Monday, January 5, 2015

Money Matters in Medicine

“Entering” the New Year has renewed my cravings for new visions and new paradigms. This is singularly imperative since the old ones are not serving us well. Finishing the book ENTERING THE SHIFT AGE by David Houle about this time has helped me crystallize these ideas. Houle notes that societies have progressed through these stages:

Agriculture

Industrial

Information

“Shift” as he defines the coming age.

He means a shift into a more conscious, or more socially responsible, cooperative way of living.

Perhaps “Consciousness,” or “Cooperative” age might have been more to the point."

Houle’s book, added to the recent exceptional article “How 21st century capitalism is failing us (BMJ 2014;349:g7516) should give you reason to ponder as you too look into your own crystal ball.

Before you read, on please understand that like the rest of you I am a Capitalist. The problem today is not Capitalism, but Crony-corrupted Capitalism. It is not serving us well anymore. This article was published in a medical journal by doctors who understand that our dysfunctional Health Care system is but a reflection of larger economic, social, political, and even spiritual problems rotting our society.

The authors use the same tools I do to arrive at their conclusions: books written by the best thinking minds of our time. For those who follow my radio show you will be familiar with the three books highlighted in this article. And now, let's step aside and quote from it:

“[Capitalism] requires a thoroughgoing democratic transformation. It leads to unfair inequality

1. “The popularity of Thomas Piketty’s book Capital was perhaps the publishing surprise of the year, but it is paradoxical for three reasons.

Firstly, its 700 academic pages are hardly an inviting bedside read.

Secondly, its appeal was primarily to people already worried by rising inequality.

Thirdly, slower economic growth leads to faster rises in inequality.”

2. Naomi Klein’s latest book, This Changes Everything--Capitalism vs the Climate

“Large corporations, particularly fossil fuel companies, have bought off governments and many environmental groups, watering down policy proposals, legislation, and international environmental agreements.”

3. Nicholas Freudenberg’s Lethal but Legal.

“Food, alcohol, tobacco, automobile, pharmaceutical, and gun industries are now the main sources of damage to public health.

Endless conflicts between public and corporate interests.

Corporations use their huge advertising wealth, media, and political influence to defend themselves.

They pack regulatory systems with people who will defend their interests, they buy politicians, and continue to maximise the sales of their products in the face of massive evidence of harm—from obesity, drunkenness, smoking related disease, environmental damage, and so on.”

“Antisocial behaviour of big corporations is a large political problem, their record on tax evasion provides it.

In 2008, the US Government Accountability Office reported that 83 of the country’s biggest 100 corporations had subsidiaries in tax havens.

“[There is a] status competition among consumers… Status anxiety is intensified by greater income inequality… more unequal societies give higher priority to buying status goods. They also work longer hours, save less, get into debt more.

“Rather than benefiting from further economic growth, health and happiness in rich countries is now better served by improvements in the quality of social relations and community life.

“Greater equality would reduce consumerism and improve the social environment.

Production is undertaken in the service of the public good, humanity, and the planet.

The obstacle is that large corporations are so powerful that our democratically elected politicians are afraid to touch them.

“Lobbying politicians and regulators by pharmaceuticals, food processing, arms, energy, alcohol compromises the democratic political process.

Solution: companies owned and controlled directly or indirectly by some or all of their employees, companies with varying degrees of employee representation on boards, consumer cooperatives, mutuals, and credit unions.

Around half the member states of the EU have at least some legal provision for employee representatives on company boards or remuneration committees.

“Democratic companies not only have smaller income differences within them but also enjoy higher productivity… Wholly employee owned companies are also part of the solution to the increasing concentration of capital ownership… More democratic businesses are more ethical.

Perhaps then our salvation lies in a thoroughgoing democratic transformation of capitalism.”

This is the only way we will fix our broken health Care system.

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