David J Black: Economic fallacies and public health realities

[Dolphin]

David J Black: Economic fallacies and public health realities
27 Nov 2024

Reading time: 8 minutes

In part two of his series on dysfunction in our health system, David J Black reminds us that the cost of bad medicine is people’s lives. Read part one here.

It is one of those facts which cries out to be universally acknowledged: when it came to understanding the nature of such illnesses as ME/CFS, Lord Freud, despite being Sigmund’s great grandson, was almost wantonly ignorant, yet he was the ‘expert’ to whom the government had turned for advice. He had once wittered: “Our approach is – and this is rather a mouthful – akin to the biopsychosocial model.” This speculative doctrine would later resurface in Sir Mansel Aylward and Gordon Waddell’s 2009 manual Models of Sickness and Disability. Aylward, medical director and head scientific adviser to the DWP, and a promoter of the Woodstock conference, would become director of the UnumProvident Centre for Psychosocial Research at Cardiff University. The phrase “conflict of interest” should not be overlooked. The stark conclusion of Aylward/Waddell manual was that individuals retain free will and bear personal responsibility for their actions; they must answer the question whether their health condition is such that it would be unreasonable to seek or be available for work – the biopsychosocial model provides the tools and the framework for that endeavour.

Continues at:
https://www.scottishlegal.com/articles/david-j-black-economic-fallacies-and-public-health-realities

https://twitter.com/user/status/1861940371095204239

 

[Trish]

Part 1:
David J Black: The great health expenditure catastrophe – diagnosing a failed panacea

Extract from the article:

The crystallisation of Britain’s vendetta against the suffering was the notorious Malingering and Illness Deception conference held at Woodstock, Oxford in 2001. This was sponsored and funded by the DWP in association with the American health insurance giant, UnumProvident, and was something of a masterclass in the persecution of the sick and ailing. Its follow up manifesto, an anthology edited by psychiatrist Peter Halligan (OUP, 2003) was a study in demonisation much praised by the Institute of Psychiatry’s Simon Fleminger who boldly speculated “that many of our patients may be deceiving us, and that much of this deception may be conscious. We are introduced to the debate as to whether or not malingering should be identified as a psychiatric disorder, a disorder of free will, or simple criminal behaviour.”

But just who were the criminals in this case? Might it be a tight-knit psychiatric faction and its state backers which clearly had an agenda to denigrate a cohort of benefit claimants who were in no condition to fight back? Perhaps some bright post-grad sociology or criminology student should forensically analyse this ruthless war of attrition on the sick with a view to establishing the actuality.

Fiscally obsessed politicians were only one aspect of the problem. Given the policy-framing role assigned to Chatanooga-based UnumProvident, which the Insurance Commissioner for California described as “an outlaw company” in 2004, and which, furthermore, was induced to settle a class action lawsuit over its “claims denials” in 2008 for $40 million, any resulting dissertation could be a riveting diagnostic Gothick Horror for sure.

And that, it seems, is where our tale is headed.

 

[Trish]

Other threads with articles by David Black:

Blog series: "Orthodoxy on trial: the pathogenesis of a diagnosis" by David Black

David J Black: Is anyone listening? Does anyone care?

 

[Sly Saint]

Part 1:
David J Black: The great health expenditure catastrophe – diagnosing a failed panacea

Extract from the article:

The crystallisation of Britain’s vendetta against the suffering was the notorious Malingering and Illness Deception conference held at Woodstock, Oxford in 2001. This was sponsored and funded by the DWP in association with the American health insurance giant, UnumProvident, and was something of a masterclass in the persecution of the sick and ailing. Its follow up manifesto, an anthology edited by psychiatrist Peter Halligan (OUP, 2003) was a study in demonisation much praised by the Institute of Psychiatry’s Simon Fleminger who boldly speculated “that many of our patients may be deceiving us, and that much of this deception may be conscious. We are introduced to the debate as to whether or not malingering should be identified as a psychiatric disorder, a disorder of free will, or simple criminal behaviour.”

But just who were the criminals in this case? Might it be a tight-knit psychiatric faction and its state backers which clearly had an agenda to denigrate a cohort of benefit claimants who were in no condition to fight back? Perhaps some bright post-grad sociology or criminology student should forensically analyse this ruthless war of attrition on the sick with a view to establishing the actuality.

Fiscally obsessed politicians were only one aspect of the problem. Given the policy-framing role assigned to Chatanooga-based UnumProvident, which the Insurance Commissioner for California described as “an outlaw company” in 2004, and which, furthermore, was induced to settle a class action lawsuit over its “claims denials” in 2008 for $40 million, any resulting dissertation could be a riveting diagnostic Gothick Horror for sure.

And that, it seems, is where our tale is headed.

see this thread
Government and Insurance companies - establishing the BPS model | Science for ME

also tag 'david black'

 

[Sean]

Perhaps some bright post-grad sociology or criminology student should forensically analyse this ruthless war of attrition on the sick with a view to establishing the actuality.​

There is enough material in this whole shabby tale to justify a few careers for historians of medicine.

 

[bicentennial]

Perhaps some bright post-grad sociology or criminology student should forensically analyse this ruthless war of attrition on the sick with a view to establishing the actuality.​

There is enough material in this whole shabby tale to justify a few careers for historians of medicine.

Sociology, criminology, history - and theatre, as suggested here during David Blacks temporary absence from his post:

He is on Twitter but not active https://twitter.com/Black_Scape . I think I tried to contact him either via Twitter or maybe via his work email at scottish legal, but got no response.

I may have imagined this...but I do think he should write the screenplay for the Hollywood Blockbuster (or west end play) about this as he is a playwright! https://sceptical.scot/author/david-black/

 

[bicentennial]

David J Black: The fallacies and fallibilities of AI
31 Oct 2025

Handy excerpts below for when The Pulse, headed up by Alistair Miller, promotes to GPs the AI agenda to replace GPs, do GP case-notes. ME/CFS marketing leads the way into primary care.

If you are too tired, these excerpts are too chatty. It took me a step forward to say the Pulse is promoting GP replacement to GPs, and its ME/CFS marketing leads the way.

singing the praises .... without question, this would change the world forever he assured me, we would all be much better off as a result. We were living in a new age. Medical science would be transfomed. ... Tne trashing of job prosepcts ... graduates end up as baristas --- was not something we need unduly concern ourselves with, apparently.

I listened with interest and attention, but somehow wasn’t entirely convinced.

After all, the University of Edinburgh had hosted a Department of Artificial Intelligence since 1963.

Headed by Donald Michie, a brilliant cryptologist who had spent much of the war codebreaking the Enigma machine at Bletchley Park, it operated out of quaint premises in the historic setting of Hope Park Square.

The staff and students would often resort to the Meadow Bar after a hard days cognitising, and it was always interesting interrogating them as to what exactly they were up to.

After being satisfied that they were not engaged in any thing sinister covered by the Official Secrets Act, or that they were not simply the sad inhabitants of Geekville Central, much was clarified.

AI scientists were committed to computational modelling as a methodology for explicating the interpretative processes which underlie intelligent behaviour, I was informed.

There were links with older disciplines such as philosophy, psychology, and neuroscience, but the digital computer was essential to support the many cycles of hypothesizing, modelling, simulating and testing involved in research into these interpretative processes.

Tragically, Donald Michie was to die in a car crash in 1983, and in 1998 this interesting division of the knowledge industry would be absorbed into something called the School of Informatics, which today occupies a truly horrible building just north of George Square.

I more or less forgot about AI until my son brought ChatGPT to my attention, explaining that if one asked it a question it could always come up with an answer, a bit like Alexa in a good mood. We asked ChatGPT.. The result was a load of incomprehensible gibberish. So far, so bad.

With scepticism in mind, I thought I might seek out any deficiencies and hallucinations with the current applications of AI, and found a bit of a cracker. A fellow sceptic, Andy Arthur, shared my doubts about an alleged... began poking about in the facts, rather than the fantasies....

Unfortunately, the fantasies had stolen a march on the facts in the form of several invented tales in the local press which owed nothing to a passing acquaintance with the truth...

Among the gullible outlets peddling this farrago as truth was Scotland’s supposed national paper of record, The Scotsman, which swallowed the lie hook, line and sinker.

The trouble with AI is its tendency to scrape everything and anything about a subject, even where the ‘facts’ turn out to be unadulterated falsehoods.

AI excursion into hallucinatory excess had clearly been scraped from various dodgy sources and recast as a true account of events ...

AI, like The Scotsman, perpetuated and repeated the lie, inscribing it as a fact of history, so that in a weird Orwellian way it somehow became ‘true’.

Only it couldn’t possibly have been true.

But one should never allow the facts to get in the way of a good story, especially when promoting ...

Fallacy masquerading as fact somehow became the authorised version, and AI was duly taken in. The greater preponderance of myth in the case ... tipped the balance, and Artificial Intelligence was duly duped.

What other fantasies, one wonders, are being peddled like this? Perhaps Sherlock Holmes could be asked to investigate.