lavendersparkle

The UK borders agency is holding a consultation on students. It's open until 31st January and you can participate in it through this link:
http://www.ukba.homeoffice.gov.uk/sitecontent/documents/policyandlaw/consultations/students/

Recently I've had a lot of experiences of of having my illusions about the world being just rudely taken from me. I find it easier to right angry blog posts rather than curl up in a corner waiting for Moshiach to come and make it all better.

One of the things which really bothers me about the spending revue, is less the details of it, which I'm not going to go into, but the way that the media is reporting on it. Basically, poorer people are going to suffer more as a proportional of their income than richer people, and poorer people have more need for the money. However, the only benefit cuts which are getting much media coverage are the ones which affect higher rate taxpayers. These people aren't even on middle incomes. The BBC's top story today is "Surely the government should spend £1 billion so that higher rate taxpayers can claim benefits without having to speak to their partners". Basically, the removal of child benefit from families with at least one higher rate taxpayer means that the higher rate taxpayer has to tick a box if someone in the household has claimed child benefit so that it can be taken back by HMRC. People are complaining that this is Intrusive and people shouldn't have to speak to their partner. People who don't speak to their partners might accidentally tick the box even though their partner isn't claiming child benefit or even worse not tick the box when their partner is claiming and be fined almost as if they were a benefit cheat.

Hang on, I thought, don't most people who claim benefits have to have to give details of their partner's income. Well yes, but that isn't intrusive or worthy of the BBC's reporting time. Long complicated forms and intrusive questions are fine for poor and disabled people. Tough talk about cracking down on benefit cheats is great, even if it's likely to cost more money than it raises, but Heaven forbid a higher rate taxpayer be asked about one detail of their partner's finances or be fined if they lie on their tax form.

It's election time and at this time of year politicians like to talk about how much they admire families and think that they are a Good Thing. In policy terms this feeling tends to at best amount to hot air and at worst be an excuse to be mean to people they view as not living up to their familial values. I know that the election manifestos have now been published, but I'd like to offer some suggestions to think about if you think that supporting families isn't just a throw away term to appease Daily Mail readers.

1) Make education more flexible and provide childcare facilities to make it more accessible to student parents.

2) Make local authorities house homeless families together rather than just taking the children into care. This would also be much cheaper than putting children into care.

3) End the detention of children seeking asylum. Stop the practice of sending a child's parents back to the country they came from and offering the child the choice to go with them or probably never see them alive again.

4) Reshape the immigration system to priorities the reunification of families.

5) Recognise marriages entered into abroad without excessive cost and red tape.

6) End the ban on spousal visas for spouses under 21.

7) Replace civil partnerships with same sex marriage, so that it more easily integrates with the legal systems of other countries. Stop requiring transsexuals to divorce their spouse before they can legally transition. Either switch to a Dutch system where everyone has a civil ceremony followed by whatever they want or allow religious groups to conduct same sex marriages if they want to.

8) Extend rights to legally recognised marriage to relationships involving more than two people.

9) End quirks in the benefit system that make it financially disadvantageous for couples to live together.

10) Provide more choice in maternity care and provide more support from health visitors etc. soon after birth.

11) Crack down on employment discrimination against pregnant women and mothers.

12) Provide longer parental leave and make it fully transferable between the parents of a baby.

13) Encourage more flexible working arrangements for everyone.

14) Make sure that the tax and benefit system ensures that families have enough money to get by on without having to work every hour G@d sends.

15) Improve the state of local authority housing. Ensure that there is affordable private and local authority housing which is three or more bedrooms to reduce overcrowding.

16) Ensure the provision of good quality childcare and give low income families more money in their pockets so that they can decide whether to spend it on childcare, forgo an income so one parent cares for the children or combine a lower paid more flexible job with childcare.

17) Reform the criminal justice system to try to help families stay together (more community sentencing, housing prisoners close to their families so that it's easier for them to visit).

Well, the election date has been announced to the surprise of almost no-one. Even before Gordon Brown went to speak to the queen, lot of quizzes had appeared on the internet to tell you who you should vote for. Now, I'll admit it, I love these things as procrastination devises. I also agree that it's good to have a quick check that you're party does indeed support the kind of policies you support. Unsurprisingly, all of the quizzes so far have found that I'm a Green/Lib Dem, which is pretty accurate. I'm a Liberal Democrat but I'd probably give the Greens my second preference if we had a half way sensible electoral system.*

So I think that these quizzes are fun and they might be a good check and a good starting point but I'd like to give a few words of warning to anyone planning to decide their vote by ticky box.

1) The quizzes don't cover all issues. There's a limit to what will be covered in the quiz. If you particularly care about foreign policy to a particular country, or plans for a development in your local area or very particular reforms in the criminal justice system, the quiz you're taking might just not take that into account. This is even more likely if happen if you have a slightly unconventional set of views, such as a libertarian free market environmentalist.

2) A lot of what a government does isn't in their manifesto, if it was we could just vote for a set of policies and and save the expense of human beings. In the 2001 election no-one could foresee the September 11th attacks and the seismic impact they had upon British policy. You need to elect the people you trust the most to do the right thing in all of the unexpected situations which will arise in the next five years. For this reason you need to not just look at a party's policies, but also the ideology and world view which is underlying these policies and how that would play out in the event of a new armed conflict, a natural disaster, a disease pandemic, an economic crisis etc.

3) You elect a person not a party. That person can switch parties without standing for re-election and most MPs who aren't mindless careerists will have the odd issue where they decent from the party line. It's worth finding out what your actual candidates support, particularly if you care a lot about a particular issue and even more if that issue tends to be a free vote issue.

*Can you tell that I'm a Lib Dem?

If I had to name the two things which I think are the issues I think of as most important they would be abortion and climate change. That might seem like a slightly odd combination but I think that they are two biggest issues facing our species. Abortion kills more than 46 million unborn humans every year and thousands of women. That's about one in four known pregnancies worldwide. Climate change is already killing people and, depending upon how we act to counter it and how it pans out it is likely to kill a lot more people and cause major irreversible changes to our way of lives.

The case for pro-lifers to be concerned about climate change is clear. Climate change kills people; it will kill more people. I think the kind of people who are concerned about the unborn are likely to also be concerned about the life chances of those people when they grow up.

Being pro-life might seem more antithetical to environmentalism but this doesn't have to be the case. Organisations such as the Optimal Population Trust make out that the best way to combat all environmental problems would be to reduce the human population but as George Monbiot points out that this isn't necessarily so. For the linkphobic the gist of his argument goes as follows. Population growth isn't what's driving increases in emissions of climate change gases. World economic growth far outstrips world population growth indicating that the thing leading to greater exploitation of the Earth's resources is higher per capita consumption, not more capitas. Even food shortages aren't caused by increases in human population, as the supply of food has outstripped the increase in population. Food shortages have been caused by higher per capita demand for meat, which is a much more resource hungry food stuff.

On top of that, global population growth is likely to end in the next century all by itself. As countries get richer they tend to go though an upside down U in terms of population growth. Initially the extra resources contribute towards such terrible things as reduced infant mortality, extermination of contagious diseases etc. which means that many more people survive to have children of their own. Then as the economic need to have children are replaced by financial instruments such as pensions and insurance, as the need to educate children makes a smaller family a better bet, as cultural norms about appropriate family size change, people tend to have fewer children. Already almost all more developed countries, plus a lot of poorer countries, have below replacement levels of fertility. Even the US is only at about replacement level. The UN estimates that the world population isn't going to make it much above 10 billion before it starts falling.

Here, however, is the kicker: where people have access to contraception, abortion doesn't lower fertility rates. This can seem counter-intuitive as surely more babies aborted means fewer babies born but that fails to take into account that pregnancy decisions effect future conception decisions. In developed countries the typical woman having an abortion is in her late teens or early twenties, before she's started family. A baby at this stage may well be compensated for by fewer children later.

Another thing which most people don't pay enough attention to is that the things which reduce average fertility rates tend to also reduce the rate of abortion. Access to contraception reduces both average fertility rates and the abortion rate. So does improving women's autonomy to decide when and how to be sexually active. Decreasing infant mortality eventually reduces fertility rates. By contrast, the draconian Chinese one child policy may have had a relative small effect upon fertility for the huge cost of death, misery and human rights abuse, because fertility rates were already falling b themselves before it was implemented.

On a more personal level, I think that one of the things which put me off engaging with climate change is a general disapproval among environmentalists toward breeding, as I would like to have a above replacement levels of fertility. There seem to be a lot of people about who think that no-one should have more than two children, but I don't think that we need to all have the same number of children. I know quite a lot of people who never want to have children, if we want to keep our average fertility rate below replacement levels, we can do that with childfree people and people with one and two child families and the increasingly rare three, four or more child families.

People often talk about criminals' and defendants' rights and victims rights as being in opposition. Actually, I think that are a lot of things which could make things better for both victims and defendants or make things better for one without being to the detriment of the other.

I get the impression that the courts are overloaded. This leads to long waits before things come to trial and that's bad for almost everyone. Firstly, memories get muddied over time so the chances of getting the correct verdict is decreased. The victim has the case hanging over her for month, during which time she can't really get closure and move on. The defendant also has the case hanging over him and bail restrictions. The only people who benefit from the delay are criminals who hope to scarper or harass witnesses into not testifying and sadistic bastards who want to use the court to string out the suffering of their victims. I don't think that we should be running a justice system for their benefit.

Even of we have to manage with overloaded courts, they could at least communicate better with the people involved in cases. Expecting a victim of a serious crime to just call up the court listings everyday to find out if her attacker's case is going to start the next day does not seem reasonable. Not bothering to tell her that it definitely won't start for a couple of days because the defence barrister is busy with another case, also not good.

I think a lot of victims of crime, rather than wanting longer sentences, just want their lives not to be even further fucked over by the trial process and not be treated as an inconvenient peripheral figure in the trial of their attacker.

I often realise that I'm marching to the beat of a drum no-one else can hear, or at least doesn't like the sound of. One of these moments was when listening to commentary on Conservative Party plans to give transferable tax allowances to married (and I think civilly partnered) couples.

Lots of people have referred to it as bribing people to get married, with ripostes of "If I marry it will be for love, not tax efficiency". The conversation is about whether marriage is a good enough thing for it to be worth bribing people to join it or whether it's fair to people who aren't married. I think my approach is quite different. In my mind I have always separated out civil marriage/civil partnerships from religious/cultural/emotional marriage. Maybe it's because I spent my teen years dreaming of marrying a girl before that would have been recognised by the state. In the end I religiously and legally married on the same day. Marriage is complex institution with lots of cultural and religious significance, but stripped down, civil marriage is basically a way of getting the state to recognise a raft of rights and entanglements between two people: immigration, medical consent, claims on each other's property and, indeed, already tax exemptions. In this discussion I haven't heard anyone claim that inheritance tax exemptions are unfair bribes for people to marry. Whilst they were all also in love, I know several people who married to obtain these legal rights. Two people very happily lived with each other for over a decade with no urge to marry until one of them was offered a job abroad and a marriage was the easiest way to obtain a visa for the other. Another two friends went to a register office and signed the paperwork with two witnesses to secure their legal marriage. The £100 it costs to secure a civil marriage is much cheaper than the cost of writing wills, medical directives and financial arrangements with a solicitor.

So adding another way to the ways in which the legal and tax system recognise civil marriage/partnerships does not seem to me to be a great break from previous form. The question should rather be whether it is desirable. The people who would benefit from a transferable tax exemption would be couples where one earns less than their tax allowance and one earns more. The most obvious example of this are couples where one partner does not work to care for children, other examples would be couples where one partner is in full-time education, or unemployed. One argument that I can see against transferable tax allowances would be that it would encourage couples to specialise with one working doing the paid employment and one doing the unpaid work. Some people feel very firmly that all parents should engage in equal amounts of paid employment and housework, and having non-transferable tax allowances encourages this. I don't think that all couples should share all work equally. Lots of people have good reason to want one partner to do more of the paid work: one partner can earn more, one partner enjoys domestic work more or one partner enjoys their career more. In my own marriage we tend to see-saw a bit in terms of who brings in the money, mainly dependent upon who's had a lucky break and who's doing something low paid for the sake of their future career. To me the question is about whether to add the ability to share tax allowances to the things which can be obtained through signing some paperwork at a register office, not about bribing people to marry or punishing the unmarried.

In my ideal world the tax system would involve a citizen's income rather than a tax allowance and these questions would be irrelevant. In the mean time I'm not really sure what I think of the idea of transferable tax allowances. It would probably benefit me, but then I'm not in the greatest need. I'd much prefer to see transferable parental leave, but I don't see why we couldn't possibly have both.

Edit: Someone posted a link to this article on Facebook and I wrote a reply.

I'm not convinced of the merits of transferable tax allowances, but some of those arguments are stupid.

Independence: if you think that you currently maintain financial independence in marriage, try getting divorced and seeing how dangerously deluded you are over that issue. Even if you don't have children each partner can make a claim on the assets amassed over the course of the marriage, regardless of who earned the money to pay for them.

More insulting than a tax allowance is the suggestion that non-earning partners aren't part of the labour force. Most estimates find that stay at home parents actually do more work than their earning partners. Does Chris Giles think that children raise themselves whilst their mothers paint their nails?

Also more insulting than a tax allowance is the implication that civil partnerships between same-sex partners are second best to civil marriages between different sex partners, which is suggested by the claim that once you let gays have transferable tax allowances, of course you should extend them to everyone else. Heaven forbid two heterosexuals shacking up together weren't given all of the benefits awarded to two people of the same sex who've made a legally binding commitment to each other.

I'd also contest this preciousness about people's motivations for marriage. I'm only 26 but I've attended two weddings which were heavily motivated by immigration considerations. I've also seen two people marry to secure the other legal protections of civil marriage. I'm sure there are other cohabiting couples who don't have a strong religious or cultural motivation to legally marry but would if there were transferable tax allowances and one of them was planning to take a break from paid employment. Marriages in this situation protect the non-earning partner who would have a greater claim upon the others income if the relationship ended.

Alec and I went to visit my parents this weekend. We went by train. I got the bus to the station as I had too much luggage and Alec cycled as he had some places to go on the way. As the station cycle park was, as always, completely full when Alec got there on Friday morning, he parked his bicycle against the fence on the pavement and locked it to itself. When we returned on Sunday evening the bicycle was gone. It had not been stolen, instead it had been dragged and thrown into a big pile of bicycles in the cycle park. Alec had to dig it out of the pile. The paintwork had been scratched, the basket had been broken, the handle bar grips were missing and the wheels were bent. All in all I'd say at least £50 worth of damage done to the bicycle by however moved it and threw other bicycles on top of it.

So I want to know the answer to a few questions:

Who moved it and why? The way that the bicycles were all piled up made it look like it was something official but there were no signs saying that they were planning a clearance or notifying cyclists that they're bikes would be in danger of officially sanctioned vandalism this weekend.

Are there any laws/rules against parking ones bicycle on the pavement? In Cambridge it's pretty unavoidable if you use cycling as your main means of transport. There's nowhere close to enough cycle parking almost anywhere in the city. The bicycle wasn't blocking the pavement, it was against a fence and there were no signs saying not to leave bicycles there.

Who can we complain to/take to the small claims court for the damage to the bicycle? It's not that damaged but I feel on principle that it might be worth at least threatening to take them to court. Even when cars are parked illegally in ways which endanger people's lives I don't think anyone would allow parking officials to smash the windscreen or slash the tiers. People should stop feeling that they can abuse cyclists.

The blogosphere is erupting with criticism and praise for the NHS, which divides along national lines. One thing you have to understand is that the NHS is one of the most sacred things to British identity. We love whingeing about it but we love it and believe it to be better than the alternatives. I'm not sure what a US equivalent would be, maybe Congress, in that they complain about it all the time but say bollocks like that it's the only true democracy in the world.

I'll be honest, some people are better off in the US system then in the UK system. The main people who are better of are:
Very rich people, because they will use private health care in both systems and in the UK system they pay twice, although this depends on how rich they are compared to how sick they get. The NHS effectively subsidises private healthcare in the UK because the moment something goes seriously wrong the patient can be transferred to an NHS hospital for them to pick up the pieces.
People who make money out of the US system e.g. people with shares in health insurance companies, medical staff probably get paid more in the US etc.
People who might benefit from expensive treatments with low success rates. Extremely premature babies are more likely to survive in the US, because US hospitals better, much more expensive treatment for them. All the extra money Americans spend on health care per capita does improve the outcome of some people at the margins.
You might be better off if you've got good, particularly employer based cover, as long as you don't get too sick. However, on average Americans pay more for their insurance than Brits do for our NHS and insurance companies put a horrific amount of time and energy into finding reasons to avoid paying out (more on that later). It also causes problems in that one's options to change jobs or marry and divorce are restricted by the effect it will have one's health coverage.

I think that I take this discussion a bit personally because my family is one of the groups of people who are much better off under the UK system. My husband has a chronic health condition (well actually a couple of them) and don't think he'd be able to get insurance in the US. As there's a strong genetic factor to it, I'm not sure if our children would either.

Anyway, what I really want to talk about, and the inspiration for the title of this post, is rationing in healthcare. Here is the uncomfortable truth: all healthcare systems involve rationing. The amount of money we could spend on healthcare tends toward infinite, or at least exceeds the per capita GDP of any country. Even if we spent the bare minimum on housing and food and every other penny on health care, we'd still have to ration healthcare in some way, and our health would be worse because access to good food and housing have a much bigger impact upon health than access to MRI machines. I'm at peace with that. I honestly prefer to have a MacBook and a house with a garden, to the couple of months my life expectancy might be extended by spending more on healthcare. If I felt differently, in the UK I'm free to purchase private healthcare and the only limit would be the amount of money I was willing and able to spend. All systems require some way of deciding which treatments, which might improve a patients chances, aren't worth the extra expense.

One of the arguments being used against a UK style system is the bogey man of healthcare rationing, which led to the amazingly stupid statement that “scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” Of course, the (sadly for my faith in humanity not deliberate) mistake is that Stephen Hawking is British has lived in Britain for the majority of his life (his being a professor at the University of Cambridge is a clue) and regular relies upon the NHS for healthcare. Maybe they were confused because he his speech box has an American accent.

The picture being spread by opponents of healthcare reform is of Orwellian panels before which people will have to justify their existence to receive healthcare. That's not actually how it works in the UK. We have an institution called the National Institute for Clinical Evidence, or NICE for short. Their job is to decide what treatments are cost effective to provide. They do this by comparing a treatment to the number of QuALYs (quality adjusted life years) it can be expected to provide a patient. Here is where the tiny grain of truth in the likes of Palin's criticism of the NHS comes in. As the years are quality adjusted, treatments which return a patient to full health are more likely to be paid for than a treatments which leave a patient in pain or with a disability.* This is a much discussed paradox in healthcare economics, it intuitively makes sense that a treatment which saves your life is better than a treatment which saves your life and leaves you blind, and patients faced with two treatments, one of which is slightly more risky but one of which may lead to a serious disability, may well prefer the more risky treatment. However, we don't like the result that saving the life of a blind person is worth less than saving the life of a sighted person. Happily most of the time these kinds of concerns aren't very relevant to NHS rationing decisions. Most treatments which don't get approved by NICE don't get approved because they're not very effective, or even have negative consequences which outweigh the positive ones, or there are alternative treatments which are cheaper and just as good. The big one which has made the headlines are certain very expensive cancer drugs. The thing which really stopped NICE approving them was that they only had quite a low chance of extending life a few months. We could get all sentimental about doing everything possible to extend someone's life, but if you give someone with terminal cancer the option of a 5% chance of an extra three months with end stage cancer or the equivalent money's worth of really good palliative care, such as 24 hour nursing in their own home, they might not pick the drugs.

And as a stated above, all healthcare systems involve rationing, even in the US. In the US rationing takes the form of whether your insurance company or you yourself will pay for it. I think maybe Americans get more squeaked by the government making life of death decisions than by leaving them to the private sector. Some insurance policies have explicit exclusions. A lot of the time they do it through rescission. Rescission is the process by which an insurance company declares a policy invalid, without having to return the premiums paid, usually under the legal reason that they was a misrepresentation or mistake on the patients original application forms. I say 'legal reason' because if you want to make a profit, there's not much point dropping clients whose medical costs are less than their premiums, even if they have made a mistake on their forms. If they're motivation were purely legal they'd explain it as "rescission is essential for combating fraud" rather than "it is one of many protections supporting the affordability and viability of individual health insurance in the United States under our current system" as Don Hamm’s (CEO of Assurant) said. He also said that rescission only effects less than 0.5% of the people Assurant covers, which sounds pretty small until you take into account that 90% of the US population use less healthcare each year than the cost of the average insurance premium. There's not much point in an insurance company rescinding their policies, given that they're making a net profit. So that 0.5% becomes a 5% chance that your insurance will cancel your policy if your healthcare costs more than that year's premium. If they target the rescissions at the 1% most expensive patients you're looking at a 50% chance of rescission if your healthcare costs go over $35,543. Here's blog a cribbed most of this off. It also features a great video in which no one in a commerce subcommittee, including the CEO of Assurant, can work out what their "easy to fill in" form means. Insurance companies have a really strong financial incentive to make sure that you don't fill in your form correctly so that they can get out of it if you get too sick. Rationing happens in all healthcare systems. In the UK it's done by government agencies; in the US it's done by insurance companies. I prefer a system in which these decisions are made transparently by people who answer to the people I elect.

Which brings me back to Stephen Hawking. Today, Prof. Hawking would receive great healthcare in either country because he's famous and eminent. However, if he'd been a US grad student when he was diagnosed with his condition at the age of 21 how likely would he have been to one of those 0.5% of patients who face rescission?

*Just to clarify, this doesn't mean that you're less likely to receive a treatment just because you have a disability. NICE makes decisions about treatments not patients. The only way in which patients pre-existing conditions work their way into the maths is when they impact upon the likely effects of the treatment, for example, there's not much point treating someone's prostate cancer if their going to die from kidney failure long before the cancer spreads from their prostate. The only place I see rationing based upon pre-existing conditions really biting is in donor transplant, where your chances of receiving an organ is lower if your life expectancy is lower or your condition makes the transplant less likely to be successful. I'm not sure of a way private healthcare could get around that other than the even more distasteful idea of organs going to the highest bidder or buying organs.

On the radio I was listening to a discussion about whether supermarkets should label food from the West Bank to make clear whether it was grown by Israelis or Palestinians so consumers could choose not to buy food grown in Israeli settlements but still buy food from West Bank Palestinians. I was reminded that this sort of labelling could go both ways. My mother proudly told me that she bought herbs from Israel rather than the West Bank and was rather put out when I told her that the West Bank herbs she was boycotting were probably grown by settlers. I'm not sure where my mum gets her hardline Zionism from. It's certainly not me, she far more jingoistic about Israel than I am and I think she was very supportive of Israel before I became Jewish. I suspect that it's because she doesn't have much time for sore losers. In her opinion Israel won all of it's territory fair and square and if it's neighbours didn't want to lose territory to Israel, they should have made peace with it when they had the chance. I also wonder whether it's a generational thing, she remembers when Israel was seen in the UK as the plucky underdog.

I think Alec's also more supportive of Israeli military actions than me. I think part of this is that, not being Jewish, he tends to have different sorts of conversations about Israel than I do. I'm more likely to get to discuss Israel in situations where everyone is relatively well informed and Israel's right to exist is a given we can get down to the rights and wrongs of specific policies and actions, whereas conversations with non-Jews are more likely to be big splodges of accusations sometimes rolled together with how this supports their pet theories of Imperialism. I'm getting better at dealing with these people. The key is to just ask them to expand their views and correct any factual or logical errors. If I've had a few drinks I still sometimes end up yelling at them. Still, unlike Alec I've never had to deal with people saying that Christian book shops should stop stocking Rosh HaShannah cards or that churches shouldn't hold Holocaust memorial services because of Israeli military actions at the time.

I think another side of it is his protectiveness. Alec really wants there to be a country where I and our children and grandchildren could go if things turned nasty. I think he fears antisemitism more than I do. I don't want to be melodramatic, but "don't you realise people are going to want to screw you over because you're Jewish" has been part of the formula with converts going back to Talmudic times. I think would have been a bit naive for it not to have crossed my mind at some point that my decision to convert might lead to the deaths of some of my descendants. I'm sort of more at peace with it. I while ago I told him that I found it very sweet that he reacted to any kind of antisemitism as a direct threat against me and our future children. He replied that, given the history of the last 100 years, wasn't that reasonable?