Posted by Martin McKee on http://martinmckeesblog.blogspot.it
People in many countries are losing faith in politics as usual. Some are returning to the politics of an earlier age, voting for neo-fascist parties such as Golden Dawn in Greece and Jobbik in Hungary. Elsewhere, those calling for transparency and direct democracy, whereby those elected should represent the people rather than powerful vested interests, are achieving success. The most newsworthy example was in Italy, where a party led by a professional comedian emerged as the largest single party in the 2013 general election although elsewhere, the Pirate Party, which originated in Sweden, is seeing electoral success in a growing number of countries, with Iceland only the most recent. In the England, the UK Independence Party is now in third place in opinion polls, despite revelations from e-mails exchanged by its senior officers that it is so desperate to have semi-coherent policies on a range of topics that it is considering buying them from sympathetic think-tanks.
History, especially that of Europe in the first half of the twentieth century, reminds us that a failure by politicians to manage an economic crisis can lead to a rejection of conventional political parties so, to some extent, what is happening now should not be a surprise. But history also reminds us that the importance of these developments should not be underestimated. No matter how justified it may seem to describe parties such as UKIP as being composed of “loonies and fruitcakes”, this rather misses the reason why a disillusioned electorate has lost faith in conventional politics.
Two recent health-related events typify this view. The wave of revulsion that followed the shooting of 20 children and six staff in Sandy Hook Elementary School, in Connecticut, seemed to many people to be a game changer. The National Rifle Association attracted ridicule when it suggested that the best way to prevent more deaths in school shootings was to arm teachers. Opinion polls shows overwhelming support for tighter gun control measures, with 92% supporting the closure of loopholes that enable those buying firearms at gun shows to avoid background checks. Yet, when even such a modest measure such as this reached the Senate, it was defeated. 43 of the 46 senators voting against it had received campaign donations from the National Rifle Association. They found every excuse possible, no matter how incredible, to justify their failure to act against products responsible for the murders of over 8,000 Americans every year. Having striven relentlessly to prevent any research that might challenge their position being undertaken, they ignored or dismissed what did exist, such as that showing a clear linkbetween the laxity of state-level gun control laws and shootings. Bizarrely, a few days later, many of the same senators, who had rejected what they saw as intrusive surveillance by the federal government, rushed to condemn the FBI for failing to identify the Boston bombers before they acted.
About the same time, the upper chamber of the UK parliament was debating another health-related matter, the regulations requiring NHS services to be opened to competition. Ministers had offered copious reassurances that the Act, from which the regulations flowed, meant something other than what it plainly said. When the regulations confirmed its true meaning they claimed it was a mistake and, after scattering a few words such as integration almost at random, claimed to have fixed it. Legal opinion, not refuted by the government’s response that sidestepped the key issues, confirmed that therevised version was effectively unchanged. A major campaign was launched to ensure that peers were aware of this and the concerns of by health professionals and their representatives, some of whom seemed finally to have woken up to the threat being posed. Yet as in the US Senate, the government dismissed the evidence. A subsequent detailed legal analysissuggests that the speech by the minister introducing the regulations was incorrect in almost every respect. Despite overwhelming opposition by those who had studies the provisions, the government was successful, leaving those responsible for managing the NHS struggling to reconcile the regulations with ministers’ stated intentions. Quite why so many peers supported this obviously flawed legislation remains unclear but, as with the US Senate, a growing number of people are asking questions about the financial links between the private healthcare industry and some of the most eloquent supporters of the Act and the subsequent regulations.
Politicians are meant to represent the views of the people, not powerful vested interests. Unfortunately, at times, they seem to echo the suggestion by Bertolt Brecht when he observed that, as the East German communist party had lost the confidence of the people, “would it not be simpler if the government simply dissolved the people and elected another?” Maybe they should reflect on this if they don’t want to join the Communist Party of the DDR in the dustbin of history.
Andrea Silenzi, MD, MPH, PhD 