Following some excellent posts by the medical blogosphere’s resident Pest Control Officer, Dr No has been learning two new words. Both get flagged as misspelt by his spelling checker, and only one has so far made it into the OED. The one that has made it into the OED is ‘commodification’, and the dictionary defines it thus:
“The action of turning something into, or treating something as, a (mere) commodity; commercialization of an activity, etc., that is not by nature commercial [emphasis added].”
At a stroke, Dr No has stumbled on the word that perfectly describes the core malevolence at the heart of Tory’s proposed healthcare reforms. And on this they have form.
It was of course the Grocer from Grantham (and here the epithet could not be more apposite) who introduced the idea that healthcare was in fact no different to apples and oranges. Her and her BATman Kenneth Clarke’s transformation of the health service into the health industry ushered in the internal market where hernias were treated as apples, and hip replacements as oranges, to be bought and sold along with other groceries. The present lot are merely travelling further and faster down that same misguided road.
Of itself, this is bad enough, for it reduces a noble art and science to mere commerce. But it is in fact malevolence squared. For, in addition to commodifying – indeed precisely because it has commodified – medical activity, it opens the door to another arguably even more sinister malevolence: that of greed, and the means of greed, manifested through the second new word: financialization.
Dr No’s trusty OED failed him on financialization. And when the OED fails, Dr No does as everyone else does, and goes to google.
Wikipedia is a bit dense on the matter. Others – perhaps unsurprisingly, because we are in economic territory here, and economic jargon has all the clarity of peanut butter, are equally opaque. But after a bit of reading around, Dr No began to get the gist of it. The essence of financialization is the transformation of just about anything into financial instruments that can be traded, as if they were stock options on the financial markets.
And where there be financial markets, there be gamblers. By now, Dr no was beginning to get a proper sense of déjà vu. Packaging up assets into ever more complicated parcels, and then gambling on the outcomes, sounds familiar, as indeed it is, for it is precisely the process that the bankers used to precipitate the recession. It was the financialization of the housing market, and the unchecked exercise of gambling and greed that lead directly to the credit crunch, the bailing out of busted banks and the recession.
Readers may feel Dr No is exaggerating the alarm. He is not. David Bennett, the new boss of the healthcare economic regulator Monitor, already talks of ‘commodity level [health] services’. The creep to commodification has already happened. And as the Witch Doctor’s black cat would no doubt observe, creep once started rarely stops. We are within a cat’s whisker of the financialization of health – and if it should come to pass, then it will only be a matter of time before the NHS the goes the way of the banks.
Ah, but the regulator – Monitor – will prevent such a catastrophe, the Tories will say. To which Dr No says: sure – just as the financial regulator spotted and stopped the banks going pop.
Monitor’s boss, Bennett, has already bought into commodification. The building blocks of financialization are already in place. All that is needed is for some bright City sparks to weave their dark magic. Only, when that happens to the health service, it wont be just a few thousand bankers who loose their jobs. We will all wake up one morning to find we have lost our NHS.