Covid in the North: Norway's Corona Commission Presents its 'Lesssons Learned' to the Gov't

And legacy media, again, screws up the reporting, with a 'bonus' analogy about post-modern technocracy, which is really anarcho-syndicalism for the few, aided and abetted by ignorant bureaucrats

Dear readers, those attentive to the time stamp in yesterday’s piece perhaps noted that I was sitting on these four scenarios and the corresponding number of possible threat levels for about a month. On the one hand, there was so much going on that I wanted to write about (which is constrained, so to say, by the darned fact that the day has ‘only’ 24 hours) while, at the same time, I didn’t consider it altogether too important.

In addition, my impression is that the timing was a kind of ‘set-up’, as it allowed the powers-that-be to claim this information was ‘out in the open’—well before the latest official report on all matters Covid-19 was handed over to the government. My gut feeling is that the information discussed in yesterday’s post is the functional equivalent of taking out the garbage before the real thing drops.

Now, why would I claim that?

Let me present you with the official report, entitled ‘Municipalities’ Handling of the Covid Pandemic’, the most recent report by the official Koronakomission, established by royal decree on 24 April 2020 and consigned, formally, to the Prime Minister on 26 April 2022. Its objection is expressed on the cover: ‘to review and draw lessons from the Covid-19 outbreak in Norway’.

You can find the entire piece over at the government’s website.

Front to backside, the report clocks in at 481 pages, and while I will present you with some of its key findings over the course of the next week, in today’s post—also due to being a bit short on time—I will present to you how the legacy media reported on it, what it highlighted, and its implications.

Note, before we dive into today’s posting, that this is a very thick report that, if printed and bound, might be used to kill medium-sized rodents rummaging through the garbage cans. Hence, as we move to Bergens Tidende’s accounting of said official report, keep in mind that the news media article was published on 27 April, i.e., while I won’t discount advance distribution of the report, it’s quite a piece of work going through almost 500 pages of officialese to publish the following (all emphases mine):

ICU Capacity at Norwegian Hospitals Must be Strengthened, and the Enterprise Model Scrapped

The Corona Commission’s recent report illustrates that the funding model for hospitals does not work.

Lack of capacity in the ICUs was several times a core argument for why society had to shut down during the pandemic.

On Tuesday, the Corona Commission’s second report was officially handed over to the government. It pays special attention to this topic, and the conclusions are not surprising: it was unknown how many ICU beds Norway actually had. What everyone agreed on [before the pandemic] was that there were too few.

It is long overdue to address the problem, and the Ministry of Health and Care Services (HOD) should read the report carefully.

Ever since the Swine Flu Pandemic in 2009, it has been clear that ICU capacity is a vulnerable point in Norwegian preparedness. It was also well known that the risk of a pandemic was high.

The Ministry of Health must now make a thorough assessment of what went wrong, but more importantly: why nothing was done about what we already knew was a problem?

Hence, it will be impossible to get past the hospitals’ financing model.

The enterprise model [Foretaksmodellen], which was introduced by the Labor government in 2002, means that each hospital is run as an independent company. The hospitals then receive money from the state based on how much activity they have, and they are themselves responsible for turning a profit.

The aim was to operate efficiently, but as the Commission report itself points out: the fact that the enterprise model is economically rational also has its downsides. Hospitals lose money by having unused ICUs ready, just in case there is a pandemic. Therefore, if ICU capacity was reduced, despite the fact that they are needed as part of the emergency preparedness.

The enterprise model also has negative consequences beyond the ICUs. Faster treatment and discharge pay off under the enterprise model. This way you can squeeze in more activity per bed and doctor, thus hospitals are able to receive more funding from the government.

In this way, areas where unprofitable elements such as time and care are crucial for good treatment become expensive priorities. Psychiatry is one example, childbirth and maternity care another.

The Corona Commission recommends a number of proposals on how ICU capacity can be strengthened.

Improving this field, however, is not sufficient, and the Ministry of Health should make an assessment of whether the enterprise model has outlived its usefulness.

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Brief Comments

Socialised medicine, and glowing, if usually unfounded, references to ‘Scandinavia’ are a common trope esp. among US left-leaning politicos, such as Bernie Sanders. Problem is: all Nordic countries have embraced what’s called ‘New Public Management’ (NPM) to ‘declutter’ their seemingly bloated state bureaucracies from the 1980s onwards.

In other words: the committee is telling the government that the neo-liberal way of healthcare funding, introduced in Norway twenty years ago (2002), has failed.

Now, I suppose we should have a broad-based discussion of the fact that the fake pandemic of yesteryear ‘broke’ that system, which, I’d argue, never worked to begin with. We shall have such a discussion, I promise, including the abomination of ‘Obamacare’ and other systems like it (e.g., the Swiss one) in these pages before too long.

Lies of (C)omission

Interestingly, the above-related piece in Bergens Tidende is supremely problematic for a number of reasons, but they at least point out that the funding system is broken and needs attention.

The key issue I have, though, is that BT’s ‘summary’ is also misleading to a degree that is beyond being reprehensible: if you’d click on the above link and go to the index, you’d see that, while certainly of importance, the section on ICU capacity that legacy media focused on exclusively, is but one of the discussed aspects: it’s part of the third segment (del III), covering pages 119-82, i.e., approx. 13% of the total report.

If you care to learn more about, you know, the content of the committee’s findings, stay tuned as I shall go through the report over the next week. We shall discuss all the highlights that legacy media won’t talk about (which, incidentally, also includes the specific recommendations outlined to ‘strengthen ICU capacity’ and increase emergency preparedness).

What went wrong, you may wish to ask? As a primer—here’s some findings from the report (p. 11):

The authorities were not adequately prepared to be able to meet and deal with a pandemic of a such seriousness and scope as the [Covid-19 Pandemic].

The pandemic caused great strain at times in some of the country’s ICUs, whose emergency preparedness in hospitals was too poor when the pandemic hit Norway.

GP [fastlege] coverage was similarly not well-enough equipped to deal with the pandemic, and local family doctors experienced a very demanding work situation.

Bottom line: we know who’s responsible:

The government has exercised strong central control over the handling of the pandemic. It has made decisions in important matters, as well as small and limited cases.

New Public Management has, officially, led to more centralised command and control, or, as I like to put it, micro-management by unqualified people.

Why do I call these people ‘unqualified’?

Anarcho-Syndicalism + Ignorance = e.g., ‘the University’

Well, let me offer you a parable from my own work environment, academia, to round this off:

Universities typically have a two-layered system in place: a) professors (faculty) self-administering themselves, aided by b) a cadre of permanent administrators who, while they may themselves typically have credentials, are not faculty.

In practice, this configuration means that while the professors vote on their own representatives (typically in sham ‘elections’ of only one person running without an opponent) organised by the permanent bureaucracy.

As such, ‘the university’ represents a perfect, if almost entirely idiosyncratic, example of how 19th-century bourgeois leaders thought about ‘democracy’: anarcho-syndicalism (one professor = one vote) for the few, replete with grandiose, if vacuous, statements about inclusive democratic representation—and a kind of pseudo-feudal organisation in various ‘estates’ (German-language academia actually uses that term, Stand) that is governed by an iron fist.

Do note that the overwhelming majority of university employees isn’t democratically represented, as administrators, non-professorial academic staff, and students are under-represented. In other words: what pissed off the National Assembly in Paris in 1789 is still deemed ‘good enough’ for the professoriat.

If you’re outraged, that’s why I told you, but it’s not even the worst aspect, for in practice, everyday work is done in the following way: the ‘elected’ professors (a) are typically senior scholars with limited, if any, management experience—and they make decisions while the permanent bureaucracy (b) are non-scholars with more or less management experience executing these decisions about issues (higher education) they virtually know nothing about.

In other words: ‘the university’ is governed by pompous narcissists (professors) without a clue while their actions are implemented by people without any knowledge of scholarship—what could go wrong?

By way of analogy, I suspect we’d better be afraid of dedicated commissions (consisting of learned men and women) advising the government on what to do next.