[A-List] Well, Anne W Gives An Interesting Lecture

[Hari Kumar <hari.kumar@xxxxxxxxxxxx>]

Anne:
I have no idea why you feel it necessary to lecture me as if I have the
brains of a retarded 18 month child. However, presumably you do have
some legitimate cause to argue in said manner. Perhaps your X-Ray vision
detected my diapers.
In any case, Christopher wrote quite sensibly as to the experience of
Canadians in a state sponsored health care system. I would echo his
views in general. I think it is worth responding to some of your
remarks, in addition:
"Anne Williamson [AW] Writes:
Hari Kumar:
1) AW: "In economics, "incentives matter." .
REPLY: A most interesting and novel thesis I am sure.
2) AW: "These prescription support programs create the incentive to
medicate since the taxpayer provides easy profits, and the unwitting
population becomes the equivalent of laboratory animals.  There are
consequences to public policy, and mostly those consequences are
unintended on the part of the good-hearted.  We have seen this again and
again throughout history, especially that of the last century. "
REPLY:
(i) In Canada the generic drug manufacturers provided drugs to the state
at a fraction of the cost by the multinationals; & as part of the NAFTA
agreement were shut down. Those drug companies were not being provided
then, by any "incentive to medicate" - other than raw profit - by the
state since the state had NO drug incentive programme at that time.
Regarding the "population as guinea pig" - you are - in part - feeding
on the mythology of the anti-medicine movement. But - yes only proven
efficacious Randomised trials level-proven-medications should be
presribed in the main.  [Hint - there are some]. As for "good-hearted" -
whoever said that public policy intents were naive "good-heartedness?"
[Please read my mild comments below to refresh your memory]. The
earliest health reforms in the British industrial revolution were
explicitly driven by a fear of revolution - as Chadwick eloquently
explained. After that it was Joseph Chamberlain - that wily gentleman of
the ruling classes who pointed out that it was necessary to make some
social reforms:
"What ransom will property pay for the security which it enjoys? What
insurance will wealth find it to its advantage to provide?"
(J.Chamberlain in J.L.Garvin 1932).
3) AW: "When you hand over medical care to the state, you make yourself
the property of the state.  Now bureaucrats in DC direct medical care,
not the doctor and not the patient - the two private parties to the
treatment.  How idiotic.  And dangerous. "
REPLY: It is indeed a long time since I have heard a panegyric to the
hallowed "doctor-patient relationship" - from a non-physician. I think
you are not entirely wrong - but are somewhat naive about it, since,
state regulation in fact enabled the hallowed patient-dr relationship
you appear to like so much - at least in vast parts of Western Europe
and in Canada - by making an effing doctor available.
3) AW: "Do you honestly think the political classes will risk their
power and privilege for some geezer baby boomer's golden years?
........The state is not your friend, it is not a benevolent
institution. And watch out for those "free" flu shots."
REPLY: Unlike most working peoples in the USA - one can only assume that
you can afford the type of "catastrophic" insurance that you casually
discuss. That is fortunate for you. What about the rest of the stiffs?
And what does your overall stance here say about the relationship of
reforms to revolution?
As for free flu shots - ... Good, at last we agree! Damages the 'ol
immune system say the boffins......Unless, you are an old geezer - But
why don't we just take a leaf out of Jonathan Swift's book, & just
change the age-scale on his prescription? eh?
Hari
___________________________________________________________________________

 REPLY TO ANNE's first note on this matter:
>  I would disagree.
> 1) Comparisons of Canadian vs USA citizens shows markedly higher drug
over-useage in the USA;
> 2) Many elderly poor in the USA - are either poor 'cos of drug bills;
or
are too poor to pay for drugs.
> 3) By no means all drug utilisation is 'over-drugging'. The rational
usage of medications is not by not supporting free prescription for
elderly. The elimination of profiteering of the companies involves far
more than denial of sick elderly - rational prescribing. Not that this
is what you are suggesting - but I think your approach is too
simplistic.
> Hari Kumar