Quackery vs Plunder

Author: 
Thomas A. Dorman, MD
Article Type: 
Feature Article
Issue: 
November/December 1998
Volume Number: 
3
Issue Number: 
6

Increasing Regulation

In recent times, we have experienced a hyperbolic increase in regulations affecting all walks of life. Medicine has taken center stage under Hillary. The on-again, postponed-again Billary national health reform cooked in secret (and illegal)(1) conclaves has produced the effect we now understand is the desired one — anxiety, agitation, a high level of uncertainty, namely cognitive dissonance. In this state of collective nervous exhaustion, any solution will be received as welcome relief. Freedom is waning. The Billary solution was the Jackson Hole proposal.(2) This instrument of socialism is managing the population's health, fecundity, and longevity through leveraged control. In time, they will control everyone; the health care providers and the complex of hospital, insurance, medicine, and pharmaceuticals (CHIMP). The name of the game is control. Ivan Illich anticipated these disasters two decades ago; we now appreciate that he was nothing less than a prophet when he wrote: “The medical establishment has become a major threat to health.”(3) After the 1993 Clinton Health Plan was stymied at the legislative level, its perpetrators are trying the back door. This back door has two keys. The first is the introduction of plans through executive fiat, by regulation. More subtly camouflaged, however, is the introduction of legislation by sleight of hand. The technique is to combine fine sounding legislative titles with fascist details, either in the small print, or deferred to subsequent regulation. The introduction of KidKare is an archetypal example.(4) As the federal government does not, ostensibly, have jurisdiction on health matters; the states do; the federal government controls the states by controlling funds from general taxation — leveraged control. The appearance of the controlling legislation, always ready and always complex, arcane and enhancing government control is no accident. The legislation for the states is manufactured by a sub rosa group with this very purpose in mind.(5)  California, for example, is seeing a frenetic increase in legislation related to workers’ compensation litigation. One might think the purpose of laws is stability governed through bureaucracies. But changing legislation every year or two achieves the opposite. Why, we might ask, is this done?

 

Economics

The relationships between men are best studied under the title economics. This realization was reflected in the title of the great economist Ludwig von Mises’ main text, Human Action: A Treatise on Economics. Freedom of action and, hence, efficient economics which in turn lead to prosperity for all, was the basis of the formation of this great Republic. It contrasts with the French Republic of similar vintage. The American principles were liberty and property rights, while the French included egalité (equality) and fraternity, the latter two contradicting liberty as pointed out at the time by Frederic Bastiat.(6) Like a conscience, Bastiat shone the light of reason as each socialist offering was foisted by illuminati agents on the gullible, the new French Republic. He was as steadfastly ignored then as prudence goes unheeded now. If you, dear reader, gain only one point from this article, may it be knowledge of Bastiat’s pamphlet, The Law (1850). Bastiat, whose interest was in property rights and their importance for maintaining freedom and, hence, general prosperity, explained the difference between legal and illegal plunder. Bastiat’s words for the establishment of laws — and what we in America call regulations and administrative law (the fourth branch of government) — are: “The choice before us: This question of legal plunder must be settled once and for all, and there are only three ways to settle it: 1) The few plunder the many; 2) Everybody plunders everybody; 3) Nobody plunders anybody. We must make our choice among limited plunder, universal plunder, and no plunder. The law can follow only one of these three.”(7) As we in America move from republic through democracy to mobocracy, the stage is set for tyranny. The law is abused by pressure groups; the many plunder the few.

 

Health Reform

Demands for health reform by the public have been generated through the dialectic and the skyrocketing costs of health care since the advent of Medicare in 1965. Government-paid free care leads to unlimited demand. The doctors who recommend, prescribe, or furnish the care are enriched; consumer caution and utility consideration are discounted. Added to this, the fear of not providing everything to everyone is whipped into a frenzy by the tort system of law and the equally unlimited growth of lawyering. We are told now that we need to control the monster, to regulate it, as if this monster came from nowhere at all. The monster of unlimited costs was entirely predictable with the provision of unlimited care, mealy-mouthed politico remonstrations to the contrary notwithstanding. The only way to undo the problem is to remove government from the formula. But instead, we are going to have government controls.

 

Control of What?

We are told that it is necessary to control the doctors. Yes, the doctors have been corrupted into providing excessive and at times irrational, even bizarre treatments and operations. The blinkers on academia have limited, nay, even restricted preventive and nutritional methods in health care. The economic engine has been in pharmaceuticals, operations, and doctoring. These have been the results of the Flexner Report (1915) and other actions of the large tax-free foundations which we now know are acting for a political agenda aiming at world peace and world control.(8-11)

 

A Profession Raped

The professionalism of a doctor is his holy commitment to his patient. For a fee, he provides his patient with “[I] will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrongdoing…” It is this doctor’s opinion that Hippocrates intended the physician’s service to his patient to be what we now consider a free market relationship. This is implicit in the Oath, but Hippocrates anticipated neither socialism nor fascism. The holy responsibility of the physician to the patient is the essence of the Oath. It elevated the patient-doctor relationship, albeit a commercial one, to a level that was superior to that of a trade, because the physician promises to provide his best according to his ability and judgment, not according to set criteria by well-meaning or evil-meaning bureaucrats, peer review organizations, or a pharmaceutical industry which is guided by the profit motive, let alone the “philanthropic” foundations which are their tax exempt alter egos.

 

Special Interests

Special interests influence legislation, always in the name of some plausible good. The best example of the apparent good is called the fallacy of the broken window. The fallacy was explained by Bastiat and its modern relevance reviewed in a book which is second in importance only to The Law itself.(12)

Let us begin with the simplest illustration possible: let us, emulating Bastiat, choose a broken pane of glass.

A young hoodlum heaves a brick through the window of a baker’s shop. The shopkeeper runs out furious, but the boy is gone. A crowd gathers and begins to stare with quiet satisfaction at the gaping hole in the window and the shattered glass over the bread and pies. After a while the crowd feels the need for philosophic reflection. Several of its members are almost certain to remind each other or the baker that, after all, the misfortune has its bright side. It will make business for some glazier. As they begin to think of this, they elaborate upon it. How much does a new plate glass window cost? A hundred dollars? That will be quite a sum. After all, if windows were never broken, what would happen to the glass business? Then, of course, the thing is endless. The glazier will have $100 more to spend with other merchants, and these in turn will have $100 more to spend with still other merchants, and so ad infinitum. The smashed window will go on providing money and employment in ever-widening circles. The logical conclusion from all this would be, if the crowd drew it, that the little hoodlum who threw the brick, far from being a public menace, was a public benefactor.

Now, let us take another look. The crowd is at least right in its first conclusion. This little act of vandalism will in the first instance mean more business for some glazier. The glazier will be no more unhappy to learn of the incident than an undertaker to learn of a death. But the shopkeeper will be out $100 that he was planning to spend for a new suit. Because he has had to replace a window, he will have to go without the suit (or some equivalent need or luxury). Instead of having a window and $100, he now has merely a window. Or, as he was planning to buy the suit that very afternoon, instead of having both a window and a suit, he must be content with the window and no suit. If we think of him as a part of the community, the community has lost a new suit that might otherwise have come into being, and is just that much poorer.

The glazier’s gain of business, in short, is merely the tailor’s loss of business. No “employment” has been added. The people in the crowd were thinking only of two parties in the transaction, the baker and the glazier. They had forgotten the potential third party involved, the tailor. They forgot him precisely because he will not now enter the scene. They will see the new window in the next day or two. They will never see the extra suit, precisely because it will never be made. They see only what is immediately visible to the eye.

So we have finished the broken window, an elementary fallacy. Anybody, one would think, would be able to avoid it after a few moments thought. Yet the broken-window fallacy, under a hundred disguises, is the most persistent in the history of economics. It is more rampant now than at any time in the past. It is solemnly reaffirmed every day by great captains of industry, by chambers of commerce, by labor union leaders, by editorial writers and newspaper columnists and radio commentators, by learned statisticians using the most refined techniques, and by professors of economics in our best universities.

 

Research

Peer-reviewed blessings are bestowed upon surgeries and pharmaceuticals which have passed the (FDA-policed) test of trial by statistics($). The system($) makes the cost so high that only large drug companies and instrument makers can amortize the FDA compliance costs and even they are on a treadmill of obsolescence and renewal. The regulation and patent treadmill (RPT) has destroyed the ethics of the pharmaceutical industry. Is it believable that all which cannot be patented is useless?

 

Peer Review

Peer review is analogous to the action of the commentators who laud the hoodlum who broke the window. As Bernard Shaw pointed out in The Doctor’s Dilemma,(13) whenever members of a profession come together the conversation invariably turns to schemes for defrauding the public. Peer review sets standards of care that are sanctioned by the law. The horrible part is done in the name of professionalism. It is by law that we have peer review in place at all.(14) The malfeasance of the doctors is in behaving like any other businessman in a market place, i.e., responding predictably to the economic and tort pressures.

In a free market, any merchant lives or fails on his reputation. In the case of large companies and franchises, enterprises prosper or fail on the basis of the reputation of the trade name. The doctor is, or should be, no different. With the advent of state licensure, when the voluntary medical societies were taken over by the state, in the name of protecting the consumer, of course, the opposite occurs. A reputation in the market place of ideas is founded on solving problems. (Let us not forget that a doctor is foremost a merchant of knowledge.) In a peer reviewed, state and federally regulated environment, a bureaucratic milieu develops. The standard of care becomes what everyone else does. In the managed care arena, the doctor has to satisfy manager and peers, not customers. In fact, the patient and his problem can become nothing more than a nuisance. It should be quite obvious that this is exactly the wrong environment for solving new problems. Herein lies the reason there is so much dissatisfaction with modern health care.

After two and a half millennia, the Oath of Hippocrates has been defiled. It is this destruction that represents the greatest gain of evil over good. The change between the old and new is gradual. We now speak of conservative care with contempt. That is the old style that brought to each according to his (financial) ability but which mostly offered the patient/consumer a utility input into his formula. The doctor acted as his agent, offered his best advice (you might say paternalistically) to the patient, doing his best to weigh the patient’s overall circumstances and using his best judgment for utility consideration, which care was appropriate to the man’s lifestyle, which needed to be reconciled with his other needs and the needs of his family (members of his economic unit). The decoupling of economic responsibility for health care brought a subtle weakening of family bonds.

 

The Seduction of Technology

One might ask how it has come about that health care is in the news now. Why is it now that health care is bankrupting the nation? And how is it that the honorable bond of the doctor to the patient in the Oath of Hippocrates has been raped in our generation? Is it the curse of Prometheus? When Prometheus (the Greek mythological half-god) brought fire (illicitly) from Mount Olympus to mortal man, he was punished. Man could not be trusted with fire. Should we apply this symbolism to modern medicine? Is the medical profession not trustworthy enough to possess (and control) modern medical technology? Can the herd of doctors be trusted to treat patients according to their needs? The term utility is used here in an economic sense. Does the patient get the best for his money when the doctor prescribes? It is contended here that business pressures, pharmaceutical promotions, the glamour of surgery, and hospital company business sway the doctors’ judgments. Nowadays, doctors sell what pays. It is not what the patient would have bought. It is the system we should blame.

 

The Last Nail in the Coffin

 The Dykstra Report was an FDA stopgap to regulate nutrition in 1993.(15) The contemporary equivalent has been globalized. It is the Codex Alimentarius. The irony is that vitamins, amino acids, and the like will be controlled through prescription by licensed physicians. There are but a handful of doctors who know how to use nutritional supplements well. These rules might be quite a test of the conventional medical establishment. With decline of the quality of our food supply, seemingly in part due to the absence of crop rotation and an incomplete understanding of the subtle nutritional needs of a genetically varied population, we shall see either wholesale decline in public health or extensive black markets and almost certainly increased fascist control. After all, so many people will be in default of these regulations that the law will fall into disrepute.

 

Quackery

Quackery is defined as the offer of an illusory cure in defiance of the holy Oath of Hippocrates, the doctor offering a false remedy for gain, using his prestige and title to deceive. Quackery is an act of thievery buttressed by the use of title and prestige. As Bastiat pointed out, public plunder is an act of robbery buttressed by the force of law. When pharmaceutical companies (or doctors) discard useful remedies for expensive ones, which are no better, but for which CHIMP has found research money on the RPT, is that not public plunder? Pharmaceutical companies, hospital management, or managed care personnel do not take the Oath of Hippocrates. This is the reason doctors must never come under their control.

 

References/Notes

1. Association of American Physicians and Surgeons v. Clinton, June 22, 1993, ruling that the interdepartmental working groups headed by Ira Magaziner along with various Task Force "cluster groups" may be subject to the Federal Advisory Committee Act — i.e., must be open to the public.

2. The Jackson Hole Initiative was concocted by a "distinguished" ad hoc group of socialists from government and private individuals under the chairmanship of Paul Ellwood M.D., seemingly under the umbrella of the tax free foundations. It was last revised in March 1992.

3. Illich Ivan. Medical Nemesis: The Expropriation of Health. Calder & Boyars Ltd., 18 Brewer Street, London, England, 1975.

4. Public Law 105-33 in part of the Balanced Budget Act of 1977, Subtitle J (Section 4901).

5. Though this information is not usually made public, one interesting exception is the publication of a centennial commemoration to this sub rosa group: A Centennial History of the National Conference of Commissioners of Uniform State Laws by Walter P. Armstrong, Jr., West Publishing Co., P.O. Box 64779, St. Paul, MN 55164-0779.

6. Bastiat, F. The Law. First published as a pamphlet in 1850. Available at many sources but also from Emissary Publications, 9205 S.E. Clackamas Road #1776, Clackamas, OR 97015 in an excellent English translation by Dean Russell of the Freedom Foundation.

7. Ibid., p. 23.

8. Smoot, D. The Invisible Government. Boston, Western Islands, 1962.

9. Allen, G. The Rockefeller File. 76 Press. 1976.

10. Anonymous. The Report from Iron Mountain on the Possibility and Desirability of Peace. New York: The Dial Press, Inc. 1967. (Also available from Emissary Publications and many other sources.)

11. The skeptical reader might wish to peruse: 1) The Great Medical Monopoly Wars and 2) You Are a Target for Elimination, author P.J. Lisa, published by International Institute of Natural Health Sciences, Inc., P.O. Box 5550, Huntington Beach, CA 92646, 1984.

12. Russell, D. Government and Legal Plunder: Bastiat Brought up to Date. The Foundation for Economic Education. 1985. Available from Emissary Publications.

13. Shaw, B. The Doctor's Dilemma. 1904.

14. This began in the Nixon administration with the PSRO (Public Law 92-603, 1973) and has been enshrined in renewed federal and state laws since.

15. Dietary Task Force Final Report. Dept of Health. May 1992 and Fed Reg 21CFR Ch.1 and Part 101 June 18 1993.

 

Dr. Dorman is a practicing physician in Kent, Washington. His address is Tahoma Clinic, 515 W. Harrison Street, Suite 200, Kent, WA 98032-4403.

Originally published in the Medical Sentinel 1998;3(6):208-211. Copyright © 1998 Association of American Physicians and Surgeons (AAPS).

 

 

 

 

 

 

 

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