Saturday, May 24, 2014

The “job snob” myth

Well, yes, since you ask (I realise you didn't), I am qualified to comment on the “job snob”.

Apart from the things that I would count as my “career” – training in electronics, caring for stadium sound systems, the shift to journalism, six years as an analyst along the way – there have been the things I did merely to eat and pay the rent.

The short job as a general labourer in a theatre, I won't give in any detail. Suffice to say that the person I answered to cared nothing for OH&S, and I quit.

I had a couple of stints as a courier. Why not? I had a car, I know my way around most of Sydney without resorting to street directories or – these days – GPS, and it almost paid the bills.

And there were a couple of years in the 1980s when I was hosing out Luna Park for a living (there was a small premium for someone who will arrive at 4:30am without complaint).

I still think politicians – especially specimens like Tony Abbott (professional career: university to a brief stint as a journalist, then into politics) and Eric Abetz (barrister and solicitor, then politician) – are talking through the wrong end of a long arse when they bang on like this:

People have no right to hold out for the job of their dreams while they are on unemployment benefits.” – Tony Abbott.

Tasmanians … simply don't want to take the jobs that are on offer.” – Eric Abetz.

Abetz went on, in talking to the ABC, to support Abbott's idea that if you can't get a job in Tasmania, you should be applying for jobs on the mainland.

It'd be nice to see a shred of human decency in their vicinity, even if these guys are only carrying it around because it stuck to the bottom of a shoe when they last stomped on a beggar's face. Alas, no.

Look: it takes money to get a job. Let me pick a place in Tasmania, say, Devonport, and put the job interview in Melbourne.

Right now, the best available Jetstar from Launceston to Melbourne is $45 (not including its extras), making the flights a minimum $90.

But you have to get from Devonport to Launceston first – the train that leaves at 8am arrives at 9:15, which lands the flyer outside the typical “hot price” flight times. Oh, the train costs $24.50 return if you're unemployed and therefore on a concession, otherwise the return is $49.

And then there's Tullamarine to Melbourne. Take the Skybus, it's a $30 return.

To make the journey for the interview – let's just skip the business of moving for a minute – is in the order of $170. That's completely out of reach of someone who's unemployed. Especially since there's going to be that dreadful second short-list interview to go through.

Now, the blithely ignorant statements that someone looking for work should “go where the work is”.

That means moving house. You've just spent the last six months on zero benefits at all (the nasty, vicious, nocturnal emission of smug, sleek libertarians), you spent your last four hundred bucks on the interviews, you're borrowing from friends to get over to Melbourne on the weekend so you can start on Monday.

You've got no home sorted out yet, you're just about to leave all your furniture behind, and all that was available anyhow was in fast food, and you're still not sure how many shifts you'll get each week. And you're paying for accommodation in two places because you had to leave the wife and kids behind …

But no worries, you can send for your family and your stuff just as soon as your paltry wage lets you put together a spare thousand or two for the transport.

These guys are out-of-touch in that special way you can only achieve when your body inhabits an ivory tower, and your brain is off chatting to Ayn Rand sitting at the right hand of the almighty.

Thursday, May 22, 2014

Healthcare, disruption and death

The other thing that the right has done with its toxic “safety net” label, a form of words so easily and unthinkingly adopted, is to make an association that public hospitals are for the poor.

Yes, I'm sure that a government member that's schooled to consider $20,000 lunches and $60,000 gifts and all the rest as normal – people in that class probably do think that way.

Now, I'll paint a scene: since Ms T has a minor procedure next week – an endoscopy – today we had to line up at St George Hospital for the pre-admission clinic (now there is a process that could be made much more efficient and cheaper, but that's for another day).

The talk in the waiting room – with no dissenting voices – was the likely horror that the government is preparing for us, by way of Americanising the health system. The only individual who didn't participate was the one that had an interpreter handy. Elsewise, the voices in one of The Shire's major hospitals were unanimous, that the government is on the wrong track.

And these weren't poor people. At least one of them was worth more on the hoof, once you count clothes and jewels, than I would usually spend on a car.

Hang on, what's someone like that doing in a public hospital.

It happens that St George has some a bunch of very good gastroenterologists, both on the diagnostic side an the surgical side. And in at least one case, Ms T's specialist, the focus is on the public system.

We first met him in the public system at RPA, he saved Ms T's life with a diagnosis that was, strictly speaking, way outside his speciality. Her gut had brought her into his care, other specialists were dithering about the diagnosis so much that she was in danger from the wait, so (let's call him) Axel made a call and got it right.

Which is why we followed him from RPA to the 45-minutes-distant St George. One of these days, he's the kind of doctor that will get an Order of Australia.

And he's still in the public system – that is, if someone says “you need the best”, they won't be sending you to the nearest private, because Axel isn't there, he's in the public system.

I think that's where he thinks he can do the most good.

I've never asked him about this, because in spite of a very-well-crafted persona that he presents to the world – confident, polished, in charge, smooth, articulate and all the rest – he's also modest. My family once encountered his at a farmers' market: his blush when I told his wife “he saved Ms T's life” was so delicious I'm grinning wildly as I remember it.

Back to the “safety net” theory.

The Liberal narrative that public hospitals are a safety net is not only insulting to some of the country's best doctors, it's manifestly untrue. It's untrue in a way that could only be adopted by journalists who have had very, very sheltered lives: they've never been told that your best or perhaps only hope is at RPA, so don't go to St Vincent's Private (since it would just be a transit trip anyhow)?

Ms T had, at one point, four professors considering her case – all in the public system. If, as is the endpoint of the Liberal philosophy, the public system is destroyed, the professors will still be there – but only if you're rich enough to be insured to your back teeth.

And the training of those professors – at least three of them regarded as gods of their specialties (guts, cardiac and immunology), as well as “Axel” – is down to the public teaching hospitals, and they're all still in the public system.

See, the public system isn't only a “safety net” for the poor. It's also a “safety net” for people whose malaise defeats the narrow silos of private health-care.

Before Ms T landed at RPA's emergency department, she was in the hands of a private clinic of note: one of its “names” gave the world the antibiotic treatment of helicobactor pilori. I don't blame them that they utterly mis-diagnosed Ms T, because it was them that sent us to emergency and saved her life.

The collegiate model, in which a big teaching hospital has access to a bunch of heavy specialists at call in the public system, doesn't just help the patients. It also helps the specialists and the teaching of those who will come after them.

Sure, the warriors of the libertarian right will say that America can produce hospitals that could replicate my experience at RPA that are wholly private. But – ignoring questions of equity – America's hospitals are an artefact of its history, exactly as Australia's hospitals are an artefact of ours.

It's absurd to think that you could take one template, impose it over an existing system, and achieve the same result without an atrocious amount of disruption on the way.

Healthcare isn't a taxi service: if you disrupt a working system in taxis, as Uber is doing, people will lose money. If you disrupt a working health system, people will die.