Tsk, see, we can't rely upon altruism

Not that we’d want this to be taken entirely and wholly seriously:

Hospitals have been told to cancel thousands of operations as blood supplies threaten to run dry.

After years of rejecting donors, NHS Blood and Transplant (NHSBT) issued its first ever amber alert status on Wednesday - meaning there are just two days of some types of blood supplies across hospitals in England.

The agency asked all existing donors who are types O negative or O positive to come forward and book an appointment to give blood.

But if this were a paid market - say, energy, food, trains, housing - then you can imagine the calls that this must be removed from being a paid market and made something different, reliant upon government or altruism or summat.

Because any stutter in a paid market always does lead to such calls. So, here we've an altruistic market which has a stutter - logical fairness requires us to insist that it can no longer be an altruistic market, right?

The not seriousness of the comment - except as a logical point - is that we've actually tried paid and altruistic markets here. At least, the US has. And the voluntary donations vastly outcompete the paid ones for whole blood. The consumer preference is overwhelming. So, altruism in whole blood it is then.

Not because there's any a priori proof that this should be so. Or that paying for whole blood is immoral - despite what many will say. But because we used the market system properly. To test, try out and find out which arrangements do work.

That is, we use that free part of free markets to find out whether cash on the nail markets work here. That use leading us to the finest solution we have in these specific circumstances. Which is the part that does need to be taken entirely and wholly seriously. This whole concept of free markets is, in one way of looking at it, a method of evidence gathering and decision making. At the start we don’t know. So, what is our method of finding out?

The value of using this method rather than - say - some insistence that money and body parts must not be mixed is that a purely altruistic system for blood products does not work. Certainly, as the continuing scandal over haemophiliacs and HIV infections shows, a paid market can have its problems here. But there is no country that successfully relies upon an altruism only collection system for blood products like plasma. Everyone, but everyone, relies at least in part upon a payment to the donors system - largely the US one.

That is, without the cash based collection system people die for lack of plasma. We can even go on to think that this is less effective than an altruism based system. Or that voluntary donations of plasma lead to higher quality - as with whole blood. Even, that it’s still immoral, money for bits of humans - as long as we’re willing to accept the cost of that moral imposition, death for some.

Again, this is the value of the free part of free market. We’ve two very closely related products and markets here, whole blood and plasma (or blood products, if preferred). In one altruism outperforms cash. In the other cash creates the supply that altruism doesn’t. And that’s the value of that free part. Without actually trying this out we’d not know that, would we? And we’re now able to manage our world because we do know.

Having plucked the logically important part out of this of course the lesson is of wider import. Only one country in the world has payment for kidney donation. Only one country doesn’t have a queue of people dying while awaiting a kidney. It’s possible to supply a part of your liver and recover just fine - as is the person it’s implanted into likely to recover just fine. Gametes, surrogacy, can be both donated and bought - well, which system actually works, in the sense of producing the optimal, even maximal, amount of bouncing babies?

Shouldn’t we find out, rather than allowing the self-appointed to determine our morals for us? After all, once we have found out then at least we’d know what those morals are costing us. Or even, what their morals are costing us.

It's too little free market, not too much

That perennial whine, housing and rentals. We’re told that:

It’s the crisis Thatcher built. It started with the “right to buy” in 1979, which eviscerated the country’s social housing stock. It was followed by Tony Blair’s private finance initiatives, or PFIs, which fragmented local services. And it has been compounded by austerity, which finished local services off. The result of 40 years of free-market extremism is visible all around us: in tent cities, food banks and record-breaking numbers of homeless deaths, which continue to rise every year. Meanwhile, private landlords swim in cash.

The problem here is not enough free market extremism, not too much. We have a national plan for how much housing should be built. We have very strict limitations on who may build what where. We’ve lines on the map insisting that no one at all can build houses Britons want to live in - the absurd idea of minimum density at 30 per hectare - anywhere near where Britons actually want to live - the Green Belt.

These are the reasons that housing is expensive in Britain. For the cost of building a house is very much the same as it is anywhere else. In the £120k to £150,000 for a nice little 3-bedder. All of the rest of the price - and this can be checked by looking at how much the insurance company will pay out if your house were to suffer a sudden dematerialisation event - is the scarcity value not of the land even, but of the pieces of paper that allow you to build a house on a specific piece of land.

So, the solution is to issue more pieces of paper. As with the way government issues money itself: print more, each piece is worth less.

The Conservative party are already subsidising people’s housing costs through housing benefit, much of which is paid into the pockets of private landlords. Wouldn’t it be more efficient to spend that money on building long-term, affordable social housing, rather than empowering landlords who have no interest in meeting the needs of the poorest renters?

It would in fact be more sensible to go all free market in a properly vicious and regulation slashing sense. Blow up the Town and Country Planning Acts 1947 and successors. Proper blow up, kablooie.

Force suppliers - landlords - to chase consumers - renters - just as Tesco, Morrisons, Waitrose, Aldi and the rest have to chase our custom for their baked beans. A proper free market will have prices at around the cost of production of the marginal unit or so. Because that’s how markets work. Second hand will be cheaper as that’s also how markets work.

The solution to the fundamental problem in the British housing market is, at bottom, not to try and tone it a bit with some twerking here and there, it’s to get all Adam Smith on its arse. Viciously so.

Kablooie.

The Department for Health Insanity

We all know how profligate the government can be with our money but this item coming right after a mini-budget calling for spending cuts is not without irony. The Department for Health and Social Care has just announced it will finance £50M on research into health inequalities. £50M on doing something about them might be excusable but giving £50M to academics to find the answers we already have is just throwing our money away. For starters, the DHSC could look at Scambler (2011) and Thomson et al. (2006)

Don’t get me wrong. Many local councils are impoverished and bunging them the occasional £50M is no bad thing, especially as the DHSC does not seem to need it. But they should be sent the money to spend on what they are good at – social care for example – not something for which they have no relevant skills whatever. No less than 13 local authorities will get about £4M each to do their own things: there will no learning from each other. Instead “every collaboration will be set up in partnership between universities and local government, capitalising on the world-leading experience and skills of the academic community.” We do not know how the 13 were chosen but it seems unlikely that the 13 universities in question are all “world-leading” in this particular field.

Of course, when they have spent the £50M on research, there will be no money left to do anything about the findings. Another £50M on adult social care or persuading NHS doctors to remain in post would have been money really well spent.

The announcement is unclear whether the £50M comes from the National Institute for Health Research (NIHR) or the DHSC itself. The NIHR has not got around to publishing an annual report since their 2019/20 one. They spent over £1bn on a miscellany of UK research projects plus £120M overseas. In addition, the Medical Research Council spent £886M, including £19M overseas, in 2021/22.

I have no idea how much the UK, or England, should spend in total on medical academic research nor how they make their decisions nor what methodology for decision-making has been shown to be the most productive. I am pretty sure the NIHR and MRC do not know the answers either because, if they did, they would tell us.

I was once involved in an application to the MRC for research support. About a year later they turned us down on the basis that the research could not possibly work, i.e. it could not be done. Luckily, we had got the money from somewhere else and it had all worked out fine.

These two bodies should be merged and introduced to the real world.

We might not like the answers but prices are information

Today’s harsh proof of the truth - we may well not like what prices tell us but they are still information.

Florencia is being forced to make a maddening choice between working and staying afloat. She and her husband employ a nanny to look after their two-year-old daughter, who has special needs, while they both work. “With the spike in costs, we can no longer afford [the nanny] so I have decided to take time off,” she tells me.

The labour of one woman is being used to look after the child, whichever way around this is done. Quite why there’s a societal interest in whether it’s Florencia doing the childcare or the nanny is something we don’t quite grasp. Or even, we’ve a way of working out what the societal interest is here. If Florencia’s non-childcare income is high enough to pay the costs of the childcare then that’s a net plus for society as a whole. If it isn’t then it isn’t. For, again, the starting set up is that the child requires the full time labour of one adult to care for it. The only question is whose - what is the societal interest in whose, that is?

“People still do not grasp this notion that if you invest in the childcare sector, you’re investing in the economy, because it enables people to work,” says Brearley. “What they think is: ‘My taxes are paying for your children.’ And that’s not fair.”

But run that through the Florencia Filter again. You are taking people away from other work to care for these children. In order for people to go out doing other work than caring for children. Only if the work being done not-caring for children is of higher value than the work being done caring for children is this a net plus for society. How do we work out what is higher value work? The income gained from doing the work. If that income supports the childcare then we have our proof that it is societally value add. And, in that cruelty of prices, if it doesn’t then we’ve our proof that it is not.

I know I’m not the only one who compares my wages each month with the cost of childcare, and wonders if the stress of juggling both, only to be barely breaking even, is worth it.

Those prices might well be saying that it isn’t.

But ask any expectant parent about the state of British childcare and you will settle upon a seemingly universal understanding: the system is woefully unfit for purpose.

After a Brexit exodus decimated staffing levels in nurseries, the pandemic quietly pushed the early years sector past the point of no return, and this winter promises even more hardship. Deliberate underfunding means providers have little choice but to charge astronomical fees, which have increased at a rate that far outstrips wages, to cover their own sizeable outgoings. And as energy prices rise, so too will costs.

That’s getting dangerously close to a claim that Brexit must be reversed in order to solve the servant problem. Which has, we agree, been something people have been complaining about for well over a century - the servant problem we mean, Brexit’s a little more recent.

We do entirely agree that there is a childcare “problem”. Children require care, so the problem is who should provide that? We also entirely agree that there’s no reason at all why it should necessarily be the mother that does so. But we do need a structure, a reasoning method, inside or with which to make the decision.

Where the work being done outside the nuclear family covers the cost of importing the childcare into the nuclear family then perhaps this should be done. Where it doesn’t it shouldn’t. As with absolutely any other discussion about home as opposed to market production of anything at all - cooking, laundry, floor sweeping, button sewing, lawn mowing, gutter clearing and all of the rest.

One added little extra piquancy here. It does seem to be those who demand more household production of all sorts of things - sew, make and mend rather than buying fast fashion, grow our own veggies on the allotment, slow cook at home rather than use the supermarket chiller shelf and on and on - who also demand that childcare should not be part of the household sector of production but must be moved over into the market sector. Which does strike us as odd, as the very reason for the household’s existence being the human economic unit is children and their long, long, raising periods.

But leave that grumpiness aside. We may well not like what prices tell us but they are information all the same. For some parents caring for their own children is higher value work than whatever it is they do in the office. Society as a whole is therefore richer - as it always is - if they do that higher value work.

We’ve our decision making structure that is - prices. We should use it.

How to solve climate change

Ms. Thunberg has invited some friends to tell us all how to deal with climate change. As we’d expect there’s very little actual thought here, more the repetition of previous positions. Very much a set of calls to do what the individual wants whether climate change exists or not, whether it’s a problem or not and whether that action would solve climate change or not.

Ms. Klein tells us to beat transnational capital (now, there’s a surprise, right?), Mr. McKibben to stop using fire. The health care guy says health care should be green, Mr. Piketty says tax the rich, a couple of climate justice folk say equity and justice is the solution and Mike Berners-Lee (no, not Tim, but Mike) says honesty in politics would be a good idea. We agree with that last one, obviously, even as we think it’s the least achievable of those desires.

None of these are specific to climate change. Mr. Piketty says tax the rich as the solution to the Sun rising in the East each day. Ms. Klein has become a transnational brand by railing against the brands created by transnational capitalism. And so on.

Our real ire, rather than just snide observation, is reserved for this from Greenpeace:

In our throwaway society, it feels as if we’re facing an avalanche of disposable plastic. One simple idea holds the key to turning this around: reuse. The practice was embedded for generations in so many cultures across the globe, yet the corporate world has made us forget those traditions and the value we place in objects that have taken natural resources and energy to produce. We need to shift to reusable packaging that stays in circulation – used, washed, reused and, crucially, out of the environment. The status quo simply isn’t working: we need to embrace the innovations that will allow reuse to flourish in the modern world.

This is not just the repetition of what Greenpeace would be saying anyway - recycle more! - whatever the subject under discussion it’s also, with climate change, often counterproductive. Assume, as they do, that we need to reduce resource use. OK, therefore we should recycle where that reduces resource use and not recycle where recycling increases resource use.

For example, we recycle must of the world’s usage of aluminium metal. Not because the ore, bauxite is particularly scarce, nor because alumina is difficult to source. But because that process of transforming alumina (Al203, or aluminium oxide) into aluminium metal uses some $1,000 per tonne or so of electricity. Remelting already extant aluminium uses perhaps $50 of electricity. So, what is actually recycled is that $950 per tonne of electricity.

Also, we calculate this by seeing that secondary aluminium - what the recycled stuff is called - is cheaper than primary. That it is cheaper shows us that fewer resources are being used. This is also why people like scrap merchants will pay for aluminium to be recycled. That is, our price system already tells us what to do here.

Just as we do not recycle the neodymium from hard drive magnets. Each hard drive might contain a few grammes of that rare earth metal, each magnet might therefore be worth - as pure metal value - twenty or thirty cents. The costs of a) pulling the magnet out of the hard drive and b) collecting enough of them in the same place to recycle them (we’d want perhaps one such plant per continent, continents are large places) are higher than that metal value. This is also - prices work, d’ye see, they’re information - proof that recycling hard drive magnets uses more resources more than digging up a bit more of Gaia to make primary neodymium.

So, recycle aluminium, don’t recycle hard drive magnets. We’ve already got that selection method of how to organise the world so as to minimise resource use.

Recycling those things that use more resources than starting afresh would do is known as being more wasteful of resources. But Greenpeace urges us to be more wasteful of resources in order to solve climate change. Not because it will solve climate change, but because Greenpeace always says we should recycle more - as with Mr. Piketty that’s their reaction to the Sun rising in the East each morning.

As to Mr. Piketty, of course he’s wrong here. The solution to climate change is innovation. Just everyone is saying that we need to change the way we do things. Great, that’s what innovation is. People who successfully innovate get very rich. This logic works the other way too - in order to encourage innovation we want to allow people to get very rich by successfully innovating.

It might even be true that taxing the extant rich is a useful place to go get money. But that inevitably damages the incentives to try to get rich by innovating. So, higher taxes on those getting rich by that desired green innovation is counterproductive, it militates against solving climate change.

But then we did pretty much insist, up at the top there, that everyone is talking their own book, promoting the bees buzzing in their own bonnets rather than actually trying to solve climate change, didn’t we?

Maybe Ms. Thunberg should have stayed in school so that she was informationally equipped to evaluate the ideas of her friends a little more?

In the end the bacon sandwich always wins

Ed Miliband clearly sees himself as the Rev Audrey’s Fat Controller. The working parts of the economy are to be moved around at his insistence and desire:

Last month, Labour’s shadow climate change secretary, Ed Miliband, called for such a cap in the Commons, citing the figures from the Tony Blair Institute and Onward. “Why would we leave this money in their pockets when it could help pay for the action on energy?” he said.

This is with reference to the profits currently being made by the renewable energy companies. One possible reason for not being all Fat Controllerish over these profits is that “their” there. It’s their money, not some giftie to be allocated as Mr. Miliband desires.

But then we agree that private property is such an antiquated, even archaic, notion these days. So we’ll need to go one step further in our explanation. The truth here being that someone famously outwitted by a bacon sandwich might not have quite enough - we emphasise the quite, for it is only a falling short, not an absence of - intellectual capacity to organise, manage and design something as complex as the economy of an entire nation. We would also emphasise, as with Hayek, that no one has that sufficient intellectual capacity. The best that can be done is to set up the system, not direct the details. Or, in the end, the bacon sandwich always wins.

So, the system. As Caroline Lucas has told us renewables are now nine times cheaper than fossil fuels. As we emphasied only yesterday, capitalists are both greedy and lazy. They’ll go for the easy profits every time. So much so that when large profits are available they’ll over-invest in an activity or sector, thereby destroying the profits and moving the value add over into the consumer surplus.

What is it that we actually desire to be happening here? In fact, what is it that Mr. Miliband desires to be happening? That folk move away from fossil fuels, that much, much, more capital be invested in renewables.

This being why we use marginal pricing of course. It is true that the costs of producing renewable energy have not gone up in tandem with the costs of producing fossil derived. Yet the sales prices have followed, leading to those massive profits. Which is exactly as we desire it to be of course.

To set up a little model - as with all models it’s illustrative, not correct. We have two ways of doing something, System A and System B. At one set of prices they’re about equally profitable to the capitalists. Now the production costs of System B rise, considerably, output prices from both System B and System A rise. Because we’re using that marginal pricing - all output is priced at the level sufficient to produce that last unit, here from that now much more expensive System B.

What happens now? Producers using System A gain vast, humongous, profits. Which, given the greed and laziness of the capitalists leads to a surge of investment in new System A production. So much so that eventually we gain all of what we desire from System A, everyone using System B goes bust and leaves the marketplace. The marginal producer is now a System A one and prices, determined by that marginal pricing system, collapse.

This is what all desire - or all putting heads above the parapet at least. More renewables, more investment in renewables and consumer pricing to reflect that reduction in cost. Great, leaving those - admittedly humongous - profits with the renewables producers achieves exactly that. In fact, our experience of human nature over time tells us that this is the most efficient method of gaining that desired outcome. Allow the capitalists to gorge on profit and watch as it gets competed away.

The only reason this won’t work is if renewables are not nine times cheaper than fossil fuels. But that can’t be true because Ms. Lucas has told us. Or, perhaps, one other get out, that given irregularity of output some portion of the system must always be fossil fuels - but then both Ms Lucas and Mr. Miliband assure us that that’s not true either.

So, we’re left with that intellectual outwitting. We’ve already set up the system - one with profits and market prices - to deliver the desired outcome. We’ve also harnessed human nature to gaining it. The only possible reasons for this not to work are because the would be Fat Controllers are wrong in their assertions.

Which does, of course, mean that we should ignore the Fat Controllers and depend upon the system that works.

Chief People Person

70 Whitehall

“Good morning, Humphrey. I see we have a new Chief People Person.” [1]

“I believe her title is Chief People Officer, Minister, and an excellent appointment it is too, if I may say so.”

“Have you met her?”

“Ms Ryland has a long line of people clamouring for her availability.”

“Her predecessor, Rupert McNeil, had the job for six years so I expect you know him well?”

“Well, I am sorry to admit to this but I have never met him either. The joke at the Oxford and Cambridge Club was that he never existed. Not, Minister, a very good joke.”

“Well, you are not really a people person, Humphrey.”

“Very droll Minister. Heading up HR for the whole of the civil service is critical for the whole future of our country. We have, as I am sure you acknowledge, the finest civil service in the world.”

“Of course, of course. Will our new Ms Ryland have charge of quangos too?”

“I take it you are referring to Non-Departmental Public Bodies? They are independent and employ public, not civil servants, so we have no responsibility for them. That would contaminate our core values which are, as you well know and admire, Minister, are ‘integrity, honesty, objectivity and impartiality.’ One way we achieve that is to get the incoming minister to reverse the decisions of his predecessor. That preserves the balance for which we are famed.”

“I’ve been looking through the Centrica annual report, Humphrey, and there are two whole pages reporting their Chief People Officer’s achievements. The 282 pages of ours do not even mention that we have a Chief People Officer.”

“Discretion, Minister, is the better part of valour. Senior civil servants do not appreciate self-aggrandisement.”

“You could have fooled me, Humphrey. Antonia Romeo seems to win promotion by flaunting her credentials. Anyway, I don’t understand why a Chief People Officer isn’t chief of the people; the Cabinet Secretary is.”

“Well yes and no, Minister. He or she may be but ‘the Civil Service Board (CSB) is responsible for the strategic leadership of the Civil Service’ and that is chaired by the Chief Operating Officer for the Civil Service.”

“OK but the Chief People Officer must be on that Board and driving things from there.”

“Well actually, under the civil service grade system, he’s not senior enough to be on the CSB but he does get a seat on some junior board reporting to it. He did read PPE at Oxford albeit at St Catherine’s. Good enough for the Club though.”

“And Fiona Ryland?”

“UCL, I fear, Minister. Nothing we can do about that but she has a challenge on her hands. Our press release said ‘Fiona will be leading our HR function at a time of huge change, as we work in partnership with Ministers to equip our people to deliver Civil Service reform.”

“Well, there are two things wrong with that. If the Civil Service is all you crack it up to be, why does it need reform? Secondly, as you so frequently remind me, civil servants do not report to ministers; the buck stops with permanent secretaries. And that’s you Humphrey.”

“Well, the last Chief People Officer never bothered me and I do not suppose this one will. As we say at the Club, ‘plus ça change, plus the same shows.’”

Hedge funds and Adam Smith

From Julian Robertson’s obituary:

In later years, Robertson said if he were beginning afresh he would probably avoid hedge funds. “People wonder why they aren’t doing better,” he said. “I think it is from increasing competition from other hedge funds.”

There is a time and a tide etc.

Or, as we can construct from Adam Smith, although in most un-Smithian language. Capitalists are both greedy and also lazy. Finding the Big New Thing is difficult.

Well, OK, there’s a parade of Big New Things past the door every morning. Finding the one that works is difficult. The one that works is the one that produces economic profit - a return over and above the normal and standard return to capital within that current economy.

Some capitalists, through work or sheer good luck, do find these new things. They then gain economic profit. The other capitalists, being both lazy and greedy, note then copy. Invest into that same sector, along very much the same lines. The competition is what drives the economic profit down - and sometimes below - that normal return in that economy at that time.

Economic profit is also known as “adding value”. The output is worth more than the costs of the inputs. Those inputs being valued at the prices of their alternative uses. This is exactly what we desire to be happening in the economy of course. We might not be so happy at the capitalists harvesting all of that economic profit but we’re still delighted that it is being created. For that’s what we all eat, drink and play with - value added.

The competition being the very thing which switches that economic profit rom the capitalists’ pocketbooks - in time - into the consumer surplus, the value add that we enjoy out here.

The maths of all this is in the Nordhaus paper, Schumpeterian Profits. But the simple truth of it is in that Robertson point. Hedge funds were wildly profitable in the 1980s and 90s. Now they’re not. The reason being that the capitalists saw those economic profits, saw that they were good, then competed them away.

All of which gives an insight into the value of this free market capitalism thing. We harness the greed and laziness of the capitalists to transform economic profit into consumer surplus. There’s a transition period, oh yes indeed there is, one where hedgies vomit money around London’s flashier quarters. But the end result is the same as with all other technological advances - we out here get richer.

More wetlands means more mosquitoes, doesn't it?

We have a tendency around here to point out that planning the economy, planning the world, is a difficult thing to do. They’re both complex systems with many moving parts, it’s near impossible to account for all of them in that one plan.

Which brings us to this particular problem:

Mosquitoes plague Provence in ‘unprecedented’ home-grown dengue outbreak

As warmer temperatures boost mosquito populations across France, experts believe it’s only a matter of time before it reaches the UK

Let’s work with the assumptions being made. A warmer world will mean mosquito populations move north (and south). Mosquitos can carry diseases like dengue, yellow fever and malaria. Yes, it requires that those exist within the human population to be picked up and then spread.

So, climate change is going to expand the areas where those diseases are a significant risk. We cannot, of course, use chemicals like DDT to fix this. Tsk, no, absolutely not.

So, so goes the mantra, climate change will kill many.

Except that’s not quite all of it. As varied investigations put it malaria was endemic in Britain for at least many centuries. The Fens, the Somerset Levels and so on, entirely infested with the agues which result from those diseases. The solution to which was, long before DDT, quinine or any actual chemistry, to drain those swamps and wetlands.

For the presence of the mosquito as the bug carrying and spreading the diseases depends not just upon temperature, the presence of the diseases in the human population, but upon those swamps and wetlands for the bugs to breed in.

So, now we can restate the current mantra. Climate change is going to increase malaria, dengue, yellow fever risk. To which our response is to increase the number of wetlands in which the mosquitos can breed in order to…..well, in order to what? We stop pumping the Somerset Levels so that Bridgewater and Glastonbury become fever ridden? Ely and Norwich should - once again - become the loci of agues?

If the construction about climate change and the range of mostquitos is correct then our response should be to drain the remaining wetlands. But public policy is to increase them.

It’s also possible to recall that malaria was endemic before climate change - therefore even if we solve that but still expand the wetlands it will come back anyway. So solving climate change isn’t the solution, draining the wetlands is.

It actually is public policy to expand those mosquito breeding wetlands too. As we say, planning that whole economy, the world, is a difficult thing to do. For public policy is currently hell bent on killing more of us. Quite why we’re not sure - not unless the Optimum Population Trust has more power than we think it does - but the fact is still there. Given the existence of mostquitos and dengue, malaria and so on, expanding British wetlands will kill people. So, why are we doing it?

If only the people at The Guardian could actually read

We’re told that:

More than 330,000 excess deaths in Great Britain in recent years can be attributed to spending cuts to public services and benefits introduced by a UK government pursuing austerity policies, according to an academic study.

No, this study did not find that. This study assumed that:

There is clear evidence of adverse changes to mortality rates in the UK from the early 2010s onwards: a slow-down in the rate of improvement overall, alongside increasing death rates among more socioeconomically deprived populations; inequalities have widened considerably as a consequence of the latter.1–9 These changes predate the COVID-19 pandemic and are important context for understanding the scale of pandemic-related inequalities.10 11

Although a number of different contributory factors were initially proposed, a considerable body of evidence now demonstrates that UK Government’s ‘austerity’ policies are the main cause of these pre-pandemic changes.12–17 This includes a recently published, large-scale, critical assessment of all the relevant evidence.18 Such policies—introduced from 2010 onwards, and following ‘the great recession’ of 2008—have removed billions of pounds from both social security and vital services, and have thus particularly impacted on poorer, more vulnerable, populations.10 15 18 Similar adverse effects of austerity measures on population health have been seen in other high-income countries.

This specific paper assumes that changes in mortality stem from “austerity”. The actual thing the paper is trying to look at is whether there is a gender aspect to this - the answer there being “dunno”.

A little memo to Guardian journalists. There’s a difference between finding that and assuming that. Quite a large one in fact.

It’s also possible to wonder about the assumption of course. For here’s the base idea:

Trends in age-standardised mortality rates were calculated, and segmented regression analyses used to identify break points between 1981 and 2019. Excess deaths were calculated for 2012–2019 based on comparison of observed deaths with numbers predicted by the linear trend for 1981–2011.

The claim is a link between government spending and mortality - or age of mortality perhaps. So, as this shows, govt spending as a percentage of GDP fell during the 80s, was low during the 90s, rose in the 00s and that much vaunted “austerity” didn’t lower it back down to the levels of the 90s and early 00s.

A link between government spending and mortality should therefore show the same sort of shape. It doesn’t. Thus the assumption that any change in mortality more recently is linked to the same changes in govt spending as a percentage of GDP is, umm, somewhat suspect, no?

But then asking journalists to understand the numbers behind politically convenient journal papers is asking too much, isn’t it?