Sunday, January 24, 2010

An Association Between Medical Marijuana and an Unreasoning Commitment to Universal Coverage? You Be the Judge!

In the wake of the 'Scott heard 'round the world' comes the news from California about the resurrection of legislation to introduce Statewide universal health care that even supporters concede 'could cost tens of billions a year.' This is from the State that barely missed a budget disaster thanks to raids on county and city rainy day funds, one-time accounting gimmicks and issuance of scrip.

At the same time, the California Supreme Court struck down a provision that limited the amount of marijuana individuals could possess for medical use, assuring the Golden State's preeminence in the national use of weed.

Hmmmm. Could there be an unidentified link between these two trends? It sure looks that way:

Regular readers of the Disease Management Care Blog understand the limits of associations between potentially independent events (just because two things happen at the same time doesn't mean they are interrelated - it could be accidental or random), sources of bias (there may be one or more other events causing both observations) and the direction of causality (which causes which?). For example, this association between 'DDE' and diabetes could be random. Skin color shouldn't be be associated with diabetes, but both are correlated with other genetic determinants and culture, which act as biases. Obesity causes diabetes, but maybe diabetes can cause (the treatment can) obesity, which is an example of two-way positive feedback loop.

The DMCB is out of its depth in divining the political calculus underlying the State's marijuana laws and the enthusiasm for universal health care in the face of deep voter skepticism and gaping budget deficits. Short of some formal research protocol, it can't tell if the association is real and if so, if there is some political undercurrent that is driving both. Perhaps ├╝ber health policy insights in Sacramento has led to a truly enlightened version of reefer madness.

Or maybe it all comes down to a simple question: just what are the political leaders out in California smoking?



diabetes management said...

when politicians become involved in any social agenda you can expect solutions that are meant to please everyone but end up pleasing a few. The Private Health care system is broken however we can all agree on that. This is an industry that has run rampart with little oversight and even worse self governance so if it takes a bunch of politicians to come up with a slightly less flawed system then I am all for it because lord knows the industry is not going right itself.
"De duobus malis, minus est semper eligendum" my friend, the lessor of two evils indeed.

Jaan Sidorov said...

C'est vrai, but I'm not sure how the majority of Americans would the definition of what "flawed" consists of. Your website is a good example of the kind of pluck it takes to coordinate all the parts of the system at an individual level. I've seen patients in the Medicaid system (for example) that have not been so lucky........