Independence - how would you vote?

[renton]

Watched the so called debate last night on stv. Sturgeon just talks over people.

Annoying as feck. Had to switch off.

How did you rate Sarwar?

[Ad Lib]

Allowing free prescriptions to be defined, without any qualification, as 'actively redistributing money to the wealthy' is one of the most egregious Unionist canards, and one that it's disappointing to see the SNP and its supporters allow to pass largely without comments.

Hardly any serious observer would date label NHS treatment as 'redistributing money to the wealthy' (again, without any qualifier), but because it's 1) Scottish and 2) innovative policy, the dominant concern is somehow to illegitimise it rather than acknowledge what it plainly is (universal) and then take a dispassionate look at its effects, costs and benefits.

Anyone doubting that this is a reverse-engineered way to give the Nats a kicking need only ask themselves if they thought prior to literally this second that they think NHS treatment is 'actively redistributing money to the wealthy' and anything other than a policy with its roots in socialism.

Relative to a means tested system, it is absolutely the case that universally free prescriptions redistribute towards the wealthy, who would otherwise pay for them in full without state subsidy. In much the same way as, relative to a means tested level of state support for other health provision, the NHS's "free at the point of use" approach is a redistribution of wealth to the wealthy by unburdening them of the cost of their own healthcare.

Of course, relative to the state "doing nothing" universal services still tend to have a broadly progressive/redistributive effect downwards, simply because the services are more likely to be used by the poor than the rich. But it's not the maximally redistributive and it is considerably less redistributive than means tested models.

Of course, there are consequences to "universal" benefits. The cost of Scottish prescription charges mean that we have less good access to certain cancer drugs than people in England. The presence of "free" undergraduate tuition in Scotland has meant that our less affluent graduates will actually pay back more on their student "loans" (because of their maintenance debt and lower repayment thresholds) than will their English counterparts. The subsidies we have to pay to the bus companies for them agreeing to provide free travel to all pensioners, rather than just those that display a pressing economic need for it, could be better spent paying them to run more services in the first place or to improve the public transport infrastructure. The money we spend on the free personal care for the affluent elderly and for their winter fuel allowances and TV licences could instead be spent keeping more less affluent pensioners out of fuel poverty. These are all choices, and ultimately forms of rationing state resources. They don't represent all-encompassing provision of service, rather a broad judgment about a basic package that will dissatisfy the fewest people in the most straightforward manner possible.

There will be cases, of course, where the money saved by means testing a service is (more than) wiped out by the costs of administering it, or where there is evidence that those who need it will, for whatever social or economic reasons, not apply for the means-tested support to which they're entitled. In these cases, there is a strong utilitarian case for a "universal benefit". But there is no inherent moral virtue in universalism, nor does it encapsulate through so-called universal policies, the broad political aims and values people espouse through them.

"Education is a fundamental right so no individual should have to pay for it" - fine, but what education? Primary? Secondary? Further? Higher? Undergraduate? Post-graduate? Doctoral? Piano lessons? Acting classes? Home tutoring? Continuing professional development? Night classes? All and any books? The internet? Is education just about the teaching resources? What about the time-based opportunity costs? What about maintenance? What should that be enough to cover? At what point does something actually fall outside the "education" umbrella that is a "fundamentalright" that "no individual should have to pay for"?

What starts with a broad and honourable goal suffers from such indeterminacy that it doesn't bear any relation to what the actual public policy debate is really about. Universal benefits are just rationing, like *any* other government policy. What we're really arguing over are how we should draw the boundaries of state intervention and what aspects of the values we think are in the greatest need of emphasis and to what end.

This is a debate Scotland needs to have. It's a debate the UK needs to have. We need to realise that beneath a very shallow surface, the things being triumphed in the name of universalism really aren't that special at all, and insofar as they are special, they aren't necessarily the best way to help the most people to the greatest extent with finite resources.

[Lambie's Pigeon Feed]

As a Liberal Democrat I resent any suggestions that we are a left wing party. We are liberal centrists.

I would also like to stick an oar in here and suggest that state-funded university tuition for specific undergraduate education for a fixed period of time only to those who are Scots domiciled, going to certain state-approved education establishments does not embody any principle of universalism whatsoever.

You've stuck that oar in before you tedious wee twat. Naff off.

[Swampy]

Relative to a means tested system,

it's not the maximally redistributive

Cool

[renton]

Relative to a means tested system, it is absolutely the case that universally free prescriptions redistribute towards the wealthy, who would otherwise pay for them in full without state subsidy. In much the same way as, relative to a means tested level of state support for other health provision, the NHS's "free at the point of use" approach is a redistribution of wealth to the wealthy by unburdening them of the cost of their own healthcare.

Of course, relative to the state "doing nothing" universal services still tend to have a broadly progressive/redistributive effect downwards, simply because the services are more likely to be used by the poor than the rich. But it's not the maximally redistributive and it is considerably less redistributive than means tested models.

Of course, there are consequences to "universal" benefits. The cost of Scottish prescription charges mean that we have less good access to certain cancer drugs than people in England. The presence of "free" undergraduate tuition in Scotland has meant that our less affluent graduates will actually pay back more on their student "loans" (because of their maintenance debt and lower repayment thresholds) than will their English counterparts. The subsidies we have to pay to the bus companies for them agreeing to provide free travel to all pensioners, rather than just those that display a pressing economic need for it, could be better spent paying them to run more services in the first place or to improve the public transport infrastructure. The money we spend on the free personal care for the affluent elderly and for their winter fuel allowances and TV licences could instead be spent keeping more less affluent pensioners out of fuel poverty. These are all choices, and ultimately forms of rationing state resources. They don't represent all-encompassing provision of service, rather a broad judgment about a basic package that will dissatisfy the fewest people in the most straightforward manner possible.

There will be cases, of course, where the money saved by means testing a service is (more than) wiped out by the costs of administering it, or where there is evidence that those who need it will, for whatever social or economic reasons, not apply for the means-tested support to which they're entitled. In these cases, there is a strong utilitarian case for a "universal benefit". But there is no inherent moral virtue in universalism, nor does it encapsulate through so-called universal policies, the broad political aims and values people espouse through them.

"Education is a fundamental right so no individual should have to pay for it" - fine, but what education? Primary? Secondary? Further? Higher? Undergraduate? Post-graduate? Doctoral? Piano lessons? Acting classes? Home tutoring? Continuing professional development? Night classes? All and any books? The internet? Is education just about the teaching resources? What about the time-based opportunity costs? What about maintenance? What should that be enough to cover? At what point does something actually fall outside the "education" umbrella that is a "fundamentalright" that "no individual should have to pay for"?

What starts with a broad and honourable goal suffers from such indeterminacy that it doesn't bear any relation to what the actual public policy debate is really about. Universal benefits are just rationing, like *any* other government policy. What we're really arguing over are how we should draw the boundaries of state intervention and what aspects of the values we think are in the greatest need of emphasis and to what end.

This is a debate Scotland needs to have. It's a debate the UK needs to have. We need to realise that beneath a very shallow surface, the things being triumphed in the name of universalism really aren't that special at all, and insofar as they are special, they aren't necessarily the best way to help the most people to the greatest extent with finite resources.

I think you are missing one important point about universality, which I touched on earlier, in that it makes the whole of society a stakeholder in the univeral services, and thus, by virtue of elightened self interest, maintains interest in those services and their timely and useful provision for everyone. Otherwise you end up with withered safety net minimum level services where the rich can use their wealth to take care of themselves, and everyone else gets to go f**k themselves. Sure a spolitics follows money, so this would happen.

[Baxter Parp]

Sturgeon just talks over people.

Well, now I'm not sure you were watching the same debate as everyone else.

[Baxter Parp]

Relative to a means tested system, it is absolutely the case that universally free prescriptions redistribute towards the wealthy,

Stopped reading there, clearly you've never heard of BUPA or noticed the sums "the rich" pay in NI. The redistribution of wealth is still downwards, as the poor may never pay enough to cover their prescriptions whereas the rich will.

[speckled tangerine]

Of course, there are consequences to "universal" benefits. The cost of Scottish prescription charges mean that we have less good access to certain cancer drugs than people in England.

What do you mean by that?

It is absolutely a good thing that Scottish prescription charges are now free at the point of need. From personal experience I remember well my mother (single parent- not broke but hardly flush) having to select which medicine she could afford out of the three or four prescribed at any given time. Result? Her health deteriorated until she ended up as an in-patient.

She's over retirement age now and her health has improved but if people like her these days need not endure financial health russian roulette and a few more affluent types get medicine gratis, then that's the way it is. Prevention is better than cure and though I accept your point about cancer drugs unavailable up here, free prescriptions, in general, has to be seen as a progressive step.

[xbl]

By the way, im not keeping up with the news, but I see that yes supporters are now being attacked on the street by unionists while the papers gloss over it?

Incidentally, universal free prescriptions are a good thing. There are no losers.

[Ad Lib]

What do you mean by that?

The government paying pharmacists to provide prescriptions to people for £0.00 in Scotland.

It is absolutely a good thing that Scottish prescription charges are now free at the point of need. From personal experience I remember well my mother (single parent- not broke but hardly flush) having to select which medicine she could afford out of the three or four prescribed at any given time. Result? Her health deteriorated until she ended up as an in-patient.

She's over retirement age now and her health has improved but if people like her these days need not endure financial health russian roulette and a few more affluent types get medicine gratis, then that's the way it is. Prevention is better than cure and though I accept your point about cancer drugs unavailable up here, free prescriptions, in general, has to be seen as a progressive step.

But rich people don't need free prescriptions. What your argument supports is a better way, a better metric of deciding how prescriptions are paid for and by whom. It doesn't support the automatic conclusion that the state should pay for all prescription drugs.

Several members of my family are heavily dependent on regular prescription medication and more besides. They and others could be better provided for without necessarily abolishing all prescription charges and letting the state pick up the bill that way. And we could potentially help more people by having a broader range of prescription medicines available through the NHS in Scotland, by asking those earning over a certain amount to make a whole or partial contribution towards the cost of it.

Or put more simply, we should only offer free prescriptions to everyone if we are confident it is a) cheaper than means testing them like we do with eye tests and dental care and b) has no detrimental effect on the overall breadth of medical provision we can provide for under the same budget.

[xbl]

"Rich people don't need prescriptions".

So? If everyone can get them then you don't need to means test, and everyone gets the same treatment that they already pay for in tax.

Incidentally, when the snp abolished them, they stated that it was cheaper than keeping them with all the caveats and exemptions.

[Swampy]

Anyone else noticed the overlap between people who whine that the NHS is bloated, bureaucratic, and inefficient, and those who think that means-testing is a good idea?

[xbl]

Anyone else noticed the overlap between people who whine that the NHS is bloated, bureaucratic, and inefficient, and those who think that means-testing is a good idea?

Things should be smaller, leaner, more efficient, simpler, and without all that bureaucracy. But with means testing for everyone and everything. Its a trojan horse, just as we've seen in England.

[Swampy]

If people want to see a brave new world of means testing I invite them to try filling in paperwork for Parkland Hospital in Dallas.

[Ad Lib]

I think you are missing one important point about universality, which I touched on earlier, in that it makes the whole of society a stakeholder in the univeral services, and thus, by virtue of elightened self interest, maintains interest in those services and their timely and useful provision for everyone. Otherwise you end up with withered safety net minimum level services where the rich can use their wealth to take care of themselves, and everyone else gets to go f**k themselves. Sure a spolitics follows money, so this would happen.

I don't agree with the premise that universal services creates a society stakeholder in state services, nor do I consider it especially desirable. On the contrary, it isn't a "safety net" if it's cushioning people at the top in their high positions. What you've described is more of a safety ladder. We shouldn't be protecting the rich; they're more than capable of protecting themselves.

It does not follow that just because the rich don't get to use state services that therefore state services will be less well funded. You're ASSUMING that anti-universalism *necessarily* comes with a series of policies designed to reduce the overall level of state spending or the overall amount of services the state is providing. This isn't the case. If you want to be able to do more for those in most need with the same amount of resources, you should take it away from those who don't need it.

The rich *already* look after themselves with supplementary services over your state minimum. They really aren't that bothered and wouldn't actually notice that much if their state benefits were taken away from them. Have a bit of courage and tell them look after themselves and help those who actually need it. Your vision of universalism, far from challenging the client-state relationship, accepts it as a fait-accomplit and puts an expensive sticking plaster on it.

Stopped reading there, clearly you've never heard of BUPA or noticed the sums "the rich" pay in NI. The redistribution of wealth is still downwards, as the poor may never pay enough to cover their prescriptions whereas the rich will.

I don't care how much the rich pay in national insurance (the answer is "not actually that much" by the way, as national insurance only relates to employment income and the rate falls off a cliff very quickly for higher incomes). They pay more in taxes because they are the most effective way to generate revenue from which services can be provided, not because they've earned them.

Incidentally, universal free prescriptions are a good thing. There are no losers.

Except, you know, those whose drugs the health system in Scotland won't pay for.

[renton]

Things should be smaller, leaner, more efficient, simpler, and without all that bureaucracy. But with means testing for everyone and everything. Its a trojan horse, just as we've seen in England.

You have to accept a certain amount of inefficiency in any system, that's one of the most fundamental physical laws of the Universe. For what it's worth, the NHS is one of the most efficient public health systems available, and those that whinge about it being bloated and inefficient are using code for: 'Not private sector' it's that basic dishonesty in language that stops us having a debate on how to make a public system more efficient without a bunch of right wing yahoos crashing through the door with delusions of privatisation.

[Swampy]

You have to accept a certain amount of inefficiency in any system, that's one of the most fundamental physical laws of the Universe. For what it's worth, the NHS is one of the most efficient public health systems available, and those that whinge about it being bloated and inefficient are using code for: 'Not private sector' it's that basic dishonesty in language that stops us having a debate on how to make a public system more efficient without a bunch of right wing yahoos crashing through the door with delusions of privatisation.

Yes, precisely. And the point I was getting at was that the 'harrumph, moar efficiency' brigade overlaps significantly with the means-testing brigade. How, precisely, is means-testing to be conducted without a vast and invasive bureaucracy?

It is jaw-dropping to see the number of people in the UK who want to imitate failed systems from elsewhere in the world solely in the name of ideological purity.

To be clear, if means testing actually, y'know, worked to save money and increase availability of niche drugs and create a more equitable healthcare environment, I'd be all for it, but it simply does not achieve these things. At all. The only reason to favor means testing is an ideological attachment to it, because it doesn't work.

Viewers in Scotland can opt out of the insanity above by voting Yes next year. Otherwise, I hope you enjoy more expensive and less efficient healthcare.

[Baxter Parp]

I don't agree with the premise that universal services creates a society stakeholder in state services, nor do I consider it especially desirable. On the contrary, it isn't a "safety net" if it's cushioning people at the top in their high positions. What you've described is more of a safety ladder. We shouldn't be protecting the rich; they're more than capable of protecting themselves.

What a lot of Unionist cant. Nobody's protecting the rich, it's cheaper and easier to abolish prescription charges than it is to means test them, it's also better for society as a whole. The idea that the Scottish NHS isn't buying certain drugs because they can't afford them is also utter rubbish. The criteria is "bang for your buck", not "the buck". The same thing happens in England & Wales. You should ask someone with a long term condition whether they think universal free prescriptions is a good idea or a bad one. The Unionist parties exploitation of cancer sufferers for political gain is absolutely disgusting and it's no surprise to see you parroting them.

[Swampy]

What a lot of Unionist cant. Nobody's protecting the rich, it's cheaper and easier to abolish prescription charges than it is to means test them.

But someone, somewhere, might Get Something For Nothing that They Don't Deserve.

The so-called 'centrist liberal' mindset is really one of punitive inefficiency if you look at its actual outcomes. It is more important to be ideologically pure than it is to actually formulate working policy that meets its goals effectively and cheaply. A more expensive policy is more desirable if it prevents people from benefitting when a 'centrist liberal' declares that they aren't worthy of benefit.

[Baxter Parp]

http://worldofstuart.excellentcontent.com/sturgeonsarwar-scotnight-5sep13.mp3

Anas Sarwar, hero of the left.