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Editor’s blog Friday 30 October 2009: New Maynard Doctrine, and a government addicted to stupid drug rulings | Health Policy Insight
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Editor’s blog Friday 30 October 2009: New Maynard Doctrine, and a government addicted to stupid drug rulings

Publish Date/Time: 
10/30/2009 - 17:40

Hello. We have a fresh shot of Maynard Doctrine for you today.

We also have another step in the death of the government with the stupid and vain (in both senses) dismissal of Professor David Nutt of the Advisory Council on the Misuse of Drugs.

Alan Johnson was not wrong about his lack of leadership calibre. Pity. At one point, I thought he might have some.

Nutt has gone because he told the truth: that the reclassification of cannabis from class C to class B was a politicised decision. It is not based on good scientific evidence. It is a Daily Mail-pleasing stunt.

The prohibition of recreational drugs is one of the greatest failed policies of the twentieth century by governments across the globe. Sadly, it remains with us.

The biggest danger in most recreational drugs is the criminality that surrounds them. Some illegal drugs are highly addictive to some people. So is alcohol. So is tobacco. So, if you want to believe the theories, are the internet, gambling and sex.

Getting your hair cut will probably be next. Clipperholics Anonymous?

Isn't it wonderful? You see, if these things are addictive, then it removes an individual's responsibility to themself, their friends and family and society to ascertain their capacity and capability to consume drugs, and remain within that or accept the consequences.

It's quite simple - what we do to our own bodies and consciousnesses, in so far as it does not cause direct harm to others, is not properly the realm of the law or of government. End of. John Stuart Mill taught us that your freedom to swing your arm extends as far as the end of my nose. It applies here.

I'll say it again. Legalise the lot (yes, even the really dog-rough ones like crystal meth and crack); regulate the lot; tax the lot. Recession over. Crime down 60-70%.

The vCJD decline of New Labour
Watching this government is reminiscent of the television footage of livestock infected with v-CJD. The brain is full of holes. The control is gone. The limbs jerk wildly, but still the beast falls.

Markets and healthcare
Meanwhile, Ken Andrerson of UBS and formerly of the DH's commercial directorate defends the market in today's Guardian, calling for critics of the market mechanisms and mixed economy in the NHS to "move(d) past the ideological infighting that has everything to do with protecting turf by the embedded self-interests involved"..

It's a lively little rejoinder to this piece by Polly Toynbee. I'll be writing something about healthcare and markets next week. Below this, I will paste some comments I left recently on Dr Grumble's excellent blog.

For now, suffice to say that I broadly agree with a comment by Jon Sussex of the Office of Health Economics, that there is a place for the market in NHS healthcare.

It just probably isn't a very big one.

From my blog comment on Dr Grumble
"Some believe that it is appropriate for healthcare to be delivered using market mechanisms to set prices. This is an interesting (if provider-centric) thesis.

"If we accept that healthcare is a public good, and that governments will always be significant actors in the payment for healthcare, then the untrammeled use of market mechanisms is debatable. It is even more debatable when government is significantly involved in the funding of healthcare infrastructure and training.

"The US has taken the market approach to healthcare further than any other major developed country in the world. If market mechanisms were effective means of price-setting, then the costs of health insurance and the level of healthcare cost-inflation in the US would not sit where they do now.

"Healthcare is not necessarily very amenable to market mechanisms. The costs of market entry are very high. Market exit has to be carefully managed. The costs of compliance with regulation are very high. The potential to harm your customer is very high (1 in 10 is the generally accepted rule of thumb). There are profound asymmetries of information and knowledge between providers and consumers about the product.

"There are a range of heroic and questionable assumptions behind the belief that functioning free markets will deliver lower prices over time. Let's examine some important sectors of the economy:

"The property market? No.

"The banking market? No.

"The public transport market? No."

P.S.
Read this piece by Clive James. It's great.