Big Pharma

Anyone who pays a lot of attention to the way business is conducted in modern American society notices something very queer: Most R&D isn't done by corporations. You have public sector innovations or private sector innovations that are so subsidized they are essentially public sector, followed by modification for market of the technology that is infinitesimally cheap compared to the monumental costs of the initial development.
http://www.nybooks.com/articles/17244
This New York Times review has some very interesting things to say, confirming what leftists have been saying about R&D for a long time. An excerpt:
"But while the rhetoric is stirring, it has very little to do with reality. First, research and development (R&D) is a relatively small part of the budgets of the big drug companies—dwarfed by their vast expenditures on marketing and administration, and smaller even than profits. In fact, year after year, for over two decades, this industry has been far and away the most profitable in the United States. (In 2003, for the first time, the industry lost its first-place position, coming in third, behind "mining, crude oil production," and "commercial banks.") The prices drug companies charge have little relationship to the costs of making the drugs and could be cut dramatically without coming anywhere close to threatening R&D.
Second, the pharmaceutical industry is not especially innovative. As hard as it is to believe, only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on taxpayer-funded research at academic institutions, small biotechnology companies, or the National Institutes of Health (NIH). The great majority of "new" drugs are not new at all but merely variations of older drugs already on the market. These are called "me-too" drugs. The idea is to grab a share of an established, lucrative market by producing something very similar to a top-selling drug. For instance, we now have six statins (Mevacor, Lipitor, Zocor, Pravachol, Lescol, and the newest, Crestor) on the market to lower cholesterol, all variants of the first. As Dr. Sharon Levine, associate executive director of the Kaiser Permanente Medical Group, put it,
If I'm a manufacturer and I can change one molecule and get another twenty years of patent rights, and convince physicians to prescribe and consumers to demand the next form of Prilosec, or weekly Prozac instead of daily Prozac, just as my patent expires, then why would I be spending money on a lot less certain endeavor, which is looking for brand-new drugs?[4] Third, the industry is hardly a model of American free enterprise. To be sure, it is free to decide which drugs to develop (me-too drugs instead of innovative ones, for instance), and it is free to price them as high as the traffic will bear, but it is utterly dependent on government-granted monopolies—in the form of patents and Food and Drug Administration (FDA)–approved exclusive marketing rights. If it is not particularly innovative in discovering new drugs, it is highly innovative— and aggressive—in dreaming up ways to extend its monopoly rights.
And there is nothing peculiarly American about this industry. It is the very essence of a global enterprise. Roughly half of the largest drug companies are based in Europe. (The exact count shifts because of mergers.) In 2002, the top ten were the American companies Pfizer, Merck, Johnson & Johnson, Bristol-Myers Squibb, and Wyeth (formerly American Home Products); the British companies GlaxoSmithKline and AstraZeneca; the Swiss companies Novartis and Roche; and the French company Aventis (which in 2004 merged with another French company, Sanafi Synthelabo, putting it in third place).[5] All are much alike in their operations. All price their drugs much higher here than in other markets.
Since the United States is the major profit center, it is simply good public relations for drug companies to pass themselves off as American, whether they are or not. It is true, however, that some of the European companies are now locating their R&D operations in the United States. They claim the reason for this is that we don't regulate prices, as does much of the rest of the world. But more likely it is that they want to feed on the unparalleled research output of American universities and the NIH. In other words, it's not private enterprise that draws them here but the very opposite—our publicly sponsored research enterprise."

Prevailing Doctrinal Assumptions, Part I

It's amazing how the assumptions of established doctrine get so firmly set into the way we discuss about issues. Recently, many of you may have heard about the attempt to stop "frivolous lawsuits". Never mind that this is a transparent attempt to interfere with the autonomy of the judicial branch. Never mind that "frivolous lawsuits" will undoubtedly be defined to include any lawsuit brought against a corporation, as we think it's within a corporation's rights to sell products without providing any information about their product's superiority, or even any information about the product whatsoever.
Maybe I'm just being cynical, but for some reason I don't think that the people pushing these insane propositions have this in mind: Today's Something Awful (www.somethingawful.com) article, talking about how Monster Cable sued Monster's Inc. (the Disney movie) and practically anything that ever uttered the word "monster", ever. These lawsuits are patently frivolous, just like Fox's whiny suit about how Al Franken was violating copyright by satirizing Fox's "fair and balanced" (when in fact even their supporters recognize them as being neither, but as being unapologetic conservative pap).

Transcript

I also couldn't pass this up. An excellent example of how, late-at-night, poetry and art can open a wildfire of loosely connected and broad philosophical topics.
_____________________________________
Tyler: wait wanna see a poem I wrote? Dance of the raven: Dance of the raven. Find a haven. Metamorphosis comes. Adrenaline drums. Look into the sun. Song of a gun.
my mind was racing the other night, I wrote four little poems and I'M not quite sure what they mean... still Fred: I once wrote rhyming couplets from the perspective of DF in exactly that manner and put them together as a story DF tells of killing people at night. Czartan loved em.
Tyler: yeah... those ones are just weird Run through the forest Bloody your nuckles Feel no pain My demon chuckles what do you you get out of them? I mean... I know what I was thinking... but what do you think about them?
Fred: I thought that the demon chuckles bit was almost a Tyler Weast reference. You could easily put them together as a dialectical poetic structure between the three aspects of Tyler's mind. Tyler mentions demon, demon speaks, Tyler mentions angel, angel speaks, angel mentions demon, demon speaks mentioning angel, angel speaks, Tyler speaks, some outside observer speaks, a friend speaks, each speaks in turn.
Tyler: three images merge to one precision lost chaos won
Fred: Yeah, it'd be a great way to get a better feeling for the character, too.
Tyler: wow... the poems make so much more sense now the last one was:
Fred [while he types]: Trust me from writing: Your mind has a way of spilling relevant crap in poetic structure. Poems can be very dream-like in that way.
Tyler: Enter. Dance. Ascencion. Trance. Death. Chance.
Fred: You start piecing together shit, seeing more and more symbols, and then you learn about yourself and your world and you widen your world. Let's see: Enter = introduction line, Dance = interplay between the three, Ascension = angel and Tyler's hope for sanity.. Trance = Demon and the demon buying off Tyler's mind with power, Death and Chance = the two possibilities of the fragmented mind Tyler has constructed. Your Chance is the corellary to Fred's Hope. Notice a distinction: Chance is external, as Tyler's life is heavily dominated by external forces; whereas Fred constantly focuses on individidual responsbility against a nasty universe, even when such responsibility is a pointless crusade against the zeitgeist.
Tyler: and I've had a problem with constantly moving around "Chance." "Trance" and "Dance."... cuz you interchange them anywhere and it seems to make sense
Fred: Well, the three have linked elements, but I see them arranged as Dance, Trance and Chance. All three are about external forces, the will of nature and of probability and of trying to momentarily see or become one with those. Consider this: Shamans danced in order to put themselves into a monomaniacal trance state in order to control or manipulate chance. And notice also how your own comment says that out of three images arises order. Which is in turn a counter-dialectical concept, as Hegel postulated that the tripartite version of evolving history would evolve towards order. Again an example of Tyler struggling against a universe seeming to block his every move.
Tyler: holy shit dude
Fred: I'd say that Tyler's salvation will instead come from oscillating between three poles constantly, so fast like a stroboscopic light that one cannot see it, so that order is brought out of chaos. A way of bringing the light out of dark that affirms Fred's theory but is rather different/
Tyler: you have an uncanny nack at making my nonsensical tendencies sensical
Fred: Lots of philosophy bullshit helps. You just have to run with it. If you imagine your writing as applying to a character, you can ossify it, then unossify it when you realize its universal implicationas. It's actually a heuristic, like in math: first you apply it to a specific case, see its application, then derive the general. Inductive logic. I'm just glad that I think I've found out the methodology that Tyler would use to achieve a measure of salvation. Now how he applies it is a separate story. Ah, simple. Tyler's final ability has his aura fluctuate by chance. Just like the I Ching or fortunetelling, where from random events you see the pattern of the future, his incredibly energy changes incredibly quickly, allowing him to adjust at a moment's notice. Bringing order out of chaos. And every move he makes to bring order out of chaos lets him stave off the pure light of the angel, the pure light of the demon, and his own struggles between these two poles. Which in turns makes Tyler in his ultimate personal power an incredibly dangerous foe because his very aura predicts and is formed by chance and future patterns. In fact, in discussions of chaos theory, scientists note that while order moves to chaos in complex systems, it also moves back, and Tyler rides the crests and valleys. Meaning that traditional shamanistic enemies, i.e. Thrash/Remzeyr, who use trances to achieve unpredictability, open themselves up to Tyler. It also means that any instance he can contemplate three distinct sides of any argument and come up with not only the famous two alternatives "Yes" and "No" but the third alternative that everyone hides behind their back or rhetorically makes problematic and in fact non-existant. Your poems also point to what Tyler should do story-wise: Spirit quests. Shamans often were schizophrenic or similarly insane, and yet leveraged it to speak to the spirits, rather than in the Middle Ages where Christians, due to dualistic ideas of good and bad, put people on ships of fools. And now we're back to insanity! Wee. _____________________________
This is an edited transcript. This is all a conversation about poems that Tyler wrote, not knowing what their significance was. We were able to connect them to a character and talk about them, deriving deeper meanings from a mustard seed. This is the great part of roleplaying: One really can explore characterization, symbols, philosophy, in a way that no boring college class can teach.

Capitalism and Disease

Firestorm of blogging, eh? This is an interesting topic. On Z Sustainers Forums, we were discussing whether or not capitalism is net beneficial. It's obvious that the question begs so many semantical and methodological questions that it's not even worth it to delve into the topic in that way; rather, the question is "What's the best we can do?" One question is disease, and one Sustainer had this to say:
" >By and large, I tend to agree. However, I would like >to note something: >>Then again, some things, like>disease, have been >controlled much better, because of>medical advances etc. >closely linked to capitalist>industrial expansion. >This seems to be a widespread sentiment, but when you >assemble information concerning this, it just doesn't turn >out to be true. With a couple rare exceptions >(smallpox being the only one of which I'm aware), the modern >world and capitalism have seen diseases become stronger >and more uncontrollable. Many bacteria are now >super-resistant to antibiotics because of irresponsible >use, including tuberculosis, which has strains that do not >respond at all to antibiotics. Many viruses have >similarly adapted. >Actually, the most significant contributing factors of >improved health and longer lifespan are basic sanitation and >escape from poverty. So... here's another argument >against capitalism and for parecon. >If you're curious, I could direct you to relevant studies on >this.
OK, I've gotten some queries for more information on this. I'll send individual emails soon, but for now, I thought I'd post here:
((FYI, For the sake of speed and brevity, I've paraphrased below some of what's in Chapter 2 of The Sociology of Health, Illness and Health Care by Rose Weitz.))
The shift in a society characterized by infectious and parasitic diseases and low life expectancy to one characterized by degenerative and chronic illnesses and high life expectancy is called the epidemiological transition. This transition seems to occur once a nation’s mean per capita income reaches about $6,400 (Wilkinson, Richard G. 1996 Unhealthy Societies: The Afflictions of Inequality. London: Routledge.).
There’s more -- which supports a lot of what progressives call for. Let me quote Rose Weitz in The Sociology of Health, Illness, and Health Care: “Increases in average income above about $6,400 (in 1999) bring only modest increases in life expectancy. Instead, further increases in life expectancy appear to occur not when absolute incomes increase but only when the relative income differential within a country narrows. In other words, if the gap in income between rich and poor narrows, as it has in Costa Rica, for example, average life expectancy increases (especially among poorer citizens). Conversely, if the income gap widens, as happened following the collapse of the Soviet Union, average life expectancy declines. As a result, life expectancy is greatest within countries that have experienced epidemiological transition and have the smallest income gap between rich and poor, like Sweden and Japan, rather than in countries like the United States, which despite its great wealth has the widest income gap among the industrialized nations, (Bradsher, 1995).”
Bradsher, Keith. 1995. “Gap in wealth in U.S. called widest in west.” New York Times, April 17:A1+
Note that medical interventions like vaccinations, new drugs, new surgical techniques, etc. played little role in the epidemiological transition, which began more than 200 years ago in western societies.
For this, see:
Leavitt, Judith Walzer, and Ronald L. Numbers. 1985. Sickness and Health in America.
Madison: University of Wisconsin Press.
McKeown, Thomas. 1979. The Role of Medicine: Dream, Mirage, or Nemesis?
Princeton, NJ: Princeton University Press.
McKinlay, John B., and Sonja J. McKinlay. 1977. “The questionable effect of medical
measures on the decline of mortality in the United States in the twentieth
century.” Millbank Memorial Fund Quarterly 55:405-428.
The McKinlay & McKinlay study is especially revealing through the use of some graphs, which show the decline of mortality from several important diseases over time. The graphs show that these declines actually PRECEDED the introduction of effective medical interventions. They estimate that medical measures account for no more than 3.5 percent of the total decline in mortality since 1900. Other, more recent studies conclude that medical care can explain no more than one-sixth of the increase in life expectancy during the twentieth century. See:
Bunker, John P., Howard S. Frazier, and Frederick Mosteller. 1994. “Improving health: Measuring effects of medical care.” Milbank Quarterly 72:225-258.
"Only polio and smallpox declined substantially after the introduction of medical interventions. Of these two, only the decline in polio can be confidently attributed to medical intervention, as we cannot separate the possible impact of inoculation on the rate of smallpox from the impact of the myriad other changes that occurred since inoculation was first widely adopted 200 years ago."
McKinlay and McKinlay’s studies suggest the delclines in infectious diseases and such are associated primarily with changes in the social environment. As nutrition and living conditions improved, so did individuals’ ability to resist infection and survive if they were affected. Public health improvements like clean water supplies also played a less important role.
Even though infectious diseases continued to run rampant in the poorer regions of the world, Americans in the second half of the 20th century had grown to believe infectious diseases were under control. Then AIDS was discovered, and scientists have identified other diseases previously unknown in western societies, such as hemorrhagic fevers, and new deadly strains of cholera and streptococcus. Previously harmless microbes have become deadly – for example, the water-borne parasite cryptospoidium seemed unable to harm humans until recently, when in 1993 sickened 400,000 Milwaukee residents. See:
Altman, Lawrence K. 1994. “Infectious diseases on the rebound in the U.S., a report
says.” New York Times May 10:B7.
Drug Resistant Diseases
The re-emergence of Tuberculosis is probably the most important development in the appearance of drug-resistant germs, because TB kills more people yearly than any other infectious disease. See:
Donnelly, John, and Dave Montgomery. 1999. “TB from ex-Soviet states resists most
drugs.” Arizona Republic March 21:A27+.
Let me quote again from Weitz:
“The incidence rate of tuberculosis in the United states declined steadily from the late nineteenth century to the 1980s but then rose steadily until 1992, especially among immigrants and minorities. According to the [CDC] . . . the current tuberculosis epidemic reflects the increases in (1) AIDS; (2) homelessness, poverty, and substance abuse; (3) persons lacking health care; and (4) drug-resistant strains of the disease (Morbidity and Mortality Weekly Report, 1993). The increase in AIDS, homeless ness, and poverty beginning in the 1980s and the continued high rates of substance abuse has left more Americans with weakened immune systems, making them more likely to become infected with tuberculosis and to develop active symptoms if infected. During the same perios, the numbers of persons without health insurance or access to health care have increased. As a result of these factors, those who develop active [TB] often do not receive consistent medical care and stop treatment once their symptoms abate rather than continuing until the bacilli are all killed.
By definition, the bacilli strains that survive are those most resistant to the drugs. Thus, a vicious cycle develops in which difficulties in treatment lead to the evolution of more resistant strains of the bacilli, which in turn makes treatment more difficult. Currently, treatment costs about $250,000 per person, takes six to eight months, and often fails (Donnelly and Montgomery, 1999). As of 1999, only 1.3 percent of U.S. cases were drug resistant, but these numbers are growing, and drug-resistant cases have been identified in all fifty states.
Other drug-resistant strains of gonorrhea, pneumonia, meningitis, and more have also appeared. "
(Sorry for the formatting, it's late). Not only are questions about technology's effect on health vs. inequity's effect on health important (and the evidence is just overwhelming that inequity is far more important), capitalism's case is made worse by the fact that the innovations against disease overwhelmingly come from the public sector, from universities, and are then purloined by the private sector, with at best minimal investment in terms of donations to colleges... These statistics, while amazing, don't even touch on the corrosive effect of capitalism's tendencies to assault the public sector in very selective ways: encouraging war (with a massive Pentagon budget, for example) as a way of scaring people/insuring a market for waste goods/funding R&D while assaulting the "bleeding-heart" sector of policy: roads, hospitals, preventive health care programs, sewer systems, schools (including health classes), etc. You also get increased world trade and jet setters carrying diseases, which leads to everyone being more scared of SARS than the flu... You also get stress caused by the huge inequity and job insecurity of capitalism, and mental disorder caused by capitalism operating with ridiculous cultural norms of beauty to sell more products women (and now men) don't need. Add onto that the nation-state, blowing everything up in its path and threatening health possibilities for who knows how many billions of lives, and being used to open markets for capital, and you have a smorgasbord of problems. Oh, and good old racism too: Not only does racism and sexism siphon productivity, it also leads people to not make investments in preventive health care, like making sure that hospitals are ready to speak whatever language somebody speaks so they can provide the proper care...

Hell: Exothermic or Endothermic?

This is so funny I couldn't pass it up. Is hell exothermic or endothermic? (This is from Z Magazine's Sustainer Program - see www.zmag.org.)
________________________
The following is supposedly an actual question given on a university chemistry exam. The answer by one student was so profound that the professor shared it with his colleagues:
Bonus Question: Is Hell exothermic (gives off heat) or endothermic (absorbs heat)?
Most of the students w ote proofs of their beliefs using Boyle''s Law(gas cools when it expands and heats when it is compressed) or some variant. One student, however, wrote the following:

First, we need to know how the mass of Hell is changing in time So we Need to know the rate at which souls are moving into Hell and the rate at Which they are leaving. I think that we can safely assume that once a soul gets to Hell, it will not leave. Therefore, no souls are leaving.
As for how many souls are entering Hell, let''s look at the different religions that exist in the world today. Most of these religions state that if you are not a member of their religion, you will go to Hell. Since there is more than one of these religions and since people do not belong to more than one religion, we can project that all souls go to Hell.

With birth and death rates as they are, we can expect the number of Souls in Hell to increase exponentially. Now, we look at the rate of change of The volume in Hell because Boyle''s Law states that in order for the Temperature and pressure in Hell to stay the same, the volume of Hell has to Expand proportionately as souls are added.

This gives two possibilities:
1. If Hell is expanding at a slower rate than the rate at which souls enter Hell, then the temperature and pressure in Hell will increase until all Hell breaks loose.
2. If Hell is expanding at a rate faster than the increase of souls in Hell, then the temperature and pressure will drop until Hell freezes over.

So which is it?

If we accept the postulate given to me by Teresa Gibbons during my Freshman year that, "it will be a cold day in Hell before I sleep with you", and take into account the fact that I slept with her last night, then number 2 must be true, and thus I am sure that Hell is exothermic and has already frozen over. The corollary of this theory is that since Hell has frozen over, it follows that it is not accepting any more souls and is therefore, extinct...leaving only Heaven thereby proving the existence of a divine being which explains why, last night, Teresa kept shouting "Oh my God."

THIS STUDENT RECEIVED THE ONLY "A"

GMing

When I and my friends GM, we often like to joke about the degree of intelligence the enemies exhibit: “So is this, Easy, Medium, or Hard Aaron Intelligence?”, for example. Our practice of doing this made me begin to think: What is the upper limit on RPGs? After all, RPGs are limited only by the imagination… and that’s precisely where we get entangled, isn’t it? RPGs are combinations of cinema, impromptu theatre, video games and anime (among a myriad array of other things), and the GM is the director, CPU and screenplay writer, yet he must not only allow but encourage his actors (PCs) to defy the script. It’ s a hard task, and limited by one’s vision and intellect.

There are GMs who are good at political intrigue, at constructing a plausible group of nations and their geopolitical arrangements and making city governments and so on; there are GMs who are brilliant at imagining combat of all types, from magic to gunfighting to swordplay; there are GMs who make fascinating characters, so much so that people can play an entire game with no combat and simply interact. Some of these GMs can do one or two of these things only. Does that mean that they shouldn’t be GMs? No, they make brilliant games; the GM will just happen to be shabby in a particular area.If a GM wishes to broaden her horizons, what can she do? Let me propose a few methods:
1. Use Your Strengths.
Any time one runs into a difficult situation, one might as well leverage one’s skills against it.

Imagine a law student GM who happens to not be the best at imagining fight scenes or creating strategic NPCs. His players waltz all over even his best villains because his villains can’t creatively use the skills he gives them. He could create a scenario where the team must bring a corrupt city police department to justice. The police department has survived every internal investigation unscathed and thus carries tremendous clout. If the players openly resist them, they could be jailed. This police department is also protected by the Mafia because of a convenient arrangement between the two. Now, the law student can bring his knowledge to full bear. The players will have to put down their rifles and spellbooks and try to find a way to bring about an investigation of the local police department. Perhaps they can bait the police into violating a rule of conduct and thus bringing the evidence they bring against the characters under the exclusionary rule, saving the characters. After the players manage to use legal means to chip away at these bad cops, getting some to turn state’s evidence against the Mafia and their former comrades and jailing others, the GM can set a finale where the Sergeant and his cronies escape to the slums, defended by a sinking ship assortment of Mafiosos and local gangs. After all this time, the players will be satisfied deeply at getting their claws on the Sergeant. The GM didn’t have to have master strategists, simply corrupt cops defended by the law. This scenario will be educational and memorable, far more so than “monster or enemy X”.
Someone who is more of a military and tactics type, masterfully able to construct armies and tactics to beat the PCs but unable to make a plausible world, could try to think of nations first in terms of armies. Maybe they could think of a nation with an effective but decentralized military, and thus create a anarchist or communal society; a more pacifist nation with an entirely defensive police force; a nation using biological weapons and other horrific items and thus viewed as a pariah state; and so on.
2. Prepare

GMs often are loath to prepare. “If I make a big scenario, my PCs will just break it somehow.” The answer is not “Don’t prepare”, but “Prepare intelligently.”

Let’s take our law student again. He’s not the type to be able to think of effective combat tactics quickly, making even his deadliest villains less effective than the players. GMs need to remember: They have the advantage of knowing what the players are doing and thinking ahead of time. While giving every one of his NPCs this ability is a little implausible, the GM is likely to have a better understanding of his PCs than they do themselves, or at least a comparable understanding. The law student could thus introduce a new big bad villain after his last one was destroyed. This villain sends a powerful body double to test the players. He is trounced because of superior tactics by the PCs. All the time, the GM takes notes, just as the villain watches secretly or has a henchman record the goings-on.

Now, during the pre-game brainstorm session, our GM sets to work. Because he is such a master of building plausible characters with good motives and because he is so intelligent, he figures that he can ad-lib those parts. Instead of wasting his time on information that he can easily conjure impromptu, he instead thinks logically about what the villain would do given the powers he’s been created with . With 15 to 30 minutes of preparation, the GM gains an edge over the PCs. He can also construct traps, another way of using his creativity in non-battle areas. The villain may construct a fortress as a decoy, keeping only a guardian in there, all to distract, confuse and anger the PCs, hopefully killing one or two. Finally, the PCs confront the villain in closed quarters, perhaps a hotel room suite with the villain having the lay of the land and a number of nasty little secrets hidden about. With foresight and preparation, the GM can compete with his tactical genius players and put their skills to a new and exciting test. With all luck, the PCs will overcome and triumph, breathing a sigh of relief at having bested a unique opponent.

If something about the game or the rules you’re using is causing you some grief, try to deal with it. In my games, the PCs usually outnumber their opponents. How can I creatively deal with this issue? I can have the villain have financial resources letting him purchase mercenaries, thugs, and all sorts of security. An evil Taoist alchemist awaiting the PCs in his corporate penthouse becomes much more dangerous when the players arrive having had to wade through security turrets and a small army of hired thugs, even when they outnumber him 8-to-1. I can also construct the fields of battle to hinder the players. For example, the players have to go across a bridge or through a very tight space. Because only a few players at a time can effectively contribute without endangering their friends or the bridge or building itself, the few enemies on the other side demoralize the players and are able to deal with them one-on-one, leveraging superior skill. Divide-and-conquer tactics also work well. Players who like to think of themselves as badass can take a sniper shot, even a minor one, and spend the entire battle looking for that sniper. The rest of my NPCs leave him alone: he’s distracted, it doesn’t matter. I can also leverage status effects, trapdoors and ways of splitting up the party, hostages or traps that must be turned off in a particular time period (thus raising the stakes and making the three or four enemies that much deadlier), and so on.

Play with your player’s heads. If you want your opponents to take hired thugs more seriously (and thus spend more of their time worrying about henchmen and not always going for the main villain), make the main villain you’ve been making the PCs hate for most of the game actually a puppet hiding in the background, or have him disguised as a normal soldier and a body double in the regalia of command during the final encounter. Or perhaps have one or two of the soldiers (the effect is ruined if all of them have it) have a nasty secret: a transformation or a deadly weapon or similar. Don't do this all the time, as it's not plausible, but once or twice will sure make your players take henchmen seriously.

Another way to do this is the reverse: Make a Wizard of Oz humbug. For example, let's say you're running a martial arts game with an element of the superhuman. One of the enemies of the PCs is a magician, and not a very good one. Nonetheless, he's able to conjure fire. The PCs think that he's conjuring this from some incredible technique or ki manifestation and prepare to fight an enemy of superior caliber. When they break through his defenses, it turns out he knows a month's worth of Tai Chi.

Since preparation takes so much time, I've found it useful to turn to the internet or fan materials. This stuff is out there; why not use it? Even a tactical blunderer can terrify his PCs by modifying a martial art or a character class online and giving it to an NPC. The players then will have to spend time thinking about how the enemy could have created such an effect and counter it. It's worthwhile to modify the material, of course. Let's say that you've been throwing a lot of demons at your PCs but you've found an excellent map that has a fire demon in a large circular room guarding a stairway down. Simply invert the stairs and have the stairway be decrepit, with the stairs only starting at halfway to the second floor. The room becomes a crowded warehouse filled with gasoline cans, crates, rags, etc. The enemy is a pyromaniac or fire mage of some sort, deftly using the crowded spaces and flammable materials to trap the PCs and divert them to a false door or trap door. The PCs will have to carefully listen to your descriptions of the room and avoid the traps, making for a tense situation. The PCs then climb onto the rafters and leap onto the walkway.

3. Review and Research
If even this isn't helping, try "reviewing" some material.

If you want to see phenomenal characterization as well as creative ideas, see Hamlet, Macbeth, pretty much anything by Shakespeare (though avoid comedies, except perhaps for Midsummer Night's Dream - they're funny, but of more value for viewing the artistry of writing), American Beauty, Boondock Saints, Big Trouble in Little China, Ghost Dog: Way of the Samurai,
If you want to see incredibly strategic combat, see Kuwabara from Yu Yu Hakusho's fight against Byakko, Majiri in the movie, Elder Toguro, Shorin, and against the Toguro Brothers and Tarukane's minions (among others; Kuwabara is commonly a strategic genius using simple powers to their fullest); Vash's fight in episode 26 of Trigun; Piccolo's fight against Android #17; Goku's fight against Super Android #17; Naruto in general; quite a bit of One Piece; and some issues of 8 Bit Theatre at Nuklearpower.com. It's rare to find examples of truly ingenious strategy, but they're smattered throughout.

For a fairly good idea of politics in a sci-fi setting (with some pseudo-Marxist philosophy thrown in), you could do no better than The Foundation series. I have my disagreements with Asimov politically (he seems rather technocratic, elitist and statist), but his characterization of future history is fascinating.