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CRITICISM OF GRAEME SAMUEL'S
to the World Bank
In criticising Graeme Samuel's speech there
are a number of aspects I want to stress.
- Samuel is absolutely genuine in his
beliefs and really believes that what he proposes is the way
ahead. Like all theorists committed to a particular frame of
interpretation he has no doubts. He believes that the "reforms" he
advocates are urgently needed. He is representative of sections of
the establishment and of dominant sections of the business and
economic communities. Not all economists share his views.
- Like others in his position and with his
beliefs he commits fatal errors in logic. He ignores critical
aspects and available evidence in order to maintain his
- Samuel's argument sounds plausible and is
couched in a language that is impressive and so readily accepted.
It is backed with all the credibility of his position as chairman
of a national establishment body.
- I want to show the fatal flaws when
alternative understandings developed in other contexts are brought
to bear on Samuel's views.
- Samuel's arguments are made in a world of
great universal theories within which the world and its citizens
are constrained. Its abstractions are untouched by contact with
the real world of experience and emotion. Samuel starts from the
general and applies it to the particular. Samuel represents 20th
century "modernist" thinking. I want to contrast this with what I
understand as "post modern" thinking. It starts from the real
living experience of individual people and the understandings they
develop in real living situations. The method of understanding
asks whether theories are relevant to the particular situation and
the people in it, and what the limits of their applicability in
that situation are. In my criticism I am suggesting that we should
be looking at the particular and asking what the relevance of the
- Samuel's arguments have little relevance
and are of no interest in the world most people who will be
affected by them live in; yet their potential consequences are
devastating for these people.
- Above all else I want to show something
about our human nature. The way we come to believe in things. How
they come to be vitally important to our lives as we invest our
time and commit ourselves to projects in their name. I believe
that if we are to move away from the problems of the past then we
must come to recognise the limits of particular belief
- I am not attacking the validity of
sensible economics in designing and running a health system.
Without money we cannot have a modern health system. What I am
attacking is the arrogant assumption that economists, with their
single frame of understanding and abstract theories can dictate
the way health care and much else in society should operate - the
way we as individuals will live. This behaviour illustrates a
fundamental problem in society and in the way individuals behave,
it is a relic of a past we must leave behind us.
- In criticising Samuel's proposal, which
is far right it is inevitable that I will use the language and the
insights of the left. These limits are imposed by the language we
use. It does not mean that I am advocating far left solutions. If
I was criticising the left then I would use right wing language
and insights. What I am attacking is extremism and what I am
advocating is a system which is congruent with the context of the
- I have used Samuel's proposal as the
basis for an attack on the application of competitive market
priciples to health care. The criticisms in the linked pages
therefore sometimes go much wider than the details of Samuel's
proposals. I try to confront the theory with real consequences in
actual health care markets and the actual human experiences of
those at the receiving end of such policies - the human
Paradigms of understanding
I am therefore setting three alternate
understandings one against the other. I suggest that you open two or
even three separate windows and move from one to the
- The first is Samuel's speech and I
suggest you read it through fully first.
- The second is my criticism of the speech.
This comes from a very different perspective. I suggest you open
it in a second window then come back and check each section of
Samuel's speech before examining the criticism. This is linked to
pages on this www site to back the criticisms made.
- The third is the actual experience of a
profit driven corporatised health system, the harsh reality behind
the pleasantly human and impressive face of corporate medicine.
This uses letters and reports describing personal experiences of
the system with all the emotionalism and anger it
Samuel's right of response
Samuel has been sent a copy of the criticism
and been given the opportunity to respond. He has not done so. If he
does so I will include it.
The web pages will not follow what Samuel was
sent exactly. I included large amounts of background material and
these criticisms have been truncated. The originals have been
augmented and modified into linked pages. Many of the arguments can
be made by linking to other pages on this site. These are more
informative. Those who have explored this site will not need to go
back over it all again. I will send you the original criticism sent
to Samuel in rtf format if you email me but the www site is
Opening a second window
To open a page in a second window in Netscape
or Internet Explorer hold the mouse down until a menu appears and
select from the menu.
CLICK, HOLD AND
SELECT -- to open the first page of
the criticism of Samuel's speech in a separate window
CLICK, HOLD AND
SELECT -- to read a letter written to
Canadians describing personal experiences of the US system
CLICK, HOLD AND
SELECT -- to open the responses of
individuals in a separate window.
HERE -- to open Samuel's speech in
HERE -- to go to the National
Competition Counsel's www site. This contains Samuel's speech in rtf,
pdf and Microsoft Word formats. (http://www.ncc.gov.au)
I found Samuels speech complex full of
economic jargon and difficult to understand. Richard Middleton
writing on the www site of the National Association of Practising
Anaesthetists has done a nice decomposition putting Samuel's speech
into simple terms so that we know what he really intends.
for a the pdf file containing the rewording of Samuel's speech. The
is worth a look around too but you will need a password to get to the
pdf file this way.
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This page created April
2000 by Michael Wynne
Last modified Feb 2002