Telling doctors how to practice medicine

 Brave New World, Health care reform, Welfare-police state  No Responses »
Sep 142007
 

There’s nothing like the opportunity to do some death and dismemberment to bring out all sorts of libertarian-sounding talk from people who ordinarily would be quite the opposite.   We got a lot of this during the embryonic stem cell debates.

Here’s a different instance from Thursday’s WSJ, in an article titled, “New limits debated for organ donation: Transplant group proposes barring donors who have certain health problems; balancing risk vs. need.”

These two paragraphs are a decent summary of the conflict:

The debate reflects a tension between the need for organ donors and concerns that doctors may be lowering standards for living donors too far or failing to catch problems that could put the donor at unacceptable risk. Many transplant programs now allow people to donate who would have been screened out a few years ago, including those who are obese or have high blood pressure or diabetes.

Often marginally qualified donors demand to be approved, contending the choice is their own to accept the risk when someone they love needs a transplant. Transplant surgeons have also loosened standards for deceased donors, accepting, for instance, organs from much older dead donors than ever before.

I suppose it doesn’t help that I’ve read of allegations of organ harvesting from China, where unwilling victims have possibly been killed in order to harvest their organs to be sold to  wealthy foreigners.   Listening to how these U.S. transplant doctors are opposed to limits on what they do makes the possibility seem not so far fetched.  I don’t think I want to be caught alone in a dark alley with these guys.

Here is where it starts to get spooky:

But some surgeons worry that insurance companies or juries will use the guidelines to penalize doctors who don’t follow them. Moreover, critics say that UNOS shouldn’t be telling doctors how to practice medicine.

(UNOS is the United Network for Organ Sharing.)

As for telling doctors how to practice medicine, that’s not really an accurate way of describing what UNOS is doing.  UNOS is attempting to define limits.  It is telling doctors what NOT to do, not what should be done.

And is it so far-fetched to think that limits might be needed?   Do doctors always have others’ interests foremost?  How about this, from Wednesday’s WSJ:  

…Federal Medicare officials want to crack down on arrangements like the one that was planned in Gainesville, where doctors refer patients to businesses in which they have a financial stake.

In recent years, many physicians have become wealthy by investing in magnetic resonance imaging, or MRI, facilities, surgery centers and diagnostic sites — and then sending their patients to them. A recent McKinsey & Co. study pegged doctors’ profits from this practice, known as self-referral, at $8 billion a year.

Bought and paid for

 Academic intolerance, First Amendment, Welfare-police state  No Responses »
Sep 132007
 

I had thought it would come to this eventually. I didn’t realize it was already here as a matter of official policy, and has been here for ten years already.

Here is John Leo in a column at townhall.com

In 1997, the National Association of Social Work (NASW) altered its ethics code, ruling that all social workers must promote social justice “from local to global level.” This call for mandatory advocacy raised the question: what kind of political action did the highly liberal field of social work have in mind? The answer wasn’t long in coming. The Council on Social Work Education, the national accreditor of social work education programs, says candidates must fight “oppression,” and sees American society as pervaded by the “global interconnections of oppression.” Now aspiring social workers must commit themselves, usually in writing, to a culturally left agenda, often including diversity programs, state-sponsored redistribution of income, and a readiness to combat heterosexism, ableism, and classism.

I’m somewhat sensitive to this issue, because I’ve occasionally had people of the left ask me why a person of my political views is working for a public university, on the public payroll.  (I have a support staff position.)    My standard response is that it’s a damning indictment of the system if giving me a paycheck is supposed to buy my political views as well.

But that’s the direction in which things are headed.  A personal observation is that young students and even faculty members are having increasing difficulty separating ecological science from environmental activism.     I wonder how many can still articulate the reasons for separating the two.   They seem to understand the difference between science and non-science when the topic of creationism comes up — but they don’t seem to be able to apply the principles generally.

Well, I don’t know if this National Association of Scholars (apparently the source of much of Leo’s information) is going to make much headway in protecting science and scholarship.

How about this:  NASW should add an amendment to its code of ethics, explaining that whenever its members engage in public discussion of political affairs, that they should add the disclaimer that their political views are bought and paid for.    Newspapers when printing letters to the editor from such persons, should point out that the political views of the writer have been bought and paid for, and are not the result of independent thought any more than those of a corporate PR flack are.

Disrecognized, discounted

 Welfare-police state  No Responses »
Sep 092007
 

Logging truck on Nate Shaw’s route

The above photo was taken on a bike ride in west-central Alabama in April 2006. Among other things, I wanted to see the places that had been described in All God’s Dangers: The Life of Nate Shaw. Nate Shaw is a pseudonym, and most of the places named in the book were pseudonyms, but this is one of the very real places he had talked about.

Nate was a sharecropper who made a good bit of extra money for himself by hauling lumber with his mule team. This is one of the roads on which he hauled lumber. The area was pretty much logged out, but trees have grown back and now there is a lumber industry again. I encountered these logging trucks all the time when I was riding there.

Nate did pretty well for himself, but had some severe obstacles to overcome. In the end he accepted the help of the Communist Party in protecting his private property rights, and ended up going to prison for using a gun to defend his property. (The same day I took the above photo, I took photos of the courthouse building where the trial was held — at least I assume it isn’t a newer courthouse. A couple of days earlier I got photos of the prison where he did most of his time.)

What has provoked me to post this now is John Edwards statement about requiring people to get physical checkups under his plan. I’ve run into people who defend that. “What about mandatory seat belt laws?” they ask, as if back at the time those laws were introduced we didn’t object, saying it would lead to nannyism like this.

I don’t think these people understand how odious this is. Maybe it would help to see how Nate Shaw reacted to that kind of behavior from a Mr. Curtis, one of his least favorite landlords.

This is from page 109 in my paperback copy of the book:

Mr. Ames was a little better man than Mr. Curtis, and not sayin that altogether because he put me on better land–it weren’t much better. I didn’t just look at one angle or one point in the difference. I looked at it this way: Mr. Ames put me on a little better land than Mr. Curtis, but I had to go by his orders, too. Well, that cut my britches; he didn’t let me branch out like I wanted to. But I got along well with him. He never did cripple my cow and he never stood over me, tell me how to drive his mule of a Sunday–Mr. Curtis done that. When I’d go and get that plow mule to hitch him to the buggy that I bought from his brother-in-law, go where I wanted to, he’d tell me–well, I know that no man wants his stuff mistreated, but I never did treat his mules wrong; he had no cause to get at me about it. And I never was pleased to mistreat my mules after I got able to buy my own mules. Mr. Curtis laid his larceny to me: “Nate, when you get to where you goin, you’ll be thar. Give the mule his time, give the mule his time.”

Didn’t want me to drive him out of a slow gait. His way of speakin was “thar”; he didn’t say “be there,” he’d say, “be thar.” That was his mule, it weren’t mine, but he just disrecognized me, considered me not to know nothin. Know or not know I had to go by his orders to please him. He just considered me not to know nothin so he would have to tell me.

It’s stamped in me, in my mind, the way I been treated, the way I have seed other colored people treated–couldn’t never go by what you think or say, had to come up to the white man’s orders. “You aint got sense enough to know this, you aint got sense enough to know that, you aint got sense enough to know nothin–just let me tell you how to do what I want you to do.” Well, that’s disrecognizin me, and then he slippin around to see that I doin like he say do, and if I don’t he don’t think it’s on account of I got my own way of doin, but he calls it ignorant and disobeyin his orders. Just disrecognized, discounted in every walk of life. “Just do what I say, like I tell you. Don’t boot me.” Showin me plain he aint got no confidence in me. That’s the way they worked it, and there’s niggers in this country believed that shit.

Edited for niceness, 10-Sep-2007

Nationalized health care = compulsion

 Health care reform, Welfare-police state  No Responses »
Sep 042007
 

I’ve been saying for several years that the greatest current threat to our civil liberties is nationalized health care.   John Edwards was recently kind enough to show how it works:

Edwards backs mandatory preventative care: 

It requires that everybody be covered. It requires that everybody get preventive care,” he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. “If you are going to be in the system, you can’t choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK. …

Edwards said his mandatory health care plan would cover preventive, chronic and long-term health care. The plan would include mental health care as well as dental and vision coverage for all Americans.

Of course, this talk about preventative care is what also gave us HMOs, brought to us by the same people who are now pushing a single-payer HMO on a national scale.

And mental health care was a formidable weapon against political dissidents in the old Soviet empire.

Let’s have separation of Health Care and State for the very same reason we have separation of Church and State.

Stop it from happening again

 Russia  No Responses »
Sep 042007
 

Interesting closing paragraph to a WSJ article about the new Museum of the Soviet Occupation in Georgia:

The story goes that Vladimir Putin considered the display highly provocative and asked President Saakashvili why Georgia would do such a thing. After all, the most prominent butchers were themselves Georgian, such as Stalin and Beria. Mr. Saakashvili responded that the Russians were free to open a museum about how Georgia had oppressed them. The Georgian no doubt knew well that such an exhibition would offend his menacing northern neighbor with a former KGB officer at its helm, but he went ahead anyway. Perhaps he calculated that it was the best way to stop any of it from happening again.

Which reminds me, well over a year ago I used to see some interesting movies on RTR Planeta about the bad old days of Stalin and his executions. I seldom get to watch that station on the internet anymore, but sometimes I do. I wonder if Putin still allows that kind of thing to be shown any more.

It’s not going to make you better

 Legislative process  No Responses »
Sep 022007
 

Quote from Peggy Noonan in the WSJ: “You’d better be pretty good going in, because it’s not going to make you better.”

She’s talking about politicians going into politics.

I’ve often said that politicians are generally less corrupt than their constituents. What often provokes me to say that is seeing what people ask their congresspersons to do for them — things that a congressperson would have no business doing in a good government.

Peggy Noonan is referring to something a little different — the way politicians both left and right need to change to deal with the Iraq war.

A time for grace

America needs unity in dealing with Iraq. That means the president must lead.

Friday, August 31, 2007 12:01 a.m. EDT

What will be needed this autumn is a new bipartisan forbearance, a kind of patriotic grace. This is a great deal to hope for. The president should ask for it, and show it.

Normally I’m against bipartisanship, but in this case I think Ms Noonan is right.

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