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Continuing Education for Professionals

Dan McGowan’s review of some claims that have recently been made about problems in the Providence school district is worth a read.  Broadly speaking, the claims about the school facilities themselves proved to have been exaggerated, while problems with management of teachers were not so much.

This item raises something that I’ve wondered about before — specifically, how much emphasis people really put on “professional development”:

Teachers get one day of professional development a year.

Grade: C

During a series of public forums following the release of the report, Infante-Green often asked attendees the same question: Would you go to a doctor who only received one day of training each year? While it is accurate that the current union contract only requires one professional development day during the school year, more nuance is required. Union president Maribeth Calabro and the Elorza administration maintain most teachers receive significantly more training each year. As an example, Calabro said at least half of her members have attended professional development sessions during their current summer vacation.

To be honest, I’d have no problem discovering that my doctor has only “one day of training each year.”  Doctors spend every day analyzing patients and determining the best treatments for their ailments.  One can expect that they are continually reviewing the latest information that might help them to do their jobs better.

The idea that they’ll simply coast along for their entire careers — doing the equivalent of handing out photocopied worksheets year after year — just seems strange.  Some will be better about this and some will be worse, but the fact that a doctor dedicated more than one day to some government-approved course of study that may or may not be relevant to my health and that may or may not have focused on some medical fad or PC indoctrination would not impress me at all.

So the question, then, is why we shouldn’t expect the same from teachers.  They have a 180-day work year.  Why should we assume that if we don’t use up some of those days for “professional development” instead of teaching, they’ll just let their skills atrophy and knowledge become antiquated?

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A Better Way to Cover Americans

With the State of Rhode Island writing ObamaCare into state law with this year’s budget, it’s worth noting a proposal floating around in conservative circles and the Trump Administration, as Avik Roy articulates here:

Last week, the White House finalized a new rule that allows employers to fund health reimbursement arrangements (HRAs) that can be used by workers to buy their own coverage on the individual market. This subtle, technical tweak has the potential to revolutionize the private health insurance market. …

The administration estimates that as many as 800,000 employers — mostly smaller businesses — will choose this option, expanding health care choices for 11 million workers in the next decade. These employers will benefit from having fiscal certainty over their health expenditures. And workers will benefit from being able to choose their coverage and take it from job to job.

This is the health-care-market fix for which I’ve been advocating for years.  Everybody would get accounts, and employers could put money into them for their employees.  So could the government, as welfare benefits, and so could charities.  So could parents or even concerned members of a community after some surprise accident or illness for a neighbor.

At the same time, eliminate most mandatory coverages for health insurance so people for whom it makes sense can buy catastrophic coverage inexpensively.  That way everybody is covered for emergencies and nobody ever has a preexisting condition, because everybody has always had some sort of coverage.  At the same time, Americans would be better able to make health care decisions because they’d more often be paying directly for the services they receive and doing the cost-benefit analyses that people several steps removed from their situations can’t possibly do.

Of course, under such a system politicians attempting to buy votes would have to be more direct about it.  They’d be limited to transparently depositing taxpayer money into accounts instead of implicitly driving up costs in our opaque system by requiring insurers to cover certain benefits.  But in a fair analysis, a better, more-sustainable health care system that doesn’t distort the employment market is probably a little bit preferable to enabling corruption in politics.

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Rhode Island: An OK Place to Live

Obviously, the more subjective the thing an index attempts to measure, the more subject it will be to interpretation, and WalletHub has made a cottage industry of cranking out subjective rankings.  That said, the Web site’s “Best States to Live in” ranking from June has some interesting considerations for the Ocean State.

Notably, the Ocean State is supposedly the 29th best state in which to live… which seems OK, considering Rhode Islanders’ expectation to come in at the very bottom of all rankings.  OK begins to look not so good, though, when one zooms out on the map.  WalletHub claims Massachusetts is #1 and New Hampshire #3.  Vermont and Maine are both in the teens, and Connecticut comes in at #20.

Looking at the subcategories, RI’s worst result was in “affordability,” which shouldn’t surprise anybody.  The Ocean State was the fourth least affordable state, after New York, California, and New Jersey.  But here’s the thing:  No New England states are very affordable.  Massachusetts, for example, is 43rd and New Hampshire is 42nd.

So what makes the difference?  Massachusetts is in the top 5 for everything else:  economy, education & health, quality of life, and safety.  New Hampshire only misses the top 5 in quality of life.  Meanwhile, Rhode Island only breaks the top 20 on the safety subcategory (at #5).  The conclusion is that Rhode Island might not be able to avoid being expensive, but that only means it can’t afford to be unattractive by other measures.

Here’s where the subjectivity of the index becomes important.  Quality of life includes things that Rhode Island can’t help, like the weather, and things that depend on one’s values and interests.  The importance of “miles of trails for bicycling and walking” will vary from person to person.

But quality of life also includes things like the quality of the roads, which is pretty universally valued.  Meanwhile, multiple criteria that the index uses center around leisure activities that cost money, which means disposable income is a factor, as is the ease with which businesses can pop up to answer the demand.

MIT’s Living Wage Calculator states that a single Rhode Islander needs to make $12.35 per hour over a 2,080-hour workyear.  However, $1.86 of that goes to taxes.  For comparison, in New Hampshire, only $1.50 per hour goes to taxes.

This all suggests an unsurprising solution for improving Rhode Island’s standing:  lower taxes, use the money that is collected for things that are of more universal value, and decrease regulations.  We’d all have more money to spend, we’d feel better about our day-to-day life, and we’d be better able to answer each other’s needs.

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Straight Up Taxpayer Dollars for Promise of a New Treatment

After Steve Ahlquist firstbrought attention to the million dollar handout that the Rhode Island House wishes to give to Dr. Victor Pedro for his Cortical Integrative Therapy (CIT), a WPRI report covered the history of Pedro’s taxpayer funding.  One can’t help but feel that there must be more to the story:

  • Legislative leaders have long gone to bat for the doctor.
  • The executive branch has apparently made extra efforts to secure Medicaid funding for his treatments.
  • And even mild-mannered Lieutenant Governor Daniel McGee has spoken well of Pedro, including his activities in Cumberland schools back when McKee was mainly known as a mayor for that town.

Amazingly, though, nobody has yet mentioned the connection of pop star Paula Abdul, which takes an only-in-Rhode-Island turn.  Says Abdul:

I wish I’d had Cortical Integrative Therapy when I first discovered I had RSD, and I wish Dr. Pedro had been a part of my support system then like he is now.  The treatment replaces the old tapes in your head that have held onto the tapes of pain.  It helps your brain to allow for new experiences and new memories that don’t involve pain.  Think of it in terms of a computer — you’re deleting old files so you can free up more space.  I didn’t find out about Cortical Integrative Therapy until recently, and it has proved to be a life-changing treatment for my RSD.

The strange Rhode Island turn is that Abdul has another connection to Rhode Island as the long-time girlfriend of John Caprio, son of Caught in Providence star judge Frank Caprio and brother of the former treasurer and gubernatorial candidate of the same name as well as former representative David Caprio.  Various online sources also seem to indicate that Abdul has set up various businesses at 2220 Plainfield Pike in Cranston in the past.

This topic could certainly take a serious turn into political theory as an example of why government shouldn’t be in the investment and research business, why Rhode Island should end legislative grants, and why the governor should have the line-item veto.  If Pedro is an innovative practitioner of alternative medicine for the stars, he shouldn’t need government subsidies.

For this post, though, let’s just close with a sincere hope that Rhode Island’s press is sufficiently interested to unravel this entire peculiar tale.

Somewhere around Twitter, I saw somebody complain that people are spreading "lies" about Virginia Democrats.  The on-point response from somebody else (paraphrasing):  "People are spreading direct quotes."

The Danger of Saving a Child’s Life

Even if I could somehow adjust for the fact that I agree with his views on abortion and human life, I think I would still struggle to understand how a story like that of Argentinian doctor Leandro Rodriguez Lastra could fail to spark cognitive dissonance among supporters of abortion:

Rodríguez is the head of the department of gynecology at the Pedro Moguillansky Hospital in Cipoletti. In May 2017, he treated a 19-year-old woman who was suffering severe pain due to ingesting misoprostol, the first of a two-part abortion pill regimen, which had been administered by an abortion group.

The doctor confirmed that the woman was almost 23 weeks pregnant and the baby weighed more than 1 lb. 2 oz., so in conjunction with the medical team and the hospital board, he decided not to terminate the pregnancy.

Rodríguez stabilized the patient and when the baby reached 35 weeks gestation, labor was induced. Days later, the baby was adopted and will soon be two years old.

This is in the news, right now, because Rodriguez faces two years in prison for the act of saving two lives.  One of the two wanted him to finish the job of killing the other, which she had started.

How — How? — could anybody think of that now-two-year-old child and think to him or her self, “This doctor must be punished because that child is alive”?  Is the child Damian, the Antichrist?

Of course it’s not this specific child.  Rather the motivation is to make of Dr. Rodriguez an example, so that doctors’ desire to save lives cannot disrupt the principle of infanticide — or, one step closer to the higher principle, complete sexual liberty.

Whether the focus is the child or the doctor, however, a society that sees either as a danger requiring punishment could not have a clearer need for self reflection.

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Dr. Stephen Skoly: Opioid Tax Bill Would Harm Families and Businesses and Do Nothing to Address the Problem

The opioid epidemic is a widespread, complicated problem, and only a collective effort will begin to solve it. The healthcare community and lawmakers need to work in tandem to find policies that effectively lessen opioid abuse while still keeping our state’s economic health as well the health and safety of the patient in mind. It’s unfortunate, however, that Senate Bill S0798, the Opioid Stewardship Act, fails on both accounts.

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Standing Up to the Forces of Modern Mania

Western civilization is in the throes of a mania, and the circumstance is precisely one in which religious people should prove the fortitude that they derive from their faith.  So, no, Catholic health plans should not cover transgender surgeries.  Agree or disagree with the policy, but there can be no argument that bodily mutilation — particularly of minors who have self-diagnosed their psychiatric needs — conflicts with Catholic teaching.

Unfortunately, powerful organizations are intent on disallowing Catholicism — or any traditional religion — from being anybody’s guide to how we organize our lives:

The ACLU cited standards of care from the World Professional Association for Transgender Health, saying these standards are recognized as authoritative by the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics. …

Omar Gonzalez-Pagan, a senior attorney with the LGBT legal group Lambda Legal, said that employer plans appear to be changing to include transgender services, many individual hospitals and doctors, especially Catholic ones, decline such services on the grounds of religious exemptions.

“It is a growing problem that we are seeing nationally because of the consolidation of hospitals,” he told Crosscut, noting that most hospitals in Washington state are Catholic-affiliated.

It doesn’t take much for a mania to grip a society (with the persuasive influence, religious folks might suggest, of malevolent whispers). Changing the impulses of certain slice of a professional class and a handful of influential organizations suffices to turn social institutions like our judicial system into weapons.

The issue is not a conditional one of determining what approach to a challenging problem will have the best overall effect.  When that is the case, a religiously founded organization can legitimately conclude that some accommodation to the outside world is allowable in order to continue its unrelated good works.

At issue, here, is whether the Church believes what it has preached and, more importantly, whether its faith in God is sufficient to stand against activists intent on perpetuating evil.  That pervasive fortitude is critical to both to the Church’s religious mission and to the continued advancement of Western civilization.

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Finland’s Health Care and a Culture That Can’t Balance

Maybe progressives are right.  Americans should look to Finland for lessons in government-driven universal health care:

The government of Finland collapsed Friday due to the rising cost of universal health care and the prime minister’s failure to enact reforms to the system.

Prime Minister Juha Sipila and the rest of the cabinet resigned after the governing coalition failed to pass reforms in parliament to the country’s regional government and health services, the Wall Street Journal reports. Finland faces an aging population, with around 26 percent of its citizens expected to be over 65 by the year 2030, an increase of 5 percent from today. …

Sipila said “there’s no other way for Finland to succeed” besides these reforms, which could have led to $3.4 billion in savings for the government.

In political philosophy, there is always a challenging balance to be struck when finding the boundaries for government action and defining what some citizens can demand from others using government force.  At the end of the day, most of the work ensuring that the balance doesn’t tip must be done in the culture, with our un-legislated sense of what is right and what is unjust.

We’re reaching the point in the United States that the balance is no more subtle than the political ability to force a change through.  (Witness ObamaCare.)  It is our deteriorating culture more than anything that ensures that any benefit, once granted, can never be taken away, even in the face of calamitous unintended consequences.

(Hat tip: Legal Insurrection)

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Rhode Island Needs A Freedom Agenda. (And It’s Coming This Week.)

The Ocean State is doomed to lose a US Congressional seat because of its hostile tax, educational, and business environment. The state’s current thinking chases away the wealth, families, and businesses that are needed for all of us to be truly prosperous. The far-left big government policies that have reigned in our state for far too long will continue to only make matters far worse. Instead, we need a change of direction.

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The Counterintuitive Consequences of Birth Control

A bit of recent research appears to confirm something I’ve been arguing from theoretical grounds for decades:

Access to the birth control pill in the U.S. has increased the births of children outside of marriage, especially among poor and minority women, according to a new study of the contraceptive’s historic effects.

“Our findings add to a growing literature which documents the power of the pill to shape women’s lives in broadly heterogenous ways, with minority and less-well-educated women bearing the brunt of the losses, a phenomenon we call the paradox of the pill,” economics professors Andrew Beauchamp and Catherine R. Pakaluk said in their paper, “The Paradox of the Pill: Heterogeneous Effects of Oral Contraceptive Access.”

“We find robust evidence that access to the pill increased nonmarital childbearing and reduced the likelihood of high-school graduation,” they said.

There are two important principles coming into view, here.  The first is something I wrote about in a 2004 post about the trajectory that our thoughts about sex, marriage, and family have been on, as a culture.  The relevant point, here, is that contraception intellectually and culturally separates sex from procreation.

Consequently, regardless of whether a particular couple is using contraception (or using it correctly), people begin behaving sexually as if children aren’t really a consideration.  When one is conceived, therefore, the tendency will be to blame the contraception, or its lack of availability, or whatever reasons one might have for not using it.  The pregnancy therefore seems unfair, increasing the demand for abortion.

The second principle is one that I expressed frequently when same-sex marriage was still a matter of public debate.  Namely, that people who don’t necessarily need marriage in order to have healthy relationships or to raise children reasonably well are actually investing in a culture of marriage that benefits more-vulnerable people.

We see the same thing with contraception.  More-privileged groups of people will not only have more access to contraception but also stronger cultural guides for the regulation of their behavior.  Yet, their view of sex will define the culture and affect the behavior of those who are less privileged and less responsible.

One aspect of the abortion debate with which one really must contend is the deception of those who advocate for abortion as a right, starting with the idea that legislation to preserve women's ability to kill their unborn children in the womb is about "reproductive health care."  Reproductive of what?

The Strange Assertions of Abortion Advocates

One aspect of the abortion debate with which one really must contend is the deception of those who advocate for abortion as a right, starting with the idea that legislation to preserve women’s ability to kill their unborn children in the womb is about “reproductive health care.”  Reproductive of what?

So much of the pro-abortion argument requires distortion of the language and concepts that are involved.  Why that is should be obvious.  The other day, a progressive state senator from Providence, Gayle Goldin, and Providence Journal reporter Katnerine Gregg responded to news that a judge had struck down an Iowa law restricting abortion when the baby’s heartbeat can be detected, implying that it’s a concern because it may give the U.S. Supreme Court an opportunity to address the question of abortion.

Think of the underlying issue.

This law that is, at the moment, arguably unconstitutional essentially states that if an unborn child is so provably unique from the mother as to have his or her own heartbeat, a doctor can’t suck out his or her brain, tear him or her limb from limb, or otherwise kill the child (presumably except to save the life of the mother).  When that’s the fact of the act, the only way to maintain support has got to be to misdirect attention some other way.

Activists at the Rhode Island State House, the other day, emphasized minorities’ access to abortion, but starting from a different perspective paints a very different picture.  Something around 8% of Rhode Island’s population is black, but they account for some 16% of abortions.  Abortion kills black babies at about twice the rate that it kills white babies in the Ocean State.

A chart from the Guttmacher Institute shows that minorities, especially black non-Hispanics, have much higher abortion rates than white non-Hispanics, yet the claim of the chart is that “lack of access to health insurance and health care plays a role, as do racism and discrimination,” in abortion rates that vary by race.   Is Guttmacher, which is associated with Planned Parenthood, suggesting that racism leads to the higher rates, or is it suggesting that, but for racism and discrimination, the United States would have even higher rates for killing black babies.

That’s what the Providence activists would seem to be suggesting when they talk about “access.”  Pursuing policies that would keep a significant portion of a minority population alive is a strange kind of bigotry.

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Learn the Lesson, Rhode Island: Doctor Shortage

It’s anecdotal, to be sure, but add Ellen Lenox Smith’s letter in the Providence Journal to the evidence that Rhode Island has a worsening doctor problem:

Just last week, I had an appointment with my pulmonologist, who shared that out of the four doctors in his practice, only two are now left. This poor doctor is expected to take on the work of the two that are now gone along with his original patients, and they are not intending to replace those gone. I am so concerned that he will decide it isn’t worth it and leave, too.

This is not the type of medicine he planned of doing: overstretched, overtired and not able to care for his patients in the manner he was first hired to do.

Rhode Island imposes a high number of mandated coverages on health insurance, driving up the cost.  We’ve pushed nearly one-third of our population into Medicaid.  And our laws are restrictive when it comes to occupational licensing, regulations, and taxation.

This environment of massive government control puts a lot of pressure on the prices that providers can charge customers, which has an effect on how much time they can afford to spend with them, meaning that the job may not be what they wanted it to be.

We need to learn this lesson, because ideological and motivated activists are trying to push our state even farther down this road.  Market forces allow us to match up the things that people want done (and can afford) on one hand and the things that other people are willing to do (for an income they are willing to accept) on the other.

Messing with that freedom-derived balance means that something else is determining who gets what from whom.  Then, the incentives of politics will make it more beneficial to promise the moon to the getters at the expense of the providers.  Even if the current providers tough that out and don’t cross the border, we’ll inevitably see fewer new ones as time goes forward, and everybody will suffer.

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“Choice” is Clear in Upcoming Furious Healthcare Debate

A federal judge recently ruled that Obamacare is unconstitutional because the individual mandate, repealed in the 2017 federal Tax Cuts and Jobs Act, is no longer in force. Even though existing federal health-care laws will remain in effect during the appeals process, states should not panic and codify Obamacare into state law, as it is not certain how long federal subsidies will remain intact.

While the courts hear the appeals, and with Democrats winning back control of the U.S. House of Representatives largely on the health-care issue, another furious debate is about to unfold.

Democrats will probably introduce some kind of government-centric plan, while Republicans are poised to introduce their own free-enterprise solution. What we all want are simply more choices at lower net costs.

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When Public Policy Squeezes Out Providers

The aptly named Stanley Bleecker foresees a problem for Rhode Islanders needing health care in the future:

Can you imagine a time when sick people will not have access to a doctor when they are in need of treatment and medical advice? I can. Recently, because of my primary doctor’s retirement, I had to find an internist and also a specialist. It was not easy. After some effort, I did secure an appointment for an annual physical with a new internist, but the earliest appointment I could get was scheduled for 12 months down the road. Subsequently, I learned my new doctor (whom I still have not yet met) has closed his practice to new patients.

The shortage is a result of many Rhode Island doctors taking early retirement or leaving to practice in other states where insurance payments are higher. Practicing doctors tell me that young doctors are not interested in practicing in Rhode Island because of low insurance payments.

Mr. Bleecker might be somewhat encouraged to learn that Rhode Island has legalized the provision of telemedicine, whereby patients don’t have to be physically present in the office to receive care.  Of course, this being Rhode Island, there’s a catch:

Rhode Island providers, however, may not use telemedicine to deliver health care services across state borders. This limitation is subject to change if Rhode Island lawmakers choose to enter the Interstate Medical Licensure Compact (“IMLC”).

In some respects, Rhode Island is moving in the wrong direction:

Similarly, Rhode Island nurses may not deliver health care services via telemedicine to patients across state borders. This was not always the case. For nearly a decade, Rhode Island was a member of the Nurse Licensure Compact (“NLC”), which permitted Rhode Island registered nurses and licensed/practical vocational nurses to use telemedicine to provide health care in 24 other states across the country.

Attentive readers might recall that Donna Cook pointed this out back in September, as a problem for professional nurses.

This shouldn’t be such a hard lesson.  When government makes it more difficult to pursue a profession or creates artificial markets with near monopolies for insurers, people will stop finding it worthwhile to go into that line of work, here.  Too often, those who craft our laws imagine that the targets of their impositions will not react.

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Where Would Excess Health Insurance CEO Pay Go

So, socialist Senator Bernie Sanders is on Twitter highlighting the pay of health insurance CEOs:

What insurance company CEOs made in 2017:
-Leonard Schleifer (Regeneron): $95.3 million
-Dave Wichmann (UnitedHealth): $83.2 million
-Mark Bertolini (Aetna): $58.7 million

We need a system that provides health care for all, not massive compensation for a few CEOs.

Putting aside Regeneron, which is not an insurance company and is therefore a different conversation, I agree with Sanders that these pay amounts are excessive, but the senator skates by an important point:  The reason insurance companies can do this sort of thing is that government insulates them from competition.  It also forces market-distorting policies on them, like requiring less-costly insurance customers to pay more to reduce the gap in prices.

For context, the pay for Wichmann that Sanders cites equates to around $2.25 from each of the company’s members, so as an isolated expense, it doesn’t mean much by way of price competition.  Still $83 million is a lot of money that could be put toward some other benefit or organizational improvement that would be salable.  Government has shaped the market landscape that allows that money to pool in executive compensation.  Naturally, the socialist’s solution to this problem is… more government!

Let’s imagine, then, what would happen to this money if the government even more-fully ran our health insurance industry.  With no competition, the government would have little incentive to ensure that the CEO’s wages were redistributed in the way that would attract more customers.  Would it reduce prices by $2.25 for everybody?  That seems useless.  If you say it would hire more doctors, do the math, and you’ll find that the United CEO’s pay would maybe allow for another 400-500 for a nation of well over 300 million people.

Two areas in which some significant portion of the money would surely go are predictable based on other government activities:  More administrators and bureaucrats would be hired, and targeted special interest groups would receive enhanced benefits or cost savings, to be distributed based on the political value of their support.

This likelihood should lead anybody who thinks the CEOs make too much money and that it ought to fund, instead, an improved healthcare system to the conclusion that we need more market force in health care rather than less.  That would squeeze the pay of the top employees and distribute it where the market finds the most value.

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Expressing the Value of Our Health Care

Health care and medicine in the United States can be expensive, but think of what we’re getting. The solution to our problems is more openness about costs and value and more-direct decision making, which is the opposite of single-payer and other big-government policies.

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Looking for Common Ground in Booker’s New Handout Plan

Of course, the idea of making the federal government something like everybody’s rich uncle, endowing every baby with a $1,000 savings account with annual deposits at taxpayer expense, strikes all the wrong chords for a conservative like me.  The details of legislation that U.S. Senator Cory Booker (D, New Jersey) has submitted don’t really help:

The accounts would be federally insured, and the funds could only be used for homeownership and “human and financial capital investments that [change] life trajectories,” according to the summary. …

The program would cost roughly $60 billion if implemented in 2019, a Booker aide told The Hill, and would be funded by increasing the capital gains tax rate by 4.2 points, increasing the estate tax to its 2009 level and raising taxes on multimillion-dollar inheritances.

So, the federal government would create and help fund individual investment accounts and then pay for it by increasing the cost of investing as well as taxing those who are able to change their “life trajectories” enough to ensure that their own children don’t need rich Uncle Sam.  That doesn’t sound like the most efficient policy design.

All of that said, Booker’s concept does have some similar features to my long-standing proposal for health care:  Set everybody up with a health savings account, which government could use as its Medicaid/Medicare mechanism, which employers could use to provide their health care benefits, which charities could use to offer assistance to the poor, and which would bring market mechanisms into health care.

That would be a better use of money than buying houses.  Moreover, some significant part of the funding could be found in government health care savings (as all of the funding for any new program should be found in the existing budget).

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We Must Stand Up to the Ideological Gestalt Targeting Children

Wesley Smith catches more evidence of our society’s descent into madness:

When I read Jane Robbins’ piece in The Federalist reporting that doctors were actually performing mastectomies on girls as young as 13 who identify as boys, I couldn’t believe my eyes. But sure enough. Not only is it happening, but a medical study published in JAMA Pediatrics recommends that children not be precluded from such radical body-altering surgery based simply on their youth …

A doctor need not be a religionist or disagree with the concept of gender dysphoria generally to be morally opposed to cutting off the healthy breasts of adolescents (or inhibiting the onset of a child’s normal puberty) as a form of “doing harm” in violation of Hippocratic ideals. But if Emanuel and his ilk have their way, in the not too distant future, a surgeon approached to perform a mastectomy on a girl who identifies as a boy could be forced into a terrible conundrum: either remove the child’s healthy body parts–or risk being charged with transphobic discrimination, investigated by medical authorities, and possibly forced out of the profession.

Now factor in the fact that “guidance” in public education generally takes the tone that teachers and school administrators should help students move in this direction — even to the point of conspiring to deceive their parents if they might have a different view.  What’s coming into shape is a culture that encourages children to experiment with their sense of identity, which experimentation is then hustled along from youthful exploration to physical expression through the school system and then solidified into irreversible medical steps through drugs or surgery.

Smith makes an important point when he brings into the discussion the silencing of Brown University researcher Lisa Littman, who found evidence that transgenderism spreads faddishly among peer groups.  Based on public outcry, the university disappeared the study and apologized for it.  As Smith suggests, this episode illustrates that the medical consensus on which we’re being told to base radical child-abusing policies cannot be taken as trustworthy on its face, but is very probably contaminated with ideology.

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When Patients Become Costs in a Socialized System

While we should keep in mind that we’re getting one person’s understandably self-interested perspective on an ongoing series of interactions, Roger Foley’s experience is not exactly out of keeping with other anecdotes or the incentives of socialized medicine:

A Canadian man suffering from an incurable disease claims that despite asking for home care, the medical team at an Ontario hospital would offer him only medically assisted suicide.

Roger Foley, a 42-year-old from Ontario, has cerebellar ataxia, a rare disorder that limits his neurological abilities, restricting mobility in his arms, legs, as well as the performance of other daily tasks.

Dissatisfied with being bedridden in a hospital for two years, Foley asked for another option, and according to some recordings that he has released, people in the hospital system offered him an exit to the graveyard.

We don’t know whether these conversations were just two out of many, the rest of which were much more life-affirming, but without the home-care solution that Foley wanted.  We also don’t know what explanations were given for denial of that service.

Still, when government takes over the health care for an entire society, relationships and the standing of patients change.  We cease to be customers and become costs.  Even in a system in which government provides health care for just a segment of the population — the poor, the elderly, veterans — the patients are still customers, but with somebody else paying.

It is mystifying that so many people assume benevolence and competence within a system that is able to take its resources by force of law.  When such a system hits the ceiling for what taxpayers and central planners are willing to pay, it still has massive power over the recipients of its services, even if that power consists mainly of offering a choice between staring at a hospital ceiling and death.

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Unions: Doing to Our Hospitals What They Did to Our Schools

One of the advantages of living on the East Bay is our easier access to Massachusetts for things like hospitals.  In a pinch, a while back, my family went to Rhode Island Hospital/Hasbro, and it turned out to be one of the most terrible decisions we’ve ever made, with lifelong consequences.  In the years since, we’ve heard from others with similar stories.

I don’t want to be unfair, though.  It’s all too easy for a bad employee or unfortunate circumstances to create a uniquely bad experience.  Especially in our time of social media, these isolated instances can come together to create a misleading impression.  Some people will swear by Apple versus PC or Verizon versus AT&T and vice versa and so on.  I don’t think this caveat applies to my take on Providence hospitals, but it might.

Let’s just say that the recent public theatrics of the nurses’ labor union in Providence don’t contradict my feelings:

Unionized nurses and other health care professionals at Rhode Island Hospital and Hasbro Children’s Hospital on Thursday voted no confidence in Lifespan’s CEO, Tim Babineau, and Rhode Island Island Hospital’s president, Margaret Van Bree, and called on Lifespan’s board “to take immediate, corrective action to restore the public’s trust in Rhode Island’s only Level One Trauma Hospital.”

Ray Sullivan, a spokesman for United Nurses and Allied Professionals Local 5098, which represents 2,400 nurses, technologists, therapists and health professionals at the two hospitals, said members also authorized union leaders to issue a 10-day strike notice if negotiations break down.

Obviously, I can’t speak for “the public,” but my lack of trust in this system has to do with people who work (or worked) there, not the management… except to the extent that management is to blame for the employees.  The union organizers from United Nurses and Allied Professionals Local 5098 definitely are to blame for enabling employees who’ve made devastating mistakes.

The unions are doing for our hospitals what they’ve done for the public school system.  That Bishop Hendricken alum Ray Sullivan is the union lead for the nurses as well as an organizer with the National Education Association of Rhode Island only drives home the point.  Among the incidents that made labor unions so distasteful to me was a plan by Tiverton teachers to picket a hospital where a school committee member worked.  Picketing a hospital — where people are suffering, grieving, and panicking — is no more acceptable when the union represents its workers than when it doesn’t.

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Blue Cross Executive Compensation and Social Lunacy

For some reason, WPRI’s Ted Nesi tacked a political ad for far-left progressive Democrat Aaron Regunberg to the end of an article about a massive parting gift from Blue Cross & Blue Shield of Rhode Island to its departing CEO:

Aaron Regunberg, a Democratic candidate for lieutenant governor, quickly criticized Blue Cross over the pay packages, and argued it shows the state needs to move to a single-payer health system.

“Every day I meet Rhode Islanders who are struggling to pay outrageous health care bills,” he said. “It feels like each year, insurance costs more and covers less. So why is Blue Cross seeking 10% rate hikes while handing their top executives immoral payouts of millions of dollars?”

It’s always strange for a news article to end with a question, which is more appropriate to commentary pieces, so let’s take a stab at an answer:  Blue Cross is seeking 10% rate hikes while handing its top executives payouts of millions of dollars because it can.  Thanks to government regulations, consumers’ options for health insurance are very limited, meaning that competitors can’t take advantage of indulgences like massive payouts to executives, and thanks to ObamaCare, the product that this limited number of providers are selling is mandatory for all Americans.

I realize that Regunberg was in high school in a distant state when Blue Cross was among the leading lights of Rhode Island corruption a decade ago.  Still, it shouldn’t take direct experience for him to understand that creating monopolies and intimate relationships between major corporations and government can lead to corruption.

That the story of Blue Cross Blue Shield of Rhode Island’s corporate pay structure could be turned into a pitch for a single-payer health system shows how far into lunacy our public discourse has drifted.  Consolidating power helps the powerful, who will quickly find that they have more incentive to work together than to enthusiastically fulfill their roles as representatives for battling factions.

Rhode Island has built this truism into the organizing principle of our entire government.  One suspects that Regunberg is not ignorant of this reality but, rather, is looking for his path to the narrow end of its funnel.

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