The Health Network

Exploiting Health:  Activists and Government v the People
Bob Browning,
Canonbury Press 9th Floor, 118 Queen Street, Melbourne, 3000.

As was the case with The Network, Browning's Exploiting Health is a record of largely publicly-funded lobbies that pursue minority interests and are allowed to have a disproportionate influence on government policy -- in this case health policy.  The material is alarming because these interests, being "minority", are often anti-majority;  and just as alarming is the news that their public funding has been going on under the noses of taxpayers for years.

Browning identifies five groupings:

• Health Activists
• Political Economists
• Legal Activists
• Feminists
• Environmentalists and Gays.

All these groupings (with the arguable exception of Gays) are overtly anti-biomedical.  For them the causes of ill-health are not biological but political, social and economic inequalities.  Consequently, for these groupings, problems of ill-health (usually identified as problems of "groups", not "individuals") are solved by removing these inequalities.

The removal process consists of, for example, promoting various forms of income redistribution (e.g. government grants to favoured groups), and identifying supposedly dangerous products as well as exposing (and sometimes destroying) the companies producing them.  Such activities show these groupings to be anti-private sector and anti-capitalist.

Rectifying capitalism's unhealthy inequalities provides (for many of the more prominent members of these groupings) careers reliant on the public sector and a chance to play out their ideological fancies.  For legal activists, it creates the opportunity for new markets and sources of income.  Browning's material, for example, on Greenpeace (now with very prominent Australian links) leaves the reader with the impression that it is simply an organisation created by people interested in making a good living from members' subscriptions.  Subscribers seem to be recruited and retained through fear created by environmental scare campaigns.  In practice, Greenpeace subscribers, as is the case with many such organisations, have little control over the organisation at all.

Thanks to these "rectifying" activities, much income and power is redistributed, but not necessarily to the unhealthy "victims".  Further, it is possible that, because of the activists' behaviour, much national wealth is foregone.  Browning points out that in the United States 10 per cent of Gross Domestic Product is said to be lost through the intimidating behaviour of legal ("consumer champion") activists.  For an economist somewhere, calculating an Australian figure would be a worthwhile exercise.

The public faces of these groupings are organisations with names found regularly in newspapers and on television:  Consumers Health Forum, Public Health Association, Student Initiatives in Community Health, Australian Community Health Association, Doctors Reform Society, Health Issues Centre, The Australian Institute of Health, Australian Consumers Association, Evatt Foundation, Women's Electoral Lobby, and the list goes on.  Most of these organisations are interconnected;  most are subsidised by taxpayers.  Browning's identification of these groups, of their links and of their taxpayer support has been painstaking and should be explored by readers for themselves.  He might have considered a diagram of their links and other details as an addendum.

USING HEALTH FOR WIDER CHANGES

The disapproval that these groupings and organisations display towards capitalism extends, for some, to major social institutions such as the family.  Browning, in Chapter Four, shows the extent to which various groups (e.g. the Women's Electoral Lobby) promote economic and taxation policies that provide disincentives for the family, and social policies that provide incentives for other types of household organisation.  This interest in promoting new types of household organisation only underlines what must become increasingly obvious to the reader:  that Health is being used by these organisations as a means to instituting other wider social, economic and political changes.

From Browning's material it is arguable that the case of Gays differs somewhat from the other groupings.  With the emergence of AIDS, Gays have become the "victims" as well as the "ideologists".  As victims, there is, consequently, little evidence in Browning's book of their demonstrating an overt anti-biomedical attitude.  Rather, their interest has been in the protection of their lifestyle from heterosexual (majority) backlash.  Their self-protection methods -- as Browning documents -- include silencing critics, creating (publicly-funded) publicity campaigns to "extend" the AIDS threat to the heterosexual community, usurping government funding for AIDS treatment and education, and manipulating language to create a separate gay "culture".  All with much funding and encouragement from government.

Why would the groupings and organisations discussed by Browning want to arrest or destroy so much of a society's wealth-creating activities, particularly when such activities provide the economic base necessary to tackle public health problems effectively?  Drawing on previous literature, Browning identifies a number of psychological and sociological explanations.  His, perhaps, minor explanations are the largely psychological phenomena of cultural discontentment and resentment and the sociological phenomena of romanticism and social engineering.

NEW CLASS CHARACTERISTICS

Browning's major explanation (on pages five to eight) is the emergence of a New (middle) Class as an enabling and participating agent.  This Class is defined (after sociologist Peter Berger) as mainly government-subsidised, university-educated, service or government sector employed, and knowledge-producing and distributing.  It is also ideologically to the left of the Old (middle) Class (and is, perhaps, mainly filled by post-war baby-boomers).  The very object of New Class disapproval and hate -- the affluence of capitalism -seems to have been the major factor enabling its birth and growth.

By the end of the book it is hard not to concur with Browning's conclusion that Australian democracy is eroding, because of the influence of unelected special interest groups.  It is also hard not to conclude that the state -- given Browning's documentation of its behaviour -- is making itself irrelevant to the interests of the majority.  Evidence of this is suggested by Browning's reproduction of relevant parts of a West Australian government pamphlet (1986) for homosexuals, describing the safest approaches to the use of various parts of the male anatomy in sexual activity.  These approaches Browning describes as "government-approved".  It is very difficult not to stop and chuckle at this description.  A second reading, however, reveals Browning's description to be quite unfunny because these "approaches" are exactly as Browning describes them -- "government-approved".

For the taxpayer and voter, Exploiting Health should be fascinating, disturbing, but necessary reading.