Thursday, October 25, 2012

Against Capitalism?

One of my most faithful pen-pals (if such a term can be applied to people who send me e-mails) shipped over this link:

Briefly, this blog post recounts the history of an exchange between Dr. Ben Goldacre, a British physician/journalist and author of a new book called Bad Pharma, and a dissident economist, Harry Shutt. Goldacre's book appears based on what I've heard so far to be same ol', same ol' for readers of this blog--he nails the drug industry and its medical hangers-on for their addiction to profits over science and health. Shutt's criticism was that all Goldacre calls for is improved regulation of the industry. How, he asked, can you assume that's any sort of adequate measure, when you've just compiled this huge body of evidence that the industry snaps its fingers at all the regulation previously put in place? Goldacre first sent a wimpy reply back, then ceased to respond at all as Shutt pressed him further.

This exchange points out a basic feature of my book HOOKED as well as of this blog. I'm guilty as Goldacre is charged. I have clung to the position that I accept that we live in a capitalist society and that the drug industry is going to continue to be run as a for-profit endeavor. I have called for a lot of changes in how the industry, medicine, and government all do business, but have not called for nationalization of the industry or making it a public utility.

I may be accused of similar wimpiness in my recent book, The Golden Calf (see I there attack economism, the belief in an unregulated free market as the solution to all human social problems. But to the extent that I offer a vision for an improved future, it's largely a return to the capitalism of the 1950s where the power of government and organized labor helped balance out the excesses of big business, and not the overthrow of capitalism.

I cannot honestly report that I have a deep philosophical commitment to capitalism, though I am persuaded by authors such as economist-philosopher Amartya Sen that basic respect for human rights and human liberty has to include respect for rights to participate in fair markets. My overall goal has been strategic rather than philosophical. I am trying to get the attention of readers, most especially my fellow physicians and health professionals. If the position from which I started is anti-capitalist, I could expect that hardly any of them would read beyond the first sentence. If I stay under the capitalist big tent and specifically detail the problems with medicine and Pharma, maybe at least a few more of them will pay attention.

Is that a coherent and responsible position to take? The beauty of a blog is that y'all get to decide.


Ben Goldacre said...

Hi there.

Very funny to see this here, I read Hooked occasionally.

I don't think it's true to say I sent a wimpy reply then disengaged. Someone asked me a question in a newspaper "readers ask the questions" thing about nationalising pharma companies, got angry about my answer, and then sent me some really long emails about it afterwards. Apparently he's a radical marxist economist. I don't really know what marxism is, but I get a lot of emails and have just got a second book out, with a dayjob on the go too, annoyingly right now I can't even read the long ones.

On the substance of the suggestion: I don't think it's something that's likely to happen, and I don't really have any knowledge or understanding of how you'd go about nationalising a set of global industries, or whether that's ever been done. It's not really my field. It would be kind of interesting to read what someone sensible in the field had to say about it, but I'm the last person who could express a useful view on it. It's a bit like angrily demanding a historian for their views on a radical branch of pharmacoepidemiology, they might have one, but they wouldn't know what they don't know, or where the pratfalls are.

The post you're discussing comes from something called Media Lens, which I'd never heard of, apparently they shout at left/liberal journalists for not being left/liberal enough. Again, it's not really my field.

Howard Brody said...

Thanks to Dr. Goldacre for taking the time to write and to tell us his side of the story. Howard Brody

We are not the beautiful said...

I have misgivings about bombarding journalists with emails but I'm not at convinced that saying it's not my field is an adequate answer. Would a politician or historian be justified in saying it's not my field to a question asking whether global warming was real?

Saying you want a competent regulatory framework is venturing into that territory anyway.

I don't think people are suggesting nationalisation as practiced after the second world war anyway. There are different options - worker controlled, not for profit, the "community" represented in some way in enterprise governance.

The profit maximisation/shareholder owned model has demonstrable effects. So talking about alternatives to that model is a debate we urgently and sensibly need to have

Anonymous said...

If Dr Goldacre only expresses comment in the field he is professionally qualified, presumably he chooses not to vote, seeing as he is not a financier, lawyer, civil engineer, economist, teacher or professional in any other field that calls for an opinion to be reached on the decisions facing society.

We are not the beautiful said...


From the article: "Doctors at the meeting said pharmaceutical industry prices were unsustainable – and the pursuit of profits stopped companies taking part in trials of combinations of their drugs with those of their competitors, which might help patients. They were also said to be not interested in testing their drugs combined with older drugs that are out of patent.