Jōkei-san's crusade

The next several months saw a flurry of activity, a flurry being an apt term, as it was hard to see what was really going on.

One of the first things Jōkei-san did after leaving Caduceus was establish a series of clinics to help victims of the opioid epidemic. While ostensibly these were methadone clinics, they offered far more diverse forms of therapy, with a particular emphasis on hypnosis and meditation. This led to criticism that Jōkei-san was starting a cult, but then it was hard to argue with the already scientifically proven benefits of auxiliary therapies.

Jōkei-san also had a solid retinue of co-workers who chose to follow him for ethical reasons, and while he couldn’t pay them at first, because of their combined experience, within weeks the operation was self-sustainable. However, unlike with generic methadone clinics, which are mainly outpatient establishments where people come to get their meds, do their therapy, and then go home, these clinics had an unusually high number of people choosing to live and work there, even after their treatment was completed, and because of the nature of doctor-patient confidentiality, it was hard to tell what was going on inside them. But judging by the high rate of recovery, whatever it was, it worked.

Following on the widely publicized success of these clinics, Jōkei-san expanded into drug manufacture, in particular, insulin. After opioids, Caduceus’ second highest grossing product was insulin, a drug they shamelessly price-gouged, even as over 10 percent of the country was living with diabetes, and many of them needed insulin to survive. While there have been biohacking initiatives in the past, as well as attempts at open-source insulin manufacture, none were particularly successful, for a combination of legal and scientific reasons.

Jōkei-san, however, was both a skilled researcher and clever legalist, much of whose career was spent tweaking existing formulas to sneak around existing laws, so you could say he was literally trained for this. In less than a month, he and his assistants were able to come up with a viable way of getting safe insulin to people for pennies on the dollar, often skirting insurance companies altogether.

The initial reaction from the news sources was that Jōkei-san must have discovered a new procedure that allowed him to massively cut down on production costs. But the truth of the matter, which he was quick to reveal, was that the process wasn’t that much cheaper, rather it was always the secrecy surrounding patented technologies that allowed companies to set whatever prices they wanted. All he did was reveal the size of the upcharge.

Some criticized Jōkei-san saying he was a communist who was undermining free enterprise. However this too seemed like a trap Jōkei-san had set. Drawing on the imagery of the caduceus, the two-snaked staff of the god of commerce, he made the following analogy concerning the medical cartel and how it in fact undermined capitalism. While normally in a free market an agent who is able to produce a product for cheaper would be able to sell more of it after undercutting his competitor, this was not how things operated in the medical sphere. Instead, a handful of big companies set prices behind the scenes, agreeing not to go below a certain threshold, thereby assuring that everyone continued to profit.

So, rather than being a communist, Jōkei-san argued that he was a true capitalist, while companies like Caduceus were like the two snakes facing each other in an artificial balance. True medicine, like the staff of Asclepius, only needs one snake.

Just as the news outlets were starting to catch up with the new developments, Jōkei-san, like some mad president that keeps up a non-stop barrage of new initiatives, revealed his plan to build a new system of unlicensed medical schools. During this period, he was something like an Indian god with an impossible number of hands, each doing its own thing.

More than the pharmaceutical price-fixing, it was the medical school cartels that led to the high price and low quality of medical service. While the need for medical professionals steadily increased over time, the number of medical degrees awarded had long remained capped, thereby creating artificial scarcity that allowed for higher and higher prices for medical care. Again, what appeared as supply and demand was in reality a charade that placed money above human life.

It was only later, when I read more about Paracelsus, the historic figure Jōkei-san talked about with the alchemist, back when he was still Hideo-sensei, that I realized the parallel between them. While teaching medicine at the University of Basel in medieval Switzerland, Paracelsus caused quite a stir by choosing to teach in colloquial German rather than traditional Latin, and by allowing barbers to study in his classes.

Back then being a doctor was the vocation of a noble. As such, doctors never actually touched their patients, and if a procedure had to be performed, they would get the local barber to do it under their guidance. Paracelsus saw this for what it was - stupid. So, he insisted on training the people who actually performed operations, rather than just the noblemen who refused to get their hands dirty.

Looking back now, of course, we know that Jōkei-san’s alternative med school did not survive long enough to produce any doctors, but I’m not sure if that was ever really his aim. I think, rather, he wanted to expose the medical system for what it was. Or maybe “diagnose” is better word, as in to know something through and through.

It was also around that time that Jōkei-san began to carry a sword.