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French drug consumption

Pass the pills

A scandal reminds patients of the health risk from taking 

too many drugs

Feb 10th 2011 | PARIS | from the print edition of the Economist

THE French are Europe's champion medicine-takers. No self-respecting family leaves the doctor's surgery without a multiple prescription for drugs to treat even minor ailments. There are substances to squirt up the nostrils for a cold, suppositories for all sorts of complaints and treatments for such bizarre ills as "heavy legs". Every so often, the health authorities strike a batch of drugs off the list for reimbursement under the social-security rules, because of "insufficient therapeutic value". Last year the reimbursement rate was cut for 150 medicines judged, in effect, useless.

A public-health scandal has now awoken the French to the dangers of a heavy drug-consumption culture. This week Jacques Servier, founder and boss of Servier Laboratories, was due to appear in court in connection with a criminal lawsuit (The pharmaceutical lobby in France is strong. Before the drug was withdrawn, Mr Servier was awarded the country's highest distinction, the Légion d'Honneur, by President Nicolas Sarkozy)  brought by patients who took a drug called Mediator. It was originally licensed for diabetics, but family doctors began to prescribe it in the mid-1990s as an appetite-suppressant. Despite the ringing of alarm bells over the years about its links to heart disease, both in other countries and within the French medical profession, the drug was not withdrawn in France until 2009. By that time, according to different estimates, between 500 and 2,000 people who had been taking the drug had died.

The story has rattled the French, knocking their faith in the competence of the public-health authorities. A report into the Mediator affair ordered by Xavier Bertrand, the health minister, published last month, is devastating. It observes "grave failings" on all sides, from the laboratory's "relentless" campaign to continue to market the drug "out of line with its medical properties", to the health authorities' cumbersome bureaucracy. "The medical-drug chain functions today in such a way that the doubt benefits not the patients or public health, but the companies," it concludes.

The French Agency for Health-Product Security has now hastily decided to publish a list of 77 drugs it has "under reinforced surveillance", because of undesirable side-effects. Yet this list, says Prescrire, a non-profit medical body, is also misleading, since it mixes drugs that should be urgently withdrawn with ones that, for certain patients, are justifiable. It urges patients not to swallow prescribed medicines uncritically. Professor Philippe Even of the Institut Necker, a research body, reckons that, of 5,000 or so drugs available in France, "nearly half serve no useful purpose", and many of those may be harmful. In 2010 the French public-health system had a €12 billion ($16 billion) shortfall. Spot the connection.
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Profundities !

Ø   The last thing I want to do is hurt you. But it's still on the list. Ø   If I agreed with you we'd both be wrong. Ø   We never really grow up, we only learn how to act in public. Ø   Knowledge is knowing a tomato is a fruit; Wisdom is not putting it in a fruit salad. Ø   Dolphins are so smart that within a few weeks of captivity, they can train people to stand on the very edge of the pool and throw them fish. Ø   I thought I wanted a career, turns out I just wanted pay cheques. Ø   Whenever I fill out an application, in the part that says "If an emergency, notify:" I put "DOCTOR". Ø   I didn't say it was your fault, I said I was blaming you. Ø   A clear conscience is usually the sign of a bad memory. Ø   The voices in my head may not be real, but they have some good ideas! Ø   Always borrow money from a pessimist. She won't expect it back. Ø   Women will never be equal to men until they can walk down the street with a bald head and a beer gut, and still think they are sexy. Ø   I discovered I scream the same way whether I'm about to be devoured by a great white shark or if a piece of seaweed touches my foot. Ø   I used to be indecisive. Now I'm not sure. Ø   When tempted to fight fire with fire, remember that the Fire Department usually uses water. Ø   Some people hear voices. Some see invisible people. Others have no imagination whatsoever. Ø   If you are supposed to learn from your mistakes, why do some people have more than one child? Ø   Change is inevitable, except from a vending machine.

Raghu Rai

Sees, Shoots And Leaves

Portraiture, says Raghu Rai, 69, is half internal attitude and half the sharpening of intuition. The acclaimed photographer has collected his and others' best works in the new book The Indians: Portraits From My Album. Here, Rai shares six suggestions on how to capture a person's essence in the black  box.

• Travel Light. Carry only your camera and a zoom lens. Skip the huge bags and the tripod. I don't want people to look at me and say, 'Oh, here is a professional.' It intimidates people.
• Shoot candid. One-to-one portraits reek of a conscious photographer and subject. Take a few pictures, talk and joke with the subject, and be relaxed and easy. Once the person has settled down and is no longer aware of the camera — click. It should be a direct contact between the camera and the person. When I shot the image of Bal Thackeray, I had taken a few shots when he stopped me and said it was time for him to drink wine. I asked him to go ahead. I made him sit on that chair with images of tigers and Shivaji in the backdrop, where he felt in his element. He lit his cigar — and there, I had the shot.
• Stop listening and start observing. If it is a journalistic portrait, you must capture what you understand about the person in a short time. I once shot former Pakistani president Zia-ul-Haq at a press conference. Someone could be saying great things from great books they read but they don't match their real personality, they are borrowed things. If you are a tyrant, you may be saying great things, but your body language and your eyes will reveal something else. I try to connect with a person's energy, not the surface reality.
• Surprise. The portrait of Satyajit Ray with that stern expression on his face was taken when I caught him off-guard. I said "I am leaving" and then he turned around quickly to look at me. I had my camera ready and I captured him. His eyes were so strong, the light and shadow created a beautiful drama and it worked out brilliantly, spontaneously. Similarly, when we were in France exhibiting together, I went to Ebrahim Alkazi and said "Arrey, you are here, let me shoot a portrait." He said something that I thought was naughty and walked off. I was thinking "How dare you walk off" and was determined to capture him. There is a mixture of arrogance and humour in the portrait that resulted.
• Pause and think before shooting away. In the age of long exposures, people had to hold their breath till the photo was taken. You hold your breath and in that moment emotions come and go in your eyes and all that intensity is captured on camera. Modern portraits are faster and can be more fluid but they lack that depth. What can you capture in the fraction of a second? Take your time.
• Suspend conditioning. Switch off the computer in your head. The early films of Satyajit Ray had a magical spiritual quality to them. His later films were still better than 10 films made in Mumbai, but they had become planned and intellectual. Unless the supernatural comes and plays a part and reveals itself, the picture is only good and nice as information can be.

As told to Yamini Deenadayalan

The History of Money & Debt

The History of Money & Debt
 
Excellent videos...
 
 
Part 1 - http://www.youtube.com/watch?v=D0IJCGuNtqk&NR=1&feature=fvwp
 
Part 2 - http://www.youtube.com/watch?v=cRCzt0VH18w&feature=related
 
Part 3 - http://www.youtube.com/watch?v=jDzo2efYUt4&feature=related 
 
Part 4 - http://www.youtube.com/watch?v=umCXbNsfito&feature=related
 
Part 5 - http://www.youtube.com/watch?v=AcVipoCIN4U&feature=related

That is how it works !

It is a slow day in a damp little Irish town. The rain is beating down and the streets are deserted. Times are tough, everybody is in debt, and everybody lives on credit. On this particular day a rich German tourist is driving through the town, stops at the local hotel and lays a €100 note on the desk, telling the hotel owner he wants to inspect the rooms upstairs in order to pick one to spend the night.
The owner gives him some keys and, as soon as the visitor has walked upstairs, the hotelier grabs the €100 note and runs next door to pay his debt to the butcher. The butcher takes the €100 note and runs down the street to repay his debt to the pig farmer. The pig farmer takes the €100 note and heads off to pay his bill at the supplier of feed and fuel. The guy at the Farmers' Co-op takes the €100 note and runs to pay his drinks bill at the pub. The publican slips the money along to the local prostitute drinking at the bar, who has also been facing hard times and has had to offer him "services" on credit. The hooker then rushes to the hotel and pays off her room bill to the hotel owner with the €100 note. The hotel proprietor then places the €100 note back on the counter so the rich traveler will not suspect anything.
At that moment the traveler comes down the stairs, picks up the €100 note, states that the rooms are not satisfactory, pockets the money, and leaves town.No one produced anything. No one earned anything. However, the whole town is now out of debt and looking to the future with a lot more optimism.

And that, Ladies and Gentlemen, is how the bailout package works .....................