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Technology pushes political agenda

Laura Kuenssberg | 20:13 UK time, Thursday, 13 August 2009

Yesterday, internet pranksters caught out Alan Duncan. Today, we've seen a different kind of technology pushing the political agenda.

Daniel Hannan, the right-wing Conservative MEP who scored his own hit on YouTube earlier this year, appeared on Fox News in the United States last Friday to talk about the NHS - you probably know that America is engaged in a torrid debate about President Obama's proposals to introduce an element of public provision in healthcare.

In his interview on Fox, Mr Hannan made disparaging comments about the health service: as well as earning him a telling-off from the Conservatives' shadow health secretary Andrew Lansley, a growing number of people have since joined a Twitter campaign lending support to the NHS.

Those posting include the prime minister, his wife and various cabinet ministers. "#welovethenhs" has become one of Twitter's "trending topics" - which, for those us who are not technologically savvy, means it's a subject that's gathering pace.

Rumour has it that Graham Linehan, the author of Father Ted, started the groundswell. Whoever it was, it's another fascinating example of how quickly, and how directly technology can respond to political events, and how it can help people to take part.


  • Comment number 1.

    For goodness sake.

    Who cares whether Mrs Brown twitters? I struggle to find a role for this lady in the UK political environment.

    I find it hard to imagine that Gordon also twitters.

    The US has a flawed health service. So? What's new?

    Obama is trying to fix some aspects, to ensure a fairly universal access to what is probably the most technologically advanced health system in the world. Bill Clinton - and his missus - had a stab many years ago. They failed.

    I guess we'd all hope that the US electorate support a genuinely open access to health procedures. How they'll achieve that is another matter. If they do something interesting, there could be lessons for the UK to learn.

    I KNOW. The NHS is sacrosanct. I love it. But if you pop over to France, you will find enough beds available whenever, fairly close to home, whatever your problem.

    Technology justs keeps rolling along. Good thing too. But sometimes, it is hard to manage the associated costs.

    That's why the NHS will struggle in future, regardless of which party forms a government next year!

    Good for him.

  • Comment number 2.

    I rather agree with David Cameron's perception of Twitter

  • Comment number 3.

    It's fairly easy to look at at the stream twitter stream:

    I've been sampling the stream for a couple of days and I think Daniel Hannan is toast. Cameron thinks Twitter uses are tw*ts but I think he's about to learn a lesson. Unless Cameron reacts very quickly on this he's going to be facing the question of whether the NHS is "safe in or hands".

  • Comment number 4.

    Steer the "attack" on the NHS to look like an attack on everyone in it, as Hannan rightly points out.

    Pfff! Labours use of Twitter just exposes the spin more widely, IMO. It's so transparent. Sickening even. It will backfire.

    It's not the NHS at fault, it's the *administration* of the NHS. Too much of it and unrealistic political promises stoking unrealistic and unsustainable expectations.

    Tell you what. Let's divert all medical research funding into finding a cure for old age. Nothing else.

    Immortal but not invincible. Suspect we might all tread a little lighter on the Earth were that the case...

  • Comment number 5.

    Having just watched Mr Hannan's interview on youtube, I am disappointed that the Tory MEP voiced such vehement opposition to the NHS on such an influential programme in the US. Yes, the NHS may have its faults but, on the whole, it is a wonderful institution which I believe is one of Britain's finest developments of the past 60 or so years. No government has since dared take it away and in many parts of the world, though maybe not amongst the rich in America, it is envied and coveted. I am proud to come from a nation where health care is free at the point of use and am glad that Mr Hannan has received so much criticism back at home. The NHS can, and needs to, improve but let us be glad that we can all go to hospital when we're ill regardless of our finances.

  • Comment number 6.

    The news coverage I have watched on Obamas Health Service provision proposals has puzzled me.

    It seemed to be the haves railing against it just because it would be a partly govt sponsored affair. They didnt actually say we are happy with what WE have and stuff the poor and seriously ill, but it was bubbling under.

    One lady even spoke against it by saying "this isnt Russia" trying to imply that a National Health Service was akin to Communism.

    What planet are there detractors from, other than the Im all rght Jack one?

    Our NHS has faults but it is a model for the rest of the world of which we should be proud if not satisfied. Always room for improvement.

  • Comment number 7.

    Its handy that this is diverting attention away from unemployment figures and the economy.

  • Comment number 8.

    7 AquaLungCumbria

    Ver true my friend and who has provided this diversion ? A Tory MEP who obviously has no concern about helping the UK Parliamentary Tory party to keep the presure on GB.

    You couldnt make it up really could you?

  • Comment number 9.

    I dont think the US right wing fundamentalists attack on the British NHS has anything to do with diverting attention from any subject in the UK political agenda. This is some very nasty people using their official mouthpiece - Fox News, owned by Murdoch - to attack President Obama. Their arguments on healthcare, like most else they spout, are garbage ... and doesn't really mask at all what all thinking Americans know full well ... that these people are opposed to Obama because he isn't white. It really is as simple as that.

  • Comment number 10.

    oh no, not Derek Hannan again! - thought we'd heard the last of him - silly, puffed up little man - and what's this Twitter? - sounds like I should be on it if it's giving Derek a hard time

  • Comment number 11.

    Did Maggie Shiels just take over Nicks blog!

  • Comment number 12.

    sagamix 10

    It's DANIEL Hannan. I rather think you made that mistake before. Maybe you are mixing him up with Derek HATTON?

    Hannan's previous effort, a full frontal public evisceration of Brown, was excellent. But he may have mixed up his skills as an orator (which he has in spades) with the skills of a politician (which he has in rather shorter supply).

    Nonetheless it's worth making the point that it is the concept of free universal healthcare that is the genuinely loved institution here. Anyone who thinks the execution of that concept, in the form of the NHS, is much better than a piecemeal, over-expensive, inefficient shambles, is trying to live a dream. I would go so far as to say that the NHS as we know it continues to exist only, absolutely only, because to replace it would cause a practical crisis the like of which no rational politician from any party would choose to face.

  • Comment number 13.

    Fighting for the NHS against the USA insurance companies and the rabid right might just save Gordon Brown and win him the next election!

    The NHS matters to the majority of the British people (I think this is a fair statement isn't it?) So perhaps Gordon Brown has found an 'event' where he can lead the British people against its enemy - just like Mrs Thatcher's Falkland's War.

    In this the people stand four square behind Gordon. ¡Vive la revolution!

  • Comment number 14.

    Good stuff! a clear dividing line on the subject of health and care.

    No surprise really, the NHS has been the tories achilles heel from the beginning.

    Surely the great British public wont put the future of the NHS in the hands of the destructive tories.

    Good! I'm fairly up beat now!

    May the force of technology be with you all.

  • Comment number 15.

    jr @ 12

    yes, Derek Hannan - that one

    I'm not the biggest fan of the NHS, as it happens - I think it needs reining in, but its "national treasure" status makes it next to impossible to do that

    Derek though - great orator? ... sorry, can't see it - he came over to me, in that YT hit, as a little over excitable and lacking in gravitas - had a touch of the "closing time at the local" about it, if you know what I mean - reason it was a hit was because he was doing something ... attacking Brown to his face ... which clowns the length and breadth of the nation would LOVE to do themselves - you, for example ... I bet you any money that when you watched that speech for the tenth time, you chanted along with it word for word ... kind of like playing air guitar to a mediocre guitar solo

    (don't worry, we've all done it at one time or another!)

  • Comment number 16.

    We love the NHS? Only if you use it excessively (drunks on a Friday night, spring to mind) or are employed by it unnecessarily (layers & layers of little dictators in the upper echelons of bureaucracy). Even the NHS drone-bureaucrats (i.e. Those that Joe Public actually speaks to) despise the upper bureaucrats. Those highfaluters pen-push at thrice the price, don't speak to anybody with a real ailment, tell everybody else what to do, constantly get the organisation wrong, then force another round of reorganisation just to keep themselves in a job & make half of their staff look busy.

    The NHS deserters would be quite happy to not be taxed, so that they could pay for their own healthcare, & quietly look after their own, out of their own pockets. Instead of being broken by a broken system, so that the broken system, in it's interference, could fail to fix the breakages! By the way it's run, Gordon Brown would love to work in it. So would most of the present incumbency of MPs. Those, within the NHS, who actually have something to offer in the career of healthcare, would be less stressed, better paid & much more highly regarded, if the system was to revert to localised private healthcare. Patients would also be seen quicker, without timewasters clogging up the waiting rooms & clinics. In a good healthcare economy, some might even learn to conduct an online diagnosis, then treat themselves for non-specialist problems, instead of being encouraged, from the point of political force, in behaving as completely incapable.

  • Comment number 17.

    Was that a spoof I've just been watching? Americans are really brainwashed aren't they! I think Derek Hannon should give up politics and either continue his propaganda ranting career playing to his fanbase on Fox News or start a new career as a Stewie griffin impersonator. You can get private health insurance in this country so what is he on about? Peter Duncan and Derek Hannan show the honest face minus the PR front of the Conservative party.

  • Comment number 18.

    The NHS is a wonderful institution? Come back & say that, once you've worked & treated people in A&E, after any significant amount of time. If Labour wants the NHS, then they can go & work in it!

  • Comment number 19.

    basic rights: free education; free health; free speech. None of these should be predicated on your income. #welovetheNHS

  • Comment number 20.

    "Surely the great British public wont put the future of the NHS in the hands of the destructive tories."

    This 'destructive tory' maintained 500,000 paper medical records (not your lightweight digital stuff!) during the course of one 3-year stint. The system was left in a lot better shape than when I found it, & I'd gotten it so efficient that they had to replace me with two people when I left. You, sir, can match me or scrap it!

  • Comment number 21.

    Interesting to see the Labour hopefuls (13, 14, 17) stumbling in all of a sudden.

    Their "theory" is that Hannan defines Conservative policy. It's a nice little propaganda story, that one. Nice Mr Cameron, who talks so pleasantly and in such a "liberal" way, turns out really just to be a front man for that nasty Mr Hannan, who will close down the NHS (when he has finished with stopping state pensions and torching OAPs' homes).

    In fact, as you all know very well, Hannan hasn't even as much influence on Tory policy as, say, Dennis Skinner has on Labour policy.

    So, my friends, pull the other one.

    Let me remind you that the only mainstream UK party that has NOT promised to maintain NHS spending is Labour.

  • Comment number 22.


    Technology: Pushes political agenda, that is true in most cases, in particular situation it was a wonderful thing since, it bought out in open the comments of a political party and there thoughts on issues...

    NB: I am a political operative in the United Kingdom...

    =Dennis Junior=

  • Comment number 23.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 24.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 25.

    Good Evening,

    "Technology Pushes Political Agenda", seems to have fairly quickly become "Technology Pushes Health Care Agenda"....

    Next they'll be touting the old "victim of their own success" line in reference to the NHS. Always thought that this was a basic nonsense. Actually, a little like MP's expenses vis-a-vis performance measures, (or lack thereof).

    Who actually is particularly bothered what MP's (or Govt Departments) are alloted, as opposed to how they perform. Surely, we all know the present Govt's recent track record in meeting performance criteria; don't we?

    Best placed to weather, etc, etc ??
    Before you know it they'll be claiming that they've saved public health care....


  • Comment number 26.

    When the NHS was a health service for British people it was a laudable concept...but now that every freeloader in the world thinks if they can just make it into Britain, then it's a free ride on the NHS...then no it is not laudable.

    Brown is the friend of 'The City' and has pushed the agenda for uncontrolled immigration into this country solely for the reason of undermining the real working class, indigenous population of this country, just in order to groom more debt slaves for the banking system to ensnare.

    Brown, the mater regime's puppet, continues to pursue the secret agenda of the International Socialist Movement....and simply does not recognise National Socialism as a worthy cause. He (and Blair before him) continues to tow the anti-statist line for his ultimate masters.

    As I've said countless times before...when Brown gets kicked out of office soon...he will land a plum job with one of the remaining global banks (it will either be Goldman Sachs, JP Morgan Chase or our very own mark my words...the top politicians, when compliant in office, are always well rewarded after their period of tenure).

    'Brown cares for the NHS'...don't make me laugh!

  • Comment number 27.

    Well! Well! the conservative party hacks come out and challenge the NHS.

    Just what kinda weight will light Dave carry across the Atlantic, while the American hawks are flying around our NHS.

  • Comment number 28.

    agent perry@23
    "Interesting to see the Labour hopefuls (13, 14, 17) stumbling in all of a sudden.

    Their "theory" is that Hannan defines Conservative policy. It's a nice little propaganda story, that one. Nice Mr Cameron, who talks so pleasantly and in such a "liberal" way, turns out really just to be a front man for that nasty Mr Hannan, who will close down the NHS (when he has finished with stopping state pensions and torching OAPs' homes)."

    I can't speak for anyone else but I'm no Denis Draper Drone. I'm a floating voter though unlikely to float anywhere near the Conservatives. I hate them for the simple reason that they make it so easy. I didn't say or mean any of the above. I suggested that the Conservative party overall wish they had an electorate like the U.S. so they could say what they really think.

  • Comment number 29.

    @ 26

    Brown continues to pursue the secret agenda of the International Socialist Movement

    I wish! ... but you're being satirical, right?

  • Comment number 30.

    What happens when the real truth about the NHS finally comes out? The popular sentiment is not necessarily accurate or lasting.

    Support for the NHS is biased. The dead can't Tweet. The suppressed have to overcome NHS barriers to speak the truth. Fear silences the rest.

  • Comment number 31.

    #26 DebtJuggler

    "When the NHS was a health service for British people it was a laudable concept...but now that every freeloader in the world thinks if they can just make it into Britain, then it's a free ride on the NHS...then no it is not laudable."

    Like to provide even a tiny bit of evidence that your assertion has any validity?

    Do you understand the system underlying the European Health Insurance Card? Do you understand that, even without Insurance, you will get emergency treatment in the US? Try reading something other than the right wing press.

  • Comment number 32.

    Few issues would cause me to take to the streets or the blogosphere in a blind rage, but the NHS is one of them. I strongly believe that the NHS has been and still is a serious force for good in the UK, and despite not being a Labour supporter, I strongly admire Atlee's government, particularly Bevan, for it's creation. It remains one of the most important Parliamentary actions in it's 850-year history.

    My glasses are mostly paid for by NHS subscriptions, my dental care is free and great, my GP will see me within hours of an appointment on most days and I know that if I need surgery, then the NHS is at my back, and will never once ask for payment. Sure, it has problems, but even though my household could afford comprehensive coverage with one of the private insurers like Bupa or HSA, we don't want it. The NHS gets it right for 95% of Britons 95% of the time.

    The twitter campaign is probably partially motivated by indignation at Americans daring to criticise a system, or more likely deliberately spread lies about it, when they actually seem to know very little about it at all and fail to take into account the statistics that justify the existence of the NHS and the other health services in the developed world. However, with approval ratings consistently at 80% or more, even above 90% last year, in patient satisfaction, [read: not grumpy average Brit's satisfaction who rarely/doesn't use the NHS or has private insurance], I would wager that we blogging Brits really do feel passionate about the right to healthcare and the good work that the NHS does.

    I know that Gordy, Sarah and Andy are posting primarily for their own political capital, but even the Labour party has some basic principles, and considering that the NHS stands proud as it's single most important achievement and the Brown's son suffers from Cystic Fibrosis, I'd say that they actually do feel quite passionate about keeping the NHS.

    I would pay for the NHS over any other government service short of defence, which is the most serious sovereign duty of a government.

  • Comment number 33.

    Everyday blatant dis-information is being fed to the America’s general populace whose attention span goes only as far as the latest sound-bite for whatever 'shock-jock' happens to be spewing his nonsense at that particular moment. Therefore, it was with great sadness that I had to bear witness to a British Euro MP speaking with such ignorance.

    It is obvious that the current system in the US is not working and without drastic action will only get worse. It is the people with the big wallets and even bigger mouths that are the ones who cry ‘socialism’ whenever an attempt is made to improve things for the common man; anything so that their profits don’t see a dip – we can’t have anything degrading that ever increasing profit margin can we? And those precious Health Insurance company profits, just so happens that they rise every year: 2002 - $1.3 billion, 2004 - $10.23 billion and in 2006 $15.39 billion. In 2007, over 60% of all bankruptcies in the US were due to medical expenses – coincidence? That this is the system Daniel Hannan is not only defending, but believe should be implemented in countries where ‘socialized’ Health-care operates better than the system in the US, considerably so in Canada’s case, displays the ignorance of someone who has obviously never had to worry about being ill because access to a Doctor will never be a problem as you are no-doubt covered by the very best health insurance the British taxpayer can afford you.

    I would be a fool not to agree that the Health-care system in the UK is not perfect and obviously could be improved but compared to the system here in the US it is light years ahead. If the system here were implemented there, you would be facing a revolution. If one person was to lose their house because they had to choose between paying for medication to keep them alive or to pay their mortgage that month then whoever was in charge of the country, be it Labour or Conservative, would be thrown to the very same wolves that they themselves had condemned the country’s sick and poor too.

    At least, for now, the UK is safe from such a terrifying, and frankly, disgusting figures – and I hope will forever remain so.

  • Comment number 34.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 35.

    Am I missing something ? The vast majority of the country does not 'twitter' so why should the BBC and other media be concentrating on the small number who do, and pretend they are driving the debate forwards ?

    No prizes for the government if they take pressure from small technically minded groups and turn it into something affecting policy.

  • Comment number 36.

    Not all Americans think their current system is so great. This article from the LA Times is interesting, comparing Canada's and the US's health care systems (especially costs).,0,538126.story

    As a Canadian as well as a Brit (currently living in the UK), I can vouch for what this article says - both my kids were born in Canada, and everything was free at the point of delivery (pun intended). I also worked as a consultant to one of the major hospitals in Toronto for many years, and we were always getting Americans visiting us wondering how we did it - provided 'free' health care for EVERYONE, for a fraction of the costs that the same procedures would cost in the US.

    But, like the NHS, Canada's health delivery systems can always withstand a bit of improvement. Some Provinces do it better than others, but overall it is a very good system, and compares favourably with any in the world.

  • Comment number 37.

    I think it's all a bit of a stunt really. As for technology being used to demonstrate the views of people, I doubt that Gordon Brown would go within a million miles of any such thing. he's not interested in othe peoples views, and presumably is using it soley to tell us what we should be thinking.

    Can you imagine Gordon Brown tittering :

    "This is a global crisis, as the do nothing tories started in America, where british jobs for british workers brought an end to boom and bust, and we are just getting on with the job of showing hardworking families that we will not walk on by with savage tory cuts, and as my father once said to me my moral compass will guide me to Obama beach with efficiency savings, where our priorities are social mobility and justice culminating in a 0% rise to bring about our priorities of education, exploitation and eradication..."

    Twitter is presumably his substitue for ideas and plans.

  • Comment number 38.

    It amazes me that as soon as Labour go on this populist march and pick a subject that clearly is intended to say 'look what THEY think!!' - everyone believes them!

    Twitter away old loves! You clearly have the same problem of denial that has dogged this administration since its inception.

    If I understand this correctly - Mr Hannan was making the point that the institution itself is old, inefficient and buried in bureaucracy.

    Now according to the spin merchants that currently rule and regulate us - 'He is attacking our NHS! Our hard working Doctors and Nurses!'

    And you believe him!!????

    Not once did he attack those that work within the NHS.

    In the last two years I, my family, friends and relatives have had cause to use the NHS. Only one has received a service that they felt was being treated like a human being and not a number. All but one of us was given useful information about our conditions or circumstances. Only one had post treatment care and received ongoing help and assistance that wasn't just thrown to the family to deal with.

    This is what you are defending. Once again you have fallen to the spin and nonsense that this government is so keen to use.

    Well Twitter this... The NHS is too big, it is inefficient, it is uncaring (because it is an institution) - The people who work in the Institution care and are (for the most part) extremely good at their jobs but are being handicapped and restricted in being able to achieve what they know needs to be done by the Institution.

    It's a fact.

    The reason Lord M, GB and SB feel the need to Twitter is because unless they bring emotion and personality to the issue, people may actually start to look more closely at the sad old edifice that is the NHS and go 'Oh yes' Mr Hannan may have been right!'

    Oh and the one who received the good treatment - was with a cottage hospital that is due to be closed soon.

    Save our NHS! Goodbye care.

  • Comment number 39.

    At last! After most of yesterday was dedicated to Alan Duncan and his indiscrete comments, we're here at last..... Daniel Hannan, representing the Conservative Party, on Fox News and other US Broadcasters slagging off the NHS, in fact, having seen the footage, I'd say synically misrepresenting the NHS.

    The BIG question is why hasn't David Cameron had the guts to come out and publicly silence him? OR, does David Cameron somehow weirdly concurr with Hannan?

    Is this Dave's idea of 'progressive' politics? A hell on earth ruled over by lots of old fashioned Tories.

    Also, why is Daniel Hannan in the States? He's a very well paid Member of the EUROPEAN Parliament.

    Personally, this show's me that if Dave really is serious about reform and mordernisation, he's going to have a tough time keeping his rightwingers (party members, backbenchers, MEPs) happy.

    Back to Hannan, the far right republicans want him to become a congressman (wonder where he stands on God, guns, pro-life, pro-death penalty, climate change, etc, etc) so hopefully we'll be rid of him - I find him an odious man.

  • Comment number 40.

    Sorry, back to Hannan (I hate him), if he really wants us to have a US system of healthcare here's some facts and figures to think about:

    According to "Dying for Coverage, New State Reports" (from Families USA, March-April 2008), "In 2002, the Institute of Medicine released a groundbreaking report, Care without Coverage: Too Little, Too Late, which estimated that 18,000 adults nationwide died in 2000 because they did not have health insurance. Subsequently, The Urban Institute estimated that 22,000 adults died in 2006 because they did not have health insurance. To find out what this means for people across the nation, Families USA has generated the first-ever state-level estimates of the number of deaths due to lack of health insurance. In Minnesota an estimated 1,100 people between the ages of 25-64 died from 2000-2006 because they didn't have health care. Across the US, the numbers who die from lack of health care is twice that of people who die from homicides."

    According to the University of Minnesota, there is worse news. Uninsured Americans are sicker, uninsured adults are 25 percent more likely to die prematurely, and Americans between 55 and 64 are at much greater risk of premature death than their insured counterparts.This makes lack of health insurance the third leading cause of death for the near-elderly, following heart disease and cancer.

    Back to the UK.... Personally, I had health insurance, however, once I'd had a bit of treatment they stopped paying. If it wasn't for the NHS, I would have had NO further treatment so would be dead.

    Can't wait for Hannan to stand for Congress wonder where he'll choose? Wichita, Kansas? Akron, Ohio? Monroe, Alabama?

  • Comment number 41.

    Speaking of Twitter campaigns, and no offence to Nick, but I think Laura's blog is as good if not better than the man himself's, and perhaps we should start a twitter campaign to get Laura her own blog?

  • Comment number 42.

    #38 sircomespect wrote:

    "...The NHS is too big, it is inefficient, it is uncaring (because it is an institution)".

    Fine, I agree the NHS needs to be reformed, however, Daniel Hannan is supporting the current US system over the NHS.

    In 2006, 22,000 American adults died because they didn't have health insurance and uninsured adults are 25 percent more likely to die prematurely, and Americans between 55 and 64 are at much greater risk of premature death than their insured counterparts. This makes lack of health insurance the third leading cause of death for the near-elderly, following heart disease and cancer.

    Even those insured find that their insurers, like in the UK, will only pay for a limited amount of cancer treatment. People in the UK do not generally die or live in extreme pain from treatable illnesses when they don't have to.

    Whilst feeling a very small degree of sympathy for Daniel Hannan's 'friend' with the broken ankle, I also say get in the queue and be a man about it. A non-complicated fractured ankle is not life threatening and does not cause that much pain.

    Perhaps when Dan becomes congressman for Wichita, he can try the current US system without insurance and compare experiences. Good ole Dan mentioned our Friday night pastime of drinking and fighting - in the States they do the same sort of thing but with guns so he may have a slightly longer wait.

  • Comment number 43.

    Right, I'm off for free, life saving NHS treatment now, treatment that my health insurance company long stopped paying for.

    Good ole Dan, he'll do well in some US backwater.... Pine Bluff, Arkansas?

  • Comment number 44.

    Not completely up to date with all the facts, but what from I heard on the Today programme, it sounded like David Hannon was saying that if Britain was designing a a public health service today it would not go down the route taken 60 odd years ago, as as the USA has that very opportunity now, he was advising them against following a route, the outcome of which is as much a burden as a blessing.

  • Comment number 45.

    here is an everyday reality


    Day 1

    Tripped and Fell
    Ambulance called and prioritized to our remote rural home in evening
    Ambulatory staff competently checked patent in home
    Ambulatory staff competently checked patent in Ambulance on way to our preferred hospital
    Hospital Staff immediately received patient and competently checked patent including a vast number of blood checks
    Pain killers administered to appropriate levels
    X-Rays undertaken
    Diagnosis made
    Patent given bed in ward

    Day 2

    Anaesthetist checks patent
    Anesthetic given
    Surgery undertaken
    ….morning over
    So in the space of 12-18 hours the patent was collected from rural home and underwent Hip Replacement

    Her age 85

    Did her age affect the British West Suffolk Hospital’s decision making

    The effect was to prioritize her attention from the medical staff

    The NHS – far from perfect but

    did she have to undergo wealth checks? No
    was payment needed? no
    – it’s the National Health Service

    I think that the slogan was “Cradle to Grave” when introduced
    well she’s to old for the Cradle part - I got that part as her son – but she is getting the “to Grave “ bit

    an 85 year old injured woman got all the required attention from the NHS - doesn’t make a good headline but it happens every day ….

    The NHS – far from perfect but, far better than most

  • Comment number 46.

    We would`nt need the NHS if we did`nt live in a dangerous over-worked over-crowded open sewer of a nation getting fed industrial poisons in our "food" and water.
    Not to mention the "vaccines".

  • Comment number 47.

    Hannan is a voice (albeit a very eloquent one)in the wilderness on the NHS and is well know for being about as far to the right of Thatcher as she is to the right of Dennis Skinner. Not a nice man but a very well spoken one, his brand of vitriol is very suited to American politics so no surprise he has made such a splash in the US. I wonder if he has been sought out as a consultant to the trash Obama's healthcare campaign and been paid for this 'contribution' of lies to the debate.

    The BBC ran a report earlier in the week covering a free clinic being run by a charity in a stadium in LA for thousands who had no other access to healthcare provision because they could not afford it. People die in the US because they cannot afford healthcare. People are bankrupted and reduced to poverty to pay for it, not a pleasant society.

    Whether Cameron supports the concept of universal healthcare provision in the principle of the NHS or not is a completely dead issue - he does, and it is obviously extremely clear and heartfelt support. Argumentation and discussion over the reforms or way of delivery can be had but the commitment to universal healthcare provision for all in the UK is not even a question.

    Cameron could draw a very clear line under it by casting Hannan into the wilderness by having the whip removed from him. But I doubt he will, slap on the wrist, don't do it again and hope we all forget about it.
    He seems to be a lot weaker than I thought he was.

  • Comment number 48.

    Yes, isn't technology wonderful.

    The problem with our technology is that it usually depends on someone plugging an appliance into an electrical socket to draw power from the grid. Due to the failure of this government to come up with a plan for power stations that does not involve a wind turbine we can look forward to power cuts in the not too distant future. What about Twitter then? What about medical technology then as well?

    As usual in the UK we don't talk about the elephant in the room we are deceived into the drivel put about by those who choose to control us.

    There is no doubt both the NHS and private insurance healthcare work to a point but both methodologies have their obvious inadequacies. Rather than crying stinking fish at each other I would much rather that the political class both here and in the USA worked towards a socialised medical system like they have in France and Germany which works for the one person who is being ignored in all this; the patient!

  • Comment number 49.

    Now...if Brown, or any of his immediate family, fell ill...I just wonder which NHS hospital they would be taken to and treated in?

    It's just a clear case of beggar thy neighbour! The NHS...a medical service for beggars...which Brown has made us all, in cahoots with his City pals.

    What's very clear is that Brown is out for Hannan after Hannan's complete humiliation of him earlier this year in the EU parliament.

    Re Hannan's comments in the US...don't believe everything you read in the press about this 'story'... and that especially includes the BBC.

  • Comment number 50.

    Twitter. Yeah, great.

    "boiled an egg for breakfast"

    "Am wearing blue socks today"

    "Looking out the window at work. It is raining"

    "Save the NHS, it's not bad"

    "Think I might have fish for tea. Or maybe pasta."

    Really ground-breaking stuff. However did we live without it? Seems to me it's the preserve of (on the one hand) boring people who delude themselves into thinking anyone might possibly be interested in the banalities of their lives, not realising that absolutely no-one is ever going to read what they write and (on the other hand) sad people who read the twitters of 'celebrities' in a vain attempt to fill what must clearly be the cold, empty lives they lead.

  • Comment number 51.

    The problem with discussing healthcare in Britain is that if anyone tries to suggest radical reform of the NHS, Labour accusses them of trying to impose U.S. style healthcare and they shy away from reform. It isn't an "it's the NHS or nothing," issue, there are many other models of healthcare provision around the world that are far more successful than the British and American systems. Australia has a tax payed funded helath insurance scheme but the hospitals and clinics are privately owned and it's system seems to work quite well, as does Canada's which was mentioned above.

    The big problem with the NHS is it's too large and beauraucratic. This is largely a consequence of Nye Bevan's decision to nationalize all the hospitals and clinics in the run up to the NHS's creation to please Labour MP's. Beveridge never suggested this, most hospitals in Britain were owned by local councils, churches or charities before 1947. Bevan's NHS was by modern standards a lean and efficient organisation and it worked well through the 1950's, this is the NHS that you see portrayed in The Royal and it is this romanticised version that makes people so dewy eyed. However things began to go wrong in the 1960's with the growth of the NHS managers, largely as a result of actions by ministers, Labour and Tory who were desperate to be seen to be doing something, mainly to justify their own jobs. This resulted in lots of half baked initiatives which required an army of pen pushers to administer and has resulted in tday's NHS which is more like Casualty than The Royal with Nathan Spencer type managers pressing medical staff to meet targets cooked up in Whitehall.

    I think all but the most stubborn lefties would agree that the NHS does need major reform. Persoanlly I would m,ove to the Australian system and break the NHS up with much of the responsibility for healthcare provision being transferred to local authorities and charitable trusts. Hannan does have some legitimate and well founded criticisms, he does not make Tory policy on the NHS and he is perfectly entitled to make his case for what he believes in. But by allowing himself to be used by whack jobs like Glen Beck he has shown terrible judgement. Some of the claims made by Obamacare's opponents such as saying that the NHS would have left Stephen Hawking and Ted Kennedy to die are totally despicable. I doubt that this issue is going to change the election result, what it will do is make Cameron adverse to grasping the issue of NHS reform so we will store up more problems for later.

  • Comment number 52.

    The NHS operates appallingly. The vitriol that follows any attack on it is pathetic and ultimately fatal for many.

  • Comment number 53.

    47. But why would he remove the whip from him? What's wrong with putting forward your own opinion about how healthcare in Britain should be reformed? OK it's an opinion which many people in Britain would not support but what's wrong with someone putting it forward?

  • Comment number 54.

    Gordon Brown is forever imposing targets on the NHS and strangely, whatever the public perception of reality, the targets always seem to be met.

    Surely all Gordon Brown has to do is impose a target on the NHS of "everyone always being healthy and living for ever" and it would be so and all our problems would be over.

  • Comment number 55.

    Twitter is great for social networking and circulating news (Iranian elections) but policy?

    Sarah Brown, Cherie Blair... it seems NewLabour PM's partners have to be in the public eye. Must be that equality thing. :-)

    As for Hannan, it looks like he's aiming for a career in the US. It's the only place big enough for his ego.

  • Comment number 56.

    claque @ 44

    it sounded like David Hannon was saying that if Britain was designing a a public health service today it would not go down the route taken 60 odd years ago

    well yes, that's a fair comment - the world has moved on and the NHS hasn't, I guess is the point there - but how many times, it is NOT David! - Hannon yes, but not "David" Hannon - or Dave even - starts with a D so well done for that (sarcasm, sorry!) but why not go the whole hog and get it exactly right? - not that difficult, is it? - fact, I'm getting a little tired of this juvenile NuLab conspiracy to spread confusion about this guy's name - so for the umpteenth (and I hope final) time, here goes ... not David and not Dominic - not Denzil - not Dirk or Dork or Dipstick - it's DEREK

  • Comment number 57.

    We may love the NHS but lets admit that it is poorly administered and used as a political scapegoat by Labour. This government have chucked so much money at it and yet all that investment has trickled off into the pockets of managers / advisers / contractors / lawyers and god knows who else. The truth is that Labour create gravy trains and there a select few who are very adept at jumping on them.

    If we want an NHS to love and be proud of we need to study the components and cut out the parasites that coagulate at every level.

  • Comment number 58.

    It is Daniel Hannan and I'm not even sure he is all that good an orator, the final phrase in that YouTube clip "the devalued Prime Minister of a devalued government", was a quote from a speech by Labour Party leader John Smith criticising then-Prime Minister John Major in 1992. Hannan's comments on Fox News have certainly caused problems for Obama and those who want to reform the unbelievably expensive and unfair US healthcare system. It must be very annoying for the 47 million Americans who can't afford healthcare to have their chances of that pushed off course by the ill considered comments of a Brit rich kid who probably has never used the NHS. He seem to be a an over educated and somewhat shallow person who likes the sound of his own voice.
    I agree with many of the comments about the NHS. It's now become unpatriotic to criticise it even though it is a bureaucratic nightmare witness the latest debacle where they have managed to spend £12bn on a computer system that doesn't even work properly and performs all sorts of tasks that no one needs.
    One last thought. Why does a blog on a website run by the British Broadcasting Corporation use a US English spell checker? Last time I looked we still spelt (not spelled) labour just like that not labor. Come the BBC get a grip.

  • Comment number 59.

    "extremesense wrote:

    In 2006, 22,000 American adults died because they didn't have health insurance and uninsured adults are 25 percent more likely to die prematurely, and Americans between 55 and 64 are at much greater risk of premature death than their insured counterparts. This makes lack of health insurance the third leading cause of death for the near-elderly, following heart disease and cancer."

    I wonder how many people in the UK have died because of funding problems in the NHS? Sadly, it is not uncommon for people to go to the courts in order to force the NHS to provide drugs which are in use in other countries (including the USA) which are not on the NICE list for cost reasons. In a population the size of America 22,000 is not a lot and I doubt there are records kept here in the UK for people who have died because the NHS did not react quickly enough in terms of treatment (I know of several people who have died of cancer because of the time it took to get treatment)

    "Even those insured find that their insurers, like in the UK, will only pay for a limited amount of cancer treatment. People in the UK do not generally die or live in extreme pain from treatable illnesses when they don't have to."

    The same is true in America, over there some people die because they don't have insurance over here people die because they require drugs which are considered too expensive to be provided on the NHS.

    I have friends and family who work in the NHS and some of the stories I have been told by them are scary (patients in danger because of understaff wards and over worked staff). My personal experience as a patient of the NHS system is one of the reasons that I have private medical insurance (went to see a doctor with a severe back pain and waited over 90 minutes for a doctor to tell me that it was probably nothing in a 5 minute check-up ended up being in and out of hospital for two weeks!)

  • Comment number 60.

    The concept of the NHS was marvellous, and the service it used to provide was marvellous ; sadly it is now a Trade union/ higher executive led political football which has become a financial drag on the economy because of political and management incompetence. Unfortunately it is impossible for any political party to make any meaningful reform because of it's perceived status as a holy cow that may not be interfered with. The executive of the NHS is unaccountable, overpaid and overstaffed; the medical staff are overworked, poorly supported and becoming increasingly uncaring because of the attitude of management and government to achieve so called targets which in most cases are meaningless and artificial.

  • Comment number 61.

    #52. JerkDickinson wrote:

    "The NHS operates appallingly. The vitriol that follows any attack on it is pathetic and ultimately fatal for many."

    It may not operate as well as it could in an ideal world, but its basis of being free at the point of need and paid for by everyone is a very valuable basis for a caring health care system.

    Last week we heard that many people miss appointments and this cost us dear, and further the NHS went on to say said that it was too expensive to collect a missed appointment fee, or fine. Personally I do not see that it would violate 'free at the point of need' if someone who made and then missed an appointment without an acceptable explanation or prior notification should not be expected to reimburse both the cost of his/her appointment and the administrative cost of collecting the fee even if this was an apparently high sum - for example miss an MRI scan appointment and you would have to pay over 1000 pounds (around the fee changed to private patients by the NHS for MRI scans.)

    The way that the NHS computer system is being implemented is against all established computer systems introduction engineering standards and should have been stopped at its inception in No 10, but as the then Prime Minister (TB) was (and I believe is still) a computer ignoramus, and blessed with a politicians arrogance, this was not possible.

    However none of this should diminish the enormous social value to us as a society to know that if you are knocked down in the street that there will be an ambulance to carry you to hospital and you will be treated on arrival, without a preliminary compulsory walletectomy - however this should not be taken an admission than any individual has the right to abuse the rest of us as a society by abusing the NHS system, for example when there is a fault claim in a motor accident it is entirely reasonable for the NHS to be paid by the insurance company of the driver at fault and to that end the NHS needs an efficient fee collection system, which it does not have at present (and I don't believe is part of the NHS computer system.)

    Simple systems such as providing credit/debit card details along with an appointment booking are simply too dangerous a security risk at present -unless and until the NHS computerised systems are far better managed and where security is far better enforced - the totally unacceptable system of having a single live login used by more than one member of staff must stop (this may involve throwing out Windows as the terminal operating system - just as most sensible ATM machine operators have done in recent years for the same reason - security risk.)

  • Comment number 62.

    #51 JPSLotus79
    I couldn't agree more the NHS has just too much bureaucracy. I met a person the other day who was a "Marketing Manager" for the NHS!!!
    I'm not so sure about going all the way to Australia for ideas though when all you have to do is cross the channel and look at the French system of public/private partnership. It's interesting that the French who have bureaucracy for everything have managed to create such a good locally based system that delivers superb health care with very little bureaucracy. It's not completely "free at point of delivery" but you get most of your money back and if you genuinely can't afford to pay you don't pay.

  • Comment number 63.

    This just confirms David Cameron's definition of twitters and the pm!

  • Comment number 64.

    "ynotoman wrote:

    an 85 year old injured woman got all the required attention from the NHS - doesn’t make a good headline but it happens every day …"

    This may have been the case for your mum but my gran had a different experience when she fell coming off a bus, she got admitted straight away but she had a much longer wait for her operation. Also my mum recently crushed a bone in her spine after slipping and this damage wasn't picked up until three days after she was discharged from A&E! Although just to provide a counter to these stories my dad did get excellent cancer treatment and was told (not be doctors but by patient groups) if he had lived elsewhere in the country he might not have got treatment in time

    I am not sure what part of the country you are from but it certainly seems that the NHS provides better service there!

  • Comment number 65.

    #49 DebtJuggler
    I don't blame Brown for going after Hannan. If you make comments of the sort he made, and plagiarise the words of others you can expect an adverse reaction. With regard to his American 'exploits' I disagree totally, I've seen the Fox News clip and personally know more than a few US citizens who would happily tear MR Hannan limb from limb for his intervention in their internal debate.

  • Comment number 66.

    i wonder if the brows are folloing int twitter campain for him to resign?

  • Comment number 67.

    Complete Storm in teacup. Of course we need the NHS but of course it needs reforming. How can an organisation that has more managers/administrators than beds be good for anyone ?

    Perhaps the point that should be noted is that if technology is driving political agenda, how come nobody at no 10 is listening to the 70,000 people who have signed the online petition asking for his resignation?

  • Comment number 68.

    I'm fairly sure the only reason the Tories messed up on this is that they still live in a world where computer's are massive valve operated things and it's still okay to be racist about colonials :-p

  • Comment number 69.

    Why are my comments getting deleted?

  • Comment number 70.

    oops sorry.... why is the site now changing our login name to you in the title?

    I prefered the old system of it always being our login name

  • Comment number 71.

    timothy @ 58

    It is Derek Hannon and I'm not even sure he IS all that good an orator

    thank you Tim! - have a feeling it's Hannan actually but no worries, the main thing is to get the first name right

    and I agree he's not Martin Luther King - no doubt one of the better speakers at his golf club, but great Orator? ...

  • Comment number 72.

    I can't get excited because an MEP says something in the USA, whichever party he comes from. Especially on Fox TV - owned by Murdoch, who was Tony Blair's best friend for a while...

    Dan Hannan doesn't exactly speak for Tory Central Office. Any more than comments by Peter Skinner could be taken as defining Labour policy.

    (Peter Skinner... Who he? A Labour MEP. Wonder how many people knew that???)

    Obama is not attemptng to create a nationalised health service for the USA. The main thrust is to ensure affordable health insurance is available to all the citizens. Medicare and Medicaid insurance is currently provided by private companies who compete for state approval. Obama appears to want better - and more consistently applied - insurance.

    I understand that Central or State organisations may be allowed to provide such insurance, which may possibly be better value for money. And that some "exchange" would be set up, so a US citizen would access at least a minimum, predictable level of health services wherever they happened to be in the country.

    That's hardly the "Sovietisation" of health provision! It's nothing like the way we operate the NHS.

    But American citizens don't like paying taxes. And their governments hate to impose them. (That's why the USA is pretty well bust. Massive national debts, huge borrowings to fill the federal budget. Mostly because Alan Greenspan - former Chairman of the US Fed Reserve - believed that "growth" just had to be constantly stoked. And he hoped - rather like Brown - that eventually the economy would be so wonderful that the debts would just melt away!)

    But to carry through Obama's plans there would be costs, which he suggests would be met by changing tax-breaks for some of the better off in particular. He wants about USD 60-70 BIL in the first instance, with USD 600-700BIL over the next ten years. Quite big bucks, so an easy environment for anyone in the US who doesn't like paying taxes (and that's most people!) to fan the flames.

    Cameron has good reason to appreciate the services the NHS provided to his family over the years. The man says that the NHS is a central part of future spending plans - even in the dire condition of the UK's economy. I believe him.

    Just remember that Blair and Milburn have introduced more private medical service providers into the NHS framework than the Tories would ever have dared.
    (Following Milburn's resignation as Secretary of State for Health (to spend more time with his family), Alan Milburn took a position as an adviser to Bridgepoint Capital, a venture capital firm heavily involved in financing private health care firms moving into the NHS. No surprise ther!)

    So we now have private companies being guaranteed income levels, regardless of the number of procedures they perform. I DON'T like that. It means that mostly relatively simple procedures are denied to the "real" NHS providers. So some of the fairly-simple ops are outsourced. That means a reduction of revenue for a hospital who could have performed those lowish-cost, lowish-risk procedures. So now they have a funding gap. Good thinking, what?

    And we have hospitals built under PFI arrangements, whose development costs were OFF-balance sheet, but whose OPERATING COSTS will defintely be ON-balance sheet. Which is why NHS trusts have been told they need to find about £4-5BIL to pay for poorly negotiated building and maintenance contracts. Way more expensive than if Brown had used the UK's budget to deliver required hospitals. Does that make sense?

    Brown keeps saying "we" have built all these schools and hospitals. Implying that his (Labour) administration had invested. He didn't. WE didn't. Contracts were signed with massive maintenance services overheads with private companies who stumped up the money. Now the real costs of operating are coming home to roost.

    I don't like "BADministration" whether in public or private sector arenas. Especially if my children will have to pay for it through their productive working lives.

    I don't meet anyone who believes that the NHS works as well as it could - including people within it.

    We've had at least 3 major NHS re-organisations since 1997. Plenty of central plans (now that's really Soviet!) and plenty of "we know better than you" initiatives from Whitehall.

  • Comment number 73.

    I doubt whether Daniel Hannan has ever seen the Michael Moore 2008 film "Sicko" to open up his mind on issue of health care and comparisons between us and the states. Hannan basically thinks that a prospective Conservative government will need to shift public support towards more private health care to lessen the burden on the state. Dream on....

  • Comment number 74.

    56. sagamix wrote:

    "...well yes, that's a fair comment - the world has moved on and the NHS hasn't, I guess is the point there - but how many times, it is NOT David!'s DEREK"

    Thanks for pointing that out, soggymess.

  • Comment number 75.

    This debate is uncomfortable, as it seems to be about the US Health system - it's their country, they can do what they like with it. From a politics standpoint there is an unwritten convention/protocol where politicians from one country do not pontificate or opinionate about political issues in another country during or immediately before an election campaign.

    Brown was very pro Obama as was the rest of Europe during last year's presidential campaign which is against the spirit of said convention. We will have an election within the next 300 days and there has been much talk of it being a "dirty campaign". But it could be dirtier still if elements in the Republican Party seek to embarass New labour purely out of revenge.

    Let me see what could come out:

    Reason for the Iraq war..
    What agreements were made about extraordinary rendition and what the PM knew about torturing suspects
    British military failures in both wars

    British politicians are playing a dangerous game, and when it comes to the US Britain is always a very JUNIOR partner.

    Electronic messaging cannot be contrained within national boundaries - the message may be aimed at the UK electorate, but the audience will be worldwide. The US audience on either side of the fence will not be very impressed.

  • Comment number 76.

    "tengearbatbike wrote:
    I'm fairly sure the only reason the Tories messed up on this is that they still live in a world where computer's are massive valve operated things and it's still okay to be racist about colonials :-p"

    The ironic thing is that the time you describe is probably the last time that the NHS was actually envied around the world and Hannan (the Tories as a party haven't made these suggestions) would have been wrong to attack it.

    However, these days the NHS is not a world beating health service and the problem is that it needs drastic reform. Unfortunately any party which even suggests reforming it would never get elected.

  • Comment number 77.

    Twitter in the UK is not relevant to the Health debate in the USA.

    It is the TV reporting in the USA which is driving their debate, including the TV reporting of the effectiveness of the UK NHS.

  • Comment number 78.

    Behind all this furore is a fundamental question, "does the NHS need changing".
    I suspect the answer is YES, when you have more pen pushers and carers.
    Where it is easy in some areas to get non life threatening fertility treatment but cannot get cancer drugs.
    Whatever your political tribe is I think a real debate on what ailments the NHS should provide free at the point of source is needed. Why should we pay our taxes to support free treatment for binge drinkers and associated injuries when most people have to pay for dental treatment.

    The NHS as a social provider of universal healthcare is envied but the cost and the bureaucracy are not.

  • Comment number 79.

    #71 Sagamix
    Bit confused by this. Are we talking about same person? I mean Daniel Hannan MEP and journalist see

  • Comment number 80.

    "modest_mark wrote:
    I doubt whether Daniel Hannan has ever seen the Michael Moore 2008 film "Sicko" to open up his mind on issue of health care and comparisons between us and the states."

    I really enjoyed watching Sicko but as with most documentaries it set out to tell a single side to the story (and told it well). However there are areas of the USA health system which are better then ours and the flaws of the NHS were not presented.

    It would be possible to create a documentary which shows the story the other way, comparing the NHS at it's worst (patients catching MRSA in dirty hospitals, patients left in corridors so they aren't technically "on ward" for too long) to the US system working at it's best (someone with the best health insurance available getting the best treatment in the world)

    Any documentary you watch will present the facts in such a way to support the view that the maker wants to present.

  • Comment number 81.

    #72 fairlyopenmind
    A very well written expose (sorry my keyboard doesn't do accents) I only disagree with one point. Dan Hannan's remarks are proving to be a great embarrassment to the Obama administration and it's cause. In that sense he has done quite a lot of damage and I think 47 million US citizens do not need his assistance. I agree that he is a light weight in the UK but the Americans don't know that.

  • Comment number 82.

    Laura -- technology and the political agenda.
    Interesting research published recently states that Twitter is still not "serious".
    US-based market research firm Pear Analytics studied 2,000 tweets from the public timeline over a two-week period, capturing tweets in half hour increments. The firm then categorised the content of the tweets into six buckets:
    Pointless Babble [40%]
    Conversational [37.5%]
    Pass-Along Value [8%]
    "Many people still perceive Twitter as just mindless babble of people telling you what they are doing minute-by-minute; as if you care they are eating a sandwich at the moment," wrote Pear Analysis founder Ryan Kelly.
    Guess one could say that Sarah and Gordon Brown's use of Twitter falls into the "Self Promotion" or perhaps "Pointless Babble" categories ?
    PS Totally agree with #41.

  • Comment number 83.

    I look at it this way: You can either have excellent health care for some and none for others (such as the American System), or you can have good health care for all (such as the NHS).

    I know, the NHS isn't perfect, but I think it's by far preferable to the unfair American system.

    Derek Hannan is just an MEP. What makes him think he's got any power, then?

  • Comment number 84.

    The debate in the US perplexes me.

    It is bizarre people are so vocal about protecting a ‘right’ to die old, ill, bankrupt and untreated.

    The only real explanation for this outcry, as mentioned in other posts, is that the 1 in 6 without healthcare are not being heard at all as the health ‘industry’ blasts the country with propaganda.

    Americans worry about creating a massive organisation with lobbying power, but they fail to realise that they are currently experiencing the lobbying power of a monolith they have already created - except that this monolith doesn't help 1 in 6 Americans.

    It would seem that America is once again proving to be a rather unstable society, more in the pocket of selfish commercial interest than any country should be comfortable with.


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