Does everyone have a right to the best medicine?

A friend recently asked me what I think about the following:

UN Human Rights  Council says everyone has the right to the highest attainable standard of physical and mental health.  Here are my thoughts:

As I wrote in my health care paper years ago, there are 3 different types of health care system which can work:

·         One-payer
·         Assured floor with rising tide that helps all ships
·         Libertarian

I favor the “rising tide” approach but people have the right to vote for any of those approaches.  Fortunately, there are some common principles which apply across all three types.  Unfortunately, those principles are not adhered to.

I don’t agree with the belief that everyone has a right to everything.  Essentially, this is the belief that everybody has the right to equal results, as opposed to equal opportunity. 

Health advances have occurred thanks to efforts in two sectors:

·         Government initiatives in terms of sanitation, requiring vaccination, etc.
·         Private enterprise – the medical advances discussed here fall into that sector.

The private sector advances have occurred because individuals have had incentive to take a variety of risks in order to pursue advancement.  Over time, all the advancements have reduced in cost, hence become available to a broader population.  Charitable organizations have contributed to spreading availability.

The risks are greater today than ever because:

·         Lawsuits make it scary to make many of these products available today.  Products have been pulled off the market.  Research is dulled also as a result.  This is a significant market access issue that the UN Human Rights Council seems to have ignored.

·         Government processes increase costs substantially and make returns more delayed and less certain.  This impacts price substantially.  Some of it (maybe a lot of it) is justified.  But there is also a restriction on human rights when a government forbids an individual from using a medicine that individual wants to use, as well as an impact on price and development.

·         Competition is much more severe in all aspects of business in the world today.  So you can get beaten to market or have a very short-lived product.

Nonetheless

1.    Profits might be too high in pharmaceuticals, but that is a huge topic that can’t be adequately addressed here.  I don’t like the short-term views of corporate management, in general.  Part of the short-term view is attributable to larger cities and more distant competition.  Businesses no longer have the same relationship with their local communities.  I’m not sure how to change this.  It is partly cultural.  However, encouraging more entrants generally leads to more competitive pricing. New technology in dealing with RNA and DNA enables gene-splicing very inexpensively, which lowers barriers and costs, helping to develop new medicines and reducing cost.  We need to encourage such competition, not discourage it.

2.    Certainly there is an opportunity to provide better health services worldwide.  For example, I love generics, but the inventor must be protected for an appropriate amount of time.

The UN Human Rights Council proposes to “delink medical research and development from the prices of medicines, diagnostics and vaccines”.  The article gave no indication of how they propose to do so.

What is Patriotism?

Robert Reich created this YouTube video What is Patriotism?, in which he defines 5 principles of patriotism.

Here are my alternative 5 principles of patriotism:

1.      Work toward the common good.

2.      Pay fair share of taxes.

3.      Respectfully discuss issues honestly and educate the public.

4.      Avoid overburdening future generations with crushing debt.

5.      Protect individual rights (including but not limited to free speech) and the separation of powers

Reich argues that we should love our government rather than hate it and we should work to improve it.  Unfortunately, Reich supports huge central government which is NOT patriotism.  Patriotism involves protecting individual rights.  It is striking that, other than the freedom to vote, Reich’s 5 principles do not mention defending individual freedom, which is the foundation of our government.  Nor does he cite the importance of separation of powers, which I think is the most important governmental characteristic that has made our country great.  Separation of powers is fragile, threatened and must be defended.  Government has a role in protecting our rights, but we must be diligent to avoid providing government powers that can lead to oppression.

Protecting the right to vote includes protecting the legitimacy of the vote.  Identification is required for many mundane things in our daily lives, yet he opposes protecting the legitimacy of vote which he cherishes.  Unfortunately, Reich and his allies have shown no interest in finding a solution to avoid election fraud, instead simply arguing fatuously that it does not exist. It does not exist?  Reich’s allies funded substantial voter fraud performed by ACORN.  We had an election in Missouri that was decided by one vote; a relative of the “winner” voted in the wrong district, thereby deciding the election.  There may well have been other fraudulent votes as well.

Reich urges that we not “buy off politicians”.  Of course, this is “apple pie”, but it is a narrow issue to address.  More broadly, politicians’ integrity should be a key litmus test in voting.  Instead most voters reward dirty politics, false campaign promises, etc.  If politicians are being bought off, we are voting for the wrong people.

Reich cites being involved politically as a principle of patriotism.  Our involvement should protect and respect free speech and educate voters by clearly defining the issues and potential consequences.  Politicians in both parties provide slanted, emotional and even false information, ignoring valid points their opponents make, preferring to persuade citizens to disrespect their opponent’s positions.  Reich’s allies are particularly guilty of trying to limit speech which is not “politically correct”.  Such repression has been typical of our universities, for example, for generations.

Reich’s 5 principles include not pandering to divisiveness.  I agree strongly, but Reich strongly supports spending money we don’t have to pander to uninformed voters at the expense of future generations.  Driving our country into insolvency is the antithesis of patriotism, in my opinion.

George Gordon is right: we need respectful discussion

http://www.kansascity.com/opinion/readers-opinion/as-i-see-it/article87291222.html

I applaud George Gordon’s “As I See It” article in the KC Star on July 4, 2016 (link above)!  We certainly need more respect for different opinions.  If probed, we'd find more common values than each side may think exist.

In Mr. Gordon's article, he did not mean to say that, in general, either side is devoid in the values of the other, solely that one side favors them more.  In some cases, the sides are much closer than people might think.  For example, the sides each value creativity, but different types of creativity, in general.

A key difference that I suspect Mr. Gordon would agree to add is that the "Main Street" mentality is more concerned about creating burdensome debt that will crush our society and our descendants.

I disagree (could be worked out by discussion) with his position that the "Liberal Arts" group values freedom of thought more than the "Main Street" group.  My observation is directly opposite.  For example, there have been repressions of freedom of thought on our campuses for decades.  The "Liberal Arts" (aka "left") has largely supported freedom of thought only for those who share their "politically correct" opinions.

We greatly need to have respectful discussion particularly among politicians and need political leadership that works successfully at bringing us together rather than dividing us.  Unfortunately, we have not had a president with a unifying approach since Bill Clinton 16 years ago and both of our 2016 presidential candidates have historically been dividers rather than unifiers.

I would reluctantly vote for the Iran treaty

I think I would reluctantly vote for the Iran treaty because:

1.      Our ability to apply pressure to Iran has already been seriously compromised.

2.      We are not likely to benefit from rejecting the treaty.

3.      In general, we need to be seen as a responsible nation with which to negotiate.  If our diplomats are not permitted to represent us in such fashion, we will suffer in the long run.

4.      Sadly, I fear that some opponents may be criticizing the treaty for political reasons rather than because they believe it to be harmful.  The extremism in our politics is poisonous, contributing to fears of this type even if they may not be accurate.

I was impressed by the effectiveness of the international boycott of Iran.  It brought Iran to the bargaining table.  However, maintaining such boycotts is difficult.  Simply sitting at the bargaining table weakens an international boycott.  As soon as the prospect of lifting the boycott arises, some boycotters start making plans for the discontinuation of the boycott.  The other party will try to create and leverage likely differences of opinion and interest among the boycotters.  For a negotiation of this type, preconditions are appropriate, because of the risks of a splintered boycott and because of the strong bargaining position we had going in.

It is important to have strong negotiation skills and strong strategic insight.  Unfortunately, even though I obviously don't know all the details, I have reason to believe that our current administration is weak in negotiation. 

a)      I agree with President Obama that diplomacy is better than force and that the previous administration used force ill-advisedly.  (I expressed my opposition to that force at that time.  It's a shame that so many people agree now, but did not stand up at that time.)  I believe most people have similar values, however our President seems to have a Pollyannaish trust of foreign people (he seems to have much less trust of people in the USA). 

b)      He has been too strong in publically denouncing our past positions and criticizing our country.  I favor admitting mistakes.  Unfortunately, President Obama admits mistakes that others in the USA have made, but not mistakes that he has made.  He has caused our adversaries to think we lack resolve militarily and also in tough negotiations.

c)      I voted for President Obama the first time he ran.  Being willing to meet with the Ayatollah without preconditions might be appropriate, under some circumstances.  But I was concerned at the time that continually campaigning on such a position weakened his future bargaining position with Iran.  It helped to create the impression that President Obama might be more committed to reaching an accord than to insist on appropriate positions.  Perception is not reality, but it influences reality.  His approach is very different from "speak softly but carry a big stick". 

d)     Similarly, announcing a future fixed date of withdrawal (from Iraq) relinquishes control of developments to your enemies.

e)      I was appalled when the administration rejected Mubarak's offer to plan a controlled transition of power in Egypt, insisting instead on an abrupt change.

f)       President Obama has repeatedly signaled to the Arab world that the USA support for Israel is flagging.  I suspect his rhetoric encouraged the Palestinians to seek full UN membership in 2011 and that the Palestinians were surprised when the USA opposed them.

If I was the President, I don't think I would have accepted the Iran deal for the following reasons.

                                i.            The boycott seemed to be effective.  I might have taken steps to buttress the boycott against  an inadequate Iranian offer or may have required pre-conditions in this circumstance.

                              ii.            There was an international agreement that the spread of nuclear weapons was unacceptable.  The Iran deal seems to have negotiated that position away, for a mere 10 to 15 year delay.  (I understand that there is hope that we can accomplish more in negotiating with Iran in the next 10 to 15 years, but I am not optimistic.)  We run the risk of encouraging nations to develop nuclear capability so that they can persuade other countries to give them concessions to alter their path.

                            iii.            The agreement may allow Iran to delay inspections sufficiently long to avoid detection of cheating.  It appears as though we'll have a series of problematic exchanges with them.  Many experts say that the agreement has adequate teeth.  Obviously, they know more about it than I do, but my experience is that people get hopeful and that there are political incentives for them to look at the optimistic side.  Hopefully, my skepticism is misplaced.

                            iv.            The agreement does not seem to put any limits on what Iran can do outside its borders.

                              v.            We are providing substantial economic support for a lot of international mischief.  That mischief will have long-term consequences and all we got in return was a 10-year delay.  I'm sorry but in my view, 10 years is a very short period of time.

                            vi.            The proponents are saying the alternative is war.  I'm not sure that is true, but the bigger issue may be that the agreement may lead to more confrontations and military spending throughout the Mideast.

Boko Haram

How can we stand by when so many crimes against humanity are occurring?

We are missing the point.  Political terrorism is one thing; crimes against humanity is critically different!

Leaving political terrorism to be dealt with at the local level may be the right approach.  But today's crimes against humanity should meet a strong coordinated international response.

We have stood by while Boko Haram has committed unspeakable crimes.  Clearly, the government of Nigeria has been unable to defeat Boko Haram.  However, an international force should be able to encircle their hide-out area and deal with them relatively easily. 

Admittedly, there is a risk that hostages (the kidnapped girls) could be killed in the process.  I lack expertise in the methods that should be used to minimize such deaths.  But allowing Boko Haram to perpetuate its atrocities is not an acceptable position.  The risk of innocent deaths must be accepted to reduce long-term exposure.

Dealing with Boko Haram would be an example for others who would commit such atrocities.

We are also standing by despite an incredible wave of people fleeing their homelands for safety.  ISIS is not just a political movement.  ISIS's crimes against Shiites, Kurds, Yazidis and others constitute crimes against humanity.  How can we turn our eyes away from wholesale murder, enslavement and torture?  Rooting out ISIS is hugely more challenging than Boko Haram, but it also should be addressed by international forces.

Power Corrupts; Absolute Power Corrupts Absolutely

Lord Acton (John Emerich Edward Dalberg-Acton) said "Power tends to corrupt, and absolute power corrupts absolutely."  According to Wikipedia, scientific experiments have confirmed his statement.  Do we really need scientific experiments to know this?

People who do good things go awry when they have too much power.  We see this again and again, yet don't learn from it.  We need checks and balances.

Just this week, the principle struck home twice:
1)  My wife and I watched a movie about J. Edgar Hoover.  He did a lot of good things, but proved to be an excellent example of this principle.
2)  Then I saw a program about Sepp Blatter who helped FIFA get on its feet financially.  His power also was unchecked and led to abuses.  Yet he was elected to head FIFA when running against a qualified reformer.

The true culprit is we, the people who allow this to occur.  We vote for people despite knowing that they are abusing power.  Unfortunately, most people accept abuse of power and often other unethical behavior if it is done by someone with whom they agree politically.

On a regular basis in the USA, people decry actions of the opposing political party (such as obstructionism and dirty politics) after having supported essentially the same actions done by the party they support.

One of my first encounters of such behavior was when Richard Nixon was running for election during the Watergate cover-up.  We did not know what had been done at the Watergate Hotel, but it was clear there was a cover-up going on.  I couldn't vote for a President who was engaged in cover-up, but when I talked with people who had voted for Nixon previously, it seemed impossible to convince them not to vote for him again.

Now President Obama is trying to disrupt the nation's historic checks and balances and many people applaud or accept his actions.  When I suggest that they might regret supporting a strengthened Presidency when a Republican is in office, they seemingly are not fazed by my comment.

Acton also said "Great men are almost always bad men."  I don't agree with that. Some great men are bad men but a lot of great men are good men.  They don't always seek too much power and they are not always given too much power.  When they get too much power, one of two things happens.  Generally, their behavior worsens.  I don't think that they are necessarily bad men; they are good men who have developed too much confidence that their goals are right and they succumb to the belief that the ends justify the means.  There are rare people given that power who don't abuse it, but successors inherit the power and succumb.

It is extremely important for leaders to surround themselves with people whose minds work differently and who are not afraid to question popular conclusions.  George W. Bush failed in this regard.  His "war hawks" had nearly identical world views which made it easy for Bush to take actions that were ill-conceived.

If we truly care about our country, we must vote more intelligently and speak up strongly for moral behavior.

Wendell B. Leimbach, Jr., USMC

Next Friday, I will attend the pinning ceremony for a new Marine Colonel (Wendell (“Wel”) B. Leimbach, Jr.) at Quantico.  It would be nice if you (and others) could jot a note of appreciation for Wel’s efforts on behalf of our country.  (As I fly on Thursday, I want to print the comments on Wednesday evening.)

I don’t have to tell you about the carnage wreaked on our troops by IEDs in Iraq and Afghanistan.  For his work improving body and vehicular armor to protect against IEDs, Wel was honored with Andrew J. Higgins Award for procurement in 2006.  His work saved countless lives.  Obviously, that effort is not his sole contribution, but it is the one of which I am most aware.

Please do NOT tell Wel’s parents (Wendell, Sr. and Sally Leimbach) about this effort. If you want to compliment them regarding their son, please create a follow-up to do so after September 13, as I intend present the "thank yous" to Wel during his “wetting down” celebration on the 13^th.

Here are some links I found regarding the armor situation.  The last one is a presentation of Wel’s that I found on-line.

        ·         http://www.nytimes.com/2006/01/07/politics/07armor.html?pagewanted=1&_r=3

·         http://www.nationaldefensemagazine.org/archive/2005/October/Pages/amid_bursting5560.aspx

·         http://www.nrl.navy.mil/content_images/06FA3.pdf

·     http://www.dtic.mil/ndia/2007combatvehicle/NDIACOMBATVehiclesDay1/PEOPMLandsYSTEMS1230PM/NDIABrief_Oct2007_3.pdf

 Thanks!