Tuesday, 28 June 2016

The need for justice and rights in Australia’s health policy debate

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by Dr Russell Solomon

As a developed country, Australia provides the resources and facilities to ensure that the majority of the population are able to access adequate health care. Generally, other socio-economic determinants of health and wellbeing are also being met in terms of the basics: nutrition, clean drinking water, sanitation and a relatively pollution free environment.

While the health care of the general population is addressed, particularly through Medicare’s bulk billing and a world class hospital system, this is done without any reference to the right to health as found in the UN’s International Covenant on Economic, Social and Cultural Rights which Australia has signed.

There are, in fact, significant gaps when considering the country’s adherence to the UN’s right to health principles of accessibility, availability, acceptability and non-discrimination.

Australia does not have a constitutional guarantee of the right to health nor a federal bill of rights.
The extensive federal and state laws providing for health services are focused on the services that are provided to certain categories of citizens, if not the population as a whole.

They are not framed as rights highlighting the primacy of equality and dignity of patients but as services that can be removed at the will of parliament.

During the current federal election campaign, the Liberal-National Coalition parties and the Labor party are busy arguing about the current freeze on the GP’s Medicare rebate and making various health spending promises to certain parts of the Australian electorate, usually with respect to hospitals or other facilities.

When not in election mode, their principal political focus is, however, around the cost of health care - with each side blaming the other when in government for inefficiencies and waste.

Their debate has been focused more on economic indicators than an improvement in health outcomes, despite the fact that health expenditure at AUD$154.6 billion in 2013-14, was only 9.8 per cent of gross domestic product (GDP) and represented relatively slow expenditure growth.

The Coalition and Labor parties have, in the main, supported the importation of neoliberal ideas into health law and policy when in government as revealed through the increasing privatisation of aspects of the public health system.

Privatisation effectively commodifies health and examples largely supported by both sides of politics include a 30 per cent health insurance taxation rebate, the growth of private hospitals and the cross-subsidisation from the public to the private health system.

Private health insurance enables patients to jump the queue ahead of public patients and access ‘private’ surgeons practising in public hospitals.

The non-discrimination principle is undermined by the private insurance companies’ pre-existing and often restrictive risk conditions, as well as recent attempts by some to encourage certain GP clinics to privilege access to particular health insurance members.

There has also been recent growth in the financial barriers to some specialist services, in terms of out of pocket expenses, as well as the reduction in the level of subsidisation for some pharmaceuticals.

Recent international free trade agreements threaten to place intellectual property rights over patented medicines ahead of Australians’ access to essential medicines.

Australians in rural and remote communities often find adequate health care inaccessible while asylum seekers in offshore detention continue to suffer both physically and mentally through inadequate medical facilities.

Australia’s provision of health care for its indigenous people has fallen below the international standards in terms of almost all the right to health principles, evidenced by an alarming health gap between indigenous and non-indigenous Australians as revealed through a number of chronic ailments and diminished life expectancy (still well over 10 years less for the indigenous population).

While Australians generally see their continued access to a high standard of health care as a matter of ‘fairness’, this vague sentiment does not address accessibility problems (economic or geographical) and the increasing commodification and privatisation of the provision of health care.

For there to be justice in terms of the accessibility to and availability of health care, the national health policy debate needs to go beyond quarrels over the cost and include an awareness of the individual’s right to health and governments’ responsibilities, at both the federal and state levels.

The health of the nation is too important to be framed in terms of the current market-led politics. Where economic arguments can be important and be used to enhance Australia’s adherence to its international right to health obligations is in addressing the longer term economic costs associated with undermining public health care.

Dr Russell Solomon teaches the Master of Justice and Criminology at RMIT University. Russell is passionate about human rights. Russell has teaching interests in human rights and welfare law, advocacy and public policy making. He has published in political economy and human rights. 

Thursday, 16 June 2016

Exploring wild ideas with RMIT's Adam Browne

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Author and library attendant Adam Browne delights in genre-play in his new book The Tame Animals of Saturn. 

“Dragons are crap!” declares Browne, “they devalue anything they appear in: they’re so easy.”

Browne pauses for a moment, “Chinese dragons are okay, there’s something deeper about them”. And Welsh dragons? He admits they probably deserve his further contemplation. It’s the dragons of popular fantasy Browne takes aim at, those that “cheapened the world of Tolkien” by being lazy and self-indulgent. “There are no ideas in it” he laments.

Browne is explaining differences between science fiction, traditional fantasy and high fantasy. He calls his new book, The Tame Animals of Saturn, “science non-fiction” because he blends genres: creative biography frolics with scientific logic. But it’s fantasy too; in the original sense of the word, Browne clarifies, “making up worlds and playing with them”. But once fantasy gets allegorical he thinks it risks sanctimony. That irks him. And he doesn’t like swords much, either.

The exploration of ideas drives Browne’s writing. In The Tame Animals of Saturn he grafts his own upon those of 19th century Christian mystic, Jakob Lorber. Although Lorber maintained his words were actually those of God, relayed to him through an inner voice. On one such visit, God told Lorber about the landscapes and animals of the solar system.

Lorber’s extensive and vivid writings were written as fact and in the form of spiritual lessons. While Browne finds them in some ways repellent “there’s so much nonsense in there and it’s pompous: he wants to be a prophet”, Lorber’s visionary style grabbed Browne by the scruff “his descriptions of fantastical creatures and plants are very painterly: it’s the inventiveness, the ridiculousness of them; they’re whimsical as anything”.

Not everyone shares Browne’s interpretation of Lorber. Posthumous publication has attracted devotees and the Internet trumpets their passions. A reproach from one opens the Tame Animals of Saturn. Eva is not happy with Browne’s misuse of “God J.Lorber’s Writings for a career or fame!!!!” and their email correspondence frames the book’s introduction, giving Browne occasion to reflection upon his project in the context of various artistic traditions. As Eva admonishes, we learn about Lorber through both biographical detail and Browne’s empathetic sensibility.

The formal play continues throughout the book, like a musical theme and variations: epistolary conflict moves to exegesis as creative essay and from this a Saturnian analogue of Lorber emerges and then a narrative concerning his daughter, Rhea. The book concludes in the form of the Victorian sub-genre, the Edisonade (which I am informed is a science-fiction modality concerning the adventures of young inventors). And all the way along there are illustrations:  Browne’s wildly intricate interpretations of Lorber’s excessive descriptions.

Browne’s writing style is playful, witty and celebratory. When speaking about his process, he compares a beautiful phrase, word or concept to a seed-crystal: something ideas can grow from and around.  “They’re a trigger. If it’s an idea I can get deeply into with a few paragraphs and play with the logic of it, that’s fun for me”. He says, one of the greatest lessons he has learnt is from Jorge Luis Borges “if you have a good idea, you have a duty to explore it”.

Along with his writing desk, the Carlton Library has been Browne’s professional habitat for at least 8 years. He’s the big bearded man who is generous with his knowledge. “The Library, especially the academic Library, is a place where ideas are safe to do what they like. Working there, I sometimes feel as if I’m learning by osmosis - I’m exposed to books and materials I would never otherwise look at.” And on that point, I ask him to share some gems he has found in the collection.

Adam Browne’s RMIT University Library picks:

Jorge Luis Borges, in collaboration with translator Norman Thomas di Giovanni: The Book of Imaginary Beings – the English edition contains descriptions of 120 mythical beasts from folklore and literature. This was Adam’s first exposure to Lorber. Browne says, “Borges writes with dry wit of Lorber’s ‘leveller’, native to Neptune. Elephant-like, like many of Lorber’s creatures, its pyramidal legs are designed by god to flatten ground preparatory to the bricklayers who follow behind.” Carlton General Collection (398.469 B732 )

Encyclopaedia Anatomica : a selection of anatomical wax models - “An exquisite little Taschen book of photos of the wax √©corch√© (anatomical models) of the Grand Duke Leopold’s Imperial-Royal Museum of Natural History founded in 1771. These sumptuous men and women, languidly posed with their viscera exposed, are for me the epitome of the beauty of the grotesque. I often look at it for inspiration.” Carlton General Collection (611 E56)

Little Nemo in Slumberland. A jumbo folio, this is a collection of the newspaper ‘funnies’ of the genius cartoonist Winsor McCay. “Rarely have I seen such a faithful depiction of the world of dreams. This book belongs in the canon of visionary fantasy literature along with Alice in Wonderland and the films of Miyazaki.” Carlton General Collection (FOL 741.5 M123)

Artforms in Nature, by Ernst Haeckel. The book is mentioned in The Tame Animals of Saturn. “I find it inspiring that Haeckel, a scientist and artist, was a pop star in his day. His illustrations of radiolarians inspired art deco designs of the fin de siecle period; there’s a Metro station entrance in Paris based on one of his diatoms, and in the Oceanographic Museum there was an incredible chandelier designed after one of his discomedusa jellyfish” Swanston General Collection (704.943 H133 ) and other locations

Horrible Histories: Adam often watches this with his daughter, Harriet, who also helped with one of the illustrations in Tame Animals. “In one episode,” he says, “we learn some of the fantastic names given to children in Victorian times. Some, like Furious Hardwick, made it into my book, but some, like Toilet, Princess Cheese, Baboon and Toilet, will have to wait for another time...” Selected episodes can be streamed via the Library website. Search for “Horrible Histories” in LibrarySearch.

Adam Browne’s The Tame Animals of Saturn is available through Peggy Bright Books http://www.peggybrightbooks.com/

And also at the Carlton Library:   823.92 B882

Source: Amanda Kerley

Monday, 6 June 2016

World Environment Day in a shifting ‘environment’

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What does World Environment Day mean in a world in which we are no longer sure what ‘environment’ means?

As an event, World Environment Day was established by the United Nations General Assembly in 1972 to mark the first United Nations Conference on the Human Environment. The name of the conference points to an enduring tension in the notion of the environment: are humans or nature at its centre?

Originally, ‘environment’ stemmed from the word ‘environs’, meaning surrounds. It was an explicitly human-centred concept, directing attention to all the external factors making us what we are.
Some commentators used the fact that we are shaped by the outside world (and not just our genes) to explain differences between human populations around the world. Many did so not just to understand biological difference but to naturalise and justify differences in opportunity generated in reality by the uneven effects of imperial, capitalist development.

Other commentators saw in the fact that we are shaped by the outside world an opportunity to use the environment as a civilising tool. The possibility of improving people by manipulating the environment underpins the idea that education is about more than the curriculum. It also underlies many competing conceptions of the city as the bright site of citizenship or dark cesspit of vice.

The relationship of prime interest in these readings of ‘the environment’ was the influence of the environment upon people. But now of course – thanks to the “environmental movement” that emerged in the 1970s with the first World Environment Day and similar events such as Earth Day – ‘the environment’ primarily means the inverse: the influence of humans upon “the natural world”. We are increasingly aware that in unimagined, long distant, long term ways, our society’s intentional efforts to positively shape the environment have unintentionally generated countless, deeply negative effects. So ‘the environment’ now tends to mean something we must somehow protect, especially given that we are also increasingly aware that the environment is indeed a powerful influence upon us, not something we can simply transcend.

But the idea of protecting the environment from ourselves can unhelpfully set up a mental model in which the only answer seems to be human extinction. Other dead-ends in our thinking about the environment also seem to have stymied the concept. This includes the fact that to some it all seems too late: global scale human-induced changes in the environment such as climate change and related shifts in how the earth system functions mean that in some ways there is no ‘natural environment’ left to protect. Human and nature, some argue, are too intermingled now for such a thing as nature to exist. Meanwhile, integrative concepts such as the earth system have strengthened the idea that humans and nature were never separate: the distinction has been a fallacy all along.

So where does this leave the notion of the environment and initiatives such as World Environment Day? That is for you to debate, but I would propose three things. First, when considered at the level of us as individuals, the word ‘environment’ – as both a source of and sink for the effects of our actions – seems to offer a way to side step the out-dated modernist desire to strongly distinguish humans and nature.

For each one of us, the environment is everything and everyone (human and nonhuman) that we coexist with. So World Environment Day, in this light, is about thinking about how each of us engages, in a bi-directional, circular way, with the rest of the world. Second, today the long-standing normative distinction between whether our effects on the environment are positive or negative is more important but more messy than ever. What seems positive at one scale, point in time or direction, frequently proves less than positive or downright dangerous from another, especially given the greater complexity and uncertainty of the disrupted systems we are part of. So World Environment Day demands we think more carefully than ever about what we are doing, perhaps reviving the old idea of the precautionary principle.

Finally, all of this is an opportunity to reinvigorate the concern with justice that the World Environment Day was borne out of. Such justice includes not only a concern with the uneven way in which environmental goods and bads are distributed between different human groups – which the environmental justice movement usefully highlights - but between humans and nonhumans. Because when we step beyond the level of the individual I suggested above, we see that the human and natural divide reappears, not as an assumption or starting point this time, but as an outcome, a frequent fault line along which winners and losers of the current regime are divided.

Story: Dr Lauren Rickards

Dr Lauren Rickards is a Senior Lecturer in Sustainability and Urban Planning at RMIT and teaches the Bachelor ofEnvironment and Society. She is also co-leader on a Climate Change and Resilience research program in the Centre of Urban Research.