Black Shards Press – Electronic Gumbo is Our Specialty

Ebola Nurse a Criminal?

30.10.2014 (9:11 pm) – Filed under: Health,Medicine,Stupidity ::

Kaci Hickox, a nurse who treated Ebola patients in Sierra Leone but has tested negative for the virus, went for a bike ride on Thursday, defying Maine’s order that she be quarantined in her home and setting up a legal collision with Governor Paul LePage.

Kaci Hickox and boyfriend Ted Wilbur go for a bike ride in Fort Kent

 

Hickox has flaunted her defiance of the governor by deliberately appearing in public over the last two days. Does this make her a common criminal?

The answer to the question is No, at least for the moment. Certainly Maine’s authorities would like nothing better than to take her into custody, if they were allowed to do so; however, no legal basis exists for her arrest.

This begs the question, however, of mere right or wrong. A certified health professional should know better than to endanger the public as Hickox has. The Hippocratic Oath applies to all health care workers and Hickox has plainly violated her duty to the citizens Maine by placing dozens, if not hundreds of people at risk. As such, the state would be well within its rights to begin the process of stripping her of her professional certifications.

Moreover, two nurses have already been diagnosed with Ebola after having previously been cleared. Despite her foolhardy bravado, Hickox could prove to be the Typhoid Mary of 2014 America, with even more deadly results. Should this happen, Hickox should be charged with 1 count of murder for each death she causes and be liable for the injuries and associated medical costs for all afflicted with the deadly disease because of her deliberate malfeasance.

Cardiologists Foresee Their Profession Ending Under DemCare

29.12.2009 (11:55 pm) – Filed under: Health,Medicine,Politics ::

USA Today reports that cardiologists, one of, if not the, most elite of surgical specialties, have filed suit against Kathleen Sebelius and the Health and Human Services department in hopes of heading off the Obama administration’s plans to make deep cuts in the amount of money Medicare will pay for life-saving heart exams and surgeries.

Some readers undoubtedly understand the inevitability of this action. For others, let me say that this is exactly the thing that I’ve been writing about in recent columns: Without sufficient compensation to the best and brightest of our physicians they will not stay in their professions, period. Moreover, the pool of newcomers to blighted fields will necessarily be of lower quality.

The lawsuit, filed in U.S. District Court for the Southern District of Florida, charges that the government’s planned cutbacks will deal a major blow to medical care in the USA, forcing thousands of cardiologists to shutter their offices, sell diagnostic equipment and work for hospitals, which charge more for the same procedures.

"What they’ve done is basically killed the private practice of cardiology," says Jack Lewin, CEO of the American College of Cardiology (ACC), which represents 90% of the roughly 40,000 heart specialists in the USA.

Any fool of a bureaucrat can cut costs in the short term by using the power of the government like a sledgehammer. I will never dispute that point. But what about the medium and long term effects? Is that even a consideration for this administration? Based on behavior, I would answer “No!”

Scott Smith, a cardiologist who works in rural Silver City, New Mexico had this to say:

“With all these cuts coming, it will make it impossible for me to break even seeing 40 patients a day.

"It’s so absurd, it’s kind of funny," he says. "I know ACC [American College of Cardiology] doesn’t think it’s funny. It’s an efficient way of getting rid of cardiology."

Surely that’s not an outcome desired by the Obama administration, is it? Perhaps it is. Health care must be allocated by some force, be it the market or the government. One way to shift costs from the elderly to younger, low-income patients would be to eliminate service offerings that cater to the former group.

Personally I don’t attribute such diabolical motives to the Obama administration. Nonetheless, such an outcome is in line with their stated goal of reducing Medicare spending while giving health insurance to the poor.

I do fear that this is merely the first of many instances of doctors being squeezed by government bureaucrats as a result of Democrats’ health care reform. As I’ve written before, such bully tactics are unacceptable and un-American. Doctors study long and hard to accumulate the knowledge and skill to execute their profession – longer and harder than any other – and they deserve to be rewarded in proportion to their talents and efforts. In no way should their income be constrained by the pay scale set forth by number crunchers in Washington D.C.

I’ll close with a question: Who do you want to take your 10-year-old daughter to see about heart surgery, a government-paid doctor with no incentive to do more than show up for an 8-hour day in the office and no chance to earn a better life for his/her own family or one who is free to practice medicine as he/she sees fit with the knowledge that any and all financial rewards are possible if positive results are attained in the O.R.?

(Consider conditions and outcomes at the government-run hospitals before answering…)

Taxing Cadillac Health Plans un-American

29.12.2009 (12:34 am) – Filed under: Health,Medicine,Politics ::

MIT professor Jonathan Gruber says that a plan to tax so-called “Cadillac” health care plans isn’t a tax at all. But what else could it be given Gruber’s own analysis of the Senate plan:

It would reduce the incentives for employers to provide excessively generous insurance, leading to more cost-conscious use of health care and, ultimately, lower spending. In other words, it "bends the curve." It would also be progressive, in that it would take from those with the most generous insurance to finance the expansion of coverage to those without insurance.

Admittedly I’m a mere public school simpleton, so there may be linguistic and economic nuances of which I’m incredibly ignorant. But where I’m from, if the government is going to “take from” one person and “finance the expansion of X” to another, that’s a tax. Dr. Gruber can pussyfoot around the wording until Judgment Day, but a tax is a tax is a tax. This all-to-common tendency on the part of liberals ne progressives to obfuscate rather than clarify is one of their more aggravating habits.

Call it what you will, the Senate plan Gruber endorses is un-American. Our Founding Fathers came to this country in order to live life on their own terms instead of kneeling to the government authority of their day. The notion that each man worked to provide for himself and his family and expected no assistance from outside that family is an integral part of the American story and perhaps THE essential element of our nation’s success.

(This is not to say that settlers didn’t work cooperatively and give charitably but rather that such group interactions were performed voluntarily and out of self-interest and so were in harmony with the idea of individualism.)

It is entirely noble of Democratic politicians to seek to provide medical care to the poor. Yet it is ignoble in the extreme to use the power of government to force charity from their unwilling fellow citizens.

Consider a land owner with a single apple tree on his property. He plants the seed one spring day in the hope that some years hence it will bear fruit. In the intervening years the man nurtures the plan, bringing it water from his well in drought and fertilizer in the proper amount from his stables, covering it against the cold and picking worms from among its leaves when they come. A decade passes and the man receives the first yield from the tree: 100 perfect Golden Delicious apples.

What claim does the government have on 40 of these apples? By what right does it deprive the man and his family of the fruit of his labor?

Of what concern is it to the government that the man’s neighbor to the left failed to plant a seed at all for fear of having to work to cultivate his own tree? Why should the government consider the neighbor on the right who planted a seed from the self-same core as the hard-working individual but through neglect or incompetence or drunkenness failed to raise a producing tree?

I am not immune from envy, though I try to steel myself against its soul-corroding effects. A health care plan costing $25,000/year would be a significant improvement for my family over our current coverage. But it is not my right to demand that a man in a more prestigious position or with greater wealth give me his plan so that we might be equal.

Such a demand flies directly in the face of every principle on which this country was founded. Moreover, a government that would enforce such a demand using its confiscatory and police powers is not one that bases its actions on the authority granted it by the Constitution.

Wisdom might indicate to such a man that his cup overfloweth and that Christian charity is called for. But if such mercy is not in the man’s heart, it is neither for Congress nor the president to force him to yield. This is, above all else, the singular principle that lies at the heart of what it means to be American. Destroy it and you destroy America.

Democratic Grinches Ruin Medical Care System on Christmas Eve

24.12.2009 (11:21 am) – Filed under: Health,Medicine,Politics ::

In a straight party-line vote, Democrats in the U.S. Senate today passed a health care system reform bill through their side of Congress, despite the fact that a sizable majority of voters oppose the measure. While it’s possible that the bill, which is over 2000 pages long at this point, may come apart in negotiations with the House, it’s more likely that this conglomeration of ill-thought, large parts of which are still unread by senators who voted for it, will become law.

This is a historic wrong on so many levels it’s nearly impossible to confront the flaws in this mess with a unified argument. To tackle them all would necessitate a book nearly the size of the bill itself, a daunting task and one certain to be without payback. The Democrats will ram this thing down the throats of real Americans – those who work and pay taxes and provide for their own medical care – regardless of what anyone who opposes them says or does.

According to Dianne Feinstein, a liberal Democrat from California, the industry “lacks a moral compass.” I’m sure that’s true, for the idea is in itself an oxymoron. Business does not exist for the purpose of exerting moral authority any more than governments do. Instead companies come into being for the sole purpose of providing goods and services for a price greater than what it costs to produce and provide them. Morality is not part of the equation on a systemic level, although individual actors within companies and industries of course guide their paths of development.

In the medical field it’s obvious to any casual observer that the primary actors in the system are doctors. The medical industry was created by men and women who provided health care services in exchange for payment. Undoubtedly some were moved by love of their fellow man; however, most were motivated to the field by a combination of aptitude and the desire to avoid the manual labor performed by their peers. In other words, doctors use their minds and skills to make a better life for themselves, their actions being the essence of the American Dream as it was defined by our Founding Fathers.

Remove doctors from the medical field and what are you left with? An empty shell, bereft of value to those who need its services. Democrats’ motives are in some respects admirable, but their thought process is lacking. Remove the advantages bestowed on members of the medical profession and you remove the motivation for the best and brightest among us to make the sacrifices needed to enter this important field.

Yes, others will certainly take their place in medical school and in practice, but the inevitable result will be a decline in the quality of care provided as a result of this mind shift. Yet the Democrats’ bill is focused, as it necessarily must be, on reducing costs and increasing systematic compliance, both of which have negative impacts on doctors and will inexorably lead, over time, to a brain drain in the medical field, a fact that Democrats doggedly ignore.

Liberals prefer instead to trumpet the need to provide medical insurance to people who cannot pay for it themselves, a goal that has some merit to it. What they conveniently ignore is history. Skyrocketing medical costs are a reality that effectively denies 5-10% of Americans access to medical services. But liberals fail to consider the key part in which their own past policies in creating this new, unfortunate situation.

Medicare, for instance, exists solely to shift the costs of late-in-life care away from those 60+ to current workers and their families. Providing medical care to the elderly is a noble goal; however, accomplishing it requires a massive transfer of wealth in order to reach it. Moreover, the inefficiency inherent in such government programs makes draconian cost-reduction measures a necessity on the provider side of the equation.

As is well-known, medical providers receive only 75-80% of the revenue from Medicare patients as they do from others. This has two effects: First, costs are increased for non-Medicare patients. This warps the health care market out of shape, the effect of which is effectively a hidden tax on working families; Second, some medical providers refuse to provide services to Medicare patients, thus reducing both convenience and quality of care to those the plan aims to help.

A second, more subtle problem with the Medicare entitlement is the mental attitudes that it fosters among both patients and physicians, namely that unlimited medical care is an essential right of every American and that equal outcomes, medically speaking, are both deserved and desirable for all Americans.

That neither is true has not stopped the creeping advance of the misguided notion that every conceivable medical treatment should be available to every American throughout every day of our lives, regardless of the cost and who must pay to provide marginally inefficient care. To put it simply, medical costs have increased in large part because Americans have come to believe the lie that they are entitled to use medical resources as if they had no cost, much like the air we breathe.

Now Democrats in Congress are on the verge of taking this fundamental wrong and increasing its scope to the breadth and width of the American populace. In fact, it may already be too late to stop this from happening – the wheels have been greased in part thanks to the hundreds of millions of dollars in “political bribes” paid to Senators Ben Nelson of Nebraska and Mary Landrieu of Louisiana.

All that stands in the path of their success and the decline of our system of medicine is the willingness of House Democrats to compromise away their support for government funded abortion. This will happen, despite the inevitable whining from the fringe left who will have to wait a few more years to sneak their abortion agenda into the national plan.

Yet perhaps if Americans who oppose this plan’s enactment take time over the holidays to remind their congressmen of their wishes all will not be lost.

The vast majority of Americans have access to the finest health care that has ever been available. We demand that the profit motive that lies behind this system, the motive that is the sole reason for that system to exist, be respected. We demand that doctors be left free and unfettered to research and to provide care as they see fit. We demand that we be allowed to seek medical care according to our own desires to receive it and our ability to pay for it. We demand, in short, for government to restrict itself to its proper functions, none of which have anything to do with medicine.

On the Potential Passing of Byrd, DemCare

21.12.2009 (10:26 pm) – Filed under: Medicine,Politics ::

Liberal blogger Matt Yglesias charges that Republicans are “hoping that they can stall long enough for Robert Byrd to die” in order to derail Democrats’ sweeping health care plans.

The fact is that Senator Byrd has lacked the mental and physical capacity to perform his duties for several years, perhaps a decade or longer. The man is a national disgrace for, while he undoubtedly loves serving his country in his way, he’s allowed pride and agenda to take the place of good sense, which would have had him resign long since.

Far be it from me to wish ill on Senator Byrd. It is nevertheless true that the fiasco Democrats are about to foist on American taxpayers demands opposition from every quarter, with all possible vigor, the whiny protests from liberals notwithstanding. The fact of the matter is that we don’t want Robert Byrd to die – we just want the left-wing do-gooders to leave us alone. That’s all and it doesn’t seem too much to ask, frankly.

Even CNN admits that more Americans want to see DemCare derailed than want to see it passed. Take a hint, kids, and maybe we’ll let you stay in office.

Government Medicine Ethics

07.11.2009 (10:39 pm) – Filed under: Health,Medicine,Politics ::

Sarah Palin is making waves by saying that the Democrats’ mega-healthcare plan – which seems likely to pass the House at any moment – will give government the power of life and death over the elderly and infirm. Of course this is true. Of course it is. It’s simple common sense that whoever controls the money controls the process. That’s one of the things that’s wrong with government-run medicine: It puts control in hands of the one group who it should never be given to – government bureaucrats.

Palin:

“In order to save government money, government health care has to be rationed… [so] than this elderly person that perhaps could be seen as costing taxpayers to pay for a non-productive life? Do you think our elderly will be first in line for limited health care? 

And what about the child who perhaps isn’t deemed normal or perfect per someone’s subjective measure of their use or questionable purpose in the eyes of a panel of bureaucrats making our healthcare decisions for us?”

Look, scarce resources have to be allocated according using some criteria. Currently that criteria is primarily based on financial success. Americans employed in middle and upper level positions have the best health care in the world. The lower end of the employment market and the unemployable get what’s left. You may not like it, but it’s a rationing system with a logical rational: The best and brightest get the best medical care.

Liberals want to change the allocation scheme to one controlled by a government bureaucracy because they believe that a government-run rationing scheme is more equitable than one based on ability and competition.

Nevertheless, theirs will still a rationing scheme, albeit one doled out by the Grays in the D.C. bureaucracy rather than by employment/cost-based allocation.  Nothing will ever change that elementary fact. The only difference is that liberals want to believe that health care is a basic right of being an American while conservatives believe that it, like all other goods and services, must be earned.

As the ultimate payer, by definition the government will have veto power over medical care provided to those persons subject to their plan. This is undeniable. When President Obama says that a public option will not change your current health care coverage he is, frankly, lying. It is inevitable that employers will stop providing medical insurance stipends if a government plan exists. Why should they when doing so would put them at a competitive disadvantage?

Indeed, the only time businesses undertake actions that damage their financial viability is when the government mandates them. No such mandate will exist for employers to continue to provide medical insurance. Just the opposite is true, because Democrats want private insurance to die off and be replaced by a government-run option.

Palin’s argument that the same philosophy that allows abortion rights could soon be invoked to allow the government to cut off health care from those it deems undesirable may sound extreme. But the truth is that when government controls the funding for public health care it is obligated to make those sorts of decisions in order to keep the plan solvent.

This, of course, is the one outcome that Americans should do everything in their power to avoid.

Democrats Making Health Care Worse

26.10.2009 (8:56 pm) – Filed under: Health,Medicine,Politics ::

Paul Krugman wonders how health care will work after the Democrats’ proposed reforms pass through Congress.  That question may be premature, although it’s a good bet that they will pass something “ugly”, in the words of Steven Hayes.

Here’s my prediction: If Democrats succeed in forcing a publicly-funded health care plan into law, it will not do anything to improve services or lower costs.  If they don’t, what’s the point of doing anything at all?

The reason why a public option will be a marginal product is self-evident.  Simply imagine a Medicare program increased by an order of magnitude and you have the disaster envisioned by Harry Reid, Nancy Pelosi, and the communist kids at Kos.

If Democrats cared about lowering health care costs then they would be looking at ways to provide health care consumers with real choices.  They are not doing so by implementing a taxpayer-funded plan because the plan will either be a financial failure like Medicare or succeed in driving private insurers out of business.  Neither is a win for consumers.

What would make a difference for real Americans, the ones who work and pay and die in this country, is to have actual choices for health insurance.  The first step in making real choice available would be to remove decades of legislation that stops insurers from competing on a national level.  Sweep aside this outdated flotsam and insurers will be forced to compete harder simply to survive.

A second step to more competitive markets would be to do away with employer-sponsored health plans.  This may sound like a radical step, but consider how insane the current situation is.  Employers have no business picking insurance plans for their employees, yet that is exactly what happens to most Americans.  If we want the employer money – which we must have simply to pay the premiums each month – we have to take the plan or plans they offer.  This is anti-competitive in the extreme.  Employers should stop offering health care plans and pay people for doing their jobs.  Employees can then go and purchase a plan that makes sense for them on the open market.

A third and different thing that Americans need is a health care savings account.  We should be paying for our own future health care expenses in advance, when we’re young, healthy, and don’t need the medical care.  Think of it as a 401k for retirement’s inevitable decline in health.  The health care spending accounts that many of us have are pale imitations of a real savings account and should be dropped.

Given that Democrats are not talking about any of these essential reforms, it seems apparent that they are simply interested in making their political hay by pandering to the ultra-liberal left that has been clamoring non-stop for socialized medicine for decades.  Their time – and ours – would be better spent on a serious discussion of the issues, not playing intra-party politics with our medical care.

The Health Care Debate We’re Not Having

20.08.2009 (2:58 pm) – Filed under: Health,Medicine,Politics ::

imageI was privy to an an email Michael Merritt recently received from a self-described liberal who called him an idiot for writing about the hypocrisy of the left’s attacks on John Mackey, CEO of Whole Foods.  In the exchange that followed, that hypocrisy was demonstrated at its most fundamental level by Michael’s accuser.  Free speech and individual thought are, in the minds of liberals, their birthright alone and must be denied to anyone who doesn’t think and speech in like fashion.

That was John Mackey’s crime.  Mackey is the president of a company that manufactures products deemed acceptable to the true believers on the left.  At least they were acceptable until Mackey wrote this gem of an editorial for the Wall Street Journal, which included this pithy truth that incensed many of his leftist customers:

A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That’s because there isn’t any. This “right” has never existed in America.

Indeed, this is the core of the matter and what should be the center of the health care debate.  Unfortunately, the discussion is centered elsewhere, the unfortunate and incorrect assumption that health care is a God-given right having been tacitly accepted by leaders of both parties.

Presumedly this acceptance, made evident by Republicans having provided their own version of an expanded government health care program, was made semi-consciously, the reflexive act of politicians shying away from a controversial principle and the necessity to uphold it, for political reasons.

Nevertheless, this is the health care debate that we should be having.  The question should be, “Should the government offer any sort of health care benefit?”, not “What kind of health care program should we implement, how much should it cost, and who will it cover?”  These are interesting questions; however, until the former is answered, resoundingly, as an affirmative they are also irrelevant.

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Liberals’ Single-Payer System to Get Floor Vote

01.08.2009 (8:04 pm) – Filed under: Medicine,Politics ::

image Probably tired of the shrill voices in his ear, Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) has evidently given in to liberal Democrats such that there will be a floor vote in the House on a government-run, single-payer system, saying “I believe their wishes will be accommodated.” 

I am not for another, larger government-bungled system. The Veterans Affairs system amply demonstrates what health care would be like if it were run by the federal government.

Nevertheless, I also think that the floor vote on the liberals’ proposal is a good thing. A significant number of representatives – and more importantly of American citizens – think such a system is just what we need. Categorically, it’s not. But let’s get the proposal out on the table, in the full light of day, and reject it so that we can move on to the next, slightly-less-bad idea.

Demanding Health Care as a Right is Wrong

08.07.2009 (7:08 am) – Filed under: Health,Medicine ::

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Even the debate over health care is not immune from commentators whose caustic, even violent rhetoric would be more at home at a third-world pit fight than in a democratic society.  Witness one Dr. Kirk James Murphy, whose idea of the Hippocratic Oath is apparently limited to those he personally approves of:

The megacorps executives don’t deserve mere corporate bankruptcy: they’ve killed and maimed so many of us to deserve a fate worse than Gitmo. In a world free of human rights concerns, I’d cheerfully nominate them all – and their in house / outside legal counsel and lobbyists – for mandatory total organ donation. Though these heartless bastards don’t have anything to offer those awaiting cardiac transplant, the rest of the transplant lists could use the relief.

Doctor, please, your hatred of free enterprise is showing and it’s not pretty.

Read the rest of Murphy’s article if you feel you must.  It can be summarized as follows: “Every one of my patients is entitled to free health care on demand, without regard to price, because I say so.”

It would be great if we could provide unlimited medical care to every man, woman, and child in America.  It really would.  But that’s unrealistic and a doctor like Murphy should know better than to get on his soap box and pretend that universal health care can be delivered without a massive transfer of wealth from the middle and upper classes to the poor and a corresponding reduction in the standard of care delivered to those who would be paying for the system.

If health care were part of the so-called “commons”, as air and water are, Murphy’s demand for universal health care would make sense.  But the truth is that medical care does not exist in elemental form.  Health care comes into being only through the study and labor of the best minds in America and these doctors and nurses deserve to be compensated according to the value they deliver to their patients. 

This is the mechanism through which our most gifted people are attracted to the medical industry.  Remove it and the result will be a reduction in the quality and supply of health care to people who need it.  This has already happened in regard to Medicare patients, many of whom have to settle for substandard care because of the program’s cost restrictions and overhead.

Hoping to drum up an emotional response, Murphy hysterically cries that his patients are dying and that he could save them if we would only give him carte blanche with our health care dollars. 

Unfortunately we’re all dying and it can’t be helped – it’s in our make-up.  No one’s like is truly saved by medicine, only prolonged.  In itself this is a noble goal and not to be diminished.  But it should be recognized for what it is, a short-term, earthly solution to the real problem, which is fear of eternity.