Category Archives: Socialism

Will Individualized Medicine Increase Health Inequality?

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?

Lessons from Atlas Shrugged

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.

Comment of the Day: “Education” Edition

Re: “Don’t Forget Your Homework…or Your Miranda Card”

Liberalism in the United States has, over the past forty years, been usurped by the socialist agenda. Our public schools are little more than indoctrination camps for the pacification of future generations.

At the same time, conservatism in the United States has been usurped by war-hawks and fundamentalist christians. Our funding for education has been marginalized, contributing to the growth of the socialist mind-set among educators and educational administrators, as well as contributing to the general ignorance of the populace concerning historical precedent for current affairs, and critical analysis of future prospects for avoiding past mistakes.

They simply do not have the funds to broaden educational horizons for students, and due to the changes in both liberalism and conservatism, have instead created lock-down facilities much like concentration camps which institutionally discourage free thought, free discourse and the development of critical thinking skills.

The continuation of this trend will erode what little is left of truly American society, turning us into a nation of frightened chattel animals whose sole purpose will be to provide revenue and labor for a totalitarian state, and predatory industry owned by the wealthy few, whose political machinations are directly contributing to this end.

Comment by Ken — February 25, 2011 @ 8:48 am

While I don’t agree entirely* with Ken’s comment, he does raise some interesting points. There certainly is a collectivist mindset that is pervasive in our culture on the Left and the Right and I think Ken has successfully identified them.

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Now this is a call to violence

Even with all the crowing from the authoritarian left about violent rhetoric, I have yet to see a call to violence as clear as this one from leftist Sociologist Frances Fox Piven:

So where are the angry crowds, the demonstrations, sit-ins and unruly mobs?

[…]

Second, before people can mobilize for collective action, they have to develop a proud and angry identity and a set of claims that go with that identity. They have to go from being hurt and ashamed to being angry and indignant.

[…]

Third, protesters need targets, preferably local and accessible ones capable of making some kind of response to angry demands.

[…]

An effective movement of the unemployed will have to look something like the strikes and riots that have spread across Greece in response to the austerity measures forced on the Greek government by the European Union, or like the student protests that recently spread with lightning speed across England in response to the prospect of greatly increased school fees.

Piven is calling for the types of protests where rocks are hurled and molotov cocktails are thrown. She wants protests where property is destroyed and people are killed. She hopes that such moves will intimidate government at all levels in this nation into further forced redistribution of wealth.

As commenter Florida pointed out over at Althouse:

They [the leftists] want violence … as long as it’s THEIR violence.

As long as they are the ones bringing the thugs to the town hall meetings.

As long as they are the ones telling US what we must buy and who we can watch and what they can say.

That’s all they want.

Yeah, that’s all they want. Remember, Piven and her ilk are the kind who claim moral superiority to the rest of us. They arrogate to themselves the moral authority to regulate any aspect of our lives they choose. If we don’t cooperate with them, they are willing to intimidate us, hurt us, and kill us. The thought of a free society of equals is simply beyond their comprehension.

To the left, words in opposition to their cause are more violent than assault and murder in support of it. Never forget that.

Marxism And Libertarian Exploitation Theory

I tend to be a stickler for definitions and proper usage of terms. One of those that stick in my craw is the use of “Marxism” to describe a lot of systems that Marx wouldn’t have supported. Marx, as an intellectual, had quite a few pretty strong insights economically, but he had some social beliefs on human nature that led him down the wrong path. While I’m no Marxist, by ANY stretch of the imagination, I find myself sometimes defending Marx from the unfair criticisms. There’s enough about his beliefs that are fair to criticize that it makes no sense to add falsehoods.

The Marxist philosophy, as I understand it, can be boiled down into theories of exploitation. He dealt first with mankind’s defeat of feudalism. Feudalism is the exploitation of the masses by the aristocracy, where all property was owned by the traditional power elite, and the masses (subjects) were given pittance as reward for toiling for those masses. Marx viewed capitalism as the proper, and beneficial, opponent of feudalism. Capitalism offered levels of freedom for the masses that feudalism before it did not, but he believed that it created a new and different type of exploitation. Capitalism offered a more free exchange of labor for property, but there were typically two classes still — the capitalists and the workers. The capitalists had enough of a stranglehold on the means of production that they extracted a surplus from the workers; they paid them too low of a wage compared to the value* those workers produced.

Thus, Marx believed that while capitalism was a positive marker on the road of human social evolution, he didn’t believe it was the end point. Marx saw an end point where the “capitalist class” ceased to exist. At that point the “worker class” would own the means of production, and thus there would be no exploitation of the surplus value. The workers would retain this surplus. But Marx’s vision DID NOT include a totalitarian state to divide the spoils of production. He saw, rightly, that the state itself could easily be an exploitative entity, and thus the Marxist communist vision of society was really anarcho-socialism.

Marx saw that to break the capitalist stranglehold on the means of production, there would likely need to be a period of state socialism. The capitalist class was not willing to give up their surplus freely. They would need to be broken, and to do so an entity with the power to carry out that duty must exist — a state. Once the capitalists had been broken, though, he believed the state itself would wither away out of lack of necessity.

Marx made what I would consider to be three critical mistakes in his analysis:

  • Humanity has far too close of a relationship with property to function in an anarcho-socialist system.
  • The state, once breaking the capitalists, had too many perks to let itself “wither away”.
  • Much of his goals for workers “owning the means of production” are already beginning to occur within capitalism.

The first point is a bit of my own conjecture, but stems from Marx’s treatment of classes as classes rather than the more individualist libertarian treatment of classes as collections of disparate individuals. Marx saw the proletariat seizing the means of production and then finding harmonious sustainable ways to equitably distribute the fruits of such production. The analysis does not take into account individual goals, which is a very human desire to maximize gains for one’s self and one’s own. Humans are cooperative, but we are cooperative individuals. Cooperation can be sustained in a system of mutual benefit, but humans typically have a difficult time sacrificing for the collective over the long haul. Anarcho-socialism relies on such mutual cooperation (and sacrifice) in the absence of a coercive entity, and thus relies on human nature to be compatible with such a system. I do not believe human nature is so constituted — which, of course, is why I’m an anarcho-capitalist.

The second point has been demonstrated in nearly every society which has taken a serious stab at state socialism. The rulers become quite fond of being the rulers, and enjoying the material and societal perks of being at the top of the food chain. Rather than dismantling the exploitive class, they replace it with themselves. If faced with the choice of “withering away” or putting down their opposition by whatever means necessary, they usually opt for the latter. Lord Acton’s old adage about power corrupting holds sway.

Finally, Marx discounted capitalism’s ability for the working class to own the means of production without seizing it — they may merely buy a piece. American corporations don’t limit stock purchases to fellow robber-barons, they let any old average Joe with an E*Trade account have a piece. In 2000, America passed the tipping point, with 50% of households owning stock. The 401K is widely used as a wealth-building vehicle, and rather than discourage this, corporations compete as to how much of a matching contribution will be added. Further, larger corporations often have employee stock purchase plans where, at discounted rates, employees can buy directly into their own company. Modern economics is blurring the line between the “working class” and the “capitalist class”. But in the reverse of Marx’s prediction, it is the inclusion of workers into the capitalist class that is blurring the line.

Interestingly, a recent paper written by Ralph Raico of the Mises Institute (and printed by the Campaign for Liberty here) compares some of Marx’s writings on the exploitation of the state over the masses to those of classical liberals. Marx saw the potential for government to stand independent and against the interest of its subjects; one wonders why he thought a transition through state socialism to pure communism would ever work:

Every common interest was straightway severed from society, counterposed to it as a higher general interest, snatched from the activity of society’s members themselves and made an object of government activity, from a bridge, a schoolhouse and the communal property of a village community to the railways, the national wealth and the national university of France…. All revolutions perfected this machine instead of smashing it. The parties that contended in turn for domination regarded the possession of this huge state edifice as the principal spoils of the victor …under the second Bonaparte [Napoleon III] …the state [seems] to have made itself completely independent. As against civil society, the state machine has consolidated its position …thoroughly. [Quoting Marx from Raico’s piece]

At the same time, classical liberal writers denounced the warmaking powers of government as tools of the elite and financial interests, operating on the backs of the masses:

The degree to which one finds the concepts of classes and class conflict used in this sense in 18th- and 19th-century liberalism, once one looks for it, is astonishing. To take two examples: this is clearly what Tom Paine is talking about in The Rights of Man, when he speaks of governments making war in order to increase expenditures; and what William Cobbett is getting at when he terms gold the poor man’s money, since inflation is a device utilized by certain knowledgeable and influential financial circles.

As [John] Bright put it:

The more you examine the matter the more you will come to the conclusion which I have arrived at, that this foreign policy, this regard for “the liberties of Europe,” this care at one time for “the Protestant interests,” this excessive love for the “balance of power,” is neither more nor less than a gigantic system of out-door relief for the aristocracy of Great Britain.”

Later in the century, Bright identified other classes as the promoters of imperialism. In the case of the British occupation of Egypt in 1882, Bright (who resigned from the cabinet on account of it) believed that the City of London (i.e., financial interests) were at work, and, according to his biographer, “he did not think that we ought to involve ourselves in a series of wars to collect the debts of bondholders or find new lands for commercial exploitation.” He agreed with his friend Goldwin Smith, the classical-liberal historian and anti-imperialist, who wrote him that it was simply a “stock-jobbers’ war.” This was long after Cobden had died, but the latter would doubtless have agreed. He once wrote: “We shall offer no excuses for so frequently resolving questions of state policy into matters of pecuniary calculation. Nearly all the revolutions and great changes in the modern world have a financial origin.

It is thus interesting that those today who would call themselves “Marxists” support the very oppressive governments that Marx himself derided, while attacking the classical liberal underpinnings of Adam Smith and the classical liberals, who were likely very influential to Marx’s own thought.

I have little love for Karl Marx and his theories. I do, however, have great interest in him. He has become a caricature of both the left and the right, celebrated or opposed for fictions about what he believed and espoused. As I’ve said, I think there’s a lot to teach about Marxism and its flaws as a theory. It offers the ability to further highlight the classical theories that led to Marx, and show why his “improvements” on said theories are bunk. But if the left equates Marx to Ghandi, and the right equates Marx to Stalin, we’re not going to get anywhere.
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