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December 6, 2019 07:54 pm PST

Prasad's Law: there's always enough health spending to concentrate wealth, never enough to diffuse it

In a recent installment of his Plenary Session podcast, hematologist-oncologist Vinay Prasad observed that "There are interventions that disperse wealth, and they give people jobs, and they send them out in the community; and there are implantable drugs, implantable devices, there are drugs, there are cancer screening tests, and we will always prioritize interventions that consolidate money in the hands of the few, over interventions that disperse money to the hands of many, with the same levels of evidence."

The "unaffordable" interventions are things like more nurses, home visitors, and other policies that give small amounts of money to a large number of people to deliver health care.

Dr Ray Poses, Clinical Associate Professor of Medicine at Brown University, has consolidated this into "Prasad's Law": "Medical goods and services that concentrate wealth can be paid for; medical goods and services that disperse wealth are 'unaffordable.'"

I would state it more generally as "Spending that involves procurements will have vendors who will use excess revenues to lobby to increase that spending. Spending that merely pays employees to do the work of the institution has no such excess capital and will therefore be squeezed out over the long term."

I first started thinking about this at an Orgcon some years ago, where I saw a rep from Reprieve present their research on civilian casualties from US drone strikes outside of theaters of war. These drone strikes are coordinated by the CIA (which is not a military organization, thus their activities are not an "act of war"), and the Agency knows next to nothing about who they kill. Read the rest


Original Link: http://feeds.boingboing.net/~r/boingboing/iBag/~3/oa3mIlpLL4w/lobby-rinse-repeat.html

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