Wednesday, August 31, 2011

The Next Europe: Left-over Euro & Deutschmark

 Dominique Faget/Agence France-Presse — Getty Images

Historian Hans-Joachim Voth gives the euro only another five years unless the euro zone is transformed into a full transfer union with massive redistribution. The continent is too culturally different to warrant a single currency, he says, adding that it would be best if Germany and other stronger economies left the euro zone.

SPIEGEL: Professor Voth, how much longer do you think the euro will survive?

Voth: Five years. The euro can't survive in its current form. We could, of course, make a full-fledged transfer union out of the euro-zone countries, complete with euro bonds and massive fiscal redistribution. In that case, we would have a different euro than the one that was originally conceived and promised to German voters. In the end, if the heads of state and government don't want that, it's likely that the euro will have to be dissolved.

SPIEGEL: You give the euro another five years -- what will Europe look like then, in your opinion?

Voth: I can imagine a world where there will a left-over euro: with France, Italy, the Mediterranean countries, perhaps Belgium as well. Apart from that the old Deutschmark zone will return, comprising Germany, Austria and the Netherlands, perhaps Denmark as well, perhaps Finland, which have no problems conducting the same monetary policy as Germany. We had a similar system during the European Exchange Rate Mechanism ERM. That was the optimal system, and then we gave it up for the euro.                                        Der Spiegel

See also Money Week

Der Spiegel:

  • The Ticking Euro Bomb: What Options Are Left for the Common Currency? - SPIEGEL ONLINE - 
  • Contagion!!! Dexia Rescue: Belgium Nationalizes Troubled Bank - SPIEGEL ONLINE - 
  • Berlin, Paris Deny Rift Rumors: EU Postpones Summit on Debt Crisis - SPIEGEL ONLINE - 
  • The Financial Crisis Returns: Europe's Attention Shifts to Its Ailing Banks - SPIEGEL ONLINE - 

Related Posts:

Monday, August 29, 2011

Wine & Tea: NHS ---- Will it die?

Margaret McCartney pleaded on her blog:

The NHS, for all it’s faults, is fuelled by people who care about their work and who will add extra in. These are the people who chase things up, will stay a bit late to help, who will take a phone call when offduty because it’s something they know about and can fix well. Numb us down to the level of contract salespeople, and we will all suffer. But some people, the sickest, you can bet will suffer far more than others.

Here is a reprint of my earlier blog on the NHS over wine and tea:
.......As he dined with his good friend who served a beautifully fresh Red Mullet cooked the Chinese style with a simple spring onion sauce, the Cockroach Catcher produced a bottle of his recent discovery: Torrontes from Argentina.
Torrontes is truly an Argentinian wine that is really suitable for our Chinese Style of cooking. On the nose, it has a delicate pear and citrus flavour. My friend who is used to the good and expensive wines took a sip and declared that it has a wonderful peach flavour. It has a long aftertaste that is unusual for this class of wine. At the price, it beats any other white wine. Let us keep that as a secret.

Over tea afterwards the topic of NHS privatization came up.

No, not all of NHS will be privatised.


Government money is the best money for anyone to make and that is really tax payer’s money. The new NHS will be the private sector’s main source of income, as only 90,000 in the UK are covered by private insurance and often they are offered cash incentives to use the NHS.

It is therefore essential for the private health care companies that the NHS is around, at least in name, so that they can make money by providing a “better value and more competitive” service to the NHS!

Some parts of the NHS will have to remain too, as it is necessary for the private sector to dump the un-profitable patients: the chronic and the long term mentally ill, for example. (Right now, 25% of NHS psychiatric patients are treated by the private sector.  But why? Even in psychiatry, there are cherries to be picked.)

Finally, in order to keep the mortality figures low at competing private hospitals, they need to be able to rush some of their patients off to NHS hospitals at the critical moments!

Have some more tea!!!
Iron Goddess of Mercy (Oolong Tea ): traditional tea  of my friend's home village, Teochiu which is of course where my family is from.

These are traditional tiny cups and the tea is lovely on the nose and has a long aftertaste. To do this tea justice, use the softest water you can get: like those for a good malt!!! (Calcium is the villain here: no more than 12mg/Litre)

So the NHS will be free at the point of delivery.
Lets hope so but the money must come from somewhere.

And some us pay taxes!!!

So nobody in their right mind would want to privatise the NHS. There is certainly more money to be made if it remained in the public domain.
Dave Cameron’s brother-in-law should not worry either as his income would go up at least 300% as long as he works for one of the private providers.

Business is business!!!

Killing the NHS is no good to the privateers!!

Wait: the sums are wrong though:If the private providers are making money and the GP commissioning teams have a limited pot and that Consultants working for the likes of BMI hospitals have a 300% increase in pay compared to old NHS Hospital pay scale, either tax payers are going to be forking out more and more money or someone is not going to get their treatment.

Is some politician heading for a top job with the likes of GHG or Bupa? Only time will tell and history told us it won’t be long: less than 2 years!

From May 26, 2011:
Useful notes:

SOUTH Africa's Netcare has become one of the world's biggest private healthcare organisations after beating three international companies to win control of Britain's General Healthcare Group (GHG) in a R23.7-billion deal.

The company won a controlling stake in the British hospital group on Monday, after a bout of frenetic dealmaking that saw management teams in Johannesburg and London go for 96 hours without sleep.

Netcare says sorry again for kidney scandal

Netcare in Scotland: ISTC
Our analysis of the only Scottish ISTC contract and a private sector report on value for money shows that the requirements for collecting and reporting data, for contracts, and for evaluation do not conform to NHS standards.
The Scottish Regional Treatment Centre treated only 32% of annual contract referrals in the first 13 months of operation at 18% of the annual contract value. If the same patterns apply in England, up to £927m of the £1.5bn may have been paid to ISTCs for patients who did not receive treatment under the wave one ISTC contracts.

Beneficence & Modern Tyranny: Rights & Wrongs!!!

It is interesting to look back at what I have blogged about as we get close to decision time for our NHS Reform. Or was it theirs?

I think I and others had it wrong. We have assumed that those in power wants us to have choice in Health Care and decided that Competition is the way forward. 

Beneficence in the House M.D. style!

Am I really so naive!!! Do I really believe in what they claim they want to do: to do good for patients?

DrRich in his response to one of my blogs (and he used it for a few prominent lectures) talked about Beneficence & Modern Tyranny in relationship to Health Care and patients' rights and autonomy: 

When our founders ... found that individuals could not rely on any earthly authority to protect them, their life and limb, or their individual prerogatives. Mankind had tried every variety of authority - kings, clergy, heroes and philosophers - and individuals were eventually trampled under by them all. For this reason our founders declared individual liberty to be the bedrock of our new culture - because everything else had been tried, and had failed. In the spirit of the enlightenment they agreed to try something new.
…… Autonomous individuals often fail - either because of inherent personal limitations, bad decisions, or bad luck.

Modern Tyranny:
Those of us who defend the principle of individual autonomy - and the economic system of capitalism that flows from it - all too often forget where it came from, and DrRich believes this is why it can be so difficult to defend it. We - and our founders - did not adopt it as the peak of all human thought, but for the very practical reason that ceding ultimate authority to any other entity, sooner or later, guarantees tyranny. This was true in 1776, and after observing the numerous experiments in socialism we have seen around the world over the past century, is even more true today.

In NHS Reform: Disingenuous Government!!!

10.32am: Dr Clive Peedell, an influential and unashamedly pro state-run NHS member of the British Medical Council, has emailed with a statement as co-chair NHS Consultants Association. Dr Peedell, a consultant oncologist, says that the government is being disingenuous in its response to the Future Forum:

The government says
We will outlaw any policy to increase the market share of any particular sector of provider. This will prevent current or future Ministers, the NHS Commissioning Board or Monitor from having a deliberate policy of encouraging the growth of the private sector over existing state providers –or vice versa. What matters is the quality of care, not the ownership model.

This statement is disguised as a control on privatisation, but note "or vice versa". This means the revised bill will outlaw the Government now, or in the future, from naming the NHS as preferred provider.

The terminology of the NHS as preferred provider implies a deliberate attempt to encourage NHS public provision, so this policy will be outlawed (by legislation if the bill passes). However, the key point is that the policy of "Any qualified/willing provider" does not explicitly encourage
private sector provision per se (although it is obvious that this is what it is designed to do.)

As long as Government policy is not seen to deliberately and directly encourage private sector provision, the market share will be allowed to change. In fact, the decisions to involve private companies will actually be made locally by the clinical commissioning groups. This is therefore local decision making and not Government policy itself. So increasing NHS privatisation is still clearly on the agenda and the idea of the NHS being the preferred provider with be confined to the dustbin of history.

Peedell said in 2009:
Those in favour of the market-based approach believe that competition and contestability between healthcare providers will increase the efficiency, quality, responsiveness, accountability and equity of healthcare, by creating an environment where only the best organisations survive. However, there is a lack of evidence to substantiate these claims. Most of the available evidence suggests that market-based healthcare systems are poor value for money and deliver worse care to the populations they serve.

Thinking back to DrRich, we indeed cannot assume that government really wanted good care for its people!!!

No! No! No! 

Now it is beginning to make sense to simple folks like me. I have been judging them from a doctor's point of view: that they like us or most of us wanted to do good. 

I must now be careful not to adopt Dr House's paternalistic view on NHS Reform:  House MD

Perhaps, he suggests, for the many viewers drawn to this arch paternalist, there is something refreshing about a doctor willing to risk all—job, reputation and legal suits—in order to fulfill his duty of care to his patients: the duty to take care that his actions or inaction do not harm his patients. Because, for good or for bad, once you’re House’s patient there is nothing he won’t do, no inaction he will tolerate, if he believes that by failing to act he will harm you.”

Politicians are not House, remember?

Related: House M.D.: Modern Tyranny

Sunday, August 28, 2011

NHS: Two Futures!!!

“There are two futures, 
the future of desire and the future of fate, 
and man's reason 
has never learnt to separate them.”

 J. D. Bernal, Professor of Physics, Birkbeck College, London, FRS ( 1901—1971)

Scenario 1: Grandpa, why didn’t you save the NHS when you were Prime Minister?

But, why, we had enough money; you do not need the money like some third world leader?

But why did you let the private firms get in. All the papers and bloggers were warning you?

I know you did buy the hospitals back, but at what cost.

Hindsight? It is not hindsight, everybody was saying it.

Scenario 2: Grandpa, you were great. You listen to your own advisers from King’s Fund, and the bloggers and you stopped privateers taking over any health care.

No, the privateers only want to sell the land, float the hospitals and make money and leave. Many are not from here.

We had enough money and you do not need a job from them when you are not Prime Minister.

Lets enjoy the sunset.
©2010 Am Ang Zhang

LONDON -(Dow Jones)- Circle Holdings PLC, an employee co-owned healthcare provider, said Wednesday it plans to float on AIM June 9.
-Circle is 50.1% owned by the Company and 49.9% owned by the Circle Partnership which is 100% beneficially owned by Circle's clinicians and employees.
-Circle's objective is to redefine secondary healthcare delivery in the U.K..

Circle’s CEO, ex-Goldman Sachs banker Ali Parsadoust set out his view that the NHS is “an unsustainable industry” that costs too much to run. “In his view, Britain has world class retailers, telecoms and financial services firms, as these sectors have been opened to competition over the past few decades,”


The collapse of national retailer Focus DIY has sparked a fresh wave of attacks on private equity firms as details emerged of a decade of deal-making and financial engineering in which buyout specialists shared payouts of nearly £1bn.

An analysis by the Observer has found that one private equity firm, Duke Street Capital, which made an initial investment of £68m in 1998, took £700m out of Focus after presiding over a series of capital and debt restructurings that turned the small Midlands-based chain into a DIY giant with sales of £1.5bn. Apax, its investment partner, which put in £120m, pocketed £183m when the Wickes chain was carved out in a £950m deal that ultimately left the remnants of the chain struggling.


BT’s pension trustees are going to court to find out if there really is a crown guarantee covering a large portion of the company’s £40 billion pension fund.
They’re asking: if the company goes bust, will the government (and the RBS-owning U.K. taxpayer knows what that means) step in to plug any gap in funding for the thousands of pensioners who were in the scheme in 1984 when Margaret Thatcher was waving her privatization wand.

Financial Services Firm:
Goldman Sachs:
Goldman Sachs has been fined £17.5 million by the FSA for not letting it know that Fabrice Tourre, a trader who moved toLondon from New York in 2008, was being investigated by the U.S. Securities and Exchange Commission.
Goldman is a bad, bad boy. But if you think the firm is the only to be blamed in this game, think again.
On the Goldman side, what else can we expect from the firm that has already admitted making a bigger mistake in the same case? To refresh the memory, the firm agreed to pay $500 million in July to settle SEC civil charges that it duped clients by selling mortgage securities that were secretly designed by a hedge-fund firm to cash in on the housing market’s collapse. The firm didn’t admit to, or deny the charges, but it acknowledged it made a “mistake” by not disclosing to investors the role of the hedge fund, Paulson & Co.

Ali Parsadoust was with Goldman Sachs.

Backed by some of the City's most powerful hedge fund tycoons and run by former Goldman Sachs vice-president Ali Parsadoust, Circle was selected in November as the first private company to run an NHS hospital. But with losses of over £27.4m, according to accounts filed at Companies House last year, Circle recently lost two lucrative contracts with the NHS worth £27m, representing more than 42% of its £63m turnover.

Looks like some clever Financial manouvres!!!

Best money is government money: our money!

Caring for vulnerable older people is a statutory obligation under the 1948 National Assistance Act and is exercised on a means-tested basis through local authorities. The National Health Service and Community Care Act 1990 allowed councils to farm out care to any willing provider.
The big companies moved in, including Southern Cross, buying up small care companies or building new homes. As they grew, private equity firms started to show an interest, among them the US firm Blackstone Capital Partners. Investors, when they look at a home full of older people, see a stream of guaranteed income, most of it from local authorities and underpinned by the 1948 legal requirement to provide care. Since the elderly population is rising, investing in care looked like a one-way bet for long-term profit.
Money can be made by separating the income flows from the actual business of care and packaging them as saleable investment instruments – securitisation. Blackstone took control of Southern Cross in 2004 from another private equity firm, West Private Equity. Significantly, that year it also bought NHP (Nursing Home Properties), whose business included leasing care homes to providers (Southern Cross was its biggest tenant) and turning the resulting rental income into high-yield bonds to be sold to investors.
Blackstone floated Southern Cross on the stock market, selling up in 2007. It also sold NHP to an investment fund, Three Delta, with controversial upward-only rental agreements with Southern Cross. This has left Southern Cross with an annual rent bill of around £240m.

From one of your own advisers: Prof Chris Ham
Parliament debate: Public Bill Committee
Chris Ham"May I add something briefly? The big question is not whether GP commissioners need expert advice or patient input or other sources of information. The big problem that we have had over the past 20 years, in successive attempts to apply market principles in the NHS, has been the fundamental weakness of commissioning, whether done by managers or GPs, and whether it has been fundholding or total purchasing."                             

“………The barriers include government policies that risk further fragmenting care rather than supporting closer integration. Particularly important in this respect are NHS Foundation Trusts based on acute hospitals only, the system of payment by results that rewards additional hospital activity, and practice based commissioning that, in the wrong hands, could accentuate instead of reduce divisions between primary and secondary care.”

"The fault, dear Brutus, is not in our stars,

But in ourselves."
Julius Caesar (I, ii, 140-141)

NHS 1978: Hope, Faith & Supermarket

Friday, August 26, 2011

Emperor’s New Clothes: Or Regurgitated Dog’s Dinner

This time the child is Dr Jacky Davis.

Most people who take an interest believe that the amended Health and Social Care Bill is a regurgitated dog’s dinner. 

Most doctors don’t want to see this legislation introduced. There is nothing here for hospital doctors, and the privatised future looks grim for junior doctors and medical students. Even GPs, who were meant to sign up in droves, have realized that the prize of GP commissioning is not worth the price they are being asked to pay.

A back of the fag packet calculation suggests that the percentage of doctors who support (as opposed to have been forced to get involved with) the Bill is in single figures.
The public don’t want it either, with polls showing widespread suspicion of the ‘reforms’

And yet it is still on the table, with a third reading at the beginning of September, when
MPs will hardly have had time to compare Tuscan tans. How can it be that the vast majority of health professionals detest the legislation and yet we still haven’t managed to see it off?

Read all about it here>>>>>>

Ground Hog Day: Goldman Sachs & Bank Of America

Warren Buffett has invested $5bn in Bank of America Photo: AP

WSJ: 24 September, 2008

Goldman Sachs Group Inc. said it will get a $5 billion investment from billionaire Warren Buffett's company, marking one of the biggest expressions of confidence in the financial system since the credit crisis intensified early this month.

WSJ: 26 August, 2011

Bank of America Corp. said it will get a $5 billion infusion from Warren Buffett, giving the nation's biggest bank a desperately needed jolt of confidence at a time when investors are questioning its health.

The deal allies the bank with a billionaire investor known as an astute judge of value, who emerged during the financial crisis as an outspoken advocate of investing in America's future.
And with a TAX break!!!

And in one day BoA shares went up 23%!!!