Check your hope.

We’ve met Dr. Jha before, let’s check in with him again. One of his latest pennings is entitled “The most powerful driver of medical costs is hope” :

My friend blasts his patients with chemotherapy, and if there are new agents, he tries them out as well. There are no short cuts with hope. When he suspects a complication of cancer, such as a clot in the lungs, he goes after it with hammer and tongs. Because there’s no retreating from hope.

Most patients who wish they are lucky outliers won’t be lucky outliers. The difference between hope and reality, therefore, is overtreatment. Hope and overtreatment are a dialectic: a marriage of convenience. Hope is a state of mind, a culture of expectation, will of the people, a belief in self-determination, and a rejection of the afterlife. Hope can’t be switched off by pressing a button. The most powerful driver of medical costs at the end of life is not the incentive structure. It is not doctors’ fear of being sued. The most powerful driver is hope.

This is what every religion worth its salt to date has long since figured out : the best pabulum for the masses is the cheapest pabulum for the massesⁱ and the cheapest pabulum for the masses is the pabulum that’s always a day away.ⁱⁱ This isn’t the life you want, how could it be ? Your life sux! But fret not, the next will be better. Trust me. Etc.

This fundamental construct – that of NIYLⁱⁱⁱ – is entirely and without exception why the nation state as a secular fiction is so monumentally limited and so grossly incompetent in praxis, not to mention why “Chief Economists” are little more than poorly dressed shamans.^iv It’s one thing for the upper crust to buy their way to heaven ; it’s quite another for the Church to do so itself, particularly when it’s via outright theft and subsequent redistribution. There’s no bargaining with the devil, after all, and no optimal stock scotch idem.

So check your hope. Leave some for your next life.

___ ___ ___

1. “Always buy the cheapest fortune teller” ™ ↩
2. Right Annie ?↩
3. “Not In Your Lifetime” as opposed to NIMT (“Not In My [Political] Term”) as used by elected commisars, or NIMBY (“Not In My Backyard”) as used by home “owners.”↩
4. I saw Todd Hirsch, the self-proclaimed “Alberta’s Economist” and star employee of the province’s crown bank, speak at a luncheon recently. When asked about the expected impacts of the upcoming “disruptive” carbon tax, he admitted that he had NFI because he hadn’t “added that to his models yet.” Instead, he projected “very modest growth for the next 2 years” despite the fact that he didn’t predict $50 oil in 2014. The fucking charlatan gall.

   That anyone would continue to feed this two-bit palm reader, much less fund his circus act, is a testament to the poisoned mind and poverty of intellect of the average man. That, and the sorry predicament that the whore of a state finds herself in… All because of you. You and your expectations. You and your “evidence-based medicine.” You and your despicable earthly aspirations.

   Enjoy your Nth Republic. You’ve earned it.↩