Category / despair

by crmayes

Depoliticising Indigenous Health via Consensus and Statistics

‘Politics’ has become a dirty word in Australia. To ‘politicise’ an issue is regarded as obfuscation. Good governments ‘govern’ and make ‘policies’. And good oppositions should work with governments to produce policies not debate endlessly, or so we’re told – usually by sitting governments.

While a lot of the ‘politics’ has devolved into oppositional tactics, political debate is essential for democracy.

At a minimum political debate should reveal the reasons and justifications for a particular policy. However, false consensus and the use of statistics are increasingly used to depoliticise debate of important issues. A recent example is Indigenous health.

Dangerous Consensus

indexIndigenous health is an area where “every opposition wants the government to succeed”. However, perhaps it is this consensus that has resulted in continual failure.

The 7th Closing the Gap report was presented in Parliament earlier this month. Prime Minister Tony Abbott gave a sobering speech, noting that most targets were not on track “despite the concerted effort of successive governments since the first report”.

Opposition Leader Bill Shorten, however, called on the Government to reverse the budget cuts to social services that disproportionately affect Indigenous populations and compound existing inequalities. Coalition MPs were unhappy with this suggestion. Some walked out and others said Shorten was playing political games on an important occasion.

The focus on consensus – that everyone wants to Close the Gap – has reduced Indigenous health and education to a national human interest story. It is bracketed from the realm of politics and serves either to inspire or a cathartic release. Sociologist Pierre Bourdieu writes that “human interest stories create a political vacuum. They depoliticize and reduce what goes on in the world to the level of anecdote and scandal”.

In breaking with the ritual bipartisanship, where Opposition and Government solemnly agree that “more should be done but it is all so very difficult”, Bill Shorten re-politicised Indigenous health, if only briefly.

While liberal political philosophy values consensus established via publicly justifiable reasons, when consensus is assumed, publicly justifiable reasons become redundant. The presumption of consensus between the two major parties on indigenous health (and anti-terror legislation and asylum seeker policy) lowers the expectation of rigorous political arguments for or against certain positions.

Shorten broke with the consensus game and exposed the gap between Abbott’s rhetoric of “concerted efforts” and the first budget he delivered. Budgets are not simply economic documents, but reflect political and moral decisions about the lives that are valued.

Politics of Life Expectancy

Not unrelated, last month Treasure Joe Hockey attracted ridicule with his comment in a 3AW interview ‘that somewhere in the world today, it’s highly probable, that a child is being born that is going to live to a 150’.

Close-the-Gap

Hockey’s comment received some support from Professor Peter Smith who points to advances in medicine and public health as reasons to expect a continued increase in human life expectancy.

Professor John Quiggin however suggested that these claims are highly dubious and ignore the fact that the extension of life expectancy in the 20th Century ‘came from a reduction in death rates for the young.’

Will Cairns also pointed to the success of reducing death rates. Writing in the Medical Journal of Australia that

our numbers plummet as we approach 100 years of age because all of these interventions [public health, disease treatment, nutrition] make no difference to the reality that we eventually wear out and die. Apart from the odd unverified outlier, only one person has ever been confirmed as living for more than 120 years.

Hiding Politics in the Statistics

Like the assumption of a consensus, Hockey’s use of life expectancy statistics to justify changes to the health system hides the political nature of these decisions.

Altering the financing of the health system through strategies such as co-payment schemes may appear reasonable. We are told Australia’s population is ageing and more people need to use the health system. However, what these statistics hide is the disparities of life expectancy in Australia.

While a child may be born today to live to 150 120, the latest ‘Closing the Gap‘ report reveals that Indigenous Australians born today can expect to live more than a decade less than non-Indigenous Australians.

The reality of significant gaps in life expectancy should be the cause for alarm and inspire the creation of a more equitable health system. Yet often population statistics hide the details. As Professor Mick Dobson notes, ‘Statistics of shortened life expectancy are our mothers and fathers, uncles and aunties who live diminished lives. We die silently under these statistics.’

Statistics: measuring and managing people

Vital statistics have been used to govern populations since the 17th century. But it’s important not slide over the word “statistics” too quickly as its literal meaning is hidden through repeated use.

Statistics is not simply about numbers but “state craft“. By knowing birth and death rates, and the incidence of disease it is possible to establish probabilities of epidemics, movement of people, and to order the State in a rational manner.

Vital statistics also enable the segmentation and division of populations. We see this all the time in professional sports. The explosion of statistics about batting averages, field goal percentage, or a players historical probability of kicking a goal from a certain angle against a certain team all help coaching staff to know who is performing and who is not.

Divisions in the details

Despite appearances, the use of statistics as political tool for governing a population is not neutral. Historian and philosopher Michel Foucault notes the way vital statistics introduce a power over life or biopolitics. The increased knowledge about nutrition, physiology and sexuality in the 19th century lead to the creation of norms from statistical averages that allowed political strategies to regulate human life. Close-the-Gap-005

Statistical analyses are used in public health to show the distribution of disease and enable interventions in populations. But as Foucault notes, these techniques also allow the identification of lives that are healthy and should be fostered and which lives are not performing and can be neglected.

A danger with the celebration of a statistically increasing life expectancy, is that it masks the very real health inequalities faced by many Australians. This is seen in a number of areas:

  • allow for certain health issues to be prioritised (e.g. ageing population), while others marginalised (e.g. health inequalities)
  • enable the allocation of funding towards some research (e.g. Medical Research Future Fund), while moving it away from other areas (e.g. preventive health)
  • suggest a particular financing models for the health system (e.g. co-payment), yet discount others (e.g. progressive taxation).

These are not simply economic decisions, but political and ethical decisions about which lives count. For too long the supposed neutrality of statistics and the assumption of consensus have allowed the political reality of Indigenous health inequalities to be hidden. To close the gap we need to recognise the historical and political processes that have made it and maintain it.

by crmayes

The Nightmares of Tony Abbott

In promising a new approach to government Tony Abbott has reverted to the well-thumbed pages of the politics of fear playbook that dominated domestic and international political rhetoric between 2001 – 2008.

In a speech to the nation he repeated his four step plan for terrorism – ‘a knife, a flag, a camera phone and a victim‘ – but also drew bizarre links between ISIS and people who “cheat” the welfare system.

It’s clear to me, that for too long, we have given those who might be a threat to our country the benefit of the doubt.

There’s been the benefit of the doubt at our borders, the benefit of the doubt for residency, the benefit of the doubt for citizenship and the benefit of the doubt at Centrelink.

And in the courts, there has been bail, when clearly there should have been jail.

We are a free and fair nation. But that doesn’t mean we should let bad people play us for mugs, and all too often they have: Well, that’s going to stop.

In connecting immigration, welfare, and the judicial system to ISIS – or as he prefers “the Islamist death cult” – the Prime Minister bundles complex and disparate institutions and policies under one banner of “national security under threat”. In using this politics of fear that equates the people on welfare or bail with ISIS, Abbott hopes to swiftly pass new legislation that purports to secure us from these fears and neuter any opposition.

The rise of the Islamist death cult in the Middle East has seen the emergence of new threats where any extremist can grab a knife, a flag, a camera phone and a victim and carry out a terror attack.

As a nation we are responding to this threat. Abroad, Australia is working with allies to disrupt and degrade the Islamist death cult. At home, we have provided our security services with more powers, more resources and stronger laws.

We are currently considering additional legislation on data retention that’s before the Parliament – and this will make it easier to keep you safe and we want to get this legislation passed as quickly as we can.

But this is an old trick and a trick that further reveals that Tony Abbott (and most senior Australian politicians) are bereft of ideas. There is no vision other than more freedoms and less threats.

As the BBC documentary ‘Power of Nightmares‘ shows, politicians in Western liberal democracies following September 11, 2001 no longer offered visions for a grand future. They, and we, have grown cynical of dreams where “the only fear is fear itself”. Instead, the focus is on nightmares. Whoever can portray the greatest fears, yet also assurance of deliverance, is king.

This tactic arguably receded with the elections of Rudd in 2007 and Obama in 2008. Both had optimistic visions. Rudd had his “2020 Summit” and Obama his “Yes We Can”. However, with financial crises, widening gaps in economic equality within nations and between them, as well as the return of Islamic terrorism with ISIS, these optimistic slogans rang hollow and arguably reinforced cynicism. Today, there is a return to a politics of fear.

With his leadership in question Tony Abbott is resorting to a tactic he knows well from his time in the Howard Government. He may not be able to answer who he is or what he stands for in positive terms, but he is able to conduct an orchestra of threats and fears – Labor, ISIS, debt, welfare fraud, radicalisation of youth, ‘inter-generational theft’, and lenient bail laws. In orchestrating these fears, he is able to give us this assurance: “As a country, we won’t let evil people exploit our freedom.”

Abbott is hopeful that this new tough line of government will save his leadership. Perhaps it will. But maybe this time we will recognise the old negative tune and demand something new – something more courageous and imaginative than borders and laws to protect “us” from a fictional “them”. Perhaps we will recognise the folly of jumping at nightmares and spectres that we help create and sustain.

See Tony Abbott’s full message here: https://www.pm.gov.au/media/2015-02-15/message-prime-minister-0

by crmayes

Tony Abbott’s ‘how to guide’ on modern terrorism

1) A knife. Stainless steel, but plastic will do in a pinch.
2) A flag. Black is scariest. Maybe that New Zealand one.
3) A camera phone. At least 6 pixel sensor resolution – grainy but not too grainy.
4) A victim. NB doesn’t have to be a human, could be something abstract, like freedom or Australian values e.g. mate-ship

See from 2:17

by crmayes

Hyper Obedience, Malicious Compliance and NYC Cycling

In Security, Territory, Population Foucault analyses a number of themes of counter-conduct in relation to the Christian pastorate. Choosing counter-conduct, rather than dissidence, Foucault is drawing attention to the way relations of power shape and invest the body, postures, comportment and conduct. To resist these relations, they need to be countered with practices and strategies that “redistribute, reverse, nullify, and partially or totally discredit pastoral power in the systems of salvation, obedience, and truth”.

One such strategy is hyper-obedience – an “exaggerated and exorbitant element” of obedience. This is not merely disobedience against an authority, but an intimate work of the self on the self that disrupts the pastors authority.

Foucault describes this strategy as  “a sort of close combat of the individual with himself in which the authority, presence, and gaze of someone else is, if not impossible, at least unnecessary.” In adopting the countering-conduct of hyper-obedience the individual or group “stifles obedience through the excess of prescriptions and challenges that the individual addresses to himself.”

The logic of hyper-obedience is articulated more precisely by Gary Ransom, a change management consultant. When asked “What kind of obstacles should business leaders anticipate as they endeavour to manage change?” Ransom responds:

[T]here are even worse things than outright resistance. One of our financial services clients coined the term “malicious compliance”… essentially, doing exactly what’s asked of you – no more, no less. Malicious compliance can be a killer because it’s hard to reprimand and because it undermines the credibility of the whole process. People come back to you and say, “See? I did just what you asked, and look at how it screwed things up”.

In doing the very thing that is being asked, the employee frustrates the goals and processes of the authority asking them to act in a particular way. A similar approach has been suggested by Matthew Woessner in response to Penn State University’s wellness plan. According to Woessner the plan requires all staff to

“complete an online wellness profile” as well as undergo a “preventive physical exam” designed to “help employees and their spouse or same-sex domestic partner learn about possible health risks and take proactive steps to enhance their well-being.”

Failure to do this will result in a $100 monthly surcharged deducted from the employees paycheck. Woessner calls on his colleagues to resist not through disobedience, but compliance. He proposes that employees fill out forms with volumes of irrelevant “lifestyle” information and use personal doctors rather than the insurers mobile medical teams. According to Woessner,

if ten thousand Penn State employees set up previously unscheduled doctor visits, (particularly if they are scheduled as full check-ups) it will have the effect of frustrating the university’s narrow budgetary objectives, making the cost of implementing these “basic biometric screening” simply unsustainable. (More details here).

Woessner calls this approach civil disobedience. I would suggest it is hyper-obedience. But whatever it is, I hope it works.

Here is another humorous example:

Gary Ransom and Tom Knighton, “Stepping up to the challenge of change,” Managing Service Quality 6, no. 5 (1996): p.13.

see Foucault, Michel. Security, Territory, Population: Lectures at the Collège De France 1977-78. Translated by Graham Burchell. Edited by Arnold I. Davidson. New York: Palgrave Macmillan, 2007. (p. 200 – 201)

by crmayes

Resisting power is easy, I do it all the time.

It is not uncommon to hear people moan about the intractable bind that Foucault’s social ontology places the subject (see Žižek, Habmeras, or most people who have heard something about Foucault through youtube or a mothballed professor). “The subject is wholly produced by power”, they say. “And any resistance the subject can muster is also produced by power”, they cry.   I just don’t think these folks are trying hard enough, either to understand Foucault or to resist.

How light power would be, and easy to dismantle no doubt, if all it did was to observe, spy, detect, prohibit, and punish; but it incites, provokes, produces. It is not simply eye and ear: it makes people act and speak. Foucault, M. (2000). Lives of Infamous Men. Power J. D. Faubion. London, Penguin. 3: 172

by crmayes

The Evil Hour

332 – The Gay Science

The evil hour. – Every philosopher has probably had an evil hour when he thought: What do I matter if people don’t accept my bad arguments, too? And then some malicious little bird flew over him and chirped: ‘What do you matter? What do you matter?’ – Nietzsche

I am trying to finsih a draft of my final chapter. The evil hour has come. However I am not concerned about whether or not people accept my bad arguments, but whether I can make(up) my bad arguments.