Letters From Beyond the Age of the Market State #6

2055 was a year that celebrated the 50th anniversary of the development by UNESCO of the Universal Declaration on Bioethics and Human Rights.
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2055 was a year that celebrated the 50th anniversary of the development by UNESCO of the Universal Declaration on Bioethics and Human Rights.

Without much fanfare, this remarkable instrument had introduced into global discussions on health care and medicines policy a 'social responsibility' principle (in article 14.2.(a)). This encouraged (the instrument was not legally binding) nations, individuals, groups, communities and institutions, as well as private and public corporations (article 1) to ensure that "progress in science and technology should advance access to quality health care and essential medicines, especially for the health of women and children, because health is essential to life itself and must be considered to be a social and human good."

Few realised at the time how significant was the ideological tussle between the supporters of "innovative" and "essential" medicines. Involved in the debate were questions as to whether 'innovation' in health care technology should be defined by the operation of what were loosely and conveniently defined as 'competitive markets,' or by expert cost-effectiveness evaluation of 'objectively demonstrated therapeutic significance.'

2055 was also the 25th anniversary of the introduction into the US of a system of taxpayer funded health care and cost-effectiveness analysis of innovative medicines linked to a central government price negotiation. The credit for this must go to Senator John Hall of Oregon. Hall was a physician before he joined the Senate and he was somehow able to shepherd his legislation through the parliamentary process whilst soothing the fears of health management, private health insurance and pharmaceutical companies. Opponents from both sides of politics attempted to deride Hall's support for concepts such as 'essential medicines,' as involving him with a loose mix of "pampered college kids, nostalgic socialists and communists, frightened cultural reactionaries, anti-US empire activists and naïve NGO idealists." The climate-induced economic crisis of 2020, however, had swung popular opinion against the capacity of multinational corporate interests to govern the world.

By another of those curious coincidences that seemed to be happening with greater frequency and significance in public life, 2025 had also been the year when one of the long lost second notebook of Dr John Hall, the son-in-law of William Shakespeare the English playwright was discovered at the back of an old bookshop that was being demolished to construct a wind and solar-power farm.

Hidden away towards the end of the notebook was "Observ. LXX" which recorded Hall's treatment of Shakespeare during the great author's final illness. The reference noted Shakespeare' pride in his late play Cardenio which, he said, "reinvents human self-recollection once again." It gave details of the play and key quotations which helped to reshape the attitudes of the general populace to measures such as universal health care. Shakespeare spoke to Hall at this time of his greatest achievement as his work on the King James bible translation committee and paid credit to his late collaborations with the exiled Marlowe.

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