Hard News: John Key(nesian)
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We're going around in circles here.
So how 'bout, put a billion into education from school entrance level thus encouraging good health. Aside of that, A programme was introduced at Middlemore to educate outpatients regarding diet (combating obesity and diabetes) and what was discovered was that Supermarkets in south Auckland had inferior product to other parts of Auckland which is a whole other kettle of fish.
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Ahem, Kyle, please remember that there's more to it than "being sick or having injuries." Disability is correlated hugely with age - 87% of over 85 year olds are disabled in some way. That's not to say they aren't also fit and healthy - the concepts are not mutually exclusive unless you're thinking like an old-fashioned medico. Disability has always been a normal part of ageing, and of life for that matter.
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Take your complaint to the smoking advert brigade though, I'm not the one putting them on. Personally I know smokers, and ex-smokers, who think the adverts are good
And I know some who buy a nice tin cigarette can and fastforward through the ads on their MySky. My anecdata cancels out your anecdata!
I'm talking about 'shaming', not 'education'. There's a line to be drawn. Education good: shaming bad.
the non athlete would be quite visibly obese
I note that the Wikipedia article on BMI says that it is not useful for: individuals who are not sedentary; athletes; children; the elderly; the infirm; and individuals who are naturally endomorphic or ectomorphic (people who don't have a medium frame). Oh. Well, that means it's relevant to about four people, then... let's keep using it! That'll work!
And who among us does not see the slippery slope from what is being proposed here and the refusal to cure people who make bad personal choices?
Which... shudder. Apparently we're heading this way: shun the smokers, the fatties, the older peeps, the druggies! Let all who pass through the public health system be morally and bodily pure, lest we all be contaminated by their lungs and their fat and their oldness and their less-than-perfect exercising patterns!
Look, I think if we have a public health system, we *have a public health system*. No exceptions. Even if you think they made 'bad choices'. Even if you think they're horrible people. Even if you, personally, would not have them over for afternoon tea. That's what public health systems are about, dammit. By all means educate people. Help them. Be preventative out the wazoo. But denying them care is a bridge too far for me.
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What Danielle says.
My mother has polymyalgia rheumatica and severe osteoarthritis: she takes medication for those conditions as well as pills for high blood pressure, and a mild cardiac condition. She is - otherwise- a fit & mentally healthy 80+ person who is the centre & matriarch of a very large whanau. Take her away, and the centre does not hold: a lot of us will spin off and die-
relationships - whanaukataka- the extraordinary social fabric that connects almost all of us -that silkworms/spiderwebs us all - the connectivity of being a human animal among human and other animals- is
lifewise government would enhance this: stupid & predatory government would do what alpha hooting males have always done- go get grab rape and pillage for temporary immediate indivuualistic gain - and to hell with tomorrow-
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Absolutely what Danielle and Islander just said. Let's hear it for some humanity. Otherwise, this way robots be.
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I'm talking about 'shaming', not 'education'. There's a line to be drawn. Education good: shaming bad.
OK, well you'll be bagging someone else then for how they spend their billion dollars. Cause I pretty clearly was talking about education.
Disability is correlated hugely with age - 87% of over 85 year olds are disabled in some way. That's not to say they aren't also fit and healthy - the concepts are not mutually exclusive unless you're thinking like an old-fashioned medico. Disability has always been a normal part of ageing, and of life for that matter.
I'm not sure what your argument is. Because people might end up with a disability anyway, they shouldn't be physically healthy in old age? Surely it's better to have one of those problems than both of them?
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Kyle, I'm with you on the value of investing in good health.
I'm saying it's not 'being old' that costs a lot of money, it's being sick or having injuries.
I was pointing out that disability is not the same as health, and that it does have significant costs that increase with age - hence my proposal for it to be insurance funded to cope with our ageing population.
I was leaving the billion for something else, and I like the sound of grass roots public health interventions. I also like the idea of well-organised entrepreneurship courses in secondary and tertiary education settings, focused on social as well as business innovation.
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WH,
I'm not sure that Key can meaningfully be described as a Keynesian on the basis of his speech to the conference, except to the extent that we all might be described as Keynesians now.
The emphasis on infrastructure is hard to dislike, but that doesn't make him a Keynesian.
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The emphasis on infrastructure is hard to dislike, but that doesn't make him a Keynesian.
Sure but it's a great play on words though... and there's ring of truth, borrow and spend out of recession. I guess the issue is at what point in the economic cycle you splurge compared with when you're a parismonious bastard?
I'd still like to know how roads will increase our trade intensity; if we don't have a debt problem, we sure as hell have a trade problem and I'm not yet sure how re-tarmacing SH1 is going to fix that?
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Cause I pretty clearly was talking about education.
Except when shame has value sometimes, as you said earlier?
I don't disagree with your main idea at all, actually. I just think it would have to be quite carefully administered. Lots of guidelines and regulations. It's quite easy to become Judgey McShamingpants - I know, I've done it myself. I'm sure we all have.
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On the not treating smokers thing, I see no great issue in refusing elective surgery to smokers. Their recovery takes longer, the risks of post-operative complications are higher. It's a consequence of nicotine's properties as a vaso-constrictor, plus all the other things that smoking does to the body, and I don't accept that a person's choice should then require the health system to pay extra for something that's not medically required.
By all means treat their urgent conditions, just as any non-smoker would be treated, but when there's free help available to assist with quitting there's no compelling reason why smokers should be allowed to consume limited health resources. -
there's no compelling reason why smokers should be allowed to consume limited health resources.
There's no compelling reason why health resources should be limited. It's a political decision.
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there's no compelling reason why smokers should be allowed to consume limited health resources
OK, fine. How about prioritising people who don't smoke ahead of those who do? There's an incentive for them to quit. But refusing care altogether... these are *people*, with lives and families and friends, who happen to smoke, not 'smokers'. It's dehumanising to define them by that one characteristic. What if that elective surgery means that they have the ability to look after their grandchildren, and before they were basically immobilised? How much 'value' does that have?
I don't accept that a person's choice should then require the health system to pay extra
And there's the rub: there will *always be choices people make that require the health system to pay extra*. It's the very nature of the system. You choose to run a red light and have an accident at an intersection: we could have avoided that cost too. Do we refuse care - say, physio, not urgent surgery or something - because the person ran a red light and it's their own fault? Of course not.
Basically: I say screw this 'why should I pay with my taxes because those people aren't as awesome as I am?' libertarian-lite-ism.
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OK, fine. How about prioritising people who don't smoke ahead of those who do? There's an incentive for them to quit.
I don't accept that either. And besides, how do you police that? And who's to say that butter doesn't kill or disable more people than cigarettes? "I'm sorry, sir, but I saw you eating an eclair for breakfast on your way here, we'll have to cancel your heart transplant."
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go get grab rape and pillage for temporary immediate indivuualistic gain - and to hell with tomorrow-
Is that National's new campaign motto?
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"I'm sorry, sir, but I saw you eating an eclair for breakfast on your way here, we'll have to cancel your heart transplant."
Or how about telling Jonah Lomu that he wasn't going to have a perfectly good liver wasted on him unless he promised to stop playing rugby, and he refused to do so he could just drop dead or spend the rest of his life in a wheelchair and good riddance?
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Or how about telling Jonah Lomu that he wasn't going to have a perfectly good liver wasted on him unless he promised to stop playing rugby
Quite, although the sports person association game leads me to what I think was an acceptable case of discrimination: George Best got a liver transplant, kept boozing, destroyed his new liver and was refused another.
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I don't accept that either.
Well, in a perfect world, nor do I. But I'm just trying to compromise with our anti-smoker friends, given our current health budget... you do make a good point with the butter, though.
George Best got a liver transplant, kept boozing, destroyed his new liver and was refused another.
See also John Phillips of The Mamas and the Papas:
In the 1990s, his years of addiction took hold; he had a liver transplant in 1992. Several months later, Phillips was photographed drinking alcohol in a bar in Palm Springs, California, as published in the National Enquirer newspaper. Phillips was questioned about the photo on the Howard Stern radio show, saying "I was just trying to 'break in' the new liver".
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__I don't accept that either.__
Well, in a perfect world, nor do I. But I'm just trying to compromise with our anti-smoker friends, given our current health budget...
Don't compromise, this notion that we cannot deliver social justice because of our limited resources is getting way out of hand - we are going into a general election with both main parties both promising to cut taxes, for Pete's sake. The madness has got to stop.
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Except when shame has value sometimes, as you said earlier?
No, Craig said my billion dollar plan was about shame, I said that while I think that can have value, that's not what my plan is about at all.
So yes I was talking about education, someone accused me of going for the shame game, which I said I wasn't doing.
Man, most controversial-for-things-it-isn't billion dollar plan I've ever suggested.
Personally I'd be horrified if health care providers stopped treating smokers just because they'd made a choice, particularly given the information that we have about marketing of cigarettes and controlling the addictive nature by tobacco companies.
Hence my billion dollar plan to try and support people making choices that don't lead to those consequences - that are good for them, and for us. Tick Kyles-Billion-Dollar-Plan on Election Day, for a healthier community.
There's lots of choices that people make which lead to them requiring medical care. Various sports and recreational activities, some of which don't pay their way at all (unlike smoking which I believe mostly does pay for its own health care costs).
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{unlike smoking which I believe mostly does pay for its own health care costs)
Current tobacco tax revenues amount to approximately $1 billion per year, and have been at that level for some years. This is just under 2 percent of total tax revenues.
- Of the approximate $1.6 billion per year retail spending on tobacco products, approximately 70 percent is tax revenue, including GST as well as tobacco excises.
- Thus, the average amount spent by New Zealand’s 750,000 smokers is approximately $2,135 each per year and approximately $1,500 is tax revenue.
NZ Medical Association, Tobacco Taxation In New Zealand, November 2007The cost of smoking-related health care to the New Zealand taxpayer is about $250 million.
The Cancer Society, Cancer Society of New Zealand Inc September 2004 -
There ya go. It's a profit-making exercise for the government, and they still discourage it. Crazy.
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And who's to say that butter doesn't kill or disable more people than cigarettes?
That wasn't my point. My point was that smoking does bad things for the body's ability to cope with surgery. Reduced lung function, reduced peripheral blood flow, etc. All those known results of being a smoker mean that surgery is riskier and lead to longer recovery.
If you can point me to a study that says that butter does similar things, then I'll add it to my list of "sins" for which elective surgery (note elective surgery, not medically-indicated surgery) should be deferred/denied. -
The cost of smoking-related health care to the New Zealand taxpayer is about $250 million.
What about the economic cost of all the tens-of-thousands of lost hours spent on smoking breaks? Or the lost output of smokers who get seriously sick? I'd love to know what the secondary costs of smoking are, because I bet that the $250m looks decidedly piddling by comparison.
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Matthew, we get it: they are not, under any circumstances, to be forgiven for their failing, and are therefore lesser humans. Let the shunning commence!
I think that cutting people some slack might be nice once in a while. None of us are perfect.
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