Hard News: John Key(nesian)
236 Responses
First ←Older Page 1 … 5 6 7 8 9 10 Newer→ Last
-
And a complete thread-jack, won't it be nice when the weather is fit for doing this again:
-
Having slept on it, the persistent thing my mind would like to see an additional billion spent on is a program of R&D to develop a suitable electric car (maybe based on the Waikato University e-car?), deploy the necessary infrastructure and manufacturing capability for this vehicle and aim to replace all central and local government car fleets with by around 2025.
-
The experience of PPP here in the UK is that the private sector will only invest if the state takes on the vast majority of the risk inherent in the projects. This means the state gets left holding the baby and paying interest on it. How this benefits the state is beyond me.
PPP is driven primarily by national accounting rules. Under said rules if the private sector borrows money to build a school or a hospital then that borrowing does not impact on the nation's books. Whereas if the state borrowed the money (at vastly lower interest rates) to build the school or the hospital that debt is on its books.
So because of an accounting rule that could be changed, a slight of hand is effected. This slight of hand extracts much more money from the public purse than would have been the case. And this is a good thing?
That is all before we get into shoddy building, buildings under specc and since the private sector usually gets to run these things after they are built, slow and inadequate maintenance. The for eg hospital management can do nothing about this as they are not party to the contract. They just have to pay the cost of it.
Of course they could buy out the contract, but to do so they would have to compensate the holder for all those years of printing money they would have had....
Don't go there.
So that's two of us, both from the UK, both with direct experience of PPP's, both saying 'don't do it'.
Now, as this is PAS, clearly we're both filthy Reds who should go back to Russia, but does anyone want to make the case for PPP's
-
It is weird talking about female health issues because it's not something thats been discussed much (by the hairy gender at least). Actually is this a health issue or just accepting there is biology that women have that men don't , a difference that almost certainly makes them the superior gender.
I knew the other half was a keeper when I asked him to pick up some pads for me at the supermarket and he said "sure, but you'll have to tell me what size."
-
I knew the other half was a keeper when I asked him to pick up some pads for me at the supermarket and he said "sure, but you'll have to tell me what size."
We are instructed to give that answer during training.
-
I knew the other half was a keeper when I asked him to pick up some pads for me at the supermarket and he said "sure, but you'll have to tell me what size."
Heh... I know a lesbian couple who take a quite unseemly delight in sending their (male) flat mate out, when his turn comes around on the shopping rota, with a detailed list of "lady stuff". If your housemates aren't going to be a running river of harmless merriment, what use are they?
-
You're like a riding, talking advertisement for not commuting on a bike!
As I said to the ambo who rode in the back with me to the hospital, "I am the statistic." That in the context of me having also had a pedestrian (who's never going to do it again) dash out in front of me while I was coming through Newmarket 10 days prior.
Yes, it can be risky. But I've also had a bad run. Three accidents, two involving transport to hospital, in the space of 10 months is not good numbers. However, I commuted by bicycle over the exact same route for 18 months before that without incident. I'm careful, but sometimes shit happens (as with the latest one), and sometimes people are idiots who shouldn't be allowed near a road.
-
We are instructed to give that answer during training.
and were you told about the 6 inches thing as well :)
-
Three accidents, two involving transport to hospital, in the space of 10 months
Did you know you can get annual membership for St Johns ?Last I heard it 's about $60 per annum.I found them cost effective:)
-
and were you told about the 6 inches thing as well :)
Um... I must have missed a fair bit of this thread....
-
does no one here remember what it was like pre-ACC?
Simple example - in the middle of the 70's oil shock no one would carpool (or even give their friends a ride) to work because they were all dead scared of being sued if they had an accident
And with good reason. Going back to the heady days of Commercial Law 101 yet again, our introduction to torts included some of the personal injury cases brought back in the day, including a car pooling case. It wasn't just an abstract risk.
-
Did you know you can get annual membership for St Johns ?Last I heard it 's about $60 per annum.I found them cost effective:)
ACC is even more cost-effective ;)
St John charge the patient (or their family) for medical-related transports, since it's not covered by ACC. ACC does cover accident-related transports, so no invoices for me :) -
Can. Of. Worms. Wouldn't that just turn into another lovely game of 'Shame the Unworthy Smokers and Fatties'?
I'm not talking about public shaming.
I'm talking about a doctor and a community nurse coming and talking to your family about health issues, inside your home, working with you to set up an action plan to address issues which cause serious long term health problems, and then helping you put that plan in action. Regular contact with the community nurse and referral to specialist support (eg, nutritionist) where helpful.
Obesity, diabetes, smoking are all going to cost us billions down the track. If we can improve lifestyles 20 years earlier, we're going to save money overall, and have a much healthier country.
You could be put into the programme through your GP, who could even be the doctor in charge of it, it wouldn't cost you anything, and the government could call it an investment, which it actually would be.
If you could match it with a housing programme to improve insulation, heating, getting rid of damp etc it'd be even better.
-
Obesity, diabetes, smoking are all going to cost us billions down the track. If we can improve lifestyles 20 years earlier, we're going to save money overall, and have a much healthier country.
They already do, and that's before the current generation of ever-increasing-waists even makes it out of their teens. There are many benefits from keeping weight in check, including things like reduced need for joint replacements. Keeping active, which is encouraged both as a weight-control measure and as a result of being less overweight, helps bone density, too, which means that the risk of fractures in old age drops. Those two things alone could mean savings of eight or nine figures a year.
Then there's the secondary health impact of diabetes (extremity gangrene, blindness, renal failure...), which is, if anything, even more scary than the things that being overweight does directly. -
I'm talking about a doctor and a community nurse coming and talking to your family about health issues, inside your home, working with you to set up an action plan to address issues which cause serious long term health problems, and then helping you put that plan in action.
Heh. Yeah, that Health Posse coming up your garden path won't be embarrassing and horrible for anyone at all, will it?
All I'm saying is that it had better be a volunteer programme.
-
There are many benefits from keeping weight in check, including things like reduced need for joint replacements. Keeping active, which is encouraged both as a weight-control measure and as a result of being less overweight, helps bone density, too, which means that the risk of fractures in old age drops. Those two things alone could mean savings of eight or nine figures a year.
I am a little sceptical of this kind of bookkeeping, I must say. The overwhelming issue with excessive weight is the increased risky of early death due to cardiovascular disease. The way it often pans out is you're fine, suddenly you have a heart attack, you die. That is very sad but not at all costly for the health system. If you live a longer, healhier life, on the other hand, things are still bound to catch up with you eventually, and caring for people in their eighties and nineties is really expensive regardless of their medical history. So by all means let's encourage healthy habits, but can we try not to look at it in terms of being a good investment or a smart use or money?
-
You know that the average weight gain of people in the midst of the 'obesity epidemic' in the ZOMG FATTIES United States is 7-10 pounds over the last fifty years, right? Which includes an inch in average height, too.
And that the reason that so many millions of Americans are now 'obese' is because in 1998 the BMI measurement for 'obese' changed from 33 to 30, putting millions more people in that category without any of them gaining weight at all?
And that BMI is one of the world's dumbest measurements for overweight and obesity anyway, yet people keep using it because shaming fat people (most of whom already hate themselves and are yo-yo dieting like crazy, incidentally) is so much fun?
And that most of the time, it doesn't matter how little you eat or how much you exercise, it won't make you thinner long-term, and that actually, exercising moderately and eating 'right' (a 'diabetic diet' high in vegetables, lean meats and complex carbohydrates, basically) is far more healthy than arbitrarily dieting to some random 'ideal weight'?
You did know that? Oh good. :)
-
I'm not talking about public shaming.
Oh, of course you are Kyle -- and what's wrong with the idea of good old fashioned public 'shame' as a mechanism of social control? While it might prick liberal sensibilities to admit obstinate realities, it happens all the time. And it happens because it works.
-
The way it often pans out is you're fine, suddenly you have a heart attack, you die.
Or not. Heart attacks are often not fatal, they just put the patient into hospital for a few days, on medication for years (if not the rest of their life), and are expensive both because of the direct costs of pre- and post-discharge care and through the diminished economic output of the victim during recovery.
Joint replacements and fractures in the elderly are an expensive use of health resources. There are plenty of articles out there about how long the waiting lists are for joint replacements, and ask any orthopaedic nurse about how many of their patients are older people who fell over and broke something (often hips, but not always). The benefits of exercise in relation to bone density and general mobility are well-known. The extra stress that being overweight puts on joints is obvious, or ought to be. We're not robots, joints don't last forever.
-
And that BMI is one of the world's dumbest measurements for overweight and obesity anyway
Totally. When the whole All Black front row would be classed as obese, you know there's something wrong with the system being used.
However, there's also something wrong when school uniform stockists routinely carry (instead of specially ordering in) pants in sizes that could fit two of me. I'm not exactly rake-like, either. -
Oh, of course you are Kyle -- and what's wrong with the idea of good old fashioned public 'shame' as a mechanism of social control?
If we're going to shame people, we might as well combine a few things at once. Put them on bikes. That way we can combine the obesity panic with some good old fashioned environmental/climate change public guilt, and make all the liberals happy.
Seriously though, if we're throwing round ideas for a billion, the cost of a stretch of new motorway, why not spend it on giving partial or complete rebates for hundreds of thousands of bikes? I'm not talking racers or mountain bikes, however, those are for racing and climbing mountains.
-
So that's two of us, both from the UK, both with direct experience of PPP's, both saying 'don't do it'.
I'd not go that far myself. I think there's a couple of issues mixed up here, there's questions about what on earth Key means by giving the private sector a bigger role (and clearly he's said privatising ACC) and I'm guessing it means PPPs for infrastructure projects - I'd welcome a clarification. But secondly, there's issues about whether PPPs are a good idea or not?
On this second point, my limited experience and knowledge of PPPs for infrastructure is that they're a very mixed bag. There's a fair number of examples in Australia, though so not many in NSW, where PPPs have been successful but there's a few recurring problems which need consideration.
1. All the contractual terms should be on public record - not the case with the Cross City Tunnel (CCT) in Sydney.
2. They shouldn't be used to reduce competition i.e. not changing roading and public transport to "encourage" drivers to use the CCT.
3. The final issue relates to who's carrying the risk - Russell noted up thread that National's plan "offer a guaranteed return from the projects they fund", this means, under National's plan, that the public is. If there's one upside of the CCT project failure it's that at least the State government didn't inherit the risk.
Key needs to provide more details so that we can assess the merits of the policy and the specific approach only then can we make a determination on the merits of the policy. My concern is that his experience, and the ideology of the party, is the dominating influence and that any PPPs will expose the public balance sheet and/or reduce competition to ensure a private sector return.
-
Or not. Heart attacks are often not fatal, they just put the patient into hospital for a few days, on medication for years (if not the rest of their life), and are expensive both because of the direct costs of pre- and post-discharge care and through the diminished economic output of the victim during recovery.
See, I'm still highly sceptical. Consider that even if you fail to be killed by the first heart attack, chances are the second one will get you and that this is most likely to happen in early retirement, just at the time when you've stopped having an 'economic output' and have started receiving a state pension. Don't get me wrong, I'm all for preventative medicine and better habits leading to longer, healthier lives, but let's not kid ourselves that it's going to save us money - we've never spent more in health services and yet we're the healthiest we've ever been.
-
...the diminished economic output of the victim during recovery.
/
So by all means let's encourage healthy habits, but can we try not to look at it in terms of being a good investment or a smart use or money?
Using the word investment can sound a bit business-like. And at one level it is - the return is years of income and wealth-generating capacity to pay back the considerable public investment in education, health, etc. That can be permanently reduced, not just during a period of recovery.
It used to be that we covered the next generation's supporting expenditure as well as ours, but there has been some major cost-shifting by boomers over the last couple of decades so that both their parents and children's generations now pay for more of their own expenses (education fees, for instance).
At a more personal level, the payoff is quality of life, which is somewhat harder to quantify.
-
On this second point, my limited experience and knowledge of PPPs for infrastructure is that they're a very mixed bag. There's a fair number of examples in Australia, though so not many in NSW, where PPPs have been successful but there's a few recurring problems which need consideration.
As far as NSW is concerned, I'm awe-struck by one of the mysteries of the ages: How incompetent, sleazy or flat out weird does an Australian state government have to be to get handed an electoral pink slip? (Marginally less incompetent, sleazy or flat out weird than the opposition, I guess.) But while the CCT is, in my view and not having followed it in great detail, a textbook example of how NOT to run a PPP, it doesn't immediately follow that PPPs are a bad idea. That's like holding up the New Zealand Immigration Service or the Corrections Department-- which, again IMNSHO, lurches from tragedy to farce without pausing in between -- as proof that the Rand-i Krishnas are right.
Post your response…
This topic is closed.