Archive for the 'Medicine' Category

Last week was a week for the conspiracy theories. First, we had Benghazi and the hearings which interviewed career State Department officers, most of whom probably vote for Democrats. The fact that they were ordered not to talk to Congressmen and denied any attempt at help when under attack, even from as close as Tripoli, invites speculation about motive. Peggy Noonan, a little unusually, hits this one out of the park.

Since it is behind a pay wall, I’ll quote a few bits.

What happened in Benghazi last Sept. 11 and 12 was terrible in every way. The genesis of the scandal? It looks to me like this:

Because of that, it could not tolerate the idea that the armed assault on the Benghazi consulate was a premeditated act of Islamist terrorism. That would carry a whole world of unhappy political implications, and demand certain actions. And the American presidential election was only eight weeks away. They wanted this problem to go away, or at least to bleed the meaning from it.

That sounds about right to me.

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At the age of 21, Danielle Fong cofounded LightSail Energy, a venture focused on energy storage via compressed air, with heat generated by the compression recovered for later use. Investors include Peter Thiel, Khosla Ventures, and Bill Gates. (GE and RWE of Germany are also developing a compressed-air-based energy storage technology that they call ADELE…it will be interesting to see how these two alternative approaches play out.)

A New York University student has developed a new substance for wound closure, which may be able to replace bandages in many cases. Any comments, Michael K?

This issue has to be handled carefully by reform proponents. Otherwise leftist pols, in tacit collaboration with tech lobbyists who want to be paid to create an automated version of the current system, with reduced costs based on fewer workers and worse (rationed) service, may frame the issue as NHS-style single-payer vs. greedy doctors. Therefore it’s important to argue that the right kinds of reforms might greatly improve the quality of medical care AND the patient’s experience, as well as reduce costs. Mead doesn’t quite make this case.

Currently one sees increased reliance (in the USA) on nurses and physician’s assistants to do things that physicians formerly did. This makes sense to some extent but there is a limit to the amount of skilled work that can be shifted away from physicians without degrading quality of care. The Obama model is to cut costs by overworking a smaller number of physicians while shifting as much work as possible to less-well-paid workers, making patients wait longer, reducing quality of care overall and expecting people to put up with it. The better alternative would lower costs and improve care by using technology to increase productivity.

The Obama model is hostile to the high-tech alternative because 1) the Obama people don’t have a clue about either economics or medicine and 2) high-tech reforms would contribute to decentralization and individual control of medicine, and Obamaism rejects decentralization and individual control on principle.

The Queen has fallen ill, gastroenteritis to be specific. She has been taken to King Edward VII hospital in London. This hospital bills itself as the leading private hospital in London.

Why is she not staying at an NHS hospital? Gastroenteritis is not particularly complicated or unusual and should be well within the capabilities of any decent hospital facility of the most rudimentary type.

The Queen of England’s main role is to provide an example, a symbol. She is doing so today with the choice of her hospital. But is anybody paying attention?

As the old Billy Joel song goes; that is, a fair portion of a civil society is built on trust. Or at least – a large portion of the citizens in that society not only trust each other, but they generally also trust the civil institutions, too. There is an assumption, albeit slightly frayed around some edges that our institutions are generally benign and have the well-being of the larger public at heart. We assume, or did in the past, that laws are passed for our benefit, that rules are instituted for the same reason, that our elected leaders did, or at least mostly made a convincing pretense of representing the interests of their constituents, and not those of lobbyists bearing large favors. Read the rest of this entry »

It’s already underway and will only get worse. J.E. Dyer’s analysis is worth reading:

It’s one thing when advertisers seek to drive emotional connections with lite beer, pick-up trucks, and air fresheners. It’s something else when the government hires advertisers to drive emotional connections with government policies and institutions. This goes far beyond the old-fashioned “good government” idea of providing information to citizens. In its essence, it differs not at all from a Stalin-era poster hyping the Soviet government’s policies to a beleaguered Russian people.
 
…
 
Advertising is a dangerous thing in the hands of the armed state. I am no more in favor of Republican administrations spending a lot of money on it than of Democrats doing so. With Obamacare, we have reached the fork in the road. A government with the powers conferred by Obamacare cannot, on principle, be trusted to “advertise” its policies to us. The inevitable descent into untrustworthy propaganda has already begun. Until Obamacare is repealed, it will continue to get worse.

Joel Runyon was working on his Mac at a coffee shop in Portland, when an older man sitting next to him asked him how he liked Apple. Resisting the temptation to politely return to his work, Joel engaged the guy in conversation…it turned out he was Russell Kirsch, who was lead designer of the first American stored-program computer (the SEAC) and was also a pioneer of computer image processing. Read about Joel’s conversation with Mr Kirsch at the link, and then read his followup post 7 things I learned from my encounter with Russell Kirsch.

Conversations with strangers can of course expose you to boringness (yes, it’s a word, I checked) and/or weirdness, but they can also often be interested or at least revealing. I was on an Air France flight back from Paris once…the aircraft had to be changed at the last minute and the new plane was not configured with First Class, so those who had reserved FC seats had to be satisfied with Business Class (which, in my experience at least, is nothing to complain about on Air France.) The guy sitting next to me was very, very upset that he didn’t get the First Class seating he had been counting on. In an attempt to get him to talk about something else, I asked him what he did for a living.

Turned out the guy was a professional Communist, on his way back from some kind of Communist meeting.

Here’s another interesting story about a chance conversation. In 2009, an American neurosurgeon overheard a conversation between two former Israel Air Force officers who were talking about flight simulation. He joined the conversation, and the eventual result was a collaboration that led to the founding of this company, which develops systems for surgery rehearsal.

Another interesting story of a chance conversation: see the second comment on this post at Tom Peters’ blog.

For those interested in the history of technology: Russell Kirsch’s SEAC, completed in early 1950, was built by the National Bureau of Standards for use of researchers and engineers who were chomping at the bit for computer capacity and were tired of waiting for more-ambitious planned machines such as EDVAC and UNIVAC. SEAC’s memory capacity was only 512 words (numbers or instructions), but it was applied to a wide range of problems, including lens design, tables for navigation, and design calculations for the hydrogen bomb. The computer also supported early digital imaging work, with the first digital image being a picture of Kirsch’s son.

More about the SEAC project here.

I am continually amazed by the level of fear, contempt, and anger that many educated/urban/upper-middle-class people demonstrate toward Christians and rural people (especially southerners.) This complex of negative emotions often greatly exceeds anything that these same people feel toward radical Islamists or dangerous rogue-state governments. I’m not a Christian myself, or really a religious person at all, but I’d think that one would be a lot more worried about people who want to cut your head off, blow you up, or at a bare minimum shut down your freedom of speech than about people who want to talk to you about Jesus (or Nascar!)

It seems that there are quite a few people who vote Democratic, even when their domestic and foreign-policy views are not closely aligned with those of the Democratic Party, because they view the Republican Party and its candidates as being dominated by Christians and “rednecks.”

What is the origin of this anti-Christian anti-”redneck” feeling? Some have suggested that it’s a matter of oikophobia…the aversion to the familiar, or “”the repudiation of inheritance and home,” as philosopher Roger Scruton uses the term. I think this is doubtless true in some cases: the kid who grew up in a rural Christian home and wants to make a clean break with his family heritage, or the individual who grew up in an oppressively-conformist Bible Belt community. But I think such cases represent a relatively small part of the category of people I’m talking about here. A fervently anti-Christian, anti-Southern individual who grew up in New York or Boston or San Francisco is unlikely to be motivated by oikophobia–indeed, far from being excessively familiar, Christians and Southern people are likely as exotic to him as the most remote tribes of New Guinea.

Equally exotic, but much safer to sneer at…and here, I think, we have the explanation for much though not all of the anti-Christian anti-Southern bigotry: It is a safe outlet for the unfortunately-common human tendency to look down on members of an out group. Safer socially than bigotry against Black people or gays or those New Guinea tribesmen; much less likely to earn you the disapproval of authority figures in school or work or of your neighbors. Safer physically than saying anything negative about Muslims, as you’re much less likely to face violent retaliation.

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An insightful critique:

But there is a much more important question being ignored by Gawande — How well does The Cheesecake Factory analogy really apply to health care? We can see how similar the kitchen is to an operating room — lots of busy people rushing about in a sterile environment, each concentrated on a task. But what about the rest of the “system?”
 
At The Cheesecake Factory, the customer is the diner. That’s who orders the service, pays the bill, and comes back again if he is happy. That is who all of the efficient, standardized food preparation is designed to please.
 
In Gawande’s ideal health care model, however, the customer isn’t the patient, but the third-party payer, be it an insurer or government. Let’s call that entity the TPP. The TPP never enters the kitchen. The TTP has no idea what happens in there, and doesn’t really care as long as the steak is cooked to his satisfaction and the tab is affordable.
 
In this model, the patient is actually the steak. It is the steak who is processed in the kitchen. It is the steak that is cut and cooked and placed on a platter. The steak doesn’t get a vote. Nobody cares if the steak is happy. The steak doesn’t pay the bill. The steak isn’t coming back again.
 
So here we are in Dr. Gawande’s kitchen, where you and I are slabs of meat and Chef Gawande will cook us to the specifications of his TPP customers — satisfaction guaranteed.

Worth reading in full.

(Via The Right Coast.)

…they may not have what you need but you can always get an apology.
 

The Supreme Court will rule on the constitutionality of Obamacare this year. The arguments and the issue which got the most publicity was the individual mandate. I don’t actually care much about this although it may well violate the Constitution. There are far worse things in the legislation and they should be emphatically rejected by the Supreme Court. The worst of the issues is discussed in detail here. This is a really frightening piece of legislation and I cannot imagine that the Court will let it stand. Of course, given the absence of argument, the Court will have to find this hidden provision itself.

Perhaps nothing in the Obamacare legislation embodies the top-down, command-and-control nature of Progressive healthcare more than the Independent Payment Advisory Board (IPAB), a 15-member panel of “experts” to be appointed by the President. There are three particular features of the IPAB that illustrate this fact: The IPAB will control all healthcare spending, public and private. The IPAB has been awarded near-dictatorial power. And the IPAB is designed to be a nearly immutable entity.

How is this accomplished ?

Specifically, Section 10320 (in the Managers’ Amendments portion of the legislation) grants the IPAB, beginning in 2015, the authority to limit all healthcare expenditures, that is, all healthcare expenditures, and not just expenditures by Medicare or government-run programs.

To emphasize this expanded authority, Section 10320 changes the name of the “Independent Medicare Advisory Board” to the “Independent Payment Advisory Board.” It directs the IPAB, at least every two years, to “submit to Congress and the President recommendations to slow the growth in national health expenditures” for private healthcare programs. Furthermore, it designates that these “recommendations” may be implemented by the Secretary of HHS or other Federal agencies “administratively” (that is, without any action by Congress).

Thus the federal government can control, under penalty of criminal prosecution of doctors, private health care spending ! This goes well beyond Medicare and Medicaid. It will prevent, unless stopped, people from spending their own money on health care.

That is not the worst of it. The IPAB cannot be changed or repealed by Congress. This is unprecedented in US law. Even the ill-advised Prohibition Amendment, promoted as another moral obligation by progressives after World War I, could be repealed by another constitutional amendment.

A quick reading of Section 3403 might leave one with the impression that the IPAB is a sort of Mr. Rogers of healthcare – a mild-mannered, friendly, always-helpful, but ultimately undemanding agent for good. This is the impression imparted by the first few paragraphs of the Section, which paint the new entity as an “advisory” board, whose main task is to develop “proposals” and “advisory reports,” which “proposals” and “advisory reports” would solely consist of various “recommendations,” that ought to be “considered” for the purpose of cost reduction.

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From a Washington Post story about Dick Cheney’s heart transplant (via Instapundit):

A study published last November found that treatment similar to what Cheney received costs $167,208 for every year of life saved. Treatments that “buy” a year of life for $50,000 or less are considered cost-effective, and those costing $50,000 to $100,000 are generally considered acceptable. (A European study in 2011 found the device much less of a bargain, at a cost of $414,275 for year of life saved).
 
Who gets a donor heart when one comes available depends on many variables, including body size and blood type. The most important one, however, is a person’s clinical condition and immediate availability for surgery.
 
There are strict guidelines for placing someone in the most urgent category and the decision is made by a team of many specialists. Moving someone to the top of the list who shouldn’t be there would be hard to do and would open a hospital to major sanctions. Both Bull and John said they are confident Cheney got no special breaks.

From the quoted passage: Treatments that “buy” a year of life for $50,000 or less are considered cost-effective, and those costing $50,000 to $100,000 are generally considered acceptable. [My italics.]

The unstated assumptions here are that 1) third parties will pay for transplants and therefore get to decide which patients will be considered to receive transplants, and 2) third parties will allocate the limited supply of transplantable organs.

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When I was a medical school junior, we had a rotation on the Neurology service at LA County Hospital. One of my classmates was planning a career in neurology but the reason it was so popular with the students like me who were interested in surgery was that we got to do tracheostomies. A number of patients with severe neurological lesions would require respirators or had trouble with airway secretions requiring a tracheostomy. This was our one chance to do surgery, even a minor procedure as things go. It was good practice and I later did a lot of tracheostomies, some quite difficult and rushed.

Our resident was a very interesting guy named Dick Boggs. He was tall and looked a lot like Orson Welles did when he was young and making “The Third Man.” Boggs was quiet and aloof but let us do trachs and work up any patient we wanted to. I had some very interesting cases. One was a woman who showed all the signs of alcoholic neuropathy, which is very similar to diabetic neuropathey. It was a popular rotation for juniors. Boggs was popular among the residents and was elected the president of the Interns’ and Residents’ Association, which under his leadership took on some of the characteristics of a union.

At the time, intern and resident pay was very low and, aside from a new dormitory that was built for single house staff, we were on our own. I was married with one child, born in March 1965, so I was really on my own. My wife quit her job as a teacher in January 1965 and I was working after hours doing histories and physicals at private hospitals for $7 per hour. Fortunately, my tuition was covered by scholarship but living expenses were tight. We lived on $200/month contributed by our parents, $100 from my father and the same from Irene’s parents. Half of that went for the rent of our two bedroom house in Eagle Rock, near Pasadena. I’m spending some time on details to emphasize what Boggs accomplished for us all.

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Francesca Minerva and Alberto Giubilini wrote a paper entitled After-birth abortion: why should the baby live?. They were subsequently shocked that their argument in favor of infanticide instead of putting up for adoption led to death threats.

There is something deeply wrong in the state of modern, academic philosophy and ethics. The first problem is in making the argument. The second is in being so isolated from society that the reaction to the article surprises them.

Update: The journal article has been moved and now resides behind a paywall.

-from SHOTS, NPR’s Health Care Blog:

Health care reform is no laughing matter, but MIT economist Jonathan Gruber’s new comic book on the subject aims to communicate some pretty complicated policy details in a way that, if not exactly side-splitting, is at least engaging.
 
In Health Care Reform: What It Is, Why It’s Necessary, How It Works, Gruber steps into the pages of a comic book to guide readers through many of the major elements of the law, including the individual mandate to buy insurance, the health insurance exchanges where people will be able to buy coverage starting in 2014 and how the law tackles controlling health care costs.

I draw your attention to another graphic novel: The 9/11 Report: A Graphic Adaptation.

While I was buying a copy of Persepolis from a real-life book store a few years ago, a young woman at the sales counter mentioned that there was a “great” graphic novel about North Korea that I might like. I’m not a graphic novel reader and I think Persepolis is it for me unless I decide to review the health care book, but it interested me that she seemed so enthusiastic about the topic of North Korea and graphic novels. I guess it makes sense given our “information overload” society. I don’t know. Why not look for clarity?

PS: Linking is not endorsement and all that.

PPS: What’s the “all that” about? Eh, I’ve been burning the candle at both ends for the past week or so and my blogging has been pretty terrible because of it. I linked the health care graphic novel because it amused me, not because I am simpatico with the message. I think you all knew that already….

The practice of medicine in these United (and for the period 1861-1865, somewhat disunited) States was for most of the 19th century a pretty hit or miss proposition, both in practice and by training. That many sensible people possessed pretty extensive kits of medicines – the modern equivalents of which are administered as prescriptions or under the care of a licensed medical professional – might tend to indicate that the qualifications required to hang out a shingle and practice medicine were so sketchy as to be well within the grasp of any intelligent and well-read amateur, and that many a citizen was of the opinion that they couldn’t possibly do any worse with a D-I-Y approach. Such was the truly dreadful state of affairs generally when it came to medicine in most places and in all but the last quarter of the 19th century – they may have been better off having a go on their own at that.

Most doctors trained as apprentices to a doctor with a current practice. There were some formal schools of medicine in the United States, but their output did not exactly dazzle with brilliance. Successful surgeons of the time possessed two basic skill sets; speed and a couple of strong assistants to hold the patient down, until he was done cutting and stitching. Most of the truly skilled doctors and surgeons had their training somewhere else – like Europe.

But in San Antonio, from 1850 on – there was a doctor-surgeon in practice, who ventured upon such daring medical remedies as to make him a legend. His patients traveled sometimes hundreds of miles to take advantage of his skill …
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Watchful Waiting = Do nothing, even though it may be a good idea to do something, because it’s difficult to justify doing something when institutional third-party payers who evaluate everything in terms of population average costs and benefits rather than your cost and your benefit are making the decisions.

Precautionary Principle = Take extreme measures, even though it may be a good idea to do nothing, because it’s difficult to justify doing nothing when activists who evaluate everything in terms of hypothetical worst cases rather than probability weighted costs and benefits are making the decisions.

The question that always matters most is “Who decides?”. Answer it and you can usually predict what the answers to the other questions will be.

Do you believe in communism? In its most technical sense, communism is the idea that bureaucrats can reasonably control production and distribution to provide adequate supply and avoid shortages. At this point, most people say no, they don’t believe, and for good reason. The quest to find a sustainable government system of production that didn’t break down has consumed decades, untold lost production, and created a river of blood as the need for scapegoats of this system’s failure consumed millions of lives.

Do you believe that there is an exception for drug production communism? The US Government thinks there is. In the 1970s it established the current production quota system, a system that is currently in the middle of breaking down as shortages pile up. It is unabashedly communistic with the Attorney General in charge of both overall production numbers of Schedule I and II drugs and List 1 chemicals as well as assigning individual company quotas on a yearly basis.

As virtually anyone with a brain could predict, the system lasted for a while and is now breaking down amidst a growing number of shortages. About 1 in 5 medical practitioners knows of circumstances where these increased shortages have adversely affected patient outcomes. It is unlikely we are going to ever get an accurate body count of this drug communism. Nobody is going to want to open themselves up for liability if they are a private practitioner and no bureaucrat is going to want to turn over this rock because of its political implications.

Fortunately, over the next two years, these regulations are going to finally come under review. So as a practical matter we’re going to have an answer to my title question, do you believe?

Well, do you?

Noting the passage of the creator of the Doritos chip who recently died at the ripe old age of 97, Glenn Reynolds quips, “I think the preservatives in junk food keep you young.”

Actually, there is reason to suspect that he might be right.

One of the most common preservatives is butylated hydroxyanisole also know has BHA or E320 in food labeling. BHA keeps foods from growing rancid by preventing the oxidation of fats by oxygen free radicals.

Say, what do you call a substances that controls oxygen free radicals? It’s right on the tip of my tongue…

… Oh, right, an anti-oxidant! You know, those things every other organic food product is advertised as having.

Benzoic acid, probably most commonly seen as Sodium Benzoate (E211) is another common bugaboo. In fact, its probably the poster child preservative being one whose name most people will recognize.

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California faces intense budget challenges. The budget gap is approximately $10 billion, and instead of “fixing” them, their budget has optimistic assumptions such as extra revenue due to an improving economy and many other sleight-of-hand items. The California executive and legislative branches are all solidly in the hands of Democrats, who control the agenda but must at least negotiate with the Republicans on the topic of tax increases (because a super-majority is needed to raise taxes).

I wrote here about how the State of California has a super-aggressive (and expensive) plan to move to “alternative energy” even though the cost / unit is much higher than traditional forms of energy, especially when transmission is taken into account.

In contrast with other states where the government is attempting to make their union workforce pay more for insurance and pensions, the completely captured Democratic officials don’t even attempt to reduce compensation, benefits or pensions.

Thus how does California intend to balance their budget, when they 1) won’t reduce government union worker pay or benefits 2) won’t back off their alternative energy zealotry?
By reducing medical care to the poorest citizens in their state. This article in today’s Chicago Tribune is titled “Health Law Model State Eyes Drastic Surgery” describes the situation in California’s medicare system which covers 6 million children and poorer residents.

California spends less per beneficiary than any state. It is now seeking waivers from the federal government to impose copays of $5 for office visits and prescriptions, $50 for emergency room visits and $100 for hospital stays.. (they) would drop reimbursement for a standard physician visit to less than $12.

It actually is a bit worse than that. The co-pays would have to be collected by the doctors, and if they can’t collect the money, then their reimbursement will fall further.

And what would the likely impact be of these cuts? Per the article:

Many doctors have already closed their doors to Medicaid patients. Other providers are following suit.

It is telling that the Democratic-controlled executive and legislative branches have decided that protecting the salaries and benefits of their union workers has a higher priority than providing basic medical care for the poorest residents in their state. They also believe that an incremental (and insignificant) move towards alternative power, which costs billions, rises above the needs of the poor for medicine.

This is analogous to the teachers’ unions that put their needs and benefits ahead of the children, who suffer through some of the worst schools in the country here in Chicago.

I can only imagine the smug outpouring of punditry that would occur if the Republicans abandoned a core principle to the same degree that the Democrats in California are abandoning the poor in this instance. Like this article in the Chicago Tribune and LA Times, the fact that the Democrats are abandoning the poor and instead focusing on their own direct needs isn’t even mentioned, since it apparently isn’t a fact that they believe their readers need to know. The situation is presented as a sad part of the budget sideshow rather than as a calculating prioritization decision made on the part of California’s Democrats, which it actually is.

Cross posted at LITGM

Global transition points like this are so rare, it’s a great time to be alive.

John Robb

Right on. Yes. Yes.

More of this type of thinking, please.

If I could live at any time in history it would be now.

(If you are not a regular reader of Mr. Robb’s Global Guerrillas, get that way.)

(Also check out Mr. Robb’s way cool new Wiki MiiU, which is all about resilience. I eagerly await his book on resilient communities.)

(Here is an xcellent John Robb talk about open source ventures, but full disclosure, a lot of it sailed over my head.)

(And if you have not read his book, Brave New War: The Next Stage of Terrorism and the End of Globalization, go get it.)

Friends, please let me know in the comments, on a scale of 1 to 5, strongly disagree to strongly agree, how you respond to this quote. Put me down as a 5, obviously enough.

So, my gut and my right foot have been bothering me since March-ish and over Memorial Day while visiting relatives, I stood up in the hotel and something just popped in my right foot and I said a few choice words. After a couple of weeks, the foot still hurt a bit and my stomach wouldn’t settle down so I went to the doc.

The verdict? My gall bladder was stoning up and I had broken the 3rd, 4th, and 5th metatarsals in my right foot. Crap. So, a week later I’m getting my gall bladder yanked and the foot doc says that while the 3rd metatarsal has healed, he doesn’t think the 4th or 5th will heal on their own and that I will need surgery to put pins in.

Yipee. A summer of two surgeries.

So, yesterday, my left foot began to hurt a little bit and it woke me up hurting worse this morning at 5am. By 8 o’clock it was really aching and my spouse says, “hmmm, sharp pain in joint of big toe? Sounds like a classical presentation of gout.” Unfortunately, my spouse is pretty smart.

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[Note: If you or a loved one is currently fighting cancer, you might want to skip this post.]

Whenever I hear someone with cancer talking about fighting the disease by adopting some supposedly super-healthy diet or taking some supplement, I always wince inside because I strongly suspect they are actively harming themselves.

Our intuitive model of fighting disease comes primarily from our experience fighting infectious diseases and the degenerative diseases of aging. In the intuitive model, anything that is good for the body’s cells, tissues and systems, e.g., eating “right”, taking anti-oxidants etc, helps the body to build immune cells and to repair damage caused by infection or life’s wear and tear.

However, cancer isn’t like any other disease.

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It looks as though the sun is entering a new dormant period, similar to the Maunder Minimum which led to the Little Ice Age.

This will almost certainly end the global warming hysteria in a few years. The people who continue to cling to this sort of hoax, will be looking for the Next Big Thing. I don’t mean to imply that the earth did not warm over the past century. The Little Ice Age ended about 1850 so a warming trend is expected following such an event. The hoax is the contrived evidence that humans are responsible. I was skeptical about that from the first. The forces involved are too large. If humans affected climate, it probably began with the development of agriculture. Perhaps we have had no ice age in the past 10,000 years because of the effects of agriculture and forest changes. I have previously discussed this and nothing has changed my mind.

The next question is what will replace global warming as the religion of the bored classes ? There are signs that it may be “New Age” medicine. This sort of thing is common in certain circles and has considerable similarity to the global warming arguments.

The Center for Integrative Medicine, Berman’s clinic, is focused on alternative medicine, sometimes known as “complementary” or “holistic” medicine. There’s no official list of what alternative medicine actually comprises, but treatments falling under the umbrella typically include acupuncture, homeopathy (the administration of a glass of water supposedly containing the undetectable remnants of various semi-toxic substances), chiropractic, herbal medicine, Reiki (“laying on of hands,” or “energy therapy”), meditation (now often called “mindfulness”), massage, aromatherapy, hypnosis, Ayurveda (a traditional medical practice originating in India), and several other treatments not normally prescribed by mainstream doctors. The term integrative medicine refers to the conjunction of these practices with mainstream medical care.

Here we have what may become the replacement for AGW in the minds of the exquisite privileged class. It has all the requirements.

1. America is corrupt and inferior ? Yes. (See the comments)

2. Capitalism is corrupt and inferior ? Yes

3. Only the truly intelligent and sensitive can appreciate it ? Well.

You might think the weight of the clinical evidence would close the case on alternative medicine, at least in the eyes of mainstream physicians and scientists who aren’t in a position to make a buck on it. Yet many extremely well-credentialed scientists and physicians with no skin in the game take issue with the black-and-white view espoused by Salzberg and other critics. And on balance, the medical community seems to be growing more open to alternative medicine’s possibilities, not less.

That’s in large part because mainstream medicine itself is failing. “Modern medicine was formed around successes in fighting infectious disease,” says Elizabeth Blackburn, a biologist at the University of California at San Francisco and a Nobel laureate. “Infectious agents were the big sources of disease and mortality, up until the last century. We could find out what the agent was in a sick patient and attack the agent medically.” To a large degree, the medical infrastructure we have today was designed with infectious agents in mind. Physician training and practices, hospitals, the pharmaceutical industry, and health insurance all were built around the model of running tests on sick patients to determine which drug or surgical procedure would best deal with some discrete offending agent. The system works very well for that original purpose, against even the most challenging of these agents—as the taming of the AIDS virus attests.

But medicine’s triumph over infectious disease brought to the fore the so-called chronic, complex diseases—heart disease, cancer, diabetes, Alzheimer’s, and other illnesses without a clear causal agent. Now that we live longer, these typically late-developing diseases have become by far our biggest killers. Heart disease, prostate cancer, breast cancer, diabetes, obesity, and other chronic diseases now account for three-quarters of our health-care spending. “We face an entirely different set of big medical challenges today,” says Blackburn. “But we haven’t rethought the way we fight illness.” That is, the medical establishment still waits for us to develop some sign of one of these illnesses, then seeks to treat us with drugs and surgery.

No doubt the author would prefer that people died too young for chronic disease to affect them.

A well-known science blog states the case for scientific medicine.

Speaking of bad ideas, in contrast to his previous article, in which he managed at least to get the gist of what Ioannidis teaches but merely spun it in what I considered to be an annoying fashion, the entire idea behind Freedman’s new article channels the worst fallacies of apologists for alternative medicine. The whole idea behind the article appears to be that, even if most of alternative medicine is quackery (which it is, by the way), it’s making patients better because its practitioners take the time to talk to patients and doctors do not. In other words, it’s a massive “What’s the harm?” argument. Yes, that’s basically the entire idea of the article boiled down into a couple of sentences. Deepak Chopra couldn’t have said it better. Tacked on to that bad idea is a massive argumentum ad populum that portrays alternative medicine (or, as purveyors of quackademic medicine like to call it, “complementary and alternative medicine” or “integrative medicine”) as the wave of the future, a wave that’s washing over medicine and teaching us cold, reductionistic doctors to care again about patients and thus make them better. Freedman even contrasts this to what he calls the “failure” of scientific medicine. I kid you not. Worse, Freedman makes this argument after having actually interviewed some prominent skeptics, including Steve Salzberg and Steve Novella, in essence, missing the point.

I expect to see more and more of “alternative medicine” because it appeals to the scientific illiterate and it damns another traditional source of authority, scientific medicine. Global warming hysteria attacks capitalism and prosperity. Alternative medicine is also going to be useful to Obamacare as a way of cutting reimbursement for traditional care. There are assumptions that it is cheaper. It may be cheaper per session, although is also uncertain, but there is no end point to such treatment. Who can say when the treatment is enough if it cannot be measured ? The theory that it is cheaper will be a powerful wind behind it. Watch for more and more about it in the left leaning media.