P J O’ROURKE is a journalist-cum-writer — and, no, that’s not necessarily a tautology — from the gonzo “school” made famous by the late and recently upwardly-mobile Hunter S Thompson, he of Fear and Loathing in Las Vegas fame.

Born in 1947 in Toledo, Ohio, O’Rourke attended The John Hopkins University in Baltimore, Maryland. He has written for numerous publications including National Lampoon, Playboy and Esquire [presumably for those purchasers who “only bought them for the articles”], New Republic and The American Spectator. Apart from his books, he is probably most identified as one of the chief writers for Rolling Stone. For more on P J O’Rourke, visit http://en.wikipedia.org/wiki/P._J._O’Rourke .

Hailed by Tom Sharpe [Riotous Assembly, Indecent Exposure, Porterhouse Blue and Blott on the Landscape, among others] as “the funniest American writer I have read since Thurber”, P J O’Rourke has also been described on back-cover blurbs as “a true satirist, not just a jokester” (NY Times), and as “an unapologetic hedonist … exuberantly malevolent” (Literary Review).

Puncturing sacred cows and thereby releasing mega whatsits of pent-up malodorous air is one of his main benefactions to mankind. Interested in what Otto von Bismarck called the Great Questions of the Day? Bored entirely witless by the dreary stodge of earnest moral high-groundery and ethical vanity that fills websites like Tasmanian Times and taxpayer funded broadcasters like “our” ABC ? You can get incisive and uproarious politico-social commentary from Republican Party Reptile, Holidays in Hell, Give War a Chance, Eat the Rich and The CEO of the Sofa.

In Eat the Rich — A Treatise on Economics [Picador, 1998; ISBN 0 330 36111 2], O’Rourke gave us succinct definitions of the four types of spending:

1 – spend your money on yourself;
2 – spend your money on other people;
3 – spend other people’s money on yourself; and
4 – spend other people’s money on other people.

Any public discussion beginning “They orta …” which invariably involves spending gazillions of tax-payers’ money — other people’s money — by bureaucrats should be put on hold until the following points are thoroughly mulled over, preferably with the help of good red wine and the odd Guinness or two.

“If you spend your money on yourself, you look for the best value at the best price … If you spend your money on other people, you still worry about the price, but you may not know — or care — what the other people want … If you spend other people’s money on yourself, it’s hard to resist coming home [with the costliest goods available — my paraphrase]. And if you spend other people’s money on other people, any damn thing will do and the hell with what it costs. Almost all government spending falls into category four. This is how the grateful residents of Ukraine got Chernobyl.” (pp 239-240)

Tasmania’s Health Minister David Llewellyn has been in the wars lately, besieged from all sides of politics. But he is not alone. Every Health Minister at every level of government is in a job that puts him or her right up against the blowtorches of public opinion and political combat. The reason ? No other portfolio has the kinds of inbuilt characteristics that make Health the sort of burden that Sisyphus^ wouldn’t swap.

Take Schooling. It’s feasible to imagine, if you try really hard, that a government could get almost everything right: buildings [and their maintenance], resources, a pool of properly trained and educated teachers, curriculums and syllabuses, and so on.

Take Transport: networks of well-engineered roads and railways and related infrastructure [and suitable maintenance schedules], appropriate road and traffic rules, suitable driver training and licensing, and so.

But not in Health.

Even if, in a Pollyanna-like world, we were all getting healthier, we would still be “consumers” of health-as-politics: freed from, say, diabetes, obesity, cancer and migraines, we’d be immediately worried by, say, acne, wrinkly knees, ingrowing fingernails and unsightly hair, and we’d want Type 4 spending of other people’s money on these “issues”. There simply is no end to this, no matter how many miracle cures are discovered for old diseases and new afflictions. There is no end to it.

But the money supply — even if it is other people’s money — is not unending.

In The Weekend Australian of 27-28 August 2005, Adam Cresswell reported on the global spread of Health Savings Accounts which “could be set up as part of Medicare, or the superannuation system. Tax-payers could make contributions of a few per cent of salaries over several years, and funds could be used to pay for treatment in private or public hospitals, and for prescription [medicines]. Medicare would need to be retained as a safety net for the unemployed and low-income groups.” [Source: Allen Consulting Group / Medicines Australia, as summarised in the print version of this report]

One of the points highlighted in Cresswell’s article [which gives every appearance of looking carefully at most of the important pros and cons] is that “health consumers” would be using Type 1 spending: they would spending their own money on their own health, whereas, at present, other people’s money is spent on them through Medicare, or medical insurers — other people — make spending decisions for them.
Read the article HERE

Is this kind of “health-superannuation” scheme a goer ? What would be the reactions of the various stakeholders, which include the medical professions, the health insurance industry, hospitals, medicine and drug companies, local GPs and medical centres, and, of course, despite the urgings of Dick the Butcher to Jack Cade the rebel leader in Henry VI Part 2*, the lawyers ?

Or are our Health Ministers, whether from left, right or centre, all condemned to be like Tantalus, who, after being admitted to the table of the Olympian gods, revealed to mankind their secrets, for which he was eternally condemned to stand up to his neck in water which flowed from him whenever he tried to drink; and, as if that were not enough, over his head hung fruit which was blown out of reach by the wind every time he attempted to grasp it.

^ Sisyphus was promising lad-turned-bad, who became fraudulent and avaricious; his punishment by the gods was to be forever rolling a big rock uphill and have it roll back down just as he though he had it balanced nicely.

* “The first thing we do, let’s kill all the lawyers”, Henry VI Part 2, Act IV, scene ii, line c. 73.

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