Open mike 16/11/2019

Written By: - Date published: 7:00 am, November 16th, 2019 - 127 comments
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127 comments on “Open mike 16/11/2019 ”

  1. Blazer 1

    Never mind used car salesmen..Those stalwarts of moral virtue have got a deal 4 u!

    ANZ has upped the ante, launching an advertised cash back offer with its home loans. The country's biggest bank is offering a $3,000 cash contribution for certain home loans taken out. The cash contribution is only available on new home loans fully approved by December 2. They must be 'new' and for $200,000+ with new residential security provided.'

    What next minimum trade ins…up to $5000 minimum towards your deposit when you trade in your old banger on a shiny new 30 year mortgage.devil

    • marty mars 2.1

      lol – pale is racist? stale is ageist? and male is sexist? ffs what a stupid line of reasoning imo – strange you've taken the bait so easily there waggy.
      oh and use fulla not falla is my advice for street cred

      • bwaghorn 2.1.1

        Funny that you so quickly jumped in to defend name calling towards us honkies.

        I thought progressives are the better people who rise above name calling.

        As for street cred, I have always been so uncool that I'm almost hip. 😎

        • marty mars 2.1.1.1

          well ok then how is pale racist? In your own words if you can would be good mate.

          • bwaghorn 2.1.1.1.1

            Pale on it's own is just a word . Context is everything.

            You look a bit pale.

            You pale old cunt.

            • marty mars 2.1.1.1.1.1

              Why would you use that sentence? Seems to me you are so insecure that you are trying to be a try hard – how about growing up and using the tiny brain you have to debate the point or are you too dim for even that eh boy
              btw you sicko – no one would insult a ‘white’ person by saying that to them – shows a lot about you and your deep issues imo

              • bwaghorn

                Humm so you've made it personal and I'm the one with the problem??

                You are just a sad little bully

                • solkta

                  Perhaps if you actually attempted to explain how pale is racist marty would have something substantive to reply to.

                    • solkta

                      I've put what i understand it to mean at 2.4 below.

                      But i wouldn't have thought "old white man" was racist either.

                    • solkta

                      please put "edit" before your links, they weren't there when i replied.

                    • The Al1en

                      I didn't call it racist, either, and whatever the flavour, the chips on some people's shoulders are always their own head balancers to me, but the articles are quite clear their is a perception pale stale male is used as an insult.

                      Nope. For certainty, best wait ten minutes before replying. I’ll add an edit only if someone replies before I’ve finished and it changes their comeback. Ta.

                    • solkta

                      I suggested that bwag "explain how pale is racist" and then you jump in so reasonable to assume you thought so.

                      For certainty, best wait ten minutes before replying.

                      Oh yes what a good idea we should all do thatfrown

                    • The Al1en

                      As it happens, my post at 10.47, with a 10 minute edit window, means your post at 11.01 was made 14 minutes later. Just saying.

                    • solkta

                      I must have gotten distracted after hitting reply. That is not really the point. The point is that people should have a right to know if something has changed since the first time they read it, and that replies may have been drafted based on the original.

                    • The Al1en

                      It's not my problem how you post comments on The Standard, though as I've written above, if my edit changes the meaning or understanding of another comment made before I've finished, I will tag it as edited.

                      In this case, in adding two links reporting how pale stale male is recognised as an insult, in context with the thread, no disclaimer was needed. It doesn't or wouldn't have changed your reply, quite clearly, as you haven't mentioned them once since.

                      On other sites I use, posts are freely editable until someone posts after, at which time they’re tagged and time stamped as edited. Maybe you should petition lprent for something similar.

                  • Naki man

                    It is the same as calling someone darkie, it is a racist slur.

                • marty mars

                  blub blub no one forced you to write what you wrote – take responsibility and debate the topic like you said you wanted to

                  how is pale racist?

                  depends on context

                  example given that isn't an example

                  try again?

                • weka

                  Marty and bwaghorn, please stop with the ad homs and personal attacks There's plenty of politics here without getting personal.

                  • "They're PASSIONATE about what they do"

                    (which kind of leaves me worrying about what sort of relationships they have – since I'm just such a caring, sharing kinda guy)

                    Apologies in advance

    • Robert Guyton 2.2

      The bald truth, eh!

      Hirsuitist as!

    • gsays 2.3

      Yes, at its best it's 'othering'.

      Akin to the climate around here when controversial moral subjects come up e.g. pot, euthanasia, abortion.

      Lump someone with a view at odds with one's own, into a group – anti vaxxers, Trumpians (Trumpets?). Sorted, you can now imply all sorts of undesirable attributes to them and their arguement.

      • marty mars 2.3.1

        othering? lol – you don't know what that means I think – think about the power dynamics that will help sort it for you imo

        Othering is not about liking or disliking someone. It is based on the conscious or unconscious assumption that a certain identified group poses a threat to the favoured group.

        https://www.theguardian.com/inequality/2017/nov/08/us-vs-them-the-sinister-techniques-of-othering-and-how-to-avoid-them

        • weka 2.3.1.1

          I think we're approaching a time when we need to take more care. I don't agree with the reverse racism/sexism part of the article, but I generally agree with his summation, which is what I think he was trying to get at.

          Despite the rise of "pale, male and stale" within media discourse and popular culture, it is time to stop and reflect on what it actually is, which is immature name-calling.

          Name-calling doesn't advance social causes or arguments. In fact, it does the opposite – it shuts down dialogue. Even worse, it can mean losing allies who were supportive of particular social causes and arguments. Let's return to arguing points, not people.

          And of course, the Boomer pejorative fails on class (as well as ageism), because that whole rhetoric makes invisible the elderly poor. Much like Generation Rent which seemed geared towards making gains that previous generations had without acknowledging that poor people have always rented. Didn't hear much about that, or what happens to people who currently retire with no savings and massive rent.

          Liberals in particular need to be rethinking this. At the moment we are acting like we're naturally going to win the progressive vs regressive war (because we're righteous, right?), and seem to think we're justified in treating people like shit who aren't on board with whatever issue from a liberal pov. Rising fascism suggests this is a dangerous strategy.

          The number of left wing people radicalising away from liberals in the past few years is scary. We can't force people to be liberal and we can't insult them into it either.

          I think much of this is a function of social media, and we haven't evolved healthy social norms for dealing with things like the fast pace of change enabled by that, or how to limit the damage from pile ons.

          Not suggesting we stop holding wealthy people to account, nor white people for racism and so on. But I do think being more nuanced in our analyses would help, and we desperately need to move to a politics of compassion, calling in, and building relationships across difference.

          • marty mars 2.3.1.1.1

            "and seem to think we're justified in treating people like shit who aren't on board with whatever issue from a liberal pov"

            Not sure what you mean by this.

            If we don't hold the line then what's the point. If I let someone be racist then why bother trying to stop others.

            • weka 2.3.1.1.1.1

              don't let someone be racist, but address the racism rather than putting the person down? Not saying that is absolute for every situation, but am pointing to the problem we have at the moment of polarisation and how the left tends to think we can force people to change into something we consider better. It's brutal at times and that brutality will not serve society well.

              You know about the calling in thing right?

              • marty mars

                No I'm not sure I do know what that means – I think I do but…

                • weka

                  thinking about it, I haven't heard it talked about in a while. It was a concept that arose a few years ago when people started to realise how much damage was being done on social media with pile ons. People were being righteous and calling out racism, sexism, all the isms, but because of the nature of social media the person being called out often ended up humiliated or worse.

                  So people started talking about the importance of calling people in. Address the racism, sexism etc, in a way that calls people in, helps them belong, enables them to feel like positive change is possible and that they're still valuable as a human being.

                  From memory, this shift from call out culture to calling in culture arose out of black culture in the US. Or at least that's where I was seeing it come from predominantly, although I saw it spread into other communities as people realised the importance of human connection. I'll see if I can dig up some links.

        • gsays 2.3.1.2

          At it's heart, othering is the reinforcement of the idea that 'they' are not like 'me', therefore 'I' can lack empathy or care for 'them'.

          Be it red heads, spectacle wearers, tories, folk who lisp, LGBTQQIA etc.

          I am heartened that my son's generation (he is nearly 18) are a lot more inclusive than I was at his age.

    • solkta 2.4

      Well i guess people could say instead "you are a member of the dominant social group and hold the dominant viewpoint of people of that group and this viewpoint has been dominant for a very long time and you should open your mind to the viewpoint and participation of others" but that does sound rather long winded.

  2. Robert Guyton 3

    Pale surely is a complexionist term and can be dwedfilly hurtful.

  3. Robert Guyton 4

    For a male, being called, "male" can be completely exposing and once said, can't be unsaid. To avoid being revealed in this way, "one" should dress and act suitably.

  4. marty mars 5

    Interesting series of articles

    There’s a huge mythology that native people here were simpletons, they were primitive, half-naked nomads running around the forest, eating hand-to-mouth whatever they could find. That’s how Europe portrays us. And it’s portrayed us that way for so many centuries that even we’ve started to believe that that’s who we were. The reality is, indigenous nations on this Turtle Island were highly organized.

    https://www.esperanzaproject.com/2019/native-american-culture/lyla-june-on-the-forest-as-farm/

    • Robert Guyton 5.1

      Articles like these are my bread and butter, marty mars. I wonder if you've read this little extract from somewhere (sorry weka, can't find the link smiley

      "I think so many of us have agreements. What I’d like to remind folks is that there was a time on Earth when agriculture didn’t exist. There was the wild plants and animals. People have always been in relationship to them, and I think agriculture as a current concept looks very different in lots of ways. We humans have been shaping the landscape since time immemorial, and we have been in collaboration with all manner of different wild plants and animals for a long, long time. But there was a time in history—some people say it was around 10,000 years ago, although you never know—that there were wild plants. I feel like it was an invitation from the wild, and this is how it’s been told to me. There were wild plants who could see the potential of being in a different sort of relationship with humans, and they invited us into this co-creative dance that we call agriculture.

      The plants gave up a little of their wildness, and we humans gave up a little of our wildness too, and we came into this covenant, this sacred covenant or this marriage. In some cultures, it’s spoken of as a marriage. We came into this relationship, and part of those agreements were to take care of one another. We were going to be bound in this reciprocal relationship, to care intimately for one another as we move forward. So that is the foundation of those agreements—that understanding of reciprocity, understanding that when you do well, I do well, and that it is a courtship. There’s an aspect of wanting to ensure that they’re well taken care of, not just because it means nourishment and food for us, but because there’s a deeper sense of love and relationality in that connection."

      • weka 5.1.2

        "sorry weka, can't find the link"

        If you copy and paste a small section of your quote (one sentence will usually do it), and put it in google with " " around each end, it will bring up the link that your quote is from.

        There is an expectation here that the person quoting will do that mahi, so that others don't have to. Esp important for people reading on phones because it's much harder to do that kind of search.

        That you don't do this puts me in a awkward position, because if you were someone else I'd be moderating by now. I'd appreciate it if you trust the moderators on this, that it's important to cite (with a link where possible) even if it doesn't seem so to you. cheers.

        • Incognito 5.1.2.1

          Yes, good point, weka, that’s what I did and by doing so, I was doing Robert a favour and making it easier on the moderators 😉

          • weka 5.1.2.1.1

            Thanks Incognito. Part of my annoyance at the moment (not with RG specifically, but with how much this is an issue on TS now) is the time I just spent writing that comment could have been spent reading Robert's quote 😉

        • ianmac 5.1.2.2

          Gee thanks Weka. I learned from you how to find the source of quotes. Very handy!

  5. francesca 6

    More trouble at the OPCW

    Undue political interference on the final Douma report

    Seems like the chlorine samples found were minimal and no different to environmental samples collected from outside the impact area

    I have a feeling this isn't going to go away.

    Written by Jonathan Steele, long time writer for the Guardian , and Middle East eye

    https://www.counterpunch.org/2019/11/15/the-opcw-and-douma-chemical-weapons-watchdog-accused-of-evidence-tampering-by-its-own-inspectors/

    • Brigid 6.1

      This is fairly serious

      "Within days of rebel-supplied videos of dead children and adults in the aftermath of the alleged attack in Douma Francois DeLattre, France’s representative at the UN Security Council, said the videos and photos showed victims with “symptoms of a potent nerve agent combined with chlorine gas”.

      The Douma fact-finding team quickly discovered this was wrong. Blood and other biological samples taken from alleged victims examined in Turkey (where some had fled after government forces regained control of Douma in mid-April) showed no evidence of nerve agents. Nor was there any in the surrounding buildings or vegetation in Douma. As the Interim Report, published on July 6 2018, put it: “No organophosphorus nerve agents or their degradation products were detected, either in the environmental samples or in plasma samples from the alleged casualties”."

      "On July 4 there was another intervention. Fairweather, the chef de cabinet, invited several members of the drafting team to his office. There they found three US officials who were cursorily introduced without making clear which US agencies they represented. The Americans told them emphatically that the Syrian regime had conducted a gas attack, and that the two cylinders found on the roof and upper floor of the building contained 170 kilograms of chlorine. The inspectors left Fairweather’s office, feeling that the invitation to the Americans to address them was unacceptable pressure and a violation of the OPCW’s declared principles of independence and impartiality."

      "An open letter to every delegate at the forthcoming OPCW conference calling for the inspectors to be heard has been signed by

      Jose Bustani, first Director General of the OPCW
      Hans von Sponeck, former UN Humanitarian Coordinator (Iraq)
      George Carey, former Archbishop of Canterbury
      Scott Ritter, UNSCOM Weapons Inspector 1991-1998.
      Noam Chomsky, Emeritus Professor, MIT.
      John Pilger, Journalist and documentary film maker
      Ray McGovern, former CIA analyst and co-founder of Veteran Intelligence Professionals for Sanity (VIPS)
      Oliver Stone, Film Director, Producer and Writer."

      The thing is that anyone with an unbiased view will see that the report that the OPCW did release was full of inconsistencies and omissions.

      • francesca 6.1.1

        Very disturbing the appearance of the American officials ,in no uncertain terms dictating the "facts" to those OPCW staff about to write the final report on Douma

        Substitute "Russian officials" or "Syrian officials" and stand back for no end of squawking

        Just as disturbing UK prosecutors taking instruction from American representatives in the latest Assange court appearance

        "What happened next was very instructive. There were five representatives of the US government present (initially three, and two more arrived in the course of the hearing), seated at desks behind the lawyers in court. The prosecution lawyers immediately went into huddle with the US representatives, then went outside the courtroom with them, to decide how to respond on the dates"

        https://www.craigmurray.org.uk/archives/2019/10/assange-in-court/

        • Stuart Munro. 6.1.1.1

          I notice the mysterious death of the white helmet founder did not disturb you – doesn't fit your narrative I guess.

          Russia's intelligence forces are off the leash, and you're cheering them on.

          • Brigid 6.1.1.1.1

            What is the connection between Le Mesurier and the dodgy practices of the OPCW ?

            Or do you know something we don't?

            Do tell.

            Actually I doubt you know anything much of consequence which is why you need to try to deflect from the topic.

            I'd say though, that your worship of Le Mesurier is not shared by many Syrians.

            Or Kosovoians.

            • Stuart Munro. 6.1.1.1.1.1

              I don't worship him – but if you were progressive instead of being the menkurt servants of a murderous kleptiarch you'd have supported the white helmets, and their efforts to help Syrian people.

              The common thread between the "dodgy practices of the OPCW " and your demonization of the white helmets of course is that both are part of Moscow created narrative you repeat as thoughtlessly as the sheep in Animal Farm.

              • Brigid

                Of all the reports and articles provided by on this site it seems you've read none. Of all the Youtube videos the White Helmets have published showing their thuggery and pathetic false flag acting it seems you've chosen to view none.

                I guess you dare not for fear of having your ignorance tested, as all you seem to be able to say is "Russia did it. Assad gassed his own people. I don't like Craig Murray."

                You're a fool Stuart. That's not an insult just a mere observation.

                I wont respond to your comments again. You've nothing to say worth reading let alone replying to.

                • Stuart Munro.

                  You're just a parrot Brigid. People who want your perspective need only read RT – it's not as if you analyze anything – which means your opinion is less than worthless, it is in fact a kind of pollution.

                  The less you intrude your ignorance into grown-up discussion the better.

          • francesca 6.1.1.1.2

            A very apt connection Stuart After all it was the White Helmets who claimed Douma residents had been killed by nerve agent at the hands of the Syrian govt. The harrowing and widely distributed video was found to be quite misleading. The OPCW found no nerve agent in environmental samples or "victims" who'd made their way to Turkey .The bodies were nowhere to be found

            The narrative then changed to weaponised chlorine.This too is disputed by the very team who collected samples in Douma

            It also happens to be the only OPCW investigation actually on site with the required chain of custody rules observed

            Oh dear , it seems the White Helmets were lying

            • Stuart Munro. 6.1.1.1.2.1

              It's amazing what can seem to be made to seem like lies, if one humours the disinformatsia of professional propagandists.

              • francesca

                So now the OPCW team at Douma are liars

                hokay

                • Stuart Munro.

                  I think I've lost count of the times the Russians have accused the OPCW of lying.

                  Just as they accused everyone else of lying about MH17, while they produced an endless series of bullshit explanations not realizing how comprehensively contemporary technology had documented their actions.

                  The Russians are incapable of telling the truth – it has no value to them. And having earned that reputation, they only win mudslinging wars among the credulous 🙂 .

                  • Dukeofurl

                    Yep . And the Ukrainians lied when they shot down the Russian airliner over the Black Sea

                    And US lied when the US Navy shot down a Iranian civil airliner on its scheduled route…some bull%$#@ about diving on to them

                    Airliner shootdown are more common than you would think….of course you are fully aware of ALL these …not

                    https://en.wikipedia.org/wiki/List_of_airliner_shootdown_incidents#1990s

                    • Stuart Munro.

                      I think it goes a little deeper in fact – to Marxist theory or possibly even to Tzarist times. Back when I was MAF observing, Russian vessels typically kept three or four different sets of books – even asked me on occasion what they should write in the quota record books. The idea that they might record what actually occurred was alien to them.

                      I am of course aware that international discourse includes a great many lies, but there is a fundamental unconcern for truth in some cases – clarified here if you're interested: https://www.youtube.com/watch?v=lArA7nMIqSI

                  • McFlock

                    Bit harsh – it's more of a conceptual difference that brings military deception into the strategic and diplomatic level.

                    When runned by competent leaders, the West tend to tell planned fibs if they want to keep something secret. "Don't believe that, believe this" sort of thing. And then most of the time the actual story leaks out decades later.

                    The Russians prefer to have multiple arms-length sources make up their own shit about any notable event, so decision-makers get lost in fog. This has the advantage of not just delaying the decision makers, but randoms around the world can pick the theory they like best and adamantly preach it.

                    • Dukeofurl

                      No go with your 'conceptual thinking' …they are all bare faced liars …full stop. Only a small portion 'gets out'

                      in the middle east its the same whether it was Saddam , Erdogan, Assad or Netanyahu.

                      Have you seen the recent bare faced lies by NZDF …and they couldnt shoot down a low flying balloon…..and the con job they do do on the taxpayer here about 'highly trained but not well equipped'

                    • Stuart Munro.

                      I relate the habit of untruth in part to the severity of Soviet and quite probably preSoviet oppression. Telling the truth under Stalin was an almost suicidal level of romantic excess. But western countries have traditionally extended some kind of protection, however imperfect, to truth tellers and whistleblowers, so that the notion is, whatever else it might be, not absurd.

                    • McFlock

                      NZDF changed their story multiple times, but said only one story at a time.

                      If they'd followed maskirovka, they'd have said fuckall while various publications were slipped conflicting and massively unlikely alternative explanations to "hit and run".

  6. Kay 7

    Things were obviously pretty stressful for us yesterday so I've just caught up with OM. Disappointing, but not at all surprising to see that some people don't consider 'only' 4 possible related deaths aren't enough to satisfy them. And variations on the theme of 'oh well x number of epileptics die every year anyway'. Talking points that are currently being seen in several commenting sections on social media/message boards, and that have originated with Pharmac. So either you're just not creative enough to come up with your own arguments, or you're on the payroll of certain government agencies who are desperately trying to deflect. At least try to be original, ok??

    If people STILL sincerely believe Pharmac are in the right over this one, despite ALL the evidence against them, then all I can do is feel very, very sorry for you, suggest you get yourself some intensive counselling for your denial problems and hope that you are never at their mercy.

    I'm not going to engage anymore on this for the time being, the stress has made me really ill, and watching Guyon's interview with "Dr" Ken Clark yesterday left me wanting to physically harm the man and I'm not a violent person. Debriefing with my colleagues later, I was not alone!

    But a brief summay/conclusion/points to dwell on.

    *Medsafe said it's dangerous, don't do it.

    *International best practice guidelines said it's dangerous to switch brands, don't do it.

    *Pharmac did it

    *It's subsequently proven to be dangerous to some people, including possible deaths,

    *There are OIA documents showing Pharmac knew there were likely to be problems

    *This is all about money, not best clinical practice, not what's best for NZers, as Dr Clark says.

    *There is NOT an issue with generics. There is just some categories of drugs where it's not safe to switch brands. Like heavy duty brain drugs. Pharmac will try this again, this is not the first time people have been harmed by this practice

    *Pharmac keep crying '"capped budget." We have to ask why does it have to be capped with no real increases for years?

    *We should be concerned that senior public servants blatantly lie and deliberately mislead the media, the public, their Ministers and the Health Select Committee, even while being showing the documents that state evidence to the contrary. Is there no code of ethics? Where does employment law come into this? HOW can this keep happening and they don't lose their jobs?

    • weka 7.1

      Thanks Kay, appreciate your work on this. I hadn't been following so it was an eye opener yesterday to read one of the comments and a link that showed how many people with epilepsy die (I had no idea) i.e we already know that people are at risk, and how unbelievably stupid Pharmac have been over this given what was known ahead of time.

      I was pretty surprised to see the unusually insensitive only 4 deaths comment too.

      Take care, hope you get some restorative time.

      • Dukeofurl 7.1.1

        Appreciate what Kay has said , but 60 people die in NZ every year from Epilepsy related 'causes' ( SUDEP).

        https://www.healthnavigator.org.nz/health-a-z/e/epilepsy/
        Others say Sudep is only 18% of all epilepsy related deaths, as just having epilepsy is considerable burden on your system
        https://www.otago.ac.nz/bhrc/news/otago629839.html

        Those families that have had this happen doesnt help them if there has been a change of meds to something that is chemically the same, but its ‘not considered to be the same’

        • weka 7.1.1.1

          Epilepsy New Zealand president and neurologist Peter Bergin said the switch could have "major consequences" for a "small but significant" group of people. "I think it's an unnecessary risk that Pharmac have taken.

          He said in theory Logem should be the same as the Arrow and Lamictal brands Pharmac had been funding, but the issue was whether it was absorbed into the body at the same rate. "As a neurologist, I'm slightly uncertain about whether the absorption characteristics in the different tablets are going to be exactly the same." He said for most people there would be a 10-20 percent difference in absorption and that would not cause problems, but for some people who had been seizure-free but "who are just on the edge", it could be enough to cause seizure recurrence.

          "The real difficulty is that we won't know whether people who have seizures have done so because they've changed the drug. The reality is that even if someone has been seizure-free for a year, there's no guarantee they'll remain seizure-free for the next year."

          My emphasis.

          https://www.rnz.co.nz/news/in-depth/399908/seizures-driving-stand-downs-as-pharmac-pulls-epilepsy-drug-funding

          • Dukeofurl 7.1.1.1.1

            Thanks for that , I understand its not clear cut if they are identical even if the chemical formula is the same.

            I just thought the people scare mongering over 'getting the Police people are dying' side needed to know epilepsy can always cause your death in a number of ways.

            • ianmac 7.1.1.1.1.1

              In one radio interview a woman said she was carefully making the transition but being easily scared had become very fearful listening the doom laden rhetoric. Maybe we should wait and see if the fault can be identified.

              My son's friend died at 27years from a nightime epilepsy event some 5 years ago. Tragic but part of the awful risk from epilepsy but nothing to do with the current changes.

          • Incognito 7.1.1.1.2

            This question has been addressed and was buried in a link in a discussion thread in Open mike 13/11/2019:

            SIGNIFICANCE:

            Some neurologists question whether bioequivalence in healthy volunteers ensures therapeutic equivalence of brand and generic antiepileptic drugs in patients with epilepsy, who may be at increased risk for problems with brand-to-generic switching. Bioequivalence results in "generic-brittle" patients with epilepsy under clinical conditions support the soundness of the FDA bioequivalence standards. Adverse events on generic were not related to the small, allowable PK differences between generic and brand.

            https://www.ncbi.nlm.nih.gov/pubmed/26201987

            However, there are still some lingering (and legal) doubts about the current regulatory requirements:

            https://www.ncbi.nlm.nih.gov/pubmed/31626574

            Please note the years of publication; the first link was cited in the second one.

      • McFlock 7.1.2

        I didn't say "only" 4.

        I asked if the rate was any different from what it would have been without any change in label.

        It might be "insensitive", but it's a necessary question when it comes to judging health funding decisions.

        • weka 7.1.2.1

          could have been framed a bit differently I think.

          Following up with the bit about necessary health rationing also came across a bit like 'some people have to die'. Which is brutally true but again framing matters.

          The thing I'm with most right now is the number of people with a very stressful and scary condition who must be additionally stressed by not knowing what is going on. Just on that level alone questions should be being asked about how this whole thing has been handled.

          • McFlock 7.1.2.1.1

            And that fear will in no small part be encouraged by the headlines about deaths that imply causation without evidence.

            I do try to consider criticism of my comments fairly, but I prefer to be criticised on what I actually wrote.

            • weka 7.1.2.1.1.1

              Fair enough. I think I read it reasonably right at the time and it seemed out of character for you. Not the wanting to apply rationality, but the insensitivity.

              "And that fear will in no small part be encouraged by the headlines about deaths that imply causation without evidence"

              I was under the impression that critiques in the 12 months before the change that it was clear that there would be negative effects from the change (albeit Pharmac presumably wasn't expecting deaths). Even without MSM current focus on deaths, this was a widely discussed issue for those that were paying attention (i.e. people with epilepsy) and the deaths would have been known about on social media anyway (but with less scrutiny perhaps). I'm sure there's always room for improvement in MSM coverage.

              Do you know why they didn't leave existing patients on the old medicine and have new patients on the generic? I gather part of the issue is that where people with epilepsy are stable on one med it's best practice to not mess with that.

              • McFlock

                They would have wanted as many people on the cheaper labels as possible. This would free up more funds to improve the quality and length of life for other patients.

                From what I gather, Pharmac normally go through a pretty solid analysis that does account for quality of life as well as lives extended. So if that process wasn't followed, that would be a bad decision. Alternatively, if they did the transfer and it had worse repercussions than calculated, the question arises as to why the predictions were off.

                If that system is broken, fair call. There will be investigations, maybe resignations and hearings, and compensation claims. Otherwise, basically people are lobbying to get more than their fair allocation of health funds.

                And there's a conflict between my (admittedly thin) impulse to listen to the fears of people who are about as safe yesterday as they are today, and my impulse to ask how much money we will spend to allay those fears when other people have more demonstrable drug needs.

                • weka

                  so you think there is no increased risk for a % of that group? What are you basing that on?

                  • McFlock

                    I'm saying that the declared number seems to be within the range of what one would expect without any label change (40-60 per year). A closer analysis of person/years might demonstrate that change from four cases (or at least make a reasonable basis for concerns it despite wide confidence intervals).

                    But at this stage there are a lot of discussions on a variety of platforms seemingly suggesting that the label change killed 4 people. Which is a load of bullshit given the available information (and pharmac/carm probably don't have too much more information than already released: specific dates and doses, but possibly not much more).

                    • Incognito

                      The number of deaths may be an anomaly but apparently 26 reports of adverse reactions to lamotrigine since brand switch began in May have been reported to the Centre for Adverse Reactions Monitoring (CARM).

                      See also https://www.medsafe.govt.nz/safety/Alerts/Lamotrigine.asp

                    • McFlock

                      Is that more or less than usual? And if it's more, is the increase in the acceptable bounds of the decision to switch funding in the first place?

                      We simply don't have the information available to assess the decision or the response.

                      It's like an engineer is told to "build a bridge 25 units long". Are those units metres, yards, or kilometres? All anyone can do is wait.

            • weka 7.1.2.1.1.2

              "imply causation without evidence."

              There's reasonably evidence that the theory is right, yeah? (seizures are dangerous for a % of sufferers, changing meds can make seizures more likely).

              How would they establish causation in specific cases?

              • McFlock

                Stuffed if I know at a clinical level. Which leaves the comparison between rates as an indicator.

    • Ad 7.2

      Needs a Police investigation into Pharmac.

      Four deaths, and very little accountability.

      Even if no charges were laid afterwards, it sends the right signal.

      • OnceWasTim 7.2.1

        Ya can't bloody do that @Ad!!!!!!!!!!

        Not even Ministers or elected Councillors

        Don't you know all senior public service officials are above reproach?

        And that's even when/after the 'good and proper' processes have been exhausted and nothing has been done. It could be construed as bullying

        (/sarc – just in case)

      • Dukeofurl 7.2.2

        Around 4 people or so die every month who have no obvious causes other than they have epilesy . Some dont even have a siezure and just die in their sleep.

        Maybe 5x that number each month have early death due to the burden epilepsy puts on their personal health.

        That seems to be unrelated to the brand name of their medications

    • A 7.3

      I haven't engaged in the debate partly because I'm having trouble understanding that they continue in the face of overwhelming evidence, and even death.

      YES – police need to be involved as this is criminal.

      • Incognito 7.3.1

        PHARMAC has reversed their decision so they are not continuing.

        At this stage, nobody knows if and how the brand switch may have contributed to any of the four deaths. All we know, from the media reports, is that they had in common being epilepsy sufferers and had switched brands. The deaths have been referred to the coroner.

        What “overwhelming evidence” are you referring to?

        • weka 7.3.1.1

          Has Pharmac reversed its decision? I thought they had just said that if people had concerns they could apply to go back to the old brand.

          • Incognito 7.3.1.1.1

            Hmmm, maybe it’s clearer when reading PHARMAC’s latest press release.

            Patients taking lamotrigine who have concerns about the change can talk with their doctor about remaining on their current brand as PHARMAC has widened the criteria for lamotrigine exceptional circumstances.

            PHARMAC will continue to fund the brand those people are currently on or were originally on before the change through the exceptional circumstances process.

            “If people have concerns, we encourage them to talk to their doctor. Their doctor can apply to PHARMAC, through our exceptional circumstances process, for continued funding of the brand they took before the funding change,” concludes Dr Clark.

            https://www.pharmac.govt.nz/news/pharmac-to-widen-access-to-the-exceptional-circumstances-process/

            I read this as being a reversal, albeit a temporary one possibly, and patients and their GP’s now have the choice; I’d assume the application process will be swift and nothing more than a formality. The unspoken issue is that, as always, effective healthcare depends on effective communication between patient and GP. It may not always be crystal clear where the onus is and who takes responsibility for what. A good relationship with your doctor is important.

            • OnceWasTim 7.3.1.1.1.1

              I guess to clear up any sort of ambiguity going forward, we should probably talk to their 'comms people'

              • Incognito

                A press release is not a substitute for information to doctors and patients. As I said, the onus is on them to find out relevant information, if they don’t already have it, and do what they think is best for them. Medical decisions, such as prescriptions and patient care are not the responsibility of PHARMAC.

            • marty mars 7.3.1.1.1.2

              Perhaps from this I put up yesterday

              In a statement, Pharmac's medical director Dr Ken Clark said "we understand the news of the three deaths of patients taking Lamotrigine will concern people. We don't know if this is linked to the brand change – and we don't want people to stop taking their medication out of fear so we're making it easier for people to stay on their current brand if their doctor believes it is the right thing for them."

              https://www.rnz.co.nz/news/in-depth/403367/pharmac-backs-down-on-epilepsy-drug-brand-switch

        • Andre 7.3.1.2

          I don't see "overwhelming evidence" anywhere.

          Whipping up a storm on the basis of 4 deaths over a period of several months, when " Epilepsy affects 48,000 New Zealanders. It's a serious condition – every year about 40 people in this country die from sudden unexplained death due to epilepsy. ", strikes me as decision-making based on loud emotional shouting, not rational examination of the evidence.

          Nevertheless, the Medsafe advice to Pharmac against forcing a switch to Logem makes sobering reading. Not because an increased risk of death, which hasn't been demonstrated, but because of the extreme adverse effects on the quality of life that would be suffered by those whose epilepsy went from well-controlled to not well-controlled because of the switch.

          • Dukeofurl 7.3.1.2.1

            People who are experts on medical statistics have a field day with the bizarre health claims in most media . It works both ways on 'deaths from' and 'saved by'.

            This big fiddle with the numbers has been revealed in 'Sports Science' which is a small part of the Cult of Statistical Significance

            https://fivethirtyeight.com/features/how-shoddy-statistics-found-a-home-in-sports-research/

            and more broadly , in this book, which covers economics as well.

            "The Cult of Statistical Significance: How the Standard Error Costs Us Jobs, Justice, and Lives"

            eg ‘How many molecules do you suppose you share with William Shakespeare? We mean molecules in your body that were once in his? Surprisingly, the correct answer, in view of the immense number of molecules in a human body and the operation of decay and Brownian motion, is “quite a few.”. but its meaningless of course , even if you live in England like he did.

            • Andre 7.3.1.2.1.1

              Yeah. That's why I find the "quality of life" argument put forward by Medsafe to be compelling, while my initial reaction to the reports of deaths is I don't yet see a reason to believe those are anything more than the normal background rate of incidences of SUDEP.

              In the case of lamotrigine, it seems that most of those that need it would successfully switch. I'll speculate that due to the complexity and variability of humans and what ails us, there may even be some who would do better from switching.

              But now with the enormous adverse publicity that has come about, significant nocebo effects are probably in play by now.

          • Incognito 7.3.1.2.2

            I think that there’s enough information to raise suspicion and act upon it based on the precautionary principle, which is exactly what happened. From what I’ve read, it does look like PHARMAC made a few debatable judgement calls.

            • Dukeofurl 7.3.1.2.2.1

              Or its the Nocebo effect , as mentioned by Andre

              ‘Some experts state that the nocebo effect may have a larger effect on clinical outcomes than the placebo effect as negative perceptions are formed much faster than positive ones.’

              The nocebo effect can be influenced by ‘media storms’. Widespread dissemination of concerns about an adverse reaction to a medicine leads to an increase in the number of reports of the adverse reaction.
              https://medsafe.govt.nz/profs/PUArticles/March2019/The%20nocebo%20effect.htm

              Id hate to think we are seeing a Media Storm whipped up by the Hidden Hand of the Big Pharma whos product is replaced by a generic

    • Patricia 7.4

      Grateful thanks to you, Kay for the frequent postings and warnings about the change-over to generics. Sympathy to all those who have now suffered because Pharmac did not listen or seemingly care. Any life lost is a tragedy. Hoping you are all back on your previous medication now.

  7. The Chairman 8

    Association of Salaried Medical Specialists Executive Director Ian Powell says annual DHB budget planning processes have become farcical.

    “DHBs are being pressured to find mythical savings that are then not realised. It is a wasteful and futile exercise in wishful thinking, he says.

    “Proper budget planning to meet the predicted actual operational costs of providing quality and accessible patient care would avoid the necessity for equity injections and would enable DHBs to engage in long-term planning, rather than chasing short-term savings that risk the standard of and access to patient care.”

    Mr Powell says Health Minister David Clark must show leadership and encourage the Ministry of Health to face reality. “He must ensure that health funding in next year’s Budget meets the estimated operational costs of district health boards providing quality care to their patients.

    “At present Dr Clark is busy trying to have it both ways. He blames the previous National government for underfunding, but at the same time implies that DHBs should be able to make ends meet.

    https://www.asms.org.nz/news/asms-news/2019/11/12/dhb-bailouts-symptomatic-of-underfunding/

    Once again, Ian Powell is on the money. We now look to Dr Clark and the Government to put it right.

    • Dukeofurl 8.1

      Compared with the Nats health budget tricks, where 'new money' was only given to DHBs to pay off debt, and even when the debt was transferred to the Crown accounts , the DHBs still had to pay interest on the debt transferred !

      But the headlines for Steven 'Hole in his pocket' Joyce before the election said "$900 mill more for DHBs. Actual money may vary ."

      Anyway the whole DHB budget thing is an exercise in Theology, as they have to fund depreciation and the Crown asset charge from operational expenditure. They can never keep up, as they replace old buildings just opening the doors on new pushes their deficit through the roof.

  8. Cinny 9

    Dodgy roger stone, caught out lying to congress, guilty on seven criminal counts.

    https://www.aljazeera.com/news/2019/11/trump-ally-roger-stone-guilty-lying-congress-191115165033067.html

    Meanwhile as the ex USA ambassador to the Ukraine, Marie Yovanovitch, testifies

    https://www.aljazeera.com/news/2019/11/trump-impeachment-inquiry-public-hearings-latest-updates-191113130549252.html

    dirty donald trump who says he isn't going to watch the hearings, starts slamming her in real time on twitter by going on a retweeting frenzy.

    https://twitter.com/realDonaldTrump

    • Sabine 10.1

      there is war, it is simply a war without bombs dropping.

      But there is a war, an extermination war. And yes, non of these women will speak up. Why on earth would they?

  9. joe90 11

    Take the water out and wow..

    https://www.youtube.com/watch?v=ExOOElyZ2Hk&feature=youtu.be

    Why do all the pictures you take underwater look blandly blue-green? The answer has to do with how light travels through water. Derya Akkaynak, an oceangoing engineer, has figured out a way to recover the colorful brilliance of the deep.

    https://www.scientificamerican.com/article/sea-thru-brings-clarity-to-underwater-photos1/

  10. Macro 12

    Now who says tRump isn't in love with Putti..

    https://twitter.com/brett_mcgurk/status/1195368417777242112

  11. greywarshark 14

    https://www.rnz.co.nz/international/pacific-news/403437/wwf-warns-of-impact-of-new-caledonian-fires

    Sad. How can the ground be kept green, with juicy non flammable undergrowth. Could bindweed come into its own??

    • marty mars 15.1

      Love it – that will tear the imposter up big time – very nice move – he will react very poorly I think and overstep the mark – hopefully bigtime cos the scarlet pimplesmell has to go

  12. McFlock 16

    Another multistorey fire in the UK, this time a student dorm. Apparently everyone got out. Suggestions that building cladding might be an issue again.

    If the cladding really is an issue after Grenfell, that's outrageous.

    Additionally, the uni is relocating students and providing support, but pulling the line that the block isn't owned or operated by them. Gotta love that "plausible capitalist deniability".