Archive for the 'Health Care' Category

Bogus Civility

Finally someone said what I’ve been thinking about this constant call to civility:

Have we transformed into so brittle a citizenry that we are unable to handle a raucous debate over the future of the country? If things were quiet, subdued and “civil” in America today, as Pelosi surely wishes, it would only be proof that democracy wasn’t working. (Please read the whole article.)

Sure, Pelosi wishes that everyone would behave already, but it is also often conservatives and others arguing over the proper way of dissenting rather than just dissenting already. There seems to be a practical meltdown in areas of the conservative blogosphere over comportment… the theory seeming to be that passion is off-putting to the all-important center. In order to win, therefore, we need to be bland.

Frankly, I think that other than those in power who would rather not be bothered by opposition, it’s only people without ideas who are arguing over civility.


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Jenny McCarthy Body Count?

though probably not the kind you were hoping for. I think the “Anti-Vaccine Body Count” version is the better one to use, but the Jenny McCarthy one will be used because it’s more sensational and attention grabbing, the same reasons anti-vaxers use Jenny McCarthy as their spokeswoman.

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The Cult of Nutritionism Suffers a Setback

(photo: gualtiero)

In a fine blow to the pseudoscientific cult of nutritionism, an intensive study conducted by the National Institutes of Health applied the same laboratory standards to vitamin supplements as are routinely applied to pharmaceuticals. Unsurprisingly, the researchers found that the supplements exerted no preventive benefit against cancer, heart disease, or any other illnesses. Dr. Edgar R. Miller, professor of medicine and epidemiology at Johns Hopkins University School of Medicine, puts it nicely:

“These things are ineffective, and in high doses they can cause harm. People are unhappy with their diets, they’re stressed out, and they think it will help. It’s just wishful thinking.”
(Los Angeles Times)

As Damian Thompson argues in Counterknowledge (his magnificent polemic against the rise of quackery and conspiracy theories in contemporary society), the alternative in ‘alternative medicine’ is to science and modernity, and has entirely predictable results.


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A Gutter-al Scream

It’s almost as if the Dems can’t help but to resort to misogynistic antagonism in dealing with Gov. Sarah Palin. This comes courtesy of Alan Colmes, citing Rogers Cadenhead who questions Palin’s maternal abilities:Gutter

One bit of weirdness associated with Palin concerns the birth of her youngest child. As the Alaskan media reported, Palin was attending an energy conference in Texas on April 18 when her water broke four weeks before her due date. After this happened, Palin didn’t head to a hospital or even leave the conference, even though the premature rupture of fetal membrances is normally a cause for an immediate examination by an obstetrician, who will observe the fetus on a monitor to guard against infection and other life-threatening complications. Two other reasons for heightened concern were Palin’s age, 43, and the fact that prenatal testing indicated the child had Down syndrome.

Palin stayed at the conference and delivered a 30-minute speech, then boarded a 12-hour Alaska Airlines flight from Dallas to Anchorage, neglecting to tell the airline her water had broken — most airlines won’t fly a woman in labor. The motivation for all of this appears to be the Palins’ desire that the child be born in Alaska. Her husband Todd told the Anchorage Daily News, “You can’t have a fish picker from Texas.”

When she arrived home, Palin was hospitalized immediately and the baby was born prematurely after labor was induced in the middle of the night.

Aside from baby Trig suffering from Down Syndrome, the child was quite healthy at delivery and has been doing fine ever since. It is true that when amino leaks occur, the general advice of doctors is to get to the hospital immediately, but that is not always the case. In fact, when delivery proceeds within 24 hours of an amino leak (a.k.a. water breaking), the risks of any complications to the baby are quite low. Indeed, some women experience minor leakages, as Palin did, well before they are due without any complications whatsoever.

In Palin’s case, she delivered Trig well within the 24 hour window recognized as “safe,” and actually had to be induced because she wasn’t in labor. Moreover, she was in touch with her physician throughout the event, and he did not advise her to act otherwise.

As an aside, the accusation that Trig was born prematurely does not seem to hold water (no pun intended … well, maybe a little) since Palin was past her 36th week, and the definition of “premature birth” is a baby born prior to the 37th week of gestation.

In any case, these are just facts that undermine the credibility of anyone asserting such ridiculous accusations. That Obama supporters are seriously challenging Palin’s credibility and competence as a mother is just stunning on a political level. Not just in the brashness, but also in the sheer stupidity of leveling such charges. I mean, how do idiots like Colmes and Cadenhead think women are going to react to their second-guessing of Palin’s birthing decisions?

I can hear my wife’s retort now: “You try carrying a bowling ball in your belly for 40 weeks, and then shooting it out your pee-hole with the entire hospital staff staring at your nether region. And that’s not even mentioning having to pee every 20 minutes, feeling like a fat cow, persistent fatigue, and constantly worrying about how your caring for unborn child. Plus you have to do your job just as competently and efficiently as you always did before you were pregnant (including dealing with any previously born children), only to be confronted with some a$$wipe having the nerve to tell you ‘You’re doing it wrong’.”

I imagine that a lot of women would feel the same way.

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Michael F. Cannon at Cato blogs about a NYTimes article on the rife fraud found and covered up at Medicare. A confidential draft of a federal inspector general’s report claimed that the behavior they found at the Medicare Administration was rife with irregularities.

Medicare reported to Congress that, for the fiscal year of 2006, AdvanceMed’s investigations had found that only 7.5 percent of claims paid by Medicare were not supported by appropriate documentation. But the inspector general’s review indicated that the actual error rate was closer to 31.5 percent.

Law makers called it “tantamount to corruption”. Michael ends his piece with some great quotes:

[One] congressional watchdog had seen it all before:

“This report doesn’t surprise me,” said Representative Pete Stark, Democrat of California and a senior member of the Ways and Means Committee. He has pushed to cut improper Medicare spending. “To look better to the public, you cook the books,” he said. “This agency is incompetent.”

Of course, Pete Stark’s solution for Medicare’s incompetence is to force you to enroll:

There is a road map laid out for us…Medicare. Medicare has lower administrative costs than any private plan on the market…Medicare has shown us the power of simplicity; we need only expand its promise to the rest of our population.

Medifraud for all!

heh, indeed.

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With This Ring

Bride What attracted you to your spouse?  Was it his devilish sense of humor?  Her warmth and abilities to be a fine mother?  His strength and intelligence?  Her beauty and sexiness?

Today, we find couples tying the knot for another reason:  excellent health insurance.

Bo and Dena McLain of Milford, Ohio, eloped in March so he could add her to his group policy because her nursing school required proof of insurance. Corey Marshall and Kim Wetzel, who had dated in San Francisco for four years, moved up their wedding plans by a year so she could switch to his policy after her employer raised premiums.

We can argue what exactly we should do to change it all.  But, are there very many out there who disagree with the proposition that our entire system of health care and insurance is in dire need of complete overhaul?

Who wants to hear their adult child phone home and breathlessly announce:  “Mom and Dad; I found my future spouse!  He has Blue Cross/Blue Shield with no deductible!”


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A Conservative Blueprint for Health Care?

Ryan Ellis, the Tax Policy Director at Americans for Tax Reform, presents 3 principles of conservative health care.

Principle 1: Conservative health care reform should neither raise taxes nor increase the size of government. You’d think this would be a no-brainer, but trust me that it isn’t.
Principle 2: Health insurance should have nothing to do with your job unless you want it to. In any event, health insurance should be 100% portable.
Principle 3: Shopping for health care should look more like currently shopping for prescription drugs, dental, vision, and cosmetic surgery, and less like going to the hospital or getting a checkup. The former is price transparent and market-responsive. The latter is bureaucratic and doesn’t work

He offers the the Health Care Freedom Coalition as a possible package and then asks for reader suggestions in the comments. Sadly the comments then fill up with sidetracking discussions about illegal immigration. If you have any ideas, feel free to chime in at the Next Right.

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Boundary Issues

Peg pointed me this way, and I really enjoyed nodding in agreement. Of course, I have long nodded in agreement with Megan. Especially on these:

2) Gay marriage. I’m basically pro, but I take the Burkean arguments seriously.

3) Immigration. Again, I’m pro–but while I think the anti-immigration side makes often ridiculously ahistorical arguments about how current immigration differs from past waves, I think that more-open-borders folks like me don’t give enough respect to the real cultural frictions that immigration causes.


5) Taxes. I don’t have any very well thought out position on the optimal level of taxation in society. I take seriously both the justice arguments of the libertarian absolutists, and the notion that anyone living in a wealthy society owes their prosperity at least as much to the wealthy society as they do to their own skill and hard work–and if you doubt this is true, I suggest you go try to deploy your rugged individualist talents in Zimbabwe. I think society has a duty to care for those who genuinely can’t care for themselves, but I am against an ever-expanding notion of what constitutes “can’t”.

6) Intergenerational equity. I don’t mean social security, which I think is largely a stupid program. I mean questions about how we should privilege the interests of people who exist now over those who will exist in the future. The environment is the most obvious, but not the only, area where these questions come up. To me, health care is another one; the core issue is that we can probably help some people by moving to a single payer system today, but only by destroying the innovation machine that will help many many more people down the road.

7) Humanitarian intervention. I am often tempted by the isolationist stance, the cool purity of its single-rule decision making. Then another Darfur rends my heart. I don’t mean to address the prudential, utilitarian calculus, but rather the question: if there’s a good chance that we could make things better, should we? And under what circumstances?

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Hippocrates Unbound

The idea of state funded and administered universal health care is a bugbear of libertarians everywhere, and especially those who are subjected to such a system as a matter of course. Routinely held up as one of the worst of the lot of state-run systems is Britain’s NHS. Now, direct from the trenches of the NHS battleground, comes one insider who thinks it’s high time that the system was scrapped:

Here is a great new book to cheer libertarians as we draw close to the sixtieth anniversary of the National Health Service. Written by the director of Nurses for Reform, Dr. Helen Evans, and published by the Institute of Economic Affairs, ‘Sixty Years On: Who Cares for the NHS?’ not only shows that the country’s top 100 health opinion formers no longer actually believe in nationalised healthcare but, gloriously, this book fundamentally challenges the medical monopoly inherent in all health systems around the world.

The IEA finds that the study underlying Dr. Evans’ book reveals an increasing dissatisfaction with state-run health care among those charged with providing it:

Containing a series of devastating blows to the NHS at 60, the research shows that when speaking off the record a substantial majority of Britain’s health elite no longer believes in nationalised healthcare. Instead, an overwhelming majority accepts a much greater role for private provision – including private hospitals, clinics, GP services and dentists.

I recall that the President of the Canadian Medical Association expressed similar sentiments not long ago, so this result is not at all surprising. What is surprising is that, despite copious amounts of evidence, and reams of historical documentation, people still believe that government can run anything very well, much less a system devoted to the ever changing circumstances inherent in the provision of health care to the masses.

Let’s be clear: the government — any government, fair or foul — is only good at two things. One, making rules. Two, using the power of the state to enforce them. That’s it. No government anywhere, throughout history, is much more than minimally competent at doing anything other than those two tasks. In fact, that is exactly why the founders of this country set up a system of limited government. Instead of carving sections of life where the government’s powers would not apply, America’s forefathers devised a system of limited government whereby the limits of action were placed on the single most powerful entity in the land rather than on the individuals comprising its subjects. It was an attempt to shackle Leviathan.

Despite that attempt, Leviathan has broken free is some places, and uses that leverage to tirelessly strain against its remaining cuffs. Advocates of universal health care encourage the beast to break free of its binds, seemingly without the least bit of comprehension as to the carnage that will result. They should take heed of those who have suffered the demon. What better authority than those who have toiled in the belly of the beast and know its strengths and weaknesses? Who better to dissuade such tomfoolery as unleashing the unquenchable thirst for power of a government monopoly over our very lives than those who have experienced such unrestrained power?

But I expect that the opinions expressed in Dr. Evans’ book will have little, if any, effect. When as potent a wellspring of power as state-run health care is dangled in front of those who lust for dominion over others, there is little chance that they won’t take the bait irrespective of the nasty hook.

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Paralyzed Woman Sues Chiropractic for Half Billion

It seems a chiropractor in Canada was manipulating a patient’s neck and paralyzed her. Luckily she isn’t dead from a stroke.

Sandy had been going to Stiles regularly for more than seven years, receiving adjustments to her back and neck that she believed helped maintained her health. Minutes after a routine chiropractic visit that included a neck adjustment, on September 13, 2007, Sandy felt ill and had to compose herself in the clinic’s waiting room. She tried to drive home but only got as far as an off ramp south of Edmonton’s Yellowhead Highway. That’s when she called her husband, David who took her directly to hospital where she suffered a massive stroke.

Stiles said he could not comment on Sandy’s experience, nor on her condition citing patient confidentiality. He declined to comment on the suit.

After life-saving surgery at the University of Alberta Hospital, Sandy, a senior land administrator in the oil and gas industry, was left almost completely paralysed, a quadriplegic totally dependent on machines, hospital staff and her husband for her life support and care.

Some .

Complete Statement of Claim here:
Sandra Nette v. Gregory John Stiles et al.

For news footage of another quadriplegic chiropractic victim, Diane Rodrigue, see here
(About 25 min 45 sec in)

Chiropractic spinal manipulation can be beneficial, but conventional treatments are usually equally effective and much cheaper. However, spinal manipulation applied to the neck can cause stroke and death. So if you see a chiropractor or know someone who does please do not let them touch your neck. You could die.

(HT to the JREF forum)

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And On This Topic -

John McCain gets my vote.

What exactly is the problem with the American health-care system?

The problem is not that Americans don’t have fine doctors, medical technology, and treatments. American medicine is the envy of the world. The problem is not that most Americans lack adequate health insurance. The vast majority of Americans have private insurance, and our government spends many billions each year to provide even more.

The biggest problem with the American health-care system is one of cost and access, and as a result tens of millions of individuals have no insurance. For example, we currently spend for about 2.4 trillion dollars a year on health care. A decade from now that number, under current projections, will double to over four trillion dollars.

The Obama and Clinton response to these problems is to promise universal coverage, whatever its cost, and the massive tax increases, mandates, and government regulation that it imposes. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We’ll have all the problems, and more, of private health care — rigid rules, long waits, and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

I have a different approach. I believe the key to real reform is to restore control over our health-care system to the patients themselves. To that end, my reforms are built on the pursuit of three goals: paying only for quality medical care, having insurance choices that are diverse and responsive to individual needs, and restoring our sense of personal responsibility.

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Why White People Like Free Health Care

Yet another reason to read Steve Newton, you discover blogs with stuff like this on it:

But the secret reason why all white people love socialized medicine is that they all love the idea of receiving health care without having a full-time job. This would allow them to work as a freelance designer/consultant/copywriter/photographer/blogger, open their own bookstore, stay at home with their kids, or be a part of an Internet start-up without having to worry about a benefits package. Though many of them would never follow this path, they appreciate having the option.

If you need to impress a white person, merely mention how you got hurt on a recent trip Canada/England/Sweden and though you were a foreigner you received excellent and free health care. They will be very impressed and likely tell you about how powerful drug and health care lobbies are destroying everything.

Though their passion for national health care runs deep, it is important to remember that white people are most in favor of it when they are healthy. They love the idea of everyone have equal access to the resources that will keep them alive, that is until they have to wait in line for an MRI.

This is very similar to the way that white people express their support for public schools when they don’t have children.

Actually, the first paragraph for the first time made me wish we did have free health care!

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Surgery on the Middle Man

We all expect to eat – but we don’t get insurance to guarantee food.  We all need various sorts of transportation.  But, other than some insurance to cover the value of a valuable vehicle, we don’t need insurance to make sure that we can get around.

Why then, do we need health insurance for routine exams, medications, doctor visits and the like?

Jonathan Kellerman, professor of pediatrics and psychology at USC’s Keck School of Medicine asks some insightful questions and provides some well grounded and thoughtful answers.

Insurance is all about betting against negative consequences and the insurance business model is unique in that profits depend upon goods and services not being provided. Using actuarial tables, insurers place their bets. Sometimes even the canniest MIT grads can’t help: Property and casualty insurers have collapsed in the wake of natural disasters.

Health insurers have taken steps to avoid that level of surprise: Once they affix themselves to the host – in this case dual hosts, both doctor and patient – they systematically suck the lifeblood out of the supply chain with obstructive strategies. For that reason, the consequences of any insurance-based health-care model, be it privately run, or a government entitlement, are painfully easy to predict. There will be progressively draconian rationing using denial of authorization and steadily rising co-payments on the patient end; massive paperwork and other bureaucratic hurdles, and steadily diminishing fee-recovery on the doctor end.

Some of us are old enough to remember visiting the doctor and paying him/her directly by check or cash. You had a pretty good idea going in what the service was going to cost. And because the doctor had to look you in the eye – and didn’t need to share a rising chunk of his profits with an insurer – the cost was likely to be reasonable. The same went for hospitals: no $20 aspirins due to insurance-company delay tactics and other shenanigans. Few physicians became millionaires, but they lived comfortably, took responsibility for their own business model, and enjoyed their work more.

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The Sickening

Cuban medical facility
A Cuban medical office with a sign reading “No prescriptions available.” Photo by: Dr. Darsi Ferrer [via The Real Cuba].

News of Fidel Castro’s retirement has elicited some interesting responses. Chris Bertram’s has to be one of the most arrogant and least informed:

So let’s hear it for universal literacy and decent standards of health care. Let’s hear it for the Cubans who help defeat the South Africans and their allies in Angola and thereby prepared the end of apartheid. Let’s hear it for the middle-aged Cuban construction workers who held off the US forces for a while on Grenada. Let’s hear it for Elian Gonzalez. Let’s hear it for 49 years of defiance in the face of the US blockade. Hasta la victoria siempre!

Bertram is being purposefully provocative with his post, which is what makes it so arrogant, but he’s doing so based on leftist myths, which is why it so misinformed.

The wonderful Cuban health careCuban hospital and education systems are shibboleths of Castro apologists everywhere. For example, film provocateur Michael Moore used the health care myth to agitate for socialized medicine in his propaganda piece entitled Sicko. However, as is the case with propaganda, reality begs to differ:

One of the greatest fallacies about the so called ‘Cuban Revolution’ has to do with healthcare.

Foreigners who visit Cuba, are fed the official line from Castro’s propaganda machine: “All Cubans are now able to receive excellent healthcare, which is also free.” But the truth is very different. Castro has built excellent health facilities for the use of foreigners, who pay with hard currency for those services.

Argentinean soccer star Maradona, for example, has traveled several times to Cuba to receive treatment to combat his drug addiction. But Cubans are not even allowed to visit those facilities. Cubans who require medical attention must go to other hospitals, that lack the most minimum requirements needed to take care of their patients.

In addition, most of these facilities are filthy and patients have to bring their own towels, bed sheets, pillows, or they would have to lay down on dirty bare mattresses stained with blood and other body fluids.

The facilities available to most Cubans are nothing like the ones featured in Sicko, and the “free health care” is not really worth much. [See what real Cuban health care looks like after the jump] (more…)

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Better off Dead

Kim at Wizbang links to this story about eugenic thinking in Brittan.

The comments came as the Lords debated an amendment, [...] that would have protected unborn disabled children from abortion after the 24 week gestational time limit. The amendment was defeated by 89 votes to 22.

Under Britain’s abortion law, children judged to have some form of disability, including such comparatively minor disabilities as club foot or cleft palate, can be aborted up to the time of natural birth.

The comments are amazing.


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Private health care comes to Sweden

Why? Because people are fed up with waiting for care and a health care bureaucracy with no incentive to improve:

Waiting times for medical care in Sweden are the longest in Europe, according to the Health Consumer Powerhouse, which analyzes health-care systems in the region. About 33,000 people had been waiting more than three months for surgery or other major treatments at the end of August, an increase of 43 percent from May, a report by the Swedish Association of Local Authorities and Regions showed.

Critics of Sweden’s welfare model say there are no incentives for hospitals to improve efficiency. Oscar Hjertqvist, director of the Health Consumer Powerhouse, likens the current system to a bad restaurant getting government funding.

“In Sweden, you would get paid just to have a restaurant, but there would be no requirements that people should get any food,” said Hjertqvist, whose group has offices in Brussels and Stockholm.

The reaction of the Swedish left to people using private care?

“The new hospital for the children of the upper classes is a mockery of the most fundamental values of the Swedish system,” said Lars Ohly, leader of the Swedish Left Party. “Care should be given based on needs, not wallets.”

Of course, he doesn’t want to merely express this opinion, but deny people the right to seek alternatives to the state run system. McQ has more.

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Look Who Pays For Mitt-Care


As governor of Massachusetts, Mitt Romney oversaw the implementation of state-wide universal health care, something that he touts as a major accomplishment on his campaign website. In fact, after signing the legislation into law, Romney penned a an Op-Ed for the Wall Street Journal extolling the virtues of the health care plan, even going so far as to hold it out as a model for other states to follow:

And so, all Massachusetts citizens will have health insurance. It’s a goal Democrats and Republicans share, and it has been achieved by a bipartisan effort, through market reforms.


Will it work? I’m optimistic, but time will tell. A great deal will depend on the people who implement the program. Legislative adjustments will surely be needed along the way. One great thing about federalism is that states can innovate, demonstrate and incorporate ideas from one another. Other states will learn from our experience and improve on what we’ve done. That’s the way we’ll make health care work for everyone.

Of course, many think Romney’s “accomplishment” is nothing to write home about, especially during a Republican primary race: (more…)

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Hanging Out in the TMC


Yeah, that’s me after a few too many cocktails in the hotel lounge. As Lance related, I’m in Houston in the Texas Medical Center (TMC) visiting my father who recently had an internal defibrillator put on his heart. The surgery went remarkably well and he seems more lively than when he went under the knife on Thursday, but he’s trapped in the bureaucratic waiting-for-approval world of hospitalization that feels like standing in line at the DMV…only with your ass hanging out of a gown. Thus my mother and I keep him company during the day and sit starring at the hotel walls at night. I decided to start obliterating the time with vodka this evening, thanks to the encouragement of the medical-student bar staff who have seen this all before.

As always when I’m here, I’m struck by the bizarre experience of this health care city (and I’ve unfortunately been here a lot with Dad’s ongoing heart problems). The TMC is the largest medical district in the world, with one of the highest concentrations of hospitals, clinics, research centers and doctors anywhere (photo of the TMC’s rows and rows of hospitals). Just looking out my hotel window I can see the Texas Children’s Hospital, St. Luke’s Hospital, the Methodist Hospital, the MD Anderson Cancer Center, Baylor’s College of Medicine, Ben Taub Hospital, office tower after office tower of medical offices, research facilities…and seemingly perpetual construction for even more. There’s a boutique across the street for designer scrubs (the official uniform of this city-state) and almost every store/cafe/bar has a somewhat medical theme or is named after a famous surgeon, doctor or whathaveyou.

It’s a highly Ballardian place, full of sanitized winding corridors to nowhere, sterilized corporate conformity, multi-million dollar ugly sculpture, startlingly advanced high technology, foreign doctors nabbed from the world over, meticulously manicured lawns, smiling receptionists in vivid eyeshadow…and just beneath the surface –infecting the place with its sole purpose– life and death. Think Super-Cannes for physicians.


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Take Two

Earlier in the day, you might have been wondering how much of your assets might melt away, as markets around the world gyrated with perceived increasingly negative news. Later, on political blogs everywhere, reports that Fred Thompson was ending a run for his party’s nomination.

Then, news that a young and successful actor had died, most likely from a drug overdose.

Usually my evenings are a strange brew of real estate work, reading blogs, playing or watching bridge online, editing photographs, and so forth. In the background, talking heads on the various political shows fill me in on what has happened during the day – occasionally inducing some mental error while I compete!

Tonight, I thought that a majority of these shows would be devoted to discussing the future for Republicans now that Fred was dropping out.


Oh, yes; Thompson got some time. But – just as on the Internet (Fred; 174 hits; Heath Ledger, over 1,800) – almost all the focus was the death of Ledger.

Please do not misunderstand me. The death of a vibrant young person is a terrible tragedy. I myself have faced the illness of addiction in my own family, and words can barely express the pain and the awful outcomes that it can produce.

Still. On political cable channels, would one expect hour upon hour of focus about a movie star, rather than on the people who will soon lead our country? I would not – but – once again, I prove myself to be a poor prognosticator of what might occur.

Back to the politics. Fred wasn’t “my guy” (Rudy was and is). Yet, Thompson would have been “my guy” had he gotten the nomination. Smart, humble, straightforward, intelligent … I particularly loved when he stood up to that ridiculous interviewer in Iowa, who wanted him to state in one or two words what he thought about some of the most important issues facing us. He wouldn’t do it. If Fred couldn’t have the opportunity to really explain his viewpoint – at least 30 or 45 seconds! – well then, he would not play along.

I wish we had more like him.

And, as long as I am wishing, I wish that whoever does get the nod to be our next president might have some insight about addiction. The War on Drugs and “Just Say No” have been sad failures. I don’t know the answers. I only hope that others may have a glimmer of a solution.

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Bloomberg Busted

From the “Holier Than Thou” department comes this interesting photo taken by Larry Fink for Wired Magazine. (link to larger photo)

Cheez-It Bloomberg

What’s that he’s reaching for with his right hand? Why, it’s a Cheez-ItTM!

After gaining national media attention for spearheading an almost total ban on trans fats in city restaurants starting last July, Bloomberg was photographed in this month’s issue of Wired magazine munching on those very same dangerous fats…

The mayor’s food choice directly counters the guidance of his own Department of Health, which specifies on its Web site that “there is no safe level of artificial trans fat consumption.” The site also points out that trans fats are responsible for at least 500 deaths in the city every year from heart disease.

That should be cautious news for Bloomberg, who in 2000 had a pair of stents inserted in his coronary artery to remove a blockage. The mayor says he takes a baby aspirin daily to reduce the risk of heart attack.

Just so we’re clear. Mayor Bloomberg initiates a crusade against trans fats, for which “there is no safe level” according to his own administration, because apparently people are too stupid to make their own choices about what and what not to eat. Yet, he has no qualms about scarfing down a bag of Cheez-ItsTM (which do contain some trans fats [see also after jump]) despite the fact that Bloomberg has a history of heart problems. According to one of the people who encouraged and promoted Bloomberg’s ban on the noxious unction:

“Trans fats cause heart attacks,” said Julie Greenstein, deputy director of health promotion policy for the Center for Science in the Public Interest, a Washington, D.C., lobbying group that advocated the ban in the city. “Trans fats raise bad cholesterol and decrease good cholesterol.”

Greenstein said even small amounts of trans fats in the diet can add up and cause big problems over time.

“If someone is concerned about heart health, he should cut out trans fat completely,” she said.

And here’s Bloomberg in his own words:

“You’re getting an ingredient out that nobody is going to miss.” September 2006, regarding the ban on trans fats

“We’re not trying to take away anybody’s ability to go out and have the kind of food they want in the quantities they want, but we are trying to make that food safer. If we can do it without trans fats, you’ll save … a couple of hundred lives a year in New York City.” December 2006

Yet another example of “do as I say, not as I do” nannyism. If Bloomberg thinks he can make intelligent decisions about what and what not to eat, and taking risks with his health by eating junk food, even after having two stents placed in his heart, then he should grant that courtesy to everyone else.

It won’t happen though, because nanny-staters persistently tell themselves and anyone who will listen that their proscriptions are for the good of everyone. They proclaim with all sincerity that the “common good” requires their iron fist, and try to convince you that the velvet glove encasing it will ease the pain just fine. In reality, they simply think that those upon whom they place these restrictions are too stupid to think for themselves — in this case, that would be all of NYC — and that their benevolent intervention is necessary to protect such idiots from themselves.

But when it comes to their own lives, well that’s much more complicated you see. Nanny-staters need to drive SUV’s and fly on private jets. Wind farms despoil their landscapes, causing unnecessary disturbances in their relaxation time when they do their best planning to save humanity. And don’t even get me started on how devastating it would be for you comrades people if the nanny-staters can’t have their Cheez-Its!

“Comrades!” he cried. “You do not imagine, I hope, that we pigs are doing this in a spirit of selfishness and privilege? Many of us actually dislike milk and apples. Milk and apples (this has been proved by Science, comrades) contain substances absolutely necessary to the well-being of a pig. We pigs are brainworkers. The whole management and organization of this farm depend on us. Day and night we are watching over your welfare. It is for your sake that we drink that milk and eat those apples.”

Squealer, Animal Farm Ch. 3


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A New Nigerian Shakedown

cigarettes and ash tray
(photo: Jonathan Boeke)

The latest 419 scams aren’t the only nuisances for American businesses emerging out of Nigeria this year. Using the vast archive of documents made public during the 1990s epidemic of class action lawsuits against tobacco companies, Nigeria has decided to get in on the gravy train. The BBC is reporting today that Nigerian prosecutors are seeking an astronomical $44 billion in damages against American and European cigarette makers, for the costs supposedly sustained by their health care system. To put this allegation in some perspective, that’s approximately 43 times the entire 2007 Nigerian national health budget.

The government seems confident enough though, describing the tobacco companies as “dead on arrival” in court. I don’t envy the firms after hearing such definitive assessments from the state. In May of last year when prosecutors were beginning work, 23 Nigerian judges were removed from the bench on charges of bribery and corruption.

For Nigeria it would be an interesting approach to federal revenue diversification. Presently the country derives 80% of its fiscal budget from oil exports. At 2007 levels of expenditure victory in this suit could finance the entire Nigerian state for three years.

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Talent, Economics 101 and Health Care

Personally I find this observation from a paper by Mark Ramseyer unsurprising to say the least:

The Japanese national health insurance provides universal coverage. Necessarily, this entails a subsidy that dramatically raises the demand for medical services. In the face of the increased demand, the government suppresses costs by suppressing prices. By combining extensive biographical (including income) data on all 449 Tokyo cosmetic surgeons and a random sample of 499 other Tokyo physicians, I explore the effect of this price suppression on the allocation of talent and the development of expertise. Crucially, the national health insurance does not cover services – like elective cosmetic surgery – deemed medically superfluous. Facing price caps in the covered sector but competitive prices in these superfluous sectors, the most talented doctors should tend to shift into the superfluous sectors and there to invest heavily in their expertise. I find evidence consistent with this: cosmetic surgeons earn higher incomes than other doctors; are more likely to have attended a national (generally more selective) medical school; are more likely to have served on the faculty of a medical school; and are more likely to be board-certified. I speculate on the broader implications this phenomenon poses for the allocation of talent in medicine.

How one deals with such obvious consequences for the distribution of talent, wherever policy tries to control its working conditions and compensation, tells a lot.

Hat tip: Alex Tabbarrok

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Whither The Middle Class?

Hillary and Obama agree on taxing Americans more, they just can’t agree on whether it’s the “middle” or “upper” class that they’re prepared to squeeze for votes (HT: Paul Caron):

Class, always an awkward topic in the United States, made a rare cameo appearance [Ed. note: Rare? Apparently Joel Achenbach is new to politics?] at a recent candidates debate in Las Vegas. The two front-running Democratic presidential contenders, Sen. Barack Obama (Ill.) and Sen. Hillary Rodham Clinton (N.Y.), sparred over tax policy and quickly got entangled in the question of whether someone making more than $97,000 a year is middle class or upper class. That’s upper class, Obama said. Not necessarily, suggested Clinton.


The exchange between Obama and Clinton began when the senator from Illinois said he was open to adjusting the cap on wages subject to the payroll tax. That’s the tax that the government prefers to call a “contribution” to Social Security. Under current law, a worker pays a flat percentage (and employers match it) of wages up to $97,500. Wages beyond that aren’t taxed.

Clinton responded by saying that lifting the payroll tax would mean a trillion-dollar tax increase, adding that she did not want to “fix the problems of Social Security on the backs of middle-class families and seniors.”

Obama replied: “Understand that only 6 percent of Americans make more than $97,000 a year. So 6 percent is not the middle class. It is the upper class.”

This exchange is rather reminiscent of the the trolls arguing over what a Hobbit is, whether or not it’s worth eating, and exactly how one should be prepared.

What’s more interesting, however, is to compare the wrangling over whether someone making $97,000 is too rich to keep his earned income to the wrangling over how a family making up to $83,000* is too poor to pay for their own health insurance:

The Senate Finance Committee recently voted to reauthorize the program. The Senate bill would expand eligibility to children in families with incomes up to 300 percent of the federal poverty level, or $62,000 for a family of four. House Democrats would raise income limits even higher — to 400 percent of the poverty level ($83,000 for a family of four) — well above the median income.

By these metrics, nearly half of all families in America are too poor to live without government assistance, while the rest are too rich to live without paying for everyone else.

Sort of makes you long for a “Leave Me The Heck Alone” kind of candidate, doesn’t it?

* (more…)

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Health Care Innovation: Updated

The meme that our private sector, especially our pharmaceutical and medical device companies, has nothing to do with our success as a health care innovator is unfortunately widespread:

The great breakthroughs in the history of medicine, from the development of the polio vaccine to the identification of cancer-killing agents, did not take place because a for-profit company saw an opportunity and invested heavily in research. They happened because of scientists toiling in academic settings. “The nice thing about people like me in universities is that the great majority are not motivated by profit,” says Cynthia Kenyon, a renowned cancer researcher at the University of California at San Francisco. “If we were, we wouldn’t be here.” And, while the United States may be the world leader in this sort of research, that’s probably not–as critics of universal coverage frequently claim–because of our private insurance system. If anything, it’s because of the federal government.

The single biggest source of medical research funding, not just in the United States but in the entire world, is the National Institutes of Health (NIH): Last year, it spent more than $28 billion on research, accounting for about one-third of the total dollars spent on medical research and development in this country (and half the money spent at universities).

Paul Krugman and others are impressed:

This piece about medical innovation is one of the best things I’ve ever read on the subject. Bottom line: the US does lead the world in medical innovation, but the high prices we pay for insurance, drugs, etc. have little to do with it. Instead, it’s about the National Institutes of Health — it’s the government, not the private sector.

I’ll just steal from Tyler Cowen on what is wrong with this:

1. The strength of American medical innovation stems from the combination between the NIH, private philanthropy, and commercial incentives. Cohn has lots of (just) praise for the NIH, as basic research is often a public good. But he doesn’t say enough about philanthropy, and he confuses pro-NIH evidence with showing the superfluity of commercial incentives.

2. Send some flowers to Cynthia Kenyon, whom I could not personally quote in this manner with a straight face. You would never know that universities are profiting from drugs, and patenting them, at an unprecedented rate. Universities are also forming partnerships with drug companies at an unprecedented rate.

3. Companies must work very hard to translate basic research into usable applied form and the U.S. is a clear world leader in this regard. A drug idea is not the same as a drug. Cohn at times admits this, but is he really denying that the supply curve here slopes upward with regard to expected profits? You can cite all kind of “mixed” factors about commercial incentives but at the end of the day that is the basic question.

4. Statins, Prozac, and anti-AIDS drugs are notable examples of #1. Or try this list of Merck products. Merck and Pfizer are much more than simply marketing or doctor bribery machines, although admittedly they are that too.

5. The standard arguments against commercial “me-too” drugs are considerably overrated.

6. FDA restrictions are at least partly responsible for the costly, overly concentrated, and blockbuster-oriented nature of U.S. and other pharmaceutical companies. Tight regulations discriminate against the small company and the small idea. Even if you think tight regulations are a good idea, don’t blame these tendencies on the big bad corporations.

7. It is odd for Cohn to cite me as his libertarian foil, since the referenced piece very clearly cites the NIH as a critical factor behind American medical innovation. This odd citation again represents the desire to replace “anti-commercial” arguments with an easier-to-make “pro-NIH” case.
9. The NIH works as well as it does because the money is mostly protected from Congress. It is not a success which can easily be replicated. The more money is at stake, the more Congress wants to influence allocation. We should guard this feature of the system jealously and try to learn from it. If we can.

The bottom line: Arguments for the NIH are not arguments against the importance of commercial incentives for medical innovation.

#9 is critical, as people often assume that because those things which the government has managed to do rather well with are assumed to prove they can do well in general, and on a larger scale.

Update: Megan McCardle, proving that great minds think alike, though I am not necessarily one of them, agrees that number nine is the most important, and also instantly thought of education as an example. I still have a post from this angle to write, but now some of it is already written. Go read her version now.

Clive Crook has some other thoughts worth considering as well.

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Veterans as victims

They have to be, so CBS tries to do the numbers. Like most of us however, when numbers fit you take them at face value:

But a five-month CBS News investigation discovered data that shows a startling rate of suicide, what some call a hidden epidemic, Chief Investigative Reporter Armen Keteyian reports exclusively.

“I just felt like this silent scream inside of me,” said Jessica Harrell, the sister of a soldier who took his own life.

“I opened up the door and there he was,” recalled Mike Bowman, the father of an Army reservist.

“I saw the hose double looped around his neck,” said Kevin Lucey, another military father.

“He was gone,” said Mia Sagahon, whose soldier boyfriend committed suicide.


It found that veterans were more than twice as likely to commit suicide in 2005 than non-vets. (Veterans committed suicide at the rate of between 18.7 to 20.8 per 100,000, compared to other Americans, who did so at the rate of 8.9 per 100,000.)

One age group stood out. Veterans aged 20 through 24, those who have served during the war on terror. They had the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age. (The suicide rate for non-veterans is 8.3 per 100,000, while the rate for veterans was found to be between 22.9 and 31.9 per 100,000.)

Of course, when you don’t like the information, maybe you do a little figuring, and maybe the numbers are not what they appear to be:

In the US, male veterans outnumber female veterans 13:1. Since four times as many males as women commit suicide in the general population, you’d expect the rate among veterans to be close to the rate among males – 17.6/100,000 per year in 2002 – and indeed it is, if the CBS raw numbers are correct.

CBS also makes an issue of the fact that suicide rates among younger veterans exceed that of the general population by an even bigger margin – but again, that’s what you’d expect, because in that age group, the male-to-female imbalance in suicide rates is greatest, almost six to one.

Suicide is tragedy. What it does not seem to be, among veterans, is an epidemic.

So when we examine numbers it is generally true we tend to show rigor right up to the point where they fit what we want to believe. I’ll leave my readers to decide who here shows a desire to believe we should find admirable.

Update- Insty:

It was my understanding that there would be no math.

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Oh, To Be a Fat Cat

The New York Times has a nice piece on the latest health research on the impact of weight on health. Of course, like most nutrition and weight related research we should approach it with some caution as John Tierney has discussed at great length (or breadth?)

I actually enjoy the social history in it the best. Somewhere in all my study of history I missed this little tidbit:

Dr. Brown is among those social scientists who say that being thin really isn’t about health, anyway, but about social class and control.

When food was scarce and expensive, they say, only the rich could afford to be fat. Thus, in the 19th century, well-do-do men with paunches joined Fat Men’s Clubs, which gave rise to the term “fat cat.”

I also found this amusing:

Dr. Brown, the Emory anthropologist, related how in the 1950s, white South African public health officials tried to warn people in a Zulu community about the dangers of obesity. They put up two posters.

One showed a fat woman standing next to an overloaded truck with a flat tire. “Both carry too much weight,” the poster said. The other showed a thin woman sweeping up dirt under a table while a fat woman stood nearby, leaning on the table for support. “Who do you want to look like,” the poster asked.

The Zulus thought the first poster showed a fortunate woman, so rich that she was fat and with so many possessions that her truck was overloaded. As for the second poster, they thought the thin woman was the servant, working for the obviously affluent fat woman.

Well, if fat is not as big a problem as previously thought, then I am in the right state.  Plenty of overweight people and food that makes you not care. I think that means Gumbo for lunch.

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The cost of not paying

Wilson Mixon notices a rather predictable, but nevertheless ironic aspect data on the cost of health care:

Russ Roberts provides a snapshot of how much third-party payments have grown since 1960.

My computations below are from the table from which he excerpts, with per-capita out-of-pocket expenditures computed and converted to real terms.

Year 1960 1970 1980 1990 2000 2003
PerCap $126 $301 $931 $2398 $3955 $4866
Paid $70 $119 $252 $540 $672 $779
RealPaid $235 $308 $306 $413 $390 $423
PaidPct 55.2 39.7 27.1 22.5 17.0 16.0

So, now that we pay 1/6 of the total cost, our out-of-pocket cost is about 80% higher than when we paid 55.2% of the total cost.

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Mankiw Responds

Greg Mankiw responds to questions about his views on health care following his piece on the misuse of statistics in the health care debate:

Q: There has been a lot of blogosphere commentary on your piece. Are you going to respond to it?

A: No. Life is too short. But I will note that I am a bit surprised at some of the strong reactions from the left. California Medicine Man is correct when he writes,

Every element of Mankiw’s analysis has been common knowledge in the healthcare economics field for several years and strictly speaking, none of this is really news. 

Read the whole thing, but I am not surprised at the reaction. He then provides us with something we adore, a conjecture!

Q: Do you think the pundits of the left are similarly confused?

A: Some are, but others have an altogether different motive. Observing dissatisfaction with the U.S. healthcare system, they are using reform as a Trojan Horse to push for more redistribution of income. Almost all sweeping health reform proposals involve higher taxes on the rich to provide benefits for those farther down the economic ladder. The redistribution, rather than health reform, is sometimes the main objective.

To judge whether my conjecture is correct, ask your favorite pundit of the left the following: What health reform would you favor if the reform were required to be distribution-neutral? That is, you can change the rules of the health system but you cannot change the distribution of economic resources between rich and poor. My guess is that your favorite pundit would either object to the question or would answer by retreating to more modest reforms. If so, this suggests that calls for sweeping reform are mainly motivated by the desire for increased redistribution.

On the most important question however he attempts to dodge the issue:

Q: Are you the devil incarnate?

A: I will get back to you on that.

He isn’t, but many think he used to work for him.

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Enough Already

A couple of days ago I linked to McQ and Mark Steyn on the state of knowledge about the “poor family” whose child was used by Senate Democrats in their push to expand the SCHIP program. Here is why:

  1. The media was taking their story and basically pushing the story verbatim, no questions asked, as a telling narrative.
  2. They already qualify for CHIP. Exactly how does that justify expanding CHIP to cover people even less deserving?
  3. The claims were inaccurate, insurance to cover most of what they needed does not cost 1200/mo. Not even close.
  4. They had other resources to help with insurance such as family who could seemingly have helped out. They want to run their own business, sometimes that requires some real sacrifice. I have been there. Family and other resources came before I would have turned to the government (and I wasn’t making even 45k a year, and yes I had 4 children.) Health insurance shouldn’t be at the top of things to sacrifice. Eventually however, you need to look for more income. If the business can’t provide it, look elsewhere, even if it means another job. I did.
  5. They live in a 3000 sq. foot home. While I understand they bought it much cheaper, it is now worth a good deal. Before people such as them reach into my pocket, sell the house. Buy a 1300 sq foot home in a less expensive area. That is what I did when I was a struggling young entrepreneur. Now with the equity you pocketed you have no mortgage and/or a lot of money to provide for health insurance while you work to make the business a go. I have never owned a 3000 sq. foot home. It would be prohibitively expensive. They don’t need to either, even with 4 children. I know, I had 4 children in a 1300 sq. foot home. That is more than the average size of a home in the forties and fifties when families were much larger.
  6. I assumed they probably had someone covering the tuition. It turns out the school has one child on scholarship, the state pays for the child with disabilities to the tune of 23k a year. Isn’t 38k in help from the rest of society enough?
  7. He has business property. Once again, I hear that it could be losing money, etc. So what? Sell it then.
  8. Finally, once again, none of this was checked!

So, there you go. Of course it is being made out that those of us who find the idea of middle class people who have to make difficult choices a less than compelling rationale for vastly expanding a program to even more advantaged people are attacking children. That we would like for our media to check it out and tell us what the full implications of the Frost family’s situation is are smearing them.

I felt the links I referenced showed reasonable objections to the narrative and the ridiculous case that families such as the Frosts show how important it is to expand SCHIP up the income stream. They may in fact be struggling, but they live a lifestyle that many would consider outside the realm of the “deserving” poor, or as deserving of pity. They are middle class people who need to prioritize.

Nor are most of the questions smears. I read at several sites about Michelle Malkin “stalking” them. I then read the piece and found it quite sympathetic to the Frosts while still questioning the use of their tale.

However, I have read some things which bother me. The Frosts are being lambasted, called names, described in the most unflattering terms by some. I am always amazed at the ability of people to act as if they know people who they know little about, and condemn them. I make all the notes above as an illustration as to why they do not justify the policy they are being used to promote. I would never claim that they need to do any of the things I list above. Those are my choices and possible solutions, they made others. It hardly justifies sneering contempt, or scathing denunciations. Just as businessman have a right to take all the deductions the law allows (a right they have probably exercised themselves) CHIP was available, they used it. We can say we wouldn’t have, or that the program is serving people who we think shouldn’t be covered. We can point out that if the program didn’t exist they could have purchased insurance.

It is no reason however for parents trying their best to provide for their family under the law to be subject to some of the more mean spirited denunciations of their character. I don’t know Halsey Frost. He may be a man who disagrees about what the purpose of government should be, but in all other respects he may be remarkable. Generous, kind, loving toward his children, active in his community. He may have an attachment to the house that makes the sacrifices of forgoing the money he could receive from it worthwhile. It is the home his children have always known, and that can mean a lot.

I may not believe that choice deserves having me subsidize it, especially since in similar circumstances; no, much more difficult financial circumstances; I chose not to go that route. However, I will not denigrate his character in general for choosing differently. It was legal for him to use the program (assuming that is true, and I will not convict him without proof.) I reserve my disdain for those using him and a media which refused to provide the proper context. We don’t know Mr. Frost, and have no business making claims about his character to make our point. I am sick of this kind of thing from liberals, conservatives and yes, even libertarians.

Enough already.

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The Clown Show

I was going to bring you up to speed on the ridiculous response the Democrats  gave to President Bush’s  veto of the expansion of SCHIP and the mainstream media’s clownish and credulous layers of fact checkers, but here are a couple of good summaries of where it stands now. Follow the links.

I especially like this conclusion from McQ:

I’d also bet if the Baltimore Sun had actually looked into this, they’d find the Frost’s represent exactly what opponents to SCHIP have been contending would happen – middle class families finding ways of opting out of private insurance to take government coverage (although in the case of the Frost’s it may be more serious than that, they may have misrepresented their income to get the health coverage).

I’m sorry the Frost children were injured in an accident and am glad they’re on the road to recovery, but to contend they are representative of the “need” for SCHIP is simply ludicrious. They’ve apparently gamed the system and found a way to get you and I to pick up the tab. The fact that the Baltimore Sun didn’t look into this any deeper than it did is telling as well. And, unsurprisingly, the fact the the Democrats exploited this child to get their disingenuous message out there is equally telling.

Retail politics at it’s lowest.

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“Universal” Health Care Failing in Japan

Some interesting observations about universal health care in Japan. I suppose limiting the amount of care the government provides for is one way to hold down health care costs, but I doubt that is what people have in mind when they hear about plans for instituting such a thing here.

If universal care were the genuine cure-all, the one country where it should work is Japan. They have a homogenous population, healthier lifestyle, eat more fish and soy, more vegetables and far less obesity than here. If universal care does not work there why should it work anywhere?

While Japanese patients want American-style treatment, their policymakers are alarmed. With a huge national debt and corporations worried about higher taxes, they say Japan can¹t afford to pour money into treatments that can¹t extend life span by very much.

“America did too much of this and that¹s why their medical costs have grown,” said Masaharu Nakajima, a surgeon and former director of the Health Bureau at the Ministry of Health, Labor and Welfare.

Since Japan enacted universal health insurance in the early 1960s, the emphasis has been on a minimum standard of care for all. People must pay a monthly health-insurance fee, and large companies pay also. Coverage decisions, doctors¹ pay, and other rules are set by the central government.

Japanese doctors complain that they have no time to spend with patients. The experience of seeing a doctor is summarized as “a three-hour wait for a three-minute visit.”

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Canadian MP comes to US for treatment-Update x2

Why? This chart might give a clue:

Seems that not only is the US the best place to be treated for cancer, Canada isn’t even in the top 20. The difference is also startlingly large. Say Anything has more.

Update: See Kav’s comment below for some clarification that my post seems to desperately need.

More: Thanks to QandO I found a breakdown of the study by Jody at Polyscifi. She has the breaks down the numbers by type of cancer, and the US looks good even when you break it down to its constituent parts. Some data on France is included as well.

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Wisconsin’s Experiment

Via McQ (who had posted on the topic previously), I see that Wisconsin is planning to introduce universal statewide health care at an initially estimated cost of about $15.2 Billion per year:

Democrats who run the Wisconsin Senate have dropped the Washington pretense of incremental health-care reform and moved directly to passing a plan to insure every resident under the age of 65 in the state. And, wow, is “free” health care expensive. The plan would cost an estimated $15.2 billion, or $3 billion more than the state currently collects in all income, sales and corporate income taxes. It represents an average of $510 a month in higher taxes for every Wisconsin worker.

In the spirit of Justice Brandeis’ famous dictum designating States as “laboratories of democracy,” John Stossel says “go for it, Wisconsin!” Or as McQ summarizes, Stossel’s “theory is that perhaps their experience will finally demonstrate for all that the ’socialist approach’ isn’t the way to go.” Both Stossel and McQ outline the government meddling (in the form of insurance mandates) that led to Wisconsin’s decision, the regressive nature of the taxes that will be assessed to pay for the program, as well as the probable reasons that it will eventually fail. I think that they are both spot on with their analyses.

However, both conclude that the eventual failure of this system may provide yet more evidence of the misery that is socialism, and thus turn American’s off supporting that ideology:


“That’s why America needs ‘Healthy Wisconsin.’ The fall of the Soviet Union deprived us of the biggest example of how socialism works. We need laboratories of failure to demonstrate what socialism is like. All we have now is Cuba, Venezuela, North Korea, the U.S. Post Office, and state motor-vehicle departments.

It’s not enough. Wisconsin can show the other 49 states what ‘universal’ coverage is like.

I feel bad for the people in Wisconsin. They already suffer from little job creation, and the Packers aren’t winning, but it’s better to experiment with one state than all of America.”


“So I’m with Stossel. Go for it Wisconsin. Run this thing. Let’s see how it works out, because we’re all interested to see if, in fact, TANSTAAFL is something to finally be tossed in the bone-yard of conventional wisdom. Just as we’ve seen others try to repeal the laws of economics, I’m interested to see how well Wisconsin does in that regard.

However, if we are lucky enough to have it turn out as most expect it will, perhaps it will provide the basis for avoiding what I believe would be a disastrous attempt by the federal government to take the Wisconsin plan national.”

My quibble with their conclusion is that there is no way in Hades that Congress, and particularly Democrats in Congress, and even more particularly Democrats from Wisconsin, will let the system fail on its own. Accepting for the moment that “Healthy Wisconsin” will suffer all the rather predictable problems noted by Stossel and McQ (which, in fact, I do), the state does not live in a bubble. If the federal government was willing to bail out Chrysler and S&L banks, its certainly not going to sit idly by while an entire State goes down the tubes. Should it? Absolutely. Will it? Absolutely not.

In addition to the practical problems with allowing a State to be crushed under the weight of its own legislative stupidity, there are also the strategic interests in play who won’t want to see anything resembling universal health care reduced to a pitiful mess that is plain for all to see. Any Senator or Representative who has universal health coverage on their agenda will be quite game to funnel money into the Wisconsin system, either through Medicare/Medicaid, SCHIP, or some euphonious block grant. So too will the representatives of States (such as Massachusetts) that are either planning to, or in the midst of, implementing their own version of such a program. And then, of course, there are the usual suspects such as Big Labor who have been pushing for universal coverage for quite some time now.

With all of those interests aligned in support of Wisconsin’s experiment, I’d be shocked if were actually allowed to fail. Most likely, no such failure will ever be acknowledged, and the burden of paying for it will slowly be shifted to the American taxpayers as a whole. If the assumed failure is admitted at all, it will be used by this same array of forces to agitate for nationwide universal health care, under the argument (akin to that employed by gun control advocates) that States who don’t put the same safeguards in place for their own populations, are merely free-riding off of Wisconsin’s superior system.

So, instead of saying “go for it, Wisconsin!” I would instead encourage the purveyors of this plan to explicitly waive any federal assistance, now or in the future, to make that waiver binding on all future actors for the State, and to make it applicable to either requests for or offers of assistance. In other words, I would say to Wisconsin “put YOUR money where your mouth is, and put it in writing.”

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