Sunday, August 20, 2017

 

Do not go back to sleep, enjoy some horror dream-escape


TOBIAS WADE – 51 SLEEPLESS NIGHTS – 2017

Fifty-one does not have the ambition of one-thousand-and-one but in a way, it seems to be the same project except that the size of the stories may vary a lot from two pages to twenty. They all are united by some element of fear and horror, at times fright and terror, but the themes are changing a lot with some kind of a pattern. Let’s take some examples.

These stories are centered on characters who have something negative going on with their family circle when they have one, with themselves all the time especially when they are alone, and they are often alone, with their inner self as opposed to their outer self, and often their inner self takes its own life in its own hands and then the character is doubled-up and each half is autonomous with the ex-inner self taking over and creating some kind of havoc.


Don’t believe this author does not know his horror classics and particularly the rule Stephen King suggested a long time ago: a horror author has to try to horrify his audience at first. If he can’t then he can try to terrify his audience. And if he can’t even do that he can try to gross out his audience. The author here, like Stephen King, uses the three options in the book, but most of the time each story only has one dimension. Gross-out is common, terror is more difficult to reach and horror is a reward to the patient reader.

Gross-out is for me best represented by the story “Unborn Doll” in which a deranged teenage mother reveals her derangement is her pregnancy, and her family does not help who wants to get the child away, hence to abort it. The child has no father at all, never mentioned. The pregnant mother and later teenage mother has a mother and a father and both are absolutely hostile to her. The teenage mother will deliver a stillborn child that she will keep with her, dress up, pamper with makeup now and then perfume to cover up the rotting smell and the punchline is the most disgusting idea a mother can have: to sew up the mouth of this baby that cries at night. That punchline punches your good taste right in its stomach and down to its heels. But it reveals something. It seems to express the fright of society in front of such teenage pregnancies and at the same time their desire to solve the problem with stillborn babies for all of them, not abortion but a God-given or nature-provided form of abortion, but then all these mothers would get berserk and would have to be locked up sooner or later. That's the worst part of it. And that grosses you out completely and you are then terrified because in real politics some may actually think of that as a solution to teenage pregnancies: stillborn births and the commitment of the mothers after birth.


In the same line, we could quote “Confessions of a Serial Killer” that explains how a father confessed, out of love for his daughter, having committed a long series of crimes perpetrated by his daughter. He is in prison probably under a death penalty sentence. He writes his confessions to his daughter and the letter is captured and confiscated when it was attempted to deliver it out of the prison. We learn from the cop taking care of the case that the daughter has disappeared. The crime of this daughter was a serial killing of young children. She captured them one by one and one after the other. She tortured them one after the other and one at a time and the main torture was to starve them to death or nearly so that the next one captured will have to eat what is still available on the body of the previous one who is not necessarily completely dead. Once again that is grossness more than terror. And that daughter is still running free.

The story reveals once again there is a strange desire in girls, the future life-giving mothers. They want to capture children and torture them to death through hunger and cannibalism to punish them for having been born and having become a burden to their mothers, to women enslaved by that phenomenon. You find this theme of the enslaved mother over and over again.


The story “Vicarious” deals with a father but this time in his relation to his son. The story has a pattern. The father is too harsh with his son; too ambitious as for what he wants his son to accomplish; too reckless about his son and letting him try anything he wants with his bike; too self-satisfied with the son he produces with his own attitude and the good result he gets in his competition. Until one day it goes berserk when the son fails to get a victory. The son will go back to training, even harder and more recklessly, until one day there will be an accident. A big bad great fall into a ravine and like Humpty Dumpty the son is killed and yet a supernatural doppelganger survives who will take the full control of the father by satisfying the father’s desire for the son to get victories.

The pattern then is clear: to replace the "dead" son with some creature from hell who takes the son's body and deemed the son to be and stay in hell. Like that there is no hope and the father lives in terror since this fake son will be able to get from him anything for him not to be obliged to admit publicly that his son is dead, and how could he prove and explain it?


Till, with no explanation, the sun comes back one day as a monster from hell and saves the situation: he expels the fake son and he himself goes back to hell to fight against these demons, Irosancts, who take over dead people to have a second life in the world. Their name is pure Latin, maybe, and may mean the saints born from angry greed if not greedy anger, stepping directly out from the medieval book of Christian exorcism.

How many fathers do this mistake of projecting their dreams into their sons? It fails most of the time and then the sons are forced by this failure to do what they, the sons, want to do, or rather what the circumstances the sons are in make them do, and that is not always very nice. Though there is one gram of hope here since this son back from the dead saves the father he should hate to the last minute of his eternal damnation. That’s the softening touch: supernatural, like a famous TV series, but in a mild version. The Winchester brothers would have destroyed the real son too since he is a monster from hell too: two monster-killing brothers destroying two monstrous brothers. Whoa!


The last example I will consider is “Virtual Terror.” It is the story of two brothers. One went to Afghanistan where he did bad things in his military missions. One day he questioned a man and tortured him to get the information he wanted by torturing the man’s son in front of him of course. No details possible here. In the end, he will get some information, good or bad does not matter, and the man and his son will be of course executed, disposed of like some waste. Torturing is a game as is well-known, a game with humans who have to be alive and it is all the more joyful if they are reactive in that lively game of torture. But this soldier ends badly due to an accident and he is in a wheel chair paralyzed the waist up. God’s punishment if you want.

His brother takes him to a Virtual Reality arcade and he has an adventure that ends badly, again. He has a fit of some epilepsy or whatever and he is taken back to his home by his brother. He tries to kill himself with some firearm but his brother intervenes and it is the brother who is killed. Then the paralyzed ex-soldier tries to kill himself again and only wounds his mouth and jaw without exploding his brain. He ends up in hospital with his father sneering at him with contempt and agony.


We are in a dual world again (and this duality is a pattern). First the two brothers, then the father and the surviving paralyzed brother. Contempt from the father, self-contempt from the paralyzed brother, fatherly love agony for the father and self-hate agony for the paralyzed brother. And finally the realization that hope and fear are the same things. One hopes for something and that something is the source of one's fear. Hope leads to fear, nourishes fear, nurtures fear, gives birth to fear. The story crystallizes the American drama. The post-Afghanistan-Iraq fear in 2008 brought hope to the White House, but this hope was partly dissatisfied, betrayed some say, and it gave birth to fear, nurtured that fear to the point of bringing the most fearful and fear-mongering nightmare to the same White House.

Is the world condemned to live in that dual vision? To be dismembered between oneself and a second "brother" or "virtual image" of ourselves? Between fear and hope? And yet the two are only one, the two sides of the same coin. God and his spirit on one side, and the absolutely unitary god on the other side. Judaism (Genesis 1:1-2) and Islam, with a vague Christian ternary pattern: father, son1, and son2, but either captured in a succession of two dualities or in a perverse ternary situation of torture.


Torturer T torturing a man's son S to make the father F speak.
Binary couple: T – S
Binary couple: T – F
Binary couple: S – F

Note how this situation makes the torturing soldier be the Holy Spirit to fulfill the Christian Trinity: The Father F, the son S and the holy spirit T. This perversion of this sanctified Trinity is speaking to the reader so much that it could even become a haunting element.

This ternary pattern is always in the background, never central. The man and the devil speaking to the man in his head are the central elements. The man on the VR game-machine and the Japanese operator that more or less accompany him in his playing are central (Is the machine the ternary element? Then the Holy Spirit is not much if it is the machine, but if the machine is the Father, then the Japanese operator is the Holy Spirit, quite a surprising suggestion for a Buddhist and Zen character). The man and hope-fear concentrated in the VR helmet are the central elements. Are we condemned to live within this dual fake choice that leads to nothing except the perpetuity of the present survival instinct in which any ternary element is only one element used to pressurize another element in a triad because of the dual link between this element and the ternary element, the way I have explained for the torture situation?


To conclude I feel like saying this ternary torturing image of three binary relations that are the sides of a triangle of evil is the pattern of modern schizophrenia. We can just wonder if that is not a prediction about the future of the White House in the present more circumstantial than historical situation? Is Tobias Wade the prophet of a new age? We could believe that since Tobias-Tobit is a rather important (tough at times evanescent) character in the Old Testament as is clearly said in the following reference:

The Book of Tobias, as it is called in the Latin Vulgate, is also known in the Greek Septuagint as the Book of Tobit, and serves as part of the Historical Books in the Latin Vulgate and Greek Septuagint Bible. Both the Hebrew origin of the book and the name Tobiah which means "Yahweh is my good" have been appreciated since antiquity . . . The recent discovery of five scrolls of Tobit - 4QTob 196-200 in both Aramaic and Hebrew among the Dead Sea Scrolls in Cave IV of Qumran has given the book renewed attention. As with all ancient texts discovered in the Dead Sea Scrolls, Hebrew was in consonantal form only. The Book of Tobit is also extant in Arabic, Armenian, Coptic, Ethiopic, and Syriac.” (http://biblescripture.net/Tobias.html)


And this Tobias Wade embodies the following prayer uttered by Tobias in his story:

3 And now, O Lord, think of me, and take not revenge of my sins, neither remember my offenses, nor those of my parents. 4 For we have not obeyed thy commandments, therefore are we delivered to spoil and to captivity, and death, and are made a fable, and a reproach to all nations, amongst which thou hast scattered us. 5 And now, O Lord, great are thy judgments, because we have not done according to thy precepts, and have not walked sincerely before thee: 6 And now, O Lord, do with me according to thy will, and command my spirit to be received in peace: for it is better for me to die, than to live.” (The Book of Tobit or Tobias, 3:3-6)

Hope is definitely not the main quality of this life. But fear is definitely the best element of this book.


Dr. Jacques COULARDEAU



 

Where is the ball of the game, do you know?


IT SURE DID NOT TAKE LONG
Nothing can stop the decline of American Imperialism, not even slow the dissolution of this imperialism down. That’s the singularity of the empire the US built over the last century starting when they set foot in Europe for the First World War. One day soon the world will be more powerful than the USA. They already are altogether and China alone in PPP. Not private-Public-Partnership but Purchasing-Power-Parity. That means the America dollar has less and less purchasing power in the USA, let alone the world.
The USA started military invasions and wars that will never end except by the withdrawal of American troops like in Vietnam in 1975. The bald eagle will run, its tail tightly squeezed between, its legs, if it still has one feather on its ass.

Obama was their last chance to settle their commercial relations with the world but they do not understand that the cost of their military forces in the world are not exports but imported costs and they make their balance of payments so bad that they would have to export three or four times more American-made goods in the world, but the dollar does not help, even if it is slowing edging down.
And of course the easy mistake is done by Congress or the White House. Congress focuses on Russia-Iran-North-Korea. The White House focuses on China-North-Korea-Iran. They should concentrate on the Shanghai Cooperation Organization.

In fact the result if the same. Europe is NOT the challenger. Russia is NOT the challenger. China is NOT the challenger. Iran is NOT the challenger. North Korea is NOT the challenger. India is NOT the challenger, etc. The challenger is the whole world under the leadership of SCO and their partner-alliances mostly centered on Asia with Europe as a possible extension and Africa as the main beneficiary.
It is not in fact the fall of the USA only. It is the fall of the West and the rise of the East. In the West it is the fall of the USA to the benefit of Europe.

The East will never be dominated by ONE country now India is awakening and Pakistan will soon awaken as soon as the Americans are out of Afghanistan (and the Middle East), and that is soon.
Let Trump send a few thousand troops so that they can see the death toll rise to ten a week or more.

The American century was finished when in 2016, one hundred years after 1916 and the turning point of the First World War and the arrival of American troops on European soil, they elected the Donald to the White House he has transformed into a circus, though without Indians, without buffaloes, without slaves, but with neo-Nazis, white supremacists, white nationalists, racists, anti-Semites, KKK (you know kill kill kill) and other racial, ethnic, religious, social bigots.
It reminds me of the Yolo County Fair in California I went to with my son in the 1980s and the clown there was a Donald too, but Ronald McDONALD. At least he was feeding people with a few dimes.

Bye Bye USA and your master of Ceremonies, or is it a Maître d’, is up to all expectations. He might even provide a nuclear firework or two, or an omelette flambée in Mar-a-Lago.
Luckily the Joint Chiefs of Staff of the armed forces decided to speak up supported by the Defense Secretary. The red button is thus protected by the second identity.


Friday, August 18, 2017

 

Sorcerer and Sorcerer's Apprentice, the TWO Sides of a Leaden Coin


JOSHUA GREEN – DEVIL’S BARGAIN – 2017

The book is a guide through the complicated career of Steve Bannon and the controversial contradictory erratic career of Donald Trump. And what’s more how the two came across each other and bonded together and are now like the hen and the egg in the shape of the puppet and the puppeteer, the sorcerer and the sorcerer’s apprentice, and we could think – as a perfect antagonistic image – of Jachin and Boaz (from right to left) the two pillars of Solomon’s Temple: “According to Josephus in Antiquities of the Jews, Boaz (Hebrew bōʿaz "In him/it [is] strength") stood on the left when entering Solomon's Temple, while Jachin (Tiberian Hebrew yāḵîn "He/it will establish") stood on the right, and the two were made by Hiram.” And the Old Testament is just as clear as the Roman-time historian: “2 Chronicles 3:17 New International Version (NIV) 17 He erected the pillars in the front of the temple, one to the south and one to the north. The one to the south he named Jakin and the one to the north Boaz.” And two notes tell us: Footnotes: a- Jakin probably means he establishes. b- Boaz probably means in him is strength. But Thomas Troward (1921) refers Boaz to Ruth and comes to a different interpretation: “Thus the two pillars typify Unity and the redeeming power of Love, with the significant suggestion that the redemption results from the Unity. They correspond with the two "bonds," or uniting principles spoken of by St. Paul, "the Unity of the Spirit which is the Bond of Peace," and "Love, which is the Bond of Perfectness.” And this interpretation is like the Christianization of the pillars by using a reference to the Old Testament itself, viz. Ruth and Boaz.


Why start with this reference which is not present in the book? Because this couple Bannon-Trump is so strongly bringing up images from Walt Disney’s Fantasia as well from the Old Testament, from what is seen as the basic reference in these two characters’ ideology, “Traditionalism” borrowed from the French occultist and metaphysician René Guénon (1886-1951) who brought together in himself Roman Catholicism, Freemasonry and Sufism, thus uniting the three Semitic traditions that are Christianity, Judaism (in the underground but acceptable form of Freemasonry that actually historically brought together Christianity and Judaism) and Islam (this last reference connected to Guénon will be in contradiction with the strongly anti-Islam position of Bannon and Trump as we will see later). The author does not insist enough on this point, and Bannon even goes further and injects into this united Semitic vision that developed in the Middle East from old Semitic traditions and Sumerian or even Zoroastrian traditions of Mesopotamia and Iran, the other religious descendant from this Iranian religious and philosophical hatchery, viz. the Four Yugas of Hinduism developed from old Sanskrit Vedas. The four Yugas are (with their timespans): 1- Satya Yuga equals 1,728,000 years; 2- Treta Yuga equals 1,296,000 years; 3- Dvapara Yuga equals 864,000 years; 4- Kali Yuga equals 432,000 years. We are supposed to be right in the middle of the first phase of this Kali Yuga. “We live in the Kali Yuga — in a world infested with impurities and vices. People possessing genial virtues are diminishing day by day. Floods and famine, war and crime, deceit and duplicity characterize this age. But, say the scriptures, final emancipation is possible only in this age.” And we are entitled to wonder what is coming next: “WHAT HAPPENS NEXT? It is predicted that at the end of the Kali Yuga, Lord Shiva shall destroy the universe and all the physical body would undergo a great transformation. After such dissolution, Lord Brahma would recreate the universe and mankind will become the 'Beings of Truth' once again.” (https://www.thoughtco.com/the-four-yugas-or-epochs-1770051)


This cyclical apocalyptic vision of the universe is by the way very similar to the Nordic mythology of the Ragnarok, or even the New Testament’s vision of the Apocalypse, the Revelation. Steve Bannon and Donald Trump are seeing the world, meaning here the American-centered world, on the verge of collapse. Robert Kuttner in his coverage of a telephone call he had from Bannon on Tuesday August 15, 2017, published in American Prospect on Wednesday August 16, reports Bannon saying: “To me,” Bannon said, “the economic war with China is everything. And we have to be maniacally focused on that. If we continue to lose it, we're five years away, I think, ten years at the most, of hitting an inflection point from which we'll never be able to recover.” (http://prospect.org/article/steve-bannon-unrepentant) The apocalypse may come in five or ten years, which means, China may become the dominant force in the world and the USA may become a non-entity, since it will no longer be the first power in this world. Trump is no philosopher or spiritualist thinker, so he sets this apocalypse in more political words: America will end, if it is not already the case, imminently if he, Trump, with the support of true Americans, does not make America great again by his protectionist policy of America first.


The book is for most of it a journalistic story about events with dates, places and participants of the surge and emergence of Donald Trump, his meeting with Steve Bannon and subsequent alliance, and the first six months or so of his presidency. It’s only in the tenth chapter that he tries to bring together a synthetic and compact summary of this “ideology-political-‘science’” vision enacted by the two protagonists. The historical vision is naïve since for them (Bannon for sure, Trump maybe) the world changed with the destruction of the Knights Templar in 1314 on the order of Philip IV, called the Fair (Philippe le Bel), King of France, and later on the Peace of Westphalia in 1648 historically known as the Treaty of Westphalia that ended the thirty years’ war between the Catholic and the Protestant entities in the German Empire. It also gave independence to Switzerland from Austria and the Netherlands from Spain (whose king was the Emperor of the German Empire). In this same historical line Bannon brings together René Guénon, as already mentioned, Julius Evola (1898-1974) who inspired Benito Mussolini, and an eclectic religious palette from his very traditional Tridentine Catholicism (Council of Trent, Italy, 1545-1563) to the Hindu concept of cyclical time, as I have already mentioned, and a little bit of Zen Buddhism, that particular spiritual meditative form of Buddhism developed in Japan that may have a strong nationalist coloration. If you add the nationalist trend of their thinking you have the skeleton of their Traditionalism that makes them consider the world is changing in their direction. They consider they are part of a vast (global?) movement that brings them together with English Nigel Farage of UKIP, French Marine Le Pen of National Front, Dutch Geert Wilders of the Party of Freedom, and American Sarah Palin and the Tea Party. Apparently Joshua Green seems to have overlooked Austrian Norbert Hofer of the Freedom Party of Austria, and he could have added the Polish brand or the Hungarian breed of such extreme right nationalistic anti-(im)migrant and traditionalist Catholics to the basket, though he adds Vladimir Putin and his ideologist Alexander Dugin. This addition is in fact opportunistic because there is not one single common point between Vladimir Putin’s reassertion of Russian national pride and power and Eurasianism on one hand, and the American nationalist protectionist hegemony of Trump on the other hand.


As a matter of fact, it is in the last chapters that this book becomes interesting. Bannon-Trump ideology is defined as based on

1-    traditional Christian faith strongly inspired by Tridentine Catholicism to which they nostalgically want to refer (note that implies a clear rejection of Judaism and Islam);


2-    the rejection of the rise of secular modernity in the West (with two contradictions since Trump would not have become and would not be the President he is without that secular modern world and its communication tools like Twitter on one hand, and the fact that they meet here with extreme Islam and Sufism that reject this very secular modernity);


3-    a strong reference to Catholic social subsidiarity (Pope Pius XI and his 1931 Encyclical, Quadragesimo anno, that is in phase with small-government conservatism, though there is then a contradiction since Trump is using the federal machine to bring up the societal transformation he is dreaming of like the famous Mexican wall, the infrastructure plan, the repealing and replacing of Obamacare, the tax reform, etc., though pushing down onto the states all federal expenses he wants to get rid of);


4-    the condemnation of and attempt to bring down the encroaching globalism that has been developing in the world over the last fifty or seventy years (with a contradiction again since he wants to bring the USA back into the dominant seat in the world and impose an American-oriented globalism);


5-    an absolute opposition to the civilizational jihad personified by the migrant crisis brought around by the will of Islam to reject and destroy the Western world and civilization (with another contradiction here in the desire to have an alliance with Sunni Arabs – not Muslims – against essentially Shia Muslims – who count hardly any Arabs – and what’s more his apparent decision to widen and increase the military intervention in Sunni Afghanistan, mostly Shia Iraq against Sunni Isis in alliance with Sunni Kurds and Sunni Syrians against the Shia Syrian government and in contradictory relation with Sunni Turkey: nothing is simple in that area);


6-    the strong triple reference to borders that have to be revalued and strengthened, currency that has to be nationally defined, and military and national identity (which defines when implemented in the American context a strong protectionist, nationalistic and interventionist vision, conception and imposition of the USA as the master of the world);


7-    a direct call and incitation to act directed to all the traditional right movements covered by the term alt-right that counts all conservative movements from the Tea Party to white nationalists, white supremacists, KKK, various movements defending male domination at all levels of society and other racial-minded movements that defend a return to the values of the past (and here the contradiction has just exploded in Charlottesville because this incitation is the ferment of some civil problems that some have called riots, upheavals, civil terrorism, and many other horrors like these people chanting “Jews will not replace us” on the Friday night torch march).


8-    The last element that the author seems to underestimate is the reference to the blue collar working class, those workers who only have a high school degree for most of them and who see the transformation of our modern world as purely evil for them since it pushes them aside.


Sure enough the book in its conclusion sees the themes it has developed coming to a dead end, an impasse, a blind alley, but not yet Charlottesville that happened after the publication of the book, and Charlottesville is a complete and dangerous stalemate in which social upheaval is possible, in which the President stubbornly refuses to remain within the presidential tradition of the USA represented for example by the two ex-Presidents George Bush and George W. Bush’s joint statement. This situation brings down the attempt to have some kind of coordination between the White House and the CEOs of most Silicon Valley firms and industrial corporations in order to rethink the problem of outsourcing various productions and bringing them back to the USA. The numerous CEOs that resigned from these commissions or committees brought up their dissolution by the President that registered his inability to go on with this plan and in a way his obstinacy at refusing what some demand him to do: apologize and condemn without any fuzziness the extreme right movements that started the confrontation in Charlottesville with the Friday night torch march that was both not announced beforehand and directly referring to the same kind of marches in the USA in the various lynching operations of the KKK or other racist movements, or even the pogroms against black ghettos for decades after the Civil War and up to very recently. To defend the statue of Robert E. Lee was contextual enough to bring back the memory of slavery and then segregation and then all kinds of extreme racial discrimination. And those are facts now, since the pictures and the recordings of these sorry events have been brought up to us thanks to modern technology. Luckily we will in no way move towards some kind of regressive reactionary retroactive going back to the world when we only had smoke signals and tam-tams to communicate “long distance.”


The book is full of information and thus extremely useful, but it is maybe too much journalistic and it has by far been overtaken by events we can only regret and condemn, events in which Steve Bannon or Donald Trump have not taken the proper stand.

Dr. Jacques COULARDEAU





Monday, August 14, 2017

 

The diagnosis is good but the Prognosis is far from realistic


ELISABETH ROSENTHAL – AN AMERICAN SICKNESS, HOW HEALTHCARE BECAME BIG BUSINESS AND HOW YOU CAN TAKE IT BACK – 2017

This book is essential to understand the total and final dead end the USA find themselves in, right now, with their ambition to repeal and replace Obamacare. But first the simple summary of the author given right at the beginning, the ten rules that negate the simple logic of a free and open capitalist market economy to replace it with totally manipulated and perverted monopolistic cannibalistic economic looting.

How Economic Incentives Have Created Our Dysfunctional US Medical Market
Real life examples from patients (and readers!) that inspired my list of 10 Economic Rules
Elisabeth Rosenthal
1.     More treatment is always better. Default to the most expensive option. 
2.     A lifetime of treatment is preferable to a cure. 
3.     Amenities and marketing matter more than good care. 
4.     As technologies age, prices can rise rather than fall. 
5.     There is no free choice. Patients are stuck. And they’re stuck buying American. 
6.     More competitors vying for business doesn’t mean better prices; it can drive prices up, not down. 
7.     Economies of scale don’t translate to lower prices. 
8.     There is no such thing as a fixed price for a procedure or test. And the uninsured pay the highest prices of all. 
9.     There are no standards for billing. There’s money to be made in billing for anything and everything. 
10.  Prices will rise to whatever the market will bear. The mother of all rules! 


What does this mean?

In Noam Chomsky’s words in his Requiem for the American Dream the political stalemate of America and the West comes from the fact that we do not have any capitalism any more right now in our societies because the private corporations with the support of the political institutions and politicians have completely taken the control of the market that is no longer free and open but entirely monopolistic with the only cannibalistic ambition to devour the public, to make them pay as much as this corporate greed can imagine.

The objective of these corporations in their economic management is not to satisfy the demand with an affordable offer but it is to make as much profit as possible, even if they have to kill the free market.

The author gives a full demonstration of how pharmaceutical companies, hospitals, doctors and insurance companies have coordinated their efforts to build a monopolistic healthcare business model in which all is calculated to make maximum profit.


The principle is simple: Build a hierarchical business model in which each tier calculates its profit separately and exponentially and projects its own calculations onto the next tiers. Let’s take the case of a hospital.

1-    The hospital as a catering real estate institution will bill its profit separately on the basis of something like a three- or four-star hotel price list.  COST A + 30% (or more). Two mistakes: the real estate value of the hospital is overvalued instead of being realistically valued and stretched over twenty years for financial coverage. The second mistake is that a hospital is not a real estate business and its real estate investment does not have to make a profit. Even the food they serve has to make a profit, be it outsourced or not.
2-    The personnel, non-medical and even medical up to nurses, will be billed not as a cost but as an investment that has to bring in a profit. COST B + 30% (or more). What’s more the whole personnel of the hospital is taken into account for every single patient which means the cost for each patient is by far over-valued. Each patient has to pay for every member of the personnel no matter whether these members have been used or not by the patient.
3-    The medical personnel will all bill their services separately, be they members of the permanent staff of the hospital as an institution or independent outsourced organizations or individuals. COST C + 30% (or more). The outsourcing brings even more speculation because one doctor for example of any specialty can via Internet connections follow three or even more surgical intervention or patients. That on-line at-a-distance intervention is billed for each patient, who is yet simultaneously treated and followed with two or more other patients, as if the doctor had operated for him alone. In other words, for a one-hour intervention, the doctor will bill three or more times the full fee and will thus multiply his income and create cost and billing inflation to his sole profit.
4-    The laboratories will work the same way either as part of the hospital as an institution or as outside, outsourced, autonomous labs. COST D + 30% (or more). All current costs for the lab to just open and function are counted for all tests accumulatively and what’s more each parameter in a blood test for example will be billed as a full separate test though the machine does many of these parameters simultaneously on the same blood sample. Instead of billing one blood test as a whole, it may bill ten to twelve different tests all at full price as if they had been done separately. And of course the analysis of the results by a doctor employed by the lab will be billed on its own as a fully separate expertise intervention.


Shall we go on? We could of course see that #1 that is billed on its own will nevertheless be taken into account at all the other levels as part of the billing at those other levels. You end up paying for stepping into the hospital and staying there for treatment two, three or four times. That’s what they call the “facility fee” and it is counted at every single level with in a lab for instance a facility fee for having spent fifteen minutes sitting on a chair while the nurse or doctor or technician was performing the particular test he had been prescribed to perform.

And that is not all. The billing is going to change according to the insurance status each patient has. If they are insured, the billing will depend on the agreement between the hospital and the particular insurance company they are dealing with and each insurance company has its particular agreement with each hospital and its particular network of medical institutions, doctors and labs they work with and cover for every particular patient. If the patient is on Medicare then normally the hospital should only bill the amount Medicare has negotiated with the particular hospital and that is what Medicare considers as the normal price, often defined as positioned between a minimum and a maximum. If you are not insured be sure the price will skyrocket into the clouds.


But that’s not all. You have to take into account the deductibles, generally a certain amount of expenses that have to be paid fully by the patient before the insurance company starts paying what they have to pay by contract. Then you have the co-payments which can be important and are the parts of all expenses that are not covered by the insurance company (within the covered price accepted by the insurance but there might be extra-billing on the side of the hospitals or doctors or labs). Pharmaceutical drugs can be so expensive that the pharmaceutical companies accept to cover the co-payment after insurance payment, which proves that this amount of money they turn into a discount for the patient does not leave them profitless. Far from it since the profit is incredibly higher than in any economic field. They call this procedure “copay assistance.” But Medicare patients are banned from this system by Medicare itself meaning that a Medicare patient who is financially less wealthy or simply poorer will not benefit from this clause and will pay more than a normal privately-insured person.

And yet that is not all. There is then the “donut hole.” That’s the most vicious element in this healthcare system. But let me quote Elisabeth Rosenthal (‘page 233):

“In 2015, for example, the patient paid the first $270 as a deductible and then a 25 percent co-payment on up to $2,960 in retail costs for drugs. If costs exceeded $2,960 in a year, patients hit what is known as the “donut hole,” when they had to pay 100 percent of the cost, making them think twice about taking very expensive medicines they might not really need. Once their outlays hit a retail cost limit of $4,700 for their medicines, Medicare kicked in again, paying 95 percent.”


That’s what is called Medicare Part D supposedly to prevent over-prescribing or over-use of drugs.

You end up in that system with a three-tier situation.

1-    At the top the insured patients who can benefit from no-pay assistance. They are those who pay least.
2-    Medicare patients are supposed to pay less but they cannot have no-pay assistance and they have the donut hole with deductibles and co-payment. They end up paying more or getting less medical treatment.
3-    The uninsured are worst off. They pay the highest prices and they have no coverage whatsoever. Among those you have the young healthy people who do not need treatment because they are not sick or have perfect vision and perfect teeth. How long, and when will the next accident happen in their health like a heart attack or hepatitis, a flu epidemic or tuberculosis, not to speak of some STDs, like AIDS? But among these you also have those who do not have insurance because they can’t afford it in a way or another even with the Affordable Care Act. For example, because they are illegal immigrants, non-documented workers or residents, and of course their children are the same. We are speaking of about 20 million uninsured Americans to which you have to add the estimated 11 million illegal immigrants or residents. Those pay the most and if they cannot pay too bad for them, isn’t it? They can always turn the other cheek.


And they will tell you that is the perfect illustration of Matthew 5:38-40 (New testament, New International Version, NIV): Eye for Eye 38 “You have heard that it was said, ‘Eye for eye, and tooth for tooth.’ 39 But I tell you, do not resist an evil person. If anyone slaps you on the right cheek, turn to them the other cheek also. 40 And if anyone wants to sue you and take your shirt, hand over your coat as well.” Diseases and sicknesses are the bad guys in this Healthcare fable and what’s more they all come from God and we have to accept God’s will, don’t we? Insurance is going against this divine guidance, isn’t it?

This system is by definition unequal and unjust. This is no longer capitalism. This is the exploitation of the market as a milch cow. That explains why the French company Sanofi’s drugs are sold in France and the US in the proportion of 1 to 3 or 1 to 4 as for prices. The health insurance of all people in France negotiate the prices and the drugs cannot be sold but at the agreed prices. In the US the very same drugs are sold at a free price, so three or four times higher, and generic drugs are in all ways restricted in their access to the market and are not encouraged, whereas in France the patients who take a brand name drug when a generic exists will be penalized, including financially. It is the responsibility of the pharmacist to implement this rule.

This situation leads some people like Dean Baker of the Center for Economic and Policy Research (CEPR) in Washington DC to demand the repeal and replace of all patents (and copyrights), hence all protection of intellectual property because it is abused by some industrialists particularly in the field of pharmaceutical drugs and school text books.


The present book is full of examples of abuse and misuse of such constitutional provisions to protect and encourage intellectual property and invention or creativity. A fair protection has been turned by some industrialists into a means to exploit and even loot the market for profit.

But the book is short about what can be done. In fact, little is proposed to improve the Affordable Care Act. Most of the suggestions are unrealistic for most people, like doing research to find the prices and costs of hospitals, or various medical operations. First of all, most people cannot, I mean do not know how to, do this. Second a lot of data in the field of real costs of medical acts is not available. You would need to be a hacker to penetrate the computer and databases of these institutions. Third who has the time to do it, if they work on a regular full time daily basis?


It is good for a patient to ask his or her doctor, dentist or eye doctor how much his or her tests, dentures or eyeglasses are going to cost. But it should be an absolute and legal obligation for various medical personnel to provide the patient with such estimations and for insurance companies to say before the acts within a short delay how much they will cover and how much the patient will have to pay.

What’s more patents should be only to cover R&D expenses, and as soon as these expenses are covered the price should be reduced and generic drugs should be authorized. This has to be federal legislation since patents are in the US constitution.

Finally, all medical drugs, equipment and procedures should have to be negotiated as for their prices with all the stake holders, and patients as well as the federal state and the fifty states should represent at least 50% of the decision makers.

The free and open market is real capitalism, as Noam Chomsky would say, when the cost of a goods or service is calculated honestly and when the profit margin is decent and enables the public to get the goods and the service at a reasonable affordable price. That means the cost of the goods and service at every step has to be calculated so that it is lean and it brings in economies of scale that have to be automatically transferred to the customers, the patients in this case.

Final cost of goods at the end of the production cycle.
$100 + producer’s profit 12% =   $112
Transportation and wholesale distribution
$112 + cost of service: $25-$50 + profit 12% =     $137 + 12% = $153.44
                                                                        $162 = 12% = $181.44
Retailing
$153.44 + cost of service $25-$50 + profit 12% =             $178.44 + 12% = $199.85
                                                                                    $203.44 + 12% = $227.85
$181.44 + cost of service $25-$50 + profit 12% =             $206.44 + 12% = $231.21
                                                                                    $231.44 + 12% = $259.21


We come up to the final range of the public price between $199.65 and $259.21. In other words, the full cost of production is multiplied by between 2 and 2.5 times or so. At most you may have to add the sales tax when it applies. And this sales tax should apply only at the very last step and if paid at previous levels it should be recuperated in a way or another. All economies of scale are supposed to reduce the productive cost or the cost of service at all levels. These figures are purely arbitrary but the system proposed here is the only sustainable economic model possible. If the market is really free and open prices should tend to go down and not up. Provided competition is guaranteed and protected.

The last element is that there should be absolutely no advertising for prescription drugs and medical institutions. No lobbying either. Simple transparent honest procedures to certify drugs and to bring information – and only true information – to the professionals of the medical profession and to the public. Moreover, all information about the patients should be available in open access to all professionals of the medical profession under the security of passwords. Along that line the new IT technology should be used to have all medical information concerning patients available in two or three clicks for any doctor or certified medical institution in only one simple and single compiled file. That should generate enormous economies of scale in clerical work and in medical time. But all that has to be ruled, regulated and managed by some legal procedure under the authority of lawmakers.

In other words, the diagnosis in this book is excellent but the prescription and the treatment are far from satisfactory. The US will have to see its life expectancy drop and its opioid addiction crisis worsen for politicians to understand healthcare has to be available at a very affordable cost to everyone RESIDING in the country, permanently or temporarily, national or foreign, legal or not.

We are still far from even the consciousness of the urgency of the problem. Trump finds it easier to flex his tongue muscle on a rostrum or his finger muscles on a twitter keyboard about North Korea than to tackle the healthcare problem. In fact, he does not care about public health since for him healthcare is not a public need but private choice, like the type of shoes you wear or the color of socks you display.


As Russell Conwell said in his “Acres of Diamonds”: “To sympathize with a man whom God has punished for his sins, thus to help him when God would still continue a just punishment, is to do wrong, no doubt about it, and we do that more than we help those who are deserving. While we should sympathize with God’s poor–that  is, those who cannot help themselves–let us remember that there is not a poor person in the United States who was not made poor by his own shortcomings, or by the shortcomings of someone else. It is all wrong to be poor, anyhow.” (http://www.americanrhetoric.com/speeches/rconwellacresofdiamonds.htm)  

And one punishment from God to the poor is that they will die younger than the rich because they do not have any serious health insurance. How do the Social Darwinists say: “Let the fitter survive”? In my dictionary that is called eugenics. But as the Britannica Encyclopedia says: “However, [eugenics] ultimately failed as a science in the 1930s and ’40s, when the assumptions of eugenicists became heavily criticized and the Nazis used eugenics to support the extermination of entire races.” (https://www.britannica.com/science/eugenics-genetics) To let the poor die early with diseases whose treatments they cannot pay for is a soft option that can easily replace the Nazi methods of euthanasia, genocide, extermination and incineration.


Dr. Jacques COULARDEAU



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