It would be good to create a spoof think-tank Libertarian Vision to pursue these ideas, and then to really take them to their natural conclusions once on the radio

Isn’t the Revolutionary Communist Party a step ahead of you here?

Now if it is cheap, and it is a single-payer health system, doesn’t that imply some pretty objectionable power structures are in place? Obviously, it is nice to be able to bid doctors’ salaries down a bit, but it means that healthcare is rationed according to government priorities. And that seems to be happening in rather more aggressive ways than Klein’s overview might be picking up: http://nhsblogdoc.blogspot.com/2009/04/who-dares-blow-whistle-who-dares-loses.html

This seems especially objectionable when there doesn’t seem to be any benefit to rationing by government officials compared with rationing controlled by patients: http://www.cato-at-liberty.org/2007/06/20/who-should-ration-health-care/

I am not sure what your point is about integrated healthcare in this context. It is clearly beneficial, but it is clearly something that works in the private sector as well as in the public sector. Judging by the fact that Kaiser Permanente and the Dutch system seem to be leaders in this respect might indicate that the private sector can deliver the incentives for co-operation between primary and secondary care rather more successfully anyway. If what you are saying is that, for now, these are the sort of reforms that could benefit our healthcare, then you have a point (I am not claiming that a complete overhaul of our system is going to be easy). But that doesn’t seem to respond to the overall criticism that the NHS could have been much better off (and have a less controlling power structure) with a market similar to what we have in Europe.

I don’t know if you know this Sunder – but there is indeed an off-shoot called Liberal Vision that does pretty much what you satirised above. Heh.

18 – as stated, it is available on request, beyond the 7000 printed copies which go out to all members and stakeholder audiences engaged with us each September. It is produced in a 32 page magazine format. We don’t currently put any full publications which are not online only on the website (only a couple of years ago we had a website which didn’t even take PDFs). We may well change that in general. I appreciate we may be somewhat behind the curve, though perhaps partly the lack of priority on online dissemination may well be in part because we have a larger hard copy reach and circulation than any of the other Westminster think-tanks through our membership. In the last year we’ve tried to begin to get to grips with what we should be doing online. There is also a full archive, covering the entire history of the Society, at the LSE.

I disagree with Nick at 8 and 11. I think we have been evidence-based. My initial challenge to Hannan showed his “sixty year mistake” warning to the Americans was nonsense. And it also acknowledged there is good evidence (from some parts of the US – eg the preventive/integration model of Kaiser Permanente – and from elsewhere) which should inform reform agendas within the NHS (though of a different kind to the PV reform agenda which sees the consumer/patient and ability to pay as the key).

Dr Howard Stoate’s Autumn 2007 Fabian pamphlet ‘Challenging the Citadel’ was evidence-based in making the case for deepening a shift away from the acute sector and secondary care to deepen prevention. The direction of travel of the Darzi review is often similar, though Stoate (who is MP for Dartford and on the health select committee) goes considerably further and challenges other parts of government policy, particularly in looking at the problem of power relations within an NHS (if there are powerful autonomous foundation hospitals) which could prove a brake on increasing the primary and preventive focus. Here is a v.brief summary of some of the argument and evidence cited
http://www.fabians.org.uk/events/event-reports/government-is-losing-hearts-and-minds-battle-for-fewer-hospitals

http://www.fabians.org.uk/publications/extracts/guardian-commentary-think-about-the-future

I gave this Chris Ham paper as a good overview of the evidence which Stoate and others have drawn on
http://www.hsmc.bham.ac.uk/staff/pdfs/Clinically_integrated_systems.pdf

IPPR have also done work on this, as have Kings Fund and others.

What I don’t accept is that it is the core principle or model of a taxpayer-funded system that must change. That seems to me ideologically driven. I also quoted and linked Ezra Klein’s 2007 piece The Health of Nations noting that (as Ham does) it drew on the evidence from the publicly run and socialised Veterans Health Administration in the US.
http://www.prospect.org/cs/articles?article=the_health_of_nations

Ironically, it seems to be the Conservatives who combine a hankering for Hannan’s fundamental critique of the principles and the idea of the NHS (and the frequent complaint of futile over-funding, which remains v.questionable in comparative perspective) with campaigns against any reconfiguration, particularly at local level (under slogans like “stop Brown’s NHS cuts”), and campaigns for more resources on popular services (like maternity services). This is incoherent opportunism, and is not evidence based on either side of this Jekyll and Hyde position on NHS policy, where they are both ‘agin in principle and for the status quo

Hannon & Co have an obvious political agenda and simply throw in a few factoids to bolster their arguments (as do other politicos of course).

Bad Science (by Ben Goldacre) is as good as anything I’ve read to illustrate why the phrase ‘pinch of salt’ often comes to mind whenever the term ‘research’ is bandied about.
The nutrition industry (for example) is particularly adept making claims for various products based on non-existent evidence.

Hannon’s cancer stats are irrelevant – to begin with cancer encompasses over a hundred different diseases, what are we meant to be comparing ?
And if even if American men do live for 12 months longer with prostate cancer (say) some might argue that a years extra suffering constitutes an equivocal improvement at best ?

Comparing Singapore with the UK is risable – I assume Hannon’s acolytes have seized on it because of low GDP spent on health allied to good health outcomes.
In fact this comparison may do no more than demonstrate that health outcomes have never been dependent on the health system alone.

Incidentally, anybody interested in some of the challenges faced by the NHS could do worse than spend time in the company of ‘The Hospital’
http://www.channel4.com/programmes/the-hospital/catch-up

Encouraging children to gamble to improve their maths skills is the silliest right-wing idea since Policy Exchange’s report suggesting everyone should move to London.

Now, I’m not going to defend any of the rest of PV’s ideas, but this one is actually interesting. I’d be really interested to know what your objections are to this idea.

First of all, calculating gambling outcomes is basically just applying simple statistical techniques, calculating probabilities and so forth. Teaching kids these techniques is a perfectly valid and positive aim of maths courses. Given how much of our lives these days involves interpreting statistics – disease risks, financial risks, risk of crime (and terrorism!) and so forth, I think giving kids the means of understanding and interpreting probabilities would be very good for them. Or, to put it another way, I think that Bayes’ theorem should be a central part of education. It just so happens that gambling – games based on probability – are a very good way of examining probabilities in action.

Secondly, I basically subscribe to the idea that “the truth shall set you free”, in the sense that we can’t actively suppress people’s understanding of how gambling works if we’re then going on to allow them to gamble. That’s just setting them up for exploitation. Why not teach children exactly how it works and exactly how unlikely it is that gambling will ever make them rich? Surely that would give them greater power over their own decisions and their own lives, as it would give them a set of rational reasons for avoiding gambling that, without some basic education in the application of probability theories, they would lack.

They took the current opinion polls, applied it as i it was a uniform national swing, and looked specifically at current Lib Dem seats only. A basic, amateur psephologist with half a days reading could tell you what’s wrong with that. Completely ignores pretty much everything political science understand regarding third party squeeze, ratchet effects, etc.

It’s a shame, on a personal level I kinda like Mark Littlewood, but the stuff he’s putting out is, well, interesting. Still, if it pays the bills…

“Regardless of the debate about the fact or attribution of climate change” is a classic too.

Speaking of ad hominem, it seems a bit of a shame for you guys to concentrate so much on Dan Hannan, the villain, when you may have yourself a potential ally on many other fronts. He wrote “The Plan” which included a great repeal bill similar to what the LibDems are now suggesting. If you want to empower the liberal elements in the Tory party, then Dan Hannan is someone to deal with.