We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.

Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

Martin Shkreli on the Milo Show

“One of my top scientists has four kids. How is he going to provide for his kids without profit?” So says Martin Shkreli on this week’s Milo Yiannopoulos Show. Shkreli is supposedly the most hated man in America for raising the price of the drug Daraprim from $18 per dose to $750. The way he tells it, it was like buying a wine company that was selling wine for $2.50 cents per bottle but losing money, when all the similar wine was selling for $100 per bottle. He saved the business.

He described being interviewed on CNBC, a business news channel.

I went on there and it felt like they were shaming me for raising the price of Daraprim and I’m sitting there saying, “all fucking day, 24 hours a day all you talk about is profits, and my profits are inappropriate?

Milo laments the regression of America from a place that celebrated success to one where the media and the government like to punish rich people. Shkreli pointed out how people used to love to hate Bill Gates, but they do not any more, now that he is giving he money away. “What else did they think he was going to do with it?” he asks, pointing out that once you have one billion dollars, you can no longer really spend any more on yourself.

Shkreli has been arrested on fraud charges. He says the charges against him make no sense, given that his investors are making lots of money.

In the interview he comes across as a fun guy who annoys the right people. His Twitter feed is entertaining, too.

Update: There is something of an Ayn Rand novel about his questioning from Congress.

War on Sugar

Mars, owner of Dolmio and Uncle Ben’s food brands, is labelling its products to tell people which ones they should only eat once per week. It is something to do with trying to get people to eat less sugar, for some reason.

Nutritionist Jenny Rosborough from Action on Sugar told the BBC’s Victoria Derbyshire programme: “It’s great that they are pushing forward this responsible labelling and raising awareness. “But the challenge we have with it is that only the health conscious will look at the labels in the first place, therefore it’s not going to hit the people who need it the most.”

By which she means poor people who are too stupid to be allowed to make their own decisions. And who are Action on Sugar anyway? The writer of the blog Hemiposterical has found that they are the same people as Consensus Action on Salt and Health, funded largely by the mysterious Marcela Trust. What motivates them, I wonder? (Incidentally, even the NHS is very lukewarm about the harmful effects of salt, when pressed.)

And where did this new war on sugar come from? There is a sugar tax. There is even an app. Made by a quango. It is like a conspiracy of very boring illuminati. And even evil multinational corporations are going along with it. Very strange.

Perhaps it originates from inside the World Health Organisation, who last year urged “countries” to reduce people’s sugar intake by half to 25g per day for adults because sugar causes bad teeth, obesity and diabetes. Yesterday I drank a 330ml bottle of lemonade containing 33g of sugar. I am not obese, do not have diabetes and still have all my teeth.

Put yourself in the position of the head of a government agency. You have an amorphous blob of population and you can poke it with various sticks (such as advice, regulation and taxes) and observe the effects (such as the amount of money spent on certain medical treatments). You can vary the pointyness of the sticks and the amount of poking and get different effects. You keep doing this until you get the effect you want. The truth of the stick is irrelevant. Individuals have no reason to think that there is any truth in government advice. It can be ignored (ignoring taxes is harder). What surprises me is that I observe people making some attempt to follow the advice and berating themselves for failing.

Death to the blasphem… long live the brave reformer!

“Let’s abandon our broken NHS and move on”, says Melanie Phillips.

Dame Julie Moore, the respected chief executive of the University Hospitals Birmingham trust, was asked last week to explain why the NHS was in such difficulty. A lot of it, she believed was down to leadership failure and incompetence on every level. “We’ve created a culture of people who are terrified of making decisions because you can’t be held to account for making no decision but you can if you make a decision,” she said.

Much of the blame lay with previous governments who had centralised power, leaving many of her colleagues “waiting for a command from God on high” instead of taking the initiative.

What Dame Julie describes is typical of highly politicised bureaucracies. In the NHS, this entails a culture of fear from the health secretary downwards. What are they all so frightened of? In essence, that the veils of illusion surrounding the NHS will be torn away and it will be seen to be the failure that it is.

That this is so surprises me not at all. That it is said by a popular, if marmite-flavoured columnist suprises me a little. That the comments ordered by recommendations enthusiastically agree with her surprises me quite a lot. One would get a very different result at the Guardian, of course. The Daily Mail? Right now, I think the Mail readers would feel as free as Times readers do to recount their bad experiences of the NHS, yet would still baulk at the words “abandon the NHS”.

Public Health Wales keeping themselves in work

E-cigarettes could be banned in Welsh public places to protect children, reports the Telegraph.

E-cigarettes could be banned in public places where children are present in a landmark vote in the Welsh Assembly.

The Labour-controlled government in Cardiff Bay is hoping to pass its Public Health (Wales) Bill in the Senedd on Wednesday.

If passed, the Bill would become a UK first and would restrict the use of nicotine inhaling devices in certain public places – such as schools, places where food is served and on public transport.

The move has been criticised by opposition parties and even divided opinion among health charities.
However, Health Minister Mark Drakeford insists the legislation will protect people from harm – and the curbs on e-cigarettes would make smoking less appealing to youngsters.

He said: “The Bill will help us to respond to a range of public health threats in Wales, including the risk of re-normalising smoking for a generation of children and young people who have grown up in largely smoke-free environments.

But if smoking could by some strange magic – some ingenious invention, let us say – be supplanted by a process that gave similar satisfaction but was much less dangerous, why would normalising that be bad? “Think of the children” is not an intrinsically bad argument. Hard-core libertarian though I am, I do concede that it would be better not to smoke around the kiddies. But making it harder for smokers to quit involves the consequence that the children of those smokers will not grow up in smoke free environments when otherwise they might have. I would have thought that the health of the children of smokers, the children we are told are being harmed with every breath they take, should be prioritized over the purely theoretical health problems that might or might not arise for a future generation after something that looks like smoking has been “renormalised”.

Cancer Research UK and the British Heart Foundation, a couple of medium-fake charities that I would once have expected to join in the chant of “ban it” are showing surprising sense. No such weakening and deviationism is seen from Public Health Wales. Nothing will sway this “health body”, whose austerely modernist Three Random Word name is purged of all extraneous prepositions, from its work of protecting itself from evidence-based policymaking:

And health body Public Health Wales’ added: “We cannot sit around and wait a couple of decades to see whether or not the conclusive evidence that people might like to see is available before making a judgment.”

UPDATE: Mr Ed tells me that the measure failed to pass by the narrowest of margins after a considered and principled change of mind by Plaid Cymru. Nah, not really. It failed after a Labour guy called Plaid a “cheap date” and Plaid got into a huff. “Oft evil will shall evil mar”, as Theoden said about Wormtongue, a bloke almost as prone as the members of the Welsh Assembly to throwing his toys out of the pram.

Doctors do not have it so bad

Sam Bowman has written a rip-roaring article about the NHS junior doctors dispute. Instantly win any debate with your NHS-worshipping Facebook friends.

This, too

Over the last month or so the Guardian has been running a series about the NHS. Here is a typical piece: That was the NHS: stories of hope, kindness and the human spirit.

Fair enough. But “the human spirit” is a god with many faces, and this, too, was the NHS:

Grandmother died of THIRST on an NHS ward ‘after nurse refused to give her a drink in case she wet the bed’

Exterminate All Mosquitoes

Zikavirus, which is now spreading rapidly throughout South America and the Caribbean, is just the latest mosquito-borne disease to plague mankind.

Mosquitoes spread Malaria, Chikungunya, Dengue Fever, Yellow Fever, a variety of forms of encephalitis (Eastern Equine Encephalitis, St. Louis Encephalitis, LaCrosse Encephalitis, Japanese encephalitis, Western Equine Encephalitis, and others), West Nile virus, Rift Valley Fever, Elephantiasis, Epidemic Polyarthritis, Ross River Fever, Bwamba fever, and dozens more.

I’ve been unable to find a reliable overall death toll for mosquito-borne disease. However, it is likely that at least a million people die a year from malaria alone. Countless more die from the other diseases. It is known that the number of people infected with one disease or another by mosquito bites every year is in the hundreds of millions.

In short, the mosquito is one of mankind’s greatest enemies.

Thanks to the recent development of CRISPR/Cas9 based gene drive technology, the human race is now at last on the cusp of having the capacity to drive those varieties of mosquito that feed upon humans (which are a minority of the 3500 known species) entirely into extinction, by producing mosquitoes that will produce fertile male descendants but no fertile female descendants. [See my explanation after the end of this essay on how this might be done.*]

Few actions could reduce human misery and improve the condition of mankind so greatly as the permanent elimination of mosquitoes and the myriad of diseases they spread throughout the world. It would be worth doing even if it required decades and vast expenditures to accomplish. The fact that it can be done at fairly low cost and quite quickly (over years rather than decades) is almost icing on the cake.

I am certain that some people will vocally and perhaps even violently oppose this work, both because of an irrational fear of genetic engineering technology and because of a misplaced belief that eliminating mosquitoes will somehow damage the environment. The general consensus is that it will not. However, I strongly feel that even if there was minor collateral damage to the environment, it would be well worth that cost to prevent at least a million deaths a year.

Some would caution we should consider an act such as the deliberate extinction of a whole class of parasitic insects with great caution and take such steps only quite slowly. However, in a world where a child dies of malaria every 40 seconds or so, I think we should, if anything, be racing ahead as fast as we can possibly manage.

Now that we have the capacity to exterminate mosquitoes, not to do so strikes me as a gravely immoral act.

→ Continue reading: Exterminate All Mosquitoes

Libertarian Home on the doctors’ strike

Zach Cope at Libertarian Home has a post that puts today’s UK NHS junior doctors’ strike into perspective.

…junior doctors have little choice of employer as there is an NHS monopoly on training; the market has shown the pay and conditions are too low, with dangerously understaffed rotas, rising emigration and increasing locum rates. The government’s proposals would reduce staff pay for an equivalent rota over time, thus hoping to delay the inevitable financial collapse of the NHS on their watch…the problem of regulation and central contracting leads necessarily to collective bargaining and industrial action.

Centralised provision of anything always leads to shortages. Mr Cope has various ideas for decentralising things in his post, too.

Personally, I envisage healthcare that is cheap and good because it is private. So cheap and good that nobody has to think twice about poor people who can not afford treatment. Much as our friend the Guardian commenter narnaglan described:

Did you know that the only medical proceedure where quality is going up and price is going down is elective Lasic eye surgery? Thats the proceedure where your cornea is made thinner to adjust the focus of your eyesight. It is not available out of stolen money, so the people who provide this service, and there are many of them, all compete with each other to give the best service at the lowest price. They compete to offer you the latest, safests techniques, using the most sophisiticated equipment.

Think about it. There are three Lasic clinics, two offering the same service at the same price and the third offering it at a lower price. Only one of the three has the latest equipment. You pick him out of the three, because he will give you the best outcome. The other two must adjust their offer to attract the clients. People with a little less money might pick the third, cheaper clinic, and the middle one might be chosen because it is closest.

What this shows is that in a dynamic market, everyone is served, and all clinics and service offerers are incentivised to do their best at the lowest price. This is completely different to the NHS, where it does not matter how dirty the hospital is, or what the outcome is; since there is no choice, no one needs to care about the price of anything or the quality of service being offered.

Of course, it will be cheap but doctors will still be well paid because they will be so effective.

A little less lobbying, a little more curing, please

Join thousands of Dryathletes dropping the drink this January and raising money to help beat cancer sooner”, says Cancer Research UK. What bilge. Abstaining from alcohol for a month does nothing and is nothing. Absent real problems, anyone can just drink exactly what they want whenever they want. That anyone takes seriously the pretence that deciding not to drink for a while is an act of effort comparable to training for an athletics event only indicates how low standards of achievement have sunk. People should be expected to grow a spine and take responsibility for their decisions as a matter of course, not pandered, patronised and praised for minor acts of agency like a toddler managing to eat his vegetables before his ice cream.

The supposed benefits of a month of abstention, apart from a “sense of achievement with your newfound hero status” — good grief — include losing weight, saving money and sleeping better. But one month out of twelve will not get you anywhere. If you are spending half of your life doing X and the other half worrying that you are doing too much of X, you are doing it all wrong. Either do less of X, or decide that the benefits of X are worth the costs. Do. Or do not. There is no try.

But maybe it will help to “beat cancer sooner”, and I should stop being a big meany. Well, it would be nice if Cancer Research UK would stop taking money away from its worthwhile research to squander on activism and lobbying.

The Dryathlon is, of course, just another bit of neo-puritan nagging. It probably makes a certain amount of sense for a cancer research charity to give out information that helps people balance fun versus risk. If I was told that my lifetime chance of getting cancer was 48% with total abstinence and 50% if I get completely drunk 3 times a week, and left it at that, I would say, “thank-you very much. Mine’s a pint of Pride.” But they will not do that. They’ll just tell me that alcohol causes 4% of cancer cases and really I should just stop thinking and drink less, and are happy to have taken a little bit of the joy out of the beer. Ok, it does not work on me but the BBC can find and interview people in a pub who have been made to feel bad about doing something they enjoy.

It does not stop there. Cancer research UK wants to prohibit product placement of alcohol. And in the latest panmedia offensive, we are told that there will be 700,000 cases of obese people getting cancer over the next 20 years, with no clue as to how significant this is. Then they are they are calling for a ban on advertising sugar before 9pm, a tax on sugary drinks, a general reorganisation of society to suit the NHS and, chillingly, the government to “take children’s health more seriously”. Supposedly children are bombarded with advertisments for sugary food and drink. I am a parent and I am not seeing it. I even have trouble buying sugary drinks without artificial sweeteners without resorting to Google and specialist suppliers.

I do not want to donate money to an organisation that is happy to goad the local mafia into “taking care” of me. Just cure cancer already so I can eat and drink what I want with impunity.

When was the NHS created?

Here is a chart of average life spans for women from the Office of National Statistics with the dates replaced with letters. At some point on the X axis the National Health Service was created. Can you guess where? Answer below the fold.

UKLifeExpectancyF4

→ Continue reading: When was the NHS created?

Medical student ‘struck off’ before he even started – because of a Facebook post

A fourth-year medical student at Leicester University, Mr Ravindu Thilakawardhana, has been deemed unfit to practice medicine by the University, after making comments on Facebook towards someone who had annoyed him, the Independent tells us. It appears that he will not be permitted to complete his degrees and graduate, quite a long way down the line too.

Ravindu Thilakawardhana, who was in his fourth year studying medicine at the University of Leicester, became furious when a fellow student posted explicit pictures of his friend onto the social networking site.

Mr Thilakawardhana retorted with a photo of the actor Liam Neeson accompanied by the words: “I will look for you, I will find you, and I will kill you,” the Leicester Mercury reports.

He later sent a private message to the student saying: “I don’t want to see you on a night out in Leicester, or in the UK.”

The student reported Mr Thilakawardhana to the medical school who reprimanded him, before deeming him “unfit to practice medicine”.

The matter is going to law, with Mr Thilakawardhana taking legal action in the hope of having his sanction overturned.

There has been no criminal conviction (not even a prosecution) of Mr Thilakawardhana over his action, and yet his career is effectively ruined, as things stand, because of an intemperate post. This has all the hallmarks of a grotesque reaction to me.

How many other medical students might be barred from the closed shop profession for expressing attitudes that render them ‘unfit to practice medicine’? How wide might this ‘catch-all’ classification extend? Has all common sense left the University? (Yes, I know, by definition…) Is this not tyrannical, with echoes of Dr Bonham?

The NHS is considering ‘blacklisting’ homeopathy – and saving £4,000,000

News reaches us that the NHS is considering blacklisting homeopathy in England, albeit at a glacial pace (with a consultation planned for 2016), by banning General Practitioners from prescribing homeopathic remedies.

I am tempted to suggest that the NHS merely dilutes the funding so much that it becomes more effective, but that would be facetious.

We are told that

…Drugs can be blacklisted if there are cheaper alternatives or if the medicine is not effective…

I am wondering how there could be a cheaper alternative to nothing?

And the Health Secretary, Mr Jeremy Hunt has chimed in, saying:

“when resources are tight we have to follow the evidence”.

One might hope that all clinical practice would follow the evidence whatever the state of resources.

Not all is lost (as it were) for adherents of homeopathy, as the proposal is limited to GP prescribing.

The result of the consultation would affect GP prescribing, but not homeopathic hospitals which account for the bulk of the NHS money spent on homeopathy.

What on Earth is a ‘homeopathic hospital’? A cemetery?

Could this be a small start in the battle against pointless government activity?