Category Archives: The Welfare State

Will Individualized Medicine Increase Health Inequality?

Civil Liberties, Government Ethics, Healthcare, Privacy, Socialism, The Nanny State, The Welfare State

Ezra Klein has a rather thought-provoking post today about human genome sequencing and its ability to allow doctors to better-tailor treatment to the specific needs of an individual patient. It presents a phenomenal opportunity to both make medicine more effective, and IMHO to make it cheaper by spending less time and energy on substandard treatments. Ezra raised a different point, though, and I think makes a logical error that warrants further discussion:

If that’s the path that medical advances ultimately take, one byproduct will be an immense explosion in health inequality. Right now, health inequality, though significant, is moderated by the fact that the marginal treatments that someone with unlimited resources can access simply don’t work that much better than the treatments someone with more modest means can access. In some cases, they’re significantly worse. In most cases, they’re pretty similar, and often literally the same.

But as those treatments begin to work better, and as we develop the ability to tailor treatments to individuals, we should expect that someone who can pay for the best treatments for their particular DNA sequences to achieve far better health-care outcomes than someone who can’t afford the best treatments and has to settle for general therapies rather than individualized medicine.

I believe Ezra makes assumes the premise that the “best” treatments are also the most expensive treatments. I believe this to be unsupported by evidence.

Suppose 10 different people all happen to have the same malady. To use a common one, let’s say that the malady is hypertension. Multiple drugs today exist for the treatment of hypertension. Some of them may be specific variants (branded or generic) of medications all within a specific class, but often multiple classes of drugs may be used to treat hypertension. Those multiple classes will affect different people in different ways, but my guess is that a typical doctor will offer a “standard” treatment regimen for hypertension and only deviate from that standard if something doesn’t appear to be effective. What’s further important to note is that different doctors may have different “standard” regimen, based on their own experience rather than exact current medical literature.

What the idea of genome sequencing may bring to the table is that medical research can form stronger predictions of a particular person’s response to certain medicines based upon their specific genes, and it is easier to tailor the treatment to the patient. This doesn’t mean that the rich person’s treatment will be more expensive than a poor person’s, but it does mean that someone who has genome sequencing will likely have more effective treatment than someone who does not. What it also means is that someone who has genome sequencing may actually have less expensive medical treatment than someone without, as less effort and dollars can be used adding treatments that are statistically likely to be ineffective.

And herein lies the rub. Will a rich person have better access to genome sequencing than a poor person? Not if we have Ezra’s wet dream: government socialized health care. Once effectiveness at reducing costs is shown, government in its awesome authoritarian-ness will undoubtedly use the desire for cost-cutting in medical treatment to demand genome sequencing of anyone participating in Obamacare. Sure, we civil libertarians will soundly object to government getting access to everyone’s DNA, but I’m sure they’ll tell us, much like they do with the TSA pornoscanners and told us with our social security numbers, that there’s NO CHANCE the genome information will ever be used for anything other than our medical care, and will be completely confidential. And since nobody listens to us civil libertarians today, they’ll get it done.

If Ezra looks at the potential from this angle, I think he’d change his tune. If he sees genome sequencing as a potential cost-cutting measure, rather than an inequality-increasing measure, I’m sure he’d actually push for wider adoption of it. And like any government authoritarian impulse, if something is good [and if we’re paying for it with tax dollars], we might as well make it mandatory, right?

Brad Warbiany
https://thelibertypapers.org/

Repost: Anyone Who Believes America is Winning the Drug War Must Be High

Castle Doctrine, Government Incompetence, Legal, Mandatory Minimum Sentences, Police Watch, The War on Drugs, The Welfare State, Theory and Ideas

Last Friday, June 17, 2011 marked the 40th anniversary of Richard Nixon’s “War on Drugs.” As Jacob Sullum points out here, the drug war didn’t actually begin with Nixon and it’s not likely to end on Obama’s watch (even though the Obama administration admits that current drug policy over this period has been a failure). In marking this dubious anniversary, I thought it would be apropos to repost one of my very first blog posts: Anyone Who Believes America is Winning the Drug War Must Be High.

Those of you who are familiar with my writing here and elsewhere might notice the style is a little different than my normal, more conversational second person style (i.e. I refer to “you” the reader frequently). This is because this essay was originally a writing assignment (note the APA format) for a college writing class I was taking at the time even before I got into blogging (I’ll leave it to you to guess what my grade was). This also means that some of the sources I used are older than what is available now. I have since learned a great deal more about how and why the war on (some) drugs is a failure. The following essay is by no means comprehensive but I still stand by these arguments as well as others we have offered here at The Liberty Papers.

Even in the face of reasonable arguments, proponents of prohibition say legalization would cause “moral destruction of the human soul” (Hannity around the 18 minute mark on this video) or say that those of us who would support anything from decriminalization to harm reduction strategies to outright legalization should spend some time with individuals or families whose lives have been destroyed because of drugs. I would counter that emotional argument with another and suggest that drug war proponents spend some time with Kathryn Johnston’s family or the many other “isolated incidents” whose victims have been (in some cases, innocently) traumatized, maimed, or killed as a result of a no knock raid gone wrong. I wonder if these actions resulting from the current drug policy cause any moral destruction of the human soul?

********************************************************************************************************************

    Anyone Who Believes America is Winning the Drug War Must Be High

Could legalizing drugs be the answer to reducing drug use in America? Most people would probably call that idea crazy. Why would the government want to encourage drug use? This is a misconception most people have when the taboo topic of legalizing drugs is brought up. Many people believe that because something is legal, the government is somehow saying it is right. Tobacco is a legal product yet it is constantly under attack. When was the last time the surgeon general told the public that tobacco is safe and healthy? Could this reasoning apply to other drugs that are currently illegal, yet kill far fewer people than tobacco? In fact, tobacco kills more people every year than all illicit drugs combined (McWilliams, 1996). What would happen if tobacco was suddenly illegal? Would people who want to smoke try to find and buy cigarettes despite it being a banned substance? What would the consequences be of this prohibition? The result of course would be a complete failure, just as the prohibition of drugs has been a failure. There are three main reasons why the prohibition of illegal drugs should end: it is ineffective, it causes unnecessary strain on the criminal justice system, and above all, it is dangerous.

Prohibition is Ineffective
America spends roughly $30 million (Federal and State) a day to fight the war on drugs (Stossel, 2004). The White House is requesting for congress to appropriate an additional $556.3 million for the 2005 fiscal year above the 2004 figure of $12.1 billion (The White House Office of National Drug Control Policy, 2004). If money was the solution to the drug problem, it would have been solved by now. Unfortunately, money and the programs the money supports has done very little to solve the problem.

While politicians fight this war from the comfort of their air conditioned offices, law enforcement officers see things from another perspective. An organization of police officers who oppose the drug war known as Law Enforcement Against Prohibition (LEAP), conducted a national survey among police officers. The survey found that 95% believe America is losing the drug war. Over 90% believe that treatment and prevention is more effective than incarceration. When asked what would happen if drugs were discriminations or legalized, 30% of the police officers believed there would be no effect or that usage would go down (McNamara, 1995). Based on these statistics, one could imagine the frustration these police officers are dealing with and the morale for fighting on cannot be very high. Retired narcotics officer and LEAP board member, Jack Cole put it this way:

After three decades of fueling the [drug] war with over half a trillion tax dollars and increasingly punitive policies, illicit drugs are easier to get,cheaper,and more potent than they were 30 years ago. While our court system is choked with ever-increasing drug prosecutions our quadrupled prison population has made building prisons this nationÂ’s fastest growing industry, with two million incarcerated-more per capita than any industrialized country in the world. Meanwhile drug barons continue to grow richer than ever before (2002).

One might conclude that with this number of people serving time for drug offences, this would be an effective deterrent. While some people may decide not to take drugs because of the sentences associated with them, most rightly conclude that the odds of getting caught are very slim. The people who are most likely to get caught are the poorest Americans. Police concentrate their efforts to fight drugs on the poor neighborhoods. The rich are less likely to get caught because police do not typically patrol rich neighborhoods unless there is a reason to suspect the illegal activity (McWilliams, 1996). Even innocent people who happen to be poor are not exempt from punishment. Strict drug laws for public housing tenants go beyond the offenders themselves. The law states that tenants are responsible for anyone who enters the property, who participates in illegal drugs in any way, on or off the premises. This means that parents who are doing the best they can to be productive citizens could be evicted from their home if their teenager brings drugs into the home. The Supreme Court ruled that the law does, in fact apply to the tenant regardless of whether the tenant has knowledge of the criminal activity or not (Pilon, 2002). Is it right for the government to remove innocent people from their homes in the name of fighting the war on drugs?

Prohibition Puts Unnecessary Strain on the Criminal Justice System
Mandatory minimum sentencing laws for drug offenders is a major cause for prison over crowding. Violent offenders, who have no mandatory minimum sentence requirements for their crimes, are released early to make room for non-violent “criminals” who do (Cole, 2002). Federal sentencing guidelines require a five year prison sentence for possessing a single gram of cocaine. One gram is equivalent to a single packet of sugar (FAMM, 2002). Approximately 4,000 people are arrested daily for selling or using drugs. Roughly a half million non-violent drug offenders are in prison right now, who committed no other crimes (Stossel, 2004). A drug felon is more likely to spend more time in prison than someone who steals, rapes, molests children or even kills (McWilliams, 1996). Is society better off locking up someone for drugs than any of these other more serious offences?

Making room for a half million non-violent drug offenders means allowing a half million violent felons to roam free. Peter McWilliams, author and expert on consensual crimes, made this observation and stated:

Here’s how over worked law enforcement is in the United States: Only 21% of the people who commit murder and negligent manslaughter, forcible rape, robbery, aggravated assault, burglary, theft, motor vehicle theft, or arson are ever arrested; 79% of them – almost four out of five get off scot-free (1996, p200)

In an effort to alleviate the problem of overcrowding prisons, some jurisdictions have turned to “drug courts” as a solution. Recognizing the ineffectiveness of incarceration, Florida policy makers created drug courts as an alternative for first time non-violent drug offenders. Through the drug courts, drug offenders are given a chance to seek treatment instead of serving prison time. Florida’s drug courts have served as a model for the rest of the country (Facts.com, 2002). In fact, the White House is recommending an increase of an additional $32 million for fiscal year 2005; nearly twice the amount appropriated in 2004 for these drug court programs (The White House Office of National Drug Control Policy, 2004). While forced treatment is a better alternative than prison, treatment is only effective for those who truly want to get help. Even if drug users kick the habit, the criminal record that goes with it still has its consequences.

Drug Prohibition is Dangerous and Breeds Crime
Drug prohibition, as well intentioned as it may be, has at least one more consequence: it breeds crime and is dangerous. Why is it that people who, after being released from prison, return to a life of crime? Do they like being criminals? To answer these questions one must consider this: convicted felons cannot apply for federal student loans, have a difficult time finding jobs, have a difficult time buying or renting homes and are prohibited from voting (unless their civil rights are restored). There are no distinctions made between violent and non-violent offenders; a felon is a felon (McWilliams, 1996). The criminal record leaves ex-convicts with very few choices. The only market these most of these people qualify for is the black market. The experience of being locked up with violent criminals teaches inmates how to commit more crimes better.

Only 15% of people who try illicit drugs become addicts (Cole, 2002). For this unfortunate 15%, they find themselves desperate for more. Because prohibition artificially inflates the price of drugs, addicts resort to crime that does harm other people. Unless the addict happens to be very wealthy, stealing, selling drugs and prostitution are a few options for those whose daily drug habit can cost between $200 and $400 (McWilliams, 1996). Participating in the drug trade is very profitable but dangerous. When one dealer encroaches on another dealerÂ’s territory, very bad things happen. Things like drive-by-shootings, which oftentimes endangers the lives of innocent people (Cole). If drugs were legalized, the price would drop dramatically and the drugs could be obtained safely. Even chronically addicted people would spend no more than $5 a day. Supporting a $5 habit would be a great deal easier than supporting a $400 habit. All that would be required would be a part-time job (McWilliams, 1996). In fact 80% of all crime is related to drugs one way or another. It is then reasonable to believe that legalizing drugs would reduce crime by 80% (Cole). Law enforcement could then use its limited resources on the other 20%.

Prohibition is also responsible for much of the health risks commonly associated with banned drugs. Risks include: selling drugs to minors, dirty needles and paraphernalia, uncertain dosages, and contamination (McWilliams, 1996). If drugs were legalized, the government could regulate and set quality control standards for all drugs; much like alcohol and tobacco. To keep children from purchasing drugs, the seller would have to be licensed and could only sell to adults. Currently, drug dealers sell to anyone who will buy them, including children. Quality control standards would result in a lower occurrence of overdoses. The users would know how potent the product is by its labeling. Dirty needles and paraphernalia would no longer be an issue (Cole, 2002). The drugs could also be taxed to fund treatment programs to help those who want to get off drugs as well as drug education programs for schools.

Conclusion
The very idea of legalizing drugs is a scary prospect to most people. Upon further examination however, one thing is very clear: the current strategy is not working. Though the risks would be dramatically reduced, a number of people would still overdose. Regrettably, though drugs would be less accessible to children, some would still get their hands on them. Minors drink alcohol and smoke cigarettes despite both products being illegal, legalizing drugs would have similar effects. As terrible as that may sound, the drug problem could at least be contained through legalization. Granting amnesty to those who have been convicted of non-violent drug offences along with legalization, regulation, treatment and education would go a long way to reducing drug use and crime in general. It is unrealistic to believe that America will ever be 100% drug free. A certain number of people will use drugs no matter what the laws are. Prohibition continues to do more harm to society than drugs ever will. Ending prohibition, though not a perfect solution, would do much less damage. This effective solution would relieve much of the burden on the criminal justice system and would make America a safer place to live. Until America as a whole believes this and plans to do something about it, our society will remain “high” on its arrogance.

References
Cole, J. A. (2002). End prohibition now!. Retrieved April 22, 2004, from http://www.leap.cc/publications/endprohnow.htm

FAMM (2002). Crack vs. powder cocaine sentencing. Retrieved April 7, 2004, from http://famm.org/si_crack_powder_sentencing.htm

Facts.com (2002, February 15). Drug courts. Retrieved April 8, 2004, from http://80-www.2facts.com.ezproxy.apollolibrary.com/ICOF/Search/i0700280_1

McNamara, J. D. (1995, April 9). Cops view of the ‘drug war’. San Francisco Examiner,. Retrieved April 7, 2004, from http://www.leap.cc/publications/copsview.htm

McWilliams, P. (1996). Ain’t nobody’s business if you do: The absurdity of consensual crimes in our free country. Los Angeles, CA: Prelude Press.

Pilon, R. (2002, September 9). Tenants, students, and drugs: A comment on the war on the rule of law. Retrieved April 7, 2004, from http://www.cato.org/pubs/scr2002/pilon.pdf

Stossel, J. (2004). Give me a break: How I exposed hucksters, cheats, scam artists and became the scourge of the liberal media…. New York: HarperCollins.

The White House Office of National Drug Control Policy (2004, March 1). National drug control strategy FY 2005 budget summary. Retrieved April 10, 2004, from http://www.whitehousedrugpolicy.gov/publications/policy/budgetsum04/index.html

Stephen Littau
http://fpffressminds.blogspot.com/

Overheated Rhetoric or Terroristic Threats?

Democrats, Dumbasses and Authoritarians, Multimedia, Political Correctness, Politics, Tea Party, The Welfare State, Unions

Just about this time a month ago, Tea Partiers and those of us who support things like cutting spending were accused of using “overheated rhetoric” in the immediate aftermath of the attempted assassination of Congresswoman Gabriel Giffords among others. Sarah Palin was blamed by Leftwing pundits for inspiring the gunman because she had “crosshairs” on a campaign map which included Giffords’ district in Tucson, AZ. Remember that?

Now fast forward to the public sector union protests in Wisconsin which overwhelmingly supports Democrats. I think Andrew Klavan of Pajamasmedia captures the violence and overheated rhetoric by these union members quite nicely in this video.

Remember, these are some of the very people who lectured Sarah Palin and the Tea Party just a month ago.

It gets better.

Republican Senators in Wisconsin have also started receiving death threats for daring to stand up against the union thugs. The following is one such e-mail:

Please put your things in order because you will be killed and your familes will also be killed due to your actions in the last 8 weeks. Please explain to them that this is because if we get rid of you and your families then it will save the rights of 300,000 people and also be able to close the deficit that you have created. I hope you have a good time in hell. Read below for
more information on possible scenarios in which you will die.

WE want to make this perfectly clear. Because of your actions today and in the past couple of weeks I and the group of people that are working with me have decided that we’ve had enough. We feel that you and the people that support the dictator have to die. We have tried many other ways of dealing with your corruption but you have taken things too far and we will not stand for it any longer. So, this is how it’s going to happen: I as well as many
others know where you and your family live, it’s a matter of public records. We have all planned to assult you by arriving at your house and putting a nice little bullet in your head. However, we decided that we wouldn’t leave it there. We also have decided that this may not be enough to send the message to you since you are so “high” on Koch and have decided that you are now going to single handedly make this a dictatorship instead of a demorcratic process. So we have also built several bombs that we have placed in various locations around the areas in which we know that you frequent. This includes, your house, your car, the state capitol, and well I won’t tell you all of them because that’s just no fun. Since we know that you are not smart enough to figure out why this is happening to you we have decided to make it perfectly clear to you. If you and your goonies feel that it’s necessary to strip the rights of 300,000 people and ruin their lives, making them unable to feed, clothe, and provide the necessities to their families and themselves then We Will “get rid of” (in which I mean kill) you. Please understand that this does not include the heroic Rep. Senator that risked everything to go aganist what you and your goonies wanted him to do. We feel
that it’s worth our lives to do this, because we would be saving the lives of 300,000 people. Please make your peace with God as soon as possible and say goodbye to your loved ones we will not wait any longer. YOU WILL DIE!!!!
Reply Reply to all Forward

What do glass houses and catapults sell for these days?

Hat tip: Boortz

Stephen Littau
http://fpffressminds.blogspot.com/

Lessons from Atlas Shrugged

Culture, Dumbasses and Authoritarians, Media, Multimedia, Political Correctness, Socialism, The Welfare State, Theory and Ideas

Turned on the news recently? It seems the looters (i.e. collectivists) are everywhere and more active than ever. The big story over recent weeks of course has been the special interest government employee union looters in Wisconsin who call themselves “ the working people” who say they have a “human right” to collective bargaining. Meanwhile in Georgia, college and high school students are protesting reforms to the HOPE scholarship that would require higher GPAs to qualify. As in most states, Georgia is in a financial bind and is looking for budget cuts. Due to the high number of students qualifying for these scholarships, some Georgia lawmakers say that there isn’t enough money* to continue to fund it because of rising education costs. Never mind that though, according to some of these protesters, the State of Georgia has “no right” to “take away” these scholarships for those who can’t quite meet the stricter GPA requirements. In both of the above cases, lawmakers bestowed benefits via wealth redistribution to certain people; these people then started referring to these benefits as “entitlements,” “rights,” and even “human rights.”

Then there is Michael Moore, the real life Ellsworth Toohey of our time, with his usual Socialistic tripe explaining that money is a “national resource” and jobs are “collectively owned” by the workers. Click here if you care to hear it.

As if none of this was enough, NFL officials have decided to rename the proposed “Industry Stadium” in Los Angeles to “Grand Crossing” because the word “industry” has a “negative connotation” to it. Apparently the word “industry” can be added to the word “profit” as dirty words in the lexicon of our increasingly collectivist culture.

After all of this, I needed to find something to remind me that there still are sane people in this country who haven’t bought into the collectivist mentality. The video below is the winning entry from a “Atlas Shrugged” video contest.

I’m seriously thinking about looking for a “Galt/Roark 2012” bumper sticker for my vehicle. It’s time for those who value the concept of the individual to be heard.

*The HOPE scholarship’s only source of funds is the Georgia Lottery and my original point that HOPE was an example of wealth redistribution was in error. I continue to stand by my overall point I was making about the entitlement mentality on the part of some of the protesters, however.

Stephen Littau
http://fpffressminds.blogspot.com/

Cuba banned Michael Moore’s “Sicko” for fear of public backlash

Civil Liberties, Healthcare, The Welfare State

The latest revelation from Wikileaks shows that Michael Moore may have been a bit too good at making agitprop even for Cuban authorities to handle:

US diplomatic cables released by Wikileaks show that the government of Cuba banned Michael Moore’s 2007 documentary, Sicko, “because it painted such a ‘mythically’ favourable picture of Cuba’s healthcare system that the authorities feared it could lead to a ‘popular backlash’, according to US diplomats in Havana.”

It continues:

The revelation, contained in a confidential US embassy cable released by WikiLeaks , is surprising, given that the film attempted to discredit the US healthcare system by highlighting what it claimed was the excellence of the Cuban system.

But the memo reveals that when the film was shown to a group of Cuban doctors, some became so “disturbed at the blatant misrepresentation of healthcare in Cuba that they left the room.” Castro’s government apparently went on to ban the film because, the leaked cable claims, it “knows the film is a myth and does not want to risk a popular backlash by showing to Cubans facilities that are clearly not available to the vast majority of them.”

TomStrong
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