: Although nothing could be less fashionable today than talk of comprehensive health care reform, the major problems of American health care have not gone away. Only a radical change in the way the U.S. finances health care--specifically, a single-payer system--will permit the achievement of universal coverage while keeping costs reasonably under control. Evidence from other countries, especially Canada, suggests the promise of this approach. In defending the single-payer approach, the author identifies several political and cultural factors that (...) make it difficult for Americans to obtain a clear view of this option. Finally, the author argues that much discussion of rationing is vitiated by bracketing more systemic questions to which the issue of rationing is inextricably linked. (shrink)
The meaning of the concept of fusion is discussed in relation with the works of Payer and those of Van Tieghem. It is pointed out that there is a difference, at the theoretical level, between the concept of fusion congénitale as defined by Payer and the concept of concrescence congénitale formulated by Van Tieghem. The former is inobservable by definition, while the latter deals with intercalary growth. For Van Tieghem, anatomy can prove the existence of fusion, even if (...) we do not see it during ontogenesis.We distinguish three complementary methods for explaining the unions of organs: ontogenetic, typological and phylogenetic. We have attempted, not so much to defend one or other of these methods, as to show that they often invoke very different interpretations for the same morphological phenomena. It is probable that only an analysis of the writings of 19th century botanists will clarify the concept of fusion and more generally the epistemology of plant morphology. (shrink)
Background: Omalizumab, an anti-immunoglobulin E antibody, reduces exacerbations and symptoms in uncontrolled allergic asthma. The study objective was to estimate the costs and consequences of omalizumab compared to usual care from a US payer perspective. Methods: We estimated payer costs, quality-adjusted survival (QALYs), and the incremental cost-effectiveness ratio (ICER) of omalizumab compared to usual care using a state-transition simulation model that included sensitivity analyses. Every 2 weeks, patients could transition between chronic asthma and exacerbation health states. The best (...) available evidence informed the clinical and cost input estimates. Five years of omalizumab treatment followed by usual care was assumed to estimate a lifetime horizon. Omalizumab responders (60.5% of treated) were modeled as a separate scenario where nonresponders reverted back to usual care after 16 weeks of active treatment. Results: The mean lifetime discounted costs and QALYs were $83 400 and 13.87 for usual care and $174 500 and 14.19 for omalizumab plus usual care resulting in $287 200/QALY (95% interval: $219 300, $557 900). The ICER was $172 300/QALY when comparing omalizumab to usual care in the responder scenario. One-way sensitivity analyses indicated that the results were sensitive to the difference in treatment-specific utilities for the chronic state, exacerbation-associated mortality, omalizumab price, exacerbation rates, and response definition. Conclusions: The results suggest that adding omalizumab to usual care improves QALYs at an increase in direct medical costs. The cost-effectiveness of omalizumab is similar to other chronic disease biologics. The value increases when omalizumab response is used to guide long-term treatment. (shrink)
Mit dem 19. Band der Fichte-Studien-Supplementa legen Wolfgang Class und Alois K. Soller den ersten Kommentar dieser Art zu Fichtes Grundlage der gesamten Wissenschaftslehre (kurz: Grundlage) vor. Auf den 571 Seiten werden der Titel, die Vorrede und die drei Teile der Grundlage Satz für Satz, wenn nicht gar Wort für Wort, kommentiert. Inbegriffen ist ein ausführliches Verzeichnis der benutzten Literatur, ein Sachregister zum Fichte-Text und ein Verzeichnis der zitierten Arbeiten Fichtes.
What emerges in Fischer’s phenomenological aesthetics is clearly the view that empathy is absolutely crucial not only to the apprehension of the aesthetic object, but also to the enjoyment of it. While this position certainly has merits, I have argued that in some ways his phenomenological description leaves something to be desired. This was particularly seen in his claim that empathy can never be described as an intuitive presentation of feeling. Perhaps another criticism which can be added here is be (...) found in a consideration of abstract works of art. In the case of these it would seem that empathy plays a much smaller role than it does in the apprehension of other aesthetic objects, especially works of art of other kinds. This is not to say that empathy could play no role at all in the apprehension of abstract works of art, for we may keep in mind that Fischer formulates the notion of mechanical empathy whereby one empathetically grasps power and other phenomena which are analogues of the will. It remains to be seen in the further development of a phenomenological aesthetics whether the notion of empathy can be applied in any other way in such cases. (shrink)
Mit der Herausgabe von Christian Friedrich Boehmes Kommentar ueber und gegen den ersten Grundsatz der Fichtischen Wissenschaftslehre erscheint der Neudruck einer 1802 verfaßten textanalytischen Untersuchung eines der zentralen Theoreme der Jenaer Philosophie Fichtes. Boehme beabsichtigt, eine Analyse des setzenden Ich der Grundlage zu geben, die die Unzureichendheit dieses Prinzips zur Begruendung von Wissen und damit auch der Philosophie selbst klar macht.
The United States has a population of three hundred million, according to latest Census Bureau estimates. Forty-seven million, including many non-citizens, are uninsured. That is, 16% of the total United States population has no health insurance. Millions more have inadequate coverage and are in danger of losing that. Private, corporatized medical coverage, structured by the insurance industry, is the basis for the current system. This article is an attempt to lay out the principal health care issues, to look at the (...) alternatives and the cost of those alternatives, and to try to determine whether there is a particular regime that, despite its imperfections, is the best available to us now. (shrink)
: In spite of recent political setbacks for the movement toward universal health insurance, considerable support remains for the idea. Among those supporting such plans, most assume that a universal insurance system, especially if it is a single-payer system, would offer a single list of basic covered services. This paper challenges that assumption and argues for the availability of multiple lists of services in a universal insurance system. The claim is made that multiple lists will be both more efficient (...) and more fair. Any single list will fund some services that are quite attractive to some people, but only marginally attractive to others. Thus any single-list plan will fund some services that produce only marginal benefit for the resources used. Moreover, since some people will hold values quite compatible with the single list and others will hold values leading to preferences for unfunded services, some people will get much more benefit from any single list than other people will. Fairness and efficiency require providing an entitlement to universal access to health insurance that could be purchased by typical consumers for a fixed price of perhaps $3500. By permitting everyone to pick their preferred list of services available at that price, each person will efficiently use his or her entitlement while getting more equal opportunity for benefits. (shrink)
: Four principal arguments have been offered in support of requiring public and private third-party payers to help fund medical research: (1) many of the costs associated with clinical trial participation are for routine care that would be reimbursed if delivered outside of a trial; (2) there is a need to promote scientific research and medical progress and lack of coverage is an impediment to enrollment; (3) to cover the costs of trials expands health care and treatment options for the (...) sick; and (4) it is beneficial for private insurers to cover the costs associated with cancer clinical trials because doing so makes such companies more attractive to consumers. Although many see third-party-payer coverage as a victory for patients and for the future of research, requiring coverage of services provided in a trial beyond those that would be provided to a comparable patient outside the research context raises a number of concerns. (shrink)
Globalization leads to cross-border business transactions between societies with very different norms and regulations regarding bribery. Bribery in international business transactions can be seen as a function of not only the demand for such bribes in different countries, but the supply, or willingness to provide bribes by multinational firms and their representatives. This study addresses the propensity of firms from 30 different countries to engage in international bribery. The study incorporates both domestic (economic development, culture, and domestic corruption in the (...) supplying country) and international factors (those countries' patterns of trade and involvement in international accords) in explaining the willingness to bribe abroad. The propensity to provide bribes was the lowest when corruption was not tolerated in the multinational firms' home countries, when the firms' countries were signatories of the Organization for Economic Cooperation and Development (OECD) anti-bribery convention, and when those countries traded heavily with wealthier nations. Further, these findings are maintained when controlling for levels of economic development and cultural values in the supplying country. In terms of culture, firms from high power distance countries showed a somewhat greater propensity for providing bribes in transactions with less-developed nations. (shrink)
Though not categorically opposed to the idea, Finnish parents tended to resist rather than endorse the view of parents as tax payers who can make demands for the efficacy of schooling and expected teacher performance. However, parents with vocational training tended to resist this view less than parents from higher educational groups. Additionally, dissatisfaction with a child?s primary schooling and support for a selective educational policy were both associated with a tendency to view this role in a relatively positive light.
In the 19th century, "Psychophysical Parallelism" was the most popular solution of the mind-body problem among physiologists, psychologists and philosophers. (This is not to be mixed up with Leibnizian and other cases of "Cartesian" parallelism.) The fate of this non-Cartesian view, as founded by Gustav Theodor Fechner, is reviewed. It is shown that Feigl's "identity theory" eventually goes back to Alois Riehl who promoted a hybrid version of psychophysical parallelism and Kantian mind-body theory which was taken up by Feigl's (...) teacher Moritz Schlick. (shrink)
. Critical realism is a frequently mentioned, but not very well-known, late nineteenth-/early twentieth-century philosophical tradition. Having its roots in Kantian epistemology, critical realism is best characterized as a revisionist approach toward the original Kantian doctrine. Its most outstanding thesis is the idea that Kantian things-in-themselves are knowable. This idea was—at least implicitly—suggested by thinkers such as Alois Riehl, Wilhelm Wundt, and Oswald Külpe. Interestingly enough, the philosophical position of the early Moritz Schlick stands in the critical realist tradition (...) as well. As will be outlined in the course of this paper, both Schlick’s magnum opus General Theory of Knowledge (1918) and his seminal Space and Time in Contemporary Physics (1917) are based on the assumption that the objects of science are relations and that relations have the status of Kantian things-in-themselves. By way of conclusion, I shall point out that this— more or less directly—leads to the current debate over ‘structural’ realism. (shrink)
continent. 2.1 (2012): 6–21. The French philosopher and novelist Tristan Garcia was born in Toulouse in 1981. This makes him rather young to have written such an imaginative work of systematic philosophy as Forme et objet , 1 the latest entry in the MétaphysiqueS series at Presses universitaires de France. But this reference to Garcia’s youthfulness is not a form of condescension: by publishing a complete system of philosophy in the grand style, he has already done what none of us (...) in the older generation of speculative realists has done so far. His book is sophisticated, erudite, rigorous, imaginatively rich, and abundant in worldly wisdom– despite the author’s conclusion that wisdom does not exist. The quality and scope of Forme et objet took few observers by surprise, since Garcia has been treated as an emerging philosopher to watch across half a decade of Parisian oral tradition. But Garcia was not just the subject of rumor, being already well known to the French public as a writer of fiction. His debut novel, La meilleure part des hommes , 2 was awarded the 2008 Prix de Flore 3 and has already appeared in English as Hate: A Romance . 4 His follow-up novel, Mémoires de la jungle , 5 made clever use of a chimpanzee narrator. Nor was Garcia only published as a novelist before last November: his philosophical study L’Image 6 had already appeared when the author was just twenty-six, a year before he was crowned by the muses at the historic Café de Flore. And then in 2011, just months before the appearance of Forme et objet , Garcia published a widely distributed work entitled Nous, animaux et humains , 7 with its focus on Jeremy Bentham’s ideas about animals. Given this prolific and versatile track record, an optimistic scenario might envisage the young Garcia as one of those combined literary/philosophical talents who appear intermittently in France across the centuries: Jean-Paul Sartre is merely the most famous recent case. While more time is needed to see how Garcia will channel his impressive mental energies, Forme et objet displays such breadth of insight that its author has a good chance to emerge as one of the leading philosophers of his generation. If we accept Aristotle’s dictum that the peak mental age is fifty-one, then to read Garcia’s massive book is to gain some idea of what European philosophy might look like in the futuristic-sounding 2030’s. The present article is confined to Forme et objet . At 486 pages, the work is obviously daunting in size. Indeed, it is even longer than it sounds, given that many of its early sections are printed in a smaller typeface to designate them as supplemental commentary to the main flow of the argument. But while the length of the book reportedly led to delays in French publication, and will probably slow the inevitable appearance of an English translation, the length of the book should not deter interested readers– much of it results from Garcia’s teacherly writing style. Whereas Quentin Meillassoux’s prose displays an arctic economy of means, Garcia’s style is reminiscent of the repeated lessons of oral classroom proceedings. Rarely is the reader given fewer than three or four chances to master an idea before the author moves on to the next. In practice, the style feels welcoming rather than long-winded. Otherwise, the structure of Forme et objet is surprisingly simple. There is a useful Introduction of less than twenty pages. Then comes Book I: Formally , running to approximately 135 pages. Here Garcia outlines the most basic features of a thing “no matter what it is,” or n’importe quoi , an everyday phrase that Garcia shapes into a technical term. This part of the book feels at times like a more amiable version of Hegel’s Science of Logic , a parallel emphasized further by the threefold articulation of its theme: 1. Thing; 2. Thing and World; 3. Being and Understanding. This is followed by the much longer Book II: Objectively , totaling more than 300 pages. It contains sixteen essay-like meditations on specific kinds of objects—including time, animals, humans, history, gender, and death. Here each chapter rolls smoothly into the next, making this second part of the book feel more like a different work of Hegel: The Phenomenology of Spirit . But these are merely analogies. Garcia is no Hegelian, even if the book contains a few dialectical flourishes that seem to reflect his early enthusiasm for the Frankfurt School. Forme et objet ends with a six-page Coda, followed by the usual page of acknowledgments. In what follows, I will briefly summarize each of these four parts of the book before ending with some more general remarks. Before doing so, it will be useful to situate Garcia biographically (as much as I am able) and philosophically. Though Toulouse is his native city, his formative years were spent largely in Algeria, where his family has deep roots. During our sole private conversation, Garcia mentioned that his parents are professors of literature. 8 As a student of philosopher Garcia flourished so early that many of his current ideas date to his teenaged years: “There are sentences in Forme et objet that I wrote when I was seventeen,” he said in response to a question on that cold night on the Canal St.-Martin. I recalled that remark when reading his brilliant account, late in the book, of the central role of adolescence in contemporary culture. While many prodigies blow through their formal academic training without serious obstruction, Garcia’s student memories are rich in tales of isolation and struggle, though equally rich in gratitude for a half-dozen or so exceptional teachers who provided the intellectual space he needed: Meillassoux and Alain Badiou are simply two of the most prominent figures on that list. Though there are many points of agreement between Garcia’s philosophical position and my own, he not only reached his position years before reading my work, 9 he arrived along a rather different path: not through phenomenology, but via the Frankfurt School, which may be one of the reasons for his profound fascination with aesthetics. Garcia’s cultural background is as broad as one could wish: he is no less informed about punk rock and European football leagues than about the spiritualist roots of Bergson’s philosophy. Curious about everything and contemptuous towards nothing, Garcia can be expected to write insightfully on dozens of topics in the years to come. Given that his philosophy is so personally tantalizing in its agreements and disagreements with my own, and given the great internal richness of Forme et objet itself, the present review is no better than a first effort at coming to terms with the challenges posed by this minstrel from the rising generation. This is especially intriguing for older Generation X’ers like me, since confrontation with the younger generation is one of the many themes treated insightfully in Garcia’s book. 1. Introduction Garcia begins in defense of a so-called “flat ontology,” in which all things are equally things. While Roy Bhaskar 10 used this term pejoratively to refer to anti-realist philosophies that flatten everything onto an epistemic plane of human access, Manuel DeLanda 11 (an admirer of Bhaskar) reversed it into the positive principle that all realities are equally realities. Similar notions can be found in the “absistence” of Alexius Meinong, 12 the “irreduction” of Bruno Latour, 13 and my own critique 14 of the undermining/overmining pair. Also noteworthy is Levi Bryant’s use of the term “flat ontology” throughout The Democracy of Objects 15 and his earlier essay “The Ontic Principle.” 16 But for Garcia, flatness is only one face of the cosmos, and one that he ultimately declares to be rather impoverished. Even so, he always remains an advocate of a flat ontology. Insofar as everything is equally something, no matter what it is ( n’importe qui ), everything is equally a thing, equally solitary in its relation with world. This is why his book abounds in those long lists of random, ontologically equivalent entities that Ian Bogost has playfully termed “Latour Litanies.” 17 The first litany in Garcia’s book runs as follows: “We live in this world of things, where a cutting of acacia, a gene, a computer-generated image, a transplantable hand, a musical sample, a trademarked name, or a sexual service are comparable things.” (7) Yet Garcia is frankly dualistic; his flat ontology only lasts until page 159 and the end of Book I (entitled “Formally”), which deals entirely with things that are equally things. Thereafter Garcia turns his attention from things to objects, which are not flat in the least, but engage in hierarchical relations with one another. In agreement with both DeLanda and the speculative realists, Garcia proclaims that his book “proposes to put to the test a thought about things rather than a thought about our thought about things .” (8) Just as ducklings are “imprinted” (9) after hatching and treat the first creature they see as their mother, philosophers are imprinted by the idea with which they begin. Hence, philosophies that begin with human access will never truly find their way back to things. This makes Garcia rather suspicious of twentieth century philosophy, since “the twentieth century—to which in some way this work proposes to bid adieu—has been a period of theorizing modes of access to things rather than things...” (9) Among other possible benefits of the philosophy of things that Garcia proposes, it is fully able to account for thought as a special variant of things, while the reverse is not possible.(10) In Book I of Forme et objet , Garcia’s “things” are so flat, so de-determined, that he is forced to renounce some of the most basic features ascribed to things by most realists. As he tells us in his foreboding third footnote: “We will maintain that the solitude [of things] is less than unity, less than identity, and that it does not imply acceptance (any more than refusal) of the principle of non-contradiction.” (11) In a contemporary world cluttered with too many things, Garcia’s flat and formal plane provides us with some breathing room: “The formal plan of thought enables or re-enables us to cut short all accumulation—whether of knowing, experience, or action—by a simplicity, an impoverished surface...” (13) As Garcia says elsewhere in responding to a Deleuzian critic of the book, his starting point in flat ontology is designed to obstruct the claims of both analytic philosophy and Hegelianism: “Hence, this work seeks to protect each thing—real, imaginary, inconsistent, contradictory—both against Ockham’s Razor and against the Aufhebung or dialectical process.” 18 Yet contrary to the equalizing spirit of many flat ontologies, “we will add to our formal ontology of the equal, an objective ontology of the unequal.” (13) But initially, Garcia joins all flat ontologists in holding that everything is irreducible: “this irreducibility, which we will term the ‘chance’ of each thing... also marks the refusal of a positive thought that reduces things exclusively to natural things, or social things, or historical things, etc.” (15) This irreducible “chance” of a thing emerges as an important technical term in the book, always paired with its inverted brother, the “price to pay” ( prix à payer ). On pages 17-19, we find the only diagrams in the book. What they illustrate is that Garcia wishes to avoid two equally dangerous extremes. The first is the philosophy of substance, featuring the thing-in-itself as a mighty river fed by attributes as if by subordinate tributary streams. This model can be found in many of the classic thinkers of West and East alike. In it, “there is obviously a hierarchization between that which is dragged towards something other than itself, and this other which serves it as an ontological support while supporting its proper being.” (16) For Garcia, the second extreme worth avoiding is the philosophy of events: “One thus conceives trajectories of being, identified as events, facts, powers, intensities, or intentionality. These vectors of being come first, bearing and supporting being, displacing it, but without ever finding a stopping point, a buffer, an objective consistency.” (17) The first model gives us a thing too wrapped up in itself, too compact . This word “compact” (the French and the English are the same) is another technical term for Garcia. But if the “compact” model of things leads us to something more than things, the philosophy of events gives us less than things, by dissolving them into a play of vectors. Garcia’s alternative lies midway between these two extremes: Being enters the thing, being comes out of it. And a thing is nothing other than the difference between the enters and the being that comes out. Thus, the circuit of being is never halted. In the thing, there is never the thing-in-itself. And the thing is never in-itself, but outside of itself. Nonetheless, being is not eventally “pollinated” by vectors: it possesses an objecting halting-point... (19) This single idea is the key to Garcia’s book: the thing is neither a self-contained durable lump nor some sort of evental flux. Instead, the thing is the difference between its various components and its relations with its environment. Or stated differently: “the price to pay for this disposition is a circulation of being that systematically distinguishes two senses of things: that which is in the thing , and that in which the thing is , or that which encompasses it and that which it encompasses,” (19) translating comprendre here as “encompass.” 19 In a beautiful description of a piece of black slate, Garcia sums up the various minerals, qualities, and shapes that compose [ comprend ] it, and calls them “that which is in the thing,” (20) noting that this tells us nothing about “that in which [the slate] is”—namely, all the various situations in which the black slate can be found. Instead, the slate is the difference between these two: the most characteristic principle of Garcia’s philosophy. 2. Formally Book One of Forme et objet , “Formally,” is concerned with the formal equality of all things in a flat world. “Two questions mark the boundaries of reflection: of what is everything composed [ composé ], and: what do all things compose?” (27) Looking downward, we wish to know what everything is made of; looking upward, we want to know the ultimate result of the combination of all things. Here we must turn our attention to the thing n’importe quoi— no matter what it is. (30) Anything with finite qualities is obviously too specific to be relevant to global ontological questions. To an equal degree, something possessing all qualities (think of Whitehead’s God) 20 would not be n’importe quoi either, since it would still be too definite, even if incredibly vast. The same holds for contradictions, since these all differ from each other. The square circle, the non-white black white, and the non-city city are all too distinct to count as the thing no matter what it is. The n’importe quoi must be devoid of all specific qualities, including contradictory ones. In one of the more intriguing points in his book, so reminiscent of Meinong, Garcia proclaims that “the ‘no matter what it is’ is neither a reality nor an abstract construction, nor both of these at once; the ‘no matter what it is’ is simply the plane of equality of that which is real, that which is possible, that which is inexistent, that which is past, that which is impossible, that which is true, that which is false, that which is bad.”(39-40) Since everything has two faces, it would be a grievous mistake to focus on just one of them at the expense of the other, as physicalism or materialism do when reducing the world to minuscule physical underpinnings. For scientistic materialism, “it is either atoms, particles, or fields of force... which are the things.” (47-48) Moreover, “these more-than-things are accompanied by less-than-things: for example, ideas or facts of consciousness are determined by the state of matter and are not autonomous things, but manifestations reduced to secondary effects of material processes...” (48) On this point, Garcia’s position is in complete accord with my own critique of undermining and overmining. 21 Where we disagree is that Garcia is more deeply suspicious of the notion of substance, which I view as salvageable with a few needed changes, while Garcia sees this operation as hopeless: “A substance, in the history of philosophy, is the more-than-thing par excellence.” (51) Another agreement between our positions is visible when Garcia claims (correctly, in my opinion) “that it is vain to distinguish between things which are material and those which are not.” (52) Yet we also find an even more important disagreement, since for Garcia withdrawal cannot be the quality of a thing. Instead, the absence of a thing is simultaneous with it, embodied in all that is not it– the absence of the sculpture of a woman is to be found in the mold that appears at the same time as it, and thus withdrawal must be viewed as an “event” rather than as something pertaining to an object. For Garcia, nothing withdraws beyond access. Since we must distinguish between “that which is something” and “that which something is,” and since the former is identified with “no matter what it is is” and the latter with “ not no matter what it is,” we can say that “everything is thus a milieu, a fragile link between ‘no matter what it is’ and ‘ not no matter what it is.’” (62) And here we find Garcia’s critique of the thing-in-itself: “A thing is never defined en bloc . We can affirm that a thing is this or that, but that does not suffice. It is still necessary to state precisely that which is this thing .” (62) Stated differently, “something is not in itself : for that which is in the thing is not the thing, and that in which the thing is is not the thing.” (62) And here Garcia and I, facing the same evidence, draw opposite conclusions. For me, the fact that nothing can be identified with either its components or its concrete location means that the thing must be something in-itself distinct from both of these. Yet for Garcia, to be in-itself would mean to be identified with just one of these two extreme terms, and hence the thing can only be the difference between them. Garcia is equally suspicious of the classical tendency to view “unity” as a property of the thing, since in his eyes unity is too relational a property to belong to things. (65) While specific things are situated determinately with respect to other things, we are still speaking here about the thing no matter what it is, and this can be viewed only in terms of solitude, which all things share: a human being, a hand, or a chair or all equally things insofar as they are on their own , not insofar as they are one . (64) A thing is alone, and relates only to the one thing that is not another thing: world. In a striking parallel to my own argument for a partial revival of occasionalism, Garcia tells us that “the things communicate only by their solitude: it is because everything is equally on its own in the world that things can be together, enmeshed in one another.” (67) Alone in their solitude, things all relate to world, which serves as a mediator allowing them to become mixed up in one another. As we have seen, one reason that nothing can be in itself is because everything is in something else. For Garcia, “to be in something and to be something are equivalent.” (69) Stated more broadly, “being is thus the difference between the two aspects of each thing: that which is it, and that which it is.” (70) And even more vividly: “a thing is almost like a sack: there is that which one puts in the sack and that which remains outside the sack.” (70) But not quite like a sack, “since a thing is not a thin skin or film. Instead, a thing is comparable to a sack that is immaterial and without thickness: it is nothing other than the difference between that which is this thing and that which thing is, between content and container.” (71) Nothing can be in-itself because everything is two selves at once. For example, we cannot say that our self is defined by our consciousness: “Everything has a self because nothing is in itself. The self is not the quality of that which is related to itself (which is conscious, for example) or which thinks itself related to itself. Nonetheless, for an entity called ‘conscious’ to be related to itself, it is necessary that this very relation should be another thing than the self to which it is related.” (71) Consciousness cannot be the self, precisely because it is other than that of which it is conscious. Nothing is able to grasp itself. The self is “the function by which being and composition [ compréhension ] are mutually excluded...” (72) The self is “the point of shadow of everything that projects some light...” (72) The in-itself faces two opposite dangers: “For something to be in-itself is to be a self. Something which is a self flies out through one of its two sides... Stated differently, being in-itself is simply the possibility of a double failure.” (73) The in-itself can be termed compact : “There remains to us a means of thinking that which does not fully enter into the world, though without exiting from it. This means is what we call the compact.” (76) In a sense, the compact is the opposite of the world. For in the case of the world, everything enters it and it enters nothing; as for the compact, it enters the world (since it is something, after all) while nothing enters it. (77) The compact marks the presence of the impossible in the world. (78) It is not impossible, but possible only on the condition that it fails. (78) The time has come to speak of where a thing is located. “The sole condition of a thing is that of being in another thing than itself, and thus in another thing than something.” (78) A condition is “that which determines something, that which forms something, that in which something is.” (78) As for humans, “the condition of someone is his situation; my social condition is that which socially determines me, my place and my function...” (79) More generally, “to be conditioned is to find oneself reduced to that in which one is.” (79) Everything is conditioned, but nothing is reducible to this condition. To determine the condition of something is to determine in what it is. A thing is located in that which contradicts it, just as a statue exists in its mold, which is precisely that which it is not. Since the thing is finite and definite, its condition or form must be infinite and indefinite. That in which all things are is the world, which Garcia also terms “the whole.” (81) “To try to be in-itself is to attempt to remain outside the world. And indeed, to try to be in-itself is only a path of entry into the world.” (83) For Garcia, “the world is not the pre-existent container of the things it contains, a priori , nor the construction by the mind of a fictional ensemble of all things, a posteriori .” (85) Instead, the world is simultaneous with all things; the two always go together. The world cannot be a determinate world, such as the physical universe or mathematical space, since these are already too specific and limited. “Every determinate world, which is in fact a universe , is a ‘big thing’ [ grosse chose ]: it is a set, however vast, of composite things which itself embodies a thing.” (85) Every determinate world is really just a “big thing.” Stated differently, “it is nothing other than a balanced milieu between the things that compose it and the thing that it composes.” (85) We generally picture the world as a physical univer. (shrink)
Making use of facilitating payments is a very widespread form of corruption. These consist of small payments or gifts made to a person – generally a public official or an employee of a private company – to obtain a favour, such as expediting an administrative process; obtaining a permit, licence or service; or avoiding an abuse of power. Unlike the worst forms of corruption, facilitating payments do not usually involve an outright injustice on the part of the payer as (...) they are entitled to what they request. This may be why public opinion tends to condone such payments; often they are assumed to be unavoidable and are excused on the grounds of low wages and lack of professionalism among public officials and disorganisation in government offices. Many companies that take the fight against “grand” corruption very seriously are inclined to overlook these “petty” transgressions, which are seen as the grease that makes the wheels of the bureaucratic machine turn more smoothly. Despite this, facilitating payments have a pernicious effect on the working of public and private administrations: all too often they are the slippery slope to more serious forms of corruption; they impose additional costs on companies and citizens; and in the long run they sap the ethical foundations of organisations. Although many articles on corruption mention facilitating payments, there have been no systematic studies from a company’s point of view. This article thus focuses on facilitating payments from the point of view of the company that makes the payment, either as the active partner (when it is the company that takes the initiative) or as the passive partner (when the official or employee is the instigator). (shrink)
This article deals with Moritz Schlick's critical realism and its sources that dominated his philosophy until about 1925. It is shown that his celebrated analysis of Einstein's relativity theory is the result of an earlier philosophical discussion about space perception and its role for the theory of space. In particular, Schlick's "method of coincidences" did not owe anything to "entirely new principles" based on the work of Einstein, Poincaré or Hilbert, as claimed by Michael Friedman, but was already in place (...) before these principles were developed. The first part of the article is devoted to Alois Riehl's critical realism—a neo-Kantian variant which rejects the dominant interpretation of the thing-in-itself as a mere limiting concept and takes empirical theories of space perception into consideration. The second part deals with the central role of "Psychological Parallelism" for Riehl and its integration with Kant's epistemology. In the third part it is shown that Schlick's theory of knowledge is based on Riehl's intricate reworking of Kantian epistemology, physiological psychology, theory of sense perception and philosophy of mathematics. The conclusion stresses the position of the unity of consciousness in Riehl's philosophy which Schlick admittedly cannot cope with. (shrink)
Much has been written about medicine and the market in recent years. This book is the first to include an assessment of market influence in both developed and developing countries, and among the very few that have tried to evaluate the actual health and economic impact of market theory and practices in a wide range of national settings. Tracing the path that market practices have taken from Adam Smith in the eighteenth century into twenty-first-century health care, Daniel Callahan and Angela (...) A. Wasunna add a fresh dimension: they compare the different approaches taken in the market debate by health care economists, conservative market advocates, and liberal supporters of single-payer or government-regulated systems. In addition to laying out the market-versus-government struggle around the world -- from Canada and the United States to Western Europe, Latin America, and many African and Asian countries -- they assess the leading market practices, such as competition, physician incentives, and co-payments, for their economic and health efficacy to determine whether they work as advertised. This timely and necessary book engages new dimensions of a development that has urgent consequences for the delivery of health care worldwide. (shrink)
On January 1, 2006, Medicare Part D prescription drug coverage was initiated. Concern was immediately voiced by the American Association of Retired Persons (AARP) and Families USA that, in response to this program, the pharmaceutical industry may raise prices for drugs most often used by the elderly. This article examines the ethical implications of a revenue-maximizing pricing strategy in an industry in which third party financing mitigates an end product's true cost to the user. The perspectives of three stakeholder groups (...) are examined: the elderly, as consumers of prescription drugs, the pharmaceutical industry, as product manufacturer and beneficiary of derived profits, and the total U. S. population, as the ultimate payer for the program via tax revenues. Key questions explored include the relationships among price strategy and access to drugs at both the micro (Medicare cohort) and macro (total population) levels, and on drug development or enhancement. The role of profit in a capitalism-based health care system is also examined. Hospital industry impact on these same stakeholder groups in response to the original 1965 Medicare law is used to compare and contrast possible outcomes of the new drug program. It is predicted that pharmaceutical firms will mimic the hospital industry, adopting a price maximizing strategy for drugs covered by the program. In the process, a utilitarian effect occurs: the benefits of increased access and diffusion of drugs counterbalance inequities in financing Medicare Part D. (shrink)
In A Thousand Plateaus, Deleuze and Guattari offer a description of what they call ‘nomad art’ by detailing its three primary characteristics: close-range vision, haptic space, and abstract line. In an attempt to unpack the significance of this provocative term, this paper will sketch the provenance of the first two of these characteristics, both of which come from Deleuze and Guattari's particular reading of Alois Riegl. Together, close-range vision and haptic space delineate the synaesthetic vision of the artist as (...) well as the space s//he creates in the work. Walter Benjamin will be invoked as a sort of phantom link between Riegl and Deleuze, a link that will both provide the proper orientation towards the central aspect of the haptic — against a Phenomenology of affect — as well as inject the necessary political significance into the discussion of nomad art. (shrink)