Category Archives: Healthcare

Aren’t You Glad To Be A Gamma?

Civil Liberties, Death Penalty, Freedom, Healthcare, Liberty, live blogging, Media, Multimedia, Political Correctness, Reproductive Rights, Technology, The Contributors, The Surveillance State

I had a really interesting philosophical discussion with Brad Warbiany, our curator at The Liberty Papers, over a Facebook status I wrote. I had just re-listened to the CBS Radio Workshop rendition of Brave New World and had commented that it seemed like a far more livable situation than 1984.

Warbiany added that California, if Prop. 19 passes and allows the modern equivalent of soma to be freely ingested, the state really will look like Brave New World. With the state already self-organized into a caste system (Listen to someone from Northern California talk about Southern California or someone from Berkeley talk about Sacramento some time), abortion and every sort of contraceptive widely available and the domination of a vapid mass culture (seen at San Diego Comic Con or Wonder Con in San Francisco) taking precedence over civic involvement for Californians, the Golden State really resembles Huxley’s “negative utopia.”

Warbiany also handed me this great cartoon:
Orwell v. Huxley

On Twitter, alot of progressive and libertarian leaning activists tend to advocate alot for issues of freedom and emancipation in countries like Iran or China. In a way, situations in so obviously repressive countries like those are much easier for the activist. They fit into the Orwell dynamic and the villains and heroes are very clear. In his opposition to the death penalty, our own Stephen Littau does take on the American equivalent to state repression. Along with questionable foreign policy and drug policy, however, those are really the only avenues for passionate American political activism.

Beyond such clear issues of state force, however, one runs into a brick wall when faced with the mass culture, dullness and vapidity of consumer society. It seems that in this society, the majority of more normal people (myself and most people reading this strongly excepted) do not become Jeffersonians but instead “turn on, tune in and cop out,” as Gil Scott Heron once said. How does one become an activist in a society in which people freely subjugate, segregate and limit themselves?

I have a funny story that relates to this, that I didn’t even remember until I read what Brad said. While living in Alameda, California, I lost my phone. A teenage girl, around college age most likely, found it and called my mom, who e-mailed me about it. When I got the phone back, I was really grateful but had no money on hand. The only possession I had literally was a copy of Aldous Huxley’s Brave New World. I offered it to her.

She literally responded, “No thanks. I don’t read.”

I know. Alameda is not a low income area where reading should be rare, either. There are several bookstores in the area, along with hip restaurants, record stores and everything else you expect in cosmopolitan society. It even has an incredible vintage movie theatre that I rank as the best in Northern California, next to Oakland’s Grand Lake Theatre. This girl was obviously more involved in other factors of modern life, all of which I can safely assume are of less consequence intellectually than the work of Huxley.

It’s especially ironic given that there is a passage in Brave New World in which infants are given books while bombarded with screeching, loud noises, in order to dissuade them from being too intellectual when they reach adulthood. With video games, television, the internet and iPhones, that seems unnecessary as modern people have been incentivized out of intellectualism.

That girl did go to extra trouble to give me my phone back, with no advantage to her, however. That means she had a decency and sense of altruism that her lack of reading hadn’t impeded. Having grown up around the hyper-educated and being on that road myself, I can also attest that we’re not the nicest group of people. Perhaps then we really are on the road to progress.

TomStrong

Medicare ‘Waste, Fraud, and Abuse’

Government Incompetence, Government Waste, Healthcare

Obama on Saturday:

“We’ve made Medicare more solvent by going after waste, fraud, and abuse – not by changing seniors’ guaranteed benefits”

Really? And how aggressively have you been “going after” them?

It took private sleuths hired by Medicare an average of six months last year to refer fraud cases to law enforcement.

According to congressional investigators, the exact average was 178 days. By that time, many cases go cold, making it difficult to catch perpetrators, much less recover money for taxpayers.

A recent inspector general report also raised questions about the contractors, who play an important role in Medicare’s overall effort to combat fraud.

Out of $835 million in questionable Medicare payments identified by private contractors in 2007, the government was only able to recover some $55 million, or about 7 percent, the report found.

Medicare overpayments – they can be anything from a billing error to a flagrant scam – totaled more than $36 billion in 2009, according to the Obama administration.

7%, huh? That’s about the percentage of people in the Obama administration who’ve actually held a real private-sector job!

PS – Numbers are tricky, but the article states that in 2007, $55M was recovered. The article also states that in 2005, the contractors were paid over $100M. Even when they’re looking for waste they appear to be creating more waste!

Brad Warbiany
https://thelibertypapers.org/

Oh Noz! Unintended Consequences!

Economics, Government Incompetence, Government Regulation, Healthcare

A few months ago, when Pelosi crowed about the immediate effects of Obamacare, I pointed out a long list of them and my responses. My thoughts:

6. NO DISCRIMINATON AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to all persons.)

Again, an increase to private health insurance premiums. But hey, who’ll complain? After all, it’s for the children.

Today, it looks like one is becoming even worse than I’d thought:

In Florida, Blue Cross and Blue Shield, Aetna, and Golden Rule — a subsidiary of UnitedHealthcare — notified the insurance commissioner that they will stop issuing individual policies for children, said Jack McDermott, a spokesman for McCarty.

The major types of coverage for children — employer plans and government programs — are not be affected by the disruption. But a subset of policies — those that cover children as individuals — may run into problems. Even so, insurers are not canceling children’s coverage already issued, but refusing to write new policies.

The administration reacted sharply to the pullback. “We’re disappointed that a small number of insurance companies are taking this unwarranted and unnecessary step,” said Jessica Santillo, a spokeswoman for the Health and Human Services department.

Starting later this year, the health care overhaul law requires insurers to accept children regardless of medical problems — a major early benefit of the complex legislation. Insurers are worried that parents will wait until kids get sick to sign them up, saddling the companies with unpredictable costs.

Blue Cross and Blue Shield of Florida issues about 9,000 to 10,000 new policies a year that only cover children. Vice president Randy Kammer said the company’s experts calculated that guaranteeing coverage for children could raise premiums for other individual policy holders by as much as 20 percent.

“We believe that the majority of people who would buy this policy were going to use it immediately, probably for high cost claims,” said Kammer. “Guaranteed issue means you could technically buy it on the way to the hospital.”

Of course, I’m being generous here in my suggestion than muscling private insurers out of providing coverage is truly an “unintended” consequence.

H/T: Jason Pye @ UL

Brad Warbiany
https://thelibertypapers.org/

What The Appointee Says, And What It Means

Healthcare, The Nanny State, The Welfare State

While most of us were in the middle of a slow week following a holiday, Obama decided to issue a recess appointment for the job heading Medicare & Medicaid.

Could it be that he issued it as a recess appointment because he didn’t want us digging too deeply into what the good Dr said? Below is his quote, and Stephen Green’s (the Vodkapundit) opinion:

I just now got around to reading the actual article Nick quoted, and get this bit:

“In America, the best predictor of cost is supply; the more we make, the more we use—hospi tal beds, consultancy services, procedures, diagnostic tests,” Dr. Berwick wrote. “… Here, you choose a harder path. You plan the supply; you aim a bit low; you prefer slightly too lit tle of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.”

That’s right — the way to reduce prices is to — wait for it, one more time– decrease supply!

It must take a major IQ and a Harvard degree to wrap your brain around that one.

With all respect to Stephen, I don’t think the Dr is making the point that he can repeal the laws of supply and demand. However, what he’s actually claiming is not, as Stephen is suggesting, stupid. Rather, it’s evil.

Allow me to demonstrate:

In America, the best predictor of cost is supply

He’s not making a point about cost of individual services. He’s making a point about consumption, and therefore spending.

the more we make, the more we use — hospital beds, consultancy services, procedures, diagnostic tests,

Okay, so he says that demand is larger than supply, because as supply increases, there is enough demand to fully utilize it. Essentially he’s saying that as medical care & technology becomes available, we want to utilize it, to do silly things like saving our own lives.

Here, you choose a harder path. You plan the supply; you aim a bit low; you prefer slightly too little of a technology or a service to too much;

You ration. You deliberately restrict supply, so that people cannot obtain the life-saving care and technology that they need. The British are well aware of this, although they use the term “queue” over there, while we prefer the less elegant “waiting in line”. Do some of them die? Sure, but hey, you spend a lot less money this way!

then you search for care bottlenecks and try to relieve them.

Translation: You make sure that the politically visible ailments — you know, the ones that have their own special colored bracelets — are well-cared for, so you seem like you’re actually helping people. At the same time, less common, less well-funded, or less dramatic diseases are starved for funding and new technology, because there’s just not a large political incentive to fix it.

Welcome to Obamacare!

Brad Warbiany
https://thelibertypapers.org/

Why I Don’t Listen To Jenny McCarthy — Or the CDC

Freedom, Government Ethics, Government Regulation, Healthcare, Individual Rights, Reproductive Rights

The journalist responsible for the original uproar about the MMR vaccine and autism has been shown to have produced very shoddy research, and widely discredited. He was even recently banned from the practice of medicine in the UK. This has, of course, not quieted the debate. In fact, it’s gotten even worse, with his vaccine supporters claiming the science is settled, and vaccine opponents acting as if this is all a big cover-up.

The problem with this debate, for most people, is that they don’t have the training to actually view the real research and make an informed decision. They’re trying to decide whether to listen to their usual source of information, an emotionally-charged celebrity (Jenny McCarthy) or to trust the authorities, who just naturally have that stink of “they must be hiding something” about them. Add a dash of humanity’s propensity to swallow conspiracy theories, and nobody knows what to believe.

As a parent, I decided it was my job to educate myself and make the decision for my kids, regardless of what the CDC said. Nothing is riskless. It is my job to weigh the risk of vaccinating against the risk of not vaccinating, both for specific vaccines, for the age of administration of those vaccines, even to the level of possibly discriminating against brands of vaccine based upon ingredient levels (you may laugh, but I have asked my pediatrician which brand they use).

Some anti-vaccine folks in my extended family supplied me with the crackpot books they’ve read (i.e. books where the author was denouncing the entire germ theory of disease as bogus), and it was clear reading these that the authors had an axe to grind. A book written from an ideological perspective is not necessarily a disqualification, but books where the ideology trumps the science are out of the question.

I ended up on a book published by my kid’s pediatrician. I chose it because it seemed to honestly and neutrally discuss the relative diseases guarded against, the ingredients of the vaccines in question, and the safety record of the vaccine. The author supports vaccination, but it was clear that he did his level best to offer the evidence without bias, separate from his own recommendations pro/con on each vaccine.

I ended up choosing the vaccine schedule that I put my kids through based on that information — i.e. a cost/benefit analysis of the likelihood my child might contract the disease in question, the severity of the disease if he did catch it, and the relative risks of the vaccine in relation to the above.

As an example, I chose that my children get the polio vaccine. While it’s a rare disease, it’s a particularly nasty disease, and the vaccine is one of the safest available. I also chose to get vaccines such as HiB and Rotavirus, because they’re relatively harmful diseases, particularly in infancy, and also diseases that my kids aren’t that unlikely to contract.

On the other hand, I chose against MMR. While measles, mumps, and rubella are common, they’re also typically mild diseases. The vaccine has a higher prevalence of adverse reactions than most, and there is a worry that some of the vaccines for “mild” diseases can lead to complications later in life, with a more virulent and dangerous form of a disease affecting the individual in adulthood. Thus I didn’t believe taking risks to protect my kids from diseases that seemed relatively innocuous in most kids made a lot of sense, especially since the long-term effect is unknown. I had the same rationale for the chickenpox vaccine.

I also opted for a more spread-out vaccine regimen (i.e. not necessarily later in life, but more visits and less shots per visit), because I think the likelihood of an adverse reaction may be increased when you subject a body to the stress of several vaccines at once.

This, of course, is done with the unique attributes of my family taken into account. It’s a low-risk household, with the kids breast-fed until 12 months, no day care, and not a huge amount of interaction with hordes of other youth. Further, they’re well-nourished and healthy kids, so I feel they’d be far better than “average” at weathering the storm of a disease like measles or chickenpox. This, of course, also makes them less likely to have an severe adverse reaction to a vaccine, so it affects the risk/benefit of vaccinating just as much as not vaccinating.

I know that this decision is my responsibility as a parent. I know that I am weighing some risks against others, and that there’s a chance that things could go wrong. It is because of that responsibility that I read 3 books cover-to-cover on the subject, discarding two of them as trash and settling on one that I thought trustworthy before making my decisions. At the end of the day, I feel like I made the best decision I could, given the evidence I had, and I and my family are going to be the ones who have to live with the consequences, right or wrong. That’s a heady weight, and one that most parents probably don’t want to bear. But that’s the responsibility that comes with raising a child.

The problem will come when the kids need to go to school. The schools typically demand that you’re current with all or most of the vaccines on the CDC schedule. Most public schools will allow you to let your unvaccinated child attend if you claim a philosophical objection to vaccinations. It’s a major hassle, but they do allow it. The problem for me is that I don’t have a philosophical objection to vaccination (especially as an atheist — no religious reasons for me). One of the pieces of evidence against a philosophical objection is to give your child any vaccines — i.e. my piecemeal approach is not philosophical.

I do have a philosophical objection to bureaucratic one-size fits all government mandates, though, and thus I don’t accept that the government should be the one demanding that I follow their cost-benefit analysis for “most” kids when it doesn’t fit my family’s particular situation. My philosophical objection is being forced to take risks with my children that the CDC wants me to take, when I’ve evaluated the research myself and I disagree. That objection, though, is less well accepted in California than Scientology.
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Brad Warbiany
https://thelibertypapers.org/
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