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Are these the numbers to look out for tomorrow night?

January 2nd, 2008

iowa weather.JPG

Will you be staying up for the big political betting night?

With the very first test of public opinion in the 2008 White House race due to take place tomorrow night the big question is how many Iowans are going to bother to turn out to attend the caucus meetings that could set the tone for the whole process of choosing the Democratic and GOP candidates.

  • The critical element is that so few people are likely to be involved. For of the 3m people in the state only 2m are registered voters and of these only about 100,000-125,000 generally attend the Democratic caucuses and less than 100,000 go to the Republican ones.

We are talking about a normal turnout of less than 12.5% which is why this contest is such a challenge for the pollsters. How do you identify the one in eight who will take part? So the weather can be critical and the forecasts suggest that across most of the state it will be cold but not quite as cold as it has been recently. Severe conditions could have a serious affect.

The events start at 1am UK time and within a quarter of an hour there will hopefully be estimates of the numbers attending selected meetings and the age/gender profile of those who have braved bitter cold to be there. It’s here that we might begin to get a sense of who is going to win - particularly in the Democrat contest.

If a trend on reported turnout levels starts to emerge then that could be the signal to adjust your betting - not just on the outcome of the caucuses but on who will get the nominations. In 2004 I was a heavy layer of the favourite Howard Dean (I was betting against him getting it) and I was able to reinforce my position quite substantially when the early news from the caucuses indicated to me that he might not do as well as the polls had suggested.

  • What you should be listening out for are comparisons with last time. If specific precincts are showing a big increase on 2004 then that is probably good news for Obama. Prospects for the black Senator from Illinois could also be greater if the number of younger people taking part is substantially higher than last time.

For Hillary backers reports of modest increases in participation rates is probably good news as will indications of a high proportion of women being there, particularly those in the older age brackets. The general view is that John Edwards will benefit from lower turnout rates.

The official results from the Republican race should start to come in by about 3am. The Democratic caucuses are likely to take a little longer.

The latest betting has Hillary at 0.46/1 on Betfair with Obama having tightened a touch to 2.95/1. If you can do stay up - it will be great fun and you could make some money.

New Links section on White House race.
I am just creating a new section of links to key information sources for this year’s election. If you have any suggestions of sites to include please drop me an email.

Mike Smithson



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96 comments to “Are these the numbers to look out for tomorrow night?”

  1. Any idea when the final results will be in by?


  2. 1. Typically earlier than the usual elections in the US. We will see so-called “entrance polls” (the caucus equivalent of exit polls taken when the caucus-goers go in) very early. I couldn’t give a time, though I would expect not ridiculously late for British with vested interests.

    Also, general wisdom is that, among the Democrats, low turnout favors Edwards, medium turnout favors Clinton, and high turnout favors Obama. I won’t go into the logic, but it adds up to me. Of course, gaugin exactly what qualifies as low, medium and high turnout is not easy, but I would say under 110,000 participants is low, 110,000-130,000 is medium, and over 130,000 is high for the Democrats.

    For Republicans, I think lower turnout would favor Huckabee and higher Romney, but I’m not certain I’m making the right assumptions about who is supporting whom among the various Iowa Republican communities.


  3. Presumably cold = low turnout = favours whichever candidate is preferred by the activists rather than the casual armchairists. Does this mean that a low turnout means the decision is made by a small group of well-informed dedicated people instead of a vast mass of ignorant proles? I, for one, do not subscribe to the conventional hysteria about trying/needing to increase turnout in elections in the UK as if it’s a good thing per se. I would prefer the decision to be made by people who know what they’re thinking about.


  4. One other thing to bear in mind is the Des Moines Register poll a couple of threads back showed Edwards had a lead amongst rural voters (or likely caucus-goers).


  5. 3. Those temperatures are not cold for Iowa in January.


  6. 5. On balance statewide, pretty much average: http://en.wikipedia.org/wiki/Iowa#Climate


  7. “If you can do stay up - it will be great fun and you could make some money.”

    Not sure about the “great fun” bit, but making money sounds interesting. Does anyone know with whom one can bet at that time, apart from Betfair? Wm Hill, for example, close their books overnight don’t they?


  8. O/T So where’s all the “Siberian” weather we were being warned about? According to this morning’s 5 day forecast it’s not even likely to dip to freezing point in the London area over this period.


  9. 8- Stop reading the Daily Express


  10. What an extraordinary idea Cameron has just come up with! He sounds more like Gordon Brown by the day!

    What on earth is the point of fining an institution because it does not meet your targets, when the money for that fine comes from the taxpayer? Cameron is barmy.

    What they ought to do is to fine the highly paid chief executives. Publicly funded institutions would soon start working properly, wouldn’t they?


  11. re 10. Yes Tressage - the Cameron proposal to fine hospitals for every patient that catches the superbug is absolute rubbish. Maybe he had too much sherry trifle over Christmas! For who loses? The patients in the very same hospital because there will be less money to spend on medical services.

    Rubbish Dave.


  12. 10&11 Yes, absolutely crazy - It’s just like “fining” the Post Office or Network Rail, etc, etc. Who “pays”, why the taxpayer of course - a totally pointless exercise in moving money from one Government department to another.
    Wake up Dave!


  13. Part of my job was to analyse weather data. Ever since the ‘Hurricane’ fiasco the Met Office has become hypersensitive to getting it wrong, this has lead to a tendency to over stress bad weather.

    For those of you who missed it, here’s Hitchens on the latest polling.

    http://hitchensblog.mailonsunday.co.uk/

    Think we can honestly say, 2008 will not see, ‘Grumpy Pete’ warm towards DC, or anyone one else for that matter!


  14. 10 & 11 agreed! One of Dave’s less bright ideas for a while. Performance related pay for executives sounds like it could cause a bot of a stir, but I’d guess that the pressure to make progress in the areas which could affect the execs’ wallets could cause other areas to be neglected. Worth looking at though.

    And congratulations to MikeL + the top performers in the 2007 Predictathon. Happy & successful punting for this year.


  15. Daft idea from Dave.

    Gordon’s even worse idea is the NHS/fat fiasco: partly because it opens himself to charges of hypocrisy for taking self-imposed risks playing rugby all those years ago but mainly because it is an attack on Labour’s own supporters. How stupid are our politicians?


  16. 16 Agree - Cameron has to be careful, in his search for media time, that he doesn’t fall into the Blair trap of headline grabbing “initiatives”.

    Better would be to look at some of the underlying causes, such as bed occupancy, targets, cleaning contracts and also look performance related pay and bonus arrangements. MRSA and the other hospital bugs won’t be resolved by deep cleans or fines.


  17. UCH hospital in London have had great success in dramatically decreasing superbug infection rates by introducing a scheme to test newly admitted patients as soon as possible after they are admitted to check if they are “carriers”. It appears to mr the NHS should instruct all hospitals to follow UCH’s example as soon as possible. Why have not any politicians picked up on this yet?!

    http://www.library.nhs.uk/rss/newsAndRssArticle.aspx?uri=http://www.library.nhs.uk/resources/?id=276635


  18. That’s the beauty of Sky+, I can set it to record both CNN and Fox News at the same time!


  19. 15 And also daft because of existing common law concepts of contributory negligence. There would be whole rafts of people dedicted to getting the amount needing to be paid for what disease / condition after initial “simple” attempts by Government to penalise certain groups eg smokers totally for their treatment had been rejected and dissected for the unfair policy they are.

    However, don’t expect this type of thinking to go away in a hurry - it will be back, again and again.


  20. A strange outbreak of consensus on PBC today… I thought all the Blue Harpies would have plunged into the fray by now.

    But the main problem, Ted (16), is, I think, one you have overlooked: top hospital bosses are out of touch with what is going on in reality; and furthermore, they don’t care, as long as their grossly inflated pay cheques keep arriving. Hit them where it hurts, I say!

    I doubt that Cameron can see this. They are all chums together.


  21. Back on thread. I assume I am the only one who won’t be staying up for the “fun” tonight. Sorry, especially after some sleep deprivation a couple of nights ago, I shall save my concentration on 12.5% turnouts etc late at night for knocking up at any local byelections we may have in 2008!!


  22. Some news from Ladbrokes. We’ve just taken £6000 on Bloomberg and have cut him from 33/1 to 16/1/.


  23. 17 Such a scheme doesn’t count in the constant search for “toughness” demanded by the tabloids!


  24. There is a superficial logic to Cameron’s proposal to withhold part of the tariff payment for a patient who contracts an avoidable hospital acquired infection.

    On one level it is analogous with not paying for poor quality workmanship. If you arrange for someone to mow your grass and he does a good job except he mows over a flowerbed, then you are likely to withhold part of his payment. (poor example, but you get the drift).

    Withholding part of the treatment tariff should be seen as a short-term accelerator to improving standards. I must say that the ability for Trusts to “fine” local authorities for delayed discharges (used to be called “bed-blocking”) for patients who stay in hospital longer than necessary because of a lack of social services support has had a profund effect on the performance of social services and a wholesale reduction in delayed discharges - which is of significant benefit to patients.

    Where Cameron could really go with this, is to develop the tariff-based payment by results system to include a number of quality/outcome indicators - and truly move treatment away from time/volume targets and “performance” and into something much more meaningful to patients - ie did it actually improve their health?

    Of course, once again all this only applies to the EHS, since the other three parts of our formerly *national* health service do not operate along these lines.


  25. Just one thing to add to Mike’s article:

    Pretty much everyone seems to be expecting an increase in turnout, and these assumptions seem to have been built into the polls as well; In this context, a modest increase on 2004 might still be a “low” turnout that bodes well for Edwards, a big increase could still be the kind of “moderate” turn out Hillary needs, and Obama could need something fairly massive to count as “big”.

    One challenge for people trying to adjust their positions based on early news as Mike suggests may well be figuring out how to calibrate these numbers, especially if turnout ends up somewhere in the range between a Hillary-helpful “big” and an Obama-inducing “massive”.


  26. Tempting to stay up. Will C-Span be allowed in to the caucuses as they progress? It’d be interesting regardless of the results to see how they work. Is there a discussion before the vote? I imagine something like a 1980s Labour branch meeting. “I really like this guy Obama because…” “Point of order chair! We should discuss female candidates first.” “That is not a point of order!” “Yes it is!” …

    What’s odd about the Cameron initiative is that it’s from the chap who is going to sweep away government targets for the NHS. A well-known target is MRSA reduction, and that one would be not just retained but enforced with pseudo-fines. I don’t think any politician is capable of giving up the target culture - it’s in the Commons DNA.

    Meanwhile, the donations/honours stuff takes a new turn:

    http://www.timesonline.co.uk/tol/news/politics/article3118843.ece

    Somed absolutely classic exchanges there. I thought this bit was especially funny:

    Lord Clement-Jones, the Lib Dem treasurer, said that he had “no idea” who had proposed Lord Hameed. After The Times said it had evidence that it was him, he said: “I couldn’t remember that. That’s fine. I thought he was a very upstanding member of the Asian community and somebody who would make a very good peer.”

    And then there’s another foreign Tory donor popped up:

    http://www.timesonline.co.uk/tol/news/politics/article3107950.ece

    Perhaps we should regard political funding as an income stream for the balance of trade?


  27. Tressage @ 20

    “top hospital bosses are out of touch with what is going on in reality; and furthermore, they don’t care, as long as their grossly inflated pay cheques keep arriving.”

    This is a fairly simplistic approach Tressage - and as a (nearly) “top hospital boss” I can assure you I see nothing in your statement that matches my day to day reality. Hospital managers are as frustrated by the Govt’s target-obsessed control freakery that forces us to hit targets but regularly miss the point of providing good healthcare.


  28. 15
    Surely there is a difference, between the risks involved in sport, and those from self indulgence. Most fat people are fat because they eat too much. Sport does involve risk, but those risks are acceptable because of the advantages, i.e. physical fitness and general well being. Sports injuries are treated sympathetically for that reason, mine always were.

    One of the problems with the NHS is it offers treatment for all, with no incentive for self discipline. As someone who is the same weight now as on my 18th birthday, I dispair when I see so many, (particularly young men) in such poor physical condition.


  29. And as far “grossly inflated pay-cheques - I manage a Surgical Division in a distict general hospital. I have approx 1100 staff and a budget of around £45m. My management team consists of a clinical director, a head nurse, 2 assistant general managers and a theatre manager. I earn about 2/3 the salary of one of my 60 consultant colleagues.

    Find me a private sector company with 1100 staff and £45m annual turnover that operates on that senior management structure or pays it’s CEO that salary…

    We do it because we are deeply committed to the NHS - otherwise we’d all be working for much more in the private sector.


  30. 22. Its pre run money. As Bloomberg speculation increases and as it comes closer to the time someone could easily be getting in early and hedging later.


  31. 22 That’s a neat bit of marketing by you Shadsy! But of course, this is the problem in betting on an unknown field, you just can’t afford to ignore a credible latecomer to the field - that’s why I had a score on him with you a couple of days ago at 33’s, so there!


  32. 26 Nick.

    The difference is that those donations are entirely legal and declared in the proper manner.

    Glasshouse and all that…


  33. 29. Robin Wiggs - were you aware of UCH’s scheme to quickly test newly admitted patients to check if they are carrying superbugs or not (see the link in post 17)? Has your hospital got a similar scheme going?


  34. [24] As ever with these proposals, the devil is in the detail. A perfectly sensible way to reward/castigate performance in hospitals would be to get patients to fill in a discharge questionnaire (probably through their GP who would need to be paid for the trouble - and who could usefully add their own opinion, too). Then you allocate a %age of the total hospital budget to be paid out to Hospital Trusts on the back of the results.

    Wont’t happen - no media narrative. Remind me someone of that line Kipling wrote for Baldwin…


  35. [34] Robin - would that suit you?


  36. 31 Two minutes ago, there was £10 available on Bloomberg with Betfair at 24-1.


  37. Is this more “flip-floping” from Brown over Drinking Laws?

    http://www.timesonline.co.uk/tol/news/politics/article3118841.ece


  38. re 28. Once when I was in hospital in Oxford the A&E unit was suddenly taken over by a large number of people who had been involved in a charity parachute jump that had gone wrong. There were lots of broken legs and ankles because they had over-shot the safe landing area.

    The medical staff were furious that dealing with these “voluntary” injuries meant that they had to divert their attention from patients with life-threatening conditions.


  39. 30 & 31. I can see that this might be a good trading position, but one would struggle to lay back much of £6000, no? Anyway, as it happens I don’t think that was the motivation behind the bet.
    What would Bloomberg’s appeal be and who is he going to take votes from? I can’t see it making any sense especially if the Republicans pick Romney, McCain or Giuliani, which is a massive odds-on shot in my book.


  40. 38. Mike - presumably they feel the same way about drunken students who jump off Magdalene Bridge from time to time!


  41. Goupillon

    We do routinely screen for MRSA certain types of patients (eg elective orthopaedics). There are problems though:

    a) emergency patients - can’t hold those up whilst you screen them;
    b) visitors
    c) some bugs are almost endemic within the community - for example I think (would need to check) that around 40% of us carry MRSA bugs on skin/in our nasal cavities.

    Screening is only one part of the answer.

    Proper cleanliness & hygiene at ward level are most important. And that means handwashing and alcohol hand gel/foam.

    Every time you enter of exit a ward/hospital make sure you use the gel. And every time you see a Dr or nurse approach a patient and you haven’t seen them do this, then stop them and ask them. In many cases it really is as simple as that…


  42. 28 Lucky man, Coldstone! Alright, well done, Coldstone. How old are you now, btw? Some of us, I am sorry to say, have not exhibited the same self-discipline. Having just hit the big 60, I am afraid I am about 3 stone heavier than at 18 (sorry, can’t be bothered to convert to kg - hope I have done nothing illegal - even if I am penalised as overweight!)


  43. 34 IA - an interesting idea.

    It could have a place in a proper reward system (I’d prefer some sort of co-payment/voucher system to really give the patient power though).

    As ever though, devil in the detail. Patients are not necessarily capable of making all the judgements necessary about quality of care, and would judge to a degree on whether their food was hot, etc.

    However, as part of the overall assessment, involving patients should be a fundamental element. Most of us already do it informally (no doubt there is a target too) and we involve patient in most of our local work about improving services.


  44. The Conservatives look set to gain their first Councillor in Manchester today as a Lib Dem defects:

    http://www.manchestereveningnews.co.uk/news/s/1030190_defection_puts_tory_in_town_hall


  45. [37] A classic example of media “narrative” (it happens to about Brown to-day, but they’ll do it to anyone). Brown promises review of 24-hr drinking. Brown reviews 24-hr drinking. Decides change is more trouble than it’s worth & moves on. This, according to The Times, “will be seen as a U-turn” - in other words, they’re saying “we suggest you consider this man has broken a promise he never made in the first place”.

    In a comment piece, of course you can say that - but that’s not how a serious newspaper should write news stories. We only have one serious newspaper, though - the FT.


  46. 38
    I wouldn’t include, ‘charity parachute jumping’ as a sport, it involves no physical self improvment, and there is little or no regulation.

    A friend who was flying to the States, to his sisters wedding, admitted to me he was nervous of the flight. Seeing as he was in his thirties I was surprised, and asked if he had flown before, ‘Only the once, when I did the charity parachute jump’
    so the only time he’d been in an aeroplane, was to jump out of it!

    Physical exercise is a good thing, its certainly better than inactivity.


  47. Robin - thank you for the info. Surely in the case of most admissions the application of a suitable nasal ointment and bodywash as a standard procedure on a newly admitted patient as soon as possible pending receival of test results would not be difficult or expensive to do?


  48. [43] Oh wonderful, Robin - in your first paragraph you want to give patients more power than I suggested, in your second you doubt their ability to exercise responsibly the level of power I wanted to give them!

    It’s because I couldn’t think like that that I was a crap public sector manager myself :lol:


  49. “Are these the numbers to look out for tomorrow night?”

    Mike, this is a stylistic point but please cut down your headline questions - they are endless and infuriating after a time. It’s clear you know which numbers we should look out for tomorrow night and you have real expertise in political gambling so raise your conviction level please. Yours pedantically, TJ.


  50. 39. Bloomberg would potentially be single figures if he ran. You only have to look at Fred Thompson who shipped plenty of money before he even started running.

    Of course, whoever put it on if they do lay it off and may have to wait!

    Bloomberg’s reported ideal opponents IIRC are Obama & Romney. No idea why but there ya go.


  51. 46,
    coldstone, I wouldn’t say that there is “little or no regulation” of parachute jumping in this country.

    There are all sorts of regulatory hoops to jump through to set up a Parachuting Drop Zone; parachuting other than in a regulated Drop Zone is classed as a display and requires a lot more regulation.

    The insurance, medical and training aspects of sports parachuting are lengthy - borne in mind by the fact that there are hundreds of thousands of sports parachuting jumps per year in this country and very few fatalities (it measures up well to many other sports in that respect).

    It is, however, commonly viewed as a lunatic pasttime, despite the most statistically dangerous part of a weekend parachuting being the drive to and from the Drop Zone. Therefore deaths and injuries sustained parachuting seem to be viewed as “just what they deserved - what were they thinking about!?” by many. Unlike skiing injuries, rugby injuries, skating injuries, jogging/running injuries, cycle-racing injuries, mountain-biking injuries …

    I will agree that charity parachute jumpers are a risk, but it’s fairly unusual for widespread injury events of the type that Mike describes - after all, there are two large Drop Zones near Oxford with thousands of jumps weekly and the event described was rare enough to be unusually significant.


  52. IA the reason that the drinking thing will look like a U turn is because this was one of a flurry of ‘reviews’ that were intended to show how Brown was a real change. And, of course, he is not. Expect the same situation with all the other spin operations launched into the run up of the election-that-never-was.


  53. re 40 Agreed. The Magdalen Bridge escapades are disgrace.

    In Cambridge the end of the summer term is marked by “Suicide Sunday” when the objective is to get totally blotto. There have been occasions when groups of drunks have assaulted A&E staff at the hospital because their friends are not being treated quickly enough.


  54. As a CEO of one of the larger sterilisation and microbial testing companies in the UK I can add some additional prespective to Robin’s comments. There is no one thing that can be done which will solve the problem of HAI (Hospital Acquired Infections). Instead it will be a combination of multiple changes of how hospitals operate plus new technology.

    To clear up a few common misconceptions
    1) MRSA is not the only bug that kills as both C difficile and Noroviruses are as bad
    2) Standard cleaning does not remove MRSA or C Difficile from surfaces
    3) Alcohol hand gels do not kill all bacteria and are ineffective against C Difficile

    Prescreening of patients is probably a good idea but of no value unless there is use of the data gained to make a real difference.

    The problem will be solved eventually I believe with a combination of much more testing of both patients and environments, the introduction of new chemicals which have residual killing properties (i.e. they dont just kill but continue to kill over extended periods), better design of hospitals and clear management of the whole process. Actions are underway but my guess is that it will be at least 5 years before we see a real difference.

    I think David Camerons plan to fine hospitals does not send the right message. Much better to help fund research and ensure that hospital CEOs are held accountable for their actions in this area.

    For my part I am sponsoring some research in Scotland at the moment to look at how to test how contaminated an operating theatre is as there is no set procedure to do this.


  55. Coldstone @ 28 et al re self-inflicted injuries. Whether or not it is good for health promotion, it is not very clever politics to attack or frighten your own supporters when you are behind in the polls.


  56. 53. As one who did the King Street run I should not comment too much on student drunkeness but I have never turned violent when indulging in alcohol excess.


  57. One for Mark Senior if he is around…..

    Mark - You have commented a number of times about regional breadown of opinion polls showing Plaid vote collapsing. I have just spent the last hour plodding through the ICM polls for the last two years, and all I can find is statistical noise. As an example, in Jan 2007, Plaid recorded 2 voters out of 511, which changed in Feb 2007 month to 7/459, March 2007 had 7/507, April had 2/533. This equates to a variation from 0.5% to 2% on a UK wide basis, or approximately 10% to 40% on a Wales only basis. In this same period, Plaid’s internal polling was consistently in the 20-25% range.

    Today the latest ICM polls for Nov 07 and Dec 07, give 4/543 & 4/501, which is right in the middle of the range given above.

    It is just a fact of opinion polls that you can not read very much into regional variations as they are not balanced or weighted.


  58. 53: Everyone is allowed one bit of drunken stupidity in their lives, it’s when it becomes a pattern that it should be dealt with.


  59. O/T For fans of continental politics : Only 2 months to go before the Spanish election

    The 2 polls published toady show narrow leads for the incumbent socialist government (PSOE) over the conservative opposition (PP)

    El Mundo (sample of 10.400 from 14 to 26 december)
    PSOE 41.9%
    PP 39.4%
    PSOE lead: 2.5%

    La Vanguardia (sample 2000)
    PSOE 42.5%
    PP 39.7%
    PSOE lead: 2.8%

    (2004 results: PSOE 42.6% - PP 37.7%)

    Analysts think that small PSOE lead could lead to a tie in seats because of the asymetric repartition of votes (the electoral system is PR in 52 multi-member constituencies)


  60. Re: the NHS.

    The idea of punishing those who do not live healthy lives is as unjust as it is practically absurd. Whether we like it or not, the NHS relies heavily on taxes garnered from Alcohol and Cigarettes. Whilst the former is perhaps causing more trouble than it is worth, the net financial benefit of smokers to the NHS makes them irreplaceable, unless you are prepared to countenance massive income tax rises.

    There is a natural justice issue of why the 105 year-old teetotal vegetarian non-smoker should get two new knees to run a marathon (having contributed the minimum in tax and NI), and yet the smoker and heavy drinker who funds the enterprise is disbarred is simply unfair. The fact that the smoker/drinker will die younger is his punishment, leading to yet another boon for the taxpayer in that he claims less State Pension.

    Dizzy also highlighted the raw injustice of compulsary NI contributions that then only offer conditional treatment (if you are a healthy-type etc). If you are going to offer a conditional and variable service, then what is to stop you from offering conditional and voluntary payments? Maybe insurance payments - and you can see where his reductio ad absurdum is taking us…

    I live with a junior doctor, and although she and her friends are not politically engaged by the standards of posters on here, they all vote (quite lefty, NW3 sort of liberals), and they take an interest in policy regarding the NHS. All believe strongly in an NHS Constitution for one simple reason - they are treating too many people for too many things that they shouldn’t be involved in at all.

    The NHS was conceived with the mission of treating illness, irrespective of ability to pay or any other consideration. The second part of that is now under threat, but the first has warped over the last 60 years, from ‘treating illness’ to ‘ensuring health and wellbeing’. Whilst nobody argues with simple measures that allow prevention rather than cure, it is simply not possible for government to ‘ensure health’ in its citizens - better, these junior doctors say, for the NHS to treat actual illness, than pitch for a more grandiose vision without having the means even to manage the smaller task. I don’t know if I agree with them, but I thought it relevant.

    “To treat illness, irrespective of personal circumstances” is where it began. As soon as it deviates from that, it is bound to be in trouble.


  61. 47 - NOt sure it is that simple - the fact “superbugs” are “super” is because they are difficult to eradicate. The reason we screen some patients is so that we are aware of the risk and can manage it accordingly.

    48 - I don’t doubt patients can exercise power responsibly - but I do doubt our ability to ensure it is an informed decision. If you paid your garage mechanic according to customer votes, he would likely be judged on timeliness, the warmth of his tea and speed at answering the phone, because most customers don’t know one end of their big end from the other. I submit that these “understandable” factors have little to do with the quality/safety of the car repair work… I can foresee an approach that brings some patient experience factors into tariff-based payment by results, but alongside not instead of clinical factors.


  62. Need to go out now, so can’t respond for a while.


  63. Simon9999 @ 37 On the drink thing I believe all Brown promised at the time was a re-examination iirc.

    To retain the status quo in which case is not a flip flop (cliche that it is), but ordinary management decision making. What is the problem? Anyway latest research says the impact of flexible opening hours has been marginal.

    I love the way right wingers go on about freeing the people and being rid of the nanny state - but then want to restrict opening hours which is about as nannyish as you can get


  64. Thanks to Robin for some interesting info on superugs / MRSA

    If we want open visiting, we visitors have got to wash our hands it would appear. I have never been asked to do that, and perhaps I should be.


  65. [26] Not sure what the story is here Nick, especially since the peer concerned sits as a cross-bencher.

    It would not be an attempt by Labour-friendly journalists at The Times to throw enough mud and get the “they are all at it” response, now would it?

    Bluntly, there is a pretty clear distinction between openly declared and legal donations and undeclared and impermissable donations from overseas residents. So, whatever the confusion the journalists think they have found, there is no question as to the legality and permissability of these donations to the Lib Dems: not true with the Labour donations, as the PM has himself admitted.

    Tim and Navnit are amongst the most decent and honourable people I have ever met, and this is just ridiculous muck raking.

    People in glass houses shouldn’t. (That sentence is complete as it stands :-) ). This set up seems to me to be a blatant and cynical attempt to distract attention from Labour crimes and is unworthy of you. When the story goes nowhere, I hope that you will acknowledge this.


  66. 61: Why aren;t you at work??


  67. I am not sure fining hospital trusts makes much sense, while I do believe that pay should be dependent upon performance.

    Too often in the state sector pay and bonuses are delivered despite demonstrable failings in performance. To use a Palmer line, this is something I know about but not part of.

    John Wheatley Brown did only promise a review on drinking, casinos etc. but it was all spun to demonstrate he was the change that was needed, so now he reaps what his rather ham-fisted team have sown.


  68. Interesting release from the Giuliani campaign outlining their strategy of not overemphasising (as they see it) Iowa and NH.

    http://corner.nationalreview.com/post/?q=ZjA2ZGFmMjg5NWI1MWQwNjk1NGEyMDIyYjE0NWY3MzI=


  69. Politically more significant in the long run is the story that the NHS is no longer national and England is the poor relation.

    http://news.bbc.co.uk/1/hi/health/7149423.stm

    All the parties are shying away from these unintended consequences of asymmetrical devolution to one degree or another, and risk damage as a result.


  70. Witan@68: Unintended consequences? More like the whole point of devolution. If you weren’t expecting different outcomes in different bits of the UK, why would you bother giving them different parliaments?


  71. 67 Paul M that is a fantastic link, thank you very much indeed.

    I don’t necessarily disagree with anything that the memo says, but all I would say is that perhaps it protesteth too much. I can understand that strategy, but if you were as confident in it, and *really* didn’t care about momentum from the early primaries, would you release this memo?

    It seems to me that releasing the memo is a mark that they are getting rattled by the idea that Giuliani is seeing his odds lengthen, and this is an attempt to settle their (presumed) supporters nationally. Is that fair?


  72. [60] Many thanks, Robin. I agree that “informed” decisions on healthcare are extremely difficult to take - it’s IMHO a key reason why the American system delivers such poor value for money - and this is something I would hope to address in the future work of the Patients’ Action Group I’m involved with. Whether the rest of the Group is also interested in it, I’ll let you know when I find out…

    [68][69] It’ll be interesting to see if Wales and Scotland become more popular as places to retire to… I can imagine financially pressed English councils musing on how to persuade the long-term sick and elderly to move there - a variation of the old London County Council’s seaside homes scheme, perhaps?


  73. 62 - this right-winger doesn’t think there should be any restrictions whatsoever on opening hours.


  74. Re: 58 - Spanish politics

    Anyone running a book?


  75. O/T but having glanced at front pages I see that Peter from Putney won yesterday mornings the “What will the Daily Express Lead On Tomorrow” competition (The McCanns).

    Then noticed that PfP brought attention to the failure of Express’s Arctic Hell story to materialise at post 8 - perhaps a hopeful post to remind us of his prophecy?


  76. US health spending value for money can be seen in this graph:
    http://ucatlas.ucsc.edu/health/spend/cost_longlife75.gif

    (Hat-tip to reddit; Ref Innocent Abroad @ 71.)


  77. Well, the gauntlet’s been thrown down for Clegg. Gordon Brown’s constitution seems a bit absurd (for example, do binge pie-eaters get penalised, but not rock clibmers? What about rugby players?) David Cameron’s dipstick proposal of fining the NHS (as mad as when the police get fined) is not exactly political genius either.

    So, that leaves Clegg. Can he come up with something madder than rationing health provision according to whether or not you eat too many pies whilst imposing a mandatory tax to pay for it? Will he match Cameron’s daft idea about fines?

    By the way, is the first 2008 PMQs on the 9th (next Wednesday)?


  78. 69 Edmund I suspect the Labour party expected to be in power in Wales and Scotland for ever, or for the foreseeable future at least, and the increasing disparities were not something they intended.

    You will recall Blair saying that the Scottish parliament would have the power of a souped up parish council, and I believe that is what many of the leadership intended.

    But the thing has moved out of their control and they are left with a mess. A mess where the largest part of the electorate are increasingly feeling hard done by in comparison to Scotland especially, and this is highlighted by having a PM from a Scottish constituency whose voters get all these additional perceived benefits while he offers less to England who has no government of its own.

    The story of the four health services today resonates with English voters, and will continue to do so as the Brownian constitution for the NHS can only apply to England in practice, as do the threats to disenfranchise the obese and the unfit and smokers. Scottish ministers nor Welsh or Northern Irish comparators have said anything of the kind to support Brown.

    There is the making of a perfect political storm here as two of the current four most sensitive political stories are education and health , are both are devolved management.

    When spending is cut, as it will have to be, who will suffer most, or perceive themselves to be suffering, and who will they blame? Brown, Labour, The union of the kingdoms?


  79. Back to US politics, I still think Joe Biden is going to perform far better in Iowa than polls or pundits predict. The difficulty is seeing how he can break into the top 3, given the strong efforts of Clinton et al. But if Obama’s youngish support fails to turn out, or Clinton has been overegged in the Iowa polls (not impossible) he could still have an interesting finish.

    I am of course playing devil’s advocate a bit here but Iowa is notoriously unpredictable and it’s highly likely that there will be at least one big surprise from a “minor” candidate in one of the races.


  80. 64: Cicero, my basic view on funding is that the current system of open-ended spending pushes all parties into desperately drumming up money wherever they can, while trying not to fall foul of the letter of the law. We should await any actual court cases before deciding whether anyone in particular is guilty. But if nobody ever broke the current law there would still be a problem to fix.

    I just thought the story was funny, though. I don’t think the conversation, if accurately reported, can be interpreted in any way except very hapless evasion. That doesn’t mean it was illegal, but to say

    (a) I don’t know how people get proposed for peerages
    (b) I don’t know who proposed the peerage
    (c) Oh, me? Well, yes, I did because he’s a good guy

    is surely worthy of a chuckle, especially as the deputy leader then contradicts some of what he says. I’m sure he’s a nice chap as you say and just not used to being pressed by reporters.


  81. PS Yes, first PMQs are on the 9th.


  82. 58 Chris from Paris

    Chris, I know you are a great dovotee of the Site and would do anything to assist your fellow PBers. Could you possibly decamp to Madrid for a couple of months, so as to provide us with a local presence?

    HNY.


  83. USA — Dem outsider Kucinich has recommended his supporters switch to Obama in the caucuses. (Supporters of candidates scoring below 15% iirc are free to change.)
    http://ap.google.com/article/ALeqM5gDC1l7fRNVdFdgW4JsjBd03lUOIAD8TTD8M00


  84. 78 Hmmm I’ve been backing Joe Biden a bit at long odds and he has had a bit of buzz in the last couple of weeks, but I think that if an upset was on the cards he would be making at least some progress in the polls - at 9/10% it might be possible his actual caucus support would be 15% or more, which even in fourth place would be enough for him (or Richardson or Dodd if they managed it) to really join the race for real. But at 5% it the polls he will do well to get even 5% of caucus delegates given the viability rules. It is possible though, better than the odds suggest I think, so as I said the other day, here’s to hoping!


  85. New thread: 2008 - the opening UK general election prices.


  86. re 80 - “PS Yes, first PMQs are on the 9th.” when many of us will be knackered after staying up for New Hampshire.


  87. 63 - Yes that is much of the answer (although hand-washing with soap and water only helps with infections like c.diff, alcohol gel/foam is needed to help prevent MRSA spread)

    65 - They call it annual leave! And if the workshy teachers were back today, then I wouldn’t have ankle-biters to look after ;-)

    68 - Yes - that is the frustration I raised on the site yesterday - within a couple of hours it was on the BBC news website - where this site leads, others follow!!!


  88. Can I just point out what a ludicrous system this is, we think ours is crazy but just imagine the following -

    Everyone is hanging onto the outcome of voting by party members in Leicestershire. Previous national polls have shown a preference for candidate A, B & C to lead their respective parties but the focus of candidates D, E, F, G & beyond on Leicestershire could change that. It is often the case that, if someone takes Leicestershire then they will go onto take Cumbria and Essex. The voters in such counties as Yorkshire and Sussex may be left with a diminished field to choose from as a result and it is plausible that the nominations may be wrapped up well before they get to that stage.

    Utterly crazy.


  89. I am going to send our temperatures in Minneapolis, Minnesota down to Iowa which could help Hilary or John - it is wonderful -4F (-20C) here this morning - and we are a neighbor state to the north - so much news coming from Iowa living here - but still no one has any idea who is going to win it - no one will put the cards on the table - they just say it could be any of the big 3 which is what everyone else is saying … so it will be fun on the night- at least we get to watch it at a sensible time as we are in same time zone as Iowa :)


  90. 82 - Kucinich will probably make little difference this time. It’s interesting that he’s gone for Obama even though he backed Edwards last time. But he campaigned hard in Iowa last time and is widely believed to have helped Edwards out, while this time he’s been virtually invisible in Iowa and is likely to have only a few second places to distribute.


  91. 70 Thanks Morus

    Yes, to me it looks like they are trying to settle their supporters as the next week is unlikely to produce positive news for Rudy.


  92. Sorry if someone’s already posted this, but does anyone know if there’s any non-satellite TV coverage of Iowa that I can watch? Are there any websites broadcasting coverage?


  93. 91: Yes, cspan.com


  94. Grand, thanks Nick.


  95. Apologies for the lengthy post.
    Well worth a read.

    Iowa Caucuses

    Iowa voters tomorrow night will go to their local precinct caucuses to cast their lot with a presidential candidate. The winner is hardly guaranteed his party’s nomination — in fact, it’s possible that neither Iowa winner will come out as the favorite for the nomination — but the caucuses will certainly be the end of the road for some candidates.

    Here are our analyses of the races as they stand now and the most likely outcomes:

    Republicans: This is a two-way contest between former Massachusetts Gov. Mitt Romney and former Arkansas Gov. Mike Huckabee. The battle for third place is among former Sen. Fred Thompson (Tenn.), Sen. John McCain (Ariz.), and Rep. Ron Paul (Tex.). Former New York Mayor Rudy Giuliani is not even spending this week in Iowa. Instead, he is campaigning in New Hampshire.

    Ever since finishing second in the Iowa straw poll last August, Huckabee steadily climbed here in Iowa, aided by his evangelical pedigree, his sincerity and the fresh-face factor, and less critical press coverage than any other candidate. Polls of likely Republican caucus-goers consistently showed Huckabee ahead throughout December, but more recent surveys are a mixed bag, showing slippage by Huckabee.

    Polling the caucuses is notoriously difficult, because caucusing, unlike voting in a primary, can take all night. Turnout is a bigger commitment, and it’s harder to predict. While pollsters try to correct for this, the room for error is huge.

    Romney is close or leading in the post-Christmas polls. This is probably good enough for him. He has a much bigger team in Iowa and much more money to spend than do Huckabee and the other Republican candidates. Romney’s campaign should be better than Huckabee’s at getting its supporters to their caucuses.

    Huckabee, however, has two potential caucus-night advantages. First, he enjoys more enthusiastic support than does Romney, who, for many Iowa Republicans, is just the most electable or the most acceptable of the top-tier candidates. Huckabee, by contrast, has a strong core of dedicated voters who share his religious views. Huckabee has recently come under a steady barrage of criticism by economic conservatives and a constant drubbing by Romney’s well-financed campaign.

    Two weeks ago, we wrote that Thompson was the “X-Factor.” Most Iowa Republicans hadn’t given him much thought as of mid-December, but he has spent the last two-and-a-half weeks in the Hawkeye State. Post-Christmas polls do not show a big spike, but he does seem to poll even with McCain for third place. A decent third-place finish for either of these men would be a boost going into New Hampshire.

    Ron Paul could make a splash, as well. He’s in fifth place in most polls, but his supporters are unmatched in enthusiasm and dedication. A third-place finish for Paul is not out of the question.

    The most likely outcome appears to be:

    1st Place: Mitt Romney
    2nd Place: Mike Huckabee
    3rd Place: Fred Thompson
    4th Place: John McCain

    Democrats: This is a three-way contest among Sen. Barack Obama (Ill.), Sen. Hillary Clinton (N.Y.), and former Sen. John Edwards (N.C.). It’s possible that there are only three survivors out of Iowa for the Democrats and that the second-tier candidates will be gone by New Hampshire.

    The similarities between Obama 2008 and Howard Dean in 2004 are real and could show themselves Thursday night. Obama is the new, fresh face in the race with youthful, enthusiastic, and idealistic supporters. For Dean, that same formula translated into caucus-day bust. Will the same happen to Obama?

    Obama leads in most polls, and significantly in some. His negatives are much lower than Clinton’s, and his positives are higher than Edwards’. He has as much money as Clinton and the edge in enthusiasm. However, his campaign team in Iowa is the least experienced of the top three. He could flame out like Dean, but all considered, he has to be viewed as the favorite.

    Hillary’s organization may be the strongest, but her negatives are the highest. Her hardball tactics against Obama will hurt her. For the Democrats, who have a viability threshold of at least 15% in each precinct, second choice matters, and that is where Hillary’s negatives will hurt her. She doesn’t appear to be the second choice for very many voters at all.

    Edwards has run in Iowa before and done well. His second-place finish in 2004, however, was in a weaker Democratic field. His negatives are low, however, and many polls have shown him as the most popular second choice among supporters of the second-tier candidates. In polls, he is right on Hillary’s heels, and it is likely he will pass her in the caucuses.

    The second-tier candidates — Sen. Joe Biden (Del.), Sen. Chris Dodd (Conn.), and New Mexico Gov. Bill Richardson — will struggle to reach the 15% viability threshold in many districts, with the top three garnering 85% among them in most areas. Of the three second-tier Democrats, Richardson has the best chance of even registering in the final results.

    The Democratic field looks to shake out this way:

    1st Place: Barack Obama
    2nd Place: John Edwards
    3rd Place: Hillary Clinton
    4th Place: Bill Richardson


  96. Des Moines Iowa Count: (C-SPAN)

    Looks like a lot of women and a few older men.

    Obama is in the lead and Hillary is in third place. Richardson is ‘not viable’.


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