Salve Lucrum: The Existential Threat of Greed in US Health Care
In the mosaic floor of the opulent atrium of a house excavated at Pompeii is a slogan ironic for being buried under 16 feet of volcanic ash: Salve Lucrum, it reads, “Hail, Profit.” That mosaic would be a fitting decoration today in many of health care’s atria.
The grip of financial self-interest in US health care is becoming a stranglehold, with dangerous and pervasive consequences. No sector of US health care is immune from the immoderate pursuit of profit, neither drug companies, nor insurers, nor hospitals, nor investors, nor physician practices.
Avarice is manifest in mergers leading to market concentration, which, despite pleas of “economies of scale,” almost always raise costs.
Yep. Don Berwick on fine form.
If you want to kill somebody….
Address issues at home before criticising Qatar over World Cup | Qatar | The Guardian
Such data bears witness to an old trade union adage – if you want to kill someone and get away with it, first set up a company, then employ them. (Steve Tombs, Emeritus professor, Open University)
By design, not bugs, in the law regarding corporations and persons.
Politics and medicine
China’s Covid patients face medical debt crisis as insurers refuse coverage | Financial Times
Echoing Rudolf Virchow, frequent bedfellows. The spectrum includes the UK.
A doctor at Shanghai No 10 Hospital said staff had been instructed by the city’s health commission to limit Covid diagnoses. “We are advised to label most cases as respiratory infection,” the doctor said.
“What is certain is that the government can’t afford to treat everyone for free.”
China’s National Healthcare Security Administration said on Saturday that it would fully cover hospitalisation for Covid patients, but continued to exclude complications. Hospitals are also under pressure to reduce medical costs after the national insurance fund was strained by the costs of the sprawling zero-Covid apparatus.
In the eastern city of Hangzhou, Frank Wang, a marketing manager who bought a Covid insurance plan early last year, was refused proof of illness after he developed lung and kidney infections after testing positive for the virus.
“The hospital made it clear that Covid proof is not easy to obtain as the disease diagnosis has been politicised,” said Wang, who paid more than Rmb20,000 for treatment. “That makes patients like me a victim.”
The deserving and the undeserving sick redux; more crony capitalism.
Ands the gods looked on
As far as Toby was concerned, Jay Crispin was your normal, rootless, amoral, plausible, half-educated, nicely spoken frozen adolescent in a bespoke suit, with an unappeasable craving for money, power and respect, regardless of where he got them from.
And from there, he wandered off into an argument with Friedrich Schiller’s grandiose statement that human stupidity was what the gods fought in vain. Not so, in Toby’s opinion, and no excuse for anybody, whether god or man. What the gods and all reasonable humans fought in vain wasn’t stupidity at all. It was sheer, wanton, bloody indifference to anybody’s interests but their own.
A Delicate Truth, John le Carré
YMMV, but for me, one of his very best.
Shareholder value
Menthol cigarettes were first promoted to soothe the airways of “health conscious” smokers. Long used as an analgesic, menthol evokes a cooling sensation that masks the harshness of tobacco smoke. In the competition to capitalize on the growing menthol market, the industry’s marketing experts “carved up, segmented, and fractionated” the population, exploiting psychology and social attitudes to shape product preferences.
[emphasis added]
Regulatory subventions
Pluralistic: 02 Jun 2021 – Pluralistic: Daily links from Cory Doctorow
Uber’s main project has always been regulatory, not technological: that’s why it funneled hundreds of millions of dollars into passing California’s Proposition 22, a law that legalized worker misclassification and banned unionization.
The irony? Uber is a “bezzle” – JK Galbraith’s name for “the magic interval when a confidence trickster knows he has the money he has appropriated but the victim does not yet understand that he has lost it.” Uber is a scam and it will never be profitable.
Resilience and sustainability
Hack the Planet: Tega Brain on Leaks, Glitches, and Preposterous Futures
This quote is actually from an article about washing machines, water supplies and ‘wastage’. But it just reminds me of the technical and intellectual debt that is drowning health care and the NHS
That balancing act reminds me of something engineer and professor Deb Chachra wrote in one of her newsletters. She wrote, “Sustainability always looks like underutilization when compared to resource extraction.”
No mothers’ milk here
Nestlé document says majority of its food portfolio is unhealthy | Financial Times
Nestlé document says majority of its food portfolio is unhealthy
An internal company presentation acknowledges more than 60% of products do not meet ‘recognised definition of health’.
No surprises here, then.
Nicely put
Capitalism on the way up, and socialism on the way down is cronyism.
From this week’s Economist | Breaking through
Yet nowhere too little capital is being channelled into innovation. Spending on R&D has three main sources: venture capital, governments and energy companies. Their combined annual investment into technology and innovative companies focused on the climate is over $80bn. For comparison, that is a bit more than twice the R&D spending of a single tech firm, Amazon.
Market and state failure may go together. Which brings me back to Stewart Brand’s idea of Pace Layering
Education is intellectual infrastructure. So is science. They have very high yield, but delayed payback. Hasty societies that can’t span those delays will lose out over time to societies that can. On the other hand, cultures too hidebound to allow education to advance at infrastructural pace also lose out.
Pace Layering: How Complex Systems Learn and Keep Learning
I won’t even mention COVID-19.