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Friday, 24 January 2014

The Dharma Bums

The self-regard of the Davos crowd reached new heights with the news that Goldie Hawn has been leading a meditation session in order to combat the stress experienced by "hard-pressed business executives". As any fule kno', stress is the result of a perceived lack of control over one's circumstances, which is why it tends to afflict the poor and the powerless disproportionately more than the rich and the powerful. Claims that the latter are the chief victims of this "killer" inevitably descend into bathos: "[they've] spent the last five years dealing with crises from the collapse of Lehman Brothers to the Syrian civil war -- all connected 24/7 to their beeping, buzzing smartphones". The poor lambs. The irony is that the Magic Mountain was originally noted for its sanitoria, where the neurasthenic bourgeoisie escaped the hurly-burly below. How times change.



The meditation spectacle is intended to convey the message both that the world economy is recovering after careful treatment, and that the physicians are not the blood-letters of popular imagination but thoughtful and humane benefactors, thus the prominence of "mindfulness". Of course, this is just a reworking of Californian solipsism (self-centred, non-judgemental), hence the significance of Hawn. The idea that investment bankers are going to focus on "living in the moment" takes on a different meaning in light of Martin Scorcese's The Wolf of Wall Street. Indeed, one of the most "mindful" books I've ever read was Bret Easton Ellis's American Psycho. What we need is less mindfulness and more thoughtfulness.

Away from the mountain, health reverts from aspirational dharma to its more usual form as a commodity with the news that NHS patient data is to be sold to private companies. Patient data has long been described as an untapped resource, even a geographical area ripe for exploitation, hence the frequency of phrases like "opening up" and "seizing the opportunity". The implication is that it is unclaimed property, alienated from the individual, thus allowing other actors to stake a claim. This tendency is often conflated with the IT concept of "openness", twisting a non-proprietary strategy into a proprietorial land-grab. In the case of healthcare data, the proponents inevitably focus on the benefits for research and better outcomes for patients, rather than commercial efficiency or the creation of new product lines. Well, they would, wouldn't they?

This commitment to "transparency" and "sharing" is in stark contrast to the reluctance of the UK government to make sensitive (i.e. politically embarrassing) data available for decades or even centuries. The news that the state has conveniently lost key documents relating to the Profumo affair was topped by the reports that it is keeping documents relating to the compensation of slave traders safely under lock and key, possibly to avoid drawing too much attention to the extent to which many modern fortunes depended on the recycling of slave capital into early industries in the UK and other types of trade, as much as fear of litigation by the descendants of slaves or by Caribbean governments. The British reticence about the slave trade is memorably exemplified in the works of Jane Austen. While the very few textual references to it have been exhaustively mined to determine that her sympathies were essentially pro-abolition, this misses the point that the whole mise-en-scene, i.e. the wealth flowing through Bristol and Bath that gave the Regency era much of its sheen, was the product of the trade.

The news about the NHS's new revenue stream (branded as the cloying "care.data") has prompted legitimate concerns about the de-anonymisation of patient records, but this ignores the likelihood that the initial goal of private buyers is the promise of "big data" rather than access to specific personal records (though that will come in time). A concern that should be more prominent is whether the data is reliable, given the pressure that now exists to massage performance (the tyranny of targets) and the inherent selection bias of an organisation (ideally) focused on cure and care rather than running trials. There is also a risk that the body charged with managing the release of data to commercial users (the Health and Social Care Information Centre) might eventually be privatised or reduced to a weak regulator, specifically once the NHS has been fragmented and a large enough subset of the data must be sourced from private healthcare providers. The new market in health data will then be complete.

Back at Davos, private companies will continue to lobby governments to ensure that their tax affairs remain private and privileged, even as they push for greater access to the rich data of the common herd. The World Economic Forum gathering provided a natural venue for the launch of a new "independent commission" (i.e. neoliberal lobby campaign) to "focus primarily on state censorship of the internet as well as the issues of privacy and surveillance raised by the Snowden leaks". Snowden's virtual presence is intended to provide PR cover for the lobby's chief objective, which is to prevent the Balkanisation of the Internet. Like Goldie Hawn, he is being used, but probably not being paid.

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