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Tuesday, February 02, 2016

Coming Soon to A Road Near You*

Here is the sort of thing for which socialism in general, and single payer health care in particular, is so justifiably famous.

No. Wait. The exact opposite of that.

*Unless you live in the United States, where these lights, thanks to the NHTSA are illegal. Yes, that is the same NHTSA that mandated sealed beam headlights at least a decade past their sell-by date.

167 comments:

Clovis e Adri said...


I don't think it is proven a safe technology yet.

The problem, in one word, is: reflections.

They create that shadow zone for cars coming the other way not to be blinded, but it can't control for reflections sitll blinding any other car either way.

File under: fancy stuff no one really needs.

Harry Eagar said...

You do realize that single payer is cheaper and more efficient than the US system?

erp said...

Skipper, those lights seem horrific. After driving all over the place for 65 years with regular headlights and/or street lights with little difficulty, I can't see why this radical "improvement" is desirable?

Harry, you do realize that a single anything aka a monopoly isn't cheaper nor more efficient once it completely destroys competition, in fact, as Skipper correctly notes above, No. Wait. The exact opposite of that.

Hey Skipper said...

Clovis, erp:

My car has lights that aren't completely dumb -- they are pitch stabilized, and predictive (i.e., they remain parallel to the road surface under braking, acceleration, and when the vehicle is unevenly loaded; also, they pivot so they point in the direction the car is turning, not where it is pointed).

They are waaayyy better than fixed headlights, but not a patch on intelligent LEDs.

[harry:] You do realize that single payer is cheaper and more efficient than the US system?

I know that it is cheaper, and it also might be more efficient. But, as usual, you are missing the point: had socialism run the board, instead of the exact opposite of that, we would never have seen innovations like these headlights, which will save lives.

So let's move to your Marxist wonderland of single payer care. Just like everything else socialism touches, it will quickly become ossified.

Which means you are happy to trade dynamism with untold benefits for a few trinkets. And that is before asking why single payer is cheaper, or more efficient.

Pro-tip: Consider disposable income.

Clovis e Adri said...

Skipper,

---
had socialism run the board, instead of the exact opposite of that, we would never have seen innovations like these headlights, which will save lives.
---

Though I do get the message you want to pass here, I really think you've chosen the wrong example. I doubt those fancy lights will do anything to save any extra lives.

Actually, they are pretty tacky if I need to give you my sincere opinion.

erp said...

Skipper, health care needs to be defined because the VA is a tragic example of medical care left to the government and I don't think many would think it cheap or efficient.

To remind everyone Obamacare is HEALTH INSURANCE, not health care and already here in a small mostly rural and retirement county of Florida, medical care has deteriorated even before total implementation. The ER doesn't take all comers anymore and the service a couple of weeks ago when my husband had an episode, took many many hours even though we have all the magic plastic cards in working order and his problem was fairly routine.

The local Free Clinic where I've worked for years along with countless other volunteers has, I just learned a couple of days ago, been taken over by Obamacare because one of those thousands of pages that no one read in the bill, forbids such all volunteer clinics to exist.

How that Harry? It cost nothing and was available to all comers. Can't beat that for cheapness and efficiency, but it wasn't under the control of the fascists, so it had to go.

Harry Eagar said...

Next time you're in France, Skipper, ask a French person to show you his Carte Vitale, then get back to me about ossification.

Hey Skipper said...

Harry, how about telling me exactly what Carte Vitale has to do with ossification?

That is on the order "Do you walk to school, or carry your lunch?"

Hey Skipper said...

[Clovis:] I doubt those fancy lights will do anything to save any extra lives.

I might have thought that, too, until driving a car with adaptive headlights, and these new ones are 100 times more adaptive, and perceptive, than the ones I have.

But you do get my central point: socialism tends strongly towards ossification. The NHTSA mandated sealed beam headlights long after they were comparative rubbish. Ford found a loophole in their rules that finally forced them to finally acknowledge reality.

Multiply that by all the instances where the dead hand of socialism gets in the way of the readily apparent.

Howard said...

Regarding healthcare:

In Western Europe, for example, numerous countries such as the Netherlands, Germany, and France have a multi-payer healthcare system with deductibles and even copays. Private insurance companies and the government both contribute to the healthcare system. Sanders even mentions some of these countries by name in his “Medicare for all” program.

There are, of course, advanced nations, such as the United Kingdom and Sanders’ beloved Denmark, that do have single-payer healthcare systems. But that in and of itself is not an argument. There are tons of less advanced nations with single-payer healthcare systems: Russia, Venezuela, and North Korea are just a few from a long list. These countries do not really have a reputation for providing amazing healthcare.


More lessons on comparison with France:

On the critical issue of costs, the lessons are more complex.
...
Medical malpractice is a third area where would-be US cost cutters might learn from French experience. France uses an approach pioneered in Scandinavia, under which cases of alleged malpractice are decided by special review boards that operate outside the court system.
...
At the same time, other elements of the French cost control experience are are less encouraging for US reformers. One is the fact that despite all efforts, health care costs have been growing faster than GDP in France, as they have in the United States, and are increasingly a cause for concern.
...
Instead, the earnings differential would seem to carry implications more like the following:

First, replication of the main elements of the French system in the United States could very well end up costing considerably more than in its home country. The difference in doctors' earnings alone would probably erase half of the cost differential that the French system currently enjoys.
Second, doctors' earnings cannot be considered in isolation. The combination of high prospective earnings, high student debt, and the US malpractice system create a risk-reward profile for a US medical career that is quite different from that in France. Over time, changes in policy could plausibly attract sufficient numbers of qualified people to the medical profession even if the package included a lower equilibrium level of earnings. But to say that is quite different than to say that doctors who are already practicing in the United States would or should accept immediate pay cuts.
Third, to some extent, the earnings differential between US and French doctors reflects decisions that shift costs from one government account to another without any real saving to the economy. Lower payments to doctors may be at least partly offset by higher government spending on education and costs of administering the malpractice compensation system.



Pretty good article - worth the time.

Peter said...

People, people, haven't we argued healthcare before, several times and at length? As I recall, we concluded that we North Americans are wasting money and health by arguing single-payer, represented by Canada (Oh Canada...) vs. private, represented by the States (America, America...), to the political damage of each of us, and that the usually ideologically constipated Europeans have beaten us pragmatic North Americans at our own game by developing workable, popular combinations of both?

OTOH, I don't believe we have ever argued headlights and I'm looking forward to a 200 comment thread on it. So far, I've learned Skipper thinks the new ones are really cool, but I trust he will be giving us links to substantiate his claim they would save lives.

erp said...

Howard, what I learned after experiencing the French health care system first hand is why people who are sick get on a plane and come home tout de suite.

erp said...

... people who are really sick and can afford it come to the U.S. even though they live in one of those countries that provide free health care.

Odd that.

erp said...

Re: Psychedelic headlights. My big Chrysler is 19 years old and I have no plans to retire it, so I'll just have to take Skipper's word for the advantages of a light show while driving.

However, I'd love to take a ride with Skipper at the wheel, car of his choice, around those curvy roads in the Alps with the ski resorts glistening in the moon light.

Clovis e Adri said...

What's up with pilots that make the girls so willing to be in their cockpit?

erp said...

It's those leather flight jackets that get us every time.

Harry Eagar said...

Well, I don't recall participating in those health care threads, or not much. But let's school erp. The reason rural areas don't get health care in the US is that it's a for-profit system.

For the same reasons small towns don't have intercity bus service, they don't get to have hospitals either. Not like countries where everybody gets health care.

Skipper, maybe you should ask what the Carte Vitale can do. Apparently you don't know.

Howard, health care costs are going up? Get out!

There's a much better rightwing argument to be made. If you were to eliminate the pointless portion of the US health care system -- the people who make money by figuring out how to not deliver health care, for example -- and bring the US spending level down to that of even the next most expensive developed nation (Switzerland), hundreds of thousands if not millions of people would be dismissed and the economy would go into an official recession.

In fact, if you were to eliminate the anti-health aspects of the US system, you would find that the US economy has been contracting for many, perhaps all, of the past 40 years or so.

I cannot imagine why rightwingers do not make this argument.

erp said...

... but Harry fascists do make this argument -- that's why so much tax payer funds is wasted on the huge bureaucracy that is local, state and federal meddling in our health. Do away with all the agencies and leave alone.

Any comment on the VA?

Clovis e Adri said...
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Clovis e Adri said...
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Clovis e Adri said...

Harry,

---
If you were to eliminate the pointless portion of the US health care system [...] hundreds of thousands if not millions of people would be dismissed and the economy would go into an official recession.
---

Doesn't make sense, Harry.

The same money used for that alleged inneficient structure would be used elsewhere, possibly in more efficient ways, so you'd end up with a better and more productive economy, not the contrary.


Actually this is something I do not recall being discussed by economists of Libertarian stripe: in a free market, is it possible that some sectors of the economy can be parasitic to others (in principle quite unrelated) ones?

Taking the analogy with biological systems, it seems not only possible, but very probable.

Bret said...

Clovis asks: "...in a free market, is it possible that some sectors of the economy can be parasitic to others (in principle quite unrelated) ones?"

Sure. Thieves, looters, thugs, protection rackets all exist in even the freest of markets. And then the government response (police etc.) is thought of by some as parasitic.

Is that what you meant? If not, can you give an example?

Clovis e Adri said...

Bret,

Not quite.

The example goes by analogy.

Let's suppose govt can in fact be parasitic: it takes money out of the people to give to some small minority whose only job is to dig up holes and fill it again (or to fill in useless papers and to harass the people to properly fill in those papers too).

Clearly, the money and resources they take could very well be used more efficiently elsewhere.

Now let us suppose that health care was made of 75% of technological quakery. That contrary to common senae, 75% of the time people went to the doctor, or did exams, or took prescriptions, they were basically indulging in an expensive placebo treatment.

Suppose yet that the costs for that were pretty high and getting higher at a rate far greater than other costs (and yet providing no correspondent higher benefits), both for govt and private entities, sucking money that could be used more efficiently elsewhere.

Would it be fair to describe that health care sector as parasitic to other sectors of the Economy?

Or we don't call a parasite as such when it has our consent to drain our blood?

Bret said...

Clovis wrote: "...money that could be used more efficiently elsewhere..."

There's no doubt that there is substantial inefficiency in a free market. Numerous factors such as delays of information, human foibles, and on and on prevent it from being anywhere near perfectly efficient.

Are some of those efficiencies parasitic? Very possibly if one stretches the definition of parasitic a little bit. One debated topic in economics is the asymmetric information problem, and I think it's a fair argument that those who take advantage of asymmetric information are sort of parasites to some extent.

Sometimes the question is who gets to call it parasitic. Can an atheist call donations to a church by believers parasitic? Can someone who thinks all chiropractors are absolute quacks call them parasitic when the chiropractor and the client enter into a transaction completely voluntarily? Are all movies and entertainment parasitic in some sense? Is wasting resources by coming up with designs to emboss toilet paper parasitic?

Perhaps whether or not something is parasitic is in the eyes of the beholder?

Free markets are far from perfect. But the "free" part as in "freedom" is very important to me and I'm more than happy to live with the imperfections that fall short of fraud, false advertising, or other criminal and unethical activities.

erp said...

Bret, I'm glad you brought up criminal, i.e., against the law activities which are not, IMO parasitic. Those who engage in that activity should be prosecuted and jailed and removed from society.

Clovis e Adri said...

Bret,

I think you missed one important aspect of my point: quantity, not quality.

All the activities you described could be well described as parasitic if they took too much of a person/society resources.

Being a good Libertarian, you went straight to the matter of freedom. But please also notice your point is not entirely coherent: "I'm more than happy to live with the imperfections that fall short of fraud, false advertising, or other criminal and unethical activities."

What if the said criminal activity was outlawed exactly because it is parasitic to individuals? Drugs are the perfect example.

To be clear, I am not arguing in favor of criminalizing health care, church donations, chiropractors, movies nor fancy toilet papers. At least not yet :-)

My point was about economics and Harry's comment above. For one thing widely believed by free marketeers is that the market will provide for a more efficient solution, including health care. What if you run experiments in many different universes and conclude that absolutely private health care ends up holding back societies, compared to single payer (or any of the European style settings)? I wonder if the parasite analogy could be part of the reason.

erp said...

Clovis, we don't have "run experiments." We need only note that whenever anything is reduced to the lowest common denominator, the result is just that. Socialism makes everyone (except the ruling elites) serfs in poverty. The situation of health care in the UK is a good example. It has been collapsing almost from inception and is now, to use a medical analogy, on death watch. Since they are in the grip of the left and that's not likely to change, health care can only get much much worse with their influx of immigrants bent on imposing their own version of the good life.

Canadian health care from what I've heard from the sun seekers who come down here in the winter, is basically first aid and if more is required, there's along wait ... and those who can afford it come here for more timely care.

Perhaps Scandinavian systems worked better while they were miracles of homogeneous Protestant ethicists, but I doubt that high level will be maintained now that the have a influx of people with the polar opposite work ethic.

Harry, Harry, Harry. Your last comment about there being no hospitals in small towns is ridiculously disingenuous even for you. Yes, the Mayo Clinic or equivalent isn't to be found in every hamlet, yet bodies of those seeking health care aren't littering the highways and byways.

Public transportation? The other bugaboo. Our little county populated by a majority of retired folk tried a pilot program to test need and found very little interest. There is a shuttle service one can call and be taken to various destinations for the fare of $1.00. Even that isn't used much, but there is a large group of volunteers who are vetted by the county and using their own cars, pick up and drop of those who can't drive to doctor's appointments and the like and that works like a charm.

Then, of course, there's old-fashioned reliance on family and friends to help out when needed for rides to the airport, malls, etc.

In other words, everything works better without the "help" of government interference.

Clovis e Adri said...

Erp,

I don't know if you noticed, but the point I am interested is not exactly which system can produce the best possible medical care for an individual in need of real health care, but what system strikes a balance between providing health care were it is needed and still avoid the pervasive use of unneeded health care.

The curve of US spenditure with health care looks quite high, maybe too high to be based on real need of care. It looks like the American system is hooked on using those health services, a bit like one can get hooked on morphine or something alike.

erp said...

Clovis, please re-read your comment.

Health care is not about creating a meaningless series of charts and graphs leading to papers and symposia about health care ala economics.

Health care is about peoples health and the reason I am pressing Harry to comment on the VA is that almost from its inception in 1930, it has been a text book case of New Deal claptrap disguised as a health care for our veterans tossing gazillions of tax payer dollars down the rat hole of bureaucracy gone berserk.

Bret said...

Clovis wrote: "For one thing widely believed by free marketeers is that the market will provide for a more efficient solution, including health care."

That is no doubt true that many "free marketeers" believe that. However, my point is that I couldn't care less, honestly. If you could prove beyond a shadow of a doubt that there were solutions that delivered far better average prosperity than the free market or far better "fairness adjusted" (or whatever) prosperity than the free market, I would still reject those solutions out-of-hand. A society without a free market is simply not a society that I can tolerate living in. I do not want to live in Mao's China, Joe's USSR, Fidel's Cuba, or Hugo's Venezuela, even if they turned out wonderfully materially prosperous.

I also tried to direct you away from health care because health care hasn't been an even vaguely free market in the United States for a really long time. Nobody here except for the really ancient (older than erp or Harry!) have any recollection of what a free health care market is or could be or what the state of health care might be had there been free markets. Well, except maybe for pet owners who will note that virtually every transaction for a pet costs 1/5 to 1/10 as much as the corresponding service or procedure for a human.

There aren't a whole lot of really free markets in the US. Clothing is pretty close to a free market. Computer/TV monitors. Toilet paper. A few others. Instead of focusing on something that's totally not free market like health care, why not look at things that are close to free market and show how non-free-market policies could help those?

Harry Eagar said...

'The same money used for that alleged inneficient structure would be used elsewhere, possibly in more efficient ways'

In a capital-short environment, that should be true. But America is suffering from excess capital.

'That contrary to common senae, 75% of the time people went to the doctor, or did exams, or took prescriptions, they were basically indulging in an expensive placebo treatment.'

The actual figure is 60%. Not total expenditure, but about 60% of doctor visits are for no organic reason. What I call FBS, Feels Bad Syndrome.

erp, T.R. Reid wrote a little book called "Healing of America." He went to the top 8 developed nations (and some others) and presented the health system with his medical Condition (bad shoulder). You should read what happened.

Short story: NHS is not collapsing. You only have to wait in Canada for electives; urgent care is delivered immediately. In only 1 country do people die for lack of care: USA.

The VA did not start in 1930.

You do not understand what "intercity" means.

Bret I am curious. (I think I have asked this before.) Do you have any eample of a free society? Or is it merely an aspiration, like heaven?
Bret,



erp said...

Harry, if the VA didn't start in 1930, take it up with Google.

Bret, I was 31 when Medicare started, so I do remember very clearly how health care was managed prior to its being taken over by the feds. Growing up we had no health insurance, but we had a doctor on the corner who took care of us -- he also made house calls.

During our working days, my husband's employers insured him, but we paid the insurance premiums for me and the kids and also picked up the 20% of all costs not picked up by insurance.

It was all very affordable and worked very well.

Harry Eagar said...

The VA was successor to the Veterans Bureau, famous as the most corrupt of the spectacularly corrupt agencies under the Republicans.

It wasn't affordable and it didn't work at all for the uninsured. Thank unions for the coverage you had. Before their rise, almost no employers provided insurance.

All nations ration health care one way or the other. Among the rich countries, only the US rations care by letting hundreds of thousands of curable people die.

And it doesn't even save money. That' why it is so bizarre to see the rightwing embrace it. I understand rightwingers don't give a damn about other people, but they do care about money.



erp said...

Harry, are you being deliberately obtuse or are you having trouble with simple declarative sentences. I said we never heard of health insurance. We had a doctor on the corner and paid him out-of-pocket as did everyone else. The problems started with commie union agitators and have escalated to the fascist government we have today when half the able-bodied are out-of-work and in custodial care.

Corrupt Republicans? Whatever they were, they couldn't hold a candle to the Clinton's and the rest of the money grubbers in the one world contingent.

Hey Skipper said...

[Harry:] But let's school erp. The reason rural areas don't get health care in the US is that it's a for-profit system.

How about we school you first. The population density in the US is 33 people per square mile; one quarter that of Western Europe. That means for plenty of areas, the cost per person to maintain an adequately staffed care facility would be prohibitively expensive.

After all, if it was just the profit motive that was at fault — which in your monochromatic universe, is always the case — then Australia wouldn't have the same problem.

Which renders this:

For the same reasons small towns don't have intercity bus service, they don't get to have hospitals either. Not like countries where everybody gets health care.

another of your indefensible pronunciamentos. (News Flash: small towns in Germany don't have intercity bus or rail service, either.)

Skipper, maybe you should ask what the Carte Vitale can do. Apparently you don't know.

Harry, you should school yourself on logical fallacies, starting with This one.

I know perfectly well what the Carte Vitale can do; but that alone says absolutely nothing about how innovative, or sclerotic, French medicine is.

Hey Skipper said...

[Peter:] People, people, haven't we argued healthcare before, several times and at length?

Yes, we have, and I had no intent on doing so again. Innovative headlight designs, and calcified regulations, are proxies for this (about French dirigisme):

The other sector singled out for intervention amid the crisis was car production: Sarkozy’s February 2009 plan de relance rescue package for the French economy in general and the car industry in particular (in the face of delocalization by Peugeot of French car production to Czech factories). …

Intervention in the car industry is partly explained by the place of the automobile industry in the French economy …

(p.220) Sarkozy’s “car pact” had three key objectives. It sought to offer, in the short term, support for demand and jobs in the car industry. The second, longer term aim was to form part of an industrial policy geared toward ensuring the future of a strategic hi-technology industry. Thirdly, and related to the second, it sought to encourage the production of cleaner cars. The total funds dedicated to the package amounted to €9 billion. It involved a €6.5 billion commitment to help Renault and PSA Peugeot-Citroën (with innovation and clean technology R&D). This financing of large development programs to develop cleaner cars took the form of cheap five-year loans at 6 percent (not 10+ percent market rate), offered in return for commitments on “doing everything possible to avoid redundancies” while in receipt of state funds.



However, if the institutions to channel the funds were novel, the logic underpinning the automobile bailout appeared less so. There was talk of exploiting the opportunity of a move to greener technologies in car production, and the exploitation of positive externalities from investment in cutting-edge technologies of the future—with the French automobile sector leading a shift to new growth areas of green technology. Yet, skepticism remained as to whether this involves strategic long-term investment, or propping up an industry locked into overproducing unwanted and insufficiently green cars.

Too many of the wrong kind of cars being produced reflect that large car firms are slow to respond to changing consumer taste. Furthermore, more efficient smaller cars are predominantly produced in Renault and Peugeot’s Eastern European plants, with production of less in vogue models concentrated on French soil. Thus, the funding perpetuated, rather than solved, the industry’s problems. The lending was conditional upon nonclosure of factories in France and job security; yet, given the changing market conditions, car-producing firms arguably needed to cut fixed costs to improve their internal balance sheets, so sites arguably needed to close (OFCE, 2009). Sure enough, once the scrappage scheme elapsed, French car sales dropped significantly in early 2011.4 A different set of initial conditions and historical, institutional, and market factors explain why this kind of state activism was not “new” enough. For all the aspiration to achieve long-term industrial policy goals, the car industry is a highly “delocalized” hi-tech industry. This undermines ambitions for supporting national champions and building up national R&D capacity in the new knowledge economy. Schumpeterian investment in innovation is likely to leak out and creates jobs abroad. This all smacks of the French post-dirigiste state “picking losers” as the revisionist literature criticized the earlier dirigiste state for doing.

Harry Eagar said...

'We had a doctor on the corner and paid him out-of-pocket as did everyone else. '

Not true.

Hey Skipper said...

[Harry:] If you were to eliminate the pointless portion of the US health care system -- the people who make money by figuring out how to not deliver health care, for example -- and bring the US spending level down to that of even the next most expensive developed nation (Switzerland), hundreds of thousands if not millions of people would be dismissed and the economy would go into an official recession.

Bollocks.

The total employment in the US health insurance industry is 444,000. Obviously, no matter what the answer is for healthcare provision, administrative overhead will never be zero. UK's NHS has an administrative overhead of 14%.

In the US, admin overhead is clearly higher:

Administrative costs accounted for 25 percent of hospital spending in the United States, more than twice the proportion seen in Canada and Scotland, which spent the least on administration. Administrative costs were notably higher in the Netherlands (20%) than in other European nation.

So if the US were to be at the NHS level of admin overhead, that would amount to 200,000 jobs. Which, over the entire country, amounts to a good month's hiring.

That's on top of Clovis's objection, which raises this question: why do progressives have such an unnatural fixation on the lump of labor fallacy?

Hey Skipper said...

[harry:] It wasn't affordable and it didn't work at all for the uninsured. Thank unions for the coverage you had. Before their rise, almost no employers provided insurance.

Bollocks:

In 1943, the Internal Revenue Service ruled that employer-based health care should be tax free. A second law, in 1954, made the tax advantages even more attractive.

Thomasson cites the huge impact of those measures on plan participation. "You start from 9 percent of the population in 1940 to 63 percent in 1953," she says. "Everybody starts getting in on it. It just grows by gangbusters. By the 1960s, 70 percent [of the population] is covered by some kind of private, voluntary health insurance plan."

Thus employer-based insurance, which started with Blue Cross selling coverage to Texas teachers and spread because of government price controls and tax breaks, became our system. By the mid-1960s, Thomasson says, Americans started to see that system — in which people with good jobs get health care through work and almost everyone else looks to government — as if it were the natural order of things.

But to Thomasson and other economic historians, there's nothing natural or inevitable about it. Instead, they see it as the profound result of historical accidents.


US history is fascinating, Harry. You really should read up on it sometime.

erp said...

Skipper, I'd like to see how those numbers are compiled. There may be more foot soldiers in the health care industry making low wages, but the administrators and all that entails are making high wages, get fabulous benefits, etc. and I'm not talking about physicians.

I'd be far more willing to believe the opposite, 25% of costs go to direct patient care while 75% goes to bureaucrats.

erp said...

Skipper, we retired at 53, so for 12 years until we were no longer by law permitted to purchase health insurance, we had a relatively inexpensive catastrophic/major medical type plan. We paid out-of-pocket for expenses until a preset amount was reached and the insurance picked up the rest (all of it) and, of course, we continued to pay our taxes which included the portion for Social Security and Medicare. I tried mightily to maintain that kind of arrangement, but to no avail, so not being in a position to risk total financial ruin, we got on the fed's treadmill.

Harry, I do know what intercity travel is and also know why it's so difficult and expensive. If you knew your history, you'd know too and wouldn't show your ignorance by putting your name to snarks such as the one above. Here's a hint, Bret's use of the word ossification describes them brilliantly.

erp said...

Harry, what's not true?

Bret said...

Harry asked: " Do you have any example of a free society?"

The Cafe Hayek guys mention them from time to time, but nearly ideal free-market societies have been pretty obscure.

However, there is more free markets versus less free markets. Hong Kong was pretty free from the end of WWII to when China took over again. The free states in the United States had pretty free markets during the first part of the 19th century. Neither were perfect, but a lot, lot free than now.

Harry Eagar said...

Yes, Hong Kong was pretty free. It was free of respect or legal protection for intellectual property.

Clovis e Adri said...

Bret.

----
A few others. Instead of focusing on something that's totally not free market like health care, why not look at things that are close to free market and show how non-free-market policies could help those?
----

Well, none of the examples of free market you mention keep the parasitic feature I am stressing.

But if Drugs, every type of them, were freely accessible to all, I guess you'd have me doing a similar argument here. You'd have an army of zombies wasting their lives and taking away people from the workforce (hence economy).

Such a free market looks to lead to worse outcomes in terms of prosperity, doesn't it?

erp said...

Clovis, Alcoholic beverages are freely sold, except to minors and although there are far too many alcoholics, they aren't numerous enough to affect the work force.

Do you think if drugs were available freely and not pushed literally on young people by those taking advantage of them for monetary gain, the problems of drug addiction would cease?

I lean toward that solution. Taking the whole drug culture out of the forbidden cool scene. Certainly what we've been doing for decades has been a failure and heroin is a strong presence in the elite schools of the northeast. It terrifies me as my granddaughter is a freshman at one of those schools and although she's a brilliant and wonderful kid, who knows what forces she might encounter.

Without the profit motive, there would be no reason to push drugs.

Clovis e Adri said...

Erp,

I suggest you should visit a crack house, afterwards you tell me if you keep the same opinion.

erp said...

… but would there be crack houses if there was no profit in creating addicts?

Bret said...

Clovis wrote: "Such a free market [illegal drugs] looks to lead to worse outcomes [e.g. "army of zombies wasting their lives"] in terms of prosperity, doesn't it?"

No.

I don't think it's even close to debatable. You have to look at all major factors and make estimates and the estimates I make tell me that it's not even close. We would be far more prosperous without a war on drugs.

Here's one of a huge number of links with an analysis similar to mine regarding the drug war.

My favorite quote:
"Prohibiting a market does not
mean destroying it. Prohibiting
means placing a prohibited
but dynamically developing
market under the total control of
criminal corporations. Moreover,
prohibiting a market means
enriching the criminal world with
hundreds of billions of dollars by
giving criminals a wide access
to public goods which will be
routed by addicts into the drug
traders pockets. Prohibiting a
market means giving the criminal
corporations opportunities and
resources for exerting a guiding
and controlling influence over
whole societies and nations.
"

Bad idea, in my opinion. And that's before we even take my quirk of highly valuing liberty into account.

erp said...

Harry,

http://www.dailymail.co.uk/news/article-3435131/Friends-girl-18-leukemia-sign-casket-loving-messages-final-goodbye-died-waiting-hospital-bed-shortage-Canada.html

Elective surgery?

Susan's Husband said...

Clovis;

"a balance between providing health care were it is needed and still avoid the pervasive use of unneeded health care"

Here's the problem for me - who decides what is "unneeded"? You treat such words as if they have an objective meaning but in situations like this they don't. This is a very common failing of progressives, using words that sound good but in practice would be highly disputed by reasonable people.

As for crack houses, our current legislative efforts clearly haven't prevented them, so I don't follow your argument that we would have them if recreational pharmaceuticals were legal. Given how well that has worked, I find it unlikely we would have substantially more in such a case.

Mr. Eagar;

OK, I will definitely blame unions for employer provided health care. It's a terrible idea that has caused enormous problems. I am strongly in favor of removing the tax loopholes that make it locally cost efficient.

erp said...

SH, of course, Harry was being sarcastic when he used the word blame because he didn't understand that when I related our trip through the health care system over the last 60 years or so, I wasn't happy with the "free" health care employers provided that in the end was far more expensive than the health care we could have purchased ourselves.

Harry Eagar said...

I am in favor of doing away with privileged health systems, too, Guy.

Something like 500,000 Americans, give or take, have died when they could gave been successfully treated -- and would have been successfully treated in any other industrial democracy -- just in this century.

Once again, you are looking through the wrong end of the telescope.

erp said...

Any comment on Laura Hiller - I believe Canada is one of the poster-child countries for socialized medicine.

Harry, you are way off because over the decades since the war, I'll bet VA hospitals were responsible for lots more than a paltry half mil deaths.

BTW - you haven't revealed what the lie is that you referenced above????

Hey Skipper said...

[harry:] Something like 500,000 Americans, give or take, have died when they could gave been successfully treated -- and would have been successfully treated in any other industrial democracy -- just in this century.

Cite, please? I'm not saying this number is wrong, only that you are so often so wrong in your pronunciamentos that your credibility is so bad as to be somewhere between a journalist's, and Hillary's.

Kind of like your assertion about unions and employer purchased health insurance in lieu of salary -- which, when you come to think of it, which you clearly didn't -- would be an astonishing thing for unions to demand. Without, that is, a size 13 boot in the bum from Congress. (Pro-tip: when you get something that badly wrong, don't be Hillary.)

Speaking of pro-tips, I can't help but notice that the OP was, as evidenced by something as seemingly trivial as headlights, really about the chasm between capitalist economies and socialist economies when it comes to innovation. IMHO, the latest headlight innovations, for which government can take no credit, and against which government must should blame, is just one example of an untold number of incremental innovations that, over time, show socialism to be another way to spell moribund.

IMHO, those headlights will save lives. Just as other innovations in the medical field have saved lives, and far more than Harry, in his unattributed, and no doubt incomplete accounting, can count.

erp said...

Skipper, re: headlights. Only teasing you. I have no informed opinion about them, but will take your word for it that are a safety feature and I'll learn to love them. :-]

Hey Skipper said...

When I drive our (now my son's) 1992 BMW 325, and our (now my daughter's) 2006 Subaru, and compare them with the adaptive xenon headlights, the phrase "like night and day" is impossible to avoid.

Clovis e Adri said...

Bret,

---
I don't think it's even close to debatable.
---

Well, it is a good thing you are approaching this with such an open mind. It always pays to argue with people in that disposition.

BTW, your link is not working for me.



Erp,


---
… but would there be crack houses if there was no profit in creating addicts?
---

It may come as a surprise to you, but once a shot is ten times cheaper than now (because legalization!), the addicts will almost certainly buy more of it. I know, it is astonishing, isn't it?




SH,

---
I find it unlikely we would have substantially more in such a case.
---

Let me see if I get your point: you believe that supply and demand law implies that, once supply of a desired but relatively scarce item grows, demand will stay just the same? That's quite some statement, isn't it?

As it happens, contrary to US national trends where youth use of pot is declining, a state that recently made it widely accessible reported increasing use of the substance among kids.

How unexpected, right?

I suppose that, once they liberalize "recreational pharmaceuticals" (hey, nice new name you've got there - and very PC too, congratulations) that get your brain hooked in less than 10 doses of it, it is just as unlikely that you'll see "substantially more" of it.

erp said...

Clovis, the point is that crack, meth, even heroin would not be available on every street corner because there would be no profit in pushing it. Those already addicted need to be weaned off it or handled medically some how, but few if any new addicts will be created.

Not perfect, but certainly nothing like what's going on now, not only users and suppliers, but in the third world growing areas.

Clovis e Adri said...

Erp,

Your affirmation is pure non-sense. But let's not make a theoretical discussion about it, just look at Colorado and tell me how it happened to end up with more users now than before.

And if you think a lower profit per unit means the end of business, you certainly never understood how your car industry became a revolution. Or you never understood Walmart. Heck, you ought to be a socialist rooting for Bernie, for you understood as much economics as him.

erp said...

Pot users were already hooked and many probably went to Colorado. Who cares. I'm not talking about those who are already users.

My point isn't that drugs will be cheaper, my point is there won't be a profit motive for pushers to get new customers by getting youngsters hooked and my understanding of supply and demand is pretty good.

Susan's Husband said...

Clovis;

"Let me see if I get your point: you believe that supply and demand law implies that, once supply of a desired but relatively scarce item grows, demand will stay just the same?"

No, you fail to get it. My point is the supply is not scarce because Prohibition is mostly ineffective, as demonstrated by the fact that it's easy to find a crack house if you know where to look. Do you really think you or I are so much more knowledgeable than law enforcement that we can do that and they can't? Yet there are the crack houses.

You might also note that I used the phrase "substantially more" rather than simply "more".

Susan's Husband said...

Mr. Eagar;

"I am in favor of doing away with privileged health systems, too"

No, you're not. A socialized system is more privileged than a free market one. Even beyond the fact that politicized systems are, well, politicized and run on privilege for the influential, there is Skipper's point that free market systems move things from the realm of the privileged down the economic scale over time, which socialists systems do little of.

On the other hand, this is such a non-sequitur that even if true is utterly meaningless to me. What is your actual point? Is there some journalistic code that forbids you from writing what you mean?

Bret said...

Clovis wrote: "...it is a good thing you are approaching this with such an open mind..."

I can't have an open mind about everything. I don't have an open mind about the color of the sky on a clear day either. Some things are just that clear and obvious to me.

Don't know why the link doesn't work for you. It works for me.

Here it is spelled out:

http://www.countthecosts.org/sites/default/files/Economics-briefing.pdf

I can take that, paste it into the browser URL window and up it comes.

Bret said...

Clovis,

The other thing that strikes me is that you're the first person I've ever encountered that has stated that drugs should be illegal because of "prosperity."

The usual reasons are:
* Conservatives might say that god forbid anybody should do anything we think god should forbid.
* Progressives might say that god forbid anybody should make a profit at anything and here's something we can get away with making illegal to make a profit.
* Others across the spectrum might say that the devastation to some individuals by drugs is so horrific that WE MUST DO SOMETHING!!!!!

But most people I've encountered agree that it's costly and damaging to prosperity to do prohibition sort of things. That was proven here in the 1920s.

So the debate with most people is whether or not the cost is worth it. Not whether or not prosperity is increased. You're unique in my experience in that respect.

Hey Skipper said...

[harry:] Short story: NHS is not collapsing. You only have to wait in Canada for electives; urgent care is delivered immediately. In only 1 country do people die for lack of care: USA.

Oh, goody, Harry's Bag o' Bollocks is getting even fuller. Lots fuller.

Thousands dying of sepsis because of poor NHS care: Delays in diagnosis means chances to save lives are being missed.

Elderly dying due to 'despicable age discrimination in NHS.

NHS failing cancer patients with life-threatening delays.

More NHS hospitals breach waiting times for cancer treatment.

NHS 111 scandal: 25 deaths blamed on ambulance delays
Exclusive: The deaths of up to 25 patients have come under investigation, after whistleblower reveals extent of policy that delayed help for seriously ill patients
.

Happy Birthday To Great Britain's Increasingly Scandalous National Health Service

Hey Skipper said...

[harry:] The VA was successor to the Veterans Bureau, famous as the most corrupt of the spectacularly corrupt agencies under the Republicans.

Oh my, Tar Brush is a fun game. Let's play another round: Woodrow Wilson is famous as the most racist of spectacularly racist progressives.

erp said...

Skipper, my kind of moral relevance :-}

Wilson gets a prog pass because being actively pro-Soviet trumps disdaining darkies.

Hey Skipper said...

Warning: no effort was expended whatsoever in proof reading.

[Clovis:] Being a good Libertarian, you went straight to the matter of freedom. But please also notice your point is not entirely coherent: "I'm more than happy to live with the imperfections that fall short of fraud, false advertising, or other criminal and unethical activities."

Of course freedom is a large part of it, but the rest lies in the unacknowledged assumptions underlying the quote; that is, a free market has imperfections and market failures. Since they obviously exist, then they are obviously identifiable, and we would always be better having a less free market, because a free market with those failures would be worse.

But if that was true, then a planned economy should out perform a free market economy, right?

Since that never happens, then there is a flaw in the unacknowledged assumption. It is one thing to posit that market failures exist, and another one entirely to accurately identify and correct them and not leave matters worse than they were before.


What if the said criminal activity was outlawed exactly because it is parasitic to individuals? Drugs are the perfect example.

Drugs are tough. I lean toward personal freedom — that there should be no laws against consuming drugs. Of course, I am making my own unstated assumption: that the capacity for addiction is specific, not general. Which is a poor way of saying that in a population, some fixed percentage (my guess, around 10%), have addictive personalities. No matter what drugs are on offer, a specific 10-ish percent will be addicts, and the other 90% won't.

I don't know if that amounts to an army of zombies, but if my assumption is true, then drug prohibition doesn't achieve much — being an alcoholic doesn't seem to have much to recommend it over being a coke head.

(Full disclosure: I have never consumed, even in the Clintonian sense, illegal drugs.)

So if I was the Head Dude What's in Charge, I would legalize the consumption of all drugs, and control the sale and distribution of them.

I know crack-houses are horrible; addiction is horrible. But laws don't stop addiction.

And there is no ignoring that people are dying in increasing numbers from some drugs, and this time they are white.

The question is: what's the least worst alternative?

Hey Skipper said...

The question is: what's the least worst alternative?

It may come as a surprise to you, but once a shot is ten times cheaper than now (because legalization!), the addicts will almost certainly buy more of it. I know, it is astonishing, isn't it?

Seems a safe enough assumption, with some caveats. First, there is, per the link above, an upper limit to consumption. And second, since addiction causes so much harm to the addict, is it better for the addict to obtain that harm more cheaply, or more expensively?

Let me see if I get your point: you believe that supply and demand law implies that, once supply of a desired but relatively scarce item grows, demand will stay just the same? That's quite some statement, isn't it?

Of course it won't stay the same, but it won't grow without bound, either. Gas prices in the US have plummeted. Has driving increased commensurately?

(He types, hoping with every letter that he isn't reproving the hazards of argument by analogy.)

Your affirmation is pure non-sense. But let's not make a theoretical discussion about it, just look at Colorado and tell me how it happened to end up with more users now than before.

I am going to risk another argument by analogy. Over the last forty years, the social costs to women of reporting rape has gone way down. IIRC, the reported incidence of rape has increased. Does that mean rape has increased, or the reporting of it?

Similarly, with marijuana, if the costs to reporting go away, and with it the effort to hide consumption, did marijuana usage actually increase?

(My bet is yes, but by much less than the headline numbers.)

What if you run experiments in many different universes and conclude that absolutely private health care ends up holding back societies, compared to single payer (or any of the European style settings)? I wonder if the parasite analogy could be part of the reason.

Hypotheticals face the same problem as argument by analogy. They are only worthwhile if they either clarify the issue, or demonstrate that there is more to the issue than appears to be the case.

Your hypothetical presumes the result, which is a form of question begging.

Which means you are ignoring the possibility that the OP highlighted: innovation. At any given instant, it is easy to demonstrate that US health care is more expensive and inefficient than European settings.

But if European settings are relatively ossified compared to the US (and that is true in many other areas), then the real comparison isn't between relative costs now, but relative benefits at some time in the future.

Clovis e Adri said...

---
[Bret] But most people I've encountered agree that it's costly and damaging to prosperity to do prohibition sort of things. That was proven here in the 1920s.


[Skipper] Of course, I am making my own unstated assumption: that the capacity for addiction is specific, not general. Which is a poor way of saying that in a population, some fixed percentage (my guess, around 10%), have addictive personalities. No matter what drugs are on offer, a specific 10-ish percent will be addicts, and the other 90% won't.
---

That's the central assumption behind all this discussion, and the assessment of costs and benefits depends crucially on that.

The 10% rule is only a good guide to "natural" drugs such as alcohol, gambling and so on. Chemical drugs can be produced in ways to induce any level of dependency you want, on any one.

The "zombie" scenario, to be fair, is indeed unlikely to happen but as a transient period. Not because only 10% of population is passive to addiction, but because the more likely scenario is one where drugs are calibrated to maximize both addiction and economic return for the drug companies.

If they create zombies (i.e. people too wasted to work and bring money) they would cut their own profits. If they create people who can still work well - as long as they have the drugs with right periodicity - they have an optimal strategy.

Alas, that happens to be exactly the case with parasites. Too deadly ones, like HIV, tend to evolve in time to become less deadly in their own interest, like supposedly happened with the Hepatitis virus, and many other ones.

So the standard argument for drugs legalization poses that, given the relatively low propensity to addiction (your 10% rule), the costs of Prohibitions surpass their supposed benefits (lesser number of severe addicts). Stated that way, I think those arguments are flawed - propensity to addiction is easily manipulated by chemical engineering.

The argument actually should be: what's more costly to society, the present war on drugs or an orderly and sheepish population paying their due to pharmaceutical parasites?

I tend to favor the first option for the very same reason Bret chooses the second: Freedom. Enforced order tends to be more honest, and less efficient to take freedom away, than blissful servitude.

Second to that, I also think the present costs (with less than 10% of society in addiction, plus collateral damages of enforcement) is still cheaper than 90% of society infected by those neo-techno-parasites. Hence my prosperity argument.


I may well be wrong and the future may bring to us all sorts of "recreational pharmaceuticals" that won't cause any damage at all, who knows. My guess though is that, as with everything else in life, there are no free lunches, and any such non-addictive drug would fail to be fun at all too. Just like non-alcoholic beer.

Bret said...

Clovis,

Let's start with the definitional. To me, lessened "prosperity" specifically means reduced GDP and GDP growth relative to what it would otherwise be. Do we have the same definition or no?

Clovis wrote: "Enforced order tends to be ... less efficient to take freedom away..."

LOL. Yeah, because it's hard to take something away that's already gone! It's hard to take freedom away from people who are already prisoners, too; and serfs, for that matter. You would've loved the Soviet Union where enforced order was quite present and I guess that means you think the Soviet citizens were endowed with tons of freedom?

Clovis wrote: "...propensity to addiction is easily manipulated by chemical engineering."

I disagree. I, of course, would never have used a wide range of recreational chemicals in my youth, but had I done such, I'm certain that personal experience and observations of others would've told me that you are likely mistaken.

While the brain chemistry cause of the "high" differs between drugs, the addictive brain chemistry does not: "The dopamine dysregulation in the limbic system of the brain seen in addiction is not able to tell the difference between addictive drugs."

Every other part of the addiction is relatively easy to beat (i.e. symptoms are relatively short lived), except that one. There's a huge problem with cross addiction because of it.

Clovis wrote: "...any such non-addictive drug would fail to be fun at all too.."

Why the focus on addiction?

For example, more than 80% of adult americans drink coffee and more than 90% drink caffeinated beverages regularly (as in mostly daily). Caffeine is fun and addictive. The typical withdrawal symptoms include: headache, sleepiness, irritability, lethargy, constipation, depression, muscle pain, stiffness, cramping, brain fog, and on and on. I personally drink tea in the winter and then generally quit in the summer and suffer many of those symptoms for a week or two when I stop.

Do we think we adult americans would be better off without coffee, tea, etc.? More prosperous? Are we in "blissful servitude" because of this particular addiction? Do most users even know that they're addicted? Do they care? Why would they? Should they?

Caffeine is probably somewhat less addictive than alcohol and tobacco (other legal recreational drugs), yet more people use caffeine than either of the other two. If addictiveness is the major predictor of use (as you seem to imply), why is that so?

I think addiction is like the bogeyman under the bed. Really scary, but, in reality, not inherently a problem in-and-of-itself as shown by the caffeine example. The problems caused by recreational chemical use are much more complex than whether or not it's addictive.

Clovis e Adri said...

Bret,

---
You would've loved the Soviet Union where enforced order was quite present [...]
---
Sure, because to outlaw drugs is just like - if not worse than - tyrannical USSR.

I guess that's why Libertarians are known for their common sense and practical nature.


---
Clovis wrote: "...propensity to addiction is easily manipulated by chemical engineering."

[Bret] I disagree. I, of course, would never have used a wide range of recreational chemicals in my youth, but had I done such, I'm certain that personal experience and observations of others would've told me that you are likely mistaken.
---

It looks like that, other than doing some dope back in the days, you share with Bernie a distinct view of capitalism - one that denies the very point the OP is selling in this thread. I propose you too should vote for him.

Given the proven record of innovation in pharma and chemical industries, you pose that a world with no laws against any kind of drug would still be locked in the old stuff you and Bernie used to take?

The present stuff already shows wide variation in addiction effectiveness. Unless you are denying so, I can't see why you doubt free market innovation forces *only* in this specific case.


---
Why the focus on addiction? For example, more than 80% of adult americans drink coffee ...
---
Sure, because coffee is just like - if not worse than - crack or... hey, did I mention already how common sense is just so prevalent around these corners?


---
The problems caused by recreational chemical use are much more complex than whether or not it's addictive.
---
True. Maybe someone should then try to outlaw that stuff before it gets even more complex...

Bret said...

Clovis wrote: "Sure, because to outlaw drugs is just like - if not worse than - tyrannical USSR."

That was sarcastic exaggeration on my part. Sorry I didn't mark it as such.

Nonetheless, "enforced order" is still the opposite of "freedom," at least in my internal definitions.

Clovis wrote: "Sure, because coffee is just like - if not worse than - crack..."

Just like I don't get your focus on addiction, I don't get your focus on crack. Maybe it's a really big deal in Brazil, but here in the United States it's a nothing drug: "Of the 7.9 percent of Americans currently using illegal drugs, 76.4 percent of them have used marijuana in the past 30 days, compared to 2.4 percent using crack."

Clovis wrote: "Maybe someone should then try to outlaw that stuff..."

More enforced order? Should we impose enforced order on alcohol use too?: "Excessive alcohol use led to approximately 88,000 deaths..." Or how about tobacco?: "Cigarette smoking is responsible for more than 480,000 deaths per year in the United States..."

These are important questions because: we've had experience as a country making alcohol illegal (prohibition) and it didn't go well; and some medical researchers think that alcohol is worse than heroin and crack. From what I've seen, that's quite believable.

Harry Eagar said...

'A socialized system is more privileged than a free market one.'

You'll have to explain that one to me since in my universe a system where everybody gets care is less privileged than one in which 1 in 6 don't.

But it's true that the dead complain less.

erp said...

Harry, refresh my mind, where exactly is your system again?

Hey Skipper said...

[harry:] Short story: NHS is not collapsing. You only have to wait in Canada for electives; urgent care is delivered immediately. In only 1 country do people die for lack of care: USA.

[followed by many examples to the contrary]

Harry, It's already been explained: your universe is like ours, except without facts.

Hey Skipper said...

[Clovis:] The present stuff already shows wide variation in addiction effectiveness. Unless you are denying so, I can't see why you doubt free market innovation forces *only* in this specific case.

Does it? By that I mean, does the variation in addiction effectiveness mean expanding the subset of the population that is addicted, or just varies in effectiveness within the already addicted portion of the population?

Given the proven record of innovation in pharma and chemical industries, you pose that a world with no laws against any kind of drug would still be locked in the old stuff you and Bernie used to take?

You seem to be ignoring the innovation in the illicit pharma industry. It is the one that makes plenty of profit, and pays only that amount of attention to laws required to get around them.

erp said...

Would illicit pharma have a reason to exist without a profit motive? Addictive personalities could get their fixes legally at affordable prices with the added assurance that various "additives" like rat poison and other of that ilk weren't part of the mix.

As far a alcohol is concerned, it's none of our business if the drunk isn't driving or out in public where he or she could get into trouble. Does anyone know why the laws against vagrancy and public drunkenness were changed? It would take care of much of the homeless population if they were restored.

Clovis e Adri said...

Bret,

---
Nonetheless, "enforced order" is still the opposite of "freedom," at least in my internal definitions.
---
AFAIK, Libertarianism is enforced order too.

But you miss the comparative in that earlier statement of mine. Enforcement is always imperfect, subject to numerous limitations the enforcer may face. Self-enforced servitude doesn't share those limits.

---
I don't get your focus on crack.
---
Because it is a good example of a drug cheap, powerful and highly addictive. And yes, it is a problem in Brazil, creating zombie-lands in our larger cities.

---
Should we impose enforced order on alcohol use too?[...] These are important questions because: we've had experience as a country making alcohol illegal (prohibition) and it didn't go well;
---
No, you shouldn't. I actually answered it before: those are cases where intrinsic limitations to addictiveness and damage make Prohibition worse than non-Prohibition.


Well, that and culture. I wouldn't be so naïve as to lose my time advocating for crack Prohibition in a country where most people used it. In this case, I would move out if that were more of a problem for me than for them. Likewise, since I do live in a culture where crack is forbidden, I prefer to keep it that way and invite our zombies out if that is a problem for them.

---
and some medical researchers think that alcohol is worse than heroin and crack. From what I've seen, that's quite believable.
---
What is believable is that it fits the very definition of chutzpah.

Make heroin and crack as free and easily accessible as alcohol, and re-run your medical statistics, you smart "medical researchers".

Clovis e Adri said...

Skipper,

---
Does it? By that I mean, does the variation in addiction effectiveness mean expanding the subset of the population that is addicted, or just varies in effectiveness within the already addicted portion of the population?
---
I return the question: since the Cigar industry started to use nicotine-enhanced tobacco plus chemical treatment to make its cigars more effective at addicting smokers, do you believe it did so to sell more cigars to their present customers, or to make sure a greater number of newbies settled as permanent smokers?

I tell you, embrace the power of "AND".

---
You seem to be ignoring the innovation in the illicit pharma industry. It is the one that makes plenty of profit, and pays only that amount of attention to laws required to get around them.
---

I am not, I only think their innovative power will be like comparing cavemen with fighter jets' pilots when, and if, the many geniuses at big pharmaceutical companies enter that business.

erp said...

Clovis, do think the campaign against cigarette smoking has been effective? Are young people in Brazil smoking cigars?

I believe here it has been phenomenally so and I believe public opinion campaigns including movies and television making drugs appear only for losers, etc. can also work.

We can't worry about those already in crack houses and opium dens, we must work on making drugs and alcohol unattractive to young people and that goes for beer commercials. We haven't watched television in years, but I remember that they were just short of orgiastic the last time I saw one and can only imagine that they've been ratcheted up since then.

What we are currently doing is making the problem worse.

Susan's Husband said...

Bret, for Turing's sake, can you not make blockquote an allowed tag?

Mr. Eagar;

I wrote: A socialized system is more privileged than a free market one.

You wrote: You'll have to explain that one to me since in my universe a system where everybody gets care is less privileged than one in which 1 in 6 don't.

I honestly don't think I can, you have proven very resistant to such explanations in the past. But, beyond Skipper's examples, one need merely look at Cuba to see who gets top end care and who doesn't. The latter category is certainly much larger than 1 in 6. Socialized system change the power of cash to the power of influence and connections which is almost always much worse in terms of equality. It is much easier for a random person to accumulate cash than to acquire influence, plus there are far more rewards for decreasing cash costs but few to negative for decreasing influence costs.

Bret said...

Susan's Husband wrote: "Bret, for Turing's sake, can you not make blockquote an allowed tag?"

I don't think so. I've googled many combinations of "blogger comments html tags allowed ..." and it looks like the answer is no. If anyone could figure out how, I'd be very happy to add that.

Bret said...

Clovis wrote: "Enforcement is always imperfect, subject to numerous limitations the enforcer may face. Self-enforced servitude doesn't share those limits."

I'm sure what you're trying to say here. Are you saying that it's easier to break the law than to break an addiction therefore a person is freer under a regime of drug prohibition?

Clovis wrote: "...those are cases where intrinsic limitations to addictiveness and damage make Prohibition worse than non-Prohibition."

Intrinsic limitations to addictiveness and damage from alcohol? What do you think those intrinsic limitations are? [Well, I guess I should make small disclosure here. My dad was a severe alcoholic and a homeless drunken bum for much of his life.] I've seen alcoholism up close and personal and I can assure you that the only limitation to addictiveness and damage from alcohol is death.

Clovis wrote: "Make heroin and crack as free and easily accessible as alcohol, and re-run your medical statistics, you smart "medical researchers"."

Pretty much done (yes, they're not quite as cheap and as available as alcohol, but an interesting data point that's along the lines of what you're suggesting).

Clovis e Adri said...

Bret,

---
Intrinsic limitations to addictiveness and damage from alcohol? What do you think those intrinsic limitations are?
---
If you expose most of the population to periodic use of alcohol, only a small part of it, typically less than 10%, will develop severe addiction.

If you do the experiment with crack, a larger number will be affected, in faster and more intense ways.

---
Well, I guess I should make small disclosure here.
---
Well, I can think of statistics and make arguments, but I won't ever be able to truly share that particular scar in your soul. I am sorry.

---
Pretty much done (yes, they're not quite as cheap and as available as alcohol, but an interesting data point that's along the lines of what you're suggesting).
---
No, that's not in any contradiction with what I think.

In Brazil we actually have the same policy: users of drugs no longer get prison time. And I absolutely agree with that.

But, just like Portugal, drug dealers are still prosecuted and seen as serious criminals.

And please notice that such a policy still makes access to heavy drugs harder and expensive.

---
Are you saying that it's easier to break the law than to break an addiction therefore a person is freer under a regime of drug prohibition?
---
Yes, I am.

Reflecting on Libertarian creed, I think a policy based only on consent is a bit meaningless when consent itself loses meaning over time. You may consent start using the stuff, but after a while you are not really practicing consent anymore.

Harry Eagar said...

Cuba? Let's look at every other industrialized nation.

I bet you will be surprised to learn that in Japan, patients don't even make appointments. They just walk in and expect attention right away.

Japan's costs are a small fraction of America's and everyone gets care.

'It is much easier for a random person to accumulate cash'

Not true. About one-third of the world is pay-as-you-go, and about one-third of the world gets no health care at all.

Harry Eagar said...

'I've seen alcoholism up close and personal and I can assure you that the only limitation to addictiveness and damage from alcohol is death.'

Amen. I had plenty of experience with that in the newsroom where hard drinking was encouraged. (50 years ago; mores have changed since then.)

When it comes to addictions, cultural norms control far more behavior than legal restrictions do. At least in societies where cultural norms really are stable.

We have a young woman working for us now who's in Drug Court for crystal meth. I asked her why she started, hadn't she seen the effects of ice addiction? She hadn't. She grew up in country club circumstances where booze was the self-destructor of choice.

She didn't want to be a drunk so she used weed. It made her cough, so when a friend told her she had something that you could smoke without coughing, she said, sure, I'll try it.



Clovis e Adri said...

Erp,

---
Clovis, do think the campaign against cigarette smoking has been effective? Are young people in Brazil smoking cigars?
---
Cigar production down here peaked in 2006 and nowadays are in levels below the production in 2000.

But I have no idea to what extent it was due to campaigns or to other trends.

For example, down here binge drinking among women were pretty uncommon only 2 decades ago, but nowadays is getting as widespread as it used to be among men, if not more than.

Did alcohol suddenly get more effective at "addicting" women? I very much doubt so. The social trends and fashions behind such things are hard to follow if you are not paying much attention.

Bret said...

Clovis wrote: "If you do the experiment with crack, a larger number will be affected, in faster and more intense ways. "

Do you have references? How many more is this "larger number"? What do you mean by faster and more intense? Does it matter, even if true? Any why? For example, yeah, my dad was a drunken bum for decades - would it really have been worse for him, me, or society if he had been a crack head for only a few years before he died earlier? (It certainly wouldn't've been worse for me - he's the only person where the news of his death made me feel relief).

Here's one of the huge number of references that begs to differ with your statement:

"A study was conducted using 1,081 U.S. residents who had first used cocaine within 24 months prior to assessment. It was found that the risk of becoming dependent upon cocaine within two years of first use was 5–6%; becoming dependent within 10 years after first use increased to 15–16%."

Looks like more or less the same as alcohol. It goes on to say:

"However, a study of non-deviant users in Amsterdam found "relative absence of destructive and compulsive use patterns over a ten year period" and concluded that cocaine users can and do exercise control. "Our respondents applied two basic types of controls to themselves: 1) restricting use to certain situations and to emotional states in which cocaine's effects would be most positive, and 2) limiting mode of ingestion to snorting of modest amounts of cocaine, staying below 2.5 grams a week for some, and below 0.5 grams a week for most. Nevertheless, those whose use level exceeded 2.5 grams a week all returned to lower levels".[7]"

Also sounds much like alcohol, or, in fact, not as bad as alcohol.

I did a lot of research regarding addiction and alcohol because of my dad and because of that research I used to dream that he would substitute cocaine or heroin for his alcohol addiction. It couldn't've been worse and, especially if legal, would likely have been better (though still far from good).

Oh, and while the above excerpts were for cocaine, crack isn't that much more addictive: "There is very little evidence to support the claims that crack is more addictive than cocaine. According to the National Household Survey on Drug Abuse in 2004 of Americans age 12 and older, 5.9% of individuals who had ever tried cocaine went on to be "current users" (reported use within the past 30 days). The same statistic for crack use was also 5.9%. These numbers show no statistical difference in the tendency towards the future use of cocaine and crack."

Bret said...

Clovis wrote: "I think a policy based only on consent is a bit meaningless when consent itself loses meaning over time. You may consent start using the stuff, but after a while you are not really practicing consent anymore."

This is nonsensical to me. I assume you drink coffee regularly? If so, you probably are (at least) slightly addicted to it. Are you not still choosing to drink the coffee? Is it not you that's moving the cup of coffee to your lips to drink? Is it some external entity?

Have you ever been addicted to anything else? Why do you think other addictions are all that much different? Why do you think that those folks aren't choosing to take more of the drug of their choice? They're not puppets. I've seen a lot of people take a lot drugs. It's always a choice. Some choose better than others.

erp said...

Guys, addicted needs to be defined. People who are addicted to drugs or alcohol lose all control and have sold their babies, killed, maimed to get it. The addiction rules them and they are apparently unable to control it.

I read long ago that heroin addiction is impossible to overcome and the best way to deal with it, is to make it available to addicts who can live normal lives when they don't have to stress over having it available. That's when methadone was introduced. I haven't heard about that in a long time, so probably it didn't work as advertised.

Comparing that to coffee or chocolate kisses is silly.

Bret said...

erp wrote: "...addicted needs to be defined."

It's a continuum. For every drug there's a wide range of addiction experiences. There's no cutoff, no black and white. That's why if you drink coffee regularly, you know what it's like to be addicted. Some people drink 20 cups a day and they have a hard time stopping with really severe withdrawal symptoms, similar to someone seriously addicted to cocaine or meth.

And it's not like there's a dividing line - one dose you're not addicted and then the next you are. Dependence increases over time.

erp wrote: "I read long ago that heroin addiction is impossible to overcome..."

That's a myth.

No drug causes every user, or even most users, to become hopelessly addicted. It is also possible, with every drug, no matter how badly addicted, to overcome that addiction. Only sudden withdrawal from alcohol and Benzodiazepines (does anybody actually use these recreationally?) can kill you. Withdrawal from the rest (such as heroin), if seriously addicted, is just really miserable.

However, I would agree that if a user is uninterested in stopping the simplest thing is to just have him keep using it: "Like most opioids, unadulterated heroin does not cause many long-term complications other than dependence and constipation." Preferably not with needles though.

Clovis e Adri said...

Bret,

---
Do you have references? How many more is this "larger number"? What do you mean by faster and more intense?
---
I do (and it is the same as one of yours, but now directly referenced). Relevant quotes:

"[From abstract] Whereas some 15-16% of cocaine users had developed cocaine dependence within 10 years of first cocaine use, the corresponding values were about 8% for marijuana users, and 12-13% for alcohol users. The most novel findings of this study document a noteworthy risk for quickly developing cocaine dependence after initial cocaine use, with about one in 16 to 20 cocaine users becoming dependent within the first year of cocaine use. For marijuana and alcohol, there is a more insidious onset of the drug dependence syndrome."

"[Page 5] As reflected in both the larger figure and the inset,
there is continuing risk for experiencing cocaine dependence
a decade or more after initial cocaine use. Both the
larger figure and the inset show less explosive development
of marijuana dependence among marijuana users.
Whereas some 15–16% of cocaine users had developed
cocaine dependence within 10 years of first cocaine use,
the corresponding values are about 8% for marijuana users,
and 12–13% for alcohol users (Figure 4)."


You tell me that "Looks like more or less the same as alcohol", and I beg to differ, because those results compare development of dependence between a substance largely available (and socially accepted) and another orders of magnitude more expensive and harder to obtain.

When I say "If you expose most of the population to periodic use of it", I mean strap them to a chair and inject it a few days per week, and physiological dependence will develop a lot faster with cocaine. Plase also notice how this statement differs from far more limited studies as the above one.

And there again, my argument was also about potential of future drugs, to which the above results would be seen as trends.


As for crack X cocaine, that study you refer to is irrelevant as it traces first users: again, not a comparison of physiological potential to dependence by periodic taking. I have met recreational users of cocaine, but have you ever met recreational users of crack? Either you get out of it earlier, or you don't.


---
Does it matter, even if true? Any why? For example, yeah, my dad was a drunken bum for decades - would it really have been worse for him, me, or society if he had been a crack head for only a few years before he died earlier? (It certainly wouldn't've been worse for me - he's the only person where the news of his death made me feel relief).
---
I would rather not treat the argument at such personal level, Bret.

But if you want to know what I get from the above, it is that stronger drugs may be better since they can kill the user earlier. It is not an argument that really helps your point for liberalization, IMHO.

Clovis e Adri said...

Bret,

---
I assume you drink coffee regularly? If so, you probably are (at least) slightly addicted to it. Are you not still choosing to drink the coffee? Is it not you that's moving the cup of coffee to your lips to drink? Is it some external entity?
---
I do drink coffee. And I am slightly addicted to it, proudly so since my daily intake is certainly within the bounds where it is a healthy habit.

---
Have you ever been addicted to anything else?
---
Yes, I have and I still am.

I tried to stop many times, but it is too good a thing and I always come back, even though it takes time from my work, my family and steals my mind away...

I am an addict at greatguys.blogspot.com - that's it, I fully confess.


---
Why do you think that those folks aren't choosing to take more of the drug of their choice? They're not puppets. I've seen a lot of people take a lot drugs. It's always a choice. Some choose better than others.
---
Do you believe that dropping the addiction is a choice just like, let us say, using your red shirt today is a choice?

Being now a father, do you believe that your father freely chose to follow a life of alcohol abuse and homelessness over taking care of his children and family? Would you conceive taking that choice of drugs over your own family?

erp said...

Waaaaaaaaaay OT. I need advice. My 17 year old grandson is not a good student. I'm not sure if that's because of the less than ideal home situation or he missed the math gene characteristic of others of the casa erp clan. His PSAT score of 1150 wasn't horrible, but certainly not the stuff of dreams (his). On top of that, he doesn't have a can-do attitude, but waits for others to make things happen.

Long intro.

His mother wants to spend $7,000 on additional private tutoring, something he's had all along, at similarly astronomical costs, before he takes the SAT (the new version) in June. Friends, now retired, who've been in public school administration all agree that private tutoring is only useful short-term for specific problems and long-term tutoring makes an unenthusiastic student dependent which is exactly what's happened here.

He's a big, good looking kid, a boy scout leader and also rows with a private club that is very expensive which we also support in part and goes to one of the nominally best high schools in the country deep in the belly of the beast that is the bay area of California.

In surfing around I found the Khan Academy which sounds ideal. Do you guys think it worthwhile pushing this idea or some other prep course on a kid lobbying for private tutors while making the relationship with his mother even worse.

We are willing to finance anything within reason.

Bret said...

erp,

Well, most of the comments have been "off topic," but I've never cared about that sort of thing. If a post about headlights stimulates discussions about drugs and education, it works for me - creating any interesting discussion is one of the main purposes of this blog and any "off topic" works for me.

I use Khan academy stuff for my daughters now and then. Generally, they'll need some help with some topic like something in probability and statistics, and it's sometimes hard to teach over the phone (older daughter is on the other side of the country at college), so I'll go to Khan and find the appropriate lesson(s) and point her at it.

Unfortunately, Khan seems to be mostly set up to be a self study program and requires a moderate amount of self-motivation ("can-do attitude"). Perhaps a tutor or parent could help direct it, but I'm not sure it would help much with the SAT.

As far as the SAT goes, we did the tutoring thing for the older daughter and I don't think it was terribly useful for her, but each kid is different, so I don't really have a recommendation for your grandson. My daughter generally understood all of the math but just makes stupid mistakes on tests. If your grandson has SAT math topics that he could use help with to understand them, then perhaps a tutor would be helpful.

erp said...

Thanks Bret both for your laissez faire attitude and your thoughts which just about echo our own.

Let's see if a question on how to motivate a kid goes off tangent (little trig lingo) into a discussion on a new idea (to me) to have the entire world in one time zone.

Bret said...

Clovis wrote: "I am an addict at greatguys.blogspot.com..."

LOL. Hopefully no worse for you than your caffeine addiction...

Clovis wrote: "Do you believe that dropping the addiction is a choice just like, let us say, using your red shirt today is a choice?"

I think it's more like choosing to get in shape, or lose weight, or learn a new skill. It takes more work than choosing to wear a red shirt. It's still a choice and it's still achievable.

Clovis wrote: "...do you believe that your father freely chose to follow a life of alcohol abuse and homelessness over taking care of his children and family?"

Absolutely his choice. As you can probably imagine, I had quite a few conversations with him on the subject. He explicitly chose drinking. Not even because it would be hard to stop for him, but because he preferred drinking to being part of his family. He said that and it was perfectly clear.

Clovis wrote: "Would you conceive taking that choice of drugs over your own family?"

Given the convincing conversations I had with him I can easily conceive that some people would choose drugs over family. I would not personally make that choice since raising children has been by far the most fulfilling part of my life. But, we're all individuals and choose different things.

My life would've been somewhat better if he didn't drink. Would've his life? I don't think so. I think if the homeless and other unpleasant episodes were removed, he definitely would've preferred his drunken existence to any likely alternative. With the unpleasant episodes? He did quit smoking and substantially cut back on drinking in the last few years of his life so I think he was maybe tiring of the drunken bum lifestyle in the end. But that also kinda proves he could've stopped earlier if he wanted to. But he chose not to.

Harry Eagar said...

Unless a kid just hates taking tests, I think the best, cheapest preparation for the SAT is the SAT. Take it twice. Count the second one. (Though I have known people who did worse on the second try.)

I don't think much of the SAT, but it or ACT is hard to avoid, I guess.

Back to addiction. A friend of mine was a big time coke addict and dealer. She got caught and jail scared her to death. So she went cold turkey on coke. But she had an addictive personality. What she was really addicted to, it turned out, was excitement.

She could not stand to be still. So she ran up bills she couldn't pay and got her kicks avoiding the bill collectors and process servers.

It would have been funny except that her son picked up on the coke and ended up dead at age 19.

We have a saying in Hawaii: 'Ass why hard. It means you can't always get what you want.







0

Bret said...

Clovis wrote: "...another orders of magnitude more expensive and harder to obtain."

Is it really that hard to obtain drugs like crack in Brazil? I suppose it depends what exactly one is comparing, but is it really that much more expensive? Cocaine (and therefore crack) was not at all hard to find and the cost wasn't really a limiting factor when some of those around me were into it all those decades ago, and my understanding is that it's gotten much, much cheaper: "George Will notes that the price of cocaine has dropped between 80 and 90 percent over the last three decades."

In the United States, during the 19th century, both alcohol and narcotics (including cocaine) were widely available, completely legal, and very cheap. There were problems from both and statistics from the period are weak. Nonetheless, when both are available and legal, neither seems to create an overwhelming problem.

Clovis wrote: "...have you ever met recreational users of crack?"

Of course. You know it's trivial to turn cocaine into crack, right (especially for college folk with aspiring young chemists wandering about)? The cocaine users I knew would occasionally cook up some crack and use it. They were not generally addicted to either.

Bret said...

Harry wrote: "... her son picked up on the coke and ended up dead at age 19."

Very sad. Overdose?

Harry Eagar said...

No. The circumstances were obscure but he was trying to get tight with a group of users/dealers who went back a ways together. There was a bust, they left the new guy holding the bag and one way or another he ended up dead.

From what I understood, the cops didn't kill him but it wasn't clear who did. No one was charged.

'neither seems to create an overwhelming problem.'

This is partly a matter of definition. In Japan when a guy gets drunk and passes out in the gutter it isn't considered a problem. In America it is. (Just as, 40 years ago when a guy got up in front of a civics group and told a series of coon jokes, it wasn't considered a problem but today it is, usually.)

The demand for drugs is inelastic in a special sense -- some people won't buy even if the price falls to 0. Me, f'rinstnce. The block pot dealer has branched out to ice and has been grooming me as a customer. But when he offered me a free sample last Friday after I finished my monthly webcast, I turned him down.

It is worth asking why he added a new line. He's been selling grass successfully (with occasional short terms in jail) for a long time. It looks to me like a new connection came on the scene and recruited him to be a subdealer for ice.

My question is, why did he take him up on it? The financial upside for John (the pot dealer) cannot be very high but the prison time downside, with his past record, for an ice bust will be huge.

Well, I never believed markets work the way the rightwingers say they do.



Clovis e Adri said...

Bret,

---
Not even because it would be hard to stop for him, but because he preferred drinking to being part of his family.
---
I am feeling a bit cheated here, Bret.

Either alcohol had nothing to do with your father situation, and you bringing it up in our present context was a red herring, or you are in a bit of denial about how addiction impacts choices (or the capacity for making them).


---
Is it really that hard to obtain drugs like crack in Brazil? I suppose it depends what exactly one is comparing, but is it really that much more expensive?
---
You are probably asking to the wrong person, as I never did a proper assessment of that market.

What I can tell you is that crack is relatively cheap - way cheaper than cocaine - hence the drug of choice of many poor people. Yet, as they are poor, they often run out of money to pay even what isn't so expensive, and start robbing and killing people to obtain that money.

See, as it is not that expensive of a drug, I can hardly see why such a person would stop robbing and killing his fellow citizens where it also a legalized substance. Hence my cold shoulder to much of this talk about legalization.


---
You know it's trivial to turn cocaine into crack, right (especially for college folk with aspiring young chemists wandering about)? The cocaine users I knew would occasionally cook up some crack and use it. They were not generally addicted to either.
---
It just occurred to me that, maybe, a big difference of perspective on this matter comes form how we have witnessed drugs consequences.

Apparently, yours come from frat parties and such around MIT. Mine comes from watching 14 years old assaulting people in the streets.

Somehow, maybe, who knows, that capacity to resist the addiction pitfalls keeps some relation to personal life structure.

Which means it must make absolute sense to advocate a policy that is favorable to that tiny part of the population made of affluent MIT kids, as opposed to the rest of the country (or the world, actually).

erp said...

Clovis, I confess to not understanding your position on drugs.

Harry, I find it hard to believe in Japan drunks are left lying in gutter ... and don't understand the connection between that and civic club leaders telling "coon" jokes 40(?) years ago.

Prior to political correctness, jokes about all ethnicities were common and not taken seriously -- mostly it was poking fun at each other in a place where we were all in the same boat that brought us here from someplace else.

Something you might not understand coming as you do from the seat of anglo southern gentry.

Harry Eagar said...

That's not how it was. Let me tell a story about Ace Parker, maybe the greatest professional ballplayer of the midcentury.

Ace was a local hero, often asked to emcee ciic groups, which were invarialy all white. He would warm up the crowd with a few vicious coon jokes.

One day --this was about 1971 -- the local Touchdown Club was awarding its persons of the year awards. Schools had been integrated not long before.

Ace started telling his vicious jokes and everybody started squirming. You see, this year one of the high school award winners was a black coach, who was in the room. A first, all the way around.

It wasn't just poking fun and nobody -- except Ace, who was oblivious -- thought it was.

Times have changed a little. Even southern racists are usually embarrassed to be around such vile behavior in a public setting, although in private -- as we saw over and over with the Tea Party email blasts -- they have not changed a bit.

It wsn't the same boat that brought everybody there, wss it?

Bret said...

Clovis wrote: "...you are in a bit of denial about how addiction impacts choices..."

Possibly. But there's a possibility that you are instead. Or maybe a little bit of both.

Your belief seems to be that addiction (at least to certain things) is a disease and that the diseased person has limited or no capacity for control or choice in the matter of overcoming his or her addiction. That's what we've all been taught and that is indeed what I once believed as well.

You can argue that your observations and various reports, news, etc. fits with the "limited or no capacity for control or choice" belief. I agree that they do. However, my claim is that they also fit with the completely opposite model - that addicts remain addicts because they (nearly) freely choose to do so and that it is even rational for them to do so.

For the sake of my argument, for now, let's assume it's true and I'll paint a picture of how it would potentially look the same to you (that the addict has no control). The propositions are this:
1. The addict chose to become an addict.
2. The addict chooses to remain an addict.
3. The addict is rational to do so because the enjoyment and fulfillment felt from using the drug is overwhelmingly better than any other possible lifestyle. In other words, the addict is choosing the most fulfilling and enjoyable life possible for himself.

If this is true, the question then, is why do many people such as yourself believe that the addict is not making a rational choice? Consider the following:
1. You are unable to imagine the addict's perspective.
1a. You may not enjoy drugs as much as the addict due to individual variation.
1b. You have a huge number of opportunities the addict does not, including a wider choice of mates, careers, and other wealth and income based amenities
1b-1. You get more enjoyment and fulfillment from those opportunities (and the pursuit thereof) than the addict will possibly get from his opportunities.
2. Society as a whole believes the addicts' choices to be immoral and a failing of character, especially if it were believed that the addict is choosing to remain an addict.
2a. The addict's behavior is illegal (not true for alcohol).
2b. The addict is well aware of society's negative attitude towards someone who chooses to continue to use drugs.

If the above is true (and I believe it is), what happens when someone asks an addict why he keeps using drugs? Most are not going to say, "because I love taking drugs!" since that would elicit a very negative response from the questioner. They are especially not going to say that if their drug of choice is illegal. A much better answer, even if a complete lie, would be to say, "I just can't control myself, I want to quit, but I just can't." That sort of response would likely elicit sympathy instead of loathing. That sort of response is more likely to keep the addict out of jail. That response throws the responsibility from the addict to those nasty pushers, bad luck, fate, the evils of society, etc., anyone but the addict.

In the end, the addict will likely say he's not in control whether or not it's true. In one case it's actually true, and in the other case, saying it puts him in a better position even though it's false. So it's really hard to know which it is and it's probably a mixture. (continued...)

Bret said...

(...continuation from previous comment)

My dad was different in that he was brutally honest (and it was somewhat brutal). He drank because he wanted to drink and loved the drunken stupor. That's how he wanted to spend his life. And he said so. And I believe him.

I think the plight of gay men more than a half century ago is relevant to this discussion. The social stigma against homosexuality was so overwhelming that the vast majority did not "come out of the closet." Some of them chose to marry, have children, and raise a family. If they were willing (and able!) to live that much of a lie for their entire lives, then it's pretty easy for an addict to say, "Oh, I can't control myself," whether or not that's true. On the other hand, if a gay guy could overcome his sex drive and pretend to be a heterosexual family man, then it seems that an addict could overcome his addiction if he really wanted to.

Now, I'm not saying that it's not partly the drugs talking when the addict doses. But it is amazing how many of them detox and then go right back to it.

Bret said...

Clovis wrote: "Which means it must make absolute sense to advocate a policy that is favorable to that tiny part of the population made of affluent MIT kids..."

You have this upside down. Never mind that MIT kids are the most compulsive, socially awkward people on the face of the planet and more likely than most to have adverse effects from drug use. No matter how you slice our discussions above about which drug is most addictive, pretty much no matter what less than 20% of the population will become destructively addicted to drugs (and alcohol). I think waaaay less as many addicts can lead productive lives while being addicted (and more would be able to if drugs were legal).

So you advocate a policy that is extraordinarily expensive, damages the worldwide social fabric (or don't you think countries like Columbia have suffered from the United States' drug war), has created a prison population of more than 500,000 people in the United States alone, and benefits (maybe) at most 20% of the population.

That doesn't make sense to me.

erp said...

Another off-the-wall non-sequitur. Of course, situations like this are ridiculous and the Touchdown Club should have informed the great athlete than racial "jokes" are not welcome.

Allegations of racism against the tea party were false (we already went through this thoroughly on multiple strings here, so I'm not bothering with links).

The only racism today comes from the fascists on the left ... and we all were in the same boat, but almost all of us got off.

Harry, I'd be surprised if you know a single black person as an individual friend, colleague, neighbor, etc. As do most lefties, you only see people as a member of a block created by your cohorts to divide and conquer We, the People, but it ain't gonna work.

Harry Eagar said...

The club couldn't have done that because racial jokes were welcome.That's why they invited Parker.

They just didn't think things through when the laws changed.

And, yes, the Tea Party is racist through and through.

erp said...

... as I've noted before Harry, wishing doesn't make it so. The tea party isn't racist nor am I, nor are millions of people who don't share your perverted view of the world.

... if the people welcomed racist jokes, why were they squirming?

Perhaps you might review cause & effect and how they impact thought processes in the rational human brain.

erp said...

I personally knew a college student who did something very similar to this. He was an affirmative action admission, came from Boston Latin High School, once one of the best in the country, was coddled and praised, but when he got into the big leagues, he simply wasn't prepared. We never found out if he could have hacked it because he chose this course of action, was found to be emotionally unstable, left school volunatarily and went into counseling.

Clovis e Adri said...

Bret,

---
The addict is rational to do so because the enjoyment and fulfillment felt from using the drug is overwhelmingly better than any other possible lifestyle. In other words, the addict is choosing the most fulfilling and enjoyable life possible for himself.
[...]
But it is amazing how many of them detox and then go right back to it.
---

The medical literature on addiciton often distinguishes between the physiological addiction and the psychological one.

IMHO, with exception to few cases, a person in the belief that "the enjoyment and fulfillment felt from using the drug is overwhelmingly better than any other possible lifestyle" is only following the psychological addiction. Which is the same reson they go right back to it after detox (i.e. after the physiological addiction is weaned off).

It is similar to people addicted to gambling. Even though such a person also develops a bit of physiological dependence to that, it is obviously very minor compared to the psychological one.


I understand you are, following your usual worries about freedom, very aware of classifying other people behavior based exclusively on your own parameters. And anything touching the word "psychological" tends to be taken with a grain of salt. Yet, in this case, I believe it is a far less subjective matter than you may think.

Back to my parasite analogy, your argument sounds to me like saying this spider, when hosting a parasitic vasp like this one, is just following what it judges to be the most fullfilling way to go with its life. (In this case, it is fullfilled indeed, pun intended.)

You may thrown whatever high arguments for freedom you want, I just won't be convinced that being a homeless bun, subject to abuse, rape, dirt, cold, disease and hunger, is just a matter of point of view and simple choice.


---
You have this upside down. Never mind that MIT kids are the most compulsive, socially awkward people
---
I actually did not intend to single out MIT in particular. I had in mind the Ivy League in general.

On the rest of your argument for legalization, I think I can better show how misguided it is by adjusting it to other criminal conducts.

You know, murder, rape and assault are all crimes. Yet, 'no matter how you slice our possible discussions about which murder is most murderous, pretty much no matter what less than 20% of the population will ever become a murderer/rapist/assaultant of any type, or be victims of such crimes. But you advocate a policy that is extraordinarily expensive, damages the worldwide social fabric (or don't you think places like Mexico, Brazil or Chicago have suffered from the anti-crime war), has created a prison population of millions of people in the United States alone, and benefits (maybe) at most 20% of the population.'

Really.

Harry Eagar said...

I am of two minds about legalization but probably am for it, because of the damage that criminalization is doing to non-users.

But legalization (with light regulation) of alcohol has not been cost-free, socially, though it has been profitable for the fisc.

I don't think we understand addiction very well. If we did then presumably treatment programs would have a higher success rate.

At the pawn shop, out of 11 full-time employees, we have 2 alcoholics, one former big-time LSD dealer who cleaned up on his own, and one former meth dealer who is cleaning up (so far) in Drug Court. We have had a good many addicts who proved to be unemployable after a few months or years.

What I can say with high confidence is that no two of these were very much alike except that schizophrenia (itself a slippery concept) was involved with several.

Hey Skipper said...

[Hey Skipper:] Does it? By that I mean, does the variation in addiction effectiveness mean expanding the subset of the population that is addicted …
---
[Clovis:] I return the question: since the Cigar industry started to use nicotine-enhanced tobacco plus chemical treatment to make its cigars more effective at addicting smokers, do you believe it did so to sell more cigars to their present customers, or to make sure a greater number of newbies settled as permanent smokers?

I tell you, embrace the power of "AND".


This goes right back to an entering argument that is, at this point, unverifiable. I presume that a smallish portion of the population will become addicted to something harmful, and that the size or composition of the population is unaffected by the substance. I think you are presuming something different — substances make the addict.

I don't know how to decide which is the most correct. However, if my presumption is correct, then the answer to your question is "no". Enhanced nicotine cigars are unlikely to sell more cigars (and may even result in fewer sold), and newbies who aren't addicts in waiting won't become addicts because of the enhanced nicotine.

So, if my presumption is correct, the true impact of enhanced nicotine cigars is to make harder for users to quit.

Hey Skipper said...

[harry:] Cuba? Let's look at every other industrialized nation.

I bet you will be surprised to learn that in Japan, patients don't even make appointments. They just walk in and expect attention right away.

Japan's costs are a small fraction of America's and everyone gets care.


Once again, reality sticks its ugly unshaven head into Harry's unicorn-fantasy world:

Japanese patients favor medical technology such as CT scans and MRIs, and they receive MRIs at a per capita rate 8 times higher than the British and twice as high as Americans.[9] In most cases, CT scans, MRIs and many other tests do not require waiting periods. Japan has about three times as many hospitals per capita as the US[24] and, on average, Japanese people visit the hospital more than four times as often as the average American.[24] Due to large numbers of people visiting hospitals for relatively minor problems, shortage of medical resources can be an issue in some regions. The problem has become a wide concern in Japan, particularly in Tokyo. A report has shown that more than 14,000 emergency patients were rejected at least three times by hospitals in Japan before getting treatment. A government survey for 2007, which got a lot of attention when it was released in 2009, cited several such incidents in the Tokyo area, including the case of an elderly man who was turned away by 14 hospitals before dying 90 minutes after being finally admitted,[25] and that of a pregnant woman complaining of a severe headache being refused admission to seven Tokyo hospitals and later dying of an undiagnosed brain hemorrhage after giving birth.[26] The so-called "tarai mawashi" (ambulances being rejected by multiple hospitals before an emergency patient is admitted) has been attributed to several factors such as medical imbursements set so low that hospitals need to maintain very high occupancy rates in order to stay solvent, hospital stays being cheaper for the patient than low cost hotels, the shortage of specialist doctors and low risk patients with minimal need for treatment flooding the system.

That would make at least twice in this thread that your pronunciamentos have been shown to contain far less than meets the eye. Care to comment?

Harry Eagar said...

I am going to guess you think you have a point but I have no idea what it might be.

erp said...

Harry, the point is your comments have little or no basis in fact.

Hey Skipper said...

[Harry:] I am going to guess you think you have a point but I have no idea what it might be.

I would have thought it blindingly obvious. You make grand pronouncements that, given just a tiny bit of google-fu, turn out to be not just factually bereft, but completely opposite to reality. Just in this thread:

Short story: NHS is not collapsing. You only have to wait in Canada for electives; urgent care is delivered immediately. In only 1 country do people die for lack of care: USA.

But let's school erp. The reason rural areas don't get health care in the US is that it's a for-profit system.

It wasn't affordable and it didn't work at all for the uninsured. Thank unions for the coverage you had. Before their rise, almost no employers provided insurance.

I bet you will be surprised to learn that in Japan, patients don't even make appointments. They just walk in and expect attention right away.

What would your arguments look like if you, for once, constrained yourself to existing in the same fact-bound universe that the rest of us do?

erp said...

Skipper, admit it. Harry's part of the fun here at GG -- comic relief, if you will. Kinda like the House of Mirrors at the carnival. We can laugh at the distortions and convolutions because we know the real world is still there waiting for us when we step back into the sun light.

Harry Eagar said...

So in a country of 125,000,000 people, you find two -- count 'em, 2 -- examples of screwups, and somehow that negates the success of a system that serves 125,000,000 people at vastly lower cost with enormously more successful outcomes then the US system.

I guess you've given up on thinking that anecdote is not data.

Clovis e Adri said...

Skipper,

---
This goes right back to an entering argument that is, at this point, unverifiable. I presume that a smallish portion of the population will become addicted to something harmful, and that the size or composition of the population is unaffected by the substance. I think you are presuming something different — substances make the addict.
---

It is not "unverifiable".

There is nothing new under the sun, so it helps to get back 100+ years ago to learn how the war on drugs started in the first place. I recommend starting at pg 171 and going up to where your curiosity takes you. (Heads up: it starts with real wars, very consequential ones by the way - maybe there wouldn't be a powerful Communist China party today if not for that past).


If you want my short version: even in cultures in contact with a drug for milennia can have exponential (and I do mean exponential, look the graphs yourself) growth of its consumption under the right circumstances.

Skepticism of that possibly happening, then as now, was always an argument conveniently used by the right lobbies - take a look at pg 178 in particular.


---
I don't know how to decide which is the most correct.
---
Neither - I highly doubt the portion of society vulnerable to drugs is a fixed pie, or that the drug alone (devoid of all the social and personal context around) makes the addict.

What I believe, though, is that the potential for harm from its unleashed market is way higher than our friends here can admit.

Hey Skipper said...

[Harry:] So in a country of 125,000,000 people, you find two -- count 'em, 2 -- examples of screwups, ...

I guess you've given up on thinking that anecdote is not data.


In order for your statement to make the least bit of sense, you must be asserting that the two I found are the only two that exist, rather than being representative of significant problems which you were either too lazy, or impenetrably ignorant, to mention.

Let me help. Here is The Economist on how wonderful Japan's health care system is.

But why rely on some roundeyes' story. The Japan Times is even more critical.

Since I know from experience you will never threaten your world view by following links, here are the nut grafs:

Murakami’s main point is that his hospital’s fiscal problems were not caused by mismanagement so much as a social attitude that sees medical care as an entitlement exclusive of other health considerations. As a doctor, he tried to emphasize preventive measures, which not only help people stay healthy but reduce medical costs, but the people he served only cared about treatment because the medical system encourages this attitude. Moreover, the media reinforces it by looking at all sick people as objects of pity rather than individuals who don’t take care of themselves.

Murakami’s thesis is at the heart of the government’s difficulties in reining in the enormous cost of the national health insurance system. Medical expenses in Japan now amount to ¥39 trillion a year, ¥10 trillion of which is used to treat so-called lifestyle diseases, including ¥2 trillion for high blood pressure, ¥1.2 trillion for diabetes and ¥800 billion for cardiovascular problems. Lifestyle diseases are preventable, but they are also profitable, and unlike Murakami, many physicians don’t mind their patients’ entitlement-minded approach to health maintenance since that’s how they stay in business.

...

On the positive side, patients can nearly always see a doctor within a day. But they must often wait hours for a three-minute consultation. Complicated cases get too little attention. The Japanese are only a quarter as likely as the Americans or French to suffer a heart attack, but twice as likely to die if they do.


And about the NHS, you are once again abusing those poor crickets.

Hey Skipper said...

[Clovis:] There is nothing new under the sun, so it helps to get back 100+ years ago to learn how the war on drugs started in the first place. I recommend starting at pg 171 ...

I will. I know Bret has made this offer before elsewhere, but I'll repeat it. I think your take on this is worthy of a GG post all on its own.

Neither - I highly doubt the portion of society vulnerable to drugs is a fixed pie, or that the drug alone (devoid of all the social and personal context around) makes the addict.

What I believe, though, is that the potential for harm from its unleashed market is way higher than our friends here can admit.


If it isn't a fixed pie, then addiction should be much more widespread in the Netherlands and Portugal. I don't know that it isn't, but I haven't heard that it is.

Also, I doubt that alcoholism was any less prevalent during Prohibition than before, or after. And sin taxes, which one would think make problem consumption far more difficult for lower income people than the well off, should create a situation where alcoholism is more prevalent among the rich than the poor.

But, so far as I know, it doesn't.

That said, I think most people against legalizing consumption of illicit drugs draw the same conclusion you do.

In my extremely limited experience, an alcoholic brother in law, he was an addict in waiting. The rest of his family, sharing the same life circumstances, weren't.

The US's state-by-state legalizing of marijuana should prove interesting.

Harry Eagar said...

Enormous costs that are about half America's yet treat everybody instead of only 5 in 6.

NHS is not collapsing, although if you read rightwing screeds you'd conclude it collapsed about 50 years ago.

Then there is erp's hysterical claim that Frenchmen leave France for care if they can. WHO set out to discover which countries provide better care and which have the greatest satisfaction among the cared for. Get ready for it: France finished first both ways. Every other industrial democracy except one finished in the top ten. I don't have to tell you which one finished equal with Cuba. Do I?

Clovis e Adri said...

Skipper,

---
I think your take on this is worthy of a GG post all on its own.
---
Thanks, but I can't see how. I probably distilled most of what I think here, and the people who would read that post are the same ones who already watched it in this comment section.

---
If it isn't a fixed pie, then addiction should be much more widespread in the Netherlands and Portugal. I don't know that it isn't, but I haven't heard that it is.
---
One of the reasons is that, in both places, supply keeps being restricted: drug dealers of hard drugs are still persecuted and seen as serious offenders.

Another one is that both places are going to the graveyard. Portugal has -0.5% population growth, Netherlands still can keep 0.3% thanks to immigrants. Fertility rates are at 1.3 and 1.7, respectively.

Guess what? Old people buy a lot less new fashion.



---
And sin taxes, which one would think make problem consumption far more difficult for lower income people than the well off, should create a situation where alcoholism is more prevalent among the rich than the poor.
---
That doesn't make sense once you pay cents for the drug. No one is too poor as to not be able to buy alcohol. Gosh, if you can even make it for free, how cheaper can it be?


---
The US's state-by-state legalizing of marijuana should prove interesting.
---
I don't think so. That's too weak a drug to make much of a difference.

Of course, the market dynamics, where Colorado turned into a booming and lucrative provider to neighboring Proihibitive states, can only count as news in Annals of Tautological Findings.

erp said...

Harry, are you serious???? I said I understand why Americans get on planes when they're sick rather than be treated anywhere abroad. Ordinary French people do as they're told like good little cogs, while rich lefties from all over the world come here when they are seriously ill.

These studies and surveys that you reference. May we see the criteria and the questions? WHO and other UN related self-serving agencies have far less credibility than the surveys on internet websites.

BTW - I missed your reply to my question of whether elective surgery in Canada includes bone marrow transplants? A real little girl died needlessly -- not number in a questionable study or a survey, but an adorable little girl who'd be giggling with her girl friends right now if she'd lived only a couple of hundred miles south of her home.

Doesn't that bother you?

Hey Skipper said...

Harry, your superpower is goal post shifting.

Here is what you actually asserted:

Short story: NHS is not collapsing. You only have to wait in Canada for electives; urgent care is delivered immediately. In only 1 country do people die for lack of care: USA.

Wrong. As my evidence clearly showed, people die for lack of care in England.

But let's school erp. The reason rural areas don't get health care in the US is that it's a for-profit system.

Wrong. The reason rural areas don't get the same health care as urban areas is population density, not profit. Otherwise, Australian rural areas wouldn't have exactly the same problem.

It wasn't affordable and it didn't work at all for the uninsured. Thank unions for the coverage you had. Before their rise, almost no employers provided insurance.

Wrong. It was post-WWII wage control policies.

I bet you will be surprised to learn that in Japan, patients don't even make appointments. They just walk in and expect attention right away.

Wrong. Japanese often wait hours, the attention they get is measured in minutes, and Japanese health care has many serious, intractable problems.

But wait, there's more:

Then there is erp's hysterical claim that Frenchmen leave France for care if they can.

Then surely you can provide the quote. Until you can, based upon your extensive track record, the only safe assumption is that she said nothing of the kind.

WHO set out to discover which countries provide better care and which have the greatest satisfaction among the cared for.

Link? How the heck are we to judge the accuracy of your characterization, or the objectivity of this so far mythical WHO study without it?

Hey Skipper said...

[Clovis:] One of the reasons is that, in both places, supply keeps being restricted: drug dealers of hard drugs are still persecuted and seen as serious offenders.


Sounds to me like a good idea — regardless of what one might think about the liberty issue involved with prohibition, criminalizing what is really a health issue strikes me as completely nuts.

Another one is that both places are going to the graveyard. Portugal has -0.5% population growth, Netherlands still can keep 0.3% thanks to immigrants. Fertility rates are at 1.3 and 1.7, respectively.

Sorry, you lost me on this one. Negative population growth is nearly universal in Europe, regardless of drug laws, and serious in Japan, where drug laws are severe.

[re: sin taxes] That doesn't make sense once you pay cents for the drug. No one is too poor as to not be able to buy alcohol. Gosh, if you can even make it for free, how cheaper can it be?

In Alaska, the tax on alcohol runs to something like 30%. For poor people, that is a significant chunk of disposable income. For the well off, it is practically zero. If sin taxes had any anti-consumption effect (or alternatively, if alcoholism was somehow related to cost and availability), then it would be biased towards poorer people; consequently, if alcoholism was to any extent voluntary, then richer people should have more consumption related problems.

They don't.

I don't think so. That's too weak a drug to make much of a difference.

Of course, the market dynamics, where Colorado turned into a booming and lucrative provider to neighboring Proihibitive states, can only count as news in Annals of Tautological Findings.


Perhaps. But it so, then it makes marijuana prohibition one of the great disasters of the 20th century.

As for market dynamics, I'm not sure where you are going with that. Did consumption increase, or were existing consumers merely avoiding risk?

erp said...

To settle this question, why not consult the media about whether increased marijuana consumption was due to new users coming from out of state.

Howard said...

Regarding the WHO study, the real question is - THE WORST STUDY EVER?:

What we have here is a prime example of the misuse of social science and the conversion of statistics from pseudo-data into propaganda. The basic principle, casually referred to as “garbage in, garbage out,” is widely accepted by all researchers as a cautionary dictum. To the authors of World Health Report 2000, it functioned as its opposite—a method to justify a preconceived agenda. The shame is that so many people, including leaders in whom we must repose our trust and whom we expect to make informed decisions based on the best and most complete data, made such blatant use of its patently false and overtly politicized claims.

Anyone above the age of twelve who cannot recognize the report as a 'pos' is an intellectual joke.

erp said...

Howard, well said!

Harry Eagar said...

The study considered about 30 different ways to judge a health delivery system. Some were somewhat subjective, while others (when people die) were hard numbers.

The satisfaction survey was, by its nature, absolute. People know whether they are satisfied or not (as we know from chiropractic).

Commentary (the first place one would look to for unbiased judgments about socialized medicine, I am sure we all agree) says:

'Before WHO released the study, it was commonly accepted that health care in countries with socialized medicine was problematic.'

So it was, at Commentary. The real world thought differently.

Peter Medawar, for example, who I rate as the toughest-minded thinker of his time, considered the NHS to be Britain's great achievement.

'Problematic' is a great weasel word. Every health care delivery system has problems. But people dying in the streets is, among the rich countries, restricted to the United States.

erp said...

Harry, what other "rich" country emptied out their institutions where people with mental and/or developmental problems were taken care of? What other "rich" country repealed vagrancy laws and allowed public drunkenness and homeless people to sleep in doorways and on the streets?

Luckily, I don't need an answer from you because I already know the answer and that is none of them.

Clovis e Adri said...

Skipper,


---
Sorry, you lost me on this one. Negative population growth is nearly universal in Europe, regardless of drug laws, and serious in Japan, where drug laws are severe.
---
Old people don't do new drugs - other than pharmaceutical ones, of course. So they either stick to their old ones or, if they were not into drugs before, will hardly start now.

IOW, a free policy on drugs will naturally be less hazardous in such places.

China's Opium endemics of 1750-1900 also happens during an explosion in population, AKA new blood for the parasites.


---
In Alaska, the tax on alcohol runs to something like 30%. For poor people, that is a
significant chunk of disposable income.
---
Yeah, so that $2 booze will get to $2.6 - OMG, no alcoholic bum will ever surpass that mountain!


---
Perhaps. But it so, then it makes marijuana prohibition one of the great disasters of the 20th century.
---
Why to single out Marijuana? There are so many other controlled substances that, in mild use, are perfectly manageable.

I am not sure I can agree with the controls they put even to antibiotics access.


---
As for market dynamics, I'm not sure where you are going with that. Did consumption increase, or were existing consumers merely avoiding risk?
---
Production surely increased. The burden to show standard market laws do not apply here are not over my shoulders.

Harry Eagar said...

erp, read this:

https://en.wikipedia.org/wiki/History_of_psychiatric_institutions

It's true that countries with moral medical care systems do a better job of providing the support that was part of the theory of de-institutionalization. In America the combination of Christian moralists and rightwingers who despise taxes has starved the sick of treatment.

erp said...

Harry, the sick were being treated. You and your cohort threw them in the street. I don't need to read about it. I was there when it was happening and watched it unfold just as predicted. One of our best friends and neighbor was the head of such a facility for the retarded, now for some reason that word is a no-no and these poor folks are developmentally disabled, but they still can't take care of themselves. So, what do you care? There are huge bureaucracies spending gazillion dollars, but like the VA that money is going union thugs and career bureaucrats while the people they are supposed to serve are lying in the gutters -- odd that the only people with real hands on help for them are those religious people and other non-lefty volunteers like me and others whom you hate so much.

Harry Eagar said...

'I don't need to read about it.'

Now there'sa surprise.

Howard said...

Harry,

In your reply, you've demonstrated yet again that your critical thinking skills are on par with your quantitative abilities, but your greatest ability is being obtuse.

Harry Eagar said...

This morning I was looking for something that I didn't find but I did find this:

https://www.commentarymagazine.com/articles/communism-in-asia/

I'd suggest that opinions 'commonly accepted' in the conference room at Commentary magazine often -- I would say almost always -- have small connection to the real world.

In 1994-5, when Hillarycare was being turned down, Taiwan and Switzerland undertook national policy reviews in order to establish national health care delivery systems. They examined actual results in all developed countries and -- quel surprise! -- they chose variants of socialized medicine.

In fact, the assertion of what is 'commonly accepted' is invalid for almost all the places that have modern health delivery systems of any kind.


(In my youth I read a lot of Podhoretz. It led me to firm skepticism about what appears in Commentary.)





Hey Skipper said...

[harry:] The study considered about 30 different ways to judge a health delivery system. Some were somewhat subjective, while others (when people die) were hard numbers.

I'm not at all clear how the quantity of criteria correlates to the quality of criteria. The Commentary article had a great deal to say, none of it complementary, on that, and you have nothing.

And your second sentence make me wonder if you actually read the article at all: while others (when people die) were hard numbers.

Really?

The WHO "report" ranked the US 19th in National Life Expectancy.

Excluding immediate deaths from murder or motor vehicle accidents, the US would have been first.

At its most egregious, the report abandoned the very pretense of assessing health care. WHO ranked the U.S. 42nd in life expectancy. In their book, The Business of Health, Robert L. Ohsfeldt and John E. Schneider of the University of Iowa demonstrated that this finding was a gross misrepresentation. WHO actually included immediate deaths from murder or fatal high-speed motor-vehicle accidents in their assessment, as if an ideal health-care system could turn back time to undo car crashes and prevent homicides.

In Getting Driven Crazy I noted that German fatalities per vehicle mile is just more than a third of the US's.

The WHO "study" didn't take that into account. Does that mean the WHO "researchers" think driver training is health care, or that they were so analytically challenged that they couldn't be bothered? And why should anyone give any credence to a "study" that can't account for even the glaringly apparent?

And, closer to home, how is it you failed to note this glaring problem?

Hey Skipper said...

Before WHO released the study, it was commonly accepted that health care in countries with socialized medicine was problematic.'

So it was, at Commentary. The real world thought differently.


You say a great many truly ignorant things, but this perhaps takes the cake. Besides the evidence I provided above about problems with socialized medicine, unlike you, I have first hand experience with it: socialized medicine is, indeed problematic.


Peter Medawar, for example, who I rate as the toughest-minded thinker of his time …

It's not at all clear, based on current performance, that he would be pleased with your endorsement.

But people dying in the streets is, among the rich countries, restricted to the United States.

Bollocks. Pure, unadulterated, bollocks.

It's true that countries with moral medical care systems do a better job of providing the support that was part of the theory of de-institutionalization.

Harry, you can't possibly have read your own link. Here it is, but new and improved to point to the relevant part of the article.

(Bonus round for those in the viewing audience: Spot Harry's gross question begging.)

Hey Skipper said...

[Clovis:] IOW, a free policy on drugs will naturally be less hazardous in such places.

Sorry, I don't know why I didn't suss your point from the outset.

However, as a statistical matter, I'm not sure you are right. Unless incidence is correlated to population, then more people = more addicts is merely a matter of arithmetic — a free policy on drugs is no more hazardous in a large or growing population than a small or static one. After all, growing populations have more non-addicts than shrinking ones, right?

Yeah, so that $2 booze will get to $2.6 - OMG, no alcoholic bum will ever surpass that mountain!

No, more like booze that costs $18 elsewhere costs nearly $30 in Alaska.

Why to single out Marijuana? There are so many other controlled substances that, in mild use, are perfectly manageable.

I am not sure I can agree with the controls they put even to antibiotics access.


Because Marijuana is an intoxicating drug, and the issue at hand is whether prohibiting intoxicating drugs causes more damage than it prevents.

As for antibiotics, I thought the evolving resistance dangers due to overconsumption were obvious enough.

Clovis e Adri said...

Skipper,

---
a free policy on drugs is no more hazardous in a large or growing population than a small or static one.
---
My main argument rests on the potential for future drugs (and a small subset of present ones) to be able to break through the 10% ceiling of "natural addictiveness".

I believe any big pharma company can easily achieve so. But no new drug will expand its reach over addictics without something very important, which is social appeal. Kids partying and playing and doing their small talk at schools, colleges and their social forums is what makes the drug successful. Old people only talk about drugs to, well, display their boring arguments such as ourselves right now.


IOW, young people are better hosts for the parasite, and rate of infection depends on the availability of hosts.


---
As for antibiotics, I thought the evolving resistance dangers due to overconsumption were obvious enough.
---
It is, again, a collective X individual thing going on.

I don't feel fine with the concept of only being able to look for a medicine for myself after consulting a doctor. Do you?


Harry Eagar said...

So socialized medicine is problematic, eh?

Does it provide care to all? Yes

Is it care of the highest quality? Yes

Is it far cheaper than non-socialized medicine? Yes

I don't see a problem

erp said...

Harry, define "care," as opposed to "highest quality care." Cheaper than what? Your comment is quite timely. The free clinic in our county which heretofore was run on voluntary contributions and volunteers at every level is in the process of being taken over by the taxpayers without their knowledge and consent. Front page article this morning that a community center currently being used by a local church for a weekly food bank is being denied access to the site for a weekly free clinic in conjunction. Reason: Rich lefties in the high rise condos on the beach don't want any of the great unwashed within their panoramic views.

Harry Eagar said...

Rich lefties in a south Florida condo? You are delusional

(I am in the process of getting mucho bucks out of a south Florida condo, as it happens. The previous owner was far from a leftist, and the prospective new owners -- yes, cash dollars, please! -- are Argentinian fascists)

erp said...

Delusional?

Argentinian fascists aka lefties in south Florida and American fascists here in Central Florida. Birds of a feather.

Glad to know you're in on the bonanza Harry.

Hey Skipper said...

[harry:] Does it provide care to all? Yes

...


Instead of being a troll, how about responding to this.

Or this.

Or this.

Or this.

Or this.

Or this.

Your choice.

Harry Eagar said...

Your hero, erp

http://www.nytimes.com/2016/02/29/world/americas/a-chilean-ex-soldier-guiltily-recalls-his-units-atrocities.html?hpw&rref=world&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-well

erp said...

Harry, wow, just wow.

Clovis e Adri said...

Harry,

I wonder, how do you know the Argentinian is a fascist?

He presented himself to you like, "Hola, soy Juan y soy un fascista"?

erp said...

Clovis, I believe Harry is referring to Pinochet as the main man fascist with Juan a mere foot soldier.

Harry Eagar said...

Not too many decamisados with cash dollars enough to buy a Miami condo

Harry Eagar said...

Skipper, you will be surprised to learn that in civilized countries, firearms control is considered a public health measure. And with something like 4,000,000 premature deaths since 1900, a serious one.

erp said...

Harry, if you mean descamisados -- they must be quite old by now and perhaps have seen the error of their ways, turned their lives around, saved their money, invested wisely and are now able to live la vida loca in Miami.

Clovis e Adri said...

Harry,

To be clear, are you implying they are fascists just because they have money to buy a condo?

Hey Skipper said...

Harry, you will be surprised to learn that outside Progworld, innumeracy is considered a public menace. And with some 4,000,000,000 ridiculous assertions since 1867, a serious one.

Because you keep trotting out this figure, you must believe it means something. That brands you as innumerate, and analytically challenged.

Let me help you out here. You have taken an ascertainable fact — 4M gunshot deaths in 116 years — and treated it as conclusive, without acknowledging the difference between gross and net.

4M deaths can only stand as a useful fact if murder and suicide were completely unknown prior to the invention of firearms. Since that is manifestly ridiculous, then at least some of those 4M people were going to die prematurely anyway, with only the means at question.

It gets worse. Some two thirds of premature deaths by firearms are suicides. Suicide varies widely by culture and gender; moreover, there is no correlation between gun ownership and suicide rates. Unless, of course, agenda journalists heroically ignore salient facts to get there.

Because roughly two-thirds of that oft-abused 4M figure are suicides, and the evidence is conclusive that there is no correlation between gun ownership and suicide rates, then 4M gross really amounts to, at most, 1.4M net.

Yet, since most of your better historians agree that murder existed before guns, and that many, if not most, societies before guns had murder rates far higher than societies with guns.

Which means, for those progs at home who are analytically challenged, the correlation between guns and murder rates is negative. In other words, it is impossible to know not only how many of those 1.4M would have been killed anyway, it is even possible that fewer people died because of guns than would have been the case otherwise.

Making matters worse for you, as it they weren't already bad enough, murder rates are far higher among African Americans than anyone else. You can explain that one of two ways: the racist way — African Americans are relatively incapable of safely owning guns; or, the guns-are-irrelevant way — that what the rest of society has done to African Americans over the last 400 years has so damaged them as a group that higher crime rates of all kinds are the result. (This is the close sibling to thinking wholly inadequate mental illness treatment is a reason to confiscate guns. But that's progressivism for you.)

The abiding mystery is why you keep trotting out a number that is so transparently worthless. My theory is that, as a progressive, you are innumerate, and incapable of analytical thought. Compounding that, your anti-gun attitude is indistinguishable from any other religious zealotry.

erp said...

Skipper, ya got some extra zeros up above. No doubt a typo due to using the infernal i-pad keyboard. Otherwise, right on.

Hey Skipper said...

What do you mean, extra zeroes?

The number of ridiculous assertions from progs since 1867 is uncountable, and certainly at least four billion. Heck, Harry is responsible for several thousand all by himself.

erp said...

Sorry, Skipper. You mention 4M further along and I made the one unforgivable faux pas - I assumed. :-(

Harry is, IMO, even among the countless academic progs with whom I lived for decades, sui generis.

Hey Skipper said...

[Clovis:] My main argument rests on the potential for future drugs (and a small subset of present ones) to be able to break through the 10% ceiling of "natural addictiveness".

To the extent it is true, that is a compelling argument. But on current form — think of the number of addictive drugs (by which I mean mood altering substances) — that doesn't seem at all likely. After all, what are the odds that, given the plethora of drugs, that it is the same 10% getting addicted, unless addiction is a function of the addict, not the substance?

Further, even if such a substance were to be found, wouldn't it make more sense to prohibit that one substance, and disregard the rest?

BTW, I read that UN report you to which you linked. OK, not the whole thing, but starting at page 175.

It was, as you said, interesting reading. I have many quibbles with it — why use countries as the unit of measure, when per capita is so much better? — but it is striking how much opium consumption varied over time and across countries.

Still, it seems that my somewhat arbitrary notion that roughly 10% of the population will be harmfully addicted to something isn't entirely out to sea.

Which again raises the question: how much effort should society put out to prevent that 10% from being addicted to something, when they will be addicted to nearly anything?

Hey Skipper said...

Bret:

This deserved a response a long time ago. (Mea culpa: I've been on the road, and almost continuously having to be — quelle horreur — sociable.

I think there is an embedded problem that you don't acknowledge: free will.

The argument about free will is nearly impossible because there is absolutely no telling free will from pre-ordained choice.

1. The addict chose to become an addict.

What is your favorite color? Song? Food?

Change them.

Even though they are entirely trivial, you cannot (honestly, that is).

There are a great many, perhaps most, things in my life I did not choose, and over which I have no real control. To me, women are overwhelmingly, without a glimmer of a chance of a notion of recovery, addictive. I promise you I had no choice in the matter.

And, in service of that addiction, I have given over every dime I earn.

I have an uncle who was, by any definition of the term, was addicted to religion. I'm pretty sure the truly religious would never agree they have a choice about their belief.

If this is true, the question then, is why do many people such as yourself believe that the addict is not making a rational choice?

Since I reject your premise, then why should I believe your consequents follow?

Regardless of that, almost all of them are situationally implausible. My uncle was addicted to his religion, which isn't illegal, nor (with caveats that defeat your consequents) immoral. You confine your notion of addiction to drugs, which blinds you to other addictions that don't involve drugs, and don't carry any intrinsic negative attitude from society.

My brother-in-law traded a family, and a good career as a jet engine mechanic for demon rum.

What kind of choice is that?

erp said...

Skipper, OMG - sociable ! Aren't there union rules protecting you guys from that?

Addiction is complicated and I wouldn't compare it to a yen for chocolate or a compulsion to collect Hummel figurines. I haven't had any first hand experience with alcoholism or drug addiction, but from what I've read and heard about it, it's pretty darn difficult, if not impossible, to overcome without Herculean effort and is very easy to fall back into it.

Taking the profit motive out of selling the stuff and letting adults make their own choices seems to me the best of a multitude of other bad choices. Those who break the law while under the influence suffer the consequences and are removed from society either to jail or other facility or institution.

Ad campaigns like the hugely successful one against smoking would be very useful in making drinking and drugs not cool.

What is missing is the will to do it.

Bret said...

Hey Skipper wrote [with respect to addiction choice]: "What is your favorite color? Song? Food?"

There's a difference between having a desire and choosing to act on it. I don't actually have a favorite color, song, or food (they all depend on context and mood for me), so let's take a different example. I do desire sex, and I don't have a choice regarding the having the desire. I do, however, have a choice to decide to pursue that desire or not.

So I reject your rejection of my premise. :-)

Hey Skipper said...

I do desire sex, and I don't have a choice regarding the having the desire. I do, however, have a choice to decide to pursue that desire or not.

You have ignored the central point: how much choice do you have to pursue that desire, or not?

I'm nearing 61, and it is dead certain that I have far more choice in that regard than I did forty years ago. Moreover, it should be obvious that for some people, deciding not to pursue that desire is much harder than for others, despite paying very heavily for doing so.

So, with regard to your father, it is impossible to say whether he was as free as you are to not drink, or even if he was engaging in self-justification.

I have no real direct experience of chemical addiction, except for one of my brothers-in-law. I am certain he did not have anything like the ability I, and most people I know, to say, long before having too much, "that's enough."