[MCP] limiting access

[Bill Braun]

Steve, you are correct that people from European countries also struggle 
with English. Can you offer an example of a general demonization of such 
a group for failing - or struggling - to do so?

Are you saying, Steve (and I ask for clarification, not a challenge) 
that your knowledge of medicine is roughly on par with your knowledge of 
auto mechanics? I suspect that you've acquired a decent knowledge of 
auto mechanics over the years as well as a network of folks who can fill 
in gaps for you. In other words, a knowledge base with which you are 
familiar, proven to be reliable, and which you can access with relative 
ease.

A car is a complex system, but a pretty simple system as complex systems 
go. All of its interactions are known, and experts are plentiful. So 
letting the market have its lead works pretty well for men who know 
about cars. What about women? Kids? Me?

The human body is a wee bit more complex, and all the interactions are 
not known, and further, only about 15% of what your physician does is 
based on evidence. The rest is based on calculated and reasoned guesses. 
Study after study has shown that people recommend physicians based on 
their looks and demeanor (interestingly, the same holds true for 
malpractice torts). Competence is assumed (i.e., the halo effect).

(Fifteen percent approximates what I know about investing. Send me your 
money, let me be your money manager; I'll take a fee, you take the risk.)

The reason the analogy is important, Steve, is that the difficulty in 
making an assessment of a physician's competency (or a hospital's, 
lab's, therapist's competency) badly disrupts the theory of free 
markets. (I am assuming Steve that by free market you mean a 
non-regulated free market; if not, you've blown your own argument.) Our 
own government acknowledges that the free flow of information (i.e., 
understandable information) is critical (Executive Order 12866). For 
further reading on the topic I refer you to Hahn and Stavins (1992), 
Azcuenaga (1995) and Furgeson (2004). For now I'll skip over the massive 
distortions of market information caused by advertising. I'll also skip 
over the considerable body of work on the ethical problems of free markets.

In any dimension of society, who are the people who are the most 
disadvantaged in free markets? The marginalized, who lack the resources 
to gather the requisite information and make sense out of it. Who are 
the people that the unscrupulous prey upon the most? The people who are 
least able to have the requisite knowledge and ability to make sense out 
of it (the elderly for example).

Don't be so quick to dismiss me for "throw[ing] the racist label or any 
of its cousins" before you look into the people who profit most from 
unregulated free markets, on whose backs they are profiting, and their 
incentives for arguing for free markets.

Bill Braun

Steve Moynihan wrote:
> Wait.  This has nothing to do with white supremacy.  There are 
> Americans of all shades who speak English, not just white Americans.  
> I know European-Americans who have a hard time with English and 
> they're /white/.  The color of the skin is not the issue, but it 
> appears that's what you want it to be.  The multicultural scene loves 
> to throw the racist label or any of it's cousins, like white 
> supremacy, on to an argument or a person - makes 'em evil. 
>  
> As for the free market issue, differential diagnosis for headaches is 
> probably one of the more complicated in medicine but is a process of 
> determine the what the numerous causes of the headache may be - 
> inflammation of the sinus, an infection in the mouth, a hangover, 
> etc.  I'm not sure why this is important.  I don't know every detail 
> of medicine.  I don't know every detail about my car - how it works 
> and how to fix it.  I take my car to different mechanics; I shop 
> around.  I listen to what other people have to say.  A free market 
> allows me to choose.  Medicine is the same.

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