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Health Care PoliciesIn our little corner of the universe we have consistently blasted governments and with good reason. But let's face it. Governments are not the only culprits here. Besides them, we have a whole ecosystem of opportunistic organizations that provide logistical and academic support to socialist policies in many aspects of political life, the health care segment being one of the biggest.

And when we say "opportunistic" we use the term in the medical sense, this is, organisms which are typically non-pathogenic (i.e. innocuous) that act as a pathogen (i.e. causing disease) in certain circumstances. They do so by attacking and exploiting weaknesses in debilitated higher order organisms. The most common example of this phenomenon are bacteria, fungi, algae, or protozoa which create infections in human bodies weakened due to malnutrition, fatigue, skin damage or other uncommon factors.

In a political sense, many of so-called Schools Of Public Health can be favourably compared within those organisms, and yes, your wallet and by extension your health are the target.

STATE OF AFFAIRS

This topic is a little bit difficult to approach because it would seem that we are recommending and/or disregarding the scientific method. Far from that. Let's be clear. A proper scientific method of researching health care is the only way forward for humanity. Experimental sciences are the best tools we have to ensure and improve human health care. There is no doubt here. No discussion. No option. No trepidation. They are. Period. Within this concept, chapeau! (i.e. hat's off) to the few organizations having the guts and stamina to do it right. They only deserve ours and your support.

However… and yes, there is always a however…

We have "other" organizations which, we are sad to report, are vastly clueless about real scientific methodology related to health care when it comes to design, implementations and logistics. It is these organizations that push for socialized health-care policies which ultimately end up destroying your money and your health.

Clear now? Good!

HEALTH CARE POLICY BY ACADEMIC DETERMINATION

Schools of Public Health Care typically find an ecological niche in universities. Sure, some of them are independent, but not too many. The ones who are, do not dare to call themselves "Schools" of anything like that because they are not that presumptuous. They prefer more realistic and reasonable titles such as "Institute" or "Fund" or "Group". That's OK. They are in the business expressing the opinion of a group of people and there is nothing wrong with that, because, typically, they are set-up with private money. This is important and we will get back to it later on.

However, the core of today's article deals with "the other" group of organizations, those who dare to use academic titles in their names such as "School" or "College" or "Department" and such, thus stating that they are not in the business of presenting a point of view but in the business of researching and, more importantly, educating other people.

The problem with this view is that they are correct. They do indeed educate other people in their point of view. There is a difference, a vast difference. The former organizations attempt to convince you about an idea, the latter ones are teaching ideas that are considered by them scientific truth. Vastly different modus operandi. Allow us to exemplify.

If you are grocery shopping for milk, you will have many different offers for a skimmed product. Each brand will attempt to convince you to buy their product because it offers better characteristics, characteristics that they hope you will find attractive. This is what the former organizations do. However, what would happen if Brand X suddenly announces that their product is scientifically superior to every other product and force supermarkets to force consumers to take a 10 minutes course explaining the scientific superiority of Brand X before anybody is allowed to purchase any milk? Would you be happy with this modus operandi? Of course not.

But if this example is ridiculous, why is that most people blindly agree our students to be "taught" by these organizations about the "truth" of their points of view? More worrying, why is that people accept without questioning that these, latter, organizations have the right to "influence" health care policies through "education"? Why is that we, the people, must follow their "scientific truth", buy their Brand X so to speak, when it comes to public health care?

Obviously, it makes no sense whatsoever. If their claim is that their position is a scientific truth, then they must absolutely, positively, definitively apply the scientific method and prove it scientifically. This means opening their points of view to scrutiny by all scientists (and particularly students) before they decree them as "scientific truth".

If they are not claiming that they are selling a "scientific truth" then they must label it for what it really is; an opinion.

PEER REVIEWED

The most common counter-argument about this "opening for scrutiny" is that their so-called "research" is "peer reviewed". The concept of Peer Review is ingrained in the scientific community as part of the scientific toolset to debunk invalid theories. The idea behind "Peer Reviewing" is that most scientific areas are so complex and unique that unless an expert in the field reviews them, it will be impossible for anybody to distinguish science from magic… or bullshit. Ergo, it makes no sense to open scientific theories and data to people lacking the know-how. And to be fair, for most sciences this is quite true. Most people (and we include scientists in here) are indeed not qualified to issue opinions outside of their field of expertise. They simply lack the know-how.

However… and yes… we have another however…Health Care is not one of those fields and there are two reasons for that:

  1. Basic Public Health Care is not that difficult. Yes, some underlying models may be quite complex, but at the end of the day the results that matter are all pretty much common sense e.g. vaccination prevents diseases… vaccination is not risk-free… vaccination is a risk-reward process and we can measure risk and reward in very simple terms. Thus, you don't need a degree in public health care to be able to make a decision.
  2. Basic Public Health Care deals with our money. We, the people, must determine how our money is being spent because it is…well… our money! They, the academics, have no saying in this because it is not their money!

Under this set of conditions, peer reviewing issues of Public Health Care not only makes no sense but it is elitist and counterproductive. Not to mention the fact that in something so simple as health care a great deal of scientists and engineers and technicians can provide unique insights into problems that so-called Public Health-Care academics cannot. To make matter worse, these academics typically lack the hard-core scientific know-how to actually deal with data in a scientific manner. Why? Because typically their education is not hard-core scientific but "soft" and "artsy" or "humanistic" or "related" or "interdisciplinary".

For example, what is the typical background of students pursuing post-grad degrees in Public Health? Biology. Medicine.

Statistics? Nope.

Engineering? Nope.

Mathematics? Nope.

Computer Science? Nope.

Chemistry? Nope.

In other words, Biologists and Doctors know some statistics, some engineering, some math, some computer science and some chemistry. But that's it. They are not experts in either of those fields.

And this matters because?

Because experimental sciences are quantitative sciences. We measure because measuring is the most objective way we have to know stuff. Problem is, in order to make sense of numbers we need statistics and statistics are tricky. For example, most people in the "artsy" field cannot differentiate between independent and dependent variables. They have no idea that correlation does not mean causation. And so on. All very important stuff that when ignored or missed leads to highly erroneous conclusions.

What all this boils down to is that a great deal of so-called "research" in public health care is so-called reviewed by so-called "peers" many of whom are not qualified for this task, particularly when it comes to health care implementation.

Because almost all "peers" have been "trained" in the same way that any other "peer", all their mindsets are identical. They can't see the forest because they are too close to the tree and in so doing they break quite a few principles of the scientific method.

Now, if you bother reviewing the websites of many so-called "Schools" you will notice that they use the keyword "interdisciplinary" quite often. Does this mean that they have people from other disciplines with them? Technically speaking, yes. Practically speaking, no. Typically "interdisciplinary" simply means "from other branches of medicine and/or biology". It does not mean Statisticians, Engineers, Mathematicians, Computer Scientists, Chemists and so on.

End result?

We end up with faulty principles which are taught as so-called "scientific truth".

Now, let's be clear. A large number of so-called "Schools" do offer courses in Biostatistics or Epidemiology or similar. Problem is, they are mostly introductory courses (despite their titles) and the people receiving those degrees are typically not Biostatisticians and they are typically not Epidemiologists and so on. Big, big difference!

Look, this is simple. When you take your car to a mechanic, would you prefer a Master Mechanic with 20 years of experience and 40 or 50 specialized courses under his belt or a coop-student going through the basics? See the difference?

Note: please see the Glossary if you are unfamiliar with certain words.

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