Re: online cash for docs


Howard McCollister wrote:

> > It's nothing new been going on for years now...
> >
> > That makes it ok?
> >
>
> No, that doesn't make it OK. I think it's intrinsically OK, all by itself.
>
> HMc


COMMENT:

Agree. One of the great reasons for decentralization of decision-making
is that it removes much of the incentive for bribery. This is as true
in politics as economics. One of the less-talked about bad things about
socialism and command economies isn't just that the commissars aren't
smart enough to decide how many widgets will be needed where, and when
(the sorts of horrors you saw with Katrina), but also there's the fact
that when decisions are made by a few on behalf of the many, there's
always corruption. That's bad enough even in Western-style democracies.
Republics are mandatory thing from the demands of information
processing, and if you have a republic, you will have junketing
politicos getting private donations for their private projects
(presidential libraries, whatever) who make doctors (ANY doctors) and
even many business people look more pure than Ceasar's wife.

What I don't understand is why anybody wants a system which encourages
this. Sure, somebody's always going to be doing complicated surgery
that nobody else can do. But there's really no reason to have many
drugs available only by prescription. Remember how long it took to get
Clariten and Prilosec over the counter? This kind of thing is what
lead directly to drug company pressure on the few, when it could (and
would) be better diffused into the many. And thereby somewhat
detoxified. Who cares about direct to consumer advertising? If the
doctors aren't too biased, the intelligent consumer can always consult
them first.

I've long argued that the only drugs which should require a
prescription are those which are intrinsically destructive to society,
like some particularly nasty form of pollution. The only ones I can
think of in that category are antibiotics. Most of the narcotics are no
worse on their total effect on society than is alcohol. We deal with
alcohol without requiring it to be prescribed by doctors.

There are cases were people's lives are destroyed by drugs-- indeed by
alcohol. But in those cases, the decision of what to do about it should
not be left in the hands of doctors. That's a social decision. If
you're destroying your own life with alcohol or seem likely to destroy
somebody else's by your use of it, the judge or jury might decide in
such cases not to make alcohol illegal for everybody, but instead
illegal for YOU PERSONALLY for the next 5 years. Or the rest of your
life. But again, such decisions are so personal and decentralized that
corruption would seem to be unlikely to be much of a problem. The
beer-makers might care if beer were outlawed altogether, but would not
give a fig if beer were outlawed for Joe Blow who wrecked his pickup
truck after drinking 2 six-packs after work on the way home. Indeed,
it's Joe who gives beer a bad name. Even the beer companies would
prefer he not partake.

Can doctors be bribed? Sure. Can juries be bribed? Sure. But fix the
system a little, and there's really no reason why the one shouldn't be
as rare as the other.

SBH

.

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