12 de febrer 2014

What is the rule of law?

If we look around us these days we can detect that these conditions have mostly vanished in many public environments:
  1. The government and its officials and agents as well as individuals and private entities are accountable under the law.
  2. The laws are clear, publicized, stable and just, are applied evenly, and protect fundamental rights, including the security of persons and property.
  3. The process by which the laws are enacted, administered and enforced is accessible, fair and efficient.
  4. Justice is delivered timely by competent, ethical, and independent representatives and neutrals who are of sufficient number, have adequate resources, and reflect the makeup of the communities they serve.
 How can health policy be implemented in a setting that doesn't conform to such criteria?. Day by day, I'm more convinced that the problem is beyond any policy. Have a look at decree 16/2012, p. 31292, one criteria for public funding of drugs is:
- Social and therapeutic value of the drug and incremental clinical benefit, taking into account its cost-effectiveness relationship
New drugs are being accepted every month, and since June 2012 the Health Ministry hasn't updated the website. Nobody knows its cost-effectiveness. Some weeks ago a transparency law was approved. It's a joke. 
There is one and only option: disconnect asap and forget this nightmare.

PS. I said something similar one year and a half ago. 

PS. Is there any price-cap on publicly funded drugs? In France, the recommendation is to limit any new drug to 50.000€. You'll find it here p.15.  Let's see what really happens here. In UK, confidential discounts apply. Welcome to the transparent world!. Have a look at my previous post on the same topic and the table.

PS. Lewis Mumford dixit:
"For most Americans, progress means accepting what is new because it is new, and discarding what is old because it is old. This may be good for a rapid turnover in business, but it is bad for continuity and stability in life. Progress, in an organic sense, should be cumulative, and though a certain amount of rubbish-clearing is always necessary, we lose part of the gain offered by a new invention if we automatically discard all the still valuable inventions that preceded it.”