My Message To Those Who Oppose The Smoking Ban

A response to Mr Eugenides. Aren't the 1,200 lives saved a year worth something? Does this have to come down to just economics? Both me and the wife would take to the streets if this ban is repealed or altered in any way. It is THE best thing Labour did in office and probably the single most important thing done for health since the 1970s.

If you are worried about pubs, support the minimum price per unit that will hit off-licence sales. Supermarkets have closed more pubs by far. Think of the millions with lung diseases and asthma that can now have a drink without having to cough their lungs up. Think of the millions who were forced to stink of smoke and risk their health against their will just because they wanted a drink in their local or wanted to see a band or dj.

The majority agree with me and the Tories know it, no matter how much the tobacco companies fund them, mess with this law at your electoral peril. You have been duped into believing the millions of PR being spent by tobacco companies who use the same techniques as big oil and big pharma. Open your eyes and see the smoke.

Healthcare: The Truth

The United States of America has massive advantages over other countries - abundance of land and raw materials which brings cheap food and rent, a massive single internal market which brings economies of scale efficiencies and increased opportunities of monopoly dominance of industries.

The US is the number one military and financial power which protects its corporations' economic interests abroad through economic sanctions, intelligence interventions in other countries political institutions, interference in foreign elections and finally the US uses military action if deemed necessary.

Through these advantages, the US has the dominant global corporations, a reserve currency and raw materials priced in dollars which allow it to borrow money cheaply and run up huge deficits.

In short, the average US citizen should enjoy unprecedented public services, quality of life and wealth in comparison with other countries, but they do not. They earn less and pay more tax.

Yes the US has the largest GDP, yes GDP per head is fairly high in comparison with other developed countries, but the median wage earner ($32,390) in the US pays higher taxes than nearly all Western European countries. The median wage in the UK is $41,098.

They also get poorer quality public services for their money! Whats more, the less you earn in the US, the more tax you have to pay as a percentage of your income. And in the US you can earn very little indeed and receive little or no government help. Inequality is off the scale by European standards.

Healthcare is a prime example of this. Tax funded healthcare in the US is inefficient and complicated and only around half the population are effectively covered by Medicare, Medicaid and other government run schemes despite more tax money being spent per head than our NHS which covers everyone. So around 120m Americans (50% of the adult population) pay taxes toward a system that provides them with no effective healthcare cover, except running to expensive Emergency Rooms when in dire need of treatment - a highly inefficient way to provide care. It is particularly scandalous that in some states children are left without healthcare.

What about rationing for those who do have cover? As the Economist puts it:-

These [tax funded] schemes lay down in great detail, in the form of national and local "coverage determinations", which treatments and procedures can be claimed for, and at what rates. And all but the most expensive private insurance policies impose limitations of their own.

So, 'death panels' as the Republicans like to call them, exist in the US already and ration just as much, if not more so, than the National Institute for Clinical Excellence (NICE) does for the NHS. And this is before we consider the millions of Americans who pay their premiums only to find insurance companies weedling out of providing coverage by citing 'pre-existing conditions' from long ago that have no bearing on the current treatment and are so obscure that the patient would never have thought to mention them on an application form.

Comparing healthcare outcomes between the US system and elsewhere is fraught with difficulty, but EVERY single report that has attemped a comparison rates the US system worse than our NHS. On an admittedly crude measure like life expectancy the UK outscores the US, 79.3 to 77.8. I know this also depends on lifestyle, and obesity is higher in the US, but even when we compare death rates for under 75s for treatable conditions, the US scores lower than our NHS despite the US spending 16% of GDP on health compared to our 8.4% of GDP. The London School of Hygiene and Tropical medicine carried out such a study. As this week's Economist puts it:-

Their study placed Britain 16th among 19 advanced nations (France came first). But America came last!

And in 2006 a study compared the health of middle aged people in the UK and the US - the US was sicker.

I am not pretending that the NHS is the best system in the world - it quite clearly is not and careful reform is welcomed. The NHS has many faults, as do all systems, but what I am saying is that it is cheaper, less bureaucratic and more efficient than the US system which is based around the interests of big pharmaceutical and insurance companies. Their lobbying and funding of both Republicans and Democrats is preventing Americans from having a better healthcare system.

One much publicised area where the US does do better than the UK is five year survival rates for cancer. Expensive new drugs become available sooner in the US and diagnostic equipment is more available 25.9 MRI scanners per million people to 8.2 in Britain, but these figures hide once again the massive inequalities in the system where the richest few get the best care in the world while the poorest get some of the worst care. Also sometimes the side effects of these drugs, although extending life, make the quality of life so unbearable for the patient they probably would be better off taking their chances with the cancer.

For example, my dad is currently receiving a drug called SUTENT for his advanced kidney cancer at a cost to the NHS of £3,500 a month (at these prices and the limited value to the patient it is easy to understand why NICE thinks the money might be better spent elsewhere). My dad has been on the drug 3 weeks now and has gone from being able to walk to the library, mow the lawn etc to being virtually bed bound with sores all over his body IN THE SPACE OF 3 WEEKS - i.e he now has no quality of life at all. The drug 'might' stop the growth of the tumours and prolong my dad's life a few months, but at what cost to his quality of life? I am not sure it is worth it. If I was my dad I would take my chances with the cancer. Until the final stages of life and with symptoms treated, you can have some quality of life - go on holiday etc. It is a horrible choice to make and I understand my dad choosing the option that promises some hope, but personally I would rather have a shorter life that enabled me to have some time to enjoy what life I have left.

In the past few decades my dad has received many thousands of pounds of treatment - 2 hip replacements, a removal of a kidney, keyhole surgery on his lung, pins in his leg and now expensive cancer treatments. All of which he would have struggled to afford.

So, the overall verdict has to be that we are very fortunate to have establised an NHS in this country. Ask any ex-pat stung by health insurance or health costs in Australia, South Africa or the USA.

An American NHS Would Mean A Cut In Their Tax Bill AND Better Healthcare.

Amazingly, the American taxpayer pays MORE than the UK taxpayer does for state funded healthcare.

Americans spend around 15% of GDP on health in total - $2.2 trillion (about 7.5% of GDP is spent by US taxpayers ($1.1 trillion).

In comparison, UK taxpayers now spend around 8% of UK GDP on health ($155 billion).

This works out as $3,200 per capita in England, and $3,700 per capita in the US. In England this provides 100% of the population with care, while only 28% of US citizens are provided with care.

This is a US rip off healthcare scam, thank heaven for the NHS over here.

We can see why Republicans funded by health insurance companies are being so hysterical - they would lose a lot of money if the US had an NHS because it is clearly far more efficient and less bureaucratic than having to access EVERY single claimant and decide a premium (or deny them care altogether as often happnes in the US).

Of course the ironic thing is that President Obama is not (sadly) even proposing an NHS, just providing direct government insurance for the 50m Americans currently uninsured. This is enough though to elicit the following lies:-

"NHS breeds terrorists" screams FOX (ironically the SUN has now called for Americans to stop their 'vicious slurs' on the NHS - if only they would tell their owner Murdoch, who of course also owns Fox).

"Death panels" screams Palin and NHS is 'Evil and Orwellian' when precisely the opposite is true - unless you are fabulously wealthy most Americans cannot access care when they really need it. Those in real need are denied insurance - there is no more a 'death panel' than that.

"Nobody over 59 would get healthcare" - laughable!

"Stephen Hawking would be dead under the NHS". Hawking was surprised to hear this, as he has lived his whole life in the UK using the NHS.

These outrageous lies have finally caught up with the Tories over here who spout them, if not yet the Republicans - whose hysterical campaign is sadly having some success despite 20,000 twitter users defending the NHS.

"Evil And Orwellian NHS"

Welcome to the world of the US media, soon to be brought over here by the Tories as they scrap regulation that keeps our broadcast media within at least some standards of decency and honesty. You have been warned!

FOREST Spending Millions On 'Amend Smoke Ban' Campaign

FOREST are funded almost exclusively by the Tobacco Companies, they have little grassroots support. The Tobacco companies are spending millions on a campaign through FOREST, they say 'will save pubs and clubs'. It is sad to see 'amend the smoke ban' videos on labour party sites like BLOGGERS4LABOUR.

This is one of the reasons why I do not take advertising on this site - messagespace and google ads are full of right-wing campaigns funded by big business and rich individuals who all support the Tories.

The truth of the matter is that this is all about saving tobacco company profits. And with a Tory government on the way (increasingly funded by tobacco company donations and therefore onside), all they have to do is shift public opinion a little to accepting an 'amendment' of the ban. They are getting increasingly confident.

The Tories will tread carefully on this one, because a lot of their voters support the present ban. It is an issue that crosses party lines like no other.

The way I think the Tories will do this is to change the law so that Local Authorities (mostly Tory because of first-past-the-post), will be able to amend the ban - allow smoking rooms and the like, or maybe scrap the ban altogether. And central government will try to stay aloof and wash their hands of it - claiming local 'democracy' at work. When these councils stay Tory for decades with just 30% of the vote under our present system - they can get away with ignoring a lot of voters wishes on this and other issues.

All of us, who care about our health and about being able to enjoy a night out without stinking of smoke and coughing our lungs up have to fight this. Especially for the sake of the millions of people who suffer from asthma and lung diseases.

Join ASH or pledge them a donation to fight the tobacco company millions.

By the way, if FOREST really did care about saving local pubs, wouldn't they be donating this millions of advertising money directly to the pubs they want to save?

The truth of the matter is that most pubs are suffering because of the recession and supermarkets absurdly cheap alcohol promotions. This is the view shared by publicans:-

"As a publican myself, I know many of the problems facing the industry, but I do think that the main issue is the disproportionate price differential between pubs and supermarkets. Over the last couple of years I have seen a huge increase in customers “pre loading” which is to consume quantities of drink at home before visiting the pub, so that they do not have to spend so much. This means that the publicans who are spending the money creating the environment for a safe and enjoyable night out are not benefiting from the sales to recoup this investment. This is forcing many pubs out of business, and costing the country not only money in the form of jobs and income tax, but more importantly in terms of loosing the community aspect of the trade. As for the city centre venues which are constantly being blamed for the “binge drinking” culture, you will find that most of the offenders have drank heavily before leaving home, and trouble is instigated when they are refused entry to the pubs and clubs, who then get blamed for the trouble as it is outside their venue.
I feel that a simple but effective solution to this would be to increase the tax on packaged alcoholic products such as bottles of beer, cans of cider and alcopops whilst reducing it on draught products such as beer, lager and cider. This would not stop people drinking, but guide them by price what to drink and where to drink it.
The benefits of draught are that firstly it is sold in a controlled environment (I have never seen a fridge ID someone or tell someone that they have had too much to drink), whereas supermarkets sell in bulk and have no control over who the end consumer is and how much they drink. Pubs do not allow people to wander the street with pints in their hands. Another huge implication for this is the green issue. Kegs and pint glasses are always washed and reused, bottles and have to be melted down and remade, repackaged and shipped out again. This would save millions of tonnes of landfill (not everybody recycles) and huge amounts of energy.
Side effects of this would be increased jobs, (because supermarkets and off licences don’t employ as many people per customer as pubs) therefore increase income tax. People would drink more locally brewed drinks which is better for the countries economy. Any place people meet creates community, that is something we are sadly lacking in this country at the moment, people would have a place where they belong, mixed ages in pubs creates respect for one another and people who have more respect tend not to behave antisocially and are more inclined to ensure their own children behave themselves".

Put an extra tax on off licence sales and increase the age of off-licence sales to 21 and the pubs would be heaving. The smoking ban has had a marginal effect. I think it has changed pub culture for the better. Far more families and women with children are coming back to pubs and this will continue while the ban is in place - all this would be lost if the ban was reversed.

Pubs are now cleaner and more inclined to serve food and have provided more decent outside seating. This is better for all customers. Pubs that are dirty and not willing to change have been the ones that have closed. A lot of these pubs would have closed anyway, the ban might have just speeded this process up. Reversing the ban more than four years into it, will not bring back these pubs, nor would most customers really want to return to these smelly establishments.

The million plus people who work in pubs and clubs (mostly young people) are now having their health protected and not being forced to breath in smoke just to have a livelyhood. This alone is worth the ban, but the benefit to customers is also the clincher.

The Torie are not going to amend or scrap the ban due to any principle or liberatarian concern (ridiculous though this claim is). They are doing it for their party's bank balance as the Tobacco companies have traditionally bankrolled the Tories and will continue to do so because they know the Tories will deliver them regressive policies like this. The Tories love big business when it gives them money.

Smoking Ban Has Been Huge Success.

Over 80% of people now support the smoking ban, 76% want to ban cigarette vending machines and 70% want fag packets out of sight in shops. 800,000 smokers have given up as a result, heart disease and strokes have dropped significantly and now even smokers chokezone Greece is set to introduce a ban on July 1st.

So what will a Tory government do when it gets in? You guessed it, relax the smoking ban. Top Tories have been in talks with their tobacco paymasters for years on how best to tackle public opposition. FOREST (the cigarette manufacturer's PR machine) fund several 'astro turf' groups to garner support for their aims.

The Tories favourite is to 'allow' local authorities to introduce 'a smoking room' within pubs. This legislation will be quietly included in a bill within two years of the Tories coming to power. We all know that this will mean the whole pub will stink of smoke, punters will end up stinking of smoke and workers once again will have to work in smoky atmospheres damaging their health. There is no practical way smokers and non-smokers can mix indoors without harming non-smokers as well. If there was, believe you me, the new Labour fudgers would have found it.

Vote Labour Or Else...

Welcome to a future Tory government.

David 'Dubya' Cameron And The Time Travelling Tories.

I really hope that David Cameron has learned to appreciate the value of the NHS and social services because of the care his son Ivan received. That is the line of the press and media and I hope they are right. But I have to say, just as Diana's death had no personal impact on my life, so too does Ivan's death. I feel more sympathy for those families who suffer or lose loved ones every day because of poverty around the world, I feel more sympathy for those who suffered and died as a result of the NHS and social service cutbacks under the last Tory government. I doubt David Cameron feels any of this, holed up in his £1.5m mansion bought without a mortgage.

Which is a real shame, because it now seems very likely that this man is going to be our next Prime Minister sometime in 2010.

There has never been a better time for this country to have a centre-left government. The right-wing, neo-liberal, laissez faire (couldn't care less for the poor) government that the Tories and their ideological friends the US Republicans stand for, is bankrupt.

As Joe Biden said recently "they are always quick to criticise but have nothing to offer in its place".

It is such a shame that Labour have been so spineless to let a loser and right wing ideologue like Brown be leader - he comes from the gutless centre of the party that is unable to stand up to the Tory press and establishment. Labour need ask themselves as a party not whether someone else could beat the Tories, but whether someone else could do better than the anihilation we are about to face under Brown. The polls now conclude almost anyone could do better.

The Tories continue to outline what they would do 'in the past' not the future - so they claim to 'stick to Labour spending until 2009'. Easy to do when they know they won't be in power till 2010. I looked for an analogy to mock this, but it is just so absurd I found it impossible to mock. The Tories are time travelling into the past to say how good they 'would have been'. This is a fantastic tactic to avoid saying what your future policies actually are. As Biden says 'all criticism and no alternative'. Is this really the future of the UK?

When Cameron replaces social service spending, public transport and NHS spending with tax cuts for those on over £100k (the top 2% of earners) and increases in military spending and inevitable continual growth in Quangos, consultants and managers (just like in the Tory 80s), I want people to think back to this moment, to Ivan Cameron sentimentality in the press, to the 'greenwash' Tory policies and 'civil liberties' guff and think, is this guy really any different to George W Bush? The cutbacks in London by Boris and the Tories here in Brighton give us a clue. Expect 'public services' to get very expensive for us mere mortals on the average wage of 24k!!! under the Tories and their hedge fund friends on massive salaries.

Isn't It A Good Thing That People Are Drinking Less?

When Labour liberalised the licensing laws in 2005, the Tories and Lib Dems (some liberals they are!) predicted a binge drinking and violence epidemic, instead we find 3 years later that people are drinking nearly 20% less and violent crime is still falling (despite a cock up in the figures there is no disputing lower homicides and gun death figures).

For those who think the smoking ban accounts for lower beer sales, remember that the latest figures show not only an 8% drop in bar sales, but a 6% drop in supermarket sales as well.

Yes, the recession is playing its part, but...

beer sales started their downward trend in 2005 when economic growth was at its peak.

It seems whatever happens under a Labour government (beer sales up or down, traffic up or down, etc etc) will be printed as bad news in the Daily Mail, Torygraph, Express, Star, Sun, Times, Metro, Standard and all the other local press and media these foreign oligarchs own.

Stirring up nationalism, racism and xenophobia at home while buying our politicians with freebie holidays on foreign billionaire's yachts is so shameless you really do wonder how people like Rupert Murdoch, Lord Rothermere and others sleep at night. This sort of 'British' corruption may be done in a very polite fashion compared to the blatent continental type, but I am not sure it is any better.

Why do we not hear about Blair, Brown and Cameron's regular meeting with these media oligarchs? Because these oligarchs own the media that is why, but it doesn't make it any less corrupt.

See my previous post on state funding to find out how we stop this expensive silliness that damages our politics and costs the taxpayer billions in corruption - a simple ban on all donations over a £1000 a year and a tick box on the ballot paper to give people the choice to donate £3 a year to local political parties (or nothing at all if they tick nothing) as advocated by the Power Inquiry.

This is simple stuff and would put determining policies back in the hands of the electorate, not the rich elite. For the first time ever, low turn-out would hit parties financially - the incentive to drive up turn-out would be strong unlike at present where there might actually be an incentive to LOWER turn-out with negative tactics (favoured most by the Right). Add in a fair (proportional) voting system to fair funding - where every vote counts equally, and power really would be returned to the people - anyway enough dreaming - back to the reality of continual grind against the distorted system we have that delivers perpetual Tory and Labour governments that the majority vote against.

'Freedom Loving' Boris Bans Booze On Tube.

I wonder what the libertarian crowd think of their Tory poster boy now? One day in power and he has already returned to 1980's Thatcherite authoritarianism. I think this rams home the message - DO NOT trust the 'cuddly' 'liberal' Tories, elect them at your peril. The Tories are just a bunch of liars who will say anything to...

get into power. Their duplicitousness is frightening. I find the new breed of Tory - Cameron, Osbourne, Dale and Johnson as even more frightening than Thatcher and Tebbit.

While on the radio (five live) yesterday, Ian Dale even had the cheek to mention the success of the smoking ban while defending the banning of alcohol on the tube.

There is a crucial and simple difference between smoking and alcohol.

EVERY smoker harms ALL around them simply by the act of smoking. It is therefore perfectly reasonable to protect those being harmed.

NO-ONE is harmed by someone drinking alcohol. This will do nothing to concentrate police resources on the minority who are anti-social (who may or may not be drinking). This will not stop drunk people getting on the tube, it will simply waste time and money harassing the majority who want to enjoy a drink and who cause no nuisance to anyone. This is an authoritarian measure of the highest order and it will be interesting to see how the so called libertarians view it. Will they now ditch their pro-Tory stance, I doubt it. I remember these sort of 'liberty' and 'freedom' organisations cropping up in the 70s, and every one turned out to be a front for extreme right-wing ideology that ended up with the election of Thatcher. (The McWhirter twins of record breakers fame were a notable distasteful example).

Ian Dale's duplicitousness is even more extreme - he is a member of the tobacco company-funded 'freedom association' and supports the 'taking liberties' campaign that is trying to reverse the smoking ban - yet in defending Boris's authoritarianism he quotes the success of the smoking ban (Boris got paid £10,000 to make a speech for the 'freedom association' - typically he failed to turn up but they paid him anyway - nice work if you can get it eh?). You couldn't make it up.

Boris To Scrap Smoking Ban.

Boris Johnson has been paid a lot of money by Tobacco lobbyists and has promised to repay them by scrapping the smoking ban. He floated some vague idea of a internet referendum on the issue in the Sun. For someone who calls postal voting corrupt, it takes the biscuit to destroy people's health in such a dismissive (and easily fiddled) way.

The smoking ban was voted against by most Tory MPs, so it is no surprise that right-wingers like Johnson want it repealed. Boris gives us an insight to what a future Tory government will be like.

The smoking ban is probably the single most effective legislation that will improve people's health over generations since Labour set up the NHS.

If you like the ban and want to save your lungs then vote for Ken. Boris must be stopped.

If you think this is a civil liberties issue (it isn't) and if you think Boris is some sort of libertarian, remember that he also wants to ban drinking alcohol on the tube.

*update* It seems Boris's minders are now typically trying to deny the whole thing - Boris just cannot control his tongue - imagine this guy trying to promote London - what a mess!

Local News - Round Up.

The Tories have upset dog owners in Brighton and Hove - by planning to ban dogs from all beaches, rather than allow them on a couple of beaches, as at present. There was a march organised along the seafront this weekend that was supported by Hove Labour MP Celia Barlow and several local councillors. I always thought a Tory administration would be more friendly to dog owners, but apparently not.

The return of...

City News to Brighton came as a shock to many, as the Tories had a long history of opposition to it when Labour was in charge of the council, funny how when the Tories took over they quickly brought it back. Good to see partizan party politics is alive and well and looking to what is good for the party rather than the people. No wonder people are fed up of these machiavellian political games.

The local school lottery system put in place by the Labour administration last year, has been making the national news and the Argus and Daily Mail are doing their best to talk up local private schools and the disenchantment of the middle classes. Frankly, surely a lottery system has to be fairer than just allowing places to be decided solely by a bidding war for houses in the catchment areas of the schools with the best results.

Talking of the Daily Mail and Argus, the Tory press are still trying to make capital out of 24 hour opening. Somehow they never seem to explain how binge drinking has increased, when alcohol sales have fallen and opening times have lengthened. I ain't no mathematician, but shurely shome mistake? They make a lot of the increase in the small number of low level violent binge drinking incidents between 12am and 2am, but conveniently forget to mention incidents have fallen at every other time, particularly drastically at the old violence spike points of 11.30pm and 2.30am.

After the closure of Vernon Gardens Day Centre for adults with learning disabilities, the Tories continue to run down social services in Brighton and Hove. The Adult Social Care budgets and Children Services budgets in particular (children are assessed for need but no longer can get access to many services, 42% cuts in some units). While trying to blame these cuts on not enough central funding for the free pensioners bus travel (the government have provided over £500m nationally), the Tories proudly proclaim on the front of their new propaganda magazine City News 'Lowest Council Tax Rise Ever'. Surely funding these services should come a higher priority than holding down council tax by a small amount?

Thankfully no sign yet of the proposed underground carparks the Tories promised under Montpelier Crescent and Hove Lawns. Why do the Tories always claim that building more car parks and re-phasing traffic lights and traffic flow even more in the favour of car drivers, at the expense of pedestrians, is the answer to congestion? Surely rather than encourage even more cars into a clogged city centre, the Tories should be doing something to discourage cars? Brighton already has a high number of pedestrians and cyclists killed on our city's roads. Has anyone noticed how long pedestrians have to wait to cross Montpelier road by Waitrose, or trying to cross the interminable dual carriageway that spoils the seafront, the lights can take an eternity to let pedestrians across. Pedestrians are just not a priority at the moment, haven't we got this the wrong way round?

Finally, another nail in the coffin of local democracy looks like being rushed through by the Tories. For some unfathomable reason the Labour government is allowing local councils to abolish committees that are currently appointed in proportion to seats the parties hold, and allowing a cabinet system that will mean the main party dominating debate. The Tories don't have to implement this change until May 2009, but with undue haste (and sadly with the support of some Labour members) it is being hastily introduced.

Tax Funded Dishonesty.

As I recently said to my girlfriend; "Homeopathy is just tax funded dishonesty and I don't like it", she replied "yes, but its the dishonesty that makes it work". And therein lies a truism. Doctors are not allowed to be openly dishonest anymore - they cannot prescribe placebos to patients, instead we have the Royal Homeopathy Hospital for the terminally ignorant.

Lots of discussion on this subject, but I'm with Wongablog and Ben Goldacre on this.

Is This Our Right-Wing Utopia?

Michael Moore vs The Trillion Dollar Health Rip Off.

Americans spend almost as much on healthcare as the entire GDP of the UK economy and will soon spend more than our entire economy (currently 15% of US GDP - and spending is out of control. US health spending is set to rise to 20% of GDP by 2017). Over 44% of this spending comes from US taxes. US taxpayers contribute more per capita to health costs than we do in the UK.

Moore's argument against the...

US system is not just about fairness, it is about efficiency. The US system is a mess. Even an extremely rightwing blogger like Devil's Kitchen has moved to the left on this issue and will not defend their health system anymore.

Michael Moore's new film - Sicko, is not about the 50m Americans who have no insurance, it is about the poor health cover the 250m insured Americans get for their money.

The following results are what you get, when you hand over healthcare decisions to insurance companies whose only motivation is profit;

i) Masses of money spent on administrators and lawyers to find any excuse to deny care to patients.

ii) Doctors promoted and receiving bonuses for denying care to patients.

iii) People without peace of mind, even if they have comprehensive insurance, it is sometimes not worth the paper it is written on.

iv) The premiums can be too high for those who need cover the most and people are never at their most financially sound when ill or injured.

v) An absurdly bureaucratic system run for the benefit of health care insurance directors and shareholders NOT the benefit of patients.

vi) Profits so large that bribery and corruption of elected officials to maintain the status quo becomes inevitable and commonplace. Moore shows dozens of congressmen bought off. Even the well intentioned Hillary Clinton was bought for $800k.

The irony of those on the right who attack universal 'socialised medicine' as some sort of communist plot, is that the US healthcare 'industrial complex' like the 'military industrial complex' of both the US and cold war USSR is self sustaining and a cancer on society. The US healthcare industry's corruption of Congress has more in common with the corrupt Politburo than any 'socialised medicine'.

As Moore points out in his film, France, Canada, the UK and even poverty stricken Cuba can provide fantastic universal cover at much less cost than the US system.

The biggest criticism of any Moore film is its polarisation of the issues and overly sentimental argument. This is very true of this film. Being talked to like a 3 year old does grate after 120 minutes. However he does manage to entertain and make funny an issue that could be very dull indeed in a lesser film-maker's hands. Moore's film is excused some artistic licence, as it is a polemic aimed at the highest possible audience (do not expect BBC4 impartiality and depth) and he succeeds in making the film highly entertaining and funny, though not as funny as his earlier successes. Moore highlights outrageous cases of hard working fully insured Americans being denied care for ridiculous bureaucratic reasons. He contrasts this with the universal cover every other industrialised nation provides for its citizens.

This film will make every British citizen so pleased they have the NHS and should make us more determined to try and protect it from the insurance company corruption that has engulfed the US. Much as Tony Benn says the NHS is untouchable, we already know how dentistry for example has been salami sliced away.

Moore paints such a bleak picture of US healthcare (ill patients dumped on the sidewalk for not paying bills), it is very heartwarming to see the inside of an NHS hospital.

Inevitably, the subject of taxation is raised. Moore's film is aimed at reassuring the US middle class, so he shows how even the lifestyles of the highly taxed French middle class can be very comfortable to counter the vigorous lies of the US media that infer communist armageddon will occur if ever the US had universal healthcare.

Overall the amounts of profit involved seem to make the prospect of change in the US very remote, no matter how much the electorate demands it. So from this point of view Moore's film is very depressing. But at least there is someone high profile making the case, and for that his film deserves to be widely seen. The case for universal healthcare is very compelling when you compare it to the despair of millions that results from the alternative. As Moore asks 'how did we get to this?'. It seems that once in that parlous state, it is very difficult to change. We in the UK should bear that in mind when we go about handing over NHS care to profit making companies.

Libertarian Frauds.

I went to the End of The Road Festival at the weekend. While there, I saw a band I quite liked called Misty's Big Adventure. During their set, the lead singer had a brief rant against the smoking ban and how the government have eroded liberty. In the next minute he started a song about the dangers of mobile phone masts.

I think this sums up for me the inconsistencies of...

these so called libertarians. On the one hand they say it is a breach of civil liberties to ban smoking indoors - something that affects people right across society and where there is pretty conclusive evidence of the danger to people's health, while on the other they rant against radiation from mobile phone masts - something where there is no evidence of harm.

I'm sure someone will say - we can avoid smoky pubs but not mast radiation. But in practise that does not happen, does it? Come on be honest for once! A theoretical choice is not a real choice.

Of course what is really happening here is that these 'libertarians' are choosing which liberty THEY consider the most important. Liberty is not a one way street - one person's increase in liberty can be another's loss of liberty. As I have tried to argue, the greater liberty is actually served by having a smoking ban, because the majority of people who desire a smoke free environment get that choice, something they are otherwise denied.

A few posters on here have tried to devise compromise positions on the smoking ban. Admirable in that they are at least CONSIDERING the views of those who want a smoke free environment, something that seemed to be ignored by most before the ban came in. Unfortunately there really is no satisfactory compromise on this issue. Like incurring any violence - each individual should not have to put up with this sort of harm as a consequence of simply wanting a night out, smoking in an enclosed public space is simply unacceptable. People should never have to put their health at risk and tolerate something they find deeply unpleasant just to satisfy someone else's habit (especially when it is only a minor inconvenience to the smoker to go outside to smoke - as the overwhelming observance of the smoking ban demonstrates).

Time to raise drinking age to 21.

At the age of 38, I can just about remember what it was like to be a teenager (honest!). I, like most of my mates used to like occasionally 'drinking cider/lager/spirits' *(delete as appropriate) in the park...

One of us, always looked more than their 15/16/17 years and managed to purchase some booze for us. This of course is just part of the problem - those however who are 11 to 14 who report 'getting drunk' are not getting their booze in this way. Someone, either an older 'friend' or relative or a dodgy off-license is selling it to them.

I don't think the drinking age of 18 for pubs should be affected, I just think think the age for buying at off-licences should be raised to 21.

There are a number of advantages to this.

1. Pubs trade will be boosted (and now they are smoke free they are probably more healthy than some homes).

2. Drinking in pubs will significantly increase the price of getting drunk for 18 to 21 year olds (there is definitely also an argument for increasing price across the board - I would propose a new tax on off-licence sales only so not to hit the pub trade).

3. 18 to 21 year olds will be more likely to behave (or encouraged to behave) in a licenced establishment and if they don't, can be more easily barred from drinking - landlords can have more control and hopefully refuse to serve those who are the worse for wear.

4. It will be much harder for dodgy off-licences to use the excuse that 16 year olds 'looked old enough'. Because of this, fines could be significantly increased on establishments and individuals that sell to under 18s.

5. 18 year olds could still purchase alcohol - so it won't seem as draconian as a across the board rising of the age or as hypocritical from us oldies stopping youngsters doing what we were doing at their age.

By the way, I notice the Daily Mail managed to sneak in a distorted stats article to support their scare mongering about 24 hour opening - Like all Daily Mail articles it is always worth reading the last paragraph;

"Data collected from 30 police forces from October 2004 to September 2006, including Devon and Cornwall, show no indication of an overall rise in the level of violent offences as a result of the Licensing Act 2003.

"The night-time economy is extremely complex; there is a range of factors and variables that can impact upon levels of crime and disorder."

Which hardly squares with their 'Pub violence has soared by half since 24-hour licensing' headline.

IF Brown wants to truly combat problem drinking he needs to increase the price not be petty about the times people want to drink.

Alcohol (as a percentage of disposable income) is cheaper than for 50 years. If Brown wants to look at the causes of binge drinking he needs to look no further than the price...

24 hour opening has been a big success in reducing binge drinking. Alcohol related violent crime is lower than before the new licensing laws came in (yes there has been a small recent rise of 1% but the total is still lower than 2005 - we also have to take into account the fact that more police resources have been put into prosecuting offenders which would increase recorded offences and because the offences have been more spread out over the night - this also has helped police catch offenders) and the consumption of alcohol in clubs and bars has also fallen slightly by 1%. This is not surprising - as I have pointed out before, people are drinking later and more locally in quiet pubs where they can take their time over their drinks and have conversation rather than going to binge drinking establishments in town that have few seats, loud music and little to do other than partake in vertical drinking. We would be mad also to return to pressure points at 11pm and 2am that caused so much pressure and violence for taxi drivers, food retailers, police and other emergency services.

The proposals to regulate supermarket deals on alcohol, increase taxes on alcohol and increase the age to 21 for off-licence purchases are the right way to go if we want to tackle problem drinkers (retailers would then have no excuse whatsoever for selling to 16 year olds and the pub trade which is struggling (due to cheap take home booze, smuggling and smoking ban) would not be further harmed). The review called by Brown is ok if it is just to examine the evidence which will highlight all of the above, but if it is just to appease the Daily Mail, it is not only wrong, like the backwards step to reclassify cannabis to class B (cannabis use has dropped since laws were relaxed) - it is a dangerous political trap Brown has fallen into. Doing the wrong thing for the wrong reasons is always bound to lose votes.

Doctor Rant socks it to 'em.

He asks four important questions about the NHS - here - here - here - here.

The answers are not to the right-wing readership's liking.

That's the trouble with these commie doctors.

The Smoking Ban.

Well, two days in and I am fantastically pleased. I have had to wait 20 years for this ban and god knows what damage my lungs have suffered in the meantime - hopefully I haven't got lung cancer already from my liking for a drink in the pub. 18 year olds are so lucky thanks to this Labour government - it never would have happened under the Tories.

In support of this ban, I have made it my duty to go to the pub every day this week. Had a great Sunday Roast and was in the pub all night yesterday. It was so great to leave without smelling like an ash tray and having to wash my clothes - also my passive smokers cough has cleared up, coincidence?

The ban seems to be self enforcing nicely, most smokers are obeying. Just a couple of minor quibbles. In the George on Trafalgar St, smokers are right outside the entrances and it seems to get sucked into the pub a bit - but I am not going to complain about this. A smoker lit up last night in the Montpelier Inn but it seemed to be a genuine error - he simply had forget and soon put his cig out. Apart from that things are going great. I can finally go to the pub without having to suffer. Looking forward to going to the quiz at the Crescent tonight and also the humanist meeting at the Farm Tavern - both great pubs but always so smoky it put me off going - now I can hopefully relax.