Thursday, January 31, 2008

Building Pressure - and other beasts of burden

New reports today point to another legacy from the Howard Decade: Private Health funding from government has accelerated relative to Public funding -

"The figures show in the last decade, average annual spending on private hospitals has risen by 25 per cent, opposed to less than eight per cent on the public system. Ms Power from the Health Care and Hospitals Association says over the same decade demand on the public sector has increased by 25 per cent.

PRUE POWER: We have a situation where public hospitals, who are responsible for pretty much all the emergency care in Australia and for a lot of the complex medical and surgical care in Australia, have been sucked dry of funding." [link]

Leaving aside, for a moment, the question of whether or not this shift is a sign of an increasingly stratified society or one of a much-needed movement into market-based decisions, what I find interesting is the language used to explain, describe and even narrate this shift.

One common phrase is 'taking pressure off the public health system'. This is related to the concept-phrase of 'burden'. Who or what is un-burdened when public-funding is redirected into the private health industry? What sort of system or institution might be de-pressurized by this redirection?

"JOE HOCKEY: By strengthening the private hospital system, the Government has been able to take some of the pressure off the public system. But under the Howard government, health funding grew from $19.5 billion to almost $52 billion last year, a massive increase.


The head of the Australian Medical Association, Doctor Rosanna Capolingua says increasing private spending is good for public hospitals.

CAPOLINGUA: Thank goodness that private hospital support by government has been increasing. The private sector in health has been providing an enormous amount of care to patients. The (inaudible) of delivery of care in the private sector is absolutely crucial because it helps to take the burden off the public sector.

SAMANTHA HAWLEY: Is the AMA finding, that the cause of this increase in funding that the private sector is receiving, that the pressure on the public system has reduced?

CAPOLINGUA: We have had a significant increase, almost doubling in private health insurance take up rates in Australia in the last ten years or so. If we didn't have that, then the burden on the public sector would be far greater than it is now." [link]

It's clear that re-directing a flow of public funding from public to private hospitals acts on Demand: the injured and ill once would have gone to the Royal X, but now are admitted to St. Z. Less demand directed at the public sector, more resources (human, medical, beds, urgency) that are thereby freed up and ready for those who can't afford private health insurance. Sounds very reasonable and prudent.

Yet, there are some hitches here and it's at the semantic level that the nature of these problems become both muddier and disturbing.

Consider: if someone ill or injured takes a bed at a private hospital for surgery, they are, according to the logic of pressures, releasing the sorts of pressures that oppress the poorer members of our communities. It's a short step in this chain of argument to attribute the use of private health insurance to altruism: we help the poor and needy (by helping ourselves - Adam Smith 101).

But if we private health insurees-users are altruistic, releasing pressure from the op-pressed, then according to this rationality, this form of reasoning, how should we characterise the sick and ill who have no choice but to use the public hospital system?
We are altruistic, they are . . . under pressure . . . or a form of pressure?

We release pressure - they build it up.
We are lessening the burden on the public health system - they are . . . a burden.

What must it feel like to be told that what you do amounts to pressure and burdens? It's enough to make you want to re-form yourself, to govern yourself better to be more flexible and lighter (because burdens and pressures have weight). But where do these much-demanded qualities of flexibility and lightness come from? Can we choose or learn them?

To go back for a moment and consider the other phrase used in this news report from Prue Power:

public hospitals . . . have been sucked dry of funding

Is this sucking dry how the burden is being lifted and pressure released? The altruism of the private-health insuree-user sours once their action is characterised as sucking dry.


We might be in need here of some help from late-1970s Rolling Stones:

I'll never be your beast of burden; My back is broad but it's a hurting; All I want is for you to make love to me; I'll never be your beast of burden; I've walked for miles my feet are hurting; All I want is for you to make love to me

We are perhaps the beasts of burden - our bodies fall apart, disease strikes, accidents happen, violence continues - who need healing, who need the care of the doctors, orderlies, nurses and administrators of the public and private health systems. But if the public hospitals are where those who are most burdened walk for miles to get to, then it follows that the burdening of public hospitals is what always happens at these places of healing and care. They are always subject to burdens and pressure - and transferring government wealth into the less burdened, less pressurized, private hospitals, actually exacerbates the state of our public hospitals.

Over at Public Opinion Gary Sauer-Thompson asks for data across state systems - both public and private - that would permit real comparisons.
[Photo is of Lake Burley Griffin - Canberra, Australia]

Wednesday, January 30, 2008

Jam & Jerusalem

After firstly ignoring Jennifer Saunders' half hour television show - Jam and Jerusalem - because it lacked a laugh track and obvious traces of Saunders-style satire and whimsy (how shallow am I?!), I now find it satisfying.
My initial responses to this show were, surprisingly, in line with what has been the critique, if you can call it that, from Melbourne's Fairfax broadsheet - The Age's - Green Guide. The Green Guide's weekly mixture of review, schedule, new media advertising and information in the form of a lift-out, usually does very nicely for me and Significant Other. Marieke Hardy's colour-pieces are nearly always slanted skewerings of some vapid and valid target in the culture, and Hardy does a wry and arch line in self-deprecation. But we read it mainly for the reviews of free-to-air TV shows and there is often cause to be shat-off with these.
Hardy aside and back to Jam & Jerusalem, it was twice dismissed as sub-standard because Dawn French was both underutilised and there were not enough zinger-funny lines! Another review (not online but in the GG last week) began by rueing the failure of J & J to realise the comedic heights it should, but ends cheering it on because Dawn French's Rosie takes centre stage in the episode under review, and being
the show's major drawcard [reminds us] that this brand of comedy might be a taste worth acquiring
All of which raises the questions: is J & J actually more situation than comedy (as in sit-com), or even more drama than comedy (dramedy)? Why is J & J being reviewed as a failed comedy? How could it not fail if comedy is being measured on the gag-meter?

J & J, successfully I think, celebrates a form of 'village' female community. I live in a sort of village, and I don't think I'm nostalgic for a Sea-Change style community from the perspective of the metropolis (eg BallykissAngel, Hamish McBeth and so on and so forth . . . ). In other words the show affirms community through an ensemble; albeit one led by 'elders' of the Woman's Guild of Clatterford, St Mary. Yes, Dawn French is funny - and as the multiple-personality character of Rosie manages to voice the harsh-truths of a village-idiot-savant. But French's Rosie is part of the ensemble and is not the sole reason for the show's charm.
So, this Village-idiot recommends having a look at J & J. It's gentle portrayal of Guild-life is sorta uplifting. Oh yeah, Jennifer Saunder's upper-middle-class Caroline Martin is a (mild) scream.

Mania: Abel Tasman and Freud

In an essay that has become more analysed and used in this decade (amongst literary-cultural studies types like moi), Freud wrote about mania as being a failure to re-cathect (to re-invest) the libido to a new object of love. In the manic phase this failure is something like the actions of an old telephone-switchboard operator, grabbing one plugged-lead after another and making connections. But . . . the connections are ephemeral. Overheard conversations (intimate, bureaucratic) between other-people. The mania is in the flurry of connecting and in the electricity of the making of connections. An image of how I imagine the brain synapses are sparking during a manic episode.

What has been lost - whether ideal, artefact, person - must instead, Freud argues, be mourned. And this work takes time - new objects must replace the lost. If only it were that easy.

What then might it mean to reside in the meat-world in Tas-mania? A state of connective hits on the switchboard of global society? Tasman comes from Abel Tasman - Dutch explorer & mercantile scout. A small island state in a federation of states - the Commonweath of Australia. Is this state also one of loss - of overhearing the intimate and bureaucratic conversations of others?

Looking around where I live, a sort of village-suburbia not far from the capital city of Tasmania, the sense of loss is marked in the Bushfire memorial at the end of Beach Rd, Snug; in the Cemetry next to the small Catholic church; in the stories of the Carbide Works on the hill towards Electrona. More melancholy than mania. Although to look down my street towards some hectares that were farms, and see two disconnected, dead-end roads with kerb and guttering still fresh and large signs advertising lots with sold-stickers announcing the coming of more residences, shops. A sort of mania of development.

A rhythmics of dissonance? Arrhythmia?

Something is being lost here. And what is new has manic rhythms: iso- and ar-rhythmics, perhaps.

If Abel Tasman's name inaugurates this mania of development, these manic rhythms, then what might it mean to be in Eurhythmania?

Sweet Dreams are made of trees

Not one of my favourite bands of the 1980s, but Dave Stewart and Annie Lennox's Eurhythmics, ticked a few boxes: synthesizers, drum machine, songcraft, lush orchestration. While they began with an icy Germanic feel, their movement into pop-soul was much less interesting.

But after more than a quarter of a century it's their name that intrigues. Was it a neologism? Something to do with Europe? Clearly, rhythm is a separate word - but eurhythmics??

Here's Henri Lefebvre from Rhythmanalysis: space, time and everyday life:

At no moment have the analysis of rhythms and the rhythmanalytical project lost sight of the body. Not the anatomical or functional body, but the body as polyrhythmic and eurhythmic (in the so-called normal state). As such, the living body has (in general) always been present: a constant reference . The theory of rhythms is founded on the experience and knowledge of the body; the concepts derive from this consciousness and this knowledge, simultaneously banal and full of surprises - of the unknown and the misunderstood.

Along with arrhythmia, isorhythmia (the equality of rhythms) completes this repertoire of fundamental concepts. With one reservation: iso- and eu-rhythmia are mutally exclusive. There are few isorhythmias, rhythmic equalities or equivalences, except of a higher order. On the other hand, eurhythmias abound: everytime there is an organism, organisation, life (living bodies).

In this respect, thought could return to the Liebnizian principle apparently abandoned by philosophers, logicians and scientific types. Were there isorhythmia between two temporalities, they would coincide. Equivalence entails identity (and reciprocally, non-identity implies difference); polyrhythmia is composed of diverse rhythms. Eurhythmia (that of the living body, normal and healthy) presupposes the association of different rhythms. In arrhythmia, rhythms break apart, alter and bypass synchronisation (the usual term for designating this phenomena). A pathological situation - agreed! - depending on the case; interventions are made, or should be made, through rhythms, without brutality. (67)

What does eurhythmia sound like? Is it limiting to narrow down rhythms to what we hear? What about the rhythms, the durations, the repetitions, of seeing birds flying between trees, of the taste of coffee every morning, of the smell of lavender in bloom, of rubbing shampoo into your scalp??

Eurhythmia, then. Polyrhythmic - multiple rhythms. But not iso-rhythmic or arrhythmic. Perhaps, as LeFebvre puts it: a harmony of rhythms.

Sounds like . . . Bill Evans' piano solo on Miles Davis sextet's All Blues.

Bill is pictured above. Dreaming of trees?