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Retro is the new rock’n’roll, they say, but I guess it’s got a little out of hand.

Wars, debt crisis, the deification of greed and materialism, millions thrown out of work, tax cuts for the rich – it’s all part of David Cameron’s passion for the 1980s, obviously.

But have we taken it just a tiny tad too far by recreating the riots that were once so fashionable in areas abandoned by the white middle classes to their unhappy fate? Do we really need to add blazing police cars, looting and violence to Mr Cameron’s Big Society?

And another thing that bothers me is this: is he planning some electorally convenient military adventure somewhere? That may be too retro, of course – surely time and the Iraq war have changed the gullibility factor of the British voter? And anyway, George Osborne’s austerity Britain is so savage our entire Navy these days consists of a few retired matelots in a rubber dinghy off the Isle of Wight.

The Tottenham riots are no laughing matter, of course. They show that issues we would dearly love to have behind us – race relations, violence and crime as an answer to lack of opportunity – are still very much here. These issues will not go away as long as we have a government that believes hurling people out of work and contracting the economy is the way out of a global economic crisis.

Talking of the global economic crisis, it struck me the other day that a familiar grumble I often dismiss may actually have some relevance after all.

It’s the anti-Europe grumble that says: “Why do we in this country stick to the rules and thereby shoot ourselves in the foot while everybody else carries on regardless?”

Should we instead be asking: “Why are we in this county trying to stick to very painful austerity measures and thereby shoot ourselves in the foot while the Americans are carrying on regardless?”

How does one stop the American juggernaut that’s sweeping aside everything in its path? How can millions of years of evolution have ended up with the Tea Party and the rest of the crazies on the Republican right?

Mind you, perhaps the very existence of Sarah Palin proves these loonies are right about evolution – if she and her ilk have developed, how can theories about the gradual and constant improvement of the species be true?

Here’s health

Lovely to hear from Roger last week. Given what I’d written about our health service, Roger wondered how other countries manage. Well, this is a public service blog, so here are the answers for the countries mentioned. In some places I have added my own bold text at no extra charge to you, the reader.

France has a system largely financed by government national health insurance. In its 2000 assessment of world health care systems, the World Health Organization found that France provided the “best overall health care” in the world. In 2005, France spent 11.2% of GDP on health care, or around £2,393 per capita, a figure much higher than the average spent by countries in Europe. Approximately 77% of health expenditures are covered by government funded agencies.

Most GPs are in private practice but draw their income from the public insurance funds. The government has taken responsibility for the financial and operational management of health insurance (by setting premium levels related to income and determining the prices of goods and services refunded).

The French National Health Service generally refunds patients 70% of most health care costs, and 100% in the case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them non-profit, mutual insurers. Until recently, coverage was restricted to those who contributed to social security (generally, workers or retirees), excluding some poor segments of the population; the government of Lionel Jospin put into place universal health coverage and extended the coverage to all those legally resident in France. Only about 3.7% of hospital treatment costs are reimbursed through private insurance, but a much higher share of the cost of spectacles and prostheses (21.9%), drugs (18.6%) and dental care (35.9%).

There are public hospitals, non-profit independent hospitals (which are linked to the public system), as well as private for-profit hospitals.

Average life expectancy in France at birth is 81 years.

Italy’s health care system is regarded as the second best in the world, after France, and according to the CIA World Factbook, Italy has the world’s 19th highest life expectancy. Health care spending in Italy accounted for 9.0% of GDP in 2006 (about £1,585 per capita) of which about 75% is public, slightly more than the average of 8.9% in OECD countries.^[2]

Life expectancy at birth was 80.9 years in 2004, which is two years above the OECD average.

Health care is provided to all citizens and residents by a mixed public-private system. The public part is the national health service (Servizio Sanitario Nazionale) which is organized under the Ministry of Health and administered on a regional basis.

Family doctors are entirely paid by the SSN, must offer visiting time at least five days a week and have a limit of 1500 patients. Prescription drugs can be acquired only if prescribed by a doctor. If prescribed by the family doctor, they are generally subsidized, requiring only a fee that depends on the medicine type and on the patient income (in many regions all the prescribed drugs are free for the poor).

Visits by specialist doctors or diagnostic tests are provided by the public hospitals or by private ones, and if prescribed by the family doctor require a fee of around £24 for a visit without any diagnostic test and are free for the poor. Waiting times are usually up to a few months in the big public facilities and up to a few weeks in the small private facilities.

Surgeries and hospitalization provided by the public hospitals are completely free of charge for everyone, regardless of the income. For planned surgeries waiting times can be up to many months, especially in the big cities.

Germany has Europe’s oldest universal health care insurance system.

Germans have three mandatory health benefits, which are co-financed by employer and employee: health insurance, accident insurance, and long-term care insurance.

Accident insurance for working accidents is covered by the employer and basically covers all risks for commuting to work and at the workplace.

Long-term care is covered half and half by employer and employee and covers cases in which a person is not able to manage his or her daily routine (provision of food, cleaning of apartment, personal hygiene, etc.). It is about 2% of a yearly salaried income or pension, with employers matching the contribution of the employee.

There are two separate types of health insurance: public health insurance and private insurance. Both systems struggle with the increasing cost of medical treatment and the changing demography. About 87.5% of people with health insurance are members of the public system, while 12.5% are covered by private insurance (as of 2006).

The government partially reimburses the costs for low-wage workers, whose premiums are capped at a predetermined value. Higher wage workers pay a premium based on their salary.

Reimbursement is on a fee-for-service basis, but the number of physicians allowed to accept Statutory Health Insurance in a given locale is regulated by the government and professional medical societies.

Spain’s health system combines both public and private health care and within each of the 17 separate states free or low cost health care is given to those who contribute to the Spanish Seguridad Social (social security). 

Although there are waiting lists for operations in the Spanish health services, they are not as long as in the UK, and there is less of a queue because many people choose private health care instead, relying on the national health system just for emergencies

Finally, having had a glimpse at how other countries manage (I’m afraid I’d rather lost the will to carry on once I got to Spain), it’s worth noting that our expenditure as a percentage of GDP on health, taking OECD figures for 2010, places us around two percentage points behind Germany and France, below Italy and Ireland, but above Hungary.

Where does this take us?

Most try and mix private and public sector. Everybody seems bogged down in the bottomless pit of dogma, if that’s what a widespread commitment to free or heavily subsidised universal health care means. Others spend more than we do as a percentage of GDP and have, it seems, better results. Our problems are not unique. The comparisons show us there are other ways of achieving what, I imagine, we all still want: health care free to all at the point of need.

After all, we seem to manage when it comes to finding money to pay for nuclear weapons systems.

Ghost story

A day out with the family at Berry Pomeroy Castle in Devon, allegedly one of the most haunted sites in the country, if not the world. Gosh, it brought back the memories.

My first job in journalism was on the nearby Totnes Times, and I once spent a spooky night at the castle with a psychic medium and a ghost-hunter for an article. We set up some spoof ghostly pictures, so I found myself at dead of night standing on the battlements holding a flare aloft, clad in a white sheet, with remote-controlled flash guns going off in the ruins behind me to create an eerie backdrop.

In those days it was not uncommon for drunks at chucking-out time in the vicinity of the old castle to daringly venture down the drive to shee shome ghosts, ahahaha. This particular night a Land Rover full of youngsters appeared in front of the castle while I stood there, spookily.

I hadn’t realised until then that you could do a handbrake turn in a Land Rover, nor that one could reach 100mph in first gear. Maybe to this day there are middle-aged farmers around Totnes who swear blind that they saw a ghost on the battlements of Berry Pomeroy Castle. I hope so.