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On fairness and efficiency. The privatisation of the public income over the past millennium
  1. E Rodríguez Ocaña
  1. Department of History of Medicine, University of Granada, Spain

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    G Miller. The Policy Press, 2000. (Pp 470; no price stated). ISBN 1-86134-221-7

    Starting out from the economic hypothesis advanced by Henry George in the 1880s—that is, the distorted balance between land, capital and labour, or rent, benefit and wages, this book seeks to explain all the contradictory features of the welfare capitalism period. The author places himself within a long tradition of “political medicine” that contributes to our understanding of society from the rationality of health. The issue tackled is: How does our social context affect human lives in terms of quality and duration of life? If epidemiology is able to provide definite knowledge about the second half of this question, as it does in the first part of this book, a great deal of scholarship and the predilection for history and sharp sociological insight shown by this author are required to continue explaining the “context” through the abridged social history of Britain in the second and last part of the book. Miller’s thorough examination of the British welfare state includes an evaluation of inequalities in death and morbidity and of the effects of unemployment on citizens’ health, as well as an analysis of welfare measures (such as education, healthcare schemes, social insurances, and housing). The overall conclusion is that welfare politics have historically been unable to reduce the gap of health inequality. It is not the general aims of welfare state that are discussed, but their extreme inadequacy. The author claims that George’s theories (which favour a “single tax” economic foundation for the State) have not been intellectually defeated but are repressed solely by political will in a political landscape dominated by the “lords of the rent”, who are primarily “lords of the land”. If, at the outset of the 21st century, we are rightly entitled to regard any single cause social theory with suspicion, the hard epidemiological facts stand as testimony for the prosecution of “the deadly legacy” imposed by social inequities. Certainly, Miller’s proposition that the offer of “help in lieu of entitlement” lies at the heart of the inadequacy of welfare politics is worthy of serious further consideration.