Tuesday, April 28, 2009

Deprofessionalization

While the planetary trend is towards professionalization, worker groups conforming to a set of rules and standards, a code of conduct, there is an urgent need to de-professionalize our failing political system. We have unfortunately in our country, a most solid example of an oligarchy, resistant to change, bent on securing their economic and political ascendancy over a cowed and cynical people. They follow their own rules and standards and without exception, everybody makes a living from politics. Just as financial wizards in Wall Street squeezed profits from complicated derivatives without adding value, our professional politicians are adept in projecting an image of working for the common good when selfish interest is the operative lingua franca that drives this totally messed-up configuration. These people will not desist from performing the most crass attention-seeking gimmicks in order to gain votes. Every day is a campaign day and the ultimate objective is the perpetuation of power and privilege. Like highly evolved parasites, they continuously exact resources from society without adding worth.

Today, 32 more people became Representatives. An added expense of at least 3 billion pesos annually. We do not need more laws nor do we need more lawmakers. There are already enough vultures happily feasting on the carrion that is our country.

Monday, April 27, 2009

No More Freebies

Since January 1, 2009, US pharmaceutical representatives have been banned from giving physicians pens, table paper, toys, clocks and calculators and other related gifts. They have also been restricted in bringing doctors to fancy restaurants in order to listen to a talk expounding on the unique benefits their drugs might have and those days when we would be invited to attend a medical conference in some golf resort are over.

I admit that I’ve eaten my share of bagels, cream cheese and lox from my residency days and there were so many lunches and dinners in New York City that my wife and I were very familiar with all the trendy spots in the City during our training. We would never have had supper at the forever lost Windows of the World (at the World Trade Center) if it weren’t for the friendly medical rep who was pushing the latest acid-suppressing agent. And we’ve been to many Four Seasons, Ritz-Carltons and other fancy resort hotels all over the US courtesy of some drug company that would fly us to these meticulously choreographed scientific lectures with one single unifying purpose: to make sure we doctors had a good time and remember with fondness the awesome efficacy of their product.

I also admit I was irritated at first when I heard about the new limitations. As if my prescribing selection would be influenced by a penlight or post-it notes. But now I understand the wisdom behind all this. Never mind convention cities like Vegas and Boston and San Diego which are bound to lose business, or the damage to pen and mug and penlight advertising companies alone will be about $1.2 billion, the point is, according to the American Board of Internal Medicine, the pharmaceutical industry directs $18.9 billion towards physicians each year and this amount is simply obscene. This is one sacrifice all physicians can bear for the sake of our patients.

How could I think these billion dollar drug behemoths would take all the trouble to wine and dine me under the cover of furthering my education? It was always pure business for these guys. Ever wonder why GM, once the bluest of blue chip stocks is skirting bankruptcy while the drug companies continue to haul billions in profits year after year? Wasn’t there a figure a few years ago that if the US drug companies sold vehicles, the average car would cost $4.5 million (representing a markup of 30,000%). They would always claim that research costs were unbelievably high when in reality, the bulk of scientific breakthroughs arise from Government /taxpayer-funded institutions. There are 18.9 billion reasons for this ridiculous scheme. And the same car would cost $5000 in Mexico?

I am inclined to believe at this point why we also need to reform this widespread practice of gift-giving to doctors in the Philippines. The clear majority of Filipinos are unable to purchase the medications prescribed to them and no amount of laws that would encourage the utilization of generic drugs will hold back the excessive profits that drug companies make for as long as physicians maintain cozy relationships with their assigned reps. Who do we think end up paying for those junkets to Europe and the US anyway?

Sunday, April 12, 2009

A Nation of Servants

A great hullabaloo it caused when Chip Tsao’s column entitled “The War at Home” was punlished in a Hong Kong magazine. In what clearly appeared to be tongue-in-cheek to this OFW anyway, Tsao stated that the Philippines didn’t have a Chinaman’s chance in the country’s claim to a group of islands in the South China Sea so long as they could hold hostage the large number of Filipina maids in Hong Kong. “There are more than 130,000 Filipina maids working at $3,580-a-month cheap labor in Hong Kong. As a nation of servants, you don’t flex your muscles at your master, from whom you earn most of your bread and butter.”

Turned out his domestic helpers were from Indonesia but he added: “I summoned Louisa, my domestic assistant who holds a degree in international politics from the University of Manila, hung a map on the wall, and gave her a harsh lecture. I sternly warned her that if she wants her wages increased next year, she had better tell every one of her compatriots in Statue Square on Sunday that the entirety of the Spratly Islands belongs to China.”

A firestorm predictably erupted, principally arising from the very prominent political sectors responsible for transforming us into, well, a nation of servants. Nothing to be proud of but nothing to be ashamed about either. We overseas Filipinos are everywhere, scrambling to provide better futures for our families because we just have to do it. We don’t have much time for self-pity, we just suck it up and keep on serving. Back home in the Philippines, you will hear some fellow Filipinos denigrate those physicians who became nurses and how they were now reduced to wiping the posteriors of foreigners. Unfortunately, in our attempt to justify failure, we frequently console ourselves by imagining an even less desirable existence elsewhere. I’ve never been embarrassed to declare that I’ve wiped my share of foreign posteriors.

We must, as a nation accept our lot. Not unlike devastated Japan after their surrender in World War II, we need to remember Emperor Hirohito’s admonition to his country: “for all the generations to come by enduring the unavoidable and suffering what is insufferable”. “Beware most strictly of any outbursts of emotion that may engender needless complications, of any fraternal contention and strife that may create confusion, lead you astray and cause you to lose the confidence of the world.”

“Let the entire nation continue as one family from generation to generation, ever firm in its faith of the imperishableness of its divine land, and mindful of its heavy burden of responsibilities, and the long road before it. Unite your total strength to be devoted to the construction for the future. Cultivate the ways of rectitude, nobility of spirit, and work with resolution so that you may enhance the innate glory of the Imperial State and keep pace with the progress of the world.”

Wednesday, April 1, 2009

Dead Aid

Dambisa Moyo in her book “Dead Aid” writes about what we in the perpetually developing world have known for a long time: “The notion that aid can alleviate systemic poverty…is a myth.” Dole-outs stunt productivity and stimulate corruption. Instead, she suggests that poor nations become agriculturally self-reliant and engage in trade with other countries; adapt microfinance credit schemes successfully tried in Bangladesh and attract more investment with amoral, pure-business countries like China which are concerned only with money-making opportunities and nothing much of anything else.

In reality, the US has been the most ruthlessly business-oriented nation for a long time. Most US citizens feel they have strutting rights because they think they give a whole lot of assistance worldwide when the US allocates less than 1% of its GDP to “aid” other nations. And most of this “assistance” come in the form of military hardware and farm products heavily subsidized by the US government. No wonder US citizens enjoy a quality of life that is the envy of the entire planet: the bottom line in the balance sheet reveals a huge advantage in favor of the American people.

I am personally offended whenever I meet people in the US with this patronizing attitude towards the Philippines. I try to let as many of them know that a great majority of these “donations” consisted of outdated, overvalued aircraft, ships and weapons that otherwise would have been dumped in some desert junkyard and whatever relatively small sums of money that remain are reliably exploited and treated as bribe money by corrupt politicians.

“Dead Aid” validates a lesson we should have learned a long time ago. We are out there on our own. We are going to have to depend on ourselves to make the Philippines a better place for all Filipinos.