Today's new word is iatrogenic

This is a article written by a businessman who set out to understand the health care system after his father died of an infection he got while in the hospital. The author says he's a Democrat, and he says he favored health care reform this year.

It's a long article; but if you want to understand the problems that we currently have in our health care system it's a good place to start.

http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/

"Iatrogenic" by the way means "caused by physicians." Every year hundreds of thousands of people die due to physician and hospital mistakes. In a way that isn't surprising, because doctors are no different from other people and hospitals are no more efficient than other human institutions. They're not perfect -they have bad days, they make mistakes, and sometimes they're careless or distracted. And, sometimes they are simply wilfull. What killed the author's father is the fact that doctors and hospitals don't pay enough attention to infection control and sterilization. On the simplest level many doctors resist the added time and effort needed to really control hospital caused infections, and hospital administrators are not willing to push them on the matter, in part because our current system of health care reimbursement does not penalize hospitals for bad results.

The snowstorm was a dud

All last night the wind raged and howled as snow came down at what seemed like a rapid rate; but even as the snow was falling it was apparent that the storm was more or less a dud. Most of yesterday's snow melted on contact with the roads and the driveway even as it piled up on the old snow in the yard and appeared impressive. And when the snow did stick it insulated the roads and driveway so there was a layer of relatively warm wet under the five or so inches that actually did accumulate.

Last evening Linda and I had a moderately exciting drive back from Sam and Deb's house at about 9:40. By then there were a couple of inches of snow on the roads where the wind was drifting it across from fields in exposed areas. All in all we had less problems on the road than we did in playing pinochele with Sam and Deb. They beat us handily in the first game and were leading heavily in the second when we decided we had better leave. Debra had an amazing run of luck with her cards. It seemed that neither she nor Sam could bid without the other having eight or ten meld and a couple of aces. I don't think they went set more than a couple of times and they took most of the bids.

This morning the snow looked impressive while it was still coming down; but when I went out at about noon to plow I was able to do the driveway in two passes.

I just returned from a trip out to the post office and the gas station. The roads were already simply wet since the sun has been out. And, thankfully, all the essential services, like the gas station and the tanning salon were open as normal.

There's something to be said for snowstorms at this time of the year. The sun is high enough to clean things up pretty quickly once the snow stops. We're hoping that Mark and Linda L were able to get their driveway plowed because we're planning to meet them for dinner if they can do it. The plan is to go to The Texas Roadhouse, which we've been wondering about for years as we've passed it on Route 422 going back and forth to the Ballroom of High.

We deserve steaks tonight because yesterday we ate pretty healthy beef barley soup that I made. And, on Wednesday we had only a light dinner because we needed to get out of here pretty promptly to go up to Pottstown for our Tango lesson.

Speaking of the tanning salon, Alex called the other night to tell us that those SOBs down in Washington are trying to tax tanning. It seems they were going to tax botox treatments and boob jobs; but the cosmetic surgeons, the Botox maker and the boob implant people must have been able to put together a fatter set of bribe envelopes than the tanning people.

http://www.reuters.com/article/idUSN2124186720091221

Who knew there were 20,000 tanning salons in the U.S.? Imagine how many wrinkle wranglers and boob ballooning surgeons there must be to outbid the tanning industry when it comes to bribing Harry Reid and the other corrupt Senators and Congresscritters down there in DC.

Is this a great country or what?

There's a Great Blue Heron wandering around

He glided in and landed down by the bridge and he's now patiently stalking along the creek. I can't imagine what he expects to catch in this cold.

But I didn't sign in to comment on the Great Blue Heron. I signed in to comment on the damn Canadian politician who's planning to swoop down here into the U.S. to have a heart operation.

We keep getting told and told and told that Canada has such a great health care system. If that's the case why is a damned Canadian politician coming down here for his operation? Perhaps all the good Canadian doctors have moved to the U.S.

http://www.nationalpost.com/news/story.html?id=2510700

In related news Sam and Deb, along with Dolores and Don, came to dinner on Sunday. So we were able to see the stitches in Sam's finger. It turns out they didn't go to the hospital emergency room but rather to the Premier Urgent Care center in Oaks. They got good efficient service there. Sam said the doctor got to him within fifteen minutes of their arrival. This urgent care concept seems to make sense. The hospitals charge far too much for most emergency room care because of the way hospital accounting works. And the waiting times in hospital emergency rooms can be long.

Sam's main concern is that the stitches should be out by the time it's warm enough for golf.

One of the red headed woodpeckers is down there on the sugar maple tree, so I have to go now.

But first I should mention that I've been listening to Charles Darwin's book The Voyage of the Beagle while driving over the past couple of weeks. A very interesting book, although you do have to be patient when he runs on and on about some particular frog, or mouse, or geological formation that has interested him. What's most interesting is how humble Darwin is. He never asserts anything.

He's groping toward explanations for a whole host of natural phenomena besides evolution, including plate techtonics, ocean currents, vulcanism, mountain uplift, climate variation and change, extinction, etc.; but it's clear he doesn't make up his mind until the evidence is overwhelming. On the subject of evolution it's neat that at that at the point of his life when he wrote this book he was still somewhat of a believer in what was later called Lysenkoism, namely that acquired traits are geneticly passed down.

A very interesting book and a very interesting man, not at all like the forbidding bearded elder who's popular image comes down to us as a result of the fact that he ultimately got to the overarching theory of evolution.

On that subject Linda and I finally saw Ben Stein's movie Expelled a few weeks ago. The movie was contentious, and Stein skewered some of the too proud and exclusionary evolutionists; but it's hard for me not to think that Stein is more reasonable in the end than the evolution explains everything true believers.

The book The Voyage of the Beagle is worth reading, and the movie Expelled is worth seeing.

A brief visit to the Peoples Republic of Massachusetts

Three days we've been away, and in that time the big sugar maple tree has dropped about half of its leaves. It was at the very peak of its splendor on Sunday of last week, all shades of gold and red and green. What leaves now remain on the tree are yellow or brown.

But I don't want to write about the swift decay of the splendor of the sugar maple, its leaves deprived of essential nutrients by the choking off of tree's systems. I want to write about the splendor of the great Peoples' Republic of Massachusetts, which Linda and I visited this weekend.

We stayed in the Brookline Holiday Inn, which Christina got for us via Priceline. A great location for observing some pretty interesting stuff, and only ten blocks or so from Alex and Christina's apartment. The very first evening was made special when I observed a local copper making time with nine well oiled young ladies who emerged from a building across the street as part of a much larger group who were perhaps the competitors for the Miss Miniskirt Massachusetts title. Every one of those girls had their heads in the clouds; but their legs reached all the way to the ground.

The copper, Steve was his name, loaned his uniform hat to one of the nine he was wooing. I was hoping she would try to make off with it the way Dillon tried to do with the Guardia Civil's fancy tricorn back in Barcelona in the 1960's; but she meekly handed it back after trying it on and displaying it to the passing cab drivers. Those cab drivers were not looking at the hat, and neither was Steve. The Guardia Civil back in Barcelona was definitely focused on his tricorn when he gestured very meaningfully at Dillon with his submachine gun. He looked pretty determined to me; but to this day I don't rightly know if he would have fired had Dillon not thought better of keeping his hat.

Steve got his hat back before he guided the nine young ladies into a cab and told the cab driver it was okay to take the passenger overload. Whether he scored a phone number or not I don't know; but he did give the dollies his email address. I hope he got a number because I don't think those lasses were in condition to remember an email address.

To be continued. . . The next thrilling episode will include our encounter with the exuberant
Russkis at the restaurant, and our tour of the Harpoon Brewery. It may also include
commentary on the events that did not occur when we found our car boxed in by the idealistic young civil engineer who was so preoccupied with saving humanity by delivering materials to the Boston Headquarters for Idealism that she had no time to worry about inconveniencing a few mere humans.

Ah to be young and heedless of the risks of rudeness. Hopefully the next time she will block in someone like me in my much younger days, for even idealists, perhaps especially idealists, need learning in the wages of sin. Randy or Dillon or Paul or Dave or Nick and I would have levied quite some wages on the car of someone who boxed us in back in college days. Thomas Harris had his character Hannibal Lecter go perhaps a smidgen too far; but it is a very certain truth that free range rudeness should be answered with consequences by anyone truly idealistic upon whom it is practiced.

Update: In other news I just got an exceedingly pleasant surprise when I leafed through the mail we collected upon returning home the other day. It included a very nice postcard from Aruba where Alex and Christina are enjoying a great honeymoon, or at least they were when they sent the postcard more than a month ago. They mention seeing "enough colorful fish, sunsets and iguanas to fill at least two honeymoons". The Aruba post office must have tied this postcard to an iguana who then hitched a ride on a fish to bring it to the U.S.

Just think how quickly and efficiently our medical care will be attended to when health care is run by the government the way the post office is.

Health care is expensive - so is the newest and biggest plasma TV

Recently there has been quite a lot written about how expensive health care is. Which isn't surprising, because health care is expensive, especially if you want access to all the latest technology, which most people do when their lives are at stake.

But the truth is that health care is just like TV. If you're satisfied to watch a ten year old technology TV you can get one at Walmart for a hundred bucks. If you want the latest huge screen plasma model it's going to cost you ten or twenty times as much.

The next time you hear someone whining about the cost of a new wonder drug remind him that he can save a lot of money by using an old generic drug that's probably almost as good. If there is no old generic drug that treats his condition you can remind him that the new drug is very logically worth quite a lot if he would have died before it was invented.

The government charges a young person something like 14% of his income for Social Security, which is insurance that he will get a fairly minimal pension in his old age. By that standard the value of medical treatments which will let him live to old age is quite high.

But just how expensive is health care? It turns out that it's not very expensive at all considering the alternative. There is a website called ehealthinsurance.com that will quickly give you quotes on health insurance if you put in your age.

It turns out that a 25 year old can get catastrophic coverage with a high deductible for $40 a month, or he can get a gold plated policy for about $175 a month. Figure one day a month working at the local McDonalds for basic catastrophic coverage and a few days a month of minimum wage work for gold plated coverage.

The rates for a 61 year old are, not surprisingly, quite a bit steeper since he's quite a bit closer to his sell by date and is probably already a medical mess. But even so, a 61 year old can buy catastrophic coverage for about $200 a month, which he can net with about a week's work at the local Wawa even after the government grabs its taxes. It's true that gold plated coverage at about $1,000 per month is pretty much out of the ballpark for the 61 year old unless he's saved up and/or built up the skills to make significant income; but if he's 61 he should already know that anybody who ever promised him a rose garden was bullshitting. A 61 year old is too dumb to be worth saving if he doesn't already know that life ain't fair, and then you die.

Another thing that gets to me is the constant whining about how the cost of extraordinary health care is driving some people to bankruptcy. Even as I feel sorry for those people, it's very hard for me to avoid thinking that bankruptcy is a whole lot better than dead, which is what they would be without the extraordinary health care.

Caught in a blatant lie within 24 hours

While watching the president's speech last night I was suspicious about the story he told of the fellow who lost his health care insurance. Here's a fellow at sweetness-light.com who probably works in pajamas at his computer doing the job that the mainstream media would be doing if they weren't so deeply in the president's pocket that they're covered with lint and smell like Chinese Chestnut flowers in the spring.

Obama Misrepresents Insurance Case

From Mr. Obama’s address to the joint session of Congress last night:
“One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn’t reported gallstones that he didn’t even know about. They delayed his treatment, and he died because of it.”

This is the sad story of Mr. Otto Raddatz, a case that Mr. Obama has cited several times before, including in his August 16th editorial in the New York Times.

For the record, however, the case is not exactly the way Mr. Obama has characterized it, at least according to the sworn testimony of Mr. Raddatz’s sister.

From Ms. Raddatz’s opening statement, from pages 58-59 of the transcript (a pdf file) of the House Subcommittee on Oversight and Investigation Committee hearings on ‘The Termination Of Individual Health Policies By Insurance Companies,’ Tuesday, June 16, 2009:

Otto began more chemotherapy for purposes of preparing him for a stem cell transplant. In the midst of his chemo treatments, Otto received a phone call and letter from Fortis Insurance Company stating his insurance was canceled. It was rescinded all the way back to the effective date of August 7, 2004.

This meant none of his cancer treatments would be covered. Most importantly, he would not be able to receive the stem cell transplant need [sic] to save his life. My brother only had a very small window of time in which to have the stem cell transplant. He needed to be scheduled within the next 3 to 4 weeks.

My brother was told he was canceled during what they called a "routine review" during which they claimed to discover a "material failure to disclose". Apparently in 2000 his doctor had done a CT scan which showed an aneurysm and gall stones. My brother was never told of either one of these conditions nor was he ever treated for them and he never reported any symptoms for them either.

After months of preparation, the stem cell transplant could not be scheduled. My brother’s hope for being a cancer survivor were dashed. His prognosis was only a matter of months without the procedure.

Mr. Radditz was faced with having to pay for the stem cell transplant himself in order to save his life.

However, Mr. Raddatz’s lawyer sister contacted the Illinois Attorney General’s Office. They investigated and found that the doctor who did the CT scans could not remember whether he had ever told Mr. Raddatz about his findings.

Consequently, the insurance company overturned their original decision to rescind her brother’s coverage, and he was reinstated in the words of his sister, "without [any] lapse."

Again, from Ms. Raddatz’s sworn testimony:

After two appeals by the Illinois Attorney General’s Office, Fortis Insurance Company finally overturned their original decision to rescind my brother’s coverage and he was reinstated without lapse. This is after weeks of constant phone calls between myself and the Attorney General’s Office and we were literally scrambling hour by hour to get this accomplished so that my brother wouldn’t lose his 3- to 4-week window of opportunity that he had prepared for and lose his opportunity to have the procedure.

In other words, Mr. Raddatz’s did receive the stem cell transplant without delay.
Indeed, Ms. Raddatz does not seem to claim anywhere in her testimony that the insurance company’s actions shortened her brother’s life. (Though she does accuse them of having been cruel and unethical.)

From page 75 of the hearings transcript:

Mr. Barton. My next question is to the gentle lady there in the middle. Your brother, has he had his stem cell transplant? Ms. Raddatz. He did indeed receive the stem cell transplant. It was extremely successful. It extended his life approximately 3-1/2 years. He did pass away January 6, 2009, and he was about to have a second stem cell transplant. Unfortunately, due to certain situations, his donor became ill at the last minute and so he did pass away on January 6. But again, it extended his life nearly 3-1/2 years and at his age, each day meant everything to him…
This is not quite the impression Mr. Obama gives with his rendition of Mr. Raddatz’s story.
Despite Mr. Obama’s claims, Mr. Raddatz’s treatment was never delayed. And he did not die because of it.

Meanwhile, in this very same speech Mr. Obama accused others of misrepresenting the facts.


Hat tip to Kathry Jean Lopez of National Review who pointed to this post at sweetness-light.com.

A couple of questions for the president

I've been trying like hell, fairly successfully, to avoid listening to political ranting on the TV shows for the past couple of weeks. But, as a patriotic American, I was compelled to watch the president spout amazing nonsense for much of the 48 minutes that he addressed the joint session of congress earlier this evening.

So here I am, wondering if President Obama is the smoothest liar I've ever seen or heard of, or whether he managed to get through Harvard and several highly profitable years in Chicago and Illinois politics without learning anything about how government bureaucracies work.

For instance, he very forcefully said, several times, that he can pay for his entire massive health care program by saving more than a hundred billion dollars each year that's currently consumed by waste and fraud in the Medicare and Medicaid programs.

Now, as it happens, I'm very cynical about the competence of government bureaucracies, so I believe Medicare and Medicare are paying for quite a bit of fraudulent care; but even I don't believe they're being defrauded for over a hundred billion dollars a year. And if they are being defrauded for that much money, I fail to see why President Obama hasn't already done a wholesale shakeup of the management of those bureaucracies. If they're really wasting more than $12 Billion per month there should be bureaucratic heads rolling all over Washington, DC.

So I have a couple of questions that I hope some reporter will ask the president.

"Mr. President, you've said you can pay for your health care program by saving over a hundred billion dollars a year in fraudulent Medicare and Medicaid payments. And you have been in office for almost nine months. Why haven't you already done something to to stop such an outrageous amount of fraud?"

And here's a follow-up question:

"Mr. President, who is the great manager that you plan to put in charge of Medicare and Medicaid to stop all that fraud? Will it be the same sort of genius you put in charge of the cash for clunkers program that can't seem to pay it's claims within the two weeks that the law explicitly promised? Or will it be the kind of genius you put in charge of the stimulus program that has given hundreds and hundreds of billions of tax dollars into the care of the same executives who ran the huge banks that made a mess of the mortgage market with their bad decisions.

Can't run Cash for Clunkers? Here, take health care.

Democratic Congressman Joe Sestak is upset because the government's much talked about Cash for Clunkers program has failed the pay the auto dealers the cash it promised for the clunkers. It seems that the geniuses down in Washington (Sestak included) passed the Cash for Clunkers scheme without having the slightest idea of how to run it efficiently.

Among other things they grossly underestimated the speed with which people and auto dealers would grab onto the cash; and they failed to think through the effect on auto dealer finances; and they set up a bureaucracy that has proven to be a total clunker at administering the program.

You can find Congressman Sestak's letter complaining to President Obama about the program here:
http://blogs.mcall.com/penn_ave/2009/08/sestak-to-feds-fix-clunkers-program-red-tape.html

It's kind of rich that Congressman Sestak is complaining about the inefficiency of a program that he himself voted for. But I guess that's the kind of things you do when you're a congressman; you vote for unworkable and inefficient programs and then you blame someone else for then.

I have a question for Congressman Sestak. If this president and this congress and the rest of the federal government can't efficiently set up and manage a very simple little $3 Billion program like Cash for Clunkers, what possible logic can there be in thinking that they can run a very, very complex $2.5 Trillion industry like health care?

National Public Radio's lying host

Yesterday afternoon at about 1:30 or so I happened to catch a brief part of a talk show on National Public Radio. During the segment I heard the host, a woman, make a clearly false statement about health care.

She said words to the effect that health care reform is needed because insurance companies cancel the policies of people with pre-existing conditions, and her guest made no effort to correct her lie.

The true state of affairs is that insurance companies must continue to cover the medical expenses of people who develop new medical problems. There is no way they can cancel someone's insurance once they have agreed to provide it.

The NPR commentator was trying to blur the fact that the current health care reform legislation requires insurance companies to write new policies for people with pre-existing conditions at the same price as for people without pre-existing conditions. This is complete madness. Writing a new health care insurance policy for someone who needs an operation tomorrow, or who is already known to have an expensive to treat condition, is welfare, not insurance, and it would quickly result in driving all of the insurance companies out of the health care market.

It's exactly the same thing as requiring a fire insurance company to write a new policy on a house that's already on fire, or requiring a flood insurance company to write new policies on houses downstream of a dam that just broke.

The day after the government passes a requirement that insurance companies cover people with pre-existing conditions the smart people in the country will cut back their health insurance to the bare minimum. While they stay healthy they will save money. When they get sick or need an operation they will apply for a full coverage policy as soon as they learn that health care is going to cost them a lot of money. Insurance companies, if they want to stay in business, will have to hugely raise their rates to cover the new consumer behavior, and that will make even more healthy people cancel their policies. It will result in a spiral that will quickly kill off private health care insurance.

This sounds like a complex matter; but it's actually very simple. Would you pay for flood insurance on a beach house every year if you knew that you could always call and get a new flood insurance policy whenever a hurricane is forecast? Would you pay for auto insurance every year if you knew you could call from the scene of an accident and get a new insurance policy to cover the damage you've already done to your car? Would you pay for life insurance all your life if you knew that you could call from your deathbed in a hospital and apply for a new life insurance policy? Would you pay all your life for health insurance coverage if you knew that you could wait and apply for a new insurance policy after your doctor tells you some bad news?

Medicaid, which is a welfare program, already exists to provide health care for people who can't afford to pay for it. The attempt by President Obama and the democrats in congress to ban pre-existing condition clauses in new insurance policies is nothing but a naked play to destroy the health care insurance industry and thus force the country to a single payer government system.

And. . . a single payer health care system will put your health care in the hands of people who are not ashamed to baldly lie to get what they want, like the National Public Radio host I heard yesterday.

Don't like the cost of new drugs? Use generics!

Many years ago Aunt Mary A angrily told me that her eye operation had cost $3,000 and only took a couple of hours. I shocked her a bit, and made her laugh, by telling her that the next time she needed a similar operation I would read up on it and then do the operation for her for a lot less money.

Another time I was talking with Frank A at a reunion and he mentioned indignantly that a friend's mother was taking a heart medicine that cost (I think) $300 a month. What really burned him, he said, was that the same company sells the same medicine for dogs for only a few dollars a month.

Always willing to fuel a good argument, I pointed out to Frank that his friend had an easy solution. If the dog medicine was truly the exact same thing as the human medicine he could save a lot of money by buying the dog medicine and giving that to his mother instead of the human medicine.

In both cases I was being facetious; but there is a great truth in these incidents that relates to the current debate about health care. One of the things the health care "reform" boosters are arguing, and have argued for a long time, is that pharmaceutical companies often make minor changes to existing drugs and then charge a lot more for the new formulations, which are often only slightly better than the old drugs. This is viewed as somehow exploitative, even though everyone agrees that pharmaceutical companies spend huge amounts of money on research and development precisely in order to refine old drugs and develop new ones.

If it's true that a new drug is only a little bit better than an older drug that is now a generic and available for much less cost, why shouldn't people who can't afford to or don't want to pay the price asked for the new drug simply be satisfied with the older drug?

In every other area of life that's the way things are. I would very much like to drive a nice new Cadillac or Lexus every year; but I drive a Ford until it pretty much craps out because I don't want to pay for a Cadillac or a Lexus, and it would certainly cramp my budget to buy a new car every year. I would like to eat nothing but tenderloin and lobster prepared by great chefs in fine restaurants; but I eat chicken and tilapia prepared at home because I don't want to pay restaurant prices for tenderloin and lobster.

Someone who relies soley on much cheaper generic drugs is, at worst, trusting his life to the very best drugs that existed in the world as of about seven or eight years ago. It's true that doing that means taking a slight but significant risk with your life; but then most people take much more substantial risks with their lives by driving cheaper cars that don't have the super sophisticated safety systems that are installed in the most expensive cars.

Why is health care viewed so much differently than the other necessities of life? Why do people beat up on pharmaceutical companies when it's the pharmaceutical companies that have provided both the generic drugs and the slightly better newer drugs?

Here's an article by Tevi Troy that appeared in the June issue of Commentary Magazine that goes into other aspects of the health care, and specifically the pharmaceutical cost, debate:

http://www.commentarymagazine.com/viewarticle.cfm/the-end-of-medical-miracles--15162?search=1

Here are some quotes from it for those too lazy to click the link:

"Americans have, at best, a love-hate relationship with the life-sciences industry—the term for the sector of the economy that produces pharmaceuticals, biologics (like vaccines), and medical devices. These days, the mere mention of a pharmaceutical manufacturer seems to elicit gut-level hostility. Journalists, operating from a bias against industry that goes as far back as the work of Upton Sinclair in the early years of the 20th century, treat companies from AstraZeneca to Wyeth as rapacious factories billowing forth nothing but profit. At the same time, Americans are adamant about the need for access to the newest cures and therapies and expect new cures and therapies to emerge for their every ailment—all of which result from work done primarily by these very same companies whose profits make possible the research that allows for such breakthroughs."

"Liberals and conservatives appear to agree on the need to unleash the possibilities in medical discovery for the benefit of all. But it cannot be ordered up at will. It takes approximately ten years and $1 billion to get a new product approved for use in the United States. Furthermore, only one in every 10,000 newly discovered molecules will lead to a medication that will be viewed favorably by the Food and Drug Administration (FDA). Only three out of every ten new medications earn back their research-and-development costs. The approval success rates are low, and may even be getting lower—30.2 percent for biotech drugs and 21.5 percent for small-molecule pharmaceuticals."

"It is the very nature of scientific discovery that makes this process so cumbersome. New developments do not appear as straight-line extrapolations. A dollar in research does not lead inexorably to a return of $1.50. Researchers will spend years in a specific area to no avail, while other areas will benefit from a happy concatenation of discoveries in a short period. It is impossible to tell which area will be fruitless; so many factors figure into the equation, including dumb luck. Alexander Fleming did not mean to leave his lab in such disarray that he would discover that an extract from moldy bread killed bacteria, yet that is how it happened. Conversely, if effort and resources were all it took, then we would have an HIV/AIDS vaccine by now; as it stands, the solution to that problem continues to elude the grasp of some of the most talented and heavily funded researchers."

"Scientific discoveries are neither inevitable nor predictable. What is more, they are affected, especially in our time, by forces outside the laboratory—in particular, the actions of politicians and government bureaucracies. The past quarter-century has offered several meaningful object lessons in this regard. For example, in the 1980s, the Reagan administration undertook a number of actions, both general and specific, that had a positive effect on the pace of discovery. On the general front, low taxes and a preference for free trade helped generate a positive economic climate for private investment, including in the rapidly growing health-care sector. More specifically, the Reagan administration engaged in new technology transfer policies to promote joint ventures, encouraged and passed the Orphan Drug Act to encourage work on products with relatively small markets, and accelerated approval and use of certain data from clinical trials in order to hasten the approval of new products. All of these initiatives helped foster discovery."

"That which the government gives, it can also take away. As the 1990s began, a set of ideas began to gain traction about health care and its affordability (it seems hard to believe, but the first election in which health care was a major issue was a Pennsylvania Senate race only eighteen years ago, in 1991). Americans began to fear that their health-care benefits were at risk; policymakers and intellectuals on both sides of the ideological divide began to fear that the health-care system was either too expensive or not comprehensive enough; and the conduct of private businesses in a field that now ate up nearly 14 percent of the nation’s gross domestic product came under intense public scrutiny."

"A leading critic of Big Pharma, Greg Critser, wrote in his 2007 Generation Rx that President Clinton picked up on a public discomfort with drug prices and “began hinting at price controls” during his first term in office. These hints had a real impact. As former FDA official Scott Gottlieb has written, “Shortly after President Bill Clinton unveiled his proposal for nationalizing the health-insurance market in the 1990s (with similar limits on access to medical care as in the [current] Obama plan), biotech venture capital fell by more than a third in a single year, and the value of biotech stocks fell 40 percent. It took three years for the ‘Biocentury’ stock index to recover. Not surprisingly, many companies went out of business.”"

"The conduct of the businesses that had been responsible for almost every medical innovation from which Americans and the world had benefited for decades became intensely controversial in the 1990s. An odd inversion came into play. Since the work they did was life-saving or life-enhancing, it was not deemed by a certain liberal mindset to be of special value, worth the expense. Rather, medical treatment came to be considered a human right to which universal access was required without regard to cost. Because people needed these goods so much, it was unscrupulous or greedy to involve the profit principle in them. What mattered most was equity. Consumers of health care should not have to be subject to market forces."

"And not only that. Since pharmaceuticals and biologics are powerful things that can do great harm if they are misused or misapplied, the companies that made them found themselves under assault for injuries they might have caused. It was little considered that the drugs had been approved for use by a federal agency that imposed the world’s most rigorous standards, and was often criticized for holding up promising treatments (especially for AIDS). Juries were convinced that companies had behaved with reckless disregard for the health of consumers, and hit them with enormous punitive damages claims."

"The late 1990s also coincided with an unpredictable slowdown in the pace of medical discovery, following a fertile period in which new antihistamines, antidepressants, and gastric-acid reducers all came to market and improved the quality of life of millions in inestimable ways. A lull in innovation then set in, and that in turn gave opponents of the pharmaceutical industry a new target of opportunity. An oft-cited 1999 study by the National Institute for Health Care Management (NIHCM) claimed that the newest and costliest products were only offering “modest improvements on earlier therapies at considerably greater expense.”"

"The NIHCM study opened fresh lines of attack. The first came from the managed-care industry, which used it as a means of arguing that drugs had simply grown too expensive. Managed care is extremely price-sensitive, and its business model is built on cutting costs; executives of the industry were well represented on the board of the institute that put out the report. They were, in effect, fighting with the pharmaceutical companies over who should get more of the consumer’s health-care dollars."

"The second came in response to the approval by the FDA in 1997 of direct consumer advertising of pharmaceuticals. The marketing explosion that followed it gave people the sense that these companies were not doing life-saving work but were rather engaged in the sale of relative trivialities, like Viagra and Rogaine, on which they had advertising dollars to burn that would be better spent on lowering the cost of drugs. And the third element of this mix was the rise of the Internet, which gave Americans a level of price transparency that they had not had before regarding cost differentials between drugs sold in the U.S. versus Canada and other Western countries."

"These three factors precipitated a full-bore campaign by public interest groups that bore remarkable fruit over the next several years. By February 2004, Time magazine was publishing a cover story on pharmaceutical pricing, noting that “the clamor for cheap Canadian imports is becoming a big issue.” Marcia Angell, a fierce critic of the pharmaceutical industry and the FDA, wrote in the New York Review of Books in 2004 that, “In the past two years, we have started to see, for the first time, the beginnings of public resistance to rapacious pricing and other dubious practices of the pharmaceutical industry.”"

"Harvard’s Robert Blendon released a Kaiser Family Foundation poll in 2005 in which 70 percent of Americans reported feeling that “drug companies put profits ahead of people” and 59 percent saying that “prescription drugs increase overall medical costs because they are so expensive.” Overall, noted the foundation’s president, Drew Altman, “Rightly or wrongly, drug companies are now the number one villain in the public’s eye when it comes to rising health-care costs.” "

Meet the Mob

Speaker of the House Nancy Pelosi and President Obama are very concerned about the far right wing loons who have been intimidating innocent Democratic Party congresscritters by going to the town hall meetings and complaining. Some of these evil protesters are even carrying signs protesting the government takeover of healthcare that the Democrats are trying to do.

This blogger has done a patriotic job of labelling the sorts of wicked right wingers who have been protesting:
http://thedanashow.wordpress.com/2009/08/06/meet-the-mob/

I know it's very annoying when the filthy peasants appear outside the door of the manor house whining about things; but as a helpful reminder to Speaker Pelosi I've quoted the First Amendment to the Constitution below:

"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

Health care and government health care

The democrats in congress are falling all over themselves to change our health care system so it will be more like the systems of Canada and Great Britain. They say that doing that would make our health care system "better."

Well. . . there's something funny about that. Every so often you read about Canadians and Europeans coming over here to the U.S. to pay with their own money for health care treatments. Canadians and Europeans do that even though health care in Canada and Europe is supposedly provided "free" by the governments there.

Why would Canadians and Europeans come to the U.S. for health care when they can get it "free" in their own countries under systems set up by government bureaucrats just like President Obama and the Democrats in congress want to set up here?

It turns out The Hoover Institution has been doing some looking into health care "outcomes" in Canada and Europe. And it has found that Canadians and Europeans get a whole lot less of a whole lot of treatments and procedures that have been proven to save and extend lives here in the U.S. And it's not just rich people who get the short end of the stick in Canada and Europe. Middle class and poor people in Canada and Europe don't get health care that matches up to the health care that middle class and poor people get here in the U.S.

For instance, "Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher."

So why do President Obama and the Democratic congress want to destroy our current health care system and replace it with a "single payer" system like they have in Canada and Europe? They're certainly not going to improve anyone's health care by doing that.

You can read the whole list of things at which the U.S. health care system does better than that in Canada and Europe by going to this link. It's a one page article and it's very straightforward.

I think it's worth your time, unless you don't care whether some government bureaucrat "improves" your health care and makes you twice as likely to die of breast cancer, or six times as likely to die of prostate cancer, or more than four times as likely to die of colorectal cancer.

http://www.hoover.org/publications/digest/49525427.html

Hat tip to Jonah Goldberg of National Review whose post on The Corner led me to this Hoover Institution article.

When she's right, she's right

I can well understand why many people dismiss Ann Coulter a cojone busting harpy. Even I sometimes wince at her shrillness when she gets going on TV, even as I mentally replace her outfit with a fetchingly studded leather one and imagine her with a little whip in her hand; despite the fact that I almost always agree with her main points.

But when she's right, she's very right; as she was yesterday in her column about health care.

http://www.anncoulter.com/

As always she gets off some perfect gems of logic. Such as:

"All the problems with the American health care system come from government intervention, so naturally the Democrats' idea for fixing it is more government intervention. This is like trying to sober up by having another drink."

"The reason seeing a doctor is already more like going to the DMV, and less like going to the Apple "Genius Bar," is that the government decided health care was too important to be left to the free market. Yes -- the same free market that has produced such a cornucopia of inexpensive goods and services that, today, even poor people have cell phones and flat-screen TVs."

"As a result, it's easier to get your computer fixed than your health. Thanks, government!"

We already have near-universal health coverage in the form of Medicare, Medicaid, veterans' hospitals, emergency rooms and tax-deductible employer-provided health care -- all government creations."

"So now, everyone expects doctors to be free. People who pay $200 for a haircut are indignant if it costs more than a $20 co-pay to see a doctor."

"The government also "helped" us by mandating that insurance companies cover all sorts of medical services, both ordinary -- which you ought to pay for yourself -- and exotic, such as shrinks, in vitro fertilization and child-development assessments -- which no normal person would voluntarily pay to insure against."

"This would be like requiring all car insurance to cover the cost of gasoline, oil and tire changes -- as well as professional car detailing, iPod docks, leather seats and those neon chaser lights I have all along the underbody of my chopped, lowrider '57 Chevy."

"But politicians are more interested in pleasing lobbyists for acupuncturists, midwives and marriage counselors than they are in pleasing recent college graduates who only want to insure against the possibility that they'll be hit by a truck. So politicians at both the state and federal level keep passing boatloads of insurance mandates requiring that all insurance plans cover a raft of non-emergency conditions that are expensive to treat -- but whose practitioners have high-priced lobbyists."

"As a result, a young, healthy person has a choice of buying artificially expensive health insurance that, by law, covers a smorgasbord of medical services of no interest to him ... or going uninsured. People who aren't planning on giving birth to a slew of children with restless leg syndrome in the near future forgo insurance -- and then politicians tell us we have a national emergency because some people don't have health insurance."

"The whole idea of insurance is to insure against catastrophes: You buy insurance in case your house burns down -- not so you can force other people in your plan to pay for your maid. You buy car insurance in case you're in a major accident, not so everyone in the plan shares the cost of gas."

"Just as people use vastly different amounts of gasoline, they also use vastly different amounts of medical care -- especially when an appointment with a highly trained physician costs less than a manicure."

"Insurance plans that force everyone in the plan to pay for everyone else's Viagra and anti-anxiety pills are already completely unfair to people who rarely go to the doctor. It's like being forced to share gas bills with a long-haul trucker or a restaurant bill with Michael Moore.
On the other hand, it's a great deal for any lonely hypochondriacs in the plan."

"Now the Democrats want to force us all into one gigantic national health insurance plan that will cover every real and mythical ailment that has a powerful lobby. But if you have a rare medical condition without a lobbying arm, you'll be out of luck."

"Even two decades after the collapse of liberals' beloved Soviet Union, they can't grasp that it's easier and cheaper to obtain any service provided by capitalism than any service provided under socialism."

"You don't have to conjure up fantastic visions of how health care would be delivered in this country if we bought it ourselves. Just go to a grocery store or get a manicure. Or think back to when you bought your last muffler, personal trainer, computer and every other product and service available in inexpensive abundance in this capitalist paradise."

"Third-party payer schemes are always a disaster -- less service for twice the price!
If you want good service at a good price, be sure to be the one holding the credit card. Under "universal health care," no one but government bureaucrats will be allowed to hold the credit card."

"Isn't food important? Why not "universal food coverage"? If politicians and employers had guaranteed us "free" food 50 years ago, today Democrats would be wailing about the "food crisis" in America, and you'd be on the phone with your food care provider arguing about whether or not a Reuben sandwich with fries was covered under your plan."

"Instead of making health care more like the DMV, how about we make it more like grocery stores? Give the poor and tough cases health stamps and let the rest of us buy health care -- and health insurance -- on the free market."

That was Ann. This is me again. And I find that I've quoted all of her paragraphs. Every one of them is a gem.

The woman is a national treasure, even without the fetchingly studded leather outfit I can so easily imagine on her lanky frame. . . hmmm. . . perhaps she would be even more of a national treasure without the fetchingly studded leather outfit. I'll have to ponder on that question. . .

Meanwhile, may she bust liberal cojones for a very long time.

Sam may be in a position to be THE guru on the economy

Sam may be in a better position to know the real state of the economy than the government's economists. This article in the Wall Street Journal says that waste disposal volume is a better measure of consumption, and therefore economic activity, than the government's statistics.

http://blogs.wsj.com/economics/2009/07/17/using-garbage-to-measure-consumption/

And, in other news, congress and President Obama want to have the government take over the whole health care system. They're going to recruit really competent career bureaucrats to decide what doctor you go to, and what drugs he's allowed to prescribe for you, and whether you are worthy of getting a new hip, and what drugs the pharmaceutical companies are allowed to produce and what research into drugs is permitted and how many nurses to hire for each ward of each hospitals all over the country, and how many minutes of break time those nurses get. . . and, and, and. . . everything to do with health care, including who lives and who is unworthy to live.

Perhaps President Obama and his pals will be able to find bureaucrats as smart as the government rocket scientists who taped over the original pictures of the first landing on the moon.

http://webmail.aol.com/43792/aol/en-us/Suite.aspx

You cannot make this sort of stuff up

There is now a retail store in the Washington, DC train station that sells nothing but Obama merchandise. I wonder if they sell vegetables from the White House garden that Michele and the girls planted a couple of months ago?

http://www.cato-at-liberty.org/2009/05/17/cultwatch-union-station-new-york-times/

Meanwhile, in other news: We went to dinner on Friday evening with Mark and Linda L and happened to run into the first night of the Blobfest, which is a cult event in commemoration of the filming of The Blob in Phoenixville. The event has gotten so popular that they now set up bleachers so spectators can watch the running of the blobbers as they flee the theater in panic at the climactic scene where the giant blob emerges through the movie screen.

Very appropriately, there was a fellow across from the theater trying to get people to sign a petition in favor of President Obama's health care plan, which is a cleverly disguised medium sized blob intended to grow to monstrous proportions and devour everything. No one was running from the Obama cultist in panic; but they should have been.

Checking further into the My Obama Store I found that it's a venture of a Jamaican fellow who calls himself Yehmon (http://www.yehmon.com/id31.html). This fellow Yehmon is somewhat of a poet. I found one of his poems right on point (http://www.yehmon.com/id28.html). I may print it out to give to the Obama health care cultist the next time we go to Phoenixville. Or I may bring a CO2 fire extinguisher in hopes of stopping his monstrous project the way Steve McQueen stopped The Blob.

In still other news: Here's a coincidence that may or may not be related to what President Obama, Speaker of the House Nancy Pelosi, Representative Barney Frank and their ilk are likely to do to the economy if they pass their plans into law.

On July 10th a lady in Virginia bought my copy of the Foxfire Book, and on July 11th a fellow in Oregon bought my copy of Foxfire 4; so two widely divergent people are suddenly interested in hog dressing, log cabin building, fiddle making, horse trading, berry buckets and other affairs of plain living.

Perhaps I should remove my remaining five Foxfire books from the "for sale" list on Amazon. Within 96 months when all of us peasants are living the simple life Al Gore and Prince Charles want us to live those books may become very valuable.

http://www.independent.co.uk/environment/green-living/just-96-months-to-save-world-says-charles-1738049.html

Meanwhile, in case you haven't noticed, Al Gore's so called global warming has provided unbelievably good weather in Collegeville so far this summer. Here it is July 13th and we still haven't needed to use our air conditioner. The very mild high seventies daytime and high fifties nightime temperatures don't quite qualify for calling this a year without a summer that the sunspot people told us was possible; but if this is the global warming Al and his fellow CO2 fanatic buddies have been harping about for the past ten years I want more of it.