How the dementia tax will become a blueprint for the NHS

One of my earliest school memories is of a teacher whose oft-repeated mantra to pupils whining about the equity of any issue was, “life isn’t fair. The quicker you get used to it, the better”.

Perhaps that was easier to learn when raised in connection with something trivial; but the wider lesson stands whatever the circumstances. If the debate provoked by Theresa May’s new social care policy serves only to bring in to sharp focus the fact that life is a lottery, it will have achieved something.

But I suspect that its legacy will be much broader than that. What is being mooted over dementia seems to me likely to become the solution to what has become known as the crisis in funding in the NHS.

I am not suggesting it will be popular. The idea that you can have built something up all your life that you wish to pass on to your children, only to see its value whittled away by the need to pay for social care if you suffer from dementia, is objectionable to many.

But the harsh reality of it, as Will Hutton pointed out in the Observer over the weekend, is it means “the spoils of undeserved brute good luck will pay for the costs of undeserved brute bad luck – and the state gets resources it otherwise would not”.

Brute bad luck indeed. The hypothetical example of two families with identical houses is laid out by Libby Purves in the Times. The offspring of parents who die suddenly inherit everything, while “next door’s oldster lingers on for a decade needing care from the state”, and the children’s inheritance dwindles to a hundred grand. The unfairness of life is laid bare, but as Purves points out, “if you are wistfully hoping your parents drop dead quickly to make you richer, you don’t deserve anything.”

The trouble is that once you have accepted the premise, the question surely becomes why you single out one disease over another. As Jeremy Hughes of the Alzheimer’s Society wrote recently to the Times, “In the lottery of life, people with dementia remain the principal victims, forced to spend hundreds of thousands on care — unlike those who develop cancer.”

Dominic Lawson’s forthright response in today’s Daily Mail, arguing from tragic (and multiple) personal experience that families “laid waste by cancer” can hardly be called “the winners in the ‘lottery of life'”, is hard to dispute. But competitive diseasing and death, which would have a touch of the Monty Python about it were it not so tragic, can be looked at from the other side of the telescope. Far from being a reason not to introduce the solution mooted to address social care, the Hutton balance could surely be looked at more widely as a means of addressing more generally scarce resource.

Many will doubtless point out the cruelty if families that are ravaged by disease should find themselves stripped of their assets to pay for the care that is required to address it – a cruelty exacerbated, presumably, the more you have to lose. But if life’s a lottery, then it is hard to see how the right place to draw the line is at dementia, rather than generally at the affordability of care. It is unquestionnable that up to a point, alleviating suffering is easier, the wealthier you are. Undeserved brute luck is surely the point, either way.

Why everyone hates Maria Sharapova

On a day when Donald Trump has done his best to remind people of the old adage that it isn’t the original act but the cover-up that does for your reputation in the end, I see that Andy Murray has stepped in with his tuppence-worth about Maria Sharapova and her wildcard in Birmingham.  The decision by the LTA to grant her one has, he says, “been a very divisive subject. Some people think it’s absolutely fine, some people think that it isn’t.”

To a degree. But what seems to have been missing from the Sharapova debate is that while it looks on the face of it to be all about drugs, in reality it is nothing of the sort. As with Trump, it’s all about the cover up. Or more specifically, it’s about the fact that Sharapova is in that group of people that seems to think the world is so stupid that they can just make anything they like up and we will all believe it.

To recap: Sharapova was banned for two years for using meldonium – a substance which had been legal for years and then suddenly wasn’t. Too blasé to notice that the rules had changed, and clearly surrounded by a support team which like her lacked attention to this particular detail, Sharapova carried on taking it after she wasn’t allowed to. She got caught.

Had she stuck her hands up at that point and said what was true, the tennis world might have forgiven her as soon as her ban had been served. “I’m sorry. Like many others, I’ve taken this stuff for years while it was a legal substance, because it gives me a bit of an edge. In the same way that some people are sharper when they take caffeine, and therefore do so within the allowable limits, I’ve taken meldonium. I was an idiot for not realising that the legal status of the drug had changed, and I hold my hands up to that. Equally let’s not pretend that my taking it for years before that moment was for some other random medical reason lacking all credibility that I might disingenuously make up. I took it because elite sport is competitive, and as all leading sportsmen know, you take any legal competitive edge if you want to get to the top.”

But that’s not what she said. Instead, she blatantly made up a pack of lies and expected the world to swallow it. She told everyone that her taking the substance was “unintentional” and that she had not tried to use a “performance-enhancing substance”.

So the reason that people hate Maria Sharapova is not that, as Eugenie Bouchard put it, she’s a “cheater”. It’s because her dishonesty takes us all for mugs.

Burke on Twitter

Love this line from Daniel Hannan:

If ever you find yourself confusing social media with public opinion, look at what Edmund Burke had to say about Twitter back in 1791:

Because half-a-dozen grasshoppers under a fern make the field ring with their importunate chink, whilst thousands of great cattle, reposed beneath the shadow of the British oak, chew the cud and are silent, pray do not imagine that those who make the noise are the only inhabitants of the field.

Source: Brexit is happening – so let’s all cheer up about it – CapX

US GDP/Debt ratio predicted to hit 150%!

Federal debt levels are going to surge to 150% of GDP in 30 years as a result of huge unfunded outlays on healthcare, social security and interest payments, according to the US Congressional Budget Office, which is an independent body.

Other than now (when is is 77% – double what it was (35%) in 2007) only once has the level of debt in America exceeded 70% – and that was immediately after World War II. Over the last 50 years, it has averaged 40%.

There are lots of reasons why that’s problematic, not least of which is that it severely limits the government’s ability to respond to unforeseen events and cannibalises government spending which has instead to be ear-marked for interest payments. It also reduces national income.

Matt Ridley nails it

We can and must make an offer to the fundamentalist Muslims: abandon your political ambitions and become a religion as this has come to be understood elsewhere in an increasingly diverse and tolerant world — a private moral code, a way of life, a philosophy — and you will find the rest of us to be friends. But threaten the hard-won political, intellectual and physical freedoms now accorded to every man and woman, yes even and especially women, in our essentially secular society and you will be resisted and, pray god, defeated.

Source: Stand up for our right to criticise Islam | Comment | The Times & The Sunday Times

The Budget debate explodes a myth

Perhaps the most interesting thing about the debate on the increase in National Insurance Contributions for the self-employed is that it lays bare the lie that people are happier to pay more tax to fund the NHS.

In December, the Guardian reported Lib Dem leader Tim Farron highlighting research from October by ITV News that suggested that 70% of people would “happily pay an extra 1p in every pound if that money was guaranteed to go to the NHS”, while almost half of the 1,000 people surveyed said that they would even pay an extra 2p in the £.

Where are these people now?  A 2p in the £ increase suggested for a sub-section of people (a sub-section, don’t forget that currently pays less than those who are employed by firms to do the same jobs, and who will still pay less even after this increase) has led to all hell breaking loose. It seems the reality is that people want more money to go into the NHS, only so long as someone else is providing it.

The extent to which that is true could be heard clearly on last night’s Question Time, where repeatedly people commented on the fact that it should be ‘the rich’ who pay more. The trouble with that is that ‘the rich’ is nearly always defined by people as ‘those who are richer than me’.

You disagree? Then tell me this: what price do you consider is a fair one for people to pay for better services and better healthcare, assuming for a moment that it is true that both are created simply by finding more money to fund them?

I’m not an accountant, but bearing in mind the personal allowance of £11,000, it seems to me that the 2% rise in National Insurance contributions for someone earning £15,000 a year will mean an additional bill of around £80 a year, or £1.30 a week. The same thing for someone earning £40,000 a year means a bill of £580 a year, or £10 a week. And if you’re earning £100,000+, your bill will go up by £1,800 a year, or just shy of £35 a week.

Can we all accept that if you are earning £100K a year, you can afford to lose £35 a week? I suspect that we can (although admittedly I know people who would debate it – the same people who don’t look at their restaurant bill twice and wouldn’t notice if they’d been charged for the wrong bottle of wine).

I wouldn’t argue with the £40,000 earners who say that they are a long way from being wealthy even if they are approaching the top band of income tax, but it seems unlikely that they would think twice about spending £10 a week on something that they really wanted. It is, after all, the price of a (bought-in-a-shop) cup of coffee a day, and a lot less than they will be spending regularly on things they would regard as less important than their health. Having to fork out £10 a week more than currently will be annoying, but hardly unmanageable.

For the £15,000 earner life is tough: they are not earning a lot, by any yardstick, and the difference here of £1.30 a week may well make a difference when finances are tight.  But there are lots of people in this bracket out there, and presumably they were included in the 1,000 people survey, where nearly half of those polled said they would be happy to pay.

The NIC debate of the last two days might be couched in terms of a broken manifesto commitment, but let’s be honest: what proportion of people knew it was before that became the narrative? How many people voted the Government in on the basis of it? The notion being touted is that the Treasury didn’t even realise, so what price the idea that the person on the street did?

The debate might also be sidetracked by arguments about how self-employed people have none of the safety net of working for a firm – although interestingly, that doesn’t exactly loom large in the ONS’s study of self-employment trends.

And equally, plenty will seek to debate whether it is ‘bad politics’, but again, that is a different argument (to which an obvious counter would be that the bad politics was making the commitment in the first place).

The reality is that the argument about the Budget explodes a myth, which is this: when people say, “I’d be prepared to pay more to fund the NHS and/or social care,” they don’t actually mean it – and we know that because when they get it, they object. They argue in favour of a hypothecated tax for social care, but this is as close to a hypothecated tax for social care as we can get: £2bn being raised from a change in NIC contributions on the same day as £2bn extra was announced for social care. And people really, really don’t like it.

So the narrative that politicians are slippery and change their minds is a nonsense when you consider the fact that the public is far, far worse. Asked by pollsters in October about a policy, people were overwhelmingly in favour.

But in March, when it has become clear that that same policy will actually affect them as individuals, on top of being paid by others, they’ve changed their minds.

 

(This article was published on Spectator Coffee House today)

Anderson, post-Burke

These days, far too many MPs seem to believe that they are a walking opinion poll. Their constituents think this, and they must be right. We need more MPs who are happy to say: “Although a majority of my constituents appear to think this, they are wrong, as I hope to persuade them. If I fail, they may choose to sack me: that is their prerogative. But I will not change my mind.” An MP who did speak in such terms might be pleasantly surprised by the respect it earned him, especially if he were from Yorkshire. “He’s a cussed bugger, right enough – but he’s our cussed bugger.”

Bruce Anderson

Source: The Lords may be flawed, but it should be heard on Brexit – Reaction

Trump’s Russia policy

Trump may attempt an abrupt reconciliation with Russia that would dramatically reverse the policies of President Barack Obama. It is hard to overstate the lasting damage that such a move would do to the U.S. relationship with Europe, to the security of the continent, and to an already fraying international order.

As Trump will likely discover, reality has a way of interfering with attempts to transform relations with Moscow. Every U.S. president from Bill Clinton on has entered office attempting to do precisely that, and each has seen his effort fail. Clinton’s endeavor to ease tensions fell apart over NATO expansion, the Balkan wars, and Russian intervention in Chechnya; George W. Bush’s collapsed after the 2008 Russian-Georgian war; and Obama’s ran aground in Ukraine. Each administration encountered the same obstacles: Russia’s transactional approach to foreign policy, its claim to a sphere of influence, its deep insecurities about a yawning power gap between it and the United States, and its opposition to what it saw as Western encroachment. Finding common ground on these issues will be difficult.

The difference between the US and Russia

We forget the difference between our societies and Russia’s at our peril. In Putin’s very first year in power, when a Russian submarine sank in the Barents Sea, the Russian leader refused to leave his Crimean vacation spot to go to the scene, even though the crew was still alive, trapped deep in the abyss for several days. Putin eventually arrived ten days after the accident to talk to wives and mothers, by which time all on board the sub were dead. Asked on CNN’s Larry King Live what had happened, Putin quipped with a smirk: “It sank”. Seventeen years later, this man is still the undisputed leader of his country.

Chad Nagle

Source: Russia, Iran, and the demise of Michael Flynn – Reaction

London’s air quality is getting better, not worse

Do you think London’s air quality is better or worse than 20 years ago? Most people would answer “worse”, but they would be wrong. London’s air quality, though bad, has been getting steadily better. The average concentration of particles 10 microns or smaller (known as PM10) is about 20 per cent less than it was 20 years ago and the average concentration of nitrogen dioxide is 30 per cent less.

Matt Ridley

Source: Dash for gas could solve the diesel crisis | Comment | The Times & The Sunday Times

Venezuela

Last year in Venezuela, imports collapsed by more than 50 per cent and the economy nosedived by 19 per cent. The budget deficit is around 20 per cent of GDP. Market distortions mean petrol is sold locally for less than one penny per litre. The country has a complex monetary arrangement that makes use of three different exchange rates simultaneously, feeding  rampant corruption: the President’s cronies can buy dollars from the state at ten bolivars a dollar but sell them at 3,300 bolivars a dollar on the black market. Price controls have made it unprofitable for small businesses to sell staple goods, leading to widespread shortages. Carjackings and kidnappings are now epidemic. Caracas’s murder rate is 80 times higher than
London’s.

Source: Britain under Corbyn? Just look at Venezuela

Business rates

Two takes on the increase in business rates:

Martin vander Weyer in the Spectator says that the idea that it can be defended because it is revenue neutral is bunkum. He writes, “a smarter calculation of ‘revenue neutrality’ would take account of profits generated, jobs created and benefits unclaimed in thriving towns and high streets. On that basis, the Treasury would be better off if there were no rises in business rates anywhere.”

But Tim Worstall on Cap-X believes that the increases make sense and the market should dictate: people who use less land, and less expensive land, should pay less tax than people who use more and more expensive. He believes we’re not converting empty pubs to houses and shops because of business rates, but because those alternative uses are more valued by the market in the first place.

Source: London Stock Exchange picked the wrong year for a pan-European merger and Why the Government is right to tax the high street

Don’t be a snowflake

John Stuart Mill diagnosed what today’s “snowflakes”, focused on no-platforming people who have views other than their own, are missing.

In On Liberty, he wrote: “The peculiar evil of silencing the expression of an opinion is that it is robbing the human race; posterity as well as the existing generation; those who dissent from the opinion, still more than those who hold it. If the opinion is right, they are deprived of the opportunity of exchanging error for truth: if wrong, they lose, what is almost as great a benefit, the clearer perception and livelier impression of truth, produced by its collision with error.”

Source: Students can’t be allowed to curb free speech | Comment | The Times & The Sunday Times

The alliance of the feminist left with Islam cannot last – Matt Ridley

One of the most surprising features of the modern world is the degree to which the left is making common cause with any religion, let alone one that is so dominated by socially conservative opinion and so frequently associated with discrimination against women and homosexuals.

Islamophobia is as great a crime as transphobia in the student world, and a greater one than criticism of Christianity or Judaism. You can mock Mormons all you like, and make a musical out of it, but woe betide you if you mock the Koran.

Consider the case of two women who have criticised each other recently. Guess which one has been no-platformed?

Ayaan Hirsi Ali is a Somali-born champion of women’s rights who suffered genital mutilation; escaped an arranged marriage by seeking asylum in Holland; left Islam; became a Dutch MP; and wrote a film whose director was murdered by an Islamist, the killer leaving a note pinned to his victim’s chest warning her that she would be next. She calls for an Islamic reformation.

Linda Sarsour is a hijab-wearing Muslim who defends Sharia, was one of the organisers of the Women’s March after Mr Trump’s inauguration and has since deleted a tweet in which she said she wished that she could “take away” Ms Hirsi Ali’s vagina.

In reply, Ms Hirsi Ali wrote: “There’s no principle that demeans, degrades and dehumanises women more than the principle of Sharia law. Linda Sarsour is a defender of that.”

Yet it was, incredibly, Ms Hirsi Ali who in 2014 was disinvited from receiving an honorary degree by Brandeis University. The episode revealed a deliberate attempt to portray criticism of Islam as equivalent to criticism of women or minorities.

Few feminists spoke up for her. “The concern,” blathered one, “is that her intervention into the issue of gender equality in Muslim societies will strengthen racism rather than weaken sexism.”

This alliance of the feminist left with Islam cannot last. Mr Trump’s crass travel ban may have breathed new life into it, but the tensions are growing and the audiences for the likes of Milo Yiannopoulos with them.

Matt Ridley

Source: Students can’t be allowed to curb free speech | Comment | The Times & The Sunday Times

Scotland, Brexit, and nightclubs

[Arguing that Scotland voted to stay in and would vote the same way if it knew that England was not going to stay in with it] is like saying that if four of five friends on a night out decide to go to a restaurant and the fifth expresses a wish to go clubbing, the person who disagreed would have wanted to go to the night club had she been on her own – or, even less likely, have left her friends to go to the club by herself.

Source: With Brexit negotiations beginning soon, we must challenge the myth that Britain remains a divided country | BrexitCentral

Bannon, by Gove

Bannon’s success has guaranteed him pride of place in the demonology of the liberal left and he’s been accused of every form of hate speech of which mankind is capable, including antisemitism. That allegation sits incongruously, to say the least, with his close personal friendship and political alliance with Kushner, who is an observant Orthodox Jew and a staunch Zionist. In person, Bannon is disconcertingly charming and he is clearly intellectually wide-ranging in his thinking, but for most in Washington his views, and his role in the Trump triumph, make him an irredeemably sulphurous character.

Michael Gove, in The Times

Source: What I found behind Trump’s showy façade | Times2 | The Times & The Sunday Times