Health care reform

Nov 052007
 

Most of us already knew that Michael Moore is a liar. But we didn’t know that he’d make the mistake of going to the UK so he could show how their National Health System is the sort of thing we’d want to emulate. Minette Marrin in The Sunday Times (UK) tells about it in Quack Michael Moore has mad view of the NHS. She doesn’t hold back in describing their system:

This, along with an even rosier portrait of the French welfare system, is what Moore says the state can and should provide. You would never guess from Sicko that the NHS is in deep trouble, mired in scandal and incompetence, despite the injection of billions of pounds of taxpayers’ money.

While there are good doctors and nurses and treatments in the NHS, there is so much that is inadequate or bad that it is dishonest to represent it as the envy of the world and a perfect blueprint for national healthcare. It isn’t.

GPs’ salaries – used by Moore as evidence that a state-run system does not necessarily mean low wages – is highly controversial; their huge pay rise has coincided with a loss of home visits, a serious problem in getting GP appointments and continuing very low pay for nurses and cleaners.

At least 20 NHS trusts have even worse problems with the hospital-acquired infection clostridium difficile, not least the trust in Kent where 90 people died of C diff in a scandal reported recently.

Many hospitals are in crisis. Money shortages, bad management, excesses of bureaucrats and deadly Whitehall micromanagement mean they have to skimp on what matters most.

Overfilling the beds is dangerous to patients, in hygiene and in recovery times, but it goes on widely. Millions are wasted on expensive agency nurses because NHS nurses are abandoning the profession in droves. Only days ago, the 2007 nurse of the year publicly resigned in despair at the health service. There is a dangerous shortage of midwives since so many have left, and giving birth on the NHS can be a shocking experience.

Meanwhile thousands of young hospital doctors, under a daft new employment scheme, were sent randomly around the country, pretty much regardless of their qualifications or wishes. As foreign doctors are recruited from Third World countries, hundreds of the best-qualified British doctors have been left unemployed. Several have emigrated.

As for consultants, the men in Whitehall didn’t believe what they said about the hours they worked, beyond their duties, and issued new contracts forcing them to work less. You could hardly make it up.

Nothing surprising there, though we can be sure it won’t stop the U.S. left wing from trying to reproduce those results in our country.

And what does Marrin herself think should be done?

None of these problems mean we should abandon the idea of a universal shared system of healthcare. It’s clear we would not want the American model, even if it isn’t quite as bad as portrayed by Moore. It’s clear our British private medical insurance provision is a rip-off. I believe we should as a society share burdens of ill health and its treatment. The only question is how best to do that and it seems to me the state-run, micromanaged NHS has failed to answer it.

OK, I can understand why she doesn’t want to exchange their system for ours. The people pushing nationalized health care may be in deep denial, but so are those who try to ignore the problems with our own health care, for example, those who say nobody is denied health care in our country — all you need to do is go to the emergency room, etc etc.

But where is the discussion about what should be done to fix the problems with existing national health care systems? All I ever hear is “the government should provide this, the government should provide that,” without talking about what it would take for the government to actually do that. There is no talk about the moral hazard issues. Marrin points out that the NHS has failed to answer the question of how best to provide universal care. Well, where does one go to find an intelligent discussion of how to fix it? All we get is a wish list of how life in fantasyland ought to be.

If I ever hear of any good discussions on the topic, I’ll be sure to blog about it here.

Oct 182007
 

Isn’t this a bit ghoulish? Don’t politicians know how to talk liberal any more?

“In the coming days, Democrats will not back down and we will insist on providing health care coverage to these 10 million children,” said Rep. Rahm Emanuel, an Illinois Democrat.

House Speaker Nancy Pelosi, a California Democrat, after the vote said Congress intends to send Bush another bill in the next two weeks that covers the same number of youngsters.

Health and Human Services Secretary Mike Leavitt said in an interview he was “optimistic” the administration and Congress could work out their differences. The administration’s goal is to sign-up 500,000 more eligible low-income children, he said.

The bill vetoed by Bush would have raised tobacco taxes to provide an extra $35 billion dollars over five years to provide health care for as many as 10 million children, compared to the 6.6 million currently enrolled.

I think they’re arguing over how many ritual child sacrifices will be needed to appease Leviathan.

URL

Oct 062007
 

Headline on Google and Voice of America: “Congress vows to override Bush veto on child health care.”

1. Congress vows that? Maybe some Congressional Democrats do, but isn’t it customary to have a vote before saying Congress does something?

2. I’ll bet it’s not child health care that Bush vetoed. I’ll bet he vetoed the latest version of the SCHIP legislation.

Oct 042007
 

Google SCHIP news

My, oh my. Google News is sure beating the drums hard on this SCHIP thing. They have made this the top story for I don’t know how long, using the most propagandistic headlines they can find.

Sep 282007
 

1959 vacation camp

This photo is one of my father’s 35mm slides from 1959. It was deteriorating badly, but I did what I could with it, along with a bunch of others I did for my parents’ 60th wedding anniversary this summer.

So what does it have to do with George Bush and SCHIP? Well, now that the Senate has passed the expansion of SCHIP, the script calls for George Bush to let some of his followers go out on a limb and support his threatened veto, then cut them down and stab them in the back by signing it anyway. Then conservative commentators will be bewildered as to why George Bush would have done such a thing, given that he’s done the same thing every time he’s had an opportunity to do so up to now.

That still doesn’t explain the photo.

I put it here because the problem with SCHIP is not so much that it will be an expensive boondoggle (though it will be that) as that it helps destroy families.

We didn’t have much money when I was growing up, but my parents managed to save enough so we could have one good travel vacation every summer. Dad built the travel trailer shown in the photo, and for a few years had to explain what it was every time we stopped at a gas station. Later pop-up campers became common. This one may look clunky, but you ought to have seen the one we borrowed for a trip to California in 1956. Dad improved on the design, substituting aluminum framework for the steel bedposts used as a tent frame on that one, and using thinner plywood.

In 1959 (the year of this photo) we went to the Canadian Rockies. I remember that Nikita Khruschev’s upcoming visit was in the news, and the idea of it was about as controversial as the recent one by Mahmoud Ahmadinejad. I remember Dad getting into a conversation with someone in Canada, saying maybe it was good that Khruschev would come for talks. It surprised me somewhat to hear him say that.  (Now that I think about it some more, I remember it better.  Dad did not say that.  It was a topic of conversation at more than one campsite, and someone else said it. )

We managed to have money for a vacation every year, but to do that we had to do without other things. For example, I have crooked teeth because my parents couldn’t afford to get them straightened. I’ve always been grateful that they chose to take us on travel vacations instead. There are lots of good memories from those trips.

When I mentioned this a few years ago to my sister (who is in the photo, as am I) she said no parent should have to make such choices. I retorted that who could better make that choice than the parents? Do we want governments making those choices for us?

Resources are limited, and such choices will be made at one place or another.

But the real problem is that if you take away all of those terrifying decisions that parents have to make for their children, they cease to be parents and the children cease to be their children. The family community is replaced by an extreme individualism in which each individual’s relationship is more with the state, and less with the family. And that results in social pathologies such as we see in Great Britain, which is now carelessly throwing away its hard-won advances in human rights in order to deal with it. (Anti-social behaviour orders, anyone?)

Would our government really be breaking up families on purpose in order to replace family relationships with others more to its liking? Of course it would. It wouldn’t be the first time. Listen to James Monroe’s state of the union address in 1818:

Experience has clearly demonstrated that independent savage communities can not long exist within the limits of a civilized population. The progress of the latter has almost invariably terminated in the extinction of the former, especially of the tribes belonging to our portion of this hemisphere, among whom loftiness of sentiment and gallantry in action have been conspicuous. To civilize them, and even to prevent their extinction, it seems to be indispensable that their independence as communities should cease, and that the control of the United States over them should be complete and undisputed. The hunter state will then be more easily abandoned, and recourse will be had to the acquisition and culture of land and to other pursuits tending to dissolve the ties which connect them together as a savage community and to give a new character to every individual. I present this subject to the consideration of Congress on the presumption that it may be found expedient and practicable to adopt some benevolent provisions, having these objects in view, relative to the tribes within our settlements.

He says he wants to break up the community relationships of the Indians so they can be more easily controlled by the government. That’s what was done then, and that’s what’s happening now with things like SCHIP.

There! Not only did I tie together George Bush, SCHIP, and our family vacations from the 50s, but I tossed in a bonus connection to James Monroe and the conquest of the Native Americans, not to mention Nikita Khruschev and Mahmoud Ahmadinejad. It’s not for nothing that I’m called The Reticulator. (Other people tend to use slightly different language for it, though.)

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.

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.