Health and prevention:
Michael James writes: Re. “Actually, prevention has been a spectacular success” (yesterday, item 5). Yesterday, Simon Chapman was spot on in noting that Bernard Keane had a rush of blood to the head in an uncharacteristic piece filled with poor examples and less than rational conclusions. While Keane has built up large reserves of goodwill amongst his readers, most of whom will forgive occasional lapses, it is unfortunate that the topic was of such huge importance, not just to public health but to future budgets and lifestyles.
Keane showed a peculiar tendency to embrace a host of failed American policies or philosophies (gun law!), ignoring the fact that the American health system is the most expensive and worst in the developed world (and not just for the poor). In a bit of economic acrobatics he adopted an American academic’s strategy of ignoring all the non-medical benefits of prevention (which showed about $5 returned in benefit to every $1 spent) to exclusively the likely saved medical costs (only 90 cents for every dollar spent). Notwithstanding the grotesque costs of US medical care, this really just proved how desperate the argument had become.
To Chapman’s excellent points about preventive medicine, I would add that the largest fraction of the improvement in health and longevity in developed societies over the last century is owed to the engineers who built the sewers and water infrastructure. To counter the current burgeoning lifestyle diseases, contrary to Bernard’s scepticism, I would say we need another burst of massive infrastructure building, namely public transport, bicycle paths and pedestrian walkways. We could build a veritable paradise for bikers and walkers using a few percent of the road budget. Bernard does not believe it but this was the conclusion, if not scientifically proven, of a recent analysis of why Manhattanites are so thin and comparatively healthy compared not only to most Americans but also to their fellow New Yorkers across the river.
The reason: “Manhattan is a place where people walk. Even subway riders need to climb stairs. Storefront yoga studios, parks and pedestrian-friendly streets make working out relatively easy.” Incidentally, in a city filled with those masters-of-the-universe finance types we all love to hate, and where “if you can make it in New York you can make it anywhere”, over 55% of all journeys (within all five city boroughs, it would be much higher for Manhattan) is done by public transport.
The mayor (a veritable GrandMaster of the Universe and no “green looney tune”) is adopting the Paris Velib free bicycle system and also adopting, for Fifth avenue, the other Parisian strategy of Friday afternoons turning some of the major boulevards over to walkers and rollerbladers. We should also enforce/reinstitute the walk to school for all children. Like the dollar calculations of the benefit of clean water and sewers, the future benefit is too large to measure, but just as real.
On the matter of diet, I agree that it seems almost impossible both to understand exactly what is the best diet or to change people’s habits. Obviously we all need to become French (and for that matter adopt their top-rated healthcare system too). And what more evidence do we need that one strays from the French diet and lifestyle at one’s own peril, by poor old Sarkozy’s fate. By being so un-French to adopt new-fangled American fad diets (that have made him look positively anorexic according to his own doctors; no cheese, chocolate or dessert!) with excessive exercise, and — horreur — abstaining from alcohol — the man needs to go back to basics and embrace his inner Gaul. Perhaps good advice to Bernard too, who may need to get out more.
The Crikey editor could do worse than assign him to cover Sarko’s recovery-sojourn in the south of France where BK can report back on these health and diet issues!
Nutritionist Dr Rosemary Stanton writes: Simon Chapman’s response to Bernard Keane’s rant against prevention (Monday) could have mentioned the huge potential savings to the health budget if we prevented 3.7 million Australians with high blood pressure having to take expensive antihypertensive drugs. The dietary guidelines would work well — but only if you follow them.
A Melbourne study of over 10,500 women found that only one-third complied with more than half of the 13 food guidelines and only two met the lot. Bernard claims prevention is “fashionable”. It may be an “in” topic for discussion, but are we really surprised that it doesn’t achieve much when it gets just 2% of the total health budget?
The food industry spends far more on encouraging us to eat junk. Now that works well!
Tony Fitzgerald:
Bill Castleden writes: Re. “It makes for great headlines, but Fitzgerald’s outburst is over the top” (yesterday, item 2). Bernard Keane is too myopic confining his limp-wristed critique of corruption to Queensland. Most likely Tony Fitzgerald is right on the money; it is Democracy itself that has become corrupt.
Just as the global financial crisis showed us that rampant credit-fuelled, derivative-driven and unfettered capitalism has failed us, so the politicians’ inability to tackle climate change shows us how democracy is failing us. Basically big business places advertisements in the media, so quite understandably the media takes more notice of the hand that feeds it than of the poor scientists or altruistic NGO’s who place no ads. Political donations allow politicians to spend on their electoral campaigns.
Most campaign funds end up being spent in media too, and the media also helps the public decide who to elect. The biggest spenders nearly always get elected. There really is no question about it, western style Democracy is corrupt; it is ruled by money and a relatively few powerful manipulators. Seriously curtail election spending; you must be joking!
Both the GFC and climate change show that we need to listen to John Stuart Mill and start to temper our unfettered deregulation with considerations for the bizarre concepts of the common good and environmental care. This would involve regulation of things like short-selling, tax havens, hedge funds and derivative-creation, and the proper costing of extractive-based energy production to include climate costs, carbon emissions, environmental and health costs.
Quite simply the earth itself cannot tolerate more unregulated extractive short-termism. Politicians are by nature short-termists with their eyes most firmly fixed on the next election, so we cannot look to them to get us out of our fix. It will take a new breed of business-person, and a new media and a public determination to elect a new kind of politician who will have the courage to do what is right. Crikey is part of that solution.
Tony Abbott and religion:
Alex Fishburn writes: Re. “Talking the town: Tony Abbott gets down on his knees” (yesterday, item 12). Margot Saville quotes Tony Abbott’s point that the lack of humanist missionaries working in the poorest and most desperate parts of the world suggests that religion is a deciding motivating factor in compassionate action. She contradicts him… “With the greatest of respect to our Christian readers, that is complete nonsense. You don’t have to believe in the Resurrection to feel compassion and express love.” That is not an argument. It is simply a denial. Abbott came up with proof for his point. Saville has her bare assertion.
She adds: “And do humanists go to war with each other over doctrine?”
Three obvious examples of humanists going to war over doctrine spring to mind: the French revolutionaries tore each other apart, the Stalinists eliminated the Trostkyites in Russia, and the Stalinists purged the Anarchists in the Spanish Civil War.
David Adler writes: So Tony Abbott had a celibacy advisor during his year as a trainee priest! I’ve never heard of such a role. Perhaps it’s a Catholic thing? What does such a person actually do? Perhaps it’s much bigger than “stop it or you’ll go blind”. Or is there an underground market for medieval chastity belts? Can someone enlighten me?
Richard Lawson writes: Re. Justin Templer (yesterday, comments) who wrote:: “I had never before realised that Christ’s way was a moveable feast.” Well, I thought you guys believed in a resurrection, doesn’t that imply a moving rather than dead “way”? Furthermore, you do realise that all you have is interpretations of two thousand year old texts written when the supposed events were already well in the past. Where or when exactly do you propose to draw the line?
I suppose some still pine for the burnings that characterised the glorious might of the Roman Church in its ascendancy, after all the last Prefect of the Congregation for the Doctrine of the Faith, previously known as the Supreme Sacred Congregation of the Roman and Universal Inquisition, is now Pope.
Kyle and Jackie O:
Jim Hart writes: Re. “Kyle and Jackie O’s live lie detector test goes very wrong” (yesterday, item 3). I’ve never held mainstream breakfast radio in any but the lowest esteem, but it’s hard to know which is worse — a radio station that thinks the lie detector segment was a good idea in the first place, or a woman who would interrogate her 14-y-o daughter on breakfast radio. And then to admit she knew of the rape “incident” after asking the distressed girl about her s-x life (not to mention the heinous crime of wagging school).
It’s also sad that the daughter agreed to participate but maybe she saw it as a chance to get stuff out if no one else was listening to her.
And finally it’s totally disheartening to think that there are people who apparently like this kind of crap with their cornflakes.
Rory Robertson vs. Steve Keen:
Chris Joye writes: Re. “Cage match 2: Steve Keen weighs in on house prices” (yesterday, item 23). Based on the latest RP Data-Rismark results, Steve Keen, who told the world Australian house prices would fall by 40 per cent, has lost his high profile bet with Macquarie Bank’s Rory Robertson as house prices have now passed their previous February 2008 peak.
Dr Keen should immediately start his long walk from Canberra to Mount Kosciuszko wearing a t-shirt emblazoned with the message, “I was hopelessly wrong on home prices. Ask me how”.
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