Cereal Box Politics
Cereal Box Politics, Economic Jenga, and Feline Displacement Consultancy.
Thursday, 25 May 2006
By Dr Frigmund Pseud
Getting doctors to agree on what they want, a federal health minister once said, is like herding cats.
When I read this analogy it made me laugh out loud in the library. Of course, there’s an unwritten code that says doctors spending time in the library during business hours should furrow their brows to reassure any passing taxpayers that their erudite public system medical staff are deeply concerned with matters of consequence, so there was a disapproving look or two from the physician trainees cramming Harrison’s in adjacent cubicles. In order to avoid their reaching the inaccurate conclusion that psychiatry registrars, being Weird, frequently giggle in public for no apparent reason, I tried to explain myself. ‘Herding cats!’ I said, grinning congenially. Score one for destigmatisation.
They didn’t get the joke, but they were on the AMA bus to the Convention Centre a few days later. I don’t think the AMA has Cat Herding in its mission statement, but it should, because there we all were, around a thousand of us in a room, agreeing heartily that Enough Was Enough. We doctors were not getting paid Enough; moreover, if the level of pre-meeting chatter was anything to go by, it seemed we were not getting out Enough either. Watching the television footage, I thought we looked far too jovial for workers on strike for better pay. Public sympathy was hardly likely to rest with a crowd of professionals that looked suspiciously like a private school reunion picnic.
In our defence, I should say I don’t think that the Enough we agreed Was Enough related so much to pay, or even to getting out, despite the fact that we wouldn’t mind more of both. Few among us were swaddled and schooled on Struggle Street. We weren’t about to starve - The AMA even made sure we had sandwiches on the bus back to work. So what made 1000 cats file in to that room? What have we really had Enough of?
Economic Jenga, of course.(Stay with me, Friggy followers, you know I get there in the end)
Economic rationalism, it’s been oft said, is more about cost-shifting than cost-reduction. I would add that not only is there a shift of financial cost, there’s a transformation of that cost, from financial into human cost. The public health system was like a Jenga tower at the start of the game: Along came some people with qualifications in economics, who prodded at the blocks, crying out in triumph when a loose one could be poked out, picked up, and stacked on the top, thereby adding MORE height to the tower with the expenditure of ZERO additional blocks. ‘Wow’, we said, ‘here’s us thinking we needed MORE money for the public health system, when all along what we really needed was ZERO! If only we’d done economics at medical school.’
All Jenga players know that the game only really starts to get interesting when each block pulled out below causes serious lurching within the tower. Now, in Economic Jenga, it is imperative that with each successful move at the ‘lurch stage’ of the game (success being in that neither the pulling out of the block from below nor its placement on the top of the tower brings about the clattering collapse of said construction) the players dance around crying out in exaltation ‘see, it works! Economics Good! Bleeding Heart Humanism Silly!’
When I see the high-rise of my employing hospital pop over the horizon each morning, I think of that Jenga tower. To be fair to the Bean Counters, it hasn’t fallen down yet. But being of a shrinky dynamicky persuasion, it’s clear to me that we public system workers carry around in us little internalised Jenga towers that mirror the big one in which we work. And I’ve seen plenty of those little ones come clattering down. Every time we turn a patient away, put them on a waiting list, or tell them that writing to their local MP is the only thing we can advise, we feel our Jenga towers grow taller, sparser, less stable. Every mini-crisis in the system that we can see could have been averted if more money was spent, causes our towers to lurch. Mine is still standing, but around me are gaps where former co-workers picked up the pile of scattered blocks that was their public system career, and shot through. Too much strain, all this injustice, all this outrage. Burnout, that’s what they call it.
In that way I see that we that remain are the blocks. We take the extra strain, because we can, for now anyway, and every day that we keep going is another day on which the economic rationalists can say ‘see, it works! Told you so.’
I don’t know what you think about while you’re eating breakfast, but at Chateau Pseud, a bit of cereal box reading is required to avoid visions of clattering collapsing Jenga blocks. ‘Satisfaction guaranteed’, my box of gruel proclaims, ‘or your money cheerfully refunded’.
When I was a kid, I thought that was brilliant. How very accommodating of Mr and Mrs Kellogg to offer a full refund if They were anything less than Grrrrrreat. I held out hope of catching the Kellogg family out. Perhaps I’d get a stale Honey Smack, then I could march up to the counter at Coles New World (remember that optimistic appellation!) and get my handful of change, which in those days could be exchanged for enough Milk Buds to make me and two mates vomit.
Nowadays, I don’t bother much with refunds. Many products do not meet my expectations, but you won’t see me, foam-mouthed, waving receipts under the pimply noses of the service counter adolescents. Because, I guess, I wonder - what do you win when you get your money back? The not inconsiderable comfort of Being Right aside, you’re left standing in a fluoro lit aisle with the money you came into the shop a week ago to spend on something. Now it’s a week and a whole lot of pfaffing about later, and all you’ve done is identify one product not to buy. Keep going like that and you’ll die Right and Rich. After a lifetime of pfaff.
This week, not even the assurances of my cereal boxes can keep my mind from wandering while I munch my gruel (with wild berries and tuscan apple, or something). On Tuesday night, I found out that despite my public health system (it’s yours too) groaning under the strain of Lurch-Stage Jenga, my federal government (it’s yours too) actually has fifty bersquillion dollars which it took from us, and didn’t get around to spending. ‘Never mind,’ said the Smirky One, ‘you’ll get your money back.’
But I don’t want my money back, Mr Treasurer. I worked rather hard for it, and I dearly want you to spend it for me. I want you to build things, pay people, nourish the society of the nation I grew up in. I know I could probably buy a bigger television with my tax cuts, but I don’t want a bigger television.
In the Doctor Cats Dream I might have tonight, I say that little speech to the 1000 gathered, standing on my cereal box, maybe throwing in the bit about Jenga. It meets with stunned silence, then they miaow in chorus: ‘You’re on your own, mate. We’re here for a pay rise.’
That’s the problem with herding cats. One of the little bleeders will always get away.
Frigmund Pseud