How to make a widely discussed phenomenon film? The simplest but also the hardest approach may be to present social reality. It is said that it works hard because under the unrated censorship system, the social reality is not so easy to put out - at least Xu Zheng has changed the title of the film twice. This makes "I Am Not a Medicine God" an atypical leftist film. "The God of Medicine" retains the most basic concern of the left: dissatisfaction with the government, capital, and ultimately social inequality. But it doesn't go straight to the most painful part of reality like the mainstream left does: it's easy to notice that the basic message at the end of the film is that this problem has been solved. But this is obviously not the final judgment of the director team. "The God of Medicine" wants to refer to Sang and scold Huai, to save the country with curves, and to knock the mountain and shake the tiger. So it is not at the heart of China's today's mighty New Left, which sits far more conservatively on the political spectrum. I think it provided a very good example for later left-wing films.
Having stated the film's basic stance, let's get back to the topic and talk about the issues it cares about. (a) why genuine drugs are so expensive; if (a) is true, then (b) why India can sell cheap generic drugs but China cannot; (c) if China accepts (a), but is reluctant to accept India (b), why did anti-cancer drugs finally be included in medical insurance; (d) did the previous proposition bring about any greater doubts? Next I will discuss the above four questions in order.
(a) "Unscrupulous drug dealers?": Why are genuine drugs so expensive?
The Swiss company in The God of Medicine certainly has its reasons. It is easy to imagine that the cost of developing a batch of new drugs is extremely high. Taking the United States as an example, if a brand new drug is to be developed, the so-called "compound screening" is the first hurdle. The newly synthesized or discovered compound by a pharmaceutical company has only a 1/1000 probability of being clinically tested, and it will eventually be like "Glindine". Only 1/5000 of the compounds listed in this way. Because it takes time to show efficacy and longer time to observe side effects, there are three clinical trials in total, and the final approval has to be cautious. The development of a single new drug will last at least 10 years and cost close to $3 billion, not to mention gained profit? If capital wants to make money, it is inevitable to raise prices. This is the relationship between the market and commodities that has been talked about badly. Many will wonder why the state is not allowed to take over drug research, and we will come back to this in (c).
(b) "India is a paradise for the poor?": Why does India allow the sale of generic drugs but not China?
The advantage of a generic drug is its price, which costs much less than a genuine drug due to the elimination of lengthy research time, and the rationale of the market: there is no reason for it to be expensive. So the real question is, why can the Indian government allow intellectual property infringement? It seems that only utilitarianism can defend it. As we all know, whether it is behavioral, indirect, or rule-utilitarian, the ultimate decisive principle is: "An action is right if and only if it is in accordance with the greatest happiness of the greatest number." Which naturally includes reducing the suffering of the greatest number. We can put aside what happiness is, because no one doubts that generic drugs will bring happiness to patients and pain to developers. Utilitarianism insists that all people's preferences are morally equal. That is, as long as there are more patients than developers, or their desire for generic drugs is higher than the developers' avoidance of them, the existence of generic drugs is justified. The above two reasons are bound to be established, and the patient waits for medicine to save his life.
Many people probably understand the problem of utilitarianism, but I hope to limit the discussion to the pharmaceutical industry, after all, there is no one principle that can defend everything in modern times. Utilitarianism is so effective that it can even distinguish Zhang Changlin from Cheng Yong: the former's behavior is not moral, because he could have behaved like the latter. But when you think about it, the principles of utilitarianism applied to the pharmaceutical industry will self-disrupt anyway. First, if this system is implemented on a large scale, the research and development of top anti-cancer drugs will inevitably come to a standstill. The premise of the utilitarian argument is that "there is a drug", otherwise it will go against the happiness of all people and collapse itself. Second, the principle of utilitarianism requires that Cheng Yong does not earn a penny, and simply distributes medicines to patients. Because Cheng Yong is only one person, there are thousands of patients. By the same token, this will lead to no one buying the medicine, and will lead to the self-disintegration of principles. The problem of utilitarianism is called "life alienation," and it's too demanding. Some indirect utilitarians argue that the above problems can be circumvented if the rules of the law and the market are followed. But in this way, utilitarianism naturally loses its radicality, and the Indian government cannot justify itself on this. Interestingly, from the perspective of globalization, utilitarian global justice is feasible. U.S. patients buy their medicines in Mexico, and India, the world’s center for generic drugs, restricts generic drugs to a small area but tacitly allows them to supply a larger market, making it possible to avoid the aforementioned problems.
But generally speaking, critiques of utilitarianism do not come from the inside as above. Rather, it takes a simpler approach to defend it from the perspective of intellectual property, and furthermore, Locke's approach. Three simple steps: I have self-ownership of myself, knowledge and property are generated by myself, so I have ownership of this part of knowledge and property. Locke gave five proofs for this, the most famous is the "labor infiltration theory", for example, you infiltrated labor into the product when you were farming, so it is your property, and the others are also in line with this in principle. Nozick famously retorted that if you made a jar of ketchup and poured it forcefully into the sea, does it mean that the place where they permeate is yours? Locke's argument is too watery. As to why we are so receptive to what even the most liberal liberals can't, we should take into account the two paths in which Marxism argues for exploitation, one is alienation and the other is self-ownership. In fact, the core problem consciousness of the two is extremely close, but the former is biased towards Hegel, and the two are close to classical liberalism.
(c) "Can you guarantee that you will not get sick for the rest of your life?": If China can accept patent rights, and at the same time oppose the argument of utilitarianism, what reason is there to include anticancer drugs in medical insurance?
This question is quite counterintuitive, especially for people who have seen the movie. When we follow the camera through the crowd attending Lu Yiyi's funeral, what reason is there to refuse to include it in medical insurance? Medical insurance and handing over companies to the state are actually two sides of the same coin. They are both basic ways for big government to intervene in the market. But there are many people who have raised deep doubts about this.
Leaving aside Popper and Hayek for the moment, their starting point is anti-totalitarianism, which has little to do with my discussion. What is worth paying attention to is Nozick's point, if I have absolute rights to property, why should I pay taxes as an obligation? If I'm not sick, why should I give the money I earn to treat someone else's disease? Isn't this a form of forced labor? If I get sick and enjoy the benefits of medical insurance, I may ask like the old lady in the movie: "Who can guarantee that he will never get sick for a lifetime?" or "Who has no sick". Fairness is a feasible rebuke to the principle, but I can still justify it. This is not what I really think, but I was forced to help. The starting point of medical insurance itself is not fair. Therefore, in Nozick's view, it is a fantasy for people with property rights to accept insurance.
How to refute Nozick and maintain our intuition? Dworkin may have given us an idea. Nozick thinks he has full ownership of the property that his natural gifts have acquired, and it is strange that he does not reflect on where the natural gifts come from. The most accidental thing in the world is birth. Are people like me who are born healthy more entitled to health than those who are born sick? Are people like me who have not had leukemia up to now more entitled to health than those patients? It must not be, because before birth, the future person never existed, let alone qualified. So why are some people born with a huge price to pay for life, and why can't they enjoy life that ordinary people can enjoy? Ethics are accustomed to calling this "luck," which is absolutely accidental. A mature society should do everything it can to achieve equality of conditions, and then allow people to choose their own lives, so that everyone has the possibility to be everyone. Dworkin's approach is "insurance," put into the health care system we're talking about, which is to "guarantee your health." This money from the healthy will be used to serve the patient, or a future patient — possibly yourself, of course. Overall, Dworkin's argument may be the best defense of Medicare, far more persuasive than pure intuition and moral argument.
(d) "There is only one disease in this world?": Is there something else behind the previous proposition?
Those who are familiar with names like Rawls, Nozick, and Dworkin may know that overly granular health insurance has no place in their thinking, and these people are concerned with "justice" issues. In the Western context, that is, "Who deserves what?" or "When is inequality possible?" What "The God of Medicine" wants to discuss is not just medical issues. Said: "In my opinion, there is only one disease in this world, the disease of poverty." Those who are interested may notice the contrast between the Oriental Pearl and the residential area of leukemia patients that can be seen everywhere in the movie. This phenomenon is widespread in Beijing and Shanghai. exist. Partial dissonance in the process of rapid urbanization is all too common, with sporadic "village-in-urban" in every major city. In urban ecosystems, they are the gutters - which seems to say, they have to be there, or where do the rubbish and dirty water go? Where will the low-end population go?
We talked about the idea, from the distribution of urban space, we can clearly understand the status of the community in the city, and of course, their living conditions. Structural-functionalists in sociology are accustomed to making false a priori arguments: without these people, no one would do the dirty work, and the middle class wouldn't feel nervous and work hard... but they didn't expect to prove it for themselves It is only the inevitability of inequality (except in the communist society, which is extremely rich in material resources), not that some people are born noble and some people are born inferior. Maybe we don't have to use the inflammatory word "born", but at least it can't make a person lose all options because of an accidental illness. Behind the "God of Medicine", behind the discussion, and behind the medical treatment, there is a serious social inequality problem that is obvious to all.
This question, stop here.
View more about Dying to Survive reviews
