The framing of any issue—be it political, cultural, interpersonal, or deeply personal—is vital to its meaning and can be intensively manipulated, externally or by our own belief systems.

Framing is the essence of advertising, propaganda and other less pernicious sounding things like a resume or trying to, well, get laid (at least in the movies).

Some might say, playfully, that politics in the United States of America (and everywhere else) also often involve a lot of “trying to screw somebody.”

The feverish and generally insulting, defamatory interaction between the two Big Parties (count ’em) is pushed forth as proof of a highly functioning democracy, and offers the full spectrum of sane options for a reasonable nation (paradoxically founded on freedom and slavery—in case anybody thought for a moment wise people don’t fool themselves by reframing the “truth”).

Also pushed is the promise that America is the epitome of democracy because anybody in the country can become President, while thus far only white men backed by literally billions of dollars have actually done so.

If the system was fair and democratic, the only reason for this “white-wash” would have to be genetics. Some would agree. I’ll put my money on the framing of the issue.

I say this, yet I love the United States. I differentiate between the people of the United States and the foreign policy of the United States (although there is, of course, some sort of relationship).

In terms of democracy, so it goes in Canada, more or less—although there is something absurd yet heart-warmingly hopeful about a country where one of the parties holds 54 of 308 seats in the House of Commons despite not even wanting to be a part of the country, and still no civil war (or even violence) breaks out.

More disconcerting in Canada is that an elected secessionist party is less threatening to the “National Interest”—and I use the term euphemistically—than parties desiring popular democracy, who are allowed on the ballot but are largely marginalised from the debate (by a media so clearly owned by covert Commies and Lefties like Rupert Murdoch and Conrad Black, in happier times).

Speaking of euphemism, let us consider the term two-tier in the Canadian Health Care system. When one hears about how the Health Care system needs to be abolished and replaced by private health care or at least two-tier medicine, the reason is immediate to all of us: because it’s too costly as it is.

An interesting question might then be: why is it that I respond so immediately and definitively—”It’s too costly!”—when I actually have no real knowledge of how the system works, who makes all the money that is being wasted, or if there are any alternative possibilities?

Noam Chomsky, in his unremitting way, offers one view:

The actual purpose which the media serve very effectively is to inculcate and defend the economic, social and political agenda of privileged groups that dominate domestic society and state. Myriad techniques are employed including: selection of topics, distribution of concerns, framing of issues, story placement, filtering of information, emphasis and tone, Orwellisms, photographs, etc. The media inoculate the public against reality creating a cordon sanitaire between fact and fiction.

Thus I am grateful for an article in Common Ground (Oct 2006) by Alan Cassels entitled none too subtly: “PharmaCare’s drug addiction bankrupting public coffers.”

(For the record, my older brother James reminded me tonight he and his colleague Dr Bob Rangno were profiled in a chapter of Cassels’ (and Ray Moynihan’s) book Selling Sickness)

In reframing the two-tier issue, Cassels writes:

I believe firmly in two-tier medicine. The tiers, however, are not between public and private, but between essential and frivolous healthcare. Basically, before you ask who needs to pay for it, you need to know whether or not a health treatment, a drug or a procedure is worth doing.

Publically, we could easily pay for what is essential from well within the current budget. But how come words such as “essential,” “frivolous” or “waste” never seem to be part of the discussion?

Let’s be clear about one basic fact: those mounting dollars we are spending on healthcare derive from somebody’s income—whether it is a drug company, a professional association or a health authority—and it goes against the laws of nature for people to voluntarily agree to have their income cut. That’s why you need to ask tough decisions about what is essential and what is frivolous and then steer public money away from the frivolous.

Pharmaceuticals lead the growth in health spending. BC PharmCare’s budget is about $1 billion per year and it grows every year by about another $90 million, or roughly $250,000 per day.

A delay in finding solutions to the health cost crisis is good for the status quo. For example, when it comes to their products, the drug companies that abhor any conversation about cost-effectiveness love a delay. Another day passes in [British Columbia] and we pay an additional $250,000 of our tax money to drug companies. We’ll hand them another $250,000 tomorrow. Today, tomorrow, the day after and forever.

Chomsky in an interview with David Barsamian, Oct 24, 1986:

The experts in legitimation, the ones who labor to make what people in power do legitimate, are mainly the privileged educated elites. The journalists, the academics, the teachers, the public relations specialists, this whole category of people have a kind of an institutional task, and that is to create the system of belief which will ensure the effective engineering of consent.

And again, the more sophisticated of them say that. In the academic social sciences, for example, there’s quite a tradition of explaining the necessity for the engineering of democratic consent. There are very few critics of this position. There are a few: there’s a well-known social scientist named Robert Dahl who has criticized this, and he pointed out-as is obviously true-that if you have a political system in which you plug in the options from a privileged position, and that’s democracy, it’s indistinguishable from totalitarianism.

It’s very rare that people point that out.

And Cassals:

It’s no stretch to see how the tactics of Big Chemical or Big Tobacco have been adopted by Big Health. You need look no further than those groups “partnered” with the moneyed powers—pharmaceutial companies, professional associations and so on—representing the “realists” willing to settle for a “win-win.” They know on which side their bread is buttered and won’t adopt positions that affect the industry’s most fundamental goal: creating returns for shareholders via growing healthcare spending.

The main problem comes down to the very “radical” notion…that we, as a society, are foolishly allowing the pharmaceutical industry and its “partners” free rein in defining diseases, and those definitions are driving the astronomical growth in pharmaceutical spending.

[L]et me leave you with one bit of advice. Before you ask the government to pay for more health care, pause for a moment and first suggest what it should stop paying for. Suggest where it might make some savings.

We have a vitally important opportunity to get some public input on how to control the skyrocketing cost of health. Let’s not squander it. Personally, I’m hoping for some fireworks.

I get the feeling that something as subtle as the intention behind the resolution of the Health Care “crisis” (and I’m thinking, perhaps naively, it’s still up for grabs) will tip the momentum of the “the Canadian Way of Life” either further towards being led by Big Power, bottom-line profits and more unsustainable waste or, as Jefferson Smith once put it, “a little bit of plain, ordinary, everyday kindness—and a little lookin’ out for the other fella, too.”

We need more everyday kindness—and if we get it I promise to quote a famous Canadian actor next time.

All I can think to add is the same advice I gave my 13 year old niece:

Whenever somebody asks, “Do you believe in God [or abortion or evolution]?” or, “Are you a Socialist or a Democrat or a Republican?” I strongly recommend…getting their definition on whatever they’re asking you so you don’t get immediately boxed in to someone else’s agenda. Because everybody has their take on “God”, and God is a very loaded term, and before you know it you’re caught in a mini-Crusade, and theoretically you could end up on the side of the infidels. But with a little sweetness of speech, a conversation may just begin that serves both people.

I often write, remind and implore myself to listen more. I’m not a natural. The framing of issues reminds me to try and understand what’s being pushed down my throat and called medicine to cure a disease I’m not sure I have.

I wish you wonderful health, physical, mental and spiritual. And love of course. Have I mentioned lately we’re all sisters and brothers?



  1. […] In preparation for my trip, I have been doing a lot of research—today on the south-east African landlocked country of Malawi. Gerard Caplan’s passing mention of Malawi in the Walrus article and the previous blog about Multi-Tiered Thinking and the Health Care System in Canada give pause for thought, if nothing else. Caplan writes: In Canada, we spend annually approximately $3,000 per capita on public and private health care; Malawi spends $13, Rwanda $7, Ethiopia $5. In Canada, annual drug spending per capita is $681; in Africa it’s two bucks. […]

  2. Thanks for posting about this issue.

    What irks me is that the Eli Lilly company’s blockbuster Zyprexa has been implicated in causing TEN times greater risk of developing type 2 diabetes.
    They then turn around and sell other blockbuster drugs to treat the same diabetes.

    Daniel Haszard

  3. Alternative Medicine

    Alternative Medicine

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