. The plan puts puts forward a government-controlled entity, with special powers for a further five years. It barely even hints at any alternative structures.

Of the options, a group of us have formed around Option 3+. This option puts control of the new entity back in the hands of the Christchurch City Council, with support from the Crown. We're not saying it's perfect, but of the limited options that we've being presented, it's the best.

If one of the other options is chosen, then the government will continue to loom large over the Council until 2020. That's this council term, the next council term, and the council term after that. If you consider that alongside the decision to extend the reign of the commissioners at ECan until 2019, you can see that there is something of a democratic deficit here in Canterbury.

So what can we do about this? Well, we're been trying. Myself, Barnaby, Ryan and Emma edited a book about the recovery, which came out almost a year ago. This Saturday, we're hosting a "recovery clinic", where people can come down to a pub and talk about city-making. We're going to encourage people to make a submission too. We're running an Option 3+ public meeting next Tuesday at the Physics Room. We'll be explaining what the situation is, what you can do about it and why you should care. 

But this isn't just about people in Christchurch. We know that the rest of the country is totally over hearing about Christchurch. This is the most dangerous time for us now. Apathy from the rest of the country is what will enable the government to assume that they can do whatever they want down here.

Next thing you know, we will have been forced to sell off our productive, strategic assets - the port, airport and the lines company - whilst being hit with the bill for a stadium we can't afford, and roads that the government have squirmed out of paying for. Economists are saying that the rebuild activity has "peaked", and we still have whole city blocks that look like something out of the Balkan conflict.

People here are exhausted. They've been trying to sort their houses, their streets, their jobs and their families for going on five years now. When we get together in the same room, we know that things aren't right, but it's hard to pick one issue as it's difficult to say what is the most wrong.

But this submission process is open to all New Zealanders, and I'm asking for your help. If we can get thousands of submissions flowing in on these proposals, then the government and the Minister will know that this isn't acceptable. It's a long shot, but given how disenfranchised we've become from the powers who control this city, it's our best shot.

Submissions close at 5pm, next Thursday (the 30th of July). You can submit via the form on the CERA website, their Facebook page, via email or snail mail.

99

What I learned in Class: Should Labour go after the "Bogan Vote"?

by Dave Snell

On July 20 Chris Trotter raised a very poignant (for Labour anyway) issue: “Should Labour go after the Bogan Vote?”

Because I’m on everyone’s rolodex whenever the dreaded ‘B-word’ is uttered, the message was passed along, and I was encouraged to provide a response. I do not have the political experience of Chris but there is one thing I know and that’s Bogans. I am one myself.

I am also one of those who grew up in the 80s and 90s. Dad voted Labour and Mum voted Labour. That was until Douglas eventuated. Now, neither disclose who they vote for, but I have a firm suspicion that it’s Winston Peters. But I’ll get to that. Overall, I want to thank Chris for his column, as it’s been very thought-provoking and sparked further thinking in an area I’ve been meaning to get to.

First and foremost, there is some initial clarification needed. Being a Bogan is not based on deficit. Perhaps it is due to academic thinking on subcultural groups such as Bogans, typified by the work of academics in the Birmingham tradition such as Hall in Resistance through Rituals, which conceptualised youth cultures as a way for young people to support each other due to class subordination. Their so-called deviant behaviour was viewed as a reaction of working-class youth to structural changes in post-war Britain.

The Birmingham tradition of sub-cultural research is hugely influential to this day, including further research in the 1970s concerning subcultures such as Mods, Rockers, and Skinheads. Chris’s column is reminiscent of this thinking, in his suggestions that Bogans are a response of sorts to Labour’s economic changes in the 1980s, vis-a-vis Roger Douglas.

I am not a political scientist. While more research would be needed in the area before a definitive statement could be made, I will say that working class is not a dirty term. The working class have marketable skills; they build your houses, they fix your car, and they replace that o-ring in the tap in your kitchen sink which you really should have done yourself.

They rent a room and not a house because it means more money to buy that gearbox they wanted. They lack tertiary qualifications not because of a lack of intelligence, but because you don’t need a doctorate to get a job as a mechanic when a certificate will do – a job that they enjoy and gives access to a decent work space.

The problem with the Birmingham tradition was that it portrayed subcultural groups as unwitting dupes or victims who banded together due to a lack of voice. While the Birmingham tradition provides a useful base for research into such groups, to apply such thinking to more modern communities silences those the research purports to give voice to. The Bogan, and by extension the working class, are not victims in a modern sense.

Instead Bogans choose this identity. Mateship is not due to a lack of social connections elsewhere. Social connections are due to their sharing a way of being and associated interests with others. Breaking from the Birmingham mould, they aren’t formed out of a lack of, or as a replacement of something, but as a social process that other groups share.

Bogans value friendships because they are a way of sharing their interest with others. Be that Heavy Metal music, cars, drinking, violent action movies or other working class pursuits that are typically frowned upon by a significant proportion of traditional psychologists. Loyalty is important to a Bogan because those social connections are a strong, positive force in themselves. They are not a replacement that brings us up to functional standards but are instead an addition.

A Bogan never struggles to make social connections. They make them easily, and these connections last for life. Loyalty is an enviable quality that Bogans possess. It’s also important to note that the Bogan is not necessarily a man. The Bogan woman has already read what I’ve previously written and made a mental note to tell me to make proper reference to their gender next time.

All this means that to be a Bogan is not to be on the downward skids of life. It is to be comfortable in your surroundings, to be able to provide for loved ones, and to still have money left over for a new gearbox or a new beer box. Their skills are much needed, but sadly go unrecognised.

And this leads me to the point of the column which is whether Labour should chase the Bogan vote. The answer is, frustratingly, ‘perhaps’. But it’s going to be a very hard sell, and not for the reasons people might think.

It’s not that the Bogans don’t trust Labour due to Douglas. The reason is because Bogans don’t trust politicians at all. They are sort of apolitical. This isn’t due to a lack of awareness or responsibility or an envy of social mobility. A Bogan can quite happily discuss political issues and comment on topics presented in the media. If a voting ballot had a “No Confidence” box, a Bogan would prefer to tick that box.

In a turning of the tables, instead of being the one without transferable skills, a Bogan sees a politician as having no redeeming value to society. A Bogan’s strong sense of loyalty and mateship means that to betray that loyalty or to be self-serving and prone to rhetoric is to be rejected. A Bogan is good with their hands and is very practical-minded, so talking in abstraction leads to rejection.

This would indeed seem to lend itself to a party or politician with working class roots, but would extend beyond a union background. To have a working class background is not enough, as the voice of the Bogans would have to be someone without any form of political background. Toeing the party line is not in our vocabulary, and any voice’s first responsibility would be to the Bogans they represent. Not to the political party. A Bogan politician would then be an oxymoron, and could only really ever be an independent. Politicians are viewed as having their party’s interests at heart first, not the people’s.

The mainstream news media only confirm this belief of the worthlessness of politicians, with stories of who is wearing what scarf or pulling whose ponytail. Political pundits are guilty too, using labels or groups that are in vogue, to try and make opinion columns more relevant and entertaining. But in the process they quickly forget that they are talking about real people and not theoretical abstractions.

The Bogan leaves the political circus to the clowns. This could explain the resurgence of the previously mentioned Winston Peters. Bogans respect a person who attacks politicians. A slogan like “Keeping them Honest” resonates strongly with a Bogan’s values. Beyond that, a Bogan’s political views are their own.

So good luck to Labour, or to any other political party, but before you chase the Bogan vote you have to prove the worth of politicians in general first. And that’s a steep uphill battle that will not be achieved prior to the next election.

So thanks Chris for the column, I thoroughly enjoyed it. But, and this may be your point, the system is not set up in a way that Bogans can make use of easily. So we’ll continue to sit on the fringes, using what voices we have to keep saying “No,” regardless of which party comes a courtin’.

And please, never compare us to Juggalos again.

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 Dr Dave Snell has a PhD in Boganology from Waikato University, and he and his Bogan cohort feature in the new TV show Bogans, coming soon to TV2.