http://www.commondreams.org/views04/0616-09.htm

On Sep 5, 5:45 am, Justintruth <[email protected]> wrote:
> It is an interesting article but if one were to try to draw an analogy
> between it and the current health care financing debate, and in
> particular if one attempts to draw and an analogy between it and the
> Obama administration's attempts to orchestrate a change in the US
> medical care financing, it would be a false one.
>
> The implication that rationing might be applied in the future, under
> an Obama heath plan, and is not applied now, without it, is the
> problem with the analogy. The implication that the Hypocratic oath is
> not routinely violated *now* in the medical community for profit, and
> that, if we are not careful under an Obama plan it *might* be, is the
> problem with the analogy. You see, right now we are seeing a kind of
> game theoretical, "milking" of the medical consumer and a failure of
> the ethics upon which the oath is based. We are paying too much *now*
> for the care we receive and the effect on the distribution of care has
> serious detrimental consequences relative to the purpose of the system
> and what's worse, reduces the effectiveness of medical intervention
> itself. People have even died from it.
>
> To be fair, we must not characterize the medical community completely
> as totally profit oriented. In fact, I believe that many, and even
> most, doctors' commitment to the Hypocratic oath is more than
> superficial. But they are often put into untenable positions in the
> game theoretical world of modern economics. And, again to be fair, we
> must realize that they (the medical community in aggregate including
> its managers) have failed to supply the US with modern medical care
> value in accordance with demonstrated international standards with
> respect to the developed world. Our medical care, when looked at from
> a value point of view, is simply substandard. We have to be honest
> with each other. The world is watching.
>
> It is that way because of the success of the economic power elite's
> use of an ideologically motivated and very destructive conservative
> political movement, which promolgated an irrational belief in market
> mechanism as the *only* answer, and fostered an irrational fear of
> regulation. They used this political movement, fostered it and
> invested in it, in order to remove constraints on their power. They
> have attacked the press, the legal system, government regulation, and
> even education. Why? Because they attack any check on their unbridled
> power. This has produced unintended consequences and has had
> disastrous consequences for American competitiveness in a host of
> areas (not the least of which is manufacturing, and as we have seen
> corporate financing), but also in medical care and may soon even
> extend to education if the conservatives ideologues end up having
> their way. In the end, like the famed hindu proverb, the scorpian
> stings the frog and may also die from it unless we can save them.
> Business is coming around to the democratic view because they know
> that their game is at stake.
>
> The mechanism of the destructive effect is to deligititimize strict
> ethical standards in favor of a wink and the nod that acknowledges
> "the way the game is played" - a kind of Machevelian or Kissingerian
> realpolitic mapped onto business ethics and a kind of hail Mary hope
> that the "market mechanism" will result in the "right things done for
> the wrong reason". Those left trying to hold the line have a choice
> between ethical behavior and economic suicide or "bending the rules"
> and surviving economically. You saw it in finance, you see it in
> manufacturing, and it is the same in health care.
>
> This program has failed and is destroying the United States in many
> areas - one of them being health care.  Ultimately behind all of these
> is the ethical crisis that Obama has described and that is being
> currently modeled in modern economic theory. If you look at the
> current meltdown in the financial system and the problems with totally
> privatized medical care the parallels are stunning.
>
> Check out a recent article in the July-August Harvard Business Review
> titled "The End of Rational Economics"  (It is not even about medical
> care) It says in part:
>
> "We are now paying a terrible price for our unblinking faith in the
> power of the invisible hand. We're painfully blinking awake to the
> falsity of standard economic theory - that human beings are capable of
> always making rational decisions and that markets and institutions in
> the aggregate are healthy self regulating. If assumptions about the
> way things are supposed to work have failed us in the hyper-rational
> world of Wall Street what damage have they done in other institutions
> and organizations that are also made up of fallible less-than logical
> people."
>
> The "invisible hand" refers to market forces. Remember, this is the
> Harvard Business Review, not some socialist diatribe.
>
> Another quote from the article: "A few years ago, my colleagues and I
> found that most individuals, operating on their own and given the
> opportunity, will cheat - but just a little bit, all the while
> indulging in rationalization that allow them to live with themselves."
>
> From another article in the same issue: "Government's role in business
> is still emerging, but it's clear that companies worldwide can no
> longer operate independent of regulatory concerns."
>
> And from still another:
>
> "As the United States strives to recover form the current economic
> crisis, its going to discover an unpleasant fact: The competitiveness
> problem of the 1980s and the early 1990s didn't really go away. It was
> hidden during the bubble years behind a mirage of prosperity and all
> the while the country's industrial base continued to erode. Now, the
> U.S. will finally have to take the problem seriously. Rebuilding its
> wealth-generating machine - that is, restoring the ability of
> enterprises to develop and manufacture high-technology products in
> America - is the only way the country can hope to pay down its
> enormous deficits and maintain, let alone raise, its citizens'
> standard of living."
>
> All of these problems are interlinked and one cannot be solved without
> the other. We need a reworking of our understanding of the "commons".
> Bill Moyers had it right in the end: "I'm going out telling the story
> that I think is the biggest story of our time: how the right-wing
> media has become a partisan propaganda arm of the Republican National
> Committee. We have an ideological press that's interested in the
> election of Republicans, and a mainstream press that's interested in
> the bottom line. Therefore, we don't have a vigilant, independent
> press whose interest is the American 
> people."http://en.wikipedia.org/wiki/Bill_Moyers.
>
>  In order to regain our competitiveness, one thing among many we need
> is government intervention in the medical system. We need it and we
> need to get moving on it. In general, we need to rebuild the American
> commons. Don't take my word for it - read the Harvard Business Reveiw:
> "Governments are often uniquely positioned to mobilize and coordinate
> the efforts of the numerous organizations needed to confront these
> huge challenges."
>
> What is being advocated is not Socialism. That is just another example
> of the Republican ideologues setting fire to the "commons". No one is
> advocating socialism. What is being advocated is intervention in the
> market mechanism with regulation and where necessary the challenging
> of the assumption that business, if it diverges from public interest,
> will remain unmolested by government. Make a game without rules and
> referees and you get just that. What is being advocated, in fact -
> instead of the lies - is a cooperative relationship between government
> and business with a real - and an improved *ethical* standard being
> put in place to underpin the alliance.
>
> Contrary to the implication in the article, it is the Obama agenda
> that is trying to *restore* the functioning of the Hypocratic oath and
> ethics in general and deliver, with all its complexity, modern medical
> care service in a way that is characterized  by excellence. It is in
> fact, a whiff of brilliance the likes of which we rarely see in
> America. From the looks of the lunatics on TV worried about Obama
> "indoctrinating" their children (I mean it is ridiculous) the plan is
> at risk and in fact may go down. The real effect, if the goals of the
> opponents to this  agenda are totally realized, will be a return to
> the mask of unbridled individualism behind which lies the corporate
> profit behemoth unfettered and unembarrassed and frankly, just playing
> by the rules that our abdication has left them with.
>
> In fact, the problem is our irrational behavior and we must act
> rationally now in our own interests. Eliminating the threat of
> government control is like removing the major competitor from the
> arena. Modern economics, which is founded in part on game theory, and
> has transcended the simple models that are rampant in ideological
> approaches, have concluded the the real economic picture is much more
> complicated and that a smart and changing mix of government
> intervention and market mechanisms are needed. We must not let our
> government representatives abandon the field.
>
> A transparent, government supervised, financing option for medical
> care can be a *very* effective check and signal the end of "business
> as usual" and in fact the competitive force that it can bring will be
> staggering. The likely effect, if it is carried out carefully, is the
> reemergence of successful managerial decisions in the private sector
> (as the rules will have changed: Why foul if your are going to get
> penalized?) and, due to the efficiencies of market driven
> organizations, the eventual victory of those organization over their
> government counterparts with the eventual elimination of the need, in
> fact, for a "government option".
>
> What is needed is not only successful regulation. What is needed in
> addition is the political awareness of the ...
>
> read more »
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