The politics of death

Austerity kills. That’s the message of new research in the BMJ:

Spending constraints between 2010 and 2014 were associated with an estimated 45 368 (95% CI 34 530 to 56 206) higher than expected number of deaths compared with pre-2010 trends…. Projections to 2020 based on 2009-2014 trend was cumulatively linked to an estimated 152 141 (95% CI 134 597 and 169 685) additional deaths.

This is consistent with a point made recently by Danny Dorling:

For the first time in well over a century the health of people in England and Wales as measured by the most basic feature – life – has stopped improving…The most plausible explanation would blame the politics of austerity, which has had an excessive impact on the poor and the elderly; the withdrawal of care support to half a million elderly people that had taken place by 2013; the effect of a million fewer social care visits being carried out every year; the cuts to NHS budgets and its reorganisation as a result of the 2012 Health and Social Care Act; increased rates of bankruptcy and general decline in the quality of care homes; the rise in fuel poverty among the old; cuts to or removal of disability benefits. The stalling of life expectancy was the result of political choice.

It's also consistent with international evidence gathered by David Stuckler and Sanjay Basu; with Sarah O’Connor’s report of a “quietly unfolding health crisis” in deprived seaside towns such as Blackpool, and with the fact that benefit sanctions have driven people to suicide.

It’s obvious what the left’s reaction to this should be. But what about the right and centre’s?

There is an intelligent response. You could argue that all this is only part of the story. Christopher Ruhm, for example, has shown that austerity can improve health in other ways. If we’re not building houses, for example, fewer men die in accidents on building sites. Hard-up people can’t afford to smoke or drink themselves to death. And if we’re under-employed we’re less likely to suffer stress-related illnesses.

Alternatively, you could invoke the trolley problem. Maybe deaths from austerity are the lesser of two evils. If the alternative to austerity is higher taxes or higher debt, it could lead to lower future growth and hence less heath spending and more death in the long run. (I don’t believe this, but some Tories sincerely do).

Neither response, though, is what we get. Instead, when Aditya Chakrabortty said on Question Time last week that the government is “send[ing] disabled people to their deaths” the reaction was as if he’d spat in the church’s collection plate (9 mins in).

Which in a sense he had. Aditya had the bad manners to point out that politics is a matter of life and death - at least for the poor - thereby puncturing his audience’s illusion that it is just a cosy little debating game in which the only costs are that a few MPs move down the career ladder. I had hoped that the Grenfell disaster would destroy this illusion, but it seems the imbecilities of posh folk don’t die as quickly as do the poor.

Here, though, is the thing. The supposedly impartial BBC is complicit in this. Its politics coverage too often carries a matey undertone broken only when confronted by someone who has the temerity to challenge the privilege of the rich or to enter politics without being posh. And it gives disproportionate weight to inconsequential tittle-tattle. Priti Patel’s flight from Uganda last week was given the sort of coverage due to Churchill’s return from Yalta. I very much doubt if the BMJ’s report will get so much attention.

What we have here are two competing conceptions of politics: one which sees it as a serious matter of life and death, the other as a game among careerists. The BBC is not impartial between these, and therefore not impartial at all.  

Comments

[Rex_Oper]

A little honesty is needed when referencing Grenfell. Residents of the building were enjoying an average rent subsidy of £17,000 per annum per flat before any housing benefits were taken into account. That subsidy had increased over the years of austerity as "social" rents were held flat by the Cameron govt whilst market rents grew. I'm hardpressed to understand how a family receiving that much support from the state could be viewed as being under the cosh of austerity.

[Ben Jeffryes]

While it seems likely that austerity has had an effect, this really needs looking at in more detail as it is complicated. If you look at death rates by cohort (people born in the same year) there have been a number of years where the cohort have had low death rates on average. These people are dying off, and cohorts with higher than average death rates are now aging. Cohort effects seem to be ignored in the standard life-expectancy projections.

[Richard]

Rex Oper, surely Chris's point is that political choices can have fatal outcomes, as witnessed by what happened at Grenfell. During the renovation, alternative cladding with better fire resistance was rejected due to the cost. The council ignored the safety concerns expressed by residents.

[e]

@ Rex Oper
Where function denotes homes to rent or buy that are within the reach of a majority, what's honest about implying the existence of a functioning market with price signals of relevance?

[Dave Timoney]

@Rex, as Grenfell residents who were tenants of the local authority could not legally realise the market value of their utility, it is as meaningless to talk of it as a "subsidy" as it would be to describe a course of NHS chemotherapy in similar terms.

[Jim]

"Grenfell residents who were tenants of the local authority could not legally realise the market value of their utility, it is as meaningless to talk of it as a "subsidy""

So having a Mobility car provided for free is not a subsidy, because you can't sell the car for cash?

Don't be daft, having a place to live provided at below the market rate IS a subsidy, because the alternative is paying the market rate. Anything that is provided at a sub market rate is a subsidy. Subsidies are not just cash, they can be goods and services too (which the taxpayer has to pay full market rate for of course).

[gastro george]

Those pontificating about "market rates" and "subsidies" ought to think carefully about how a market is defined and structured, and who does the defining.

At the most simple level, a monopoly can set a price it likes. Is any price offered below that a subsidy?

Housing is not a free market. Politics has decided that the public sector are currently not allowed to build a significant number of houses - houses that could be built economically and generate a real return over the lifetime of those houses. So it can easily be argued that this decision grants the owners of scarce housing a subsidy by allowing them to raise their rents in the absence of fair competition.

[Amb]

“I'm hardpressed to understand how a family receiving that much support from the state could be viewed as being under the cosh of austerity.“

Rex- It’s encouraged mg that you can recognise your weaknesses.
The next stage, of course, is to press on and learn to understand.

[Chaiman LMAO]

@Rex_Oper "I'm hardpressed to understand how a family receiving that much support from the state could be viewed as being under the cosh of austerity."

Perhaps you are, but the point Chris was making was that political decisions killed people in their homes. Do you struggle with that point, rather than the whataboutery thing you are concentrating on?

[Jim]

" Chris was making was that political decisions killed people in their homes."

See, I think this is b*llocks.

The Grenfell Tower refurb committe had a choice between two sorts of cladding. One was better insulating (and cheaper) and one was more expensive and lesser insulating, and both (as far as everyone sat around the table knew) were perfectly safe. So how is the decision to go for the cheaper (and more 'green' don't forget) version a result of austerity? Do you automatically buy the most expensive version of everything regardless of its utility? I don't but then I don't have the ability to force other people to pay for my decisions via taxes.

The entire refurb was about £9m I think, and the saving from the choice of cladding was under £300k. (source: http://www.bbc.co.uk/news/uk-40453054). Finding a 3% cost saving on a project without putting the lives of the public at risk is something the State ought to be able to manage. If not, it should stop managing things.

[e]

@Jim “Finding a 3% cost saving...something the State ought to be able to manage.” Perhaps.
“If not, it should stop managing things.” But it has, that's the point. This is why you can say: “as far as everyone sat around the table knew”. The management of Grenfell Tower is in the doc; the political ideology which led to the management of building and fire regulations being farmed out needs to be there too, front and centre.

[Phil]

"the reaction was as if he’d spat in the church’s collection plate"

Stella Creasy's reaction was particularly instructive, hélas.

"if we’re under-employed we’re less likely to suffer stress-related illnesses."

Could you run that past me again? The feeling of not knowing where next month's money is coming from is certainly different from the feeling of having too many calls on your time, but I'm not sure it's any less stressful. Reminds me of a med student friend, just out of Cambridge, who told me blandly that the idea of a link between heart disease and stress had been debunked - because actually it was people in lower social categories who had more heart attacks, and obviously if stress was involved you'd expect it to be the other way round.

Jim - regarding 'subsidies' would you care to tackle the part of the sentence you cut off? Is chemotherapy - and NHS treatment in general - also a subsidy? How about the police - I never call them from one year's end to the next, my taxes must be subsidising people who use their services regularly. Or does the language of subsidies not really work when we're talking about universal services funded out of taxation and provided on the basis of need?

[Dave Timoney]

@Jim,

You're confusing a benefit with a subsidy. This is a classic rhetorical manoeuvre of the right because it suggests that all benefits have a market equivalent and can therefore be provided by the market.

A subsidy is only meaningful within a market because it is geared to a price (a characteristic of a subsidy is that it can be formally accounted for as a monetary value).

By defining a differential of £17k, you (and Rex before you) are projecting a council flat into the local housing market. But a council flat is by definition not in that market. That it might become so at a future point is irrelevant.

To put this in the terms of your other analogy, being provided with a mobility car for free because you have been judged disabled is a benefit. The zero-rating of mobility cars for VAT is a subsidy. They are not the same thing.

[Dave Timoney]

@Phil,

I presume your med student mate was referring to the famous Whitehall Study that found it was pool drivers and the like, rather than mandarins, who were most at risk of heart attacks, essentially because they had so little control over their working lives. In other words, the stress of high-powered jobs isn't stress at all, it's just performative anxiety.

[Ralph Musgrave]

The word austerity has two quite separate meanings: 1, inadequate demand, and 2, inadequate public spending (assuming constant demand). The standard of debate on this issue would rise hugely if folk differentiated between those two meanings.

Unfortunately, for 95% of the population, it’s the EMOTIONAL thrill derived from a word that matters: by contrast, its dictionary definition is almost irrelevant.

[aragon]

The detail behind the statitics:

https://www.independent.co.uk/news/uk/home-news/anorexic-woman-dead-universal-credit-benefits-cut-found-freezing-cold-flat-too-ill-meeting-elaine-a8045796.html

Planning gain and the free housing market (LVT).
https://www.theguardian.com/money/blog/2017/nov/18/house-prices-land-prices-cheaper-homes

Austerity is cutting public spending (def 2).

[Keith]

Tories and new labour neoliberal blairite types are simply put murderers. They are happy to kill the plebs. Jim and his side kick rax oper are pieces of shit. This has a name, class war. it is long since past time we move back to a civilised politics which aims to advance the welfare of all members of the community rather than a small wealthy minority.

[David Jones]

If austerity kills so does spending what tax revenue we do have on supporting the ballet, theatre, and public art galleries. All that money could be diverted into effective & direct health spending.

Over to you.

[c1ue]

Angry conservatives often point to the dollar amounts of the subsidies which poor families reap from subsidized housing.
This is legitimate.
However, what is equally legitimate is the social atmosphere and economic opportunities arising from said housing.
I can't speak for Grenfell, but in the American city I live in - the subsidized housing comes replete with addicts, disease, hopelessness and crime.
Certainly there are some people who are happy to trade a monthly rent nut for the above, but the vast majority of decent people would much prefer being able to pay for safe, decent housing surrounded by decent people.